Segment
X12 EDI Release 00303
To provide benefit information on insured entities
Elements
  • INS011073Yes/No Condition or Response Code
    ID
    M必须(Mandatory)

    Code indicating a Yes or No condition or response.

    Codes (3)
  • INS021069Individual Relationship Code
    ID
    M必须(Mandatory)

    Code indicating the relationship between two individuals or entities.

    Codes (41)
  • INS03875Maintenance Type Code
    ID
    O可选(Optional)

    Code identifying the specific type of item maintenance.

    Codes (16)
  • INS041203Maintenance Reason Code
    ID
    O可选(Optional)

    Code identifying the reason for the maintenance change.

    Codes (42)
  • INS051216Benefit Status Code
    ID
    O可选(Optional)

    The type of coverage under which benefits are paid.

    Codes (3)
  • INS061218Medicare Plan Code
    ID
    O可选(Optional)

    Code identifying the Medicare Plan.

    Codes (5)
  • INS071219Consolidated Omnibus Budget Reconciliation Act (COBRA) Qualifying Event Code
    ID
    O可选(Optional)

    A Qualifying Event is any of the following which results in loss of coverage for a Qualified Beneficiary.

    Codes (9)
  • INS08584Employment Status Code
    ID
    O可选(Optional)

    Code showing the general employment status of an employee/claimant.

    Codes (41)
  • INS091220Student Status Code
    ID
    O可选(Optional)

    Code indicating the student status of the patient if 19 years of age or older, not handicapped and not the insured

    Codes (3)
  • INS101073Yes/No Condition or Response Code
    ID
    O可选(Optional)

    Code indicating a Yes or No condition or response.

    Codes (3)
  • INS111250Date Time Period Format Qualifier
    ID
    O可选(Optional)

    Code indicating the date format, time format, or date and time format.

    Codes (22)
  • INS121251Date Time Period
    AN
    O可选(Optional)
    Min 1 / Max 35

    Expression of a date, a time, or range of dates, times or dates and times.

  • INS131165Confidentiality Code
    ID
    O可选(Optional)

    Code indicating the access to insured information.

    Codes (3)
  • INS1419City Name
    AN
    O可选(Optional)
    Min 2 / Max 30

    Free-form text for city name.

  • INS15156State or Province Code
    ID
    O可选(Optional)
    Min 2 / Max 2

    Code (Standard State/Province) as defined by appropriate government agency.

  • INS1626Country Code
    ID
    O可选(Optional)
    Min 2 / Max 3

    Code identifying the country.