EDI Dictionary
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X12 Release 4010
X12 Release
4010
4020
4030
4040
4050
4060
5010
5020
5030
5040
5050
6010
6020
6030
6040
6050
7010
7020
7030
7040
7050
7060
8010
Transaction Sets
Segments
Elements
EDI-Dictionary
4010
SBR
SBR
Subscriber Information
Batch
To record information specific to the primary insured and the insurance carrier for that insured
Elements
Position
Element
Name
Type
Min/Max
Repeat
1
1138
Payer Responsibility Sequence Number Code
Mandatory
ID
1/1
1
2
1069
Individual Relationship Code
Opt
ID
2/2
1
3
127
Reference Identification
Opt
Alphanumeric
1/30
1
4
93
Name
Opt
Alphanumeric
1/60
1
5
1336
Insurance Type Code
Opt
ID
1/3
1
6
1143
Coordination of Benefits Code
Opt
ID
1/1
1
7
1073
Yes/No Condition or Response Code
Opt
ID
1/1
1
8
584
Employment Status Code
Opt
ID
2/2
1
9
1032
Claim Filing Indicator Code
Opt
ID
1/2
1
Element Details
ID
1138
Name
Payer Responsibility Sequence Number Code
Length
Min 1 / Max 1
Position
1
Requirement
Mandatory
Codes
<>
P
Primary
<>
N
Unconfirmed
<>
T
Tertiary
<>
O
Noncapitated Agreement
<>
U
Unknown
<>
S
Secondary