hippo_eyeDoc 0.0.1

data/lib/hippo_eyeDoc/transaction_sets/HIPAA_837/L2010BA.rb

@@ -0,0 +1,76 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_837
+
+    class L2010BA < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L2010BA'    #Subscriber Name
+
+      #Subscriber Name
+      segment Hippo_eyeDoc::Segments::NM1,
+                :name           => 'Subscriber Name',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 150,
+                :identified_by => {
+                  'NM101' => 'IL',
+                  'NM102' => ["1", "2"]
+                }
+
+      #Subscriber Address
+      segment Hippo_eyeDoc::Segments::N3,
+                :name           => 'Subscriber Address',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 250
+
+      #Subscriber City, State, ZIP Code
+      segment Hippo_eyeDoc::Segments::N4,
+                :name           => 'Subscriber City, State, ZIP Code',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 300
+
+      #Subscriber Demographic Information
+      segment Hippo_eyeDoc::Segments::DMG,
+                :name           => 'Subscriber Demographic Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 320,
+                :identified_by => {
+                  'DMG01' => 'D8',
+                  'DMG03' => ["F", "M", "U"]
+                }
+
+      #Subscriber Secondary Identification
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Subscriber Secondary Identification',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 350,
+                :identified_by => {
+                  'REF01' => 'SY'
+                }
+
+      #Property and Casualty Claim Number
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Property and Casualty Claim Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 360,
+                :identified_by => {
+                  'REF01' => 'Y4'
+                }
+
+      #Property and Casualty Subscriber Contact Information
+      segment Hippo_eyeDoc::Segments::PER,
+                :name           => 'Property and Casualty Subscriber Contact Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 400,
+                :identified_by => {
+                  'PER01' => 'IC',
+                  'PER03' => 'TE'
+                }
+
+    end
+  end
+end

data/lib/hippo_eyeDoc/transaction_sets/HIPAA_837/L2010BB.rb

@@ -0,0 +1,55 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_837
+
+    class L2010BB < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L2010BB'    #Payer Name
+
+      #Payer Name
+      segment Hippo_eyeDoc::Segments::NM1,
+                :name           => 'Payer Name',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 150,
+                :identified_by => {
+                  'NM101' => 'PR',
+                  'NM102' => '2',
+                  'NM108' => ["PI", "XV"]
+                }
+
+      #Payer Address
+      segment Hippo_eyeDoc::Segments::N3,
+                :name           => 'Payer Address',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 250
+
+      #Payer City, State, ZIP Code
+      segment Hippo_eyeDoc::Segments::N4,
+                :name           => 'Payer City, State, ZIP Code',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 300
+
+      #Payer Secondary Identification
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Payer Secondary Identification',
+                :minimum        => 0,
+                :maximum        => 3,
+                :position       => 350,
+                :identified_by => {
+                  'REF01' => ["2U", "EI", "FY", "NF"]
+                }
+
+      #Billing Provider Secondary Identification
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Billing Provider Secondary Identification',
+                :minimum        => 0,
+                :maximum        => 2,
+                :position       => 370,
+                :identified_by => {
+                  'REF01' => ["G2", "LU"]
+                }
+
+    end
+  end
+end

data/lib/hippo_eyeDoc/transaction_sets/HIPAA_837/L2010CA.rb

@@ -0,0 +1,76 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_837
+
+    class L2010CA < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L2010CA'    #Patient Name
+
+      #Patient Name
+      segment Hippo_eyeDoc::Segments::NM1,
+                :name           => 'Patient Name',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 150,
+                :identified_by => {
+                  'NM101' => 'QC',
+                  'NM102' => '1'
+                }
+
+      #Patient Address
+      segment Hippo_eyeDoc::Segments::N3,
+                :name           => 'Patient Address',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 250
+
+      #Patient City, State, ZIP Code
+      segment Hippo_eyeDoc::Segments::N4,
+                :name           => 'Patient City, State, ZIP Code',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 300
+
+      #Patient Demographic Information
+      segment Hippo_eyeDoc::Segments::DMG,
+                :name           => 'Patient Demographic Information',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 320,
+                :identified_by => {
+                  'DMG01' => 'D8',
+                  'DMG03' => ["F", "M", "U"]
+                }
+
+      #Property and Casualty Claim Number
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Property and Casualty Claim Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 360,
+                :identified_by => {
+                  'REF01' => 'Y4'
+                }
+
+      #Property and Casualty Patient Identifier
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Property and Casualty Patient Identifier',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 362,
+                :identified_by => {
+                  'REF01' => ["1W", "SY"]
+                }
+
+      #Property and Casualty Patient Contact Information
+      segment Hippo_eyeDoc::Segments::PER,
+                :name           => 'Property and Casualty Patient Contact Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 400,
+                :identified_by => {
+                  'PER01' => 'IC',
+                  'PER03' => 'TE'
+                }
+
+    end
+  end
+end

data/lib/hippo_eyeDoc/transaction_sets/HIPAA_837/L2300.rb

@@ -0,0 +1,570 @@
+module Hippo_eyeDoc::TransactionSets
+  module HIPAA_837
+
+    class L2300 < Hippo_eyeDoc::TransactionSets::Base
+      loop_name 'L2300'    #Claim Information
+
+      #Claim Information
+      segment Hippo_eyeDoc::Segments::CLM,
+                :name           => 'Claim Information',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 1300,
+                :identified_by => {
+                  'CLM06' => ["N", "Y"],
+                  'CLM07' => ["A", "B", "C"],
+                  'CLM08' => ["N", "W", "Y"],
+                  'CLM09' => ["I", "Y"]
+                }
+
+      #Date - Onset of Current Illness or Symptom
+      segment Hippo_eyeDoc::Segments::DTP,
+                :name           => 'Date - Onset of Current Illness or Symptom',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1350,
+                :identified_by => {
+                  'DTP01' => '431',
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Initial Treatment Date
+      segment Hippo_eyeDoc::Segments::DTP,
+                :name           => 'Date - Initial Treatment Date',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1370,
+                :identified_by => {
+                  'DTP01' => '454',
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Last Seen Date
+      segment Hippo_eyeDoc::Segments::DTP,
+                :name           => 'Date - Last Seen Date',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1390,
+                :identified_by => {
+                  'DTP01' => '304',
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Acute Manifestation
+      segment Hippo_eyeDoc::Segments::DTP,
+                :name           => 'Date - Acute Manifestation',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 13,
+                :identified_by => {
+                  'DTP01' => '453',
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Accident
+      segment Hippo_eyeDoc::Segments::DTP,
+                :name           => 'Date - Accident',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 13,
+                :identified_by => {
+                  'DTP01' => '439',
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Last Menstrual Period
+      segment Hippo_eyeDoc::Segments::DTP,
+                :name           => 'Date - Last Menstrual Period',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 13,
+                :identified_by => {
+                  'DTP01' => '484',
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Last X-ray Date
+      segment Hippo_eyeDoc::Segments::DTP,
+                :name           => 'Date - Last X-ray Date',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 13,
+                :identified_by => {
+                  'DTP01' => '455',
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Hearing and Vision Prescription Date
+      segment Hippo_eyeDoc::Segments::DTP,
+                :name           => 'Date - Hearing and Vision Prescription Date',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 13,
+                :identified_by => {
+                  'DTP01' => '471',
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Disability Dates
+      segment Hippo_eyeDoc::Segments::DTP,
+                :name           => 'Date - Disability Dates',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 13,
+                :identified_by => {
+                  'DTP01' => ["314", "360", "361"],
+                  'DTP02' => ["D8", "RD8"]
+                }
+
+      #Date - Last Worked
+      segment Hippo_eyeDoc::Segments::DTP,
+                :name           => 'Date - Last Worked',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 13,
+                :identified_by => {
+                  'DTP01' => '297',
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Authorized Return to Work
+      segment Hippo_eyeDoc::Segments::DTP,
+                :name           => 'Date - Authorized Return to Work',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 13,
+                :identified_by => {
+                  'DTP01' => '296',
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Admission
+      segment Hippo_eyeDoc::Segments::DTP,
+                :name           => 'Date - Admission',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 13,
+                :identified_by => {
+                  'DTP01' => '435',
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Discharge
+      segment Hippo_eyeDoc::Segments::DTP,
+                :name           => 'Date - Discharge',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 13,
+                :identified_by => {
+                  'DTP01' => '096',
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Assumed and Relinquished Care Dates
+      segment Hippo_eyeDoc::Segments::DTP,
+                :name           => 'Date - Assumed and Relinquished Care Dates',
+                :minimum        => 0,
+                :maximum        => 2,
+                :position       => 13,
+                :identified_by => {
+                  'DTP01' => ["090", "091"],
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Property and Casualty Date of First Contact
+      segment Hippo_eyeDoc::Segments::DTP,
+                :name           => 'Date - Property and Casualty Date of First Contact',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 13,
+                :identified_by => {
+                  'DTP01' => '444',
+                  'DTP02' => 'D8'
+                }
+
+      #Date - Repricer Received Date
+      segment Hippo_eyeDoc::Segments::DTP,
+                :name           => 'Date - Repricer Received Date',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 13,
+                :identified_by => {
+                  'DTP01' => '050',
+                  'DTP02' => 'D8'
+                }
+
+      #Claim Supplemental Information
+      segment Hippo_eyeDoc::Segments::PWK,
+                :name           => 'Claim Supplemental Information',
+                :minimum        => 0,
+                :maximum        => 10,
+                :position       => 1550,
+                :identified_by => {
+                  'PWK01' => ["03", "04", "05", "06", "07", "08", "09", "10", "11", "13", "15", "21", "A3", "A4", "AM", "AS", "B2", "B3", "B4", "BR", "BS", "BT", "CB", "CK", "CT", "D2", "DA", "DB", "DG", "DJ", "DS", "EB", "HC", "HR", "I5", "IR", "LA", "M1", "MT", "NN", "OB", "OC", "OD", "OE", "OX", "OZ", "P4", "P5", "PE", "PN", "PO", "PQ", "PY", "PZ", "RB", "RR", "RT", "RX", "SG", "V5", "XP"],
+                  'PWK02' => ["AA", "BM", "EL", "EM", "FT", "FX"]
+                }
+
+      #Contract Information
+      segment Hippo_eyeDoc::Segments::CN1,
+                :name           => 'Contract Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1600,
+                :identified_by => {
+                  'CN101' => ["01", "02", "03", "04", "05", "06", "09"]
+                }
+
+      #Patient Amount Paid
+      segment Hippo_eyeDoc::Segments::AMT,
+                :name           => 'Patient Amount Paid',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1760,
+                :identified_by => {
+                  'AMT01' => 'F5'
+                }
+
+      #Service Authorization Exception Code
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Service Authorization Exception Code',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 17,
+                :identified_by => {
+                  'REF01' => '4N'
+                }
+
+      #Mandatory Medicare (Section 4081) Crossover Indicator
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Mandatory Medicare (Section 4081) Crossover Indicator',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 17,
+                :identified_by => {
+                  'REF01' => 'F5'
+                }
+
+      #Mammography Certification Number
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Mammography Certification Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 17,
+                :identified_by => {
+                  'REF01' => 'EW'
+                }
+
+      #Referral Number
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Referral Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 17,
+                :identified_by => {
+                  'REF01' => '9F'
+                }
+
+      #Prior Authorization
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Prior Authorization',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1800,
+                :identified_by => {
+                  'REF01' => 'G1'
+                }
+
+      #Payer Claim Control Number
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Payer Claim Control Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1810,
+                :identified_by => {
+                  'REF01' => 'F8'
+                }
+
+      #Clinical Laboratory Improvement Amendment (CLIA) Number
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Clinical Laboratory Improvement Amendment (CLIA) Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1820,
+                :identified_by => {
+                  'REF01' => 'X4'
+                }
+
+      #Repriced Claim Number
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Repriced Claim Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1830,
+                :identified_by => {
+                  'REF01' => '9A'
+                }
+
+      #Adjusted Repriced Claim Number
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Adjusted Repriced Claim Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1840,
+                :identified_by => {
+                  'REF01' => '9C'
+                }
+
+      #Investigational Device Exemption Number
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Investigational Device Exemption Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1850,
+                :identified_by => {
+                  'REF01' => 'LX'
+                }
+
+      #Claim Identifier For Transmission Intermediaries
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Claim Identifier For Transmission Intermediaries',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1860,
+                :identified_by => {
+                  'REF01' => 'D9'
+                }
+
+      #Medical Record Number
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Medical Record Number',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1890,
+                :identified_by => {
+                  'REF01' => 'EA'
+                }
+
+      #Demonstration Project Identifier
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Demonstration Project Identifier',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 18,
+                :identified_by => {
+                  'REF01' => 'P4'
+                }
+
+      #Care Plan Oversight
+      segment Hippo_eyeDoc::Segments::REF,
+                :name           => 'Care Plan Oversight',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 18,
+                :identified_by => {
+                  'REF01' => '1J'
+                }
+
+      #File Information
+      segment Hippo_eyeDoc::Segments::K3,
+                :name           => 'File Information',
+                :minimum        => 0,
+                :maximum        => 10,
+                :position       => 18
+
+      #Claim Note
+      segment Hippo_eyeDoc::Segments::NTE,
+                :name           => 'Claim Note',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1900,
+                :identified_by => {
+                  'NTE01' => ["ADD", "CER", "DCP", "DGN", "TPO"]
+                }
+
+      #Ambulance Transport Information
+      segment Hippo_eyeDoc::Segments::CR1,
+                :name           => 'Ambulance Transport Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 1950,
+                :identified_by => {
+                  'CR104' => ["A", "B", "C", "D", "E"],
+                  'CR105' => 'DH'
+                }
+
+      #Spinal Manipulation Service Information
+      segment Hippo_eyeDoc::Segments::CR2,
+                :name           => 'Spinal Manipulation Service Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 2000,
+                :identified_by => {
+                  'CR208' => ["A", "C", "D", "E", "F", "G", "M"]
+                }
+
+      #Ambulance Certification
+      segment Hippo_eyeDoc::Segments::CRC,
+                :name           => 'Ambulance Certification',
+                :minimum        => 0,
+                :maximum        => 3,
+                :position       => 2200,
+                :identified_by => {
+                  'CRC01' => '07',
+                  'CRC02' => ["N", "Y"],
+                  'CRC03' => ["01", "04", "05", "06", "07", "08", "09", "12"]
+                }
+
+      #Patient Condition Information: Vision
+      segment Hippo_eyeDoc::Segments::CRC,
+                :name           => 'Patient Condition Information: Vision',
+                :minimum        => 0,
+                :maximum        => 3,
+                :position       => 2210,
+                :identified_by => {
+                  'CRC01' => ["E1", "E2", "E3"],
+                  'CRC02' => ["N", "Y"],
+                  'CRC03' => ["L1", "L2", "L3", "L4", "L5"]
+                }
+
+      #Homebound Indicator
+      segment Hippo_eyeDoc::Segments::CRC,
+                :name           => 'Homebound Indicator',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 2220,
+                :identified_by => {
+                  'CRC01' => '75',
+                  'CRC02' => 'Y',
+                  'CRC03' => 'IH'
+                }
+
+      #EPSDT Referral
+      segment Hippo_eyeDoc::Segments::CRC,
+                :name           => 'EPSDT Referral',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 2230,
+                :identified_by => {
+                  'CRC01' => 'ZZ',
+                  'CRC02' => ["N", "Y"],
+                  'CRC03' => ["AV", "NU", "S2", "ST"]
+                }
+
+      #Health Care Diagnosis Code
+      segment Hippo_eyeDoc::Segments::HI,
+                :name           => 'Health Care Diagnosis Code',
+                :minimum        => 1,
+                :maximum        => 1,
+                :position       => 2310
+
+      #Anesthesia Related Procedure
+      segment Hippo_eyeDoc::Segments::HI,
+                :name           => 'Anesthesia Related Procedure',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 2313
+
+      #Condition Information
+      segment Hippo_eyeDoc::Segments::HI,
+                :name           => 'Condition Information',
+                :minimum        => 0,
+                :maximum        => 2,
+                :position       => 2320
+
+      #Claim Pricing/Repricing Information
+      segment Hippo_eyeDoc::Segments::HCP,
+                :name           => 'Claim Pricing/Repricing Information',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 2410,
+                :identified_by => {
+                  'HCP01' => ["00", "01", "02", "03", "04", "05", "07", "08", "09", "10", "11", "12", "13", "14"]
+                }
+
+      #Referring Provider Name
+      loop    Hippo_eyeDoc::TransactionSets::HIPAA_837::L2310A,
+                :name           => 'Referring Provider Name',
+                :minimum        => 0,
+                :maximum        => 2,
+                :position       => 2500,
+                :identified_by => {
+                  'NM1.NM101' => ["DN", "P3"],
+                  'NM1.NM102' => '1'
+                }
+
+      #Rendering Provider Name
+      loop    Hippo_eyeDoc::TransactionSets::HIPAA_837::L2310B,
+                :name           => 'Rendering Provider Name',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 2500,
+                :identified_by => {
+                  'NM1.NM101' => '82',
+                  'NM1.NM102' => ["1", "2"]
+                }
+
+      #Service Facility Location Name
+      loop    Hippo_eyeDoc::TransactionSets::HIPAA_837::L2310C,
+                :name           => 'Service Facility Location Name',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 2500,
+                :identified_by => {
+                  'NM1.NM101' => '77',
+                  'NM1.NM102' => '2'
+                }
+
+      #Supervising Provider Name
+      loop    Hippo_eyeDoc::TransactionSets::HIPAA_837::L2310D,
+                :name           => 'Supervising Provider Name',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 2500,
+                :identified_by => {
+                  'NM1.NM101' => 'DQ',
+                  'NM1.NM102' => '1'
+                }
+
+      #Ambulance Pick-up Location
+      loop    Hippo_eyeDoc::TransactionSets::HIPAA_837::L2310E,
+                :name           => 'Ambulance Pick-up Location',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 2500,
+                :identified_by => {
+                  'NM1.NM101' => 'PW',
+                  'NM1.NM102' => '2'
+                }
+
+      #Ambulance Drop-off Location
+      loop    Hippo_eyeDoc::TransactionSets::HIPAA_837::L2310F,
+                :name           => 'Ambulance Drop-off Location',
+                :minimum        => 0,
+                :maximum        => 1,
+                :position       => 2500,
+                :identified_by => {
+                  'NM1.NM101' => '45',
+                  'NM1.NM102' => '2'
+                }
+
+      #Other Subscriber Information
+      loop    Hippo_eyeDoc::TransactionSets::HIPAA_837::L2320,
+                :name           => 'Other Subscriber Information',
+                :minimum        => 0,
+                :maximum        => 10,
+                :position       => 2900,
+                :identified_by => {
+                  'SBR.SBR01' => ["A", "B", "C", "D", "E", "F", "G", "H", "P", "S", "T", "U"],
+                  'SBR.SBR02' => ["01", "18", "19", "20", "21", "39", "40", "53", "G8"]
+                }
+
+      #Service Line Number
+      loop    Hippo_eyeDoc::TransactionSets::HIPAA_837::L2400,
+                :name           => 'Service Line Number',
+                :minimum        => 1,
+                :maximum        => 50,
+                :position       => 3650
+
+    end
+  end
+end