MOA Outpatient Adjudication

Batch

To provide claim level data related to the adjudication of outpatient claims

Elements

Position	Element	Name		Type	Min/Max	Repeat

1	954	Percentage as Decimal	Opt	Decimal	1/10	1
2	782	Monetary Amount	Opt	Decimal	1/18	1
3	127	Reference Identification	Opt	Alphanumeric	1/80	1
4	127	Reference Identification	Opt	Alphanumeric	1/80	1
5	127	Reference Identification	Opt	Alphanumeric	1/80	1
6	127	Reference Identification	Opt	Alphanumeric	1/80	1
7	127	Reference Identification	Opt	Alphanumeric	1/80	1
8	782	Monetary Amount	Opt	Decimal	1/18	1
9	782	Monetary Amount	Opt	Decimal	1/18	1

ID954

NamePercentage as Decimal

LengthMin 1 / Max 10

Position1

RequirementOpt