Segment
X12 EDI Release 00403
To convey claim-level data related to the adjudication of Medicare claims not related to an inpatient setting
Elements
  • MOA01954Percent
    R
    O可选(Optional)
    Min 1 / Max 10

    Percentage expressed as a decimal

  • MOA02782Monetary Amount
    R
    O可选(Optional)
    Min 1 / Max 18

    Monetary amount

  • MOA03127Reference Identification
    AN
    O可选(Optional)
    Min 1 / Max 50

    Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier

  • MOA04127Reference Identification
    AN
    O可选(Optional)
    Min 1 / Max 50

    Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier

  • MOA05127Reference Identification
    AN
    O可选(Optional)
    Min 1 / Max 50

    Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier

  • MOA06127Reference Identification
    AN
    O可选(Optional)
    Min 1 / Max 50

    Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier

  • MOA07127Reference Identification
    AN
    O可选(Optional)
    Min 1 / Max 50

    Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier

  • MOA08782Monetary Amount
    R
    O可选(Optional)
    Min 1 / Max 18

    Monetary amount

  • MOA09782Monetary Amount
    R
    O可选(Optional)
    Min 1 / Max 18

    Monetary amount