Segment
X12 EDI Release 00405
To supply information on coordination of benefits
Elements
  • COB011138Payer Responsibility Sequence Number Code
    ID
    O可选(Optional)

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

    Codes (6)
  • COB02127Reference 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

  • COB031143Coordination of Benefits Code
    ID
    O可选(Optional)

    Code identifying whether there is a coordination of benefits

    Codes (9)
  • COB041365Service Type Code
    ID
    O可选(Optional)

    Code identifying the classification of service

    Codes (183)