EDI Dictionary
Schedule demo
EDI Dictionary
Transaction Sets
Segments
Elements
X12 Release 4040
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
Schedule demo
X12 Release 4040
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
4040
837 Health Care Claim
SV4-3850
1330-14
1330
Dosage Form Code
Code indicating the form in which the drug is dispensed
Batch
Element Details
Type
ID
Length
Min 2 / Max 2
Codes
<>
84
Aerosol Spray
<>
51
Ophthalmic Liquid
<>
73
Vaginal Cream
<>
15
Soluble Tablet
<>
61
Suspension
<>
07
Dosepak
<>
96
Soap
<>
25
Enteric Coated Capsule
<>
78
Vaginal Ointment
<>
43
Injectable Lyophilized Powder
<>
82
Dental Product
<>
75
Urethral Suppository
<>
13
Buccal or Sublingual Tablet
<>
31
Internal Powder
<>
14
Chewable Tablet
<>
85
External Liquid
<>
50
Ophthalmic
<>
72
Vaginal Tablet
<>
22
Capsule Unspecified
<>
66
Pediatric Liquid
<>
91
Gargle
<>
88
Inhalant (Refill Canister Only)
<>
83
Aerosol Powder
<>
74
Vaginal Foam
<>
12
Sustained Release Tablet
<>
30
Lozenge or Troche
<>
86
External Powder
<>
53
Ophthalmic Liquid (Compliance Cap)
<>
71
Vaginal Suppository
<>
68
Oral, Liquid and Sustained Release
<>
67
Liquid
<>
01
Combination Forms
<>
90
Irrigant
<>
89
External Powder
<>
23
Tablet 21 Day Supply
<>
40
Injection
<>
62
Syrup
<>
04
Devices
<>
95
Otic
<>
52
Ophthalmic or Otic
<>
70
Rectal Suppository
<>
16
Tablet Unspecified
<>
34
Swabs
<>
69
Rectal Cream or Ointment
<>
87
Dental Mouth Rinse
<>
20
Capsule
<>
64
Emulsion
<>
02
Test Kits
<>
93
Nasal
<>
94
Inhalant
<>
41
Sustained Release Injection
<>
63
Solution
<>
05
Patch or Disc
<>
99
Miscellaneous Unspecified
<>
80
External Ointment
<>
77
Douche
<>
11
Enteric Coated Tablet
<>
33
Granules
<>
65
Drops
<>
03
Contraceptive Devices
<>
92
Throat Spray and Swabs
<>
21
Sustained Release Capsule
<>
24
Tablet 28 Day Supply
<>
79
Contraceptive Sponge
<>
42
Injectable Unspecified
<>
60
Elixir
<>
06
Chewable (candy) Bar
<>
97
Stick
<>
76
Enema
<>
10
Tablet
<>
32
Chewing Gum
<>
98
Dressing or Bandage
<>
81
External Cream