Segment
X12 EDI Release 00404
To provide details on a specific insurance claim
Elements
  • LID011250Date Time Period Format Qualifier
    ID
    M必须(Mandatory)

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

    Codes (41)
  • LID021251Date Time Period
    AN
    M必须(Mandatory)
    Min 1 / Max 35

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

  • LID031271Industry Code
    AN
    O可选(Optional)
    Min 1 / Max 30

    Code indicating a code from a specific industry code list

  • LID041271Industry Code
    AN
    O可选(Optional)
    Min 1 / Max 30

    Code indicating a code from a specific industry code list

  • LID05352Description
    AN
    O可选(Optional)
    Min 1 / Max 80

    A free-form description to clarify the related data elements and their content

  • LID061073Yes/No Condition or Response Code
    ID
    O可选(Optional)

    Code indicating a Yes or No condition or response

    Codes (4)
  • LID071073Yes/No Condition or Response Code
    ID
    O可选(Optional)

    Code indicating a Yes or No condition or response

    Codes (4)
  • LID08352Description
    AN
    O可选(Optional)
    Min 1 / Max 80

    A free-form description to clarify the related data elements and their content

  • LID091073Yes/No Condition or Response Code
    ID
    O可选(Optional)

    Code indicating a Yes or No condition or response

    Codes (4)