F12 Basic Claim Information - Automotive

Batch

To provide information for automotive claims

Elements

Position	Element	Name		Type	Min/Max	Repeat

1	127	Reference Identification	Mandatory	Alphanumeric	1/30	1
2	127	Reference Identification	Mandatory	Alphanumeric	1/30	1
3	373	Date	Mandatory	Date	8/8	1
4	475	Credit/Debit Adjustment Number	Mandatory	Alphanumeric	1/22	1
5	373	Date	Mandatory	Date	8/8	1
6	543	Labor Rate	Mandatory	Number	3/6	1
7	543	Labor Rate	Mandatory	Number	3/6	1
8	927	Damage Code Qualifier	Opt	ID	1/1	1

ID127

NameReference Identification

LengthMin 1 / Max 30

Position1

RequirementMandatory