Segment
X12 EDI Release 00504
To specify pricing or repricing information about a health care claim or line item
Elements
  • HCP011473Pricing Methodology
    ID
    O可选(Optional)

    Code specifying pricing methodology at which the claim or line item has been priced or repriced

    Codes (15)
  • HCP02782Monetary Amount
    R
    O可选(Optional)
    Min 1 / Max 18

    Monetary amount

  • HCP03782Monetary Amount
    R
    O可选(Optional)
    Min 1 / Max 18

    Monetary amount

  • HCP04127Reference Identification
    AN
    O可选(Optional)
    Min 1 / Max 80

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

  • HCP05118Rate
    R
    O可选(Optional)
    Min 1 / Max 9

    Rate expressed in the standard monetary denomination for the currency specified

  • HCP06127Reference Identification
    AN
    O可选(Optional)
    Min 1 / Max 80

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

  • HCP07782Monetary Amount
    R
    O可选(Optional)
    Min 1 / Max 18

    Monetary amount

  • HCP08234Product/Service ID
    AN
    O可选(Optional)
    Min 1 / Max 48

    Identifying number for a product or service

  • HCP09235Product/Service ID Qualifier
    ID
    O可选(Optional)

    Code identifying the type/source of the descriptive number used in Product/Service ID (234)

    Codes (511)
  • HCP10234Product/Service ID
    AN
    O可选(Optional)
    Min 1 / Max 48

    Identifying number for a product or service

  • HCP11355Unit or Basis for Measurement Code
    ID
    O可选(Optional)

    Code specifying the units in which a value is being expressed, or manner in which a measurement has been taken

    Codes (884)
  • HCP12380Quantity
    R
    O可选(Optional)
    Min 1 / Max 15

    Numeric value of quantity

  • HCP13901Reject Reason Code
    ID
    O可选(Optional)

    Code assigned by issuer to identify reason for rejection

    Codes (209)
  • HCP141526Policy Compliance Code
    ID
    O可选(Optional)

    Code specifying policy compliance

    Codes (5)
  • HCP151527Exception Code
    ID
    O可选(Optional)

    Code specifying the exception reason for consideration of out-of-network health care services

    Codes (6)