EQ Eligibility or Benefit Inquiry

Batch

To specify inquired eligibility or benefit information

Elements

Position	Element	Name		Type	Min/Max	Repeat

1	1365	Service Type Code	Rel	ID	1/2	1
C003Composite Medical Procedure IdentifierRel 1
3	1207	Coverage Level Code	Opt	ID	3/3	1
4	1336	Insurance Type Code	Opt	ID	1/3	1

Element Details

ID1365

NameService Type Code

LengthMin 1 / Max 2

Position1

RequirementRel

Codes

<>84Abortion
<>51Hospital - Emergency Accident
<>73Diagnostic Medical
<>15Alternate Method Dialysis
<>37Dental Accident
<>A5Psychiatric - Room and Board
<>48Hospital - Inpatient
<>AEPhysical Medicine
<>BNGastrointestinal
<>61In-vitro Fertilization
<>ANRoutine Exam
<>96Professional (Physician)
<>BEMassage Therapy
<>7Anesthesia
<>25Restorative
<>78Chemotherapy
<>43Home Health Prescriptions
<>ACRehabilitation - Outpatient
<>BHPediatric
<>82Family Planning
<>28Adjunctive Dental Services
<>57Air Transportation
<>75Prosthetic Device
<>13Ambulatory Service Center Facility
<>A3Professional (Physician) Visit - Home
<>31Benefit Disclaimer
<>14Renal Supplies in the Home
<>36Dental Crowns
<>A4Psychiatric
<>49Hospital - Room and Board
<>ADOccupational Therapy
<>85AIDS
<>50Hospital - Outpatient
<>72Inhalation Therapy
<>22Social Work
<>19Pneumonia Vaccine
<>A9Rehabilitation
<>44Home Health Visits
<>66Pathology
<>BREye
<>AISubstance Abuse
<>91Brand Name Prescription Drug
<>BBPartial Hospitalization (Psychiatric)
<>88Pharmacy
<>83Infertility
<>56Medically Related Transportation
<>74Private Duty Nursing
<>12Durable Medical Equipment Purchase
<>30Health Benefit Plan Coverage
<>A2Professional (Physician) Visit - Skilled Nursing Facility
<>ARExperimental Drug Therapy
<>ABRehabilitation - Inpatient
<>BINursery
<>BLCardiac
<>86Emergency Services
<>53Hospital - Ambulatory Surgical
<>71Audiology Exam
<>17Pre-Admission Testing
<>35Dental Care
<>A7Psychiatric - Inpatient
<>68Well Baby Care
<>AGSkilled Nursing Care
<>45Hospice
<>67Smoking Cessation
<>BSInvasive Procedures
<>AHSkilled Nursing Care - Room and Board
<>90Mail Order Prescription Drug
<>BCDay Care (Psychiatric)
<>89Free Standing Prescription Drug
<>1Medical Care
<>23Diagnostic Dental
<>18Durable Medical Equipment Rental
<>A8Psychiatric - Outpatient
<>40Oral Surgery
<>62MRI/CAT Scan
<>AMFrames
<>95Podiatry - Nursing Home Visits
<>BFPulmonary Rehabilitation
<>4Diagnostic X-Ray
<>26Endodontics
<>59Licensed Ambulance
<>52Hospital - Emergency Medical
<>70Transplants
<>16Chronic Renal Disease (CRD) Equipment
<>34Chiropractic Office Visits
<>A6Psychotherapy
<>69Maternity
<>AFSpeech Therapy
<>BMLymphatic
<>87Cancer
<>2Surgical
<>20Second Surgical Opinion
<>39Prosthodontics
<>46Respite Care
<>64Acupuncture
<>BPEndocrine
<>AKDrug Addiction
<>93Podiatry
<>94Podiatry - Office Visits
<>BGCardiac Rehabilitation
<>5Diagnostic Lab
<>58Cabulance
<>27Maxillofacial Prosthetics
<>41Routine (Preventive) Dental
<>63Donor Procedures
<>ALVision (Optometry)
<>AARehabilitation - Room and Board
<>99Professional (Physician) Visit - Inpatient
<>BJSkin
<>80Immunizations
<>8Surgical Assistance
<>55Major Medical
<>77Otological Exam
<>11Used Durable Medical Equipment
<>33Chiropractic
<>A1Professional (Physician) Visit - Nursing Home
<>AQNonmedically Necessary Physical
<>38Orthodontics
<>47Hospital
<>65Newborn Care
<>BQNeurology
<>AJAlcoholism
<>92Generic Prescription Drug
<>BAIndependent Medical Evaluation
<>3Consultation
<>21Third Surgical Opinion
<>24Periodontics
<>79Allergy Testing
<>42Home Health Care
<>60General Benefits
<>AOLenses
<>97Anesthesiologist
<>BDCognitive Therapy
<>6Radiation Therapy
<>9Other Medical
<>54Long Term Care
<>76Dialysis
<>10Blood Charges
<>A0Professional (Physician) Visit - Outpatient
<>32Plan Waiting Period
<>98Professional (Physician) Visit - Office
<>BKOrthopedic
<>81Routine Physical

EDI Dictionary

EQ Eligibility or Benefit Inquiry

Elements

Element Details