EDI Dictionary

Transaction Sets Segments

EDI-Dictionary

4010

INS

INS Insured Benefit

Batch

To provide benefit information on insured entities

Elements

Position	Element	Name		Type	Min/Max	Repeat

1	1073	Yes/No Condition or Response Code	Mandatory	ID	1/1	1
2	1069	Individual Relationship Code	Mandatory	ID	2/2	1
3	875	Maintenance Type Code	Opt	ID	3/3	1
4	1203	Maintenance Reason Code	Opt	ID	2/3	1
5	1216	Benefit Status Code	Opt	ID	1/1	1
6	1218	Medicare Plan Code	Opt	ID	1/1	1
7	1219	Consolidated Omnibus Budget Reconciliation Act (COBRA) Qualifying Event Code	Opt	ID	1/2	1
8	584	Employment Status Code	Opt	ID	2/2	1
9	1220	Student Status Code	Opt	ID	1/1	1
10	1073	Yes/No Condition or Response Code	Opt	ID	1/1	1
11	1250	Date Time Period Format Qualifier	Rel	ID	2/3	1
12	1251	Date Time Period	Rel	Alphanumeric	1/35	1
13	1165	Confidentiality Code	Opt	ID	1/1	1
14	19	City Name	Opt	Alphanumeric	2/30	1
15	156	State or Province Code	Opt	ID	2/2	1
16	26	Country Code	Opt	ID	2/3	1
17	1470	Number	Opt	Number	1/9	1

Element Details

ID1073

NameYes/No Condition or Response Code

LengthMin 1 / Max 1

Position1

RequirementMandatory

Codes

<>WNot Applicable
<>NNo
<>UUnknown
<>YYes