Zenbridge
Transaction SetsSegments

PRV Provider Information

Opt
AtMax 1

To specify the identifying characteristics of a provider

Elements

PositionElementNameTypeMin/MaxRepeat
1
1221
Provider CodeMandatoryID1/3AtMax 1
2
128
Reference Identification QualifierRelID2/3AtMax 1
3
127
Reference IdentificationRelAlphanumeric1/50AtMax 1
4
156
State or Province CodeOptID2/2AtMax 1
C035Provider Specialty InformationOpt
AtMax 1
6
1223
Provider Organization CodeOptID3/3AtMax 1

Element Details

ID1221
NameProvider Code
LengthMin 1 / Max 3
Position1
RequirementMandatory
Codes
  • <>OPOperating
  • <>ASAssistant Surgeon
  • <>CVCovering
  • <>ATAttending
  • <>ADAdmitting
  • <>LALaboratory
  • <>HHHome Health Care
  • <>SKSkilled Nursing Facility
  • <>BIBilling
  • <>SUSupervising
  • <>P1Pharmacist
  • <>BSBilling Service
  • <>PTPay-To
  • <>RFReferring
  • <>COConsulting
  • <>RRural Health Clinic
  • <>P2Pharmacy
  • <>RPReporting Provider
  • <>OROrdering
  • <>PUPurchasing
  • <>PEPerforming
  • <>HHospital
  • <>PCPrimary Care Physician
  • <>OTOther Physician
  • <>ONOn Staff
  • <>SBSubmitting