To supply disability information
Position | Element | Name | Type | Min/Max | Repeat | |
---|---|---|---|---|---|---|
1 | 1146 | Disability Type Code | Mandatory | ID | 1/1 | AtMax 1 |
2 | 380 | Quantity | Opt | Decimal | 1/15 | AtMax 1 |
3 | 1149 | Occupation Code | Opt | ID | 4/6 | AtMax 1 |
4 | 1154 | Work Intensity Code | Opt | ID | 1/1 | AtMax 1 |
5 | 1161 | Product Option Code | Opt | ID | 1/2 | AtMax 1 |
6 | 782 | Monetary Amount | Opt | Decimal | 1/18 | AtMax 1 |
7 | 235 | Product/Service ID Qualifier | Rel | ID | 2/2 | AtMax 1 |
8 | 1137 | Medical Code Value | Rel | Alphanumeric | 1/15 | AtMax 1 |