EDI Dictionary
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X12 Release 4030
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
4030
IHCEBR Interactive Health Care Eligibility Benefit Information Message
COO-90
COO
Coordination of Benefits
Rel
AtMax 15
To provide coordination of benefit information.
Elements
Position
Element
Name
Type
Min/Max
Repeat
I001
Reference Number
Rel
AtMax 1
2
3036
Party Name
Rel
Alphanumeric
1/35
AtMax 1
I011
Service Type Code
Rel
AtMax 1
I001
Reference Number
Rel
AtMax 1
5
3036
Party Name
Rel
Alphanumeric
1/35
AtMax 1
6
1154-I
Reference Number
Rel
Alphanumeric
1/35
AtMax 1
7
3036
Party Name
Rel
Alphanumeric
1/35
AtMax 1
I004
Address
Rel
AtMax 1
I006
Date
Rel
AtMax 2
10
4703
Insurance Type, coded
Rel
Alphanumeric
1/3
AtMax 1
I004
Address
Rel
AtMax 1
I001
Reference Number
Rel
AtMax 1
13
4711
Condition/Response, coded
Rel
Alphanumeric
1/3
AtMax 1
Element Details
ID
3036
Name
Party Name
Length
Min 1 / Max 35
Position
2
Requirement
Rel
