SVD Service Line Adjudication

Opt
AtMax 1

To convey service line adjudication information for coordination of benefits between the initial payers of a health care claim and all subsequent payers

Elements

PositionElementNameTypeMin/MaxRepeat
1
67
Identification CodeMandatoryAlphanumeric2/80AtMax 1
2
782
Monetary AmountMandatoryDecimal1/18AtMax 1
C003Composite Medical Procedure IdentifierOpt
AtMax 1
4
234
Product/Service IDOptAlphanumeric1/80AtMax 1
5
380
QuantityOptDecimal1/15AtMax 1
6
554
Assigned NumberOptNumber1/6AtMax 1

Element Details

ID67
NameIdentification Code
LengthMin 2 / Max 80
Position1
RequirementMandatory