Segment
X12 EDI Release 00504
To provide claim-level data related to the adjudication of Medicare inpatient claims
Elements
  • MIA01380Quantity
    R
    M必须(Mandatory)
    Min 1 / Max 15

    Numeric value of quantity

  • MIA02782Monetary Amount
    R
    O可选(Optional)
    Min 1 / Max 18

    Monetary amount

  • MIA03380Quantity
    R
    O可选(Optional)
    Min 1 / Max 15

    Numeric value of quantity

  • MIA04782Monetary Amount
    R
    O可选(Optional)
    Min 1 / Max 18

    Monetary amount

  • MIA05127Reference 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

  • MIA06782Monetary Amount
    R
    O可选(Optional)
    Min 1 / Max 18

    Monetary amount

  • MIA07782Monetary Amount
    R
    O可选(Optional)
    Min 1 / Max 18

    Monetary amount

  • MIA08782Monetary Amount
    R
    O可选(Optional)
    Min 1 / Max 18

    Monetary amount

  • MIA09782Monetary Amount
    R
    O可选(Optional)
    Min 1 / Max 18

    Monetary amount

  • MIA10782Monetary Amount
    R
    O可选(Optional)
    Min 1 / Max 18

    Monetary amount

  • MIA11782Monetary Amount
    R
    O可选(Optional)
    Min 1 / Max 18

    Monetary amount

  • MIA12782Monetary Amount
    R
    O可选(Optional)
    Min 1 / Max 18

    Monetary amount

  • MIA13782Monetary Amount
    R
    O可选(Optional)
    Min 1 / Max 18

    Monetary amount

  • MIA14782Monetary Amount
    R
    O可选(Optional)
    Min 1 / Max 18

    Monetary amount

  • MIA15380Quantity
    R
    O可选(Optional)
    Min 1 / Max 15

    Numeric value of quantity

  • MIA16782Monetary Amount
    R
    O可选(Optional)
    Min 1 / Max 18

    Monetary amount

  • MIA17782Monetary Amount
    R
    O可选(Optional)
    Min 1 / Max 18

    Monetary amount

  • MIA18782Monetary Amount
    R
    O可选(Optional)
    Min 1 / Max 18

    Monetary amount

  • MIA19782Monetary Amount
    R
    O可选(Optional)
    Min 1 / Max 18

    Monetary amount

  • MIA20127Reference 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

  • MIA21127Reference 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

  • MIA22127Reference 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

  • MIA23127Reference 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

  • MIA24782Monetary Amount
    R
    O可选(Optional)
    Min 1 / Max 18

    Monetary amount