SEARCH
MAP_MSTR_IK | VENDOR_REC | VENDOR_FIELD_NUM | FRIENDLY_NAME | LOOP | SEGMENT | DATA_ELEMENT | ODS TABLES | ODS COLUMNS | GLOBAL_RULE | MAO_SPECIFIC_RULE | ACA_SPECIFIC_RULE | LOGICAL_RULE_EXPLANATION | 837_ELEMENT_DESCRIPTION | NOTES | FORMATTING_RULE |
MAP_MSTR_IK | VNDRHDR | 1 | 00 Record | ||||||||||||
MAP_MSTR_IK | VNDRHDR | 2 | EMCSV | HEADER | HEADER | FILE TYPE INDICATOR | LITERAL "EMCSV" | ||||||||
MAP_MSTR_IK | VNDRHDR | 3 | Version | ||||||||||||
MAP_MSTR_IK | VNDRHDR | 4 | FileID | ||||||||||||
MAP_MSTR_IK | VNDRHDR | 5 | File Type | ||||||||||||
MAP_MSTR_IK | VNDRHDR | 6 | FileCreationDateTime | ||||||||||||
MAP_MSTR_IK | VNDRHDR | 7 | SenderID | ||||||||||||
MAP_MSTR_IK | VNDRHDR | 8 | ReceiverID | ||||||||||||
MAP_MSTR_IK | 100 | 1 | 100 Record | ||||||||||||
MAP_MSTR_IK | 100 | 2 | 100 KEY | AUDT_CLM_STS | CLM_IK | ||||||||||
MAP_MSTR_IK | 100 | 3 | ClaimStatus | ||||||||||||
MAP_MSTR_IK | 100 | 4 | ClaimType | ||||||||||||
MAP_MSTR_IK | 100 | 5 | SenderID | ||||||||||||
MAP_MSTR_IK | 100 | 6 | Receiver ID | ||||||||||||
MAP_MSTR_IK | 100 | 7 | OriginatorID | ||||||||||||
MAP_MSTR_IK | 100 | 8 | Contract ID (CMS CONTRACT CODE Hxxxxx) | ||||||||||||
MAP_MSTR_IK | 100 | 9 | DestinationID (who is receiving it in the end. Receiver ISA-08) | ||||||||||||
MAP_MSTR_IK | 100 | 10 | HistoricalIndicator | ||||||||||||
MAP_MSTR_IK | 100 | 11 | HistoricalDispositionStatus | ||||||||||||
MAP_MSTR_IK | 100 | 12 | HistoricalEncounterICN | ||||||||||||
MAP_MSTR_IK | 100 | 13 | HistoricalEncounterID | ||||||||||||
MAP_MSTR_IK | 100 | 14 | Paper | ||||||||||||
MAP_MSTR_IK | 100 | 15 | DME | ||||||||||||
MAP_MSTR_IK | 100 | 16 | Administrative Denial | ||||||||||||
MAP_MSTR_IK | 100 | 17 | Chart Review Data | ||||||||||||
MAP_MSTR_IK | 100 | 18 | Source | ||||||||||||
MAP_MSTR_IK | 100 | 19 | Filler | ||||||||||||
MAP_MSTR_IK | 100 | 20 | TraceNumber | NOT MAPPED | |||||||||||
MAP_MSTR_IK | 100 | 21 | 1000A_NM101_SubmitterEntityRole | ||||||||||||
MAP_MSTR_IK | 100 | 22 | 1000A_NM102_SubmitterPersonIndicator | ||||||||||||
MAP_MSTR_IK | 100 | 23 | 1000A_NM103_SubmitterLastName | ||||||||||||
MAP_MSTR_IK | 100 | 24 | 1000A_NM108_SubmitterIdentifierQualifier | ||||||||||||
MAP_MSTR_IK | 100 | 25 | 1000A_NM109_SubmitterIdentifier | ||||||||||||
MAP_MSTR_IK | 100 | 26 | 1000A_PER01_01_SubmitterContactIdentifier | ||||||||||||
MAP_MSTR_IK | 100 | 27 | 1000A_PER02_01_SubmitterContactName | ||||||||||||
MAP_MSTR_IK | 100 | 28 | 1000A_PER03_01_SubmitterContactQualifier1 | ||||||||||||
MAP_MSTR_IK | 100 | 29 | 1000A_PER04_01_SubmitterContact1 | ||||||||||||
MAP_MSTR_IK | 100 | 30 | 1000A_PER05_01_SubmitterContacQualifier2 | ||||||||||||
MAP_MSTR_IK | 100 | 31 | 1000A_PER06_01_SubmitterContact2 | ||||||||||||
MAP_MSTR_IK | 100 | 32 | 1000B_NM101_ReceiverEntityRole | ||||||||||||
MAP_MSTR_IK | 100 | 33 | 1000B_NM102_PersonIndicator | ||||||||||||
MAP_MSTR_IK | 100 | 34 | 1000B_NM103_ReceiverName | ||||||||||||
MAP_MSTR_IK | 100 | 35 | 1000B_NM108_ReceiverIdentifierQualifier | ||||||||||||
MAP_MSTR_IK | 100 | 36 | 1000B_NM109_ReceiverIdentifier | ||||||||||||
MAP_MSTR_IK | 100 | 37 | 2000A_PRV01_BillingProviderCode | ||||||||||||
MAP_MSTR_IK | 100 | 38 | 2000A_PRV02_BillingProviderCodeQualifier | ||||||||||||
MAP_MSTR_IK | 100 | 39 | 2000A_PRV03_BillingProviderTaxonomy | BLAH BLAH BLAH | |||||||||||
MAP_MSTR_IK | 100 | 40 | 2010AA_NM101_BillingProviderRole | ||||||||||||
MAP_MSTR_IK | 100 | 41 | 2010AA_NM102_BillingPersonIndicator | 2010AA | NM1 | NM102 | CLM_BILL_PRVDR | ALWAYS 2 NON PERSON | |||||||
MAP_MSTR_IK | 100 | 42 | 2010AA_NM103_BillingOrg_LastName | ||||||||||||
MAP_MSTR_IK | 100 | 43 | 2010AA_NM104_BillingFirstName | ||||||||||||
MAP_MSTR_IK | 100 | 44 | 2010AA_NM105_BillingMiddleName | ||||||||||||
MAP_MSTR_IK | 100 | 45 | 2010AA_NM107_BillingSuffix | ||||||||||||
MAP_MSTR_IK | 100 | 46 | 2010AA_NM108_BillingProviderIdentifierQualifier | ||||||||||||
MAP_MSTR_IK | 100 | 47 | 2010AA_NM109_BillingProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 100 | 48 | 2010AA_N301_BillingAddressLine1 | ||||||||||||
MAP_MSTR_IK | 100 | 49 | 2010AA_N302_BillingAddressLine2 | ||||||||||||
MAP_MSTR_IK | 100 | 50 | 2010AA_N401_BillingCity | ||||||||||||
MAP_MSTR_IK | 100 | 51 | 2010AA_N402_BillingState | ||||||||||||
MAP_MSTR_IK | 100 | 52 | 2010AA_N403_BillingPostalCode | ||||||||||||
MAP_MSTR_IK | 100 | 53 | 2010AA_N404_BillingCountry | ||||||||||||
MAP_MSTR_IK | 100 | 54 | 2010AA_REF01_BillingProviderIdentifierQualifier_1 | ||||||||||||
MAP_MSTR_IK | 100 | 55 | 2010AA_REF02_BillingProviderIdentifier_1 | ||||||||||||
MAP_MSTR_IK | 100 | 56 | 2010AA_REF01_BillingProviderIdentifierQualifier_2 | ||||||||||||
MAP_MSTR_IK | 100 | 57 | 2010AA_REF02_BillingProviderIdentifier_2 | ||||||||||||
MAP_MSTR_IK | 100 | 58 | 2010AA_BillingProviderSpeciality | ||||||||||||
MAP_MSTR_IK | 100 | 59 | 2010AA_BillingProviderType | ||||||||||||
MAP_MSTR_IK | 100 | 60 | 2010AA_PER01_BillingProviderContactFunction_1 | ||||||||||||
MAP_MSTR_IK | 100 | 61 | 2010AA_PER02_BillingProviderContactName_1 | ||||||||||||
MAP_MSTR_IK | 100 | 62 | 2010AA_PER03_BillingProviderCommunicationNumberQualifier_1 | ||||||||||||
MAP_MSTR_IK | 100 | 63 | 2010AA_PER04_BillingProviderCommunicationNumber_1 | ||||||||||||
MAP_MSTR_IK | 100 | 64 | 2010AA_PER05_BillingProviderCommunicatioNumberQualifier_1 | ||||||||||||
MAP_MSTR_IK | 100 | 65 | 2010AA_PER06_BillingProviderCommunicationNumber_1 | ||||||||||||
MAP_MSTR_IK | 100 | 66 | 2010AA_PER07_BillingProviderCommunicatioNumberQualifier_1 | ||||||||||||
MAP_MSTR_IK | 100 | 67 | 2010AA_PER08_BillingProviderCommunicationNumber_1 | ||||||||||||
MAP_MSTR_IK | 100 | 68 | 2010AA_PER01_BillingProviderContactFunction_2 | ||||||||||||
MAP_MSTR_IK | 100 | 69 | 2010AA_PER02_BillingProviderContactName_2 | ||||||||||||
MAP_MSTR_IK | 100 | 70 | 2010AA_PER03_CommunicatioNumberQualifier_2 | ||||||||||||
MAP_MSTR_IK | 100 | 71 | 2010AA_PER04_BillingProviderCommunicationNumber_2 | ||||||||||||
MAP_MSTR_IK | 100 | 72 | 2010AA_PER05_BillingProviderCommunicatioNumberQualifier_2 | ||||||||||||
MAP_MSTR_IK | 100 | 73 | 2010AA_PER06_BillingProviderCommunicationNumber_2 | ||||||||||||
MAP_MSTR_IK | 100 | 74 | 2010AA_PER07_BillingProviderCommunicatioNumberQualifier_2 | ||||||||||||
MAP_MSTR_IK | 100 | 75 | 2010AA_PER08_BillingProviderCommunicationNumber_2 | ||||||||||||
MAP_MSTR_IK | 100 | 76 | 2010AB_NM101_PayToProviderRole | ||||||||||||
MAP_MSTR_IK | 100 | 77 | 2010AB_NM102_PayToPersonIndicator | ||||||||||||
MAP_MSTR_IK | 100 | 78 | 2010AB_N301_PayToAddressLine1 | ||||||||||||
MAP_MSTR_IK | 100 | 79 | 2010AB_N302_PayToAddressLine2 | ||||||||||||
MAP_MSTR_IK | 100 | 80 | 2010AB_N401_PayToCity | ||||||||||||
MAP_MSTR_IK | 100 | 81 | 2010AB_N402_PayToState | ||||||||||||
MAP_MSTR_IK | 100 | 82 | 2010AB_N403_PayToPostalCode | ||||||||||||
MAP_MSTR_IK | 100 | 83 | 2010AB_N404_PayToCountry | ||||||||||||
MAP_MSTR_IK | 100 | 84 | 2010AC_NM101_PayToPlanOrganizationRole | ||||||||||||
MAP_MSTR_IK | 100 | 85 | 2010AC_NM102_PayToPlanPersonIndicator | ||||||||||||
MAP_MSTR_IK | 100 | 86 | 2010AC_NM103_PayToPlanName | ||||||||||||
MAP_MSTR_IK | 100 | 87 | 2010AC_NM108_PayToPlanOrganizationIDQualifier | ||||||||||||
MAP_MSTR_IK | 100 | 88 | 2010AC_NM109_PayToPlanOrganizationIdentifier | ||||||||||||
MAP_MSTR_IK | 100 | 89 | 2010AC_N301_PayToPlanAddressLine1 | ||||||||||||
MAP_MSTR_IK | 100 | 90 | 2010AC_N302_PayToPlanAddressLine2 | ||||||||||||
MAP_MSTR_IK | 100 | 91 | 2010AC_N401_PayToPlanCity | ||||||||||||
MAP_MSTR_IK | 100 | 92 | 2010AC_N402_PayToPlanState | ||||||||||||
MAP_MSTR_IK | 100 | 93 | 2010AC_N403_PayToPlanPostalCode | ||||||||||||
MAP_MSTR_IK | 100 | 94 | 2010AC_N404_PayToPlanCountry | ||||||||||||
MAP_MSTR_IK | 100 | 95 | 2010AC_REF01_OrganizationIDQualifier_1 | ||||||||||||
MAP_MSTR_IK | 100 | 96 | 2010AC_REF02_OrganizationIdentifier_1 | ||||||||||||
MAP_MSTR_IK | 100 | 97 | 2010AC_REF01_OrganizationIDQualifier_2 | ||||||||||||
MAP_MSTR_IK | 100 | 98 | 2010AC_REF02_OrganizationIdentifier_2 | ||||||||||||
MAP_MSTR_IK | 100 | 99 | Claim_Encounter Cleanup | NOT MAPPED | |||||||||||
MAP_MSTR_IK | 100 | 100 | Atypical Provider Flag | ||||||||||||
MAP_MSTR_IK | 100 | 101 | Supplemental Interim Flag | ||||||||||||
MAP_MSTR_IK | 100 | 102 | Interim Late Charge Flag | ||||||||||||
MAP_MSTR_IK | 100 | 103 | IssuerIdentifier | ||||||||||||
MAP_MSTR_IK | 100 | 104 | 100-Filler 05 | ||||||||||||
MAP_MSTR_IK | 100 | 105 | 100R_MonetaryAmountChangeFlag | ||||||||||||
MAP_MSTR_IK | 100 | 106 | 1000A_NM104_SubmitterFirstName | ||||||||||||
MAP_MSTR_IK | 100 | 107 | BillingCountyCode | ||||||||||||
MAP_MSTR_IK | 100 | 108 | 100-Filler 06 | ||||||||||||
MAP_MSTR_IK | 100 | 109 | ClaimInputMethod | ||||||||||||
MAP_MSTR_IK | 100 | 110 | Rehab Flag | ||||||||||||
MAP_MSTR_IK | 100 | 111 | PS Custom Field 1 | ||||||||||||
MAP_MSTR_IK | 100 | 112 | Void Reason | ||||||||||||
MAP_MSTR_IK | 100 | 113 | 100-Filler 11 | ||||||||||||
MAP_MSTR_IK | 100 | 114 | Claim Processing Date | ||||||||||||
MAP_MSTR_IK | 100 | 115 | REFERENCE CLAIM ID | ||||||||||||
MAP_MSTR_IK | 100 | 116 | 100-Filler 14 | ||||||||||||
MAP_MSTR_IK | 100 | 117 | 100-Filler 15 | ||||||||||||
MAP_MSTR_IK | 100 | 118 | HistoricalPassThroughIndicator | REF | D9 | PAYER CLAIM CONTROL NUMBER | WHEN CLAIM IS A HISTORY MIGRATED CLAIM, THE ICN OF THE LATEST ACCEPTED VERSION OF THE CLAIM IS RETRIEVED AND THIS FLAG IS SET TO TRUE, IF THIS HISTORY CLAIM NEEDS TO BE SUBMITTED DUE TO SOME SUBSEQUENT ACTION - AN LCR AGAINST THIS CLAIM, A RESEND ETC. THIS TELLS THE VENDOR THAT THEY DO NOT HAVE THIS CLAIM AND TO TAKE THE ICN THE RESERVED FIELD IN 100 RECORD AND SEND IT ON TO CMS. THIS APPLIES ONLY TO MAO, AS ACA DOES NOT DEAL WITH HISTORY....RATHER ONLY THE CURRENT BENEFIT YEAR DATA IS SUBMITTED. | DOES NOT APPLY TO ACA | |||||||
MAP_MSTR_IK | 100 | 119 | HistoricalOriginalClaimID | ||||||||||||
MAP_MSTR_IK | 150 | 1 | 150 Record | ||||||||||||
MAP_MSTR_IK | 150 | 2 | 150 KEY | ||||||||||||
MAP_MSTR_IK | 150 | 3 | 2000B_SBR01_SubscriberPayerResponsibilitySequence | ||||||||||||
MAP_MSTR_IK | 150 | 4 | 2000B_SBR02_SubscriberRelationship | ||||||||||||
MAP_MSTR_IK | 150 | 5 | 2000B_SBR03_SubscriberPolicyNumber | ||||||||||||
MAP_MSTR_IK | 150 | 6 | 2000B_SBR04_InsuredGroupName | ||||||||||||
MAP_MSTR_IK | 150 | 7 | 2000B_SBR09_ClaimFilingIndicator | ||||||||||||
MAP_MSTR_IK | 150 | 8 | 2010BA_NM101_SubscriberPersonRole | ||||||||||||
MAP_MSTR_IK | 150 | 9 | 2010BA_NM102_SubscriberPersonIndicator | ||||||||||||
MAP_MSTR_IK | 150 | 10 | 2010BA_NM103_SubscriberLastName | ||||||||||||
MAP_MSTR_IK | 150 | 11 | 2010BA_NM104_SubscriberFirstName | ||||||||||||
MAP_MSTR_IK | 150 | 12 | 2010BA_NM105_SubscriberMiddleName | ||||||||||||
MAP_MSTR_IK | 150 | 13 | 2010BA_NM107_SubscriberSuffix | ||||||||||||
MAP_MSTR_IK | 150 | 14 | 2010BA_NM108_SubscriberIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 150 | 15 | 2010BA_NM109_SubscriberIdentifier | ||||||||||||
MAP_MSTR_IK | 150 | 16 | 2010BA_REF01_SubscriberSSNQualifier | ||||||||||||
MAP_MSTR_IK | 150 | 17 | 2010BA_REF02_Subscriber_Identifier_SSN | ||||||||||||
MAP_MSTR_IK | 150 | 18 | 2010BA_REF01_PropertyandCasualty_Qualifier | ||||||||||||
MAP_MSTR_IK | 150 | 19 | 2010BA_REF02_PropertyandCasualty_Identifier | ||||||||||||
MAP_MSTR_IK | 150 | 20 | 2010BA_N301_SubscriberAddressLine1 | ||||||||||||
MAP_MSTR_IK | 150 | 21 | 2010BA_N302_SubscriberAddressLine2 | ||||||||||||
MAP_MSTR_IK | 150 | 22 | 2010BA_N401_SubscriberCity | ||||||||||||
MAP_MSTR_IK | 150 | 23 | 2010BA_N402_SubscriberState | ||||||||||||
MAP_MSTR_IK | 150 | 24 | 2010BA_N403_SubscriberPostalCode | ||||||||||||
MAP_MSTR_IK | 150 | 25 | 2010BA_N404_SubscriberCountry | ||||||||||||
MAP_MSTR_IK | 150 | 26 | 2010BA_DMG01_DateQualifer | ||||||||||||
MAP_MSTR_IK | 150 | 27 | 2010BA_DMG02_DateOfBirth | ||||||||||||
MAP_MSTR_IK | 150 | 28 | 2010BA_DMG03_Gender | ||||||||||||
MAP_MSTR_IK | 150 | 29 | 2010BA_REF01_SubscriberIdentifierQualifier_1 | ||||||||||||
MAP_MSTR_IK | 150 | 30 | 2010BA_REF02_SubscriberIdentifier_1 | ||||||||||||
MAP_MSTR_IK | 150 | 31 | 2010BA_REF01_SubscriberIdentifierQualifer_2 | ||||||||||||
MAP_MSTR_IK | 150 | 32 | 2010BA_REF02_SubscriberIdentifier_2 | ||||||||||||
MAP_MSTR_IK | 150 | 33 | 2010BB_NM101_Payer OrganizationRole | ||||||||||||
MAP_MSTR_IK | 150 | 34 | 2010BB_NM102_PayerPersonIndicator | ||||||||||||
MAP_MSTR_IK | 150 | 35 | 2010BB_NM103_PayerName | ||||||||||||
MAP_MSTR_IK | 150 | 36 | 2010BB_NM108_PayerOrganizationIDQualifier | ||||||||||||
MAP_MSTR_IK | 150 | 37 | 2010BB_NM109_PayerOrganizationIdentifier | ||||||||||||
MAP_MSTR_IK | 150 | 38 | 2010BB_N301_PayerAddressLine1 | ||||||||||||
MAP_MSTR_IK | 150 | 39 | 2010BB_N302_PayerAddressLine2 | ||||||||||||
MAP_MSTR_IK | 150 | 40 | 2010BB_N401_PayerCity | ||||||||||||
MAP_MSTR_IK | 150 | 41 | 2010BB_N402_PayerState | ||||||||||||
MAP_MSTR_IK | 150 | 42 | 2010BB_N403_PayerPostalCode | ||||||||||||
MAP_MSTR_IK | 150 | 43 | 2010BB_N404_PayerCountry | ||||||||||||
MAP_MSTR_IK | 150 | 44 | 2010BB_REF01_PayerOrganizationIDQualifier_1 | ||||||||||||
MAP_MSTR_IK | 150 | 45 | 2010BB_REF02_PayerOrganizationIdentifier_1 | ||||||||||||
MAP_MSTR_IK | 150 | 46 | 2010BB_REF01_ProviderIDQualifier_1 | ||||||||||||
MAP_MSTR_IK | 150 | 47 | 2010BB_REF02_BillingProviderIdentifier_1 | ||||||||||||
MAP_MSTR_IK | 150 | 48 | 2010BB_REF01_BillingProviderIDQualifier_2 | ||||||||||||
MAP_MSTR_IK | 150 | 49 | 2010BB_REF02_BillingProviderIdentifier_2 | ||||||||||||
MAP_MSTR_IK | 150 | 50 | 2010BB_REF01_BillingProviderIDQualifier_3 | ||||||||||||
MAP_MSTR_IK | 150 | 51 | 2010BB_REF02_ProviderIdentifier_3 | ||||||||||||
MAP_MSTR_IK | 150 | 52 | 2010BB_REF01_BillingProviderIDQualifier_4 | ||||||||||||
MAP_MSTR_IK | 150 | 53 | 2010BB_REF02_BillingProviderIdentifier_4 | ||||||||||||
MAP_MSTR_IK | 150 | 54 | 150_Patient_Last_Name (2010CA DEPENDENT PATIENT) | ||||||||||||
MAP_MSTR_IK | 150 | 55 | 150_Patient_First_Name (2010CA DEPENDENT PATIENT) | ||||||||||||
MAP_MSTR_IK | 150 | 56 | 150_Patient_Middle_Name (2010CA DEPENDENT PATIENT) | ||||||||||||
MAP_MSTR_IK | 150 | 57 | 150_Patient_SSN (2010CA DEPENDENT PATIENT) | ||||||||||||
MAP_MSTR_IK | 150 | 58 | 150_Patient_Member_ID (2010CA DEPENDENT PATIENT) | ||||||||||||
MAP_MSTR_IK | 150 | 59 | 150_Patient_Gender (2010CA DEPENDENT PATIENT) | ||||||||||||
MAP_MSTR_IK | 150 | 60 | 150_Patient_DOB (2010CA DEPENDENT PATIENT) | ||||||||||||
MAP_MSTR_IK | 150 | 61 | 150_Patient_Address_Line1 (2010CA DEPENDENT PATIENT) | ||||||||||||
MAP_MSTR_IK | 150 | 62 | 150_Patient_Address_Line2 (2010CA DEPENDENT PATIENT) | ||||||||||||
MAP_MSTR_IK | 150 | 63 | 150_Patient_Address_City (2010CA DEPENDENT PATIENT) | ||||||||||||
MAP_MSTR_IK | 150 | 64 | 150_Patient_Address_State (2010CA DEPENDENT PATIENT) | ||||||||||||
MAP_MSTR_IK | 150 | 65 | 150_Patient_Address_Zip (2010CA DEPENDENT PATIENT) | ||||||||||||
MAP_MSTR_IK | 150 | 66 | 150_PCP_ID_Qual | ||||||||||||
MAP_MSTR_IK | 150 | 67 | 150_PCP_ID | ||||||||||||
MAP_MSTR_IK | 150 | 68 | 150_PCP_Group_Identifier | ||||||||||||
MAP_MSTR_IK | 150 | 69 | 150_PDP_IPA_PMG_Type | ||||||||||||
MAP_MSTR_IK | 150 | 70 | 150_PDP_IPA_PMG_ID | ||||||||||||
MAP_MSTR_IK | 150 | 71 | 150_PCP_Open_Indic | ||||||||||||
MAP_MSTR_IK | 150 | 72 | 150_PCP_Eligibility_Ind | ||||||||||||
MAP_MSTR_IK | 150 | 73 | 150_COS | ||||||||||||
MAP_MSTR_IK | 150 | 74 | 150_Service_Category_Type | ||||||||||||
MAP_MSTR_IK | 150 | 75 | 150_Rendering_Prov_Eff_Date | ||||||||||||
MAP_MSTR_IK | 150 | 76 | 150_Rendering_Prov_Term_Date | ||||||||||||
MAP_MSTR_IK | 150 | 77 | 150_Rendering_Prov_DEA_ID | ||||||||||||
MAP_MSTR_IK | 150 | 78 | 150_Rendering_Prov_Gender | ||||||||||||
MAP_MSTR_IK | 150 | 79 | 150_Provider_Par_Non_Par | ||||||||||||
MAP_MSTR_IK | 150 | 80 | Care Plan Option Indicator | ||||||||||||
MAP_MSTR_IK | 150 | 81 | Group Indentifier | ||||||||||||
MAP_MSTR_IK | 150 | 82 | Care Type Code | ||||||||||||
MAP_MSTR_IK | 150 | 83 | Financial Arrangement Code | ||||||||||||
MAP_MSTR_IK | 150 | 84 | 150-Filler 05 | ||||||||||||
MAP_MSTR_IK | 150 | 85 | 2000B_SBR05_InsuranceTypeCode | ||||||||||||
MAP_MSTR_IK | 150 | 86 | 2000B_PAT09_PregnancyIndicator | ||||||||||||
MAP_MSTR_IK | 150 | 87 | 150-Filler 06 | ||||||||||||
MAP_MSTR_IK | 150 | 88 | 150-Filler 07 | ||||||||||||
MAP_MSTR_IK | 150 | 89 | 150-Filler 08 | ||||||||||||
MAP_MSTR_IK | 150 | 90 | 150-Filler 09 | ||||||||||||
MAP_MSTR_IK | 150 | 91 | 150-Filler 10 | ||||||||||||
MAP_MSTR_IK | 150 | 92 | 150-Filler 11 | ||||||||||||
MAP_MSTR_IK | 150 | 93 | 150-Filler 12 | ||||||||||||
MAP_MSTR_IK | 150 | 94 | 150-Filler 13 | ||||||||||||
MAP_MSTR_IK | 150 | 95 | 150-Filler 14 | ||||||||||||
MAP_MSTR_IK | 150 | 96 | 150-Filler 15 | ||||||||||||
MAP_MSTR_IK | 150 | 97 | 2000B_PAT06_PatientDeathDate | ||||||||||||
MAP_MSTR_IK | 150 | 98 | 2000C_PAT01_PatientRelationship | ||||||||||||
MAP_MSTR_IK | 150 | 99 | 2000C_PAT06_PatientDeathDate | ||||||||||||
MAP_MSTR_IK | 150 | 100 | 2000C_PAT08_PatientWeight | ||||||||||||
MAP_MSTR_IK | 150 | 101 | 2000C_PAT09_PregnancyIndicator | ||||||||||||
MAP_MSTR_IK | 150 | 102 | 150_SubscriberRegionCode | ||||||||||||
MAP_MSTR_IK | 150 | 103 | SubscriberOtherInsuranceCoverage | ||||||||||||
MAP_MSTR_IK | 150 | 104 | 150_PurchasedIndicator | ||||||||||||
MAP_MSTR_IK | 150 | 105 | 150_BehavioralHealth_COS | ||||||||||||
MAP_MSTR_IK | 20P | 1 | 20P Record (Professional - Occurs Once) | ||||||||||||
MAP_MSTR_IK | 20P | 2 | 20P KEY | ||||||||||||
MAP_MSTR_IK | 20P | 3 | 2300P_CLM01_ClaimNumber | 2300 | CLM | 01 | AUDT_CLM_STS | CLM_NB | PREFIX WITH REGION CODE | FOR ORIGINAL OR ADJ CLAIM THIS IS CDW CLM NM. IF A VOID THEN THIS IS THE CLAIM NUMBER OF THE CLAIM WE INTEND TO VOID. | |||||
MAP_MSTR_IK | 20P | 4 | 2300P_CLM02_TotalClaimCharge | ||||||||||||
MAP_MSTR_IK | 20P | 5 | 2300P_CLM05-01_PlaceOfService | ||||||||||||
MAP_MSTR_IK | 20P | 6 | 2300P_CLM05-02_BillTypeQualifier | ||||||||||||
MAP_MSTR_IK | 20P | 7 | 2300P_CLM05-03_ClaimFrequencyCode | ||||||||||||
MAP_MSTR_IK | 20P | 8 | 2300P_CLM06_ProviderSignature | ||||||||||||
MAP_MSTR_IK | 20P | 9 | 2300P_CLM07_MedicareAssignment | ||||||||||||
MAP_MSTR_IK | 20P | 10 | 2300P_CLM08_BenefitAssignmentIndicator | ||||||||||||
MAP_MSTR_IK | 20P | 11 | 2300P_CLM09_ReleaseOfInformation | ||||||||||||
MAP_MSTR_IK | 20P | 12 | 2300P_CLM10_PatientSignatureSource | ||||||||||||
MAP_MSTR_IK | 20P | 13 | 2300P_CLM11-01_RelatedCausesCode | ||||||||||||
MAP_MSTR_IK | 20P | 14 | 2300P_CLM11-02_RelatedCausesCode | ||||||||||||
MAP_MSTR_IK | 20P | 15 | 2300P_CLM11-04_AccidentState | ||||||||||||
MAP_MSTR_IK | 20P | 16 | 2300P_CLM11-05_AccidentCountry | ||||||||||||
MAP_MSTR_IK | 20P | 17 | 2300P_CLM12_SpecialProgramIndicator | ||||||||||||
MAP_MSTR_IK | 20P | 18 | 2300P_CLM20_DelayReason | ||||||||||||
MAP_MSTR_IK | 20P | 19 | 2300P_DTP01_DateTimeQualifier_1 | ||||||||||||
MAP_MSTR_IK | 20P | 20 | 2300P_DTP02_FormatQualifier_1 | ||||||||||||
MAP_MSTR_IK | 20P | 21 | 2300P_DTP03_DateTime_1 | ||||||||||||
MAP_MSTR_IK | 20P | 22 | 2300P_DTP01_DateTimeQualifier_2 | ||||||||||||
MAP_MSTR_IK | 20P | 23 | 2300P_DTP02_FormatQualifier_2 | ||||||||||||
MAP_MSTR_IK | 20P | 24 | 2300P_DTP03_DateTime_2 | ||||||||||||
MAP_MSTR_IK | 20P | 25 | 2300P_DTP01_DateTimeQualifier_3 | ||||||||||||
MAP_MSTR_IK | 20P | 26 | 2300P_DTP02_FormatQualifier_3 | ||||||||||||
MAP_MSTR_IK | 20P | 27 | 2300P_DTP03_DateTime_3 | ||||||||||||
MAP_MSTR_IK | 20P | 28 | 2300P_DTP01_DateTimeQualifier_4 | ||||||||||||
MAP_MSTR_IK | 20P | 29 | 2300P_DTP02_FormatQualifier_4 | ||||||||||||
MAP_MSTR_IK | 20P | 30 | 2300P_DTP03_DateTime_4 | ||||||||||||
MAP_MSTR_IK | 20P | 31 | 2300P_DTP01_DateTimeQualifier_5 | ||||||||||||
MAP_MSTR_IK | 20P | 32 | 2300P_DTP02_FormatQualifier_5 | ||||||||||||
MAP_MSTR_IK | 20P | 33 | 2300P_DTP03_DateTime_5 | ||||||||||||
MAP_MSTR_IK | 20P | 34 | 2300P_DTP01_DateTimeQualifier_6 | ||||||||||||
MAP_MSTR_IK | 20P | 35 | 2300P_DTP02_FormatQualifier_6 | ||||||||||||
MAP_MSTR_IK | 20P | 36 | 2300P_DTP03_DateTime_6 | ||||||||||||
MAP_MSTR_IK | 20P | 37 | 2300P_DTP01_DateTimeQualifier_7 | ||||||||||||
MAP_MSTR_IK | 20P | 38 | 2300P_DTP02_FormatQualifier_7 | ||||||||||||
MAP_MSTR_IK | 20P | 39 | 2300P_DTP03_DateTime_7 | ||||||||||||
MAP_MSTR_IK | 20P | 40 | 2300P_CN101_ContractTypeCode | ||||||||||||
MAP_MSTR_IK | 20P | 41 | 2300P_CN102_MonetaryAmount | ||||||||||||
MAP_MSTR_IK | 20P | 42 | 2300P_CN103_ContractPercentage | ||||||||||||
MAP_MSTR_IK | 20P | 43 | 2300P_CN104_ContractCode | ||||||||||||
MAP_MSTR_IK | 20P | 44 | 2300P_CN105_TermsDiscountPercent | ||||||||||||
MAP_MSTR_IK | 20P | 45 | 2300P_CN106_ContractVersionIdentifier | ||||||||||||
MAP_MSTR_IK | 20P | 46 | 2300P_AMT01_AmountQualifier | ||||||||||||
MAP_MSTR_IK | 20P | 47 | 2300P_AMT02_PatientAmountPaid | ||||||||||||
MAP_MSTR_IK | 20P | 48 | 2300P_REF01_ClaimReferenceNumberQualifier_1 | ||||||||||||
MAP_MSTR_IK | 20P | 49 | 2300P_REF02_ClaimReferenceNumber_1 | ||||||||||||
MAP_MSTR_IK | 20P | 50 | 2300P_REF01_ClaimReferenceNumberQualifier_2 | ||||||||||||
MAP_MSTR_IK | 20P | 51 | 2300P_REF02_ClaimReferenceNumber_2 | ||||||||||||
MAP_MSTR_IK | 20P | 52 | 2300P_REF01_ClaimReferenceNumberQualifier_3 | ||||||||||||
MAP_MSTR_IK | 20P | 53 | 2300P_REF02_ClaimReferenceNumber_3 | ||||||||||||
MAP_MSTR_IK | 20P | 54 | 2300P_REF01_ClaimReferenceNumberQualifier_4 | ||||||||||||
MAP_MSTR_IK | 20P | 55 | 2300P_REF02_ClaimReferenceNumber_4 | ||||||||||||
MAP_MSTR_IK | 20P | 56 | 2300P_REF01_ClaimReferenceNumberQualifier_5 | ||||||||||||
MAP_MSTR_IK | 20P | 57 | 2300P_REF02_ClaimReferenceNumber_5 | ||||||||||||
MAP_MSTR_IK | 20P | 58 | 2300P_REF01_ClaimReferenceNumberQualifier_6 | ||||||||||||
MAP_MSTR_IK | 20P | 59 | 2300P_REF02_ClaimReferenceNumber_6 | ||||||||||||
MAP_MSTR_IK | 20P | 60 | 2300P_REF01_ClaimReferenceNumberQualifier_7 | ||||||||||||
MAP_MSTR_IK | 20P | 61 | 2300P_REF02_ClaimReferenceNumber_7 | ||||||||||||
MAP_MSTR_IK | 20P | 62 | 2300P_REF01_ClaimReferenceNumberQualifier_8 | ||||||||||||
MAP_MSTR_IK | 20P | 63 | 2300P_REF02_ClaimReferenceNumber_8 | ||||||||||||
MAP_MSTR_IK | 20P | 64 | 2300P_NTE01_ClaimNoteType | ||||||||||||
MAP_MSTR_IK | 20P | 65 | 2300P_NTE02_ClaimNote | 2300 | NTE | NTE02 | |||||||||
MAP_MSTR_IK | 20P | 66 | 20P_Ambulance_Transport_Count | ||||||||||||
MAP_MSTR_IK | 20P | 67 | 2300P_CR101_AmbPatientWeightQualifier | ||||||||||||
MAP_MSTR_IK | 20P | 68 | 2300P_CR102_AmbulancePatientWeight | ||||||||||||
MAP_MSTR_IK | 20P | 69 | 2300P_CR104_AmbulanceTransportReason | ||||||||||||
MAP_MSTR_IK | 20P | 70 | 2300P_CR105_AmbulanceMeasure | ||||||||||||
MAP_MSTR_IK | 20P | 71 | 2300P_CR106_AmbulanceDistance | ||||||||||||
MAP_MSTR_IK | 20P | 72 | 2300P_CR109_AmbulanceRoundTripDesc | ||||||||||||
MAP_MSTR_IK | 20P | 73 | 2300P_CR110_StretcherPurposeDescription | ||||||||||||
MAP_MSTR_IK | 20P | 74 | 2300P_CRC01_ServiceCertificationCategory | ||||||||||||
MAP_MSTR_IK | 20P | 75 | 2300P_CRC02_ServiceCertificationIndicator | ||||||||||||
MAP_MSTR_IK | 20P | 76 | 2300P_CRC03_ConditionIndicatorCode | ||||||||||||
MAP_MSTR_IK | 20P | 77 | 2300P_CRC04_ConditionIndicatorCode | ||||||||||||
MAP_MSTR_IK | 20P | 78 | 2300P_CRC05_ConditionIndicatorCode | ||||||||||||
MAP_MSTR_IK | 20P | 79 | 2300P_CRC06_ConditionIndicatorCode | ||||||||||||
MAP_MSTR_IK | 20P | 80 | 2300P_CRC07_ConditionIndicatorCode | ||||||||||||
MAP_MSTR_IK | 20P | 81 | 2300P_HI01-01_DXType_1 | ||||||||||||
MAP_MSTR_IK | 20P | 82 | 2300P_HI01-02_DXCode_1 | ||||||||||||
MAP_MSTR_IK | 20P | 105 | 2310AP_NM101_ProviderRole | ||||||||||||
MAP_MSTR_IK | 20P | 106 | 2310AP_NM102_PersonIndicator | ||||||||||||
MAP_MSTR_IK | 20P | 107 | 2310AP_NM103_LastName | ||||||||||||
MAP_MSTR_IK | 20P | 108 | 2310AP_NM104_FirstName | ||||||||||||
MAP_MSTR_IK | 20P | 109 | 2310AP_NM105_MiddleName | ||||||||||||
MAP_MSTR_IK | 20P | 110 | 2310AP_NM107_Suffix | ||||||||||||
MAP_MSTR_IK | 20P | 111 | 2310AP_NM108_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 20P | 112 | 2310AP_NM109_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 20P | 113 | 2310AP_REF01_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 20P | 114 | 2310AP_REF02_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 20P | 115 | 2310AP_REF01_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 20P | 116 | 2310AP_REF02_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 20P | 117 | 2310BP_NM101_ProviderRole | ||||||||||||
MAP_MSTR_IK | 20P | 118 | 2310BP_NM102_PersonIndicator | ||||||||||||
MAP_MSTR_IK | 20P | 119 | 2310BP_NM103_LastName | ||||||||||||
MAP_MSTR_IK | 20P | 120 | 2310BP_NM104_FirstName | ||||||||||||
MAP_MSTR_IK | 20P | 121 | 2310BP_NM105_MiddleName | ||||||||||||
MAP_MSTR_IK | 20P | 122 | 2310BP_NM107_Suffix | ||||||||||||
MAP_MSTR_IK | 20P | 123 | 2310BP_NM108_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 20P | 124 | 2310BP_NM109_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 20P | 125 | 2310BP_PRV01_ProviderCode | ||||||||||||
MAP_MSTR_IK | 20P | 126 | 2310BP_PRV02_ProviderCodeQualifer | ||||||||||||
MAP_MSTR_IK | 20P | 127 | 2310BP_PRV03_ProviderTaxonomy | ||||||||||||
MAP_MSTR_IK | 20P | 128 | 2310BP_REF01_ProviderIdentifierQualifer_1 | ||||||||||||
MAP_MSTR_IK | 20P | 129 | 2310BP_REF02_ProviderIdentifier_1 | ||||||||||||
MAP_MSTR_IK | 20P | 130 | 2310BP_REF01_ProviderIdentifierQualifer_2 | ||||||||||||
MAP_MSTR_IK | 20P | 131 | 2310BP_REF02_ProviderIdentifier_2 | ||||||||||||
MAP_MSTR_IK | 20P | 132 | 20P_RenderingProviderAddress1 | ||||||||||||
MAP_MSTR_IK | 20P | 133 | 20P_RenderingProviderAddress2 | ||||||||||||
MAP_MSTR_IK | 20P | 134 | 20P_RenderingProviderCity | ||||||||||||
MAP_MSTR_IK | 20P | 135 | 20P_RenderingProviderState | ||||||||||||
MAP_MSTR_IK | 20P | 136 | 20P_RenderingProviderZip | ||||||||||||
MAP_MSTR_IK | 20P | 137 | 2310CP_NM101_ProviderRole | ||||||||||||
MAP_MSTR_IK | 20P | 138 | 2310CP_NM102_PersonIndicator | ||||||||||||
MAP_MSTR_IK | 20P | 139 | 2310CP_NM103_LastName | ||||||||||||
MAP_MSTR_IK | 20P | 140 | 2310CP_NM108_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 20P | 141 | 2310CP_NM109_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 20P | 142 | 2310CP_N301_AddressLine1 | ||||||||||||
MAP_MSTR_IK | 20P | 143 | 2310CP_N302_AddressLine2 | ||||||||||||
MAP_MSTR_IK | 20P | 144 | 2310CP_N401_City | ||||||||||||
MAP_MSTR_IK | 20P | 145 | 2310CP_N402_State | ||||||||||||
MAP_MSTR_IK | 20P | 146 | 2310CP_N403_PostalCode | ||||||||||||
MAP_MSTR_IK | 20P | 147 | 2310CP_N404_Country | ||||||||||||
MAP_MSTR_IK | 20P | 148 | 2310CP_REF01_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 20P | 149 | 2310CP_REF02_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 20P | 150 | 2310DP_NM101_ProviderRole | ||||||||||||
MAP_MSTR_IK | 20P | 151 | 2310DP_NM102_PersonIndicator | ||||||||||||
MAP_MSTR_IK | 20P | 152 | 2310DP_NM103_LastName | ||||||||||||
MAP_MSTR_IK | 20P | 153 | 2310DP_NM104_FirstName | ||||||||||||
MAP_MSTR_IK | 20P | 154 | 2310DP_NM105_MiddleName | ||||||||||||
MAP_MSTR_IK | 20P | 155 | 2310DP_NM107_Suffix | ||||||||||||
MAP_MSTR_IK | 20P | 156 | 2310DP_NM108_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 20P | 157 | 2310DP_NM109_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 20P | 158 | 2310DP_REF01_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 20P | 159 | 2310DP_REF02_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 20P | 160 | 2310EP_NM101_ProviderRole | ||||||||||||
MAP_MSTR_IK | 20P | 161 | 2310EP_NM102_PersonIndicator | ||||||||||||
MAP_MSTR_IK | 20P | 162 | 2310EP_N301_AddressLine1 | ||||||||||||
MAP_MSTR_IK | 20P | 163 | 2310EP_N302_AddressLine2 | ||||||||||||
MAP_MSTR_IK | 20P | 164 | 2310EP_N401_City | ||||||||||||
MAP_MSTR_IK | 20P | 165 | 2310EP_N402_State | ||||||||||||
MAP_MSTR_IK | 20P | 166 | 2310EP_N403_PostalCode | ||||||||||||
MAP_MSTR_IK | 20P | 167 | 2310EP_N404_Country | ||||||||||||
MAP_MSTR_IK | 20P | 168 | 2310EP_REF01_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 20P | 169 | 2310EP_REF02_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 20P | 170 | 2310FP_NM101_ProviderRole | ||||||||||||
MAP_MSTR_IK | 20P | 171 | 2310FP_NM102_PersonIndicator | ||||||||||||
MAP_MSTR_IK | 20P | 172 | 2310FP_NM103_ORG_LastName | ||||||||||||
MAP_MSTR_IK | 20P | 173 | 2310FP_N301_AddressLine1 | ||||||||||||
MAP_MSTR_IK | 20P | 174 | 2310FP_N302_AddressLine2 | ||||||||||||
MAP_MSTR_IK | 20P | 175 | 2310FP_N401_City | ||||||||||||
MAP_MSTR_IK | 20P | 176 | 2310FP_N402_State | ||||||||||||
MAP_MSTR_IK | 20P | 177 | 2310FP_N403_PostalCode | ||||||||||||
MAP_MSTR_IK | 20P | 178 | 2310FP_N404_Country | ||||||||||||
MAP_MSTR_IK | 20P | 179 | 2310FP_REF01_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 20P | 180 | 2310FP_REF02_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 20P | 181 | 2300P_PWK01_AttachmentReportType | ||||||||||||
MAP_MSTR_IK | 20P | 182 | 2300P_PWK02_AttachmentTransmissionCode | ||||||||||||
MAP_MSTR_IK | 20P | 183 | 2300P_PWK06_AttachmentControlNumber | ||||||||||||
MAP_MSTR_IK | 20P | 184 | 2300P_REF01_InvestigationalDeviceExemptionNumber_Qualifier | ||||||||||||
MAP_MSTR_IK | 20P | 185 | 2300P_REF02_InvestigationalDeviceExemptionNumber | ||||||||||||
MAP_MSTR_IK | 20P | 186 | 2300P_REF01_ServiceAuthorizationExceptionCode_Qualifier | ||||||||||||
MAP_MSTR_IK | 20P | 187 | 2300P_REF02_ServiceAuthorizationExceptionCode | ||||||||||||
MAP_MSTR_IK | 20P | 188 | 2300P_REF01_MammographyCertificationNumber_Qualifier | ||||||||||||
MAP_MSTR_IK | 20P | 189 | 2300P_REF01_MammographyCertificationNumber | ||||||||||||
MAP_MSTR_IK | 20P | 190 | 2300P_CR208_PatientConditionCode | ||||||||||||
MAP_MSTR_IK | 20P | 191 | 2300P_CR210_PatientDescription | ||||||||||||
MAP_MSTR_IK | 20P | 192 | 2300P_CR211_PatientDescription | ||||||||||||
MAP_MSTR_IK | 20P | 193 | 2300P_HI101-2_AnesthesiaRelatedSurgicalProcedure | ||||||||||||
MAP_MSTR_IK | 20P | 194 | 2300P_HI102-2_AnesthesiaRelatedSurgicalProcedure | ||||||||||||
MAP_MSTR_IK | 20P | 195 | 2300P_DTP01_DateTimeQualifier_7 | ||||||||||||
MAP_MSTR_IK | 20P | 196 | 2300P_DTP02_FormatQualifier_7 | ||||||||||||
MAP_MSTR_IK | 20P | 197 | 2300P_DTP03_DateTime_7 | ||||||||||||
MAP_MSTR_IK | 20P | 198 | 2300P_DTP01_DateTimeQualifier_8 | ||||||||||||
MAP_MSTR_IK | 20P | 199 | 2300P_DTP02_FormatQualifier_8 | ||||||||||||
MAP_MSTR_IK | 20P | 200 | 2300P_DTP03_DateTime_8 | ||||||||||||
MAP_MSTR_IK | 20P | 201 | 2300P_DTP01_DateTimeQualifier_9 | ||||||||||||
MAP_MSTR_IK | 20P | 202 | 2300P_DTP02_FormatQualifier_9 | ||||||||||||
MAP_MSTR_IK | 20P | 203 | 2300P_DTP03_DateTime_9 | ||||||||||||
MAP_MSTR_IK | 20P | 204 | 2300P_DTP01_DateTimeQualifier_10 | ||||||||||||
MAP_MSTR_IK | 20P | 205 | 2300P_DTP02_FormatQualifier_10 | ||||||||||||
MAP_MSTR_IK | 20P | 206 | 2300P_DTP03_DateTime_10 | ||||||||||||
MAP_MSTR_IK | 20P | 207 | 2300P_DTP01_DateTimeQualifier_11 | ||||||||||||
MAP_MSTR_IK | 20P | 208 | 2300P_DTP02_FormatQualifier_11 | ||||||||||||
MAP_MSTR_IK | 20P | 209 | 2300P_DTP03_DateTime_11 | ||||||||||||
MAP_MSTR_IK | 20P | 210 | 2300P_DTP01_DateTimeQualifier_12 | ||||||||||||
MAP_MSTR_IK | 20P | 211 | 2300P_DTP02_FormatQualifier_12 | ||||||||||||
MAP_MSTR_IK | 20P | 212 | 2300P_DTP03_DateTime_12 | ||||||||||||
MAP_MSTR_IK | 20P | 213 | 2300P_DTP01_DateTimeQualifier_13 | ||||||||||||
MAP_MSTR_IK | 20P | 214 | 2300P_DTP02_FormatQualifier_13 | ||||||||||||
MAP_MSTR_IK | 20P | 215 | 2300P_DTP03_DateTime_13 | ||||||||||||
MAP_MSTR_IK | 20P | 216 | 2300P_DTP01_DateTimeQualifier_14 | ||||||||||||
MAP_MSTR_IK | 20P | 217 | 2300P_DTP02_FormatQualifier_14 | ||||||||||||
MAP_MSTR_IK | 20P | 218 | 2300P_DTP03_DateTime_14 | ||||||||||||
MAP_MSTR_IK | 20P | 219 | 2300P_DTP01_DateTimeQualifier_15 | ||||||||||||
MAP_MSTR_IK | 20P | 220 | 2300P_DTP02_FormatQualifier_15 | ||||||||||||
MAP_MSTR_IK | 20P | 221 | 2300P_DTP03_DateTime_15 | ||||||||||||
MAP_MSTR_IK | 20P | 222 | 2300P_DTP01_DateTimeQualifier_16 | ||||||||||||
MAP_MSTR_IK | 20P | 223 | 2300P_DTP02_FormatQualifier_16 | ||||||||||||
MAP_MSTR_IK | 20P | 224 | 2300P_DTP03_DateTime_16 | ||||||||||||
MAP_MSTR_IK | 20P | 225 | 2300P_HCP01_PricingMethodology | ||||||||||||
MAP_MSTR_IK | 20P | 226 | 2300P_HCP02_RepricedAllowedAmount | ||||||||||||
MAP_MSTR_IK | 20P | 227 | 2300P_HCP03_RepricedSavingAmount | ||||||||||||
MAP_MSTR_IK | 20P | 228 | 2300P_HCP04_RepricingOrganizationIdentifier | ||||||||||||
MAP_MSTR_IK | 20P | 229 | 2300P_HCP05_RepricingPerDiemAmount | ||||||||||||
MAP_MSTR_IK | 20P | 230 | 2300P_HCP06_RepricedApprovedAmbulatoryPatientGroupCode | ||||||||||||
MAP_MSTR_IK | 20P | 231 | 2300P_HCP07_RepricedApprovedAmbulatoryPatientGroupAmount | ||||||||||||
MAP_MSTR_IK | 20P | 232 | 2300P_HCP13_RejectReasonCode | ||||||||||||
MAP_MSTR_IK | 20P | 233 | 2300P_HCP14_PolicyComplianceCode | ||||||||||||
MAP_MSTR_IK | 20P | 234 | 2300P_HCP15_ExceptionCode | ||||||||||||
MAP_MSTR_IK | 20P | 235 | 2300P_HI01-01_ConditionCodeQualifier | ||||||||||||
MAP_MSTR_IK | 20P | 236 | 2300P_HI01-02_ConditionCode | ||||||||||||
MAP_MSTR_IK | 20P | 259 | 2300P_REF01_FileInformation_Qualifier | ||||||||||||
MAP_MSTR_IK | 20P | 260 | 2300P_REF01_FileInformation | ||||||||||||
MAP_MSTR_IK | 20P | 261 | Claim Processor Receiver Date | ||||||||||||
MAP_MSTR_IK | 20P | 262 | InNetworkIndicator | ||||||||||||
MAP_MSTR_IK | 20P | 263 | PatientControlNumber | ||||||||||||
MAP_MSTR_IK | 20P | 264 | 20P-Filler 04 | ||||||||||||
MAP_MSTR_IK | 20P | 265 | 20P-Filler 05 | ||||||||||||
MAP_MSTR_IK | 20P | 266 | 20P-Filler 06 | ||||||||||||
MAP_MSTR_IK | 20P | 267 | 20P-Filler 07 | ||||||||||||
MAP_MSTR_IK | 20P | 268 | 20P-Filler 08 | ||||||||||||
MAP_MSTR_IK | 20P | 269 | 20P-Filler 09 | ||||||||||||
MAP_MSTR_IK | 20P | 270 | 20P-Filler 10 | ||||||||||||
MAP_MSTR_IK | 20P | 271 | 20P-Filler 11 | ||||||||||||
MAP_MSTR_IK | 20P | 272 | 20P-Filler 12 | ||||||||||||
MAP_MSTR_IK | 20P | 273 | 20P-Filler 13 | ||||||||||||
MAP_MSTR_IK | 20P | 274 | 20P-Filler 14 | ||||||||||||
MAP_MSTR_IK | 20P | 275 | 20P-Filler 15 | ||||||||||||
MAP_MSTR_IK | 20P | 276 | 2300P_HI13-01_ConditionCodeQualifier | ||||||||||||
MAP_MSTR_IK | 20P | 277 | 2300P_HI13-02_ConditionCode | ||||||||||||
MAP_MSTR_IK | 20P | 300 | 2300P_REF01_FileInformation2 | ||||||||||||
MAP_MSTR_IK | 20P | 301 | 2300P_REF01_FileInformation3 | ||||||||||||
MAP_MSTR_IK | 20P | 302 | 2300P_REF01_FileInformation4 | ||||||||||||
MAP_MSTR_IK | 20P | 303 | 2300P_REF01_FileInformation5 | ||||||||||||
MAP_MSTR_IK | 20P | 304 | 2300P_REF01_FileInformation6 | ||||||||||||
MAP_MSTR_IK | 20P | 305 | 2300P_REF01_FileInformation7 | ||||||||||||
MAP_MSTR_IK | 20P | 306 | 2300P_REF01_FileInformation8 | ||||||||||||
MAP_MSTR_IK | 20P | 307 | 2300P_REF01_FileInformation9 | ||||||||||||
MAP_MSTR_IK | 20P | 308 | 2300P_REF01_FileInformation10 | ||||||||||||
MAP_MSTR_IK | 20P | 309 | RenderingProviderSpecialty | ||||||||||||
MAP_MSTR_IK | 20P | 310 | Special Need Ind | ||||||||||||
MAP_MSTR_IK | 20P | 311 | Type of Attendant | ||||||||||||
MAP_MSTR_IK | 20P | 312 | Number of Individuals Accompanying | ||||||||||||
MAP_MSTR_IK | 20P | 313 | Was beneficiary picked up | ||||||||||||
MAP_MSTR_IK | 20P | 314 | Date trip was requested | ||||||||||||
MAP_MSTR_IK | 20I | 1 | 20I Record (Institutional - Occurs Once) | ||||||||||||
MAP_MSTR_IK | 20I | 2 | 20I KEY | ||||||||||||
MAP_MSTR_IK | 20I | 3 | 2300I_CLM01_ClaimNumber | ||||||||||||
MAP_MSTR_IK | 20I | 4 | 2300I_CLM02_TotalClaimCharge | ||||||||||||
MAP_MSTR_IK | 20I | 5 | 2300I_CLM05-01_FacilityTypeCode | ||||||||||||
MAP_MSTR_IK | 20I | 6 | 2300I_CLM05-02_BillTypeQualifier | ||||||||||||
MAP_MSTR_IK | 20I | 7 | 2300I_CLM05-03_ClaimFrequencyCode | ||||||||||||
MAP_MSTR_IK | 20I | 8 | 2300I_CLM07_MedicareAssignment | ||||||||||||
MAP_MSTR_IK | 20I | 9 | 2300I_CLM08_BenefitAssignmentIndicator | ||||||||||||
MAP_MSTR_IK | 20I | 10 | 2300I_CLM09_ReleaseOfInformation | ||||||||||||
MAP_MSTR_IK | 20I | 11 | 2300I_CLM20_DelayReason | ||||||||||||
MAP_MSTR_IK | 20I | 12 | 2300I_DTP01_DateTimeQualifier_1 | ||||||||||||
MAP_MSTR_IK | 20I | 13 | 2300I_DTP02_FormatQualifier_1 | ||||||||||||
MAP_MSTR_IK | 20I | 14 | 2300I_DTP03_DateTime_1 | ||||||||||||
MAP_MSTR_IK | 20I | 15 | 2300I_DTP01_DateTimeQualifier_2 | ||||||||||||
MAP_MSTR_IK | 20I | 16 | 2300I_DTP02_FormatQualifier_2 | ||||||||||||
MAP_MSTR_IK | 20I | 17 | 2300I_DTP03_DateTime_2 | ||||||||||||
MAP_MSTR_IK | 20I | 18 | 2300I_DTP01_DateTimeQualifier_3 | ||||||||||||
MAP_MSTR_IK | 20I | 19 | 2300I_DTP02_FormatQualifier_3 | ||||||||||||
MAP_MSTR_IK | 20I | 20 | 2300I_DTP03_DateTime_3 | ||||||||||||
MAP_MSTR_IK | 20I | 21 | 2300I_DTP01_DateTimeQualifier_4 | ||||||||||||
MAP_MSTR_IK | 20I | 22 | 2300I_DTP02_FormatQualifier_4 | ||||||||||||
MAP_MSTR_IK | 20I | 23 | 2300I_DTP03_DateTime_4 | ||||||||||||
MAP_MSTR_IK | 20I | 24 | 2300I_CL101_AdmissionType | ||||||||||||
MAP_MSTR_IK | 20I | 25 | 2300I_CL102_AdmissionSource | ||||||||||||
MAP_MSTR_IK | 20I | 26 | 2300I_CL103_PatientStatus | ||||||||||||
MAP_MSTR_IK | 20I | 27 | 2300I_CN101_ContractTypeCode | ||||||||||||
MAP_MSTR_IK | 20I | 28 | 2300I_CN102_MonetaryAmount | ||||||||||||
MAP_MSTR_IK | 20I | 29 | 2300I_CN103_ContractPercentage | ||||||||||||
MAP_MSTR_IK | 20I | 30 | 2300I_CN104_ContractCode | ||||||||||||
MAP_MSTR_IK | 20I | 31 | 2300I_CN105_TermsDiscountPercent | ||||||||||||
MAP_MSTR_IK | 20I | 32 | 2300I_CN106_ContractVersionIdentifier | ||||||||||||
MAP_MSTR_IK | 20I | 33 | 2300I_AMT01_AmountQualifier | ||||||||||||
MAP_MSTR_IK | 20I | 34 | 2300I_AMT02_PatientAmountDue | ||||||||||||
MAP_MSTR_IK | 20I | 35 | 2300I_REF01_ClaimReferenceNumberQualifier_1 | ||||||||||||
MAP_MSTR_IK | 20I | 36 | 2300I_REF02_ClaimReferenceNumber_1 | ||||||||||||
MAP_MSTR_IK | 20I | 37 | 2300I_REF01_ClaimReferenceNumberQualifier_2 | ||||||||||||
MAP_MSTR_IK | 20I | 38 | 2300I_REF02_ClaimReferenceNumber_2 | ||||||||||||
MAP_MSTR_IK | 20I | 39 | 2300I_REF01_ClaimReferenceNumberQualifier_3 | ||||||||||||
MAP_MSTR_IK | 20I | 40 | 2300I_REF02_ClaimReferenceNumber_3 | ||||||||||||
MAP_MSTR_IK | 20I | 41 | 2300I_REF01_ClaimReferenceNumberQualifier_4 | ||||||||||||
MAP_MSTR_IK | 20I | 42 | 2300I_REF02_ClaimReferenceNumber_4 | ||||||||||||
MAP_MSTR_IK | 20I | 43 | 2300I_REF01_ClaimReferenceNumberQualifier_5 | ||||||||||||
MAP_MSTR_IK | 20I | 44 | 2300I_REF02_ClaimReferenceNumber_5 | ||||||||||||
MAP_MSTR_IK | 20I | 45 | 2300I_REF01_ClaimReferenceNumberQualifier_6 | ||||||||||||
MAP_MSTR_IK | 20I | 46 | 2300I_REF02_ClaimReferenceNumber_6 | ||||||||||||
MAP_MSTR_IK | 20I | 47 | 2300I_REF01_ClaimReferenceNumberQualifier_7 | ||||||||||||
MAP_MSTR_IK | 20I | 48 | 2300I_REF02_ClaimReferenceNumber_7 | ||||||||||||
MAP_MSTR_IK | 20I | 49 | 2300I_REF01_ClaimReferenceNumberQualifier_8 | ||||||||||||
MAP_MSTR_IK | 20I | 50 | 2300I_REF02_ClaimReferenceNumber_8 | ||||||||||||
MAP_MSTR_IK | 20I | 51 | 2300I_NTE01_ClaimNoteType | ||||||||||||
MAP_MSTR_IK | 20I | 52 | 2300I_NTE02_ClaimNote | ||||||||||||
MAP_MSTR_IK | 20I | 53 | 2300I_NTE01_BillNoteType | ||||||||||||
MAP_MSTR_IK | 20I | 54 | 2300I_NTE01_BillNote | ||||||||||||
MAP_MSTR_IK | 20I | 55 | 2300I_CRC01_ServiceCertificationCategory | ||||||||||||
MAP_MSTR_IK | 20I | 56 | 2300I_CRC02_ServiceCertificationIndicator | ||||||||||||
MAP_MSTR_IK | 20I | 57 | 2300I_CRC03_ConditionIndicatorCode | ||||||||||||
MAP_MSTR_IK | 20I | 58 | 2300I_CRC04_ConditionIndicatorCode | ||||||||||||
MAP_MSTR_IK | 20I | 59 | 2300I_CRC05_ConditionIndicatorCode | ||||||||||||
MAP_MSTR_IK | 20I | 60 | 2300I_HI01-01_PrinDXType | ||||||||||||
MAP_MSTR_IK | 20I | 61 | 2300I_HI01-02_PrincipalDXCode | ||||||||||||
MAP_MSTR_IK | 20I | 62 | 2300I_HI01-09_PrincipalDXPOA | ||||||||||||
MAP_MSTR_IK | 20I | 63 | 2300I_HI01-01_AdmittingDXType | ||||||||||||
MAP_MSTR_IK | 20I | 64 | 2300I_HI01-02_AdmittingDXCode | ||||||||||||
MAP_MSTR_IK | 20I | 65 | 2300I_HI01-01_PatientDXType | ||||||||||||
MAP_MSTR_IK | 20I | 66 | 2300I_HI01-02_PatientDXCode | ||||||||||||
MAP_MSTR_IK | 20I | 67 | 2300I_HI02-01_PatientDXType | ||||||||||||
MAP_MSTR_IK | 20I | 68 | 2300I_HI02-02_PatientDXCode | ||||||||||||
MAP_MSTR_IK | 20I | 69 | 2300I_HI03-01_PatientDXType | ||||||||||||
MAP_MSTR_IK | 20I | 70 | 2300I_HI03-02_PatientDXCode | ||||||||||||
MAP_MSTR_IK | 20I | 71 | 2300I_HI01-01_ECIDXType | ||||||||||||
MAP_MSTR_IK | 20I | 72 | 2300I_HI01-02_ECIDXCode | ||||||||||||
MAP_MSTR_IK | 20I | 73 | 2300I_HI01-09_ECIDXPOA | ||||||||||||
MAP_MSTR_IK | 20I | 107 | 2300I_HI01-01_DRGType | ||||||||||||
MAP_MSTR_IK | 20I | 108 | 2300I_HI01-02_DRGCode | ||||||||||||
MAP_MSTR_IK | 20I | 109 | 20I_DRG_Version | ||||||||||||
MAP_MSTR_IK | 20I | 110 | 20I_DRG_Severity | ||||||||||||
MAP_MSTR_IK | 20I | 111 | 20I_DRG_Risk | ||||||||||||
MAP_MSTR_IK | 20I | 112 | 2300I_HI01-01_DXType_1 | ||||||||||||
MAP_MSTR_IK | 20I | 113 | 2300I_HI01-02_DXCode_1 | ||||||||||||
MAP_MSTR_IK | 20I | 114 | 2300I_HI01-09_DXPOA_1 | ||||||||||||
MAP_MSTR_IK | 20I | 190 | 2300I_HI01-01_PrincipalPXType | ||||||||||||
MAP_MSTR_IK | 20I | 191 | 2300I_HI01-02_PrincipalPXCode | ||||||||||||
MAP_MSTR_IK | 20I | 192 | 2300I_HI01-03_PrincipalPXDateQualifier | ||||||||||||
MAP_MSTR_IK | 20I | 193 | 2300I_HI01-04_PrincipalPXDate | ||||||||||||
MAP_MSTR_IK | 20I | 194 | 2300I_HI01-01_PXType_1 | ||||||||||||
MAP_MSTR_IK | 20I | 195 | 2300I_HI01-02_PXCode_1 | ||||||||||||
MAP_MSTR_IK | 20I | 196 | 2300I_HI01-03_PXDateQualifier_1 | ||||||||||||
MAP_MSTR_IK | 20I | 197 | 2300I_HI01-04_PXDate_1 | ||||||||||||
MAP_MSTR_IK | 20I | 241 | 2300I_HI12-04_PXDate_1 | ||||||||||||
MAP_MSTR_IK | 20I | 290 | 2300I_HI01-01_OccurSpanType | ||||||||||||
MAP_MSTR_IK | 20I | 291 | 2300I_HI01-02_OccurSpanCode | ||||||||||||
MAP_MSTR_IK | 20I | 292 | 2300I_HI01-03_OccurSpanDateQualifier | ||||||||||||
MAP_MSTR_IK | 20I | 338 | 2300I_HI01-01_OccurType | ||||||||||||
MAP_MSTR_IK | 20I | 339 | 2300I_HI01-02_OccurCode | ||||||||||||
MAP_MSTR_IK | 20I | 340 | 2300I_HI01-03_OccurDateQualifier | ||||||||||||
MAP_MSTR_IK | 20I | 341 | 2300I_HI01-04_OccurDate | ||||||||||||
MAP_MSTR_IK | 20I | 386 | 2300I_HI01-01_ValueCodeQualifer_1 | ||||||||||||
MAP_MSTR_IK | 20I | 387 | 2300I_HI01-02_ValueCode_1 | ||||||||||||
MAP_MSTR_IK | 20I | 388 | 2300I_HI01-05_ValueCodeAmount_1 | ||||||||||||
MAP_MSTR_IK | 20I | 458 | 2300I_HI01-01_ConditionCodeQualifier | ||||||||||||
MAP_MSTR_IK | 20I | 459 | 2300I_HI01-02_ConditionCode | ||||||||||||
MAP_MSTR_IK | 20I | 482 | 2300I_HI01-01_TreatmentCode | ||||||||||||
MAP_MSTR_IK | 20I | 483 | 2300I_HI01-02_TreatmentCode | ||||||||||||
MAP_MSTR_IK | 20I | 506 | 2300I_HCP01_PricingMethod | ||||||||||||
MAP_MSTR_IK | 20I | 507 | 2300I_HCP02_AllowedAmount | ||||||||||||
MAP_MSTR_IK | 20I | 508 | 2300I_HCP03_SavingAmount | ||||||||||||
MAP_MSTR_IK | 20I | 509 | 2300I_HCP04_OrgID | ||||||||||||
MAP_MSTR_IK | 20I | 510 | 2300I_HCP05_PricingRate | ||||||||||||
MAP_MSTR_IK | 20I | 511 | 2300I_HCP06_ApprovedDRGCode | ||||||||||||
MAP_MSTR_IK | 20I | 512 | 2300I_HCP07_ApprovedDRGAmount | ||||||||||||
MAP_MSTR_IK | 20I | 513 | 2300I_HCP08_ApprovedRevenueCode | ||||||||||||
MAP_MSTR_IK | 20I | 514 | 2300I_HCP11_Units | ||||||||||||
MAP_MSTR_IK | 20I | 515 | 2300I_HCP12_Quatity | ||||||||||||
MAP_MSTR_IK | 20I | 516 | 2300I_HCP13_RejectReason | ||||||||||||
MAP_MSTR_IK | 20I | 517 | 2300I_HCP14_PolicyCompliance | ||||||||||||
MAP_MSTR_IK | 20I | 518 | 2300I_HCP15_ExceptionCode | ||||||||||||
MAP_MSTR_IK | 20I | 519 | 2310AI_NM101_ProviderRole | ||||||||||||
MAP_MSTR_IK | 20I | 520 | 2310AI_NM102_PersonIndicator | ||||||||||||
MAP_MSTR_IK | 20I | 521 | 2310AI_NM103_LastName | ||||||||||||
MAP_MSTR_IK | 20I | 522 | 2310AI_NM104_FirstName | ||||||||||||
MAP_MSTR_IK | 20I | 523 | 2310AI_NM105_MiddleName | ||||||||||||
MAP_MSTR_IK | 20I | 524 | 2310AI_NM107_Suffix | ||||||||||||
MAP_MSTR_IK | 20I | 525 | 2310AI_NM108_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 20I | 526 | 2310AI_NM109_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 20I | 527 | 2310AI_PRV01_ProviderCode | ||||||||||||
MAP_MSTR_IK | 20I | 528 | 2310AI_PRV02_ProviderCodeQualifer | ||||||||||||
MAP_MSTR_IK | 20I | 529 | 2310AI_PRV03_ProviderTaxonomy | ||||||||||||
MAP_MSTR_IK | 20I | 530 | 2310AI_REF01_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 20I | 531 | 2310AI_REF02_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 20I | 532 | 2310AI_REF01_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 20I | 533 | 2310AI_REF02_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 20I | 534 | 2310BI_NM101_ProviderRole | ||||||||||||
MAP_MSTR_IK | 20I | 535 | 2310BI_NM102_PersonIndicator | ||||||||||||
MAP_MSTR_IK | 20I | 536 | 2310BI_NM103_LastName | ||||||||||||
MAP_MSTR_IK | 20I | 537 | 2310BI_NM104_FirstName | ||||||||||||
MAP_MSTR_IK | 20I | 538 | 2310BI_NM105_MiddleName | ||||||||||||
MAP_MSTR_IK | 20I | 539 | 2310BI_NM107_Suffix | ||||||||||||
MAP_MSTR_IK | 20I | 540 | 2310BI_NM108_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 20I | 541 | 2310BI_NM109_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 20I | 542 | 2310BI_REF01_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 20I | 543 | 2310BI_REF02_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 20I | 544 | 2310BI_REF01_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 20I | 545 | 2310BI_REF02_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 20I | 546 | 2310CI_NM101_ProviderRole | ||||||||||||
MAP_MSTR_IK | 20I | 547 | 2310CI_NM102_PersonIndicator | ||||||||||||
MAP_MSTR_IK | 20I | 548 | 2310CI_NM103_LastName | ||||||||||||
MAP_MSTR_IK | 20I | 549 | 2310CI_NM104_FirstName | ||||||||||||
MAP_MSTR_IK | 20I | 550 | 2310CI_NM105_MiddleName | ||||||||||||
MAP_MSTR_IK | 20I | 551 | 2310CI_NM107_Suffix | ||||||||||||
MAP_MSTR_IK | 20I | 552 | 2310CI_NM108_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 20I | 553 | 2310CI_NM109_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 20I | 554 | 2310CI_REF01_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 20I | 555 | 2310CI_REF02_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 20I | 556 | 2310CI_REF01_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 20I | 557 | 2310CI_REF02_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 20I | 558 | 2310DI_NM101_ProviderRole | ||||||||||||
MAP_MSTR_IK | 20I | 559 | 2310DI_NM102_PersonIndicator | ||||||||||||
MAP_MSTR_IK | 20I | 560 | 2310DI_NM103_LastName | ||||||||||||
MAP_MSTR_IK | 20I | 561 | 2310DI_NM104_FirstName | ||||||||||||
MAP_MSTR_IK | 20I | 562 | 2310DI_NM105_MiddleName | ||||||||||||
MAP_MSTR_IK | 20I | 563 | 2310DI_NM107_Suffix | ||||||||||||
MAP_MSTR_IK | 20I | 564 | 2310DI_NM108_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 20I | 565 | 2310DI_NM109_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 20I | 566 | 2310DI_REF01_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 20I | 567 | 2310DI_REF02_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 20I | 568 | 2310DI_REF01_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 20I | 569 | 2310DI_REF02_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 20I | 570 | 20I_RenderingProviderAddress1 | ||||||||||||
MAP_MSTR_IK | 20I | 571 | 20I_RenderingProviderAddress2 | ||||||||||||
MAP_MSTR_IK | 20I | 572 | 20I_RenderingProviderCity | ||||||||||||
MAP_MSTR_IK | 20I | 573 | 20I_RenderingProviderState | ||||||||||||
MAP_MSTR_IK | 20I | 574 | 20I_RenderingProviderZip | ||||||||||||
MAP_MSTR_IK | 20I | 575 | 2310EI_NM101_ProviderRole | ||||||||||||
MAP_MSTR_IK | 20I | 576 | 2310EI_NM102_PersonIndicator | ||||||||||||
MAP_MSTR_IK | 20I | 577 | 2310EI_NM103_ORG_LastName | ||||||||||||
MAP_MSTR_IK | 20I | 578 | 2310EI_NM108_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 20I | 579 | 2310EI_NM109_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 20I | 580 | 2310EI_N301_AddressLine1 | ||||||||||||
MAP_MSTR_IK | 20I | 581 | 2310EI_N302_AddressLine2 | ||||||||||||
MAP_MSTR_IK | 20I | 582 | 2310EI_N401_City | ||||||||||||
MAP_MSTR_IK | 20I | 583 | 2310EI_N402_State | ||||||||||||
MAP_MSTR_IK | 20I | 584 | 2310EI_N403_PostalCode | ||||||||||||
MAP_MSTR_IK | 20I | 585 | 2310EI_N404_Country | ||||||||||||
MAP_MSTR_IK | 20I | 586 | 2310EI_REF01_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 20I | 587 | 2310EI_REF02_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 20I | 588 | 2310EI_REF01_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 20I | 589 | 2310EI_REF02_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 20I | 590 | 2310FI_NM101_ProviderRole | ||||||||||||
MAP_MSTR_IK | 20I | 591 | 2310FI_NM102_PersonIndicator | ||||||||||||
MAP_MSTR_IK | 20I | 592 | 2310FI_NM103_LastName | ||||||||||||
MAP_MSTR_IK | 20I | 593 | 2310FI_NM104_FirstName | ||||||||||||
MAP_MSTR_IK | 20I | 594 | 2310FI_NM105_MiddleName | ||||||||||||
MAP_MSTR_IK | 20I | 595 | 2310FI_NM107_Suffix | ||||||||||||
MAP_MSTR_IK | 20I | 596 | 2310FI_NM108_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 20I | 597 | 2310FI_NM109_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 20I | 598 | 2310FI_REF01_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 20I | 599 | 2310FI_REF02_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 20I | 600 | 2310FI_REF01_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 20I | 601 | 2310FI_REF02_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 20I | 602 | 2300I_PWK01_AttachmentReportType | ||||||||||||
MAP_MSTR_IK | 20I | 603 | 2300I_PWK02_AttachmentTransmissionCode | ||||||||||||
MAP_MSTR_IK | 20I | 604 | 2300I_PWK06_AttachmentControlNumber | ||||||||||||
MAP_MSTR_IK | 20I | 605 | 2300I_REF01_ServiceAuthorizationExceptionCode_Qualifier | 2300 | REF | REF01 | NOT MAPPED | ||||||||
MAP_MSTR_IK | 20I | 606 | 2300I_REF02_ServiceAuthorizationExceptionCode | 2300 | REF | REF9U | |||||||||
MAP_MSTR_IK | 20I | 607 | 2300I_REF01_InvestigationalDeviceExemptionNumber_Qualifier | ||||||||||||
MAP_MSTR_IK | 20I | 608 | 2300I_REF02_InvestigationalDeviceExemptionNumber | ||||||||||||
MAP_MSTR_IK | 20I | 609 | 2300I_REF01_DemonstrationProject_Qualifier | ||||||||||||
MAP_MSTR_IK | 20I | 610 | 2300I_REF02_DemonstrationProjectIdentifier | ||||||||||||
MAP_MSTR_IK | 20I | 611 | 2300I_REF01_PeerReviewOrganization_Qualifier | ||||||||||||
MAP_MSTR_IK | 20I | 612 | 2300I_REF02_PeerReviewOrganizationNumber | ||||||||||||
MAP_MSTR_IK | 20I | 613 | 2300I_REF01_FileInformation_Qualifier | ||||||||||||
MAP_MSTR_IK | 20I | 614 | 2300I_REF01_FileInformation | ||||||||||||
MAP_MSTR_IK | 20I | 615 | Claim Processor Receiver Date | ||||||||||||
MAP_MSTR_IK | 20I | 616 | InNetworkIndicator | ||||||||||||
MAP_MSTR_IK | 20I | 617 | PatientControlNumber | ||||||||||||
MAP_MSTR_IK | 20I | 618 | 20I-Filler 04 | ||||||||||||
MAP_MSTR_IK | 20I | 619 | 20I-Filler 05 | ||||||||||||
MAP_MSTR_IK | 20I | 620 | 20I-Filler 06 | ||||||||||||
MAP_MSTR_IK | 20I | 621 | 20I-Filler 07 | ||||||||||||
MAP_MSTR_IK | 20I | 622 | 20I-Filler 08 | ||||||||||||
MAP_MSTR_IK | 20I | 623 | 20I-IFiller 09 | ||||||||||||
MAP_MSTR_IK | 20I | 624 | 20I-IFiller 10 | ||||||||||||
MAP_MSTR_IK | 20I | 625 | 20I-IFiller 11 | ||||||||||||
MAP_MSTR_IK | 20I | 626 | 20I-IFiller 12 | ||||||||||||
MAP_MSTR_IK | 20I | 627 | 20I-IFiller 13 | ||||||||||||
MAP_MSTR_IK | 20I | 628 | 20I-IFiller 14 | ||||||||||||
MAP_MSTR_IK | 20I | 629 | 20I-IFiller 15 | ||||||||||||
MAP_MSTR_IK | 20I | 774 | 2300I_REF01_FileInformation2 | ||||||||||||
MAP_MSTR_IK | 20I | 775 | 2300I_REF01_FileInformation3 | ||||||||||||
MAP_MSTR_IK | 20I | 776 | 2300I_REF01_FileInformation4 | ||||||||||||
MAP_MSTR_IK | 20I | 777 | 2300I_REF01_FileInformation5 | ||||||||||||
MAP_MSTR_IK | 20I | 778 | 2300I_REF01_FileInformation6 | ||||||||||||
MAP_MSTR_IK | 20I | 779 | 2300I_REF01_FileInformation7 | ||||||||||||
MAP_MSTR_IK | 20I | 780 | 2300I_REF01_FileInformation8 | ||||||||||||
MAP_MSTR_IK | 20I | 781 | 2300I_REF01_FileInformation9 | ||||||||||||
MAP_MSTR_IK | 20I | 782 | 2300I_REF01_FileInformation10 | ||||||||||||
MAP_MSTR_IK | 20I | 783 | Service Facility Secondary Identification Code Qualifier | ||||||||||||
MAP_MSTR_IK | 20I | 784 | Service Facility Identifier | ||||||||||||
MAP_MSTR_IK | 310 | 1 | 310 Record (OTHER SUBSCRIBER, PAYER, CLAIM LEVEL CAS) | ||||||||||||
MAP_MSTR_IK | 310 | 2 | 310 KEY | ||||||||||||
MAP_MSTR_IK | 310 | 3 | 2320_SBR01_PayerResponsibilitySequence | ||||||||||||
MAP_MSTR_IK | 310 | 4 | 2320_SBR02_SubscriberRelationship | ||||||||||||
MAP_MSTR_IK | 310 | 5 | 2320_SBR03_PolicyNumber | ||||||||||||
MAP_MSTR_IK | 310 | 6 | 310_ProductIDNumber | ||||||||||||
MAP_MSTR_IK | 310 | 7 | 310_DelegatedBenefitAdminOrgID | ||||||||||||
MAP_MSTR_IK | 310 | 8 | 2320_SBR04_InsuredGroupName | ||||||||||||
MAP_MSTR_IK | 310 | 9 | 2320_SBR05_InsuranceType | ||||||||||||
MAP_MSTR_IK | 310 | 10 | 2320_SBR09_ClaimFilingIndicator | ||||||||||||
MAP_MSTR_IK | 310 | 11 | 310_ClaimDisposition | ||||||||||||
MAP_MSTR_IK | 310 | 12 | 310_RiskAssessmentCode_1 | ||||||||||||
MAP_MSTR_IK | 310 | 36 | 2320_ClaimLevelDenial_1 | ||||||||||||
MAP_MSTR_IK | 310 | 46 | 2320_CAS01_ClaimAdjustmentGroup_1 | ||||||||||||
MAP_MSTR_IK | 310 | 47 | 2320_CAS02_ClaimAdjustmentReason_1 | ||||||||||||
MAP_MSTR_IK | 310 | 48 | 2320_CAS03_ClaimAdjustmentAmount_1 | ||||||||||||
MAP_MSTR_IK | 310 | 141 | 2320_AMT01_AmountQualifier_1 | ||||||||||||
MAP_MSTR_IK | 310 | 142 | 2320_AMT02_COBAmount_1 | ||||||||||||
MAP_MSTR_IK | 310 | 143 | 2320_AMT01_AmountQualifier_2 | ||||||||||||
MAP_MSTR_IK | 310 | 144 | 2320_AMT02_COBAmount_2 | ||||||||||||
MAP_MSTR_IK | 310 | 145 | 2320_AMT01_AmountQualifier_3 | ||||||||||||
MAP_MSTR_IK | 310 | 146 | 2320_AMT02_COBAmount_3 | ||||||||||||
MAP_MSTR_IK | 310 | 147 | 2320_OI03_AssignBenefitsIndicator | ||||||||||||
MAP_MSTR_IK | 310 | 148 | 2320_OI04_PatientSignature | ||||||||||||
MAP_MSTR_IK | 310 | 149 | 2320_OI06_ReleaseOfInformation | ||||||||||||
MAP_MSTR_IK | 310 | 150 | 2320_MIA01_AdjudQuantity | ||||||||||||
MAP_MSTR_IK | 310 | 151 | 2320_MIA03_AdjudQuantity | ||||||||||||
MAP_MSTR_IK | 310 | 152 | 2320_MIA04_AdjudAmount | ||||||||||||
MAP_MSTR_IK | 310 | 153 | 2320_MIA05_RemarkCode | ||||||||||||
MAP_MSTR_IK | 310 | 168 | 2320_MIA20_RemarkCode | ||||||||||||
MAP_MSTR_IK | 310 | 169 | 2320_MIA21_RemarkCode | ||||||||||||
MAP_MSTR_IK | 310 | 170 | 2320_MIA22_RemarkCode | ||||||||||||
MAP_MSTR_IK | 310 | 171 | 2320_MIA23_RemarkCode | ||||||||||||
MAP_MSTR_IK | 310 | 172 | 2320_MIA24_AdjudAmount | ||||||||||||
MAP_MSTR_IK | 310 | 173 | 2320_MOA01_AdjudAmount | ||||||||||||
MAP_MSTR_IK | 310 | 174 | 2320_MOA02_AdjudAmount | ||||||||||||
MAP_MSTR_IK | 310 | 182 | 2330A_NM101_PersonRole | ||||||||||||
MAP_MSTR_IK | 310 | 183 | 2330A_NM102_PersonIndicator | ||||||||||||
MAP_MSTR_IK | 310 | 184 | 2330A_NM103_LastName | ||||||||||||
MAP_MSTR_IK | 310 | 185 | 2330A_NM104_FirstName | ||||||||||||
MAP_MSTR_IK | 310 | 186 | 2330A_NM105_MiddleName | ||||||||||||
MAP_MSTR_IK | 310 | 187 | 2330A_NM107_Suffix | ||||||||||||
MAP_MSTR_IK | 310 | 188 | 2330A_NM108_PersonIdentifierQualifier | ||||||||||||
MAP_MSTR_IK | 310 | 189 | 2330A_NM109_PersonIdentifier | ||||||||||||
MAP_MSTR_IK | 310 | 190 | 2330A_N301_AddressLine1 | ||||||||||||
MAP_MSTR_IK | 310 | 191 | 2330A_N302_AddressLine2 | ||||||||||||
MAP_MSTR_IK | 310 | 192 | 2330A_N401_City | ||||||||||||
MAP_MSTR_IK | 310 | 193 | 2330A_N402_State | ||||||||||||
MAP_MSTR_IK | 310 | 194 | 2330A_N403_PostalCode | ||||||||||||
MAP_MSTR_IK | 310 | 195 | 2330A_N404_Country | ||||||||||||
MAP_MSTR_IK | 310 | 196 | 2330B_NM101_OrganizationRole | ||||||||||||
MAP_MSTR_IK | 310 | 197 | 2330B_NM102_PersonIndicator | ||||||||||||
MAP_MSTR_IK | 310 | 198 | 2330B_NM103_Name | ||||||||||||
MAP_MSTR_IK | 310 | 199 | 2330B_NM108_OrganizationIdQualifier | ||||||||||||
MAP_MSTR_IK | 310 | 200 | 2330B_NM109_OrganizationIdentifier | ||||||||||||
MAP_MSTR_IK | 310 | 201 | 2330B_N301_AddressLine1 | ||||||||||||
MAP_MSTR_IK | 310 | 202 | 2330B_N302_AddressLine2 | ||||||||||||
MAP_MSTR_IK | 310 | 203 | 2330B_N401_City | ||||||||||||
MAP_MSTR_IK | 310 | 204 | 2330B_N402_State | ||||||||||||
MAP_MSTR_IK | 310 | 205 | 2330B_N403_PostalCode | ||||||||||||
MAP_MSTR_IK | 310 | 206 | 2330B_N404_Country | ||||||||||||
MAP_MSTR_IK | 310 | 207 | 2330B_DTP01_DateTimeQualifier | ||||||||||||
MAP_MSTR_IK | 310 | 208 | 2330B_DTP02_DateTimeFormat | ||||||||||||
MAP_MSTR_IK | 310 | 209 | 2330B_DTP03_ClaimPaidDate | ||||||||||||
MAP_MSTR_IK | 310 | 210 | 310_OverPaymentID | ||||||||||||
MAP_MSTR_IK | 310 | 211 | 2330B_REF01_OrganizationIdQualifier_1 | ||||||||||||
MAP_MSTR_IK | 310 | 212 | 2330B_REF01_OrganizationIdentifier_1 | ||||||||||||
MAP_MSTR_IK | 310 | 213 | 2330B_REF01_OrganizationIdQualifier_2 | ||||||||||||
MAP_MSTR_IK | 310 | 214 | 2330B_REF01_OrganizationIdentifier_2 | ||||||||||||
MAP_MSTR_IK | 310 | 215 | 2330B_REF01_OrganizationIdQualifier_2 | ||||||||||||
MAP_MSTR_IK | 310 | 216 | 2330B_REF01_OrganizationIdentifier_2 | ||||||||||||
MAP_MSTR_IK | 310 | 217 | 2330B_REF01_OrganizationIdQualifier_3 | ||||||||||||
MAP_MSTR_IK | 310 | 218 | 2330B_REF01_OrganizationIdentifier_3 | ||||||||||||
MAP_MSTR_IK | 310 | 219 | 2330B_REF01_OrganizationIdQualifier_3 | ||||||||||||
MAP_MSTR_IK | 310 | 220 | 2330B_REF01_OrganizationIdentifier_3 | ||||||||||||
MAP_MSTR_IK | 310 | 221 | 310_ReportBeginDate | ||||||||||||
MAP_MSTR_IK | 310 | 222 | 310_ReportEndDate | ||||||||||||
MAP_MSTR_IK | 310 | 223 | 310_PaymentYear | ||||||||||||
MAP_MSTR_IK | 310 | 224 | 2330B_REF01_AdjudicatedDRGQualifier | ||||||||||||
MAP_MSTR_IK | 310 | 225 | 2330B_REF02_AdjudicatedDRG | ||||||||||||
MAP_MSTR_IK | 310 | 226 | 2330B_REF04-01_ReferenceIdentificationQualifier | ||||||||||||
MAP_MSTR_IK | 310 | 227 | 2330B_REF04-02_DRGGrouperVersion | ||||||||||||
MAP_MSTR_IK | 310 | 228 | 310_Rate_Increase_Indicator | ||||||||||||
MAP_MSTR_IK | 310 | 229 | 310_Bundle_Indicator | ||||||||||||
MAP_MSTR_IK | 310 | 230 | 310_Bundle_Claim_Number | ||||||||||||
MAP_MSTR_IK | 310 | 231 | ClaimApprovedAmount | ||||||||||||
MAP_MSTR_IK | 310 | 232 | 310_PaymentCheckDate | ||||||||||||
MAP_MSTR_IK | 310 | 233 | 310-Filler 03 | ||||||||||||
MAP_MSTR_IK | 310 | 234 | 310-Filler 04 | ||||||||||||
MAP_MSTR_IK | 310 | 235 | 310-Filler 05 | ||||||||||||
MAP_MSTR_IK | 310 | 236 | 310-Filler 06 | ||||||||||||
MAP_MSTR_IK | 310 | 237 | 310-Filler 07 | ||||||||||||
MAP_MSTR_IK | 310 | 238 | 310-Filler 08 | ||||||||||||
MAP_MSTR_IK | 310 | 239 | 310-Filler 09 | ||||||||||||
MAP_MSTR_IK | 310 | 240 | 310-Filler 10 | ||||||||||||
MAP_MSTR_IK | 310 | 241 | 310-Filler 11 | ||||||||||||
MAP_MSTR_IK | 310 | 242 | 310-Filler 12 | ||||||||||||
MAP_MSTR_IK | 310 | 243 | 310-Filler 13 | ||||||||||||
MAP_MSTR_IK | 310 | 244 | 310-Filler 14 | ||||||||||||
MAP_MSTR_IK | 310 | 245 | 310-Filler 15 | ||||||||||||
MAP_MSTR_IK | 310 | 246 | 310_RecipientAidCategory | ||||||||||||
MAP_MSTR_IK | 310 | 247 | Other Subscriber SSN Qualifier | ||||||||||||
MAP_MSTR_IK | 310 | 248 | Other Subscriber SSN Identifier | ||||||||||||
MAP_MSTR_IK | 320 | 1 | 320 Record | ||||||||||||
MAP_MSTR_IK | 320 | 2 | 320 KEY | ||||||||||||
MAP_MSTR_IK | 320 | 3 | 2320_SBR01_PayerResponsibilitySequence | ||||||||||||
MAP_MSTR_IK | 320 | 4 | 2320_SBR02_SubscriberRelationship | ||||||||||||
MAP_MSTR_IK | 320 | 5 | 2320_SBR03_PolicyNumber | ||||||||||||
MAP_MSTR_IK | 320 | 6 | 2320_SBR04_InsuredGroupName | ||||||||||||
MAP_MSTR_IK | 320 | 7 | 2320_SBR05_InsuranceType | ||||||||||||
MAP_MSTR_IK | 320 | 8 | 2320_SBR09_ClaimFilingIndicator | ||||||||||||
MAP_MSTR_IK | 320 | 9 | 2320_ClaimLevelDenial_1 | ||||||||||||
MAP_MSTR_IK | 320 | 19 | 2320_CAS01_ClaimAdjustmentGroup_1 | ||||||||||||
MAP_MSTR_IK | 320 | 20 | 2320_CAS02_ClaimAdjustmentReason_1 | ||||||||||||
MAP_MSTR_IK | 320 | 21 | 2320_CAS03_ClaimAdjustmentAmount_1 | ||||||||||||
MAP_MSTR_IK | 320 | 22 | 2320_CAS04_ClaimAdjustmentquantity_1 | ||||||||||||
MAP_MSTR_IK | 320 | 114 | 2320_AMT01_AmountQualifier_1 | ||||||||||||
MAP_MSTR_IK | 320 | 115 | 2320_AMT02_COBAmount_1 | ||||||||||||
MAP_MSTR_IK | 320 | 116 | 2320_AMT01_AmountQualifier_2 | ||||||||||||
MAP_MSTR_IK | 320 | 117 | 2320_AMT02_COBAmount_2 | ||||||||||||
MAP_MSTR_IK | 320 | 118 | 2320_AMT01_AmountQualifier_3 | ||||||||||||
MAP_MSTR_IK | 320 | 119 | 2320_AMT02_COBAmount_3 | ||||||||||||
MAP_MSTR_IK | 320 | 120 | 2320_OI03_AssignBenefitsIndicator | ||||||||||||
MAP_MSTR_IK | 320 | 121 | 2320_OI04_PatientSignature | ||||||||||||
MAP_MSTR_IK | 320 | 122 | 2320_OI06_ReleaseOfInformation | ||||||||||||
MAP_MSTR_IK | 320 | 123 | 2320_MIA01_AdjudQuantity | ||||||||||||
MAP_MSTR_IK | 320 | 124 | 2320_MIA03_AdjudQuantity | ||||||||||||
MAP_MSTR_IK | 320 | 125 | 2320_MIA04_AdjudAmount | ||||||||||||
MAP_MSTR_IK | 320 | 126 | 2320_MIA05_RemarkCode | ||||||||||||
MAP_MSTR_IK | 320 | 146 | 2320_MOA01_AdjudAmount | ||||||||||||
MAP_MSTR_IK | 320 | 147 | 2320_MOA02_AdjudAmount | ||||||||||||
MAP_MSTR_IK | 320 | 148 | 2320_MOA03_RemarkCode | ||||||||||||
MAP_MSTR_IK | 320 | 155 | 2330A_NM101_PersonRole | ||||||||||||
MAP_MSTR_IK | 320 | 156 | 2330A_NM102_PersonIndicator | ||||||||||||
MAP_MSTR_IK | 320 | 157 | 2330A_NM103_LastName | ||||||||||||
MAP_MSTR_IK | 320 | 158 | 2330A_NM104_FirstName | ||||||||||||
MAP_MSTR_IK | 320 | 159 | 2330A_NM105_MiddleName | ||||||||||||
MAP_MSTR_IK | 320 | 160 | 2330A_NM107_Suffix | ||||||||||||
MAP_MSTR_IK | 320 | 161 | 2330A_NM108_PersonIdentifierQualifier | ||||||||||||
MAP_MSTR_IK | 320 | 162 | 2330A_NM109_PersonIdentifier | ||||||||||||
MAP_MSTR_IK | 320 | 163 | 2330A_N301_AddressLine1 | ||||||||||||
MAP_MSTR_IK | 320 | 164 | 2330A_N302_AddressLine2 | ||||||||||||
MAP_MSTR_IK | 320 | 165 | 2330A_N401_City | ||||||||||||
MAP_MSTR_IK | 320 | 166 | 2330A_N402_State | ||||||||||||
MAP_MSTR_IK | 320 | 167 | 2330A_N403_PostalCode | ||||||||||||
MAP_MSTR_IK | 320 | 168 | 2330A_N404_Country | ||||||||||||
MAP_MSTR_IK | 320 | 169 | 2330B_NM101_OrganizationRole | ||||||||||||
MAP_MSTR_IK | 320 | 170 | 2330B_NM102_PersonIndicator | ||||||||||||
MAP_MSTR_IK | 320 | 171 | 2330B_NM103_Name | ||||||||||||
MAP_MSTR_IK | 320 | 172 | 2330B_NM108_OrganizationIdQualifier | ||||||||||||
MAP_MSTR_IK | 320 | 173 | 2330B_NM109_OrganizationIdentifier | ||||||||||||
MAP_MSTR_IK | 320 | 174 | 2330B_N301_AddressLine1 | ||||||||||||
MAP_MSTR_IK | 320 | 175 | 2330B_N302_AddressLine2 | ||||||||||||
MAP_MSTR_IK | 320 | 176 | 2330B_N401_City | ||||||||||||
MAP_MSTR_IK | 320 | 177 | 2330B_N402_State | ||||||||||||
MAP_MSTR_IK | 320 | 178 | 2330B_N403_PostalCode | ||||||||||||
MAP_MSTR_IK | 320 | 179 | 2330B_N404_Country | ||||||||||||
MAP_MSTR_IK | 320 | 180 | 2330B_DTP01_DateTimeQualifier | ||||||||||||
MAP_MSTR_IK | 320 | 181 | 2330B_DTP02_DateTimeFormat | ||||||||||||
MAP_MSTR_IK | 320 | 182 | 2330B_DTP03_ClaimPaidDate | ||||||||||||
MAP_MSTR_IK | 320 | 183 | 2330B_REF01_OrganizationIdQualifier_1 | ||||||||||||
MAP_MSTR_IK | 320 | 184 | 2330B_REF01_OrganizationIdentifier_1 | ||||||||||||
MAP_MSTR_IK | 320 | 185 | 2330B_REF01_OrganizationIdQualifier_2 | ||||||||||||
MAP_MSTR_IK | 320 | 186 | 2330B_REF01_OrganizationIdentifier_2 | ||||||||||||
MAP_MSTR_IK | 320 | 187 | 2330B_REF01_OrganizationIdQualifier_2 | ||||||||||||
MAP_MSTR_IK | 320 | 188 | 2330B_REF01_OrganizationIdentifier_2 | ||||||||||||
MAP_MSTR_IK | 320 | 189 | 2330B_REF01_OrganizationIdQualifier_3 | ||||||||||||
MAP_MSTR_IK | 320 | 190 | 2330B_REF01_OrganizationIdentifier_3 | ||||||||||||
MAP_MSTR_IK | 320 | 191 | 2330B_REF01_OrganizationIdQualifier_3 | ||||||||||||
MAP_MSTR_IK | 320 | 192 | 2330B_REF01_OrganizationIdentifier_3 | ||||||||||||
MAP_MSTR_IK | 320 | 193 | ClaimApprovedAmount | ||||||||||||
MAP_MSTR_IK | 320 | 194 | 320-Filler 02 | ||||||||||||
MAP_MSTR_IK | 320 | 195 | 320-Filler 03 | ||||||||||||
MAP_MSTR_IK | 320 | 196 | 320-Filler 04 | ||||||||||||
MAP_MSTR_IK | 320 | 197 | 320-Filler 05 | ||||||||||||
MAP_MSTR_IK | 320 | 198 | 320-Filler 06 | ||||||||||||
MAP_MSTR_IK | 320 | 199 | 320-Filler 07 | ||||||||||||
MAP_MSTR_IK | 320 | 200 | 320-Filler 08 | ||||||||||||
MAP_MSTR_IK | 320 | 201 | 320-Filler 09 | ||||||||||||
MAP_MSTR_IK | 320 | 202 | 320-Filler 10 | ||||||||||||
MAP_MSTR_IK | 320 | 203 | 320-Filler 11 | ||||||||||||
MAP_MSTR_IK | 320 | 204 | 320-Filler 12 | ||||||||||||
MAP_MSTR_IK | 320 | 205 | 320-Filler 13 | ||||||||||||
MAP_MSTR_IK | 320 | 206 | 320-Filler 14 | ||||||||||||
MAP_MSTR_IK | 320 | 207 | 320-Filler 15 | ||||||||||||
MAP_MSTR_IK | 320 | 208 | Other Subscriber SSN Qualifier | ||||||||||||
MAP_MSTR_IK | 320 | 209 | Other Subscriber SSN Identifier | ||||||||||||
MAP_MSTR_IK | 330 | 1 | 330 Record | ||||||||||||
MAP_MSTR_IK | 330 | 2 | 330 KEY | ||||||||||||
MAP_MSTR_IK | 330 | 3 | 2320_SBR01_PayerResponsibilitySequence | ||||||||||||
MAP_MSTR_IK | 330 | 4 | 2320_SBR02_SubscriberRelationship | ||||||||||||
MAP_MSTR_IK | 330 | 5 | 2320_SBR03_PolicyNumber | ||||||||||||
MAP_MSTR_IK | 330 | 6 | 2320_SBR04_InsuredGroupName | ||||||||||||
MAP_MSTR_IK | 330 | 7 | 2320_SBR05_InsuranceType | ||||||||||||
MAP_MSTR_IK | 330 | 8 | 2320_SBR09_ClaimFilingIndicator | ||||||||||||
MAP_MSTR_IK | 330 | 9 | 2320_ClaimLevelDenial_1 | ||||||||||||
MAP_MSTR_IK | 330 | 19 | 2320_CAS01_ClaimAdjustmentGroup_1 | ||||||||||||
MAP_MSTR_IK | 330 | 20 | 2320_CAS02_ClaimAdjustmentReason_1 | ||||||||||||
MAP_MSTR_IK | 330 | 21 | 2320_CAS03_ClaimAdjustmentAmount_1 | ||||||||||||
MAP_MSTR_IK | 330 | 22 | 2320_CAS04_ClaimAdjustmentquantity_1 | ||||||||||||
MAP_MSTR_IK | 330 | 114 | 2320_AMT01_AmountQualifier_1 | ||||||||||||
MAP_MSTR_IK | 330 | 115 | 2320_AMT02_COBAmount_1 | ||||||||||||
MAP_MSTR_IK | 330 | 116 | 2320_AMT01_AmountQualifier_2 | ||||||||||||
MAP_MSTR_IK | 330 | 117 | 2320_AMT02_COBAmount_2 | ||||||||||||
MAP_MSTR_IK | 330 | 118 | 2320_AMT01_AmountQualifier_3 | ||||||||||||
MAP_MSTR_IK | 330 | 119 | 2320_AMT02_COBAmount_3 | ||||||||||||
MAP_MSTR_IK | 330 | 120 | 2320_OI03_AssignBenefitsIndicator | ||||||||||||
MAP_MSTR_IK | 330 | 121 | 2320_OI04_PatientSignature | ||||||||||||
MAP_MSTR_IK | 330 | 122 | 2320_OI06_ReleaseOfInformation | ||||||||||||
MAP_MSTR_IK | 330 | 123 | 2320_MIA01_AdjudQuantity | ||||||||||||
MAP_MSTR_IK | 330 | 124 | 2320_MIA03_AdjudQuantity | ||||||||||||
MAP_MSTR_IK | 330 | 125 | 2320_MIA04_AdjudAmount | ||||||||||||
MAP_MSTR_IK | 330 | 126 | 2320_MIA05_RemarkCode | ||||||||||||
MAP_MSTR_IK | 330 | 146 | 2320_MOA01_AdjudAmount | ||||||||||||
MAP_MSTR_IK | 330 | 147 | 2320_MOA02_AdjudAmount | ||||||||||||
MAP_MSTR_IK | 330 | 148 | 2320_MOA03_RemarkCode | ||||||||||||
MAP_MSTR_IK | 330 | 155 | 2330A_NM101_PersonRole | ||||||||||||
MAP_MSTR_IK | 330 | 156 | 2330A_NM102_PersonIndicator | ||||||||||||
MAP_MSTR_IK | 330 | 157 | 2330A_NM103_LastName | ||||||||||||
MAP_MSTR_IK | 330 | 158 | 2330A_NM104_FirstName | ||||||||||||
MAP_MSTR_IK | 330 | 159 | 2330A_NM105_MiddleName | ||||||||||||
MAP_MSTR_IK | 330 | 160 | 2330A_NM107_Suffix | ||||||||||||
MAP_MSTR_IK | 330 | 161 | 2330A_NM108_PersonIdentifierQualifier | ||||||||||||
MAP_MSTR_IK | 330 | 162 | 2330A_NM109_PersonIdentifier | ||||||||||||
MAP_MSTR_IK | 330 | 163 | 2330A_N301_AddressLine1 | ||||||||||||
MAP_MSTR_IK | 330 | 164 | 2330A_N302_AddressLine2 | ||||||||||||
MAP_MSTR_IK | 330 | 165 | 2330A_N401_City | ||||||||||||
MAP_MSTR_IK | 330 | 166 | 2330A_N402_State | ||||||||||||
MAP_MSTR_IK | 330 | 167 | 2330A_N403_PostalCode | ||||||||||||
MAP_MSTR_IK | 330 | 168 | 2330A_N404_Country | ||||||||||||
MAP_MSTR_IK | 330 | 169 | 2330B_NM101_OrganizationRole | ||||||||||||
MAP_MSTR_IK | 330 | 170 | 2330B_NM102_PersonIndicator | ||||||||||||
MAP_MSTR_IK | 330 | 171 | 2330B_NM103_Name | ||||||||||||
MAP_MSTR_IK | 330 | 172 | 2330B_NM108_OrganizationIdQualifier | ||||||||||||
MAP_MSTR_IK | 330 | 173 | 2330B_NM109_OrganizationIdentifier | ||||||||||||
MAP_MSTR_IK | 330 | 174 | 2330B_N301_AddressLine1 | ||||||||||||
MAP_MSTR_IK | 330 | 175 | 2330B_N302_AddressLine2 | ||||||||||||
MAP_MSTR_IK | 330 | 176 | 2330B_N401_City | ||||||||||||
MAP_MSTR_IK | 330 | 177 | 2330B_N402_State | ||||||||||||
MAP_MSTR_IK | 330 | 178 | 2330B_N403_PostalCode | ||||||||||||
MAP_MSTR_IK | 330 | 179 | 2330B_N404_Country | ||||||||||||
MAP_MSTR_IK | 330 | 180 | 2330B_DTP01_DateTimeQualifier | ||||||||||||
MAP_MSTR_IK | 330 | 181 | 2330B_DTP02_DateTimeFormat | ||||||||||||
MAP_MSTR_IK | 330 | 182 | 2330B_DTP03_ClaimPaidDate | ||||||||||||
MAP_MSTR_IK | 330 | 183 | 2330B_REF01_OrganizationIdQualifier_1 | ||||||||||||
MAP_MSTR_IK | 330 | 184 | 2330B_REF01_OrganizationIdentifier_1 | ||||||||||||
MAP_MSTR_IK | 330 | 185 | 2330B_REF01_OrganizationIdQualifier_2 | ||||||||||||
MAP_MSTR_IK | 330 | 186 | 2330B_REF01_OrganizationIdentifier_2 | ||||||||||||
MAP_MSTR_IK | 330 | 187 | 2330B_REF01_OrganizationIdQualifier_2 | ||||||||||||
MAP_MSTR_IK | 330 | 188 | 2330B_REF01_OrganizationIdentifier_2 | ||||||||||||
MAP_MSTR_IK | 330 | 189 | 2330B_REF01_OrganizationIdQualifier_3 | ||||||||||||
MAP_MSTR_IK | 330 | 190 | 2330B_REF01_OrganizationIdentifier_3 | ||||||||||||
MAP_MSTR_IK | 330 | 191 | 2330B_REF01_OrganizationIdQualifier_3 | ||||||||||||
MAP_MSTR_IK | 330 | 192 | 2330B_REF01_OrganizationIdentifier_3 | ||||||||||||
MAP_MSTR_IK | 330 | 193 | ClaimApprovedAmount | ||||||||||||
MAP_MSTR_IK | 330 | 194 | 330-Filler 02 | ||||||||||||
MAP_MSTR_IK | 330 | 195 | 330-Filler 03 | ||||||||||||
MAP_MSTR_IK | 330 | 196 | 330-Filler 04 | ||||||||||||
MAP_MSTR_IK | 330 | 197 | 330-Filler 05 | ||||||||||||
MAP_MSTR_IK | 330 | 198 | 330-Filler 06 | ||||||||||||
MAP_MSTR_IK | 330 | 199 | 330-Filler 07 | ||||||||||||
MAP_MSTR_IK | 330 | 200 | 330-Filler 08 | ||||||||||||
MAP_MSTR_IK | 330 | 201 | 330-Filler 09 | ||||||||||||
MAP_MSTR_IK | 330 | 202 | 330-Filler 10 | ||||||||||||
MAP_MSTR_IK | 330 | 203 | 330-Filler 11 | ||||||||||||
MAP_MSTR_IK | 330 | 204 | 330-Filler 12 | ||||||||||||
MAP_MSTR_IK | 330 | 205 | 330-Filler 13 | ||||||||||||
MAP_MSTR_IK | 330 | 206 | 330-Filler 14 | ||||||||||||
MAP_MSTR_IK | 330 | 207 | 330-Filler 15 | ||||||||||||
MAP_MSTR_IK | 330 | 208 | Other Subscriber SSN Qualifier | ||||||||||||
MAP_MSTR_IK | 330 | 209 | Other Subscriber SSN Identifier | ||||||||||||
MAP_MSTR_IK | 40P | 1 | 40P Record | ||||||||||||
MAP_MSTR_IK | 40P | 2 | 40P KEY | ||||||||||||
MAP_MSTR_IK | 40P | 3 | 2400P_LX01_LineCounter | ||||||||||||
MAP_MSTR_IK | 40P | 4 | 2400P_SV101-01_ServiceCodeType | ||||||||||||
MAP_MSTR_IK | 40P | 5 | 2400P_SV101-02_ServiceCode | ||||||||||||
MAP_MSTR_IK | 40P | 6 | 2400P_SV101-03_ServiceModifier1 | ||||||||||||
MAP_MSTR_IK | 40P | 7 | 2400P_SV101-04_ServiceModifier2 | ||||||||||||
MAP_MSTR_IK | 40P | 8 | 2400P_SV101-05_ServiceModifier3 | ||||||||||||
MAP_MSTR_IK | 40P | 9 | 2400P_SV101-06_ServiceModifier4 | ||||||||||||
MAP_MSTR_IK | 40P | 10 | 2400P_SV101-07_ServiceCodeDescription | ||||||||||||
MAP_MSTR_IK | 40P | 11 | 2400P_SV102_LineCharge | ||||||||||||
MAP_MSTR_IK | 40P | 12 | 2400P_SV103_ServiceUnitMeasure | ||||||||||||
MAP_MSTR_IK | 40P | 13 | 2400P_SV104_Quantity | ||||||||||||
MAP_MSTR_IK | 40P | 14 | 2400P_SV105_PlaceOfService | ||||||||||||
MAP_MSTR_IK | 40P | 15 | 2400P_SV107-01_DiagnosisPointer | ||||||||||||
MAP_MSTR_IK | 40P | 16 | 2400P_SV107-02_DiagnosisPointer | ||||||||||||
MAP_MSTR_IK | 40P | 17 | 2400P_SV107-03_DiagnosisPointer | ||||||||||||
MAP_MSTR_IK | 40P | 18 | 2400P_SV107-04_DiagnosisPointer | ||||||||||||
MAP_MSTR_IK | 40P | 19 | 2400P_SV109_EmergencyService | ||||||||||||
MAP_MSTR_IK | 40P | 20 | 2400P_SV111_EPSDTService | THIS IS SERVICE LINE - INDICATES THAT THE PATIENT WAS SEEN AS A RESULT OF AN EPSDT REFERRAL | |||||||||||
MAP_MSTR_IK | 40P | 21 | 2400P_SV112_FamilyPlanningService | ||||||||||||
MAP_MSTR_IK | 40P | 22 | 2400P_SV115_CoPayExempt | ||||||||||||
MAP_MSTR_IK | 40P | 23 | 2400P_SV501-01_ServiceCodeType | ||||||||||||
MAP_MSTR_IK | 40P | 24 | 2400P_SV501-02_ServiceCode | ||||||||||||
MAP_MSTR_IK | 40P | 25 | 2400P_SV502_ServiceUnitMeasure | ||||||||||||
MAP_MSTR_IK | 40P | 26 | 2400P_SV503_LengthMedicalNecessity | ||||||||||||
MAP_MSTR_IK | 40P | 27 | 2400P_SV504_RentalPrice | ||||||||||||
MAP_MSTR_IK | 40P | 28 | 2400P_SV505_PurchasePrice | ||||||||||||
MAP_MSTR_IK | 40P | 29 | 2400P_SV506_RentalUnitPrice | ||||||||||||
MAP_MSTR_IK | 40P | 30 | 2400P_PWK01_ReportType | ||||||||||||
MAP_MSTR_IK | 40P | 31 | 2400P_PWK02_TransmissionCode | ||||||||||||
MAP_MSTR_IK | 40P | 32 | 2400P_PWK05_CodeQualifier | ||||||||||||
MAP_MSTR_IK | 40P | 33 | 2400P_PWK06_ControlNumber | ||||||||||||
MAP_MSTR_IK | 40P | 34 | 2400P_CR101_PatientWeightQualifier | ||||||||||||
MAP_MSTR_IK | 40P | 35 | 2400P_CR102_PatientWeight | ||||||||||||
MAP_MSTR_IK | 40P | 36 | 2400P_CR104_TransportReason | ||||||||||||
MAP_MSTR_IK | 40P | 37 | 2400P_CR105_ServiceMeasureCode | ||||||||||||
MAP_MSTR_IK | 40P | 38 | 2400P_CR106_Distance | ||||||||||||
MAP_MSTR_IK | 40P | 39 | 2400P_CR109_RoundTripDesc | ||||||||||||
MAP_MSTR_IK | 40P | 40 | 2400P_CR110_StretcherPurpose | ||||||||||||
MAP_MSTR_IK | 40P | 41 | 2400P_DTP01_DateTimeQualifier_1 | ||||||||||||
MAP_MSTR_IK | 40P | 42 | 2400P_DTP02_FormatQualifier_1 | ||||||||||||
MAP_MSTR_IK | 40P | 43 | 2400P_DTP03_Date_1 | ||||||||||||
MAP_MSTR_IK | 40P | 44 | 2400P_DTP01_DateTimeQualifier_2 | ||||||||||||
MAP_MSTR_IK | 40P | 45 | 2400P_DTP02_FormatQualifier-2 | ||||||||||||
MAP_MSTR_IK | 40P | 46 | 2400P_DTP03_Date-2 | ||||||||||||
MAP_MSTR_IK | 40P | 47 | 2400P_DTP01_DateTimeQualifier_3 | ||||||||||||
MAP_MSTR_IK | 40P | 48 | 2400P_DTP02_FormatQualifier_3 | ||||||||||||
MAP_MSTR_IK | 40P | 49 | 2400P_DTP03_Date_3 | ||||||||||||
MAP_MSTR_IK | 40P | 50 | 2400P_DTP01_DateTimeQualifier_4 | ||||||||||||
MAP_MSTR_IK | 40P | 51 | 2400P_DTP02_FormatQualifier-4 | ||||||||||||
MAP_MSTR_IK | 40P | 52 | 2400P_DTP03_Date-4 | ||||||||||||
MAP_MSTR_IK | 40P | 53 | 2400P_DTP01_DateTimeQualifier_5 | ||||||||||||
MAP_MSTR_IK | 40P | 54 | 2400P_DTP02_FormatQualifier_5 | ||||||||||||
MAP_MSTR_IK | 40P | 55 | 2400P_DTP03_Date_5 | ||||||||||||
MAP_MSTR_IK | 40P | 56 | 2400P_DTP01_DateTimeQualifier_6 | ||||||||||||
MAP_MSTR_IK | 40P | 57 | 2400P_DTP02_FormatQualifier-6 | ||||||||||||
MAP_MSTR_IK | 40P | 58 | 2400P_DTP03_Date-6 | ||||||||||||
MAP_MSTR_IK | 40P | 59 | 2400P_DTP01_DateTimeQualifier_7 | ||||||||||||
MAP_MSTR_IK | 40P | 60 | 2400P_DTP02_FormatQualifier_7 | ||||||||||||
MAP_MSTR_IK | 40P | 61 | 2400P_DTP03_Date_7 | ||||||||||||
MAP_MSTR_IK | 40P | 62 | 2400P_DTP01_DateTimeQualifier_8 | ||||||||||||
MAP_MSTR_IK | 40P | 63 | 2400P_DTP02_FormatQualifier-8 | ||||||||||||
MAP_MSTR_IK | 40P | 64 | 2400P_DTP03_Date-8 | ||||||||||||
MAP_MSTR_IK | 40P | 65 | 2400P_DTP01_DateTimeQualifier_9 | ||||||||||||
MAP_MSTR_IK | 40P | 66 | 2400P_DTP02_FormatQualifier-9 | ||||||||||||
MAP_MSTR_IK | 40P | 67 | 2400P_DTP03_Date-9 | ||||||||||||
MAP_MSTR_IK | 40P | 68 | 2400P_DTP01_DateTimeQualifier_10 | ||||||||||||
MAP_MSTR_IK | 40P | 69 | 2400P_DTP02_FormatQualifier_10 | ||||||||||||
MAP_MSTR_IK | 40P | 70 | 2400P_DTP03_Date_10 | ||||||||||||
MAP_MSTR_IK | 40P | 71 | 2400P_DTP01_DateTimeQualifier_11 | ||||||||||||
MAP_MSTR_IK | 40P | 72 | 2400P_DTP02_FormatQualifier-11 | ||||||||||||
MAP_MSTR_IK | 40P | 73 | 2400P_DTP03_Date-11 | ||||||||||||
MAP_MSTR_IK | 40P | 74 | 2400P_QTY01_QuantityQuakiferID_1 | ||||||||||||
MAP_MSTR_IK | 40P | 75 | 2400P_QTY02_Quantity_1 | ||||||||||||
MAP_MSTR_IK | 40P | 76 | 2400P_QTY01_QuantityQualiferID_2 | ||||||||||||
MAP_MSTR_IK | 40P | 77 | 2400P_QTY02_Quantity_2 | ||||||||||||
MAP_MSTR_IK | 40P | 78 | 2400P_MEA01_MeasurementIdentifierCode_1 | ||||||||||||
MAP_MSTR_IK | 40P | 79 | 2400P_MEA02_MeasurementQualifier_1 | ||||||||||||
MAP_MSTR_IK | 40P | 80 | 2400P_MEA03_MeasurementValue_1 | ||||||||||||
MAP_MSTR_IK | 40P | 81 | 2400P_MEA01_MeasurementIdentifierCode_2 | ||||||||||||
MAP_MSTR_IK | 40P | 82 | 2400P_MEA02_MeasurementQualifier_2 | ||||||||||||
MAP_MSTR_IK | 40P | 83 | 2400P_MEA03_MeasurementValue_2 | ||||||||||||
MAP_MSTR_IK | 40P | 84 | 2400P_MEA01_MeasurementIdentifierCode_3 | ||||||||||||
MAP_MSTR_IK | 40P | 85 | 2400P_MEA02_MeasurementQualifier_3 | ||||||||||||
MAP_MSTR_IK | 40P | 86 | 2400P_MEA03_MeasurementValue_3 | ||||||||||||
MAP_MSTR_IK | 40P | 87 | 2400P_MEA01_MeasurementIdentifierCode_4 | ||||||||||||
MAP_MSTR_IK | 40P | 88 | 2400P_MEA02_MeasurementQualifier_4 | ||||||||||||
MAP_MSTR_IK | 40P | 89 | 2400P_MEA03_MeasurementValue_4 | ||||||||||||
MAP_MSTR_IK | 40P | 90 | 2400P_MEA01_MeasurementIdentifierCode_5 | ||||||||||||
MAP_MSTR_IK | 40P | 91 | 2400P_MEA02_MeasurementQualifier_5 | ||||||||||||
MAP_MSTR_IK | 40P | 92 | 2400P_MEA03_MeasurementValue_5 | ||||||||||||
MAP_MSTR_IK | 40P | 93 | 2400P_CN101_ContractType | ||||||||||||
MAP_MSTR_IK | 40P | 94 | 2400P_CN102_ContractAmount | ||||||||||||
MAP_MSTR_IK | 40P | 95 | 2400P_CN103_ContractPercentage | ||||||||||||
MAP_MSTR_IK | 40P | 96 | 2400P_CN104_ContractCode | ||||||||||||
MAP_MSTR_IK | 40P | 97 | 2400P_CN105_TermsDiscountPercent | ||||||||||||
MAP_MSTR_IK | 40P | 98 | 2400P_CN106_ContractVersionIdentifier | ||||||||||||
MAP_MSTR_IK | 40P | 99 | 2400P_REF01_ServiceRefNumberQualifier_1 | ||||||||||||
MAP_MSTR_IK | 40P | 100 | 2400P_REF02_ServiceRefNumber_1 | ||||||||||||
MAP_MSTR_IK | 40P | 101 | 2400P_REF01_ServiceRefNumberQualifier_2 | ||||||||||||
MAP_MSTR_IK | 40P | 102 | 2400P_REF02_ServiceRefNumber_2 | ||||||||||||
MAP_MSTR_IK | 40P | 103 | 2400P_REF01_ServiceRefNumberQualifier_3 | ||||||||||||
MAP_MSTR_IK | 40P | 104 | 2400P_REF02_ServiceRefNumber_3 | ||||||||||||
MAP_MSTR_IK | 40P | 105 | 2400P_REF01_ServiceRefNumberQualifier_4 | ||||||||||||
MAP_MSTR_IK | 40P | 106 | 2400P_REF02_ServiceRefNumber_4 | ||||||||||||
MAP_MSTR_IK | 40P | 107 | 2400P_REF01_ServiceRefNumberQualifier_5 | ||||||||||||
MAP_MSTR_IK | 40P | 108 | 2400P_REF02_ServiceRefNumber_5 | ||||||||||||
MAP_MSTR_IK | 40P | 109 | 2400P_REF01_ServiceRefNumberQualifier_6 | ||||||||||||
MAP_MSTR_IK | 40P | 110 | 2400P_REF02_ServiceRefNumber_6 | ||||||||||||
MAP_MSTR_IK | 40P | 111 | 2400P_REF01_ServiceRefNumberQualifier_7 | ||||||||||||
MAP_MSTR_IK | 40P | 112 | 2400P_REF02_ServiceRefNumber_7 | ||||||||||||
MAP_MSTR_IK | 40P | 113 | 2400P_REF01_ServiceRefNumberQualifier_8 | ||||||||||||
MAP_MSTR_IK | 40P | 114 | 2400P_REF02_ServiceRefNumber_8 | ||||||||||||
MAP_MSTR_IK | 40P | 115 | 2400P_REF04-01_AssignedByQualifier_8 | ||||||||||||
MAP_MSTR_IK | 40P | 116 | 2400P_REF04-02_AssignedBy_8 | ||||||||||||
MAP_MSTR_IK | 40P | 117 | 2400P_REF01_ServiceRefNumberQualifier_9 | ||||||||||||
MAP_MSTR_IK | 40P | 118 | 2400P_REF02_ServiceRefNumber_9 | ||||||||||||
MAP_MSTR_IK | 40P | 119 | 2400P_REF04-01_AssignedByQualifier_9 | ||||||||||||
MAP_MSTR_IK | 40P | 120 | 2400P_REF04-02_AssignedBy_9 | ||||||||||||
MAP_MSTR_IK | 40P | 121 | 2400P_AMT01_AmountQualfier_1 | ||||||||||||
MAP_MSTR_IK | 40P | 122 | 2400P_AMT02_Amount_1 | ||||||||||||
MAP_MSTR_IK | 40P | 123 | 2400P_AMT01_AmountQualfier_2 | ||||||||||||
MAP_MSTR_IK | 40P | 124 | 2400P_AMT02_Amount_2 | ||||||||||||
MAP_MSTR_IK | 40P | 125 | 2400P_K301_FixedFormatInformation_1 | ||||||||||||
MAP_MSTR_IK | 40P | 126 | 2400P_K301_FixedFormatInformation_2 | ||||||||||||
MAP_MSTR_IK | 40P | 127 | 2400P_K301_FixedFormatInformation_3 | ||||||||||||
MAP_MSTR_IK | 40P | 128 | 2400P_K301_FixedFormatInformation_4 | ||||||||||||
MAP_MSTR_IK | 40P | 129 | 2400P_K301_FixedFormatInformation_5 | ||||||||||||
MAP_MSTR_IK | 40P | 130 | 2400P_K301_FixedFormatInformation_6 | ||||||||||||
MAP_MSTR_IK | 40P | 131 | 2400P_K301_FixedFormatInformation_7 | ||||||||||||
MAP_MSTR_IK | 40P | 132 | 2400P_K301_FixedFormatInformation_8 | ||||||||||||
MAP_MSTR_IK | 40P | 133 | 2400P_K301_FixedFormatInformation_9 | ||||||||||||
MAP_MSTR_IK | 40P | 134 | 2400P_K301_FixedFormatInformation_10 | ||||||||||||
MAP_MSTR_IK | 40P | 135 | 2400P_NTE01_NoteType_1 | ||||||||||||
MAP_MSTR_IK | 40P | 136 | 2400P_NTE02_Note_1 | ||||||||||||
MAP_MSTR_IK | 40P | 137 | 2400P_NTE01_NoteType_2 | ||||||||||||
MAP_MSTR_IK | 40P | 138 | 2400P_NTE02_Note_2 | ||||||||||||
MAP_MSTR_IK | 40P | 139 | 2400P_HCP01_PricingMethod | ||||||||||||
MAP_MSTR_IK | 40P | 140 | 2400P_HCP02_RepricedAllowedAmt | ||||||||||||
MAP_MSTR_IK | 40P | 141 | 2400P_HCP03_RepricedSavingAmt | ||||||||||||
MAP_MSTR_IK | 40P | 142 | 2400P_HCP04_RepricingOrdID | ||||||||||||
MAP_MSTR_IK | 40P | 143 | 2400P_HCP05_PricingRange | ||||||||||||
MAP_MSTR_IK | 40P | 144 | 2400P_HCP06_APGPricingCode | ||||||||||||
MAP_MSTR_IK | 40P | 145 | 2400P_HCP07_APGPricingAmt | ||||||||||||
MAP_MSTR_IK | 40P | 146 | 2400P_HCP09_ServiceType | ||||||||||||
MAP_MSTR_IK | 40P | 147 | 2400P_HCP10_ApprovedServiceCode | ||||||||||||
MAP_MSTR_IK | 40P | 148 | 2400P_HCP11_RepricingUnits | ||||||||||||
MAP_MSTR_IK | 40P | 149 | 2400P_HCP12_RepricingQuantity | ||||||||||||
MAP_MSTR_IK | 40P | 150 | 2400P_HCP13_RejectReasonCode | ||||||||||||
MAP_MSTR_IK | 40P | 151 | 2400P_HCP14_PolicyComplianceCode | ||||||||||||
MAP_MSTR_IK | 40P | 152 | 2400P_HCP15_ExceptionCode | ||||||||||||
MAP_MSTR_IK | 40P | 153 | 2410P_LIN02_DrugCodeType | ||||||||||||
MAP_MSTR_IK | 40P | 154 | 2410P_LIN03_NationalDrugCode | ||||||||||||
MAP_MSTR_IK | 40P | 155 | 2410P_CTP04_Quantity | ||||||||||||
MAP_MSTR_IK | 40P | 156 | 2410P_CTP05-01_Units | ||||||||||||
MAP_MSTR_IK | 40P | 157 | 2410P_REF01_ReferenceIDQualifier | ||||||||||||
MAP_MSTR_IK | 40P | 158 | 2410P_REF02_ReferenceIdentifier | ||||||||||||
MAP_MSTR_IK | 40P | 159 | 2420GP_NM101_ProviderRole | ||||||||||||
MAP_MSTR_IK | 40P | 160 | 2420GP_NM102_PersonIndicator | ||||||||||||
MAP_MSTR_IK | 40P | 161 | 2420GP_N301_AddressLine1 | ||||||||||||
MAP_MSTR_IK | 40P | 162 | 2420GP_N302_AddressLine2 | ||||||||||||
MAP_MSTR_IK | 40P | 163 | 2420GP_N401_City | ||||||||||||
MAP_MSTR_IK | 40P | 164 | 2420GP_N402_State | ||||||||||||
MAP_MSTR_IK | 40P | 165 | 2420GP_N403_PostalCode | ||||||||||||
MAP_MSTR_IK | 40P | 166 | 2420GP_N404_Country | ||||||||||||
MAP_MSTR_IK | 40P | 167 | 2420HP_NM101_ProviderRole | ||||||||||||
MAP_MSTR_IK | 40P | 168 | 2420HP_NM102_PersonIndicator | ||||||||||||
MAP_MSTR_IK | 40P | 169 | 2420HP_NM103_ORG_LastName | ||||||||||||
MAP_MSTR_IK | 40P | 170 | 2420HP_N301_AddressLine1 | ||||||||||||
MAP_MSTR_IK | 40P | 171 | 2420HP_N302_AddressLine2 | ||||||||||||
MAP_MSTR_IK | 40P | 172 | 2420HP_N401_City | ||||||||||||
MAP_MSTR_IK | 40P | 173 | 2420HP_N402_State | ||||||||||||
MAP_MSTR_IK | 40P | 174 | 2420HP_N403_PostalCode | ||||||||||||
MAP_MSTR_IK | 40P | 175 | 2420HP_N404_Country | ||||||||||||
MAP_MSTR_IK | 40P | 176 | 2400P_PWK02_DMEAttachmentTransmissionCode | ||||||||||||
MAP_MSTR_IK | 40P | 177 | 2400P_CR301_CertificationTypeCode | ||||||||||||
MAP_MSTR_IK | 40P | 178 | 2400P_CR303_DurableMedicalEquipmentDuration | ||||||||||||
MAP_MSTR_IK | 40P | 179 | 2400P_CRC02_CertificationConditionIndicator | ||||||||||||
MAP_MSTR_IK | 40P | 180 | 2400P_CRC03_ConditionCode | ||||||||||||
MAP_MSTR_IK | 40P | 181 | 2400P_CRC04_ConditionCode | ||||||||||||
MAP_MSTR_IK | 40P | 182 | 2400P_CRC05_ConditionCode | ||||||||||||
MAP_MSTR_IK | 40P | 183 | 2400P_CRC06_ConditionCode | ||||||||||||
MAP_MSTR_IK | 40P | 184 | 2400P_CRC07_ConditionCode | ||||||||||||
MAP_MSTR_IK | 40P | 185 | 2400P_REF01_RepricedLineItemReferenceQualifier | ||||||||||||
MAP_MSTR_IK | 40P | 186 | 2400P_REF02_RepricedLineItemReferenceNumber | ||||||||||||
MAP_MSTR_IK | 40P | 187 | 2400P_PS101_PurchasedSerivceProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 40P | 188 | 2400P_PS102_PurchasedServiceChargeAmount | ||||||||||||
MAP_MSTR_IK | 40P | 189 | 40P-Filler 01 | ||||||||||||
MAP_MSTR_IK | 40P | 190 | 40P-Filler 02 | ||||||||||||
MAP_MSTR_IK | 40P | 191 | 40P-Filler 03 | ||||||||||||
MAP_MSTR_IK | 40P | 192 | 40P-Filler 04 | ||||||||||||
MAP_MSTR_IK | 40P | 193 | 40P-Filler 05 | ||||||||||||
MAP_MSTR_IK | 40P | 194 | 2420AP_NM101_ProviderRole | ||||||||||||
MAP_MSTR_IK | 40P | 195 | 2420AP_NM102_PersonIndicator | ||||||||||||
MAP_MSTR_IK | 40P | 196 | 2420AP_NM103_LastName | ||||||||||||
MAP_MSTR_IK | 40P | 197 | 2420AP_NM104_FirstName | ||||||||||||
MAP_MSTR_IK | 40P | 198 | 2420AP_NM105_MiddleName | ||||||||||||
MAP_MSTR_IK | 40P | 199 | 2420AP_NM107_Suffix | ||||||||||||
MAP_MSTR_IK | 40P | 200 | 2420AP_NM108_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 40P | 201 | 2420AP_NM109_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 40P | 202 | 2420AP_PRV03_ProviderTaxonomy | ||||||||||||
MAP_MSTR_IK | 40P | 203 | 2420AP_REF01_ProviderIdentifierQualifer_1 | ||||||||||||
MAP_MSTR_IK | 40P | 204 | 2420AP_REF02_ProviderIdentifier_1 | ||||||||||||
MAP_MSTR_IK | 40P | 205 | 2420AP_REF01_ProviderIdentifierQualifer_2 | ||||||||||||
MAP_MSTR_IK | 40P | 206 | 2420AP_REF02_ProviderIdentifier_2 | ||||||||||||
MAP_MSTR_IK | 40P | 207 | 2420AP_REF01_ProviderIdentifierQualifer_3 | ||||||||||||
MAP_MSTR_IK | 40P | 208 | 2420AP_REF02_ProviderIdentifier_3 | ||||||||||||
MAP_MSTR_IK | 40P | 209 | 2420BP_NM101_ProviderRole | ||||||||||||
MAP_MSTR_IK | 40P | 210 | 2420BP_NM102_PersonIndicator | ||||||||||||
MAP_MSTR_IK | 40P | 211 | 2420BP_NM108_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 40P | 212 | 2420BP_NM109_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 40P | 213 | 2420BP_REF01_ProviderIdentifierQualifer_1 | ||||||||||||
MAP_MSTR_IK | 40P | 214 | 2420BP_REF02_ProviderIdentifier_1 | ||||||||||||
MAP_MSTR_IK | 40P | 215 | 2420BP_REF01_ProviderIdentifierQualifer_2 | ||||||||||||
MAP_MSTR_IK | 40P | 216 | 2420BP_REF02_ProviderIdentifier_2 | ||||||||||||
MAP_MSTR_IK | 40P | 217 | 2420CP_NM101_ProviderRole | ||||||||||||
MAP_MSTR_IK | 40P | 218 | 2420CP_NM102_PersonIndicator | ||||||||||||
MAP_MSTR_IK | 40P | 219 | 2420CP_NM103_LastName | ||||||||||||
MAP_MSTR_IK | 40P | 220 | 2420CP_NM108_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 40P | 221 | 2420CP_NM109_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 40P | 222 | 2420CP_N301_AddressLine1 | ||||||||||||
MAP_MSTR_IK | 40P | 223 | 2420CP_N302_AddressLine2 | ||||||||||||
MAP_MSTR_IK | 40P | 224 | 2420CP_N401_City | ||||||||||||
MAP_MSTR_IK | 40P | 225 | 2420CP_N402_State | ||||||||||||
MAP_MSTR_IK | 40P | 226 | 2420CP_N403_PostalCode | ||||||||||||
MAP_MSTR_IK | 40P | 227 | 2420CP_N404_Country | ||||||||||||
MAP_MSTR_IK | 40P | 228 | 2420CP_REF01_ProviderIdentifierQualifer_1 | ||||||||||||
MAP_MSTR_IK | 40P | 229 | 2420CP_REF02_ProviderIdentifier_1 | ||||||||||||
MAP_MSTR_IK | 40P | 230 | 2420CP_REF01_ProviderIdentifierQualifer_2 | ||||||||||||
MAP_MSTR_IK | 40P | 231 | 2420CP_REF02_ProviderIdentifier_2 | ||||||||||||
MAP_MSTR_IK | 40P | 232 | 2420DP_NM101_ProviderRole | ||||||||||||
MAP_MSTR_IK | 40P | 233 | 2420DP_NM102_PersonIndicator | ||||||||||||
MAP_MSTR_IK | 40P | 234 | 2420DP_NM103_LastName | ||||||||||||
MAP_MSTR_IK | 40P | 235 | 2420DP_NM104_FirstName | ||||||||||||
MAP_MSTR_IK | 40P | 236 | 2420DP_NM105_MiddleName | ||||||||||||
MAP_MSTR_IK | 40P | 237 | 2420DP_NM107_Suffix | ||||||||||||
MAP_MSTR_IK | 40P | 238 | 2420DP_NM108_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 40P | 239 | 2420DP_NM109_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 40P | 240 | 2420DP_REF01_ProviderIdentifierQualifer_1 | ||||||||||||
MAP_MSTR_IK | 40P | 241 | 2420DP_REF02_ProviderIdentifier_1 | ||||||||||||
MAP_MSTR_IK | 40P | 242 | 2420DP_REF01_ProviderIdentifierQualifer_2 | ||||||||||||
MAP_MSTR_IK | 40P | 243 | 2420DP_REF02_ProviderIdentifier_2 | ||||||||||||
MAP_MSTR_IK | 40P | 244 | 2420DP_REF01_ProviderIdentifierQualifer_3 | ||||||||||||
MAP_MSTR_IK | 40P | 245 | 2420DP_REF02_ProviderIdentifier_3 | ||||||||||||
MAP_MSTR_IK | 40P | 246 | 2420EP_NM101_ProviderRole | ||||||||||||
MAP_MSTR_IK | 40P | 247 | 2420EP_NM102_PersonIndicator | ||||||||||||
MAP_MSTR_IK | 40P | 248 | 2420EP_NM103_LastName | ||||||||||||
MAP_MSTR_IK | 40P | 249 | 2420EP_NM104_FirstName | ||||||||||||
MAP_MSTR_IK | 40P | 250 | 2420EP_NM105_MiddleName | ||||||||||||
MAP_MSTR_IK | 40P | 251 | 2420EP_NM107_Suffix | ||||||||||||
MAP_MSTR_IK | 40P | 252 | 2420EP_NM108_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 40P | 253 | 2420EP_NM109_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 40P | 254 | 2420EP_N301_AddressLine1 | ||||||||||||
MAP_MSTR_IK | 40P | 255 | 2420EP_N302_AddressLine2 | ||||||||||||
MAP_MSTR_IK | 40P | 256 | 2420EP_N401_City | ||||||||||||
MAP_MSTR_IK | 40P | 257 | 2420EP_N402_State | ||||||||||||
MAP_MSTR_IK | 40P | 258 | 2420EP_N403_PostalCode | ||||||||||||
MAP_MSTR_IK | 40P | 259 | 2420EP_N404_Country | ||||||||||||
MAP_MSTR_IK | 40P | 260 | 2420EP_REF01_ProviderIdentifierQualifer_1 | ||||||||||||
MAP_MSTR_IK | 40P | 261 | 2420EP_REF02_ProviderIdentifier_1 | ||||||||||||
MAP_MSTR_IK | 40P | 262 | 2420EP_REF01_ProviderIdentifierQualifer_2 | ||||||||||||
MAP_MSTR_IK | 40P | 263 | 2420EP_REF02_ProviderIdentifier_2 | ||||||||||||
MAP_MSTR_IK | 40P | 264 | 2420FP_NM101_ProviderRole | ||||||||||||
MAP_MSTR_IK | 40P | 265 | 2420FP_NM102_PersonIndicator | ||||||||||||
MAP_MSTR_IK | 40P | 266 | 2420FP_NM103_LastName | ||||||||||||
MAP_MSTR_IK | 40P | 267 | 2420FP_NM104_FirstName | ||||||||||||
MAP_MSTR_IK | 40P | 268 | 2420FP_NM105_MiddleName | ||||||||||||
MAP_MSTR_IK | 40P | 269 | 2420FP_NM107_Suffix | ||||||||||||
MAP_MSTR_IK | 40P | 270 | 2420FP_NM108_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 40P | 271 | 2420FP_NM109_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 40P | 272 | 2420FP_REF01_ProviderIdentifierQualifer_1 | ||||||||||||
MAP_MSTR_IK | 40P | 273 | 2420FP_REF02_ProviderIdentifier_1 | ||||||||||||
MAP_MSTR_IK | 40P | 274 | 2420FP_REF01_ProviderIdentifierQualifer_2 | ||||||||||||
MAP_MSTR_IK | 40P | 275 | 2420FP_REF02_ProviderIdentifier_2 | ||||||||||||
MAP_MSTR_IK | 40P | 276 | InNetworkIndicator | ||||||||||||
MAP_MSTR_IK | 40P | 277 | ServiceLineContractID | ||||||||||||
MAP_MSTR_IK | 40P | 278 | TPLPaidAmount | ||||||||||||
MAP_MSTR_IK | 40P | 279 | AmbulancePickUpTime | ||||||||||||
MAP_MSTR_IK | 40P | 280 | AmbulanceDropOffTime | ||||||||||||
MAP_MSTR_IK | 40P | 281 | AmbulancePickUpLoc | ||||||||||||
MAP_MSTR_IK | 40P | 282 | AmbulanceDropOffLoc | ||||||||||||
MAP_MSTR_IK | 40P | 283 | AmbulanceTripType | ||||||||||||
MAP_MSTR_IK | 40P | 284 | AmbulanceTripLeg | ||||||||||||
MAP_MSTR_IK | 40P | 285 | 40P-Filler 15 | ||||||||||||
MAP_MSTR_IK | 40P | 286 | ServiceHealthPlan | ||||||||||||
MAP_MSTR_IK | 40P | 287 | ServiceBenefitPlan | ||||||||||||
MAP_MSTR_IK | 40P | 288 | ServiceAdministrativeCounty | ||||||||||||
MAP_MSTR_IK | 40P | 289 | ServiceResidenceCounty | ||||||||||||
MAP_MSTR_IK | 40P | 290 | ServiceEligibilityCode | ||||||||||||
MAP_MSTR_IK | 40P | 291 | ServiceSubProgram1 | ||||||||||||
MAP_MSTR_IK | 40P | 292 | ServiceSubProgram2 | ||||||||||||
MAP_MSTR_IK | 40P | 293 | ServiceSubProgram3 | ||||||||||||
MAP_MSTR_IK | 40P | 294 | ServiceSubProgram4 | ||||||||||||
MAP_MSTR_IK | 40P | 295 | ServiceArrangementCode | ||||||||||||
MAP_MSTR_IK | 40P | 296 | ServiceTribalCode | ||||||||||||
MAP_MSTR_IK | 40P | 297 | CategoryOfService | ||||||||||||
MAP_MSTR_IK | 40P | 298 | RenderingProviderSpeciality | ||||||||||||
MAP_MSTR_IK | 40P | 299 | PurchasedIndicator | ||||||||||||
MAP_MSTR_IK | 40P | 300 | BH_ESPDTIndicator | ||||||||||||
MAP_MSTR_IK | 40P | 301 | MPIServiceLocation | ||||||||||||
MAP_MSTR_IK | 40P | 302 | EBPPCode01 | ||||||||||||
MAP_MSTR_IK | 40P | 303 | EBPPCode02 | ||||||||||||
MAP_MSTR_IK | 40P | 304 | EBPPCode03 | ||||||||||||
MAP_MSTR_IK | 40P | 305 | EBPPCode04 | ||||||||||||
MAP_MSTR_IK | 40P | 306 | EBPPCode05 | ||||||||||||
MAP_MSTR_IK | 40P | 307 | Ordering Provider Location Code | ||||||||||||
MAP_MSTR_IK | 40P | 308 | MediaType | ||||||||||||
MAP_MSTR_IK | 40P | 309 | Beneficiary Cost Sharing Status | ||||||||||||
MAP_MSTR_IK | 40P | 310 | Out of Pocket Maximum | ||||||||||||
MAP_MSTR_IK | 40P | 311 | Beneficiary Lock-In Status | ||||||||||||
MAP_MSTR_IK | 40P | 312 | Type of transportation used | ||||||||||||
MAP_MSTR_IK | 40P | 313 | Appointment time | ||||||||||||
MAP_MSTR_IK | 40P | 314 | What time did driver arrive | ||||||||||||
MAP_MSTR_IK | 40P | 315 | What time did driver and beneficiary leave | ||||||||||||
MAP_MSTR_IK | 40I | 1 | 40I Record | ||||||||||||
MAP_MSTR_IK | 40I | 2 | 40I KEY | ||||||||||||
MAP_MSTR_IK | 40I | 3 | 2400I_LX01_LineCounter | ||||||||||||
MAP_MSTR_IK | 40I | 4 | 2400I_SV201_RevenueCode | ||||||||||||
MAP_MSTR_IK | 40I | 5 | 2400I_SV202-01_ServiceCodeType | ||||||||||||
MAP_MSTR_IK | 40I | 6 | 2400I_SV202-02_ServiceCode | ||||||||||||
MAP_MSTR_IK | 40I | 7 | 2400I_SV202-03_ServiceModifier1 | ||||||||||||
MAP_MSTR_IK | 40I | 8 | 2400I_SV202-04_ServiceModifier2 | ||||||||||||
MAP_MSTR_IK | 40I | 9 | 2400I_SV202-05_ServiceModifier3 | ||||||||||||
MAP_MSTR_IK | 40I | 10 | 2400I_SV202-06_ServiceModifier4 | ||||||||||||
MAP_MSTR_IK | 40I | 11 | 2400I_SV202-07_ServiceCodeDescription | ||||||||||||
MAP_MSTR_IK | 40I | 12 | 2400I_SV203_LineCharge | ||||||||||||
MAP_MSTR_IK | 40I | 13 | 2400I_SV204_ServiceUnitMeasure | ||||||||||||
MAP_MSTR_IK | 40I | 14 | 2400I_SV205_Quantity | ||||||||||||
MAP_MSTR_IK | 40I | 15 | 2400I_SV207_NonCoveredCharge | ||||||||||||
MAP_MSTR_IK | 40I | 16 | 2400I_PWK01_ReportType | ||||||||||||
MAP_MSTR_IK | 40I | 17 | 2400I_PWK02_TransmissionCode | ||||||||||||
MAP_MSTR_IK | 40I | 18 | 2400I_PWK05_CodeQualifier | ||||||||||||
MAP_MSTR_IK | 40I | 19 | 2400I_PWK06_ControlNumber | ||||||||||||
MAP_MSTR_IK | 40I | 20 | 2400I_DTP01_DateTimeQualifier | ||||||||||||
MAP_MSTR_IK | 40I | 21 | 2400I_DTP02_FormatQualifier | ||||||||||||
MAP_MSTR_IK | 40I | 22 | 2400I_DTP03_Date | ||||||||||||
MAP_MSTR_IK | 40I | 23 | 2400I_REF01_ServiceRefNumberQualifier | ||||||||||||
MAP_MSTR_IK | 40I | 24 | 2400I_REF02_ServiceRefNumber | ||||||||||||
MAP_MSTR_IK | 40I | 25 | 2410I_LIN02_DrugCodeType | ||||||||||||
MAP_MSTR_IK | 40I | 26 | 2410I_LIN03_NationalDrugCode | ||||||||||||
MAP_MSTR_IK | 40I | 27 | 2410I_CTP04_Quantity | ||||||||||||
MAP_MSTR_IK | 40I | 28 | 2410I_CTP05-01_Units | ||||||||||||
MAP_MSTR_IK | 40I | 29 | 2410I_REF01_ReferenceIDQualifier | ||||||||||||
MAP_MSTR_IK | 40I | 30 | 2410I_REF02_ReferenceIdentifier | ||||||||||||
MAP_MSTR_IK | 40I | 31 | 2400I_REF01_RepricedLineItemReference_Qualifier | ||||||||||||
MAP_MSTR_IK | 40I | 32 | 2400I_REF02_RepricedLineItemReferenceNumber | ||||||||||||
MAP_MSTR_IK | 40I | 33 | 2400I_REF01_AdjustedRepricedLineItemReference_Qualifier | ||||||||||||
MAP_MSTR_IK | 40I | 34 | 2400I_REF02_AdjustedRepricedLineItemReferenceNumber | ||||||||||||
MAP_MSTR_IK | 40I | 35 | 2400I_HCP01_PricingMethodology | ||||||||||||
MAP_MSTR_IK | 40I | 36 | 2400I_HCP02_RepricedAllowedAmt | ||||||||||||
MAP_MSTR_IK | 40I | 37 | 2400I_HCP03_RepricedSavingAmt | ||||||||||||
MAP_MSTR_IK | 40I | 38 | 2400I_HCP04_RepricingOrganziationIdentifier | ||||||||||||
MAP_MSTR_IK | 40I | 39 | 2400I_HCP05_RepricingPerDiem | ||||||||||||
MAP_MSTR_IK | 40I | 40 | 2400I_HCP06_APGPricingCode | ||||||||||||
MAP_MSTR_IK | 40I | 41 | 2400I_HCP07_APGPricingAmt | ||||||||||||
MAP_MSTR_IK | 40I | 42 | 2400I_HCP09_ServiceType | ||||||||||||
MAP_MSTR_IK | 40I | 43 | 2400I_HCP10_ApprovedServiceCode | ||||||||||||
MAP_MSTR_IK | 40I | 44 | 2400I_HCP11_RepricingUnits | ||||||||||||
MAP_MSTR_IK | 40I | 45 | 2400I_HCP12_RepricingQuantity | ||||||||||||
MAP_MSTR_IK | 40I | 46 | 2400I_HCP13_RejectReasonCode | ||||||||||||
MAP_MSTR_IK | 40I | 47 | 2400I_HCP14_PolicyComplianceCode | ||||||||||||
MAP_MSTR_IK | 40I | 48 | 2400I_HCP15_ExceptionCode | ||||||||||||
MAP_MSTR_IK | 40I | 49 | 2410I_REF01_ReferenceIDQualifier_2 | ||||||||||||
MAP_MSTR_IK | 40I | 50 | 2410I_REF02_ReferenceIdentifier_2 | ||||||||||||
MAP_MSTR_IK | 40I | 51 | 40-IFiller 01 | ||||||||||||
MAP_MSTR_IK | 40I | 52 | 40I-Filler 02 | ||||||||||||
MAP_MSTR_IK | 40I | 53 | 40I-Filler 03 | ||||||||||||
MAP_MSTR_IK | 40I | 54 | 40I-Filler 04 | ||||||||||||
MAP_MSTR_IK | 40I | 55 | 40I-Filler 05 | ||||||||||||
MAP_MSTR_IK | 40I | 56 | 2420AI_NM101_ProviderRole | ||||||||||||
MAP_MSTR_IK | 40I | 57 | 2420AI_NM102_PersonIndicator | ||||||||||||
MAP_MSTR_IK | 40I | 58 | 2420AI_NM103_LastName | ||||||||||||
MAP_MSTR_IK | 40I | 59 | 2420AI_NM104_FirstName | ||||||||||||
MAP_MSTR_IK | 40I | 60 | 2420AI_NM105_MiddleName | ||||||||||||
MAP_MSTR_IK | 40I | 61 | 2420AI_NM107_Suffix | ||||||||||||
MAP_MSTR_IK | 40I | 62 | 2420AI_NM108_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 40I | 63 | 2420AI_NM109_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 40I | 64 | 2420AI_REF01_ProviderIdentifierQualifer_1 | ||||||||||||
MAP_MSTR_IK | 40I | 65 | 2420AI_REF02_ProviderIdentifier_1 | ||||||||||||
MAP_MSTR_IK | 40I | 66 | 2420AI_REF01_ProviderIdentifierQualifer_2 | ||||||||||||
MAP_MSTR_IK | 40I | 67 | 2420AI_REF02_ProviderIdentifier_2 | ||||||||||||
MAP_MSTR_IK | 40I | 68 | 2420AI_REF01_ProviderIdentifierQualifer_3 | ||||||||||||
MAP_MSTR_IK | 40I | 69 | 2420AI_REF02_ProviderIdentifier_3 | ||||||||||||
MAP_MSTR_IK | 40I | 70 | 2420BI_NM101_ProviderRole | ||||||||||||
MAP_MSTR_IK | 40I | 71 | 2420BI_NM102_PersonIndicator | ||||||||||||
MAP_MSTR_IK | 40I | 72 | 2420BI_NM103_LastName | ||||||||||||
MAP_MSTR_IK | 40I | 73 | 2420BI_NM104_FirstName | ||||||||||||
MAP_MSTR_IK | 40I | 74 | 2420BI_NM105_MiddleName | ||||||||||||
MAP_MSTR_IK | 40I | 75 | 2420BI_NM107_Suffix | ||||||||||||
MAP_MSTR_IK | 40I | 76 | 2420BI_NM108_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 40I | 77 | 2420BI_NM109_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 40I | 78 | 2420BI_REF01_ProviderIdentifierQualifer_1 | ||||||||||||
MAP_MSTR_IK | 40I | 79 | 2420BI_REF02_ProviderIdentifier_1 | ||||||||||||
MAP_MSTR_IK | 40I | 80 | 2420BI_REF01_ProviderIdentifierQualifer_2 | ||||||||||||
MAP_MSTR_IK | 40I | 81 | 2420BI_REF02_ProviderIdentifier_2 | ||||||||||||
MAP_MSTR_IK | 40I | 82 | 2420BI_REF01_ProviderIdentifierQualifer_3 | ||||||||||||
MAP_MSTR_IK | 40I | 83 | 2420BI_REF02_ProviderIdentifier_3 | ||||||||||||
MAP_MSTR_IK | 40I | 84 | 2420CI_NM101_ProviderRole | ||||||||||||
MAP_MSTR_IK | 40I | 85 | 2420CI_NM102_PersonIndicator | ||||||||||||
MAP_MSTR_IK | 40I | 86 | 2420CI_NM103_LastName | ||||||||||||
MAP_MSTR_IK | 40I | 87 | 2420CI_NM104_FirstName | ||||||||||||
MAP_MSTR_IK | 40I | 88 | 2420CI_NM105_MiddleName | ||||||||||||
MAP_MSTR_IK | 40I | 89 | 2420CI_NM107_Suffix | ||||||||||||
MAP_MSTR_IK | 40I | 90 | 2420CI_NM108_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 40I | 91 | 2420CI_NM109_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 40I | 92 | 2420CI_REF01_ProviderIdentifierQualifer_1 | ||||||||||||
MAP_MSTR_IK | 40I | 93 | 2420CI_REF02_ProviderIdentifier_1 | ||||||||||||
MAP_MSTR_IK | 40I | 94 | 2420CI_REF01_ProviderIdentifierQualifer_2 | ||||||||||||
MAP_MSTR_IK | 40I | 95 | 2420CI_REF02_ProviderIdentifier_2 | ||||||||||||
MAP_MSTR_IK | 40I | 96 | 2420CI_REF01_ProviderIdentifierQualifer_3 | ||||||||||||
MAP_MSTR_IK | 40I | 97 | 2420CI_REF02_ProviderIdentifier_3 | ||||||||||||
MAP_MSTR_IK | 40I | 98 | 2420DI_NM101_ProviderRole | ||||||||||||
MAP_MSTR_IK | 40I | 99 | 2420DI_NM102_PersonIndicator | ||||||||||||
MAP_MSTR_IK | 40I | 100 | 2420DI_NM103_LastName | ||||||||||||
MAP_MSTR_IK | 40I | 101 | 2420DI_NM104_FirstName | ||||||||||||
MAP_MSTR_IK | 40I | 102 | 2420DI_NM105_MiddleName | ||||||||||||
MAP_MSTR_IK | 40I | 103 | 2420DI_NM107_Suffix | ||||||||||||
MAP_MSTR_IK | 40I | 104 | 2420DI_NM108_ProviderIdentifierQualifer | ||||||||||||
MAP_MSTR_IK | 40I | 105 | 2420DI_NM109_ProviderIdentifier | ||||||||||||
MAP_MSTR_IK | 40I | 106 | 2420DI_REF01_ProviderIdentifierQualifer_1 | ||||||||||||
MAP_MSTR_IK | 40I | 107 | 2420DI_REF02_ProviderIdentifier_1 | ||||||||||||
MAP_MSTR_IK | 40I | 108 | 2420DI_REF01_ProviderIdentifierQualifer_2 | ||||||||||||
MAP_MSTR_IK | 40I | 109 | 2420DI_REF02_ProviderIdentifier_2 | ||||||||||||
MAP_MSTR_IK | 40I | 110 | InNetworkIndicator | ||||||||||||
MAP_MSTR_IK | 40I | 111 | ServiceLineContractID | ||||||||||||
MAP_MSTR_IK | 40I | 112 | TPLPaidAmount | ||||||||||||
MAP_MSTR_IK | 40I | 113 | 2400I_NTE02_ServiceNote | ||||||||||||
MAP_MSTR_IK | 40I | 114 | 40I-IFiller 10 | ||||||||||||
MAP_MSTR_IK | 40I | 115 | 40I-IFiller 11 | ||||||||||||
MAP_MSTR_IK | 40I | 116 | 40I-IFiller 12 | ||||||||||||
MAP_MSTR_IK | 40I | 117 | 40I-IFiller 13 | ||||||||||||
MAP_MSTR_IK | 40I | 118 | 40I-IFiller 14 | ||||||||||||
MAP_MSTR_IK | 40I | 119 | 40I-IFiller 15 | ||||||||||||
MAP_MSTR_IK | 40I | 120 | ServiceHealthPlan | ||||||||||||
MAP_MSTR_IK | 40I | 121 | ServiceBenefitPlan | ||||||||||||
MAP_MSTR_IK | 40I | 122 | ServiceAdministrativeCounty | ||||||||||||
MAP_MSTR_IK | 40I | 123 | ServiceResidenceCounty | ||||||||||||
MAP_MSTR_IK | 40I | 124 | ServiceEligibilityCode | ||||||||||||
MAP_MSTR_IK | 40I | 125 | ServiceSubProgram1 | ||||||||||||
MAP_MSTR_IK | 40I | 126 | ServiceSubProgram2 | ||||||||||||
MAP_MSTR_IK | 40I | 127 | ServiceSubProgram3 | ||||||||||||
MAP_MSTR_IK | 40I | 128 | ServiceSubProgram4 | ||||||||||||
MAP_MSTR_IK | 40I | 129 | ServiceArrangementCode | ||||||||||||
MAP_MSTR_IK | 40I | 130 | ServiceTribalCode | ||||||||||||
MAP_MSTR_IK | 40I | 131 | Family Planning Indicator | ||||||||||||
MAP_MSTR_IK | 40I | 132 | MediaType | ||||||||||||
MAP_MSTR_IK | 40I | 133 | Beneficiary Cost Sharing Status | ||||||||||||
MAP_MSTR_IK | 40I | 134 | Out of Pocket Maximum | ||||||||||||
MAP_MSTR_IK | 40I | 135 | Beneficiary Lock-In Status | ||||||||||||
MAP_MSTR_IK | 431 | 1 | 431 REC | ||||||||||||
MAP_MSTR_IK | 431 | 2 | 431 KEY | ||||||||||||
MAP_MSTR_IK | 431 | 3 | 2430_SVD01_COBPrimaryPayerID | ||||||||||||
MAP_MSTR_IK | 431 | 4 | 2430_SVD02_COBServicePaidAmount | ||||||||||||
MAP_MSTR_IK | 431 | 5 | 431_ClaimLineDisposition | ||||||||||||
MAP_MSTR_IK | 431 | 6 | 2430_SVD03_01_ServiceCodeType | ||||||||||||
MAP_MSTR_IK | 431 | 7 | 2430_SVD03_02_ServiceCode | ||||||||||||
MAP_MSTR_IK | 431 | 8 | 2430_SVD03_03_ServiceModifier1 | ||||||||||||
MAP_MSTR_IK | 431 | 9 | 2430_SVD03_04_ServiceModifier2 | ||||||||||||
MAP_MSTR_IK | 431 | 10 | 2430_SVD03_05_ServiceModifier3 | ||||||||||||
MAP_MSTR_IK | 431 | 11 | 2430_SVD03_06_ServiceModifier4 | ||||||||||||
MAP_MSTR_IK | 431 | 12 | 2430_SVD03_07_ServiceCodeDescription | ||||||||||||
MAP_MSTR_IK | 431 | 13 | 2430_SVD04_RevenueCode | ||||||||||||
MAP_MSTR_IK | 431 | 14 | 2430_SVD05_Quantity | ||||||||||||
MAP_MSTR_IK | 431 | 15 | 2430_SVD06_BundledLineNumber | ||||||||||||
MAP_MSTR_IK | 431 | 16 | 2430_LineLevelDenial_1 | ||||||||||||
MAP_MSTR_IK | 431 | 17 | 2430_LineLevelDenial_2 | ||||||||||||
MAP_MSTR_IK | 431 | 18 | 2430_LineLevelDenial_3 | ||||||||||||
MAP_MSTR_IK | 431 | 19 | 2430_LineLevelDenial_4 | ||||||||||||
MAP_MSTR_IK | 431 | 20 | 2430_LineLevelDenial_5 | ||||||||||||
MAP_MSTR_IK | 431 | 21 | 2430_LineLevelDenial_6 | ||||||||||||
MAP_MSTR_IK | 431 | 22 | 2430_LineLevelDenial_7 | ||||||||||||
MAP_MSTR_IK | 431 | 23 | 2430_LineLevelDenial_8 | ||||||||||||
MAP_MSTR_IK | 431 | 24 | 2430_LineLevelDenial_9 | ||||||||||||
MAP_MSTR_IK | 431 | 25 | 2430_LineLevelDenial_10 | ||||||||||||
MAP_MSTR_IK | 431 | 26 | 2430_CAS01_ClaimAdjustmentGroup_1 | ||||||||||||
MAP_MSTR_IK | 431 | 27 | 2430_CAS02_ClaimAdjustmentReason_1 | ||||||||||||
MAP_MSTR_IK | 431 | 28 | 2430_CAS03_ClaimAdjustmentAmount_1 | ||||||||||||
MAP_MSTR_IK | 431 | 29 | 2430_CAS04_ClaimAdjustmentquantity_1 | ||||||||||||
MAP_MSTR_IK | 431 | 121 | 2430_DTP01_DateTimeQualifier | ||||||||||||
MAP_MSTR_IK | 431 | 122 | 2430_DTP02_DateTimeFormat | ||||||||||||
MAP_MSTR_IK | 431 | 123 | 2430_DTP03_ServicePaidDate | ||||||||||||
MAP_MSTR_IK | 431 | 124 | 2430_AMT01_AmountQualifier | ||||||||||||
MAP_MSTR_IK | 431 | 125 | 2430_AMT02_PatientLiabilityAmount | ||||||||||||
MAP_MSTR_IK | 431 | 126 | 431_Allowed_Amount | ||||||||||||
MAP_MSTR_IK | 431 | 127 | 431-Filler 01 | ||||||||||||
MAP_MSTR_IK | 431 | 128 | 431-Filler 02 | ||||||||||||
MAP_MSTR_IK | 431 | 129 | 431-Filler 03 | ||||||||||||
MAP_MSTR_IK | 431 | 130 | 431-Filler 04 | ||||||||||||
MAP_MSTR_IK | 431 | 131 | 431-Filler 05 | ||||||||||||
MAP_MSTR_IK | 431 | 132 | 431-Filler 06 | ||||||||||||
MAP_MSTR_IK | 431 | 133 | 431-Filler 07 | ||||||||||||
MAP_MSTR_IK | 431 | 134 | 431-Filler 08 | ||||||||||||
MAP_MSTR_IK | 431 | 135 | 431-Filler 09 | ||||||||||||
MAP_MSTR_IK | 431 | 136 | 431-Filler 10 | ||||||||||||
MAP_MSTR_IK | 431 | 137 | 431-Filler 11 | ||||||||||||
MAP_MSTR_IK | 431 | 138 | 431-Filler 12 | ||||||||||||
MAP_MSTR_IK | 431 | 139 | 431-Filler 13 | ||||||||||||
MAP_MSTR_IK | 431 | 140 | 431-Filler 14 | ||||||||||||
MAP_MSTR_IK | 431 | 141 | 431-Filler 15 | ||||||||||||
MAP_MSTR_IK | 431 | 142 | 431_ RecipientAidCategory | ||||||||||||
MAP_MSTR_IK | 432 | 1 | 432 REC | ||||||||||||
MAP_MSTR_IK | 432 | 2 | 432 KEY | ||||||||||||
MAP_MSTR_IK | 432 | 3 | 2430_SVD01_COBPrimaryPayerID | ||||||||||||
MAP_MSTR_IK | 432 | 4 | 2430_SVD02_COBServicePaidAmount | ||||||||||||
MAP_MSTR_IK | 432 | 5 | 2430_SVD03_01_ServiceCodeType | ||||||||||||
MAP_MSTR_IK | 432 | 6 | 2430_SVD03_02_ServiceCode | ||||||||||||
MAP_MSTR_IK | 432 | 7 | 2430_SVD03_03_ServiceModifier1 | ||||||||||||
MAP_MSTR_IK | 432 | 8 | 2430_SVD03_04_ServiceModifier2 | ||||||||||||
MAP_MSTR_IK | 432 | 9 | 2430_SVD03_05_ServiceModifier3 | ||||||||||||
MAP_MSTR_IK | 432 | 10 | 2430_SVD03_06_ServiceModifier4 | ||||||||||||
MAP_MSTR_IK | 432 | 11 | 2430_SVD03_07_ServiceCodeDescription | ||||||||||||
MAP_MSTR_IK | 432 | 12 | 2430_SVD04_RevenueCode | ||||||||||||
MAP_MSTR_IK | 432 | 13 | 2430_SVD05_Quantity | ||||||||||||
MAP_MSTR_IK | 432 | 14 | 2430_SVD06_BundledLineNumber | ||||||||||||
MAP_MSTR_IK | 432 | 15 | 2430_LineLevelDenial_1 | ||||||||||||
MAP_MSTR_IK | 432 | 16 | 2430_LineLevelDenial_2 | ||||||||||||
MAP_MSTR_IK | 432 | 17 | 2430_LineLevelDenial_3 | ||||||||||||
MAP_MSTR_IK | 432 | 18 | 2430_LineLevelDenial_4 | ||||||||||||
MAP_MSTR_IK | 432 | 19 | 2430_LineLevelDenial_5 | ||||||||||||
MAP_MSTR_IK | 432 | 20 | 2430_LineLevelDenial_6 | ||||||||||||
MAP_MSTR_IK | 432 | 21 | 2430_LineLevelDenial_7 | ||||||||||||
MAP_MSTR_IK | 432 | 22 | 2430_LineLevelDenial_8 | ||||||||||||
MAP_MSTR_IK | 432 | 23 | 2430_LineLevelDenial_9 | ||||||||||||
MAP_MSTR_IK | 432 | 24 | 2430_LineLevelDenial_10 | ||||||||||||
MAP_MSTR_IK | 432 | 25 | 2430_CAS01_ClaimAdjustmentGroup_1 | ||||||||||||
MAP_MSTR_IK | 432 | 26 | 2430_CAS02_ClaimAdjustmentReason_1 | ||||||||||||
MAP_MSTR_IK | 432 | 27 | 2430_CAS03_ClaimAdjustmentAmount_1 | ||||||||||||
MAP_MSTR_IK | 432 | 28 | 2430_CAS04_ClaimAdjustmentquantity_1 | ||||||||||||
MAP_MSTR_IK | 432 | 120 | 2430_DTP01_DateTimeQualifier | ||||||||||||
MAP_MSTR_IK | 432 | 121 | 2430_DTP02_DateTimeFormat | ||||||||||||
MAP_MSTR_IK | 432 | 122 | 2430_DTP03_ServicePaidDate | ||||||||||||
MAP_MSTR_IK | 432 | 123 | 2430_AMT01_AmountQualifier | ||||||||||||
MAP_MSTR_IK | 432 | 124 | 2430_AMT02_PatientLiabilityAmount | ||||||||||||
MAP_MSTR_IK | 432 | 125 | 432-Filler 01 | ||||||||||||
MAP_MSTR_IK | 432 | 126 | 432-Filler 02 | ||||||||||||
MAP_MSTR_IK | 432 | 127 | 432-Filler 03 | ||||||||||||
MAP_MSTR_IK | 432 | 128 | 432-Filler 04 | ||||||||||||
MAP_MSTR_IK | 432 | 129 | 432-Filler 05 | ||||||||||||
MAP_MSTR_IK | 432 | 130 | 432-Filler 06 | ||||||||||||
MAP_MSTR_IK | 432 | 131 | 432-Filler 07 | ||||||||||||
MAP_MSTR_IK | 432 | 132 | 432-Filler 08 | ||||||||||||
MAP_MSTR_IK | 432 | 133 | 432-Filler 09 | ||||||||||||
MAP_MSTR_IK | 432 | 134 | 432-Filler 10 | ||||||||||||
MAP_MSTR_IK | 432 | 135 | 432-Filler 11 | ||||||||||||
MAP_MSTR_IK | 432 | 136 | 432-Filler 12 | ||||||||||||
MAP_MSTR_IK | 432 | 137 | 432-Filler 13 | ||||||||||||
MAP_MSTR_IK | 432 | 138 | 432-Filler 14 | ||||||||||||
MAP_MSTR_IK | 432 | 139 | 432-Filler 15 | ||||||||||||
MAP_MSTR_IK | TRAILER | 1 | 01 Trailer Record | ||||||||||||
MAP_MSTR_IK | TRAILER | 2 | TRT Record | ||||||||||||
MAP_MSTR_IK | TRAILER | 3 | Total_Professional | ||||||||||||
MAP_MSTR_IK | TRAILER | 4 | Total_Institutional | ||||||||||||
MAP_MSTR_IK | TRAILER | 5 | Total_Dental | ||||||||||||
MAP_MSTR_IK | TRAILER | 6 | Total_Claim_Count |