EDI Dictionary

Transaction Sets Segments

EDI-Dictionary

7020

CLP

CLP Claim Level Data

Batch

To supply information common to all services of a claim

Elements

Position	Element	Name		Type	Min/Max	Repeat

1	1028	Claim Submitter's Identifier	Mandatory	Alphanumeric	1/38	1
2	1029	Claim Status Code	Mandatory	ID	1/2	1
3	782	Monetary Amount	Mandatory	Decimal	1/18	1
4	782	Monetary Amount	Mandatory	Decimal	1/18	1
5	782	Monetary Amount	Opt	Decimal	1/18	1
6	1032	Claim Filing Indicator Code	Opt	ID	1/2	1
7	127	Reference Identification	Opt	Alphanumeric	1/80	1
8	1331	Facility Code Value	Opt	Alphanumeric	1/3	1
9	1325	Claim Frequency Type Code	Opt	ID	1/1	1
10	1352	Patient Status Code	Opt	ID	1/2	1
C022Health Care Code InformationRel 1
12	380	Quantity	Rel	Decimal	1/15	1
13	954	Percentage as Decimal	Opt	Decimal	1/10	1
14	1073	Yes/No Condition or Response Code	Opt	ID	1/1	1
15	280	Exchange Rate	Opt	Decimal	4/10	1
16	1732	Source of Payment Typology Code	Opt	ID	2/6	1

Element Details

ID1028

NameClaim Submitter's Identifier

LengthMin 1 / Max 38

Position1

RequirementMandatory