Zenbridge
EDI Dictionary

PRV Provider Information

Opt
AtMax 1

To specify the identifying characteristics of a provider

Elements

PositionElementNameTypeMin/MaxRepeat
1
1221
Provider CodeMandatoryID1/3AtMax 1
2
128
Reference Identification QualifierRelID2/3AtMax 1
3
127
Reference IdentificationRelAlphanumeric1/80AtMax 1
4
156
State or Province CodeOptID2/2AtMax 1
C035Provider Specialty InformationOpt
AtMax 1
6
1223
Provider Organization CodeOptID3/3AtMax 1

Element Details

ID1221
NameProvider Code
LengthMin 1 / Max 3
Position1
RequirementMandatory
Codes
  • <>OP
    Operating
  • <>AS
    Assistant Surgeon
  • <>CV
    Covering
  • <>AT
    Attending
  • <>AD
    Admitting
  • <>LA
    Laboratory
  • <>HH
    Home Health Care
  • <>SK
    Skilled Nursing Facility
  • <>BI
    Billing
  • <>SU
    Supervising
  • <>P1
    Pharmacist
  • <>BS
    Billing Service
  • <>PT
    Pay-To
  • <>RF
    Referring
  • <>CO
    Consulting
  • <>R
    Rural Health Clinic
  • <>P2
    Pharmacy
  • <>RP
    Reporting Provider
  • <>OR
    Ordering
  • <>PU
    Purchasing
  • <>PE
    Performing
  • <>H
    Hospital
  • <>PC
    Primary Care Physician
  • <>OT
    Other Physician
  • <>ON
    On Staff
  • <>SB
    Submitting