EQ Eligibility or Benefit Inquiry

Opt

AtMax 1

To specify inquired eligibility or benefit information

Elements

Position	Element	Name		Type	Min/Max	Repeat

C064Service TypeRel AtMax 99
C003Composite Medical Procedure IdentifierRel AtMax 99
3	1207	Coverage Level Code	Opt	ID	3/3	AtMax 1
4	1788	Insurance Product Code	Opt	ID	1/3	AtMax 1
5	1328	Diagnosis Code Pointer	Opt	Number	1/2	AtMax 12
6	1791	Network Indicator Code	Opt	ID	1/2	AtMax 1

Element Details

ID1207

NameCoverage Level Code

LengthMin 3 / Max 3

Position3

RequirementOpt

Codes

<>E5D
Employee and One or More Dependents
<>SPO
Spouse Only
<>E6D
Employee and Two or More Dependents
<>E3D
Employee and Three Dependents
<>SS5
Subscriber, spouse, and 1 or more children
<>S5C
Subscriber and 1 or more children
<>E9D
Employee and Five or More Dependents
<>EMP
Employee Only
<>SPC
Spouse and Children
<>SS6
Subscriber, spouse, and 2 or more children
<>E7D
Employee and Three or More Dependents
<>ESP
Employee and Spouse
<>TWO
Two Party
<>CHD
Children Only
<>FAM
Family
<>SSP
Subscriber and spouse
<>E1D
Employee and One Dependent
<>E2D
Employee and Two Dependents
<>IND
Individual
<>ECH
Employee and Children
<>S6C
Subscriber and 2 or more children
<>S1C
Subscriber and 1 child
<>SS1
Subscriber, spouse, and 1 child
<>E8D
Employee and Four or More Dependents
<>DEP
Dependents Only