Segment
X12 EDI Release 00304
To supply information on coordination of benefits
Elements
  • COB011138Payer Responsibility Sequence Number Code
    ID
    O可选(Optional)

    Code indentifying the insurance carrier's level of responsibility for a payment of a claim

    Codes (5)
  • COB02127Reference Number
    AN
    O可选(Optional)
    Min 1 / Max 30

    Reference number or identification number as defined for a particular Transaction Set, or as specified by the Reference Number Qualifier.

  • COB031143Coordination of Benefits Code
    ID
    O可选(Optional)

    Code identifying whether there is a coordination of benefits

    Codes (7)