EDI X12 00302 CLP Segment Schema | 知行 EDI 规范查询平台

Elements

CLP01 1028 Claim Submitter's Identifier
AN
M必须(Mandatory)
Min 1 / Max 38
Identifier used to track a claim from creation by the health care provider through payment.
CLP02 1029 Claim Status Code
ID
M必须(Mandatory)
Code identifying the status of an entire claim as assigned by the payor.
Codes (5)
- 1Processed as Primary
- 2Processed as Secondary
- 3Processed as Tertiary
- 4Denied
- 5Pended
CLP03 782 Monetary Amount
R
M必须(Mandatory)
Min 1 / Max 15
Monetary amount.
CLP04 782 Monetary Amount
R
M必须(Mandatory)
Min 1 / Max 15
Monetary amount.
CLP05 782 Monetary Amount
R
O可选(Optional)
Min 1 / Max 15
Monetary amount.
CLP06 1032 Claim Filing Indicator Code
ID
O可选(Optional)
Code identifying the type of health insurance or program.
Codes (15)
- BLBlue Cross/Blue Shield
- CHChampus
- CICommercial Insurance Co.
- FIFederal Employees Program
- HMHealth Maintenance Organization
- MAMedicare Part A
- MBMedicare Part B
- MCMedicaid
- MHManaged Care Non-HMO
- OFOther Federal Program
- SASelf-administered Group
- TVTitle V
- VAVeterans Affairs Plan
- WCWorkers' Compensation Health Claim
- ZZMutually Defined