Segment
X12 EDI Release 00401
To supply beneficiary, co-participant, and owner information
Elements
Code indicating the relationship between two individuals or entities
Codes (153)- 10Foster Child
- 11Son-in-law or Daughter-in-law
- 12Brother-in-law or Sister-in-law
- 13Mother-in-law or Father-in-law
- 14Brother or Sister
- 15Ward
- 17Stepson or Stepdaughter
- 18Self
- 19Child
- 20Employee
- 21Unknown
- 22Handicapped Dependent
- 23Sponsored Dependent
- 24Dependent of a Minor Dependent
- 25Ex-spouse
- 26Guardian
- 27Student
- 28Friend
- 29Significant Other
- 30Both Parents
- 31Court Appointed Guardian
- 32Mother
- 33Father
- 34Other Adult
- 36Emancipated Minor
- 37Agency Representative
- 38Collateral Dependent
- 39Organ Donor
- 40Cadaver Donor
- 41Injured Plaintiff
- 43Child Where Insured Has No Financial Responsibility
- 45Widow
- 46Widower
- 47State Fund
- 48Stepfather
- 49Stepmother
- 50Foster Parent
- 51Emergency Contact
- 52Employer
- 53Life Partner
- 55Adopted Daughter
- 56Adopted Son
- 57Adoptive Father
- 58Adoptive Mother
- 59Adoptive Parents
- 60Annuitant
- 61Aunt
- 62Brother
- 63Brother-in-Law
- 64Business
- 65Business Associate
- 66Business Insurance Trust
- 67Business Partner
- 68Charity
- 70Children of Marriage
- 71Company
- 72Corporation
- 73Creditor
- 74Daughter
- 75Daughter-in-Law
- 76Dependent
- 78Estate
- 79Ex-wife
- 80Family Member
- 81Father-in-Law
- 82Fiancé (Male)
- 83Financée (Female)
- 84Fiduciary
- 86Foster Daughter
- 87Foster Father
- 88Foster Mother
- 90Foster Son
- 91God Daughter
- 92God Father
- 93God Parents
- 94God Son
- 95Grandchildren
- 96Granddaughter
- 97Grandfather
- 98Grandmother
- 99Grandparents
- 01Spouse
- 02Son or Daughter
- 03Father or Mother
- 04Grandfather or Grandmother
- 05Grandson or Granddaughter
- 06Uncle or Aunt
- 07Nephew or Niece
- 08Cousin
- 09Adopted Child
- A1Grandson
- A2Great Aunt
- A3Ex-husband
- A4Half Brother
- A5Half Sister
- A6Husband
- A7Institution
- A8Mortgage Holder
- A9Mother-in-Law
- B1Nephew
- B2Niece
- B3Parents-in-Law
- B4Partnership
- B5Partner
- B6Personal Insurance Trust
- B7Sister
- B8Sister-in-Law
- B9Sole Proprietorship
- C1Son
- C2Son-in-Law
- C3Step Brother
- C4Step Children
- C5Step Daughter
- C8Step Sister
- C9Step Son
- D1Trust
- D2Trustee
- D3Uncle
- D4Wife
- D5Teacher
- D6School Counselor
- D7School Principal
- D8Other School Administrator
- D9Coach
- E1Activity Sponsor
- E2Supervisor
- E3Co-worker
- E4Minister or Priest
- E5Ecclesiastical or Religious Leader
- E6God Mother
- E7Probation Officer
- E8Accountant
- E9Advisor
- F1Alma Mater
- F2Applicant
- F3Banker
- F6Clergyman
- F7Client
- F8Club or Organization Officer
- F9Doctor
- G2Educator/Teacher/Instructor
- G3Betrothed
- G4Insured
- G5Lawyer
- G6Medical Care Provider
- G7Neighbor
- G8Other Relationship
- G9Other Relative
- H1Owner
- H4Payor
- N1None
- OTNon-applicable Individual Relationship Category
- ZZMutually Defined
Code defining the type of ownership
Codes (33)- 10Terminated
- 11Shared
- 12Undesignated
- 13Lessee
- 14Contract for Deed Purchaser
- 15Life Estate
- 16Joint Contractual Liability
- 17Joint Ownership
- 18Nonapplicant Spouse
- 19Participant
- 20Maker (With Co-maker)
- 21Co-maker
- 22Borrower
- 23Co-borrower
- 24Borrower and Co-borrower
- 25Joint with Spouse
- 26Joint with Non-Spouse
- 27Fee Simple
- 28Leasehold
- 29Charitable Institution
- 30Estate
- 31Export Account
- 32Import Account
- 33Local Account
- 01Sole (Individual)
- 02Joint Ownership or Obligation in Severalty
- 03Joint Owner or Obligation with the Right of Survivorship
- 04Trust
- 05Custodial
- 06Corporate
- 07Partnership
- 08Authorized User
- 09On Behalf Of