EDI X12 00403 MLA Segment Schema | 知行 EDI 规范查询平台

MLA01 127 Reference Identification

AN

Min 1 / Max 50

Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier

MLA02 367 Contract Number

AN

Min 1 / Max 30

Contract number

MLA03 782 Monetary Amount

R

Min 1 / Max 18

Monetary amount

MLA04 380 Quantity

R

Min 1 / Max 15

Numeric value of quantity

MLA05 1365 Service Type Code

ID

Code identifying the classification of service

Codes (168)

1Medical Care
2Surgical
3Consultation
4Diagnostic X-Ray
5Diagnostic Lab
6Radiation Therapy
7Anesthesia
8Surgical Assistance
9Other Medical
10Blood Charges
11Used Durable Medical Equipment
12Durable Medical Equipment Purchase
13Ambulatory Service Center Facility
14Renal Supplies in the Home
15Alternate Method Dialysis
16Chronic Renal Disease (CRD) Equipment
17Pre-Admission Testing
18Durable Medical Equipment Rental
19Pneumonia Vaccine
20Second Surgical Opinion
21Third Surgical Opinion
22Social Work
23Diagnostic Dental
24Periodontics
25Restorative
26Endodontics
27Maxillofacial Prosthetics
28Adjunctive Dental Services
30Health Benefit Plan Coverage
31Benefit Disclaimer
32Plan Waiting Period
33Chiropractic
34Chiropractic Office Visits
35Dental Care
36Dental Crowns
37Dental Accident
38Orthodontics
39Prosthodontics
40Oral Surgery
41Routine (Preventive) Dental
42Home Health Care
43Home Health Prescriptions
44Home Health Visits
45Hospice
46Respite Care
47Hospital
48Hospital - Inpatient
49Hospital - Room and Board
50Hospital - Outpatient
51Hospital - Emergency Accident
52Hospital - Emergency Medical
53Hospital - Ambulatory Surgical
54Long Term Care
55Major Medical
56Medically Related Transportation
57Air Transportation
58Cabulance
59Licensed Ambulance
60General Benefits
61In-vitro Fertilization
62MRI/CAT Scan
63Donor Procedures
64Acupuncture
65Newborn Care
66Pathology
67Smoking Cessation
68Well Baby Care
69Maternity
70Transplants
71Audiology Exam
72Inhalation Therapy
73Diagnostic Medical
74Private Duty Nursing
75Prosthetic Device
76Dialysis
77Otological Exam
78Chemotherapy
79Allergy Testing
80Immunizations
81Routine Physical
82Family Planning
83Infertility
84Abortion
85AIDS
86Emergency Services
87Cancer
88Pharmacy
89Free Standing Prescription Drug
90Mail Order Prescription Drug
91Brand Name Prescription Drug
92Generic Prescription Drug
93Podiatry
94Podiatry - Office Visits
95Podiatry - Nursing Home Visits
96Professional (Physician)
97Anesthesiologist
98Professional (Physician) Visit - Office
99Professional (Physician) Visit - Inpatient
BNon-escrow or Non-impound Service
CEscrow or Impound Service
A0Professional (Physician) Visit - Outpatient
A1Professional (Physician) Visit - Nursing Home
A2Professional (Physician) Visit - Skilled Nursing Facility
A3Professional (Physician) Visit - Home
A4Psychiatric
A5Psychiatric - Room and Board
A6Psychotherapy
A7Psychiatric - Inpatient
A8Psychiatric - Outpatient
A9Rehabilitation
AARehabilitation - Room and Board
ABRehabilitation - Inpatient
ACRehabilitation - Outpatient
ADOccupational Therapy
AEPhysical Medicine
AFSpeech Therapy
AGSkilled Nursing Care
AHSkilled Nursing Care - Room and Board
AISubstance Abuse
AJAlcoholism
AKDrug Addiction
ALVision (Optometry)
AMFrames
ANRoutine Exam
AOLenses
AQNonmedically Necessary Physical
ARExperimental Drug Therapy
BAIndependent Medical Evaluation
BBPartial Hospitalization (Psychiatric)
BCDay Care (Psychiatric)
BDCognitive Therapy
BEMassage Therapy
BFPulmonary Rehabilitation
BGCardiac Rehabilitation
BHPediatric
BINursery
BJSkin
BKOrthopedic
BLCardiac
BMLymphatic
BNGastrointestinal
BPEndocrine
BQNeurology
BREye
BSInvasive Procedures
BTGynecological
BUObstetrical
BVObstetrical/Gynecological
BWMail Order Prescription Drug: Brand Name
BXMail Order Prescription Drug: Generic
BYPhysician Visit - Office: Sick
BZPhysician Visit - Office: Well
CAPrivate Duty Nursing - Inpatient
CBPrivate Duty Nursing - Home
CCSurgical Benefits - Professional (Physician)
CDSurgical Benefits - Facility
CEMental Health Provider - Inpatient
CFMental Health Provider - Outpatient
CGMental Health Facility - Inpatient
CHMental Health Facility - Outpatient
CISubstance Abuse Facility - Inpatient
CJSubstance Abuse Facility - Outpatient
CKScreening X-ray
CLScreening laboratory
CMMammogram, High Risk Patient
CNMammogram, Low Risk Patient
COFlu Vaccination
CPEyewear and Eyewear Accessories

MLA06 546 Status Code

ID

Code identifying the status of a business transaction, such as a claim, policy, real estate, or securities transaction

Codes (181)

10Extended Term
11Automatic
12Follow Up
13Facultative
14Group Expired
15Incomplete
16In Force
17Facultative Placed
18Issued
19New Business
20Lapsed
21Mailed
22Policy Change
23Not Taken
24Offer Final
25Offer - First Subject To
26Paid
27Paid Up
28Payor Death
29Payor Disabled
30Pending
31Placed
32Postpone
33Premium Paying
34Quoted
35Reduced Paid up
36Reinstatement
37Reapproved
38Receipted
39Reissue
40Repended
41Satisfied
42Trial Application
43Limited
44Terminated
45Waived
46Contingent
47Sold
48Rented
49On Probation
50Under Contract
51Deposit
52Continue to Show
53Temporarily off the Market
54Leased
55Off-Market
56Forwarded
57Not Required
58Ordered
59Outstanding
60Pending 1035 Exchange
61Required
62Do Not Mail
63Do Not Rent or Exchange
64Filed
65Facultative Submission
66Additional Information
67Status Request
68Submission Change
69Rating Reduction Requested
70Facultative Opinion
71Reserve Facilities
72Offer Accepted
73Placed Other Carrier
74Capacity Unavailable
75Retained
76Death
77Disabled
78Divorced
79Free Look Canceled
80Processed
81Rejected
82Reversed
83Non-Transferable
84Sent for Registration Transfer to be Delivered at a Later Date
85In Transfer at Time of Request
86Temporary
87Legal Description Provided
88Legal Description Incomplete
89Legal Description Provided Via Paper
90Inactive Taxing Authority
91Inactive Taxing Authority - No longer collects separate city tax
92Inactive Taxing Authority - No longer collects separate school tax
93Inactive Taxing Authority - No longer collects separate special district tax
94Inactive Taxing Authority - No longer collects separate combined city and school tax
95Inactive Taxing Authority - No longer collects separate county tax
96Foreclosure
98Under Appeal
99Other Status
01Accepted
02Approved
03Back Bill
04Conditional Issue
05Converted
06Deceased
07Deleted
08Delivery Pending
09Double Jeopardy
AAAnnuitized
ABArrived
ACActive
ADApplicant Denied
AEMultiple Delinquency
AFLegal Description Not Provided
AGPartial Payment
AHDeeded Property
AIMoney In-house
AJReturned Check
AKBankruptcy
ALCurrent Tax Open
AMCurrent Tax Paid
ANTax Delinquent
AOTax Exception or Protest
APTax Paid
ARAssuming Company Review
C1Contemplated
C2Contained in Record
C3Current
CCCeding Company Review - With Copy to Assuming Company
CDCanceled
CECeding Company Review - No Copy to Assuming Company
CFCanceled Free Look Cash
CHChangeable
CICanceled by Internal Revenue Service
CLClosed
COComplete
CRClosed Record
CTContained in Transaction
DCDeclined
DNDeclined - No Response from Claimant to Correspondence
DSDeclined/Paid Salvage Only
DUDuplicate
EFEquipment Failed
ESEstimated
EWExchange or Transfer Withdrawn
EXExpired
F0Follow Up 10 or More
F1Follow Up 1
F2Follow Up 2
F3Follow Up 3
F4Follow Up 4
F5Follow Up 5
F6Follow Up 6
F7Follow Up 7
F8Follow Up 8
F9Follow Up 9
FLFree Look
FPFiled Pending Further Correspondence
FTFuture
FXFaxed
IAInactive
LALetter of Acceptance Sent
MTMatured
NANot in Good Order
NPNew Premium Only
NRNo Record Claim Receipt
NTNo Longer Under Treatment
OFOn File
OHOn Hand - Under Investigation
OPOther Parties Obligations Have Been Excluded
PDPending Death
PFPaid in Full
PMPartial Payment Received
PPPaid in Part/Denied in Part
PRPaperwork Received
PWPaperwork Pending
RARated
RCRescinded
REReceived
RQRequest
RSRestricted
RVRevoked
SPSuspense
SRSignature Required
SSSuspended
SUSurrendered
UTUnder Treatment
WDWithdrawn
WIWaiting Initial Payment
WPWaiting Period
ZZMutually Defined

MLA0701 1720 Tax Service Non-payment Code
ID
M必须(Mandatory)
Code identifying the reason for non-payment of the tax amount owed
Codes (19)
- 0Cannot Identify Loan
- BNon-escrow or Non-impound Loan
- ZMutually Defined
- CCContract Canceled
- CSContract Service with Another Vendor
- E1Missing Legal Description
- E2Contract or Maintenance Accepted
- E3Missing Homeowner Authorization
- E4Service Type Not Available
- E5Audit Exception
- R2Modified Payment Enclosed
- R3Loan Paid in Full
- R4Loan Service Released
- R5Other Non-payment Reason
- NSDNew Subdivision
- UMLUnmatched or Missing Lender
- UMTUnmatched or Missing Tax Authority
- WOIWith Other Interest
- WOPWith Other Property
MLA0702 1720 Tax Service Non-payment Code
ID
O可选(Optional)
Code identifying the reason for non-payment of the tax amount owed
Codes (19)
- 0Cannot Identify Loan
- BNon-escrow or Non-impound Loan
- ZMutually Defined
- CCContract Canceled
- CSContract Service with Another Vendor
- E1Missing Legal Description
- E2Contract or Maintenance Accepted
- E3Missing Homeowner Authorization
- E4Service Type Not Available
- E5Audit Exception
- R2Modified Payment Enclosed
- R3Loan Paid in Full
- R4Loan Service Released
- R5Other Non-payment Reason
- NSDNew Subdivision
- UMLUnmatched or Missing Lender
- UMTUnmatched or Missing Tax Authority
- WOIWith Other Interest
- WOPWith Other Property
MLA0703 1720 Tax Service Non-payment Code
ID
O可选(Optional)
Code identifying the reason for non-payment of the tax amount owed
Codes (19)
- 0Cannot Identify Loan
- BNon-escrow or Non-impound Loan
- ZMutually Defined
- CCContract Canceled
- CSContract Service with Another Vendor
- E1Missing Legal Description
- E2Contract or Maintenance Accepted
- E3Missing Homeowner Authorization
- E4Service Type Not Available
- E5Audit Exception
- R2Modified Payment Enclosed
- R3Loan Paid in Full
- R4Loan Service Released
- R5Other Non-payment Reason
- NSDNew Subdivision
- UMLUnmatched or Missing Lender
- UMTUnmatched or Missing Tax Authority
- WOIWith Other Interest
- WOPWith Other Property
MLA0704 1720 Tax Service Non-payment Code
ID
O可选(Optional)
Code identifying the reason for non-payment of the tax amount owed
Codes (19)
- 0Cannot Identify Loan
- BNon-escrow or Non-impound Loan
- ZMutually Defined
- CCContract Canceled
- CSContract Service with Another Vendor
- E1Missing Legal Description
- E2Contract or Maintenance Accepted
- E3Missing Homeowner Authorization
- E4Service Type Not Available
- E5Audit Exception
- R2Modified Payment Enclosed
- R3Loan Paid in Full
- R4Loan Service Released
- R5Other Non-payment Reason
- NSDNew Subdivision
- UMLUnmatched or Missing Lender
- UMTUnmatched or Missing Tax Authority
- WOIWith Other Interest
- WOPWith Other Property
MLA0705 1720 Tax Service Non-payment Code
ID
O可选(Optional)
Code identifying the reason for non-payment of the tax amount owed
Codes (19)
- 0Cannot Identify Loan
- BNon-escrow or Non-impound Loan
- ZMutually Defined
- CCContract Canceled
- CSContract Service with Another Vendor
- E1Missing Legal Description
- E2Contract or Maintenance Accepted
- E3Missing Homeowner Authorization
- E4Service Type Not Available
- E5Audit Exception
- R2Modified Payment Enclosed
- R3Loan Paid in Full
- R4Loan Service Released
- R5Other Non-payment Reason
- NSDNew Subdivision
- UMLUnmatched or Missing Lender
- UMTUnmatched or Missing Tax Authority
- WOIWith Other Interest
- WOPWith Other Property
MLA0706 1720 Tax Service Non-payment Code
ID
O可选(Optional)
Code identifying the reason for non-payment of the tax amount owed
Codes (19)
- 0Cannot Identify Loan
- BNon-escrow or Non-impound Loan
- ZMutually Defined
- CCContract Canceled
- CSContract Service with Another Vendor
- E1Missing Legal Description
- E2Contract or Maintenance Accepted
- E3Missing Homeowner Authorization
- E4Service Type Not Available
- E5Audit Exception
- R2Modified Payment Enclosed
- R3Loan Paid in Full
- R4Loan Service Released
- R5Other Non-payment Reason
- NSDNew Subdivision
- UMLUnmatched or Missing Lender
- UMTUnmatched or Missing Tax Authority
- WOIWith Other Interest
- WOPWith Other Property
MLA0707 1720 Tax Service Non-payment Code
ID
O可选(Optional)
Code identifying the reason for non-payment of the tax amount owed
Codes (19)
- 0Cannot Identify Loan
- BNon-escrow or Non-impound Loan
- ZMutually Defined
- CCContract Canceled
- CSContract Service with Another Vendor
- E1Missing Legal Description
- E2Contract or Maintenance Accepted
- E3Missing Homeowner Authorization
- E4Service Type Not Available
- E5Audit Exception
- R2Modified Payment Enclosed
- R3Loan Paid in Full
- R4Loan Service Released
- R5Other Non-payment Reason
- NSDNew Subdivision
- UMLUnmatched or Missing Lender
- UMTUnmatched or Missing Tax Authority
- WOIWith Other Interest
- WOPWith Other Property
MLA0708 1720 Tax Service Non-payment Code
ID
O可选(Optional)
Code identifying the reason for non-payment of the tax amount owed
Codes (19)
- 0Cannot Identify Loan
- BNon-escrow or Non-impound Loan
- ZMutually Defined
- CCContract Canceled
- CSContract Service with Another Vendor
- E1Missing Legal Description
- E2Contract or Maintenance Accepted
- E3Missing Homeowner Authorization
- E4Service Type Not Available
- E5Audit Exception
- R2Modified Payment Enclosed
- R3Loan Paid in Full
- R4Loan Service Released
- R5Other Non-payment Reason
- NSDNew Subdivision
- UMLUnmatched or Missing Lender
- UMTUnmatched or Missing Tax Authority
- WOIWith Other Interest
- WOPWith Other Property

MLA08 100 Currency Code

ID

Min 3 / Max 3

Code (Standard ISO) for country in whose currency the charges are specified