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This is the service line level reference segment ID qualifier. |
May contain organization-specific values: Yes |
Category Entries: |
Group or policy number |
Member identification number |
Repriced claim reference number |
Adjusted repriced claim reference number |
Employee identification number 4010 |
Authorization number |
Class of contract code |
Medical record identification number |
Original reference number |
Prior authorization number |
Predetermination of benefits identification number |
Insurance policy number |
Social security number |
Blue cross provider number |
Blue shield provider number |
Medicare provider number |
Medicaid provider number |
Provider UPIN number |
Tricare Identification Number |
National association of boards of pharmacy number |
Provider commercial number |
Ambulatory patient group (APG) number |
Provider control number |
Attachment code |
Location number |
Rate code number |
Facility ID number |
Health care financing administration national provider identifier |
Federal taxpayer's identification number |
Employee Identification Number |
Group Number |
State Licence Number |
Ambulatory Payment Classification |
Policy Form Identifying Number |
Supplemental Remittance Information |