To specify detail information for itemized calls
| Position | Element | Name | Type | Min/Max | Repeat | |
|---|---|---|---|---|---|---|
| 1 | 350 | Assigned Identification | Opt | Alphanumeric | 1/20 | AtMax 1 |
| 2 | 373 | Date | Opt | Date | 8/8 | AtMax 1 |
| 3 | 337 | Time | Opt | Time | 4/8 | AtMax 1 |
| 4 | 309 | Location Qualifier | Rel | ID | 1/2 | AtMax 1 |
| 5 | 310 | Location Identifier | Rel | Alphanumeric | 1/30 | AtMax 1 |
| 6 | 156 | State or Province Code | Opt | ID | 2/2 | AtMax 1 |
| 7 | 309 | Location Qualifier | Rel | ID | 1/2 | AtMax 1 |
| 8 | 310 | Location Identifier | Rel | Alphanumeric | 1/30 | AtMax 1 |
| 9 | 156 | State or Province Code | Opt | ID | 2/2 | AtMax 1 |
| 10 | 739 | Measurement Value | Opt | Decimal | 1/20 | AtMax 1 |
| 11 | 739 | Measurement Value | Opt | Decimal | 1/20 | AtMax 1 |
| 12 | 782 | Monetary Amount | Opt | Decimal | 1/18 | AtMax 1 |
| 13 | 782 | Monetary Amount | Opt | Decimal | 1/18 | AtMax 1 |
| 14 | 782 | Monetary Amount | Opt | Decimal | 1/18 | AtMax 1 |
| 15 | 782 | Monetary Amount | Opt | Decimal | 1/18 | AtMax 1 |
| 16 | 662 | Relationship Code | Opt | ID | 1/1 | AtMax 1 |