EDI Dictionary

Transaction Sets Segments

EDI-Dictionary

6030

COB

COB Coordination of Benefits

Batch

To supply information on coordination of benefits

Elements

Position	Element	Name		Type	Min/Max	Repeat

1	1138	Payer Responsibility Sequence Number Code	Opt	ID	1/1	1
2	127	Reference Identification	Opt	Alphanumeric	1/80	1
3	1143	Coordination of Benefits Code	Opt	ID	1/1	1
4	1365	Service Type Code	Opt	ID	1/2	9

Element Details

ID1138

NamePayer Responsibility Sequence Number Code

LengthMin 1 / Max 1

Position1

RequirementOpt

Codes

<>GPayer Responsibility Ten
<>PPrimary
<>NUnconfirmed
<>APayer Responsibility Four
<>DPayer Responsibility Seven
<>TTertiary
<>ONoncapitated Agreement
<>BPayer Responsibility Five
<>EPayer Responsibility Eight
<>UUnknown
<>HPayer Responsibility Eleven
<>CPayer Responsibility Six
<>SSecondary
<>FPayer Responsibility Nine