知行 EDI 规范查询平台™
Segment
X12 EDI Release 00601
SV7Drug Adjudication
To specify the claim service detail for drug services that have been adjudicated
Elements
  • SV701127Reference Identification
    AN
    O可选(Optional)
    Min 1 / Max 80

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

  • SV702127Reference Identification
    AN
    O可选(Optional)
    Min 1 / Max 80

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

  • SV7031355Prescription Denial Override Code
    ID
    O可选(Optional)

    Code indicating that a pharmacist has overridden the denial of a prescription

    Codes (8)
  • SV7041207Coverage Level Code
    ID
    M必须(Mandatory)

    Code indicating the level of coverage being provided for this insured

    Codes (25)
  • SV705750Product/Process Characteristic Code
    ID
    M必须(Mandatory)

    Code identifying the general class of a product or process characteristic

    Codes (274)
  • SV7061073Yes/No Condition or Response Code
    ID
    O可选(Optional)

    Code indicating a Yes or No condition or response

    Codes (4)
  • SV707C059Drug Use Review (DUR)O可选(Optional)
    173817391740
    • SV707011738Reason for Service Code
      ID
      M必须(Mandatory)
      Min 2 / Max 2

      Code identifying the type of utilization conflict detected

    • SV707021739Professional Service Code
      ID
      M必须(Mandatory)
      Min 2 / Max 2

      Code identifying pharmacist intervention when a conflict code has been identified

    • SV707031740Result of Service Code
      ID
      M必须(Mandatory)
      Min 2 / Max 2

      Code identifying action taken by a pharmacist in response to a conflict

知行 EDI 规范查询平台™ 2023 - 3.1.18
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