stupidedi 1.1.0 → 1.2.1

data/lib/stupidedi/editor/004010/N4.rb

@@ -0,0 +1,63 @@
+class Stupidedi
+  module Editor
+
+    class FortyTenEd
+      module N4
+
+        def critique_n4(n4, acc)
+          edit(:N4) do
+            usa_canada =
+              n4.element(2).select(&:present?).defined? ||
+              n4.element(4).select(&:blank?).defined?   ||
+              n4.element(4).select{|e| e.node == "US" }.defined? ||
+              n4.element(7).select(&:blank?).defined?
+
+            # State or Province Code
+            n4.element(2).tap do |e|
+              if usa_canada
+                if e.node.blank? and e.node.situational?
+                  # Required
+                end
+              else
+                if e.node.present? and e.node.situational?
+                  # Forbidden
+                end
+              end
+            end
+
+            # Postal Code
+            n4.element(3).tap do |e|
+              if usa_canada and e.node =~ /^(\d{1,8}|\d{10,})$/
+                acc.warn(e, "must be 9-digits for usa")
+              end
+            end
+
+            # Country Code
+            n4.element(4).tap do |e|
+              if usa_canada
+                if e.node.present? and e.node.situational?
+                  # Forbidden
+                end
+              else
+                # Country codes 2-digit from ISO 3166
+              end
+            end
+
+            # Country Subdivision Code
+          # n4.element(7).tap do |e|
+          #   if usa_canada
+          #     if e.node.present? and e.node.situational?
+          #       # Forbidden
+          #     end
+          #   else
+          #     # Country subdivision codes from ISO 3166
+          #   end
+          # end
+          end
+        end
+
+      end
+    end
+
+  end
+end

data/lib/stupidedi/editor/X12.rb

@@ -0,0 +1,157 @@
+module Stupidedi
+  module Editor
+
+    class X12 < AbstractEd
+
+      # @return [Config]
+      attr_reader :config
+
+      # @return [Time]
+      attr_reader :received
+
+      def initialize(config, received)
+        @config, @received =
+          config, received
+      end
+
+      def critique(st, acc)
+        acc.tap do
+          critique_st(st, acc)
+
+        # st.find(:SE).tap do |se|
+        #   st.distance(se).tap do |n|
+        #     n.times { st.next.tap{|z| z }}
+        #   end
+        # end
+
+        end
+      end
+
+    private
+
+      def critique_isa(isa, acc)
+        edit(:ISA07) do
+          isa.element(7).tap do |e|
+            if e.node.present? and e.node.valid?
+              unless %w(02 ZZ).include?(e.node)
+                acc.ta105(e, "R", "005", "must be '02', or 'ZZ'")
+              end
+            end
+          end
+        end
+
+        edit(:ISA12) do
+          isa.element(12).tap do |e|
+            if e.node.present? and e.node.valid?
+              unless e.node == "00401"
+                acc.ta105(e, "R", "017", "must be '00401'")
+              end
+            end
+          end
+        end
+      end
+
+      def critique_gs(gs, acc)
+      end
+
+      def critique_st(st, acc)
+        st.parent.tap do |gs|
+          gs.parent.tap do |isa|
+            critique_isa(isa, acc)
+          end
+
+          critique_gs(gs, acc)
+        end
+      end
+
+      def critique_nm1(nm1, acc)
+        edit(:NM1) do
+          # Organization/last name
+          nm1.element(3).tap do |e|
+            if e.node.blank? and e.node.usage.optional?
+              acc.warn(e, "optional element is not present")
+            end
+          end
+
+          # Non-person entity
+          if nm1.element(2).select{|e| e.node == "2" }.defined?
+            # First name
+            nm1.element(4).tap do |e|
+              if e.node.present? and e.node.usage.optional?
+                acc.stc01(e, "T", "A8", "505", "must not be present when NM102 is 2")
+              end
+            end
+
+            # Middle name
+            nm1.element(5).tap do |e|
+              if e.node.present? and e.node.usage.optional?
+                acc.stc01(e, "T", "A8", "514", "must not be present when NM102 is 2")
+              end
+            end
+
+            # Prefix name
+            nm1.element(6).tap do |e|
+              if e.node.present? and e.node.usage.optional?
+                acc.stc01(e, "T", "A8", "125", "must not be present when NM102 is 2")
+              end
+            end
+
+            # Suffix name
+            nm1.element(7).tap do |e|
+              if e.node.present? and e.node.usage.optional?
+                acc.stc01(e, "T", "A8", "125", "must not be present when NM102 is 2")
+              end
+            end
+          end
+
+          # Person
+          if nm1.element(2).select{|e| e.node == "1" }.defined?
+            # First name
+            nm1.element(4).tap do |e|
+              if e.node.blank? and e.node.usage.optional?
+                acc.warn(e, "optional element is not present")
+              end
+            end
+
+            # Middle name
+            nm1.element(5).tap do |e|
+              if e.node.blank? and e.node.usage.optional?
+                acc.warn(e, "optional element is not present")
+              end
+            end
+
+            # Prefix name
+            nm1.element(6).tap do |e|
+              if e.node.blank? and e.node.usage.optional?
+                acc.warn(e, "optional element is not present")
+              end
+            end
+
+            # Suffix name
+            nm1.element(7).tap do |e|
+              if e.node.blank? and e.node.usage.optional?
+                acc.warn(e, "optional element is not present")
+              end
+            end
+          end
+        end
+      end
+
+      def critique_n3(n3, acc)
+        edit(:N3) do
+          n3.element(2).tap do |e|
+            if e.node.usage.optional?
+              unless n3.element(1).reject(&:blank?).defined?
+                # Second address line (N302) shouldn't be present if the
+                # first (N301) isn't also present
+                acc.warn(e, "second address line present without first line")
+              end
+            end
+          end
+        end
+      end
+
+    end
+
+  end
+end

data/lib/stupidedi/editor/transaction_set_ed.rb

@@ -166,7 +166,7 @@ module Stupidedi
               end
             end
           else
-            acc.ik304(child, "R", "2", "unexpected segment")
+            acc.ik304(zipper, "R", "2", "unexpected segment")
           end
 
         elsif zipper.node.loop?

data/lib/stupidedi/either.rb

@@ -53,7 +53,7 @@ module Stupidedi
         true
       end
 
-      def fetch(default)
+      def fetch(default = nil)
         @value
       end
 
@@ -174,7 +174,7 @@ module Stupidedi
         false
       end
 
-      def fetch(default)
+      def fetch(default = nil)
         default
       end
 

data/lib/stupidedi/guides.rb

@@ -1,5 +1,6 @@
 module Stupidedi
   module Guides
+    autoload :FortyTen, "stupidedi/guides/004010"
     autoload :FiftyTen, "stupidedi/guides/005010"
   end
 end

data/lib/stupidedi/guides/004010.rb

@@ -0,0 +1,19 @@
+module Stupidedi
+  module Guides
+
+    #
+    # @see Stupidedi::Versions::FunctionalGroups::FortyTen
+    #
+    module FortyTen
+
+      autoload :SegmentReqs,  "stupidedi/guides/004010/segment_reqs"
+      autoload :ElementReqs,  "stupidedi/guides/004010/element_reqs"
+      autoload :GuideBuilder, "stupidedi/guides/004010/guide_builder"
+
+      module X091A1
+        autoload :HP835,  "stupidedi/guides/004010/X091A1-HP835"
+      end
+
+    end
+  end
+end

data/lib/stupidedi/guides/004010/X091A1-HP835.rb

@@ -0,0 +1,530 @@
+module Stupidedi
+  module Guides
+    module FortyTen
+      module X091A1
+
+        b = GuideBuilder
+        d = Schema
+        r = SegmentReqs
+        e = ElementReqs
+        s = Versions::FunctionalGroups::FortyTen::SegmentDefs
+        t = Versions::FunctionalGroups::FortyTen::TransactionSetDefs
+
+        HP835 = b.build(t::HP835,
+          d::TableDef.header("Table 1 - Header",
+            b::Segment(100, s::ST, "Transaction Set Header",
+              r::Required, d::RepeatCount.bounded(1),
+              b::Element(e::Required,    "Transaction Set Identifier Code", b::Values("835")),
+              b::Element(e::Required,    "Transaction Set Control Number")),
+            b::Segment(200, s::BPR, "Financial Information",
+              r::Required, d::RepeatCount.bounded(1),
+              b::Element(e::Required,    "Transaction Handling Code", b::Values("C", "D", "H", "I", "P", "U", "X")),
+              b::Element(e::Required,    "Total Actual Provider Payment Amount", b::MaxLength(11)),
+              b::Element(e::Required,    "Credit or Debit Flag Code", b::Values("C", "D")),
+              b::Element(e::Required,    "Payment Method Code", b::Values("ACH", "BOP", "CHK", "FWT", "NON")),
+              b::Element(e::Situational, "Payment Format Code", b::Values("CCP", "CTX")),
+              b::Element(e::Situational, "Depository Financial Institution (DFI) Identification Number Qualifier", b::Values("01", "04")),
+              b::Element(e::Situational, "Sender DFI Number"),
+              b::Element(e::Situational, "Account Number Qualifier", b::Values("DA")),
+              b::Element(e::Situational, "Sender Bank Account Number"),
+              b::Element(e::Situational, "Payer Identifier"),
+              b::Element(e::Situational, "Originating Company Supplemental Code"),
+              b::Element(e::Situational, "Depository Financial Institution (DFI) Identification Number Qualifier", b::Values("01", "04")),
+              b::Element(e::Situational, "Receiver or Provider Bank ID Number"),
+              b::Element(e::Situational, "Account Number Qualifier", b::Values("DA", "SG")),
+              b::Element(e::Situational, "Receiver or Provider Account Number"),
+              b::Element(e::Required,    "Check Issue or EFT Effective Date"),
+              b::Element(e::NotUsed,     "Business Function Code"),
+              b::Element(e::NotUsed,     "(DFI) ID Number Qualifier"),
+              b::Element(e::NotUsed,     "(DFI) Identification Number"),
+              b::Element(e::NotUsed,     "Account Number Qualifier"),
+              b::Element(e::NotUsed,     "Account Number")),
+            b::Segment(400, s::TRN, "Reassociation Trace Number",
+              r::Required, d::RepeatCount.bounded(1),
+              b::Element(e::Required,    "Trace Type Code", b::Values("1")),
+              b::Element(e::Required,    "Check or EFT Trace Number"),
+              b::Element(e::Required,    "Payer Identifier"),
+              b::Element(e::Situational, "Originating Company Supplemental Code")),
+            b::Segment(500, s::CUR, "Foreign Currency Information",
+              r::Situational, d::RepeatCount.bounded(1),
+              b::Element(e::Required,    "Entity Identifier Code", b::Values("PR")),
+              b::Element(e::Required,    "Currency Code"),
+              b::Element(e::Situational, "Exchange Rate"),
+              b::Element(e::NotUsed,     "Entity Identifier Code"),
+              b::Element(e::NotUsed,     "Currency Code"),
+              b::Element(e::NotUsed,     "Currency Market/Exchange Code"),
+              b::Element(e::NotUsed,     "Date/Time Qualifier"),
+              b::Element(e::NotUsed,     "Date"),
+              b::Element(e::NotUsed,     "Time"),
+              b::Element(e::NotUsed,     "Date/Time Qualifier"),
+              b::Element(e::NotUsed,     "Date"),
+              b::Element(e::NotUsed,     "Time"),
+              b::Element(e::NotUsed,     "Date/Time Qualifier"),
+              b::Element(e::NotUsed,     "Date"),
+              b::Element(e::NotUsed,     "Time"),
+              b::Element(e::NotUsed,     "Date/Time Qualifier"),
+              b::Element(e::NotUsed,     "Date"),
+              b::Element(e::NotUsed,     "Time"),
+              b::Element(e::NotUsed,     "Date/Time Qualifier"),
+              b::Element(e::NotUsed,     "Date"),
+              b::Element(e::NotUsed,     "Time")),
+            b::Segment(600, s::REF, "Receiver Identification",
+              r::Situational, d::RepeatCount.bounded(1),
+              b::Element(e::Required,    "Reference Identification Qualifier", b::Values("EV")),
+              b::Element(e::Required,    "Receiver Identifier"),
+              b::Element(e::NotUsed,     "Description"),
+              b::Element(e::NotUsed,     "REFERENCE IDENTIFIER")),
+            b::Segment(600, s::REF, "Version Identification",
+              r::Situational, d::RepeatCount.bounded(1),
+              b::Element(e::Required,    "Reference Identification Qualifier", b::Values("F2")),
+              b::Element(e::Required,    "Version Identification Code"),
+              b::Element(e::NotUsed,     "Description"),
+              b::Element(e::NotUsed,     "REFERENCE IDENTIFIER")),
+            b::Segment(700, s::DTM, "Production Date",
+              r::Situational, d::RepeatCount.bounded(1),
+              b::Element(e::Required,    "Date/Time Qualifier", b::Values("405")),
+              b::Element(e::Required,    "Production Date"),
+              b::Element(e::NotUsed,     "Time"),
+              b::Element(e::NotUsed,     "Time Code"),
+              b::Element(e::NotUsed,     "Date Time Period Format Qualifier"),
+              b::Element(e::NotUsed,     "Date Time Period")),
+
+            d::LoopDef.build("1000A PAYER IDENTIFICATION",
+              d::RepeatCount.bounded(1),
+              b::Segment( 800, s::N1, "Payer Identification",
+                r::Required, d::RepeatCount.bounded(1),
+                b::Element(e::Required,    "Entity Identifier Code", b::Values("PR")),
+                b::Element(e::Situational, "Payer Name"),
+                b::Element(e::Situational, "Identification Code Qualifier", b::Values("XV")),
+                b::Element(e::Situational, "Payer Identifier"),
+                b::Element(e::NotUsed,     "Entity Relationship Code"),
+                b::Element(e::NotUsed,     "Entity Identifier Code")),
+              b::Segment(1000, s::N3, "Payer Address",
+                r::Required, d::RepeatCount.bounded(1),
+                b::Element(e::Required,    "Payer Address Line"),
+                b::Element(e::Situational, "Payer Address Line")),
+              b::Segment(1100, s::N4, "Payer City, State, ZIP Code",
+                r::Required, d::RepeatCount.bounded(1),
+                b::Element(e::Required,    "Payer City Name"),
+                b::Element(e::Required,    "Payer State or Province Code"),
+                b::Element(e::Required,    "Payer Postal Zone or ZIP Code"),
+                b::Element(e::NotUsed, "Country Code"),
+                b::Element(e::NotUsed,     "Location Qualifier"),
+                b::Element(e::NotUsed,     "Location Identifier")),
+              b::Segment(1200, s::REF, "Additional Payer Identification",
+                r::Situational, d::RepeatCount.bounded(4),
+                b::Element(e::Required,    "Reference Identification Qualifier", b::Values("2U", "EO", "HI", "NF")),
+                b::Element(e::Required,    "Additional Payer Identifier"),
+                b::Element(e::NotUsed,     "Description"),
+                b::Element(e::NotUsed,     "REFERENCE IDENTIFIER")),
+              b::Segment(1300, s::PER, "Payer Contact Information",
+                r::Situational, d::RepeatCount.bounded(1),
+                b::Element(e::Required,    "Contact Function Code", b::Values("CX")),
+                b::Element(e::Situational, "Payer Contact Name"),
+                b::Element(e::Situational, "Communication Number Qualifier", b::Values("EM", "FX", "TE")),
+                b::Element(e::Situational, "Communication Number"),
+                b::Element(e::Situational, "Communication Number Qualifier", b::Values("EM", "EX", "FX", "TE")),
+                b::Element(e::Situational, "Communication Number"),
+                b::Element(e::Situational, "Communication Number Qualifier", b::Values("EX")),
+                b::Element(e::Situational, "Communication Number"),
+                b::Element(e::NotUsed,     "Contact Inquiry Reference"))),
+
+            d::LoopDef.build("1000B PAYEE IDENTIFICATION",
+              d::RepeatCount.bounded(1),
+              b::Segment( 800, s::N1, "Payee Identification",
+                r::Required, d::RepeatCount.bounded(1),
+                b::Element(e::Required,    "Entity Identifier Code", b::Values("PE")),
+                b::Element(e::Situational, "Payee Name"),
+                b::Element(e::Required,    "Identification Code Qualifier", b::Values("FI", "XX")),
+                b::Element(e::Required,    "Payee Identification Code"),
+                b::Element(e::NotUsed,     "Entity Relationship Code"),
+                b::Element(e::NotUsed,     "Entity Identifier Code")),
+              b::Segment(1000, s::N3, "Payee Address",
+                r::Situational, d::RepeatCount.bounded(1),
+                b::Element(e::Required,    "Payee Address Line"),
+                b::Element(e::Situational, "Payee Address Line")),
+              b::Segment(1100, s::N4, "Payee City, State, ZIP Code",
+                r::Situational, d::RepeatCount.bounded(1),
+                b::Element(e::Required,    "Payee City Name"),
+                b::Element(e::Required,    "Payee State or Province Code"),
+                b::Element(e::Required,    "Payee Postal Zone or ZIP Code"),
+                b::Element(e::Situational, "Country Code"),
+                b::Element(e::NotUsed,     "Location Qualifier"),
+                b::Element(e::NotUsed,     "Location Identifier")),
+              b::Segment(1200, s::REF, "Payee Additional Identification",
+                r::Situational, d::RepeatCount.unbounded,
+                b::Element(e::Required,    "Reference Identification Qualifier", b::Values("0B", "1A", "1B", "1C", "1E", "1F", "1G", "1H", "D3", "G2", "N5", "PQ", "TJ")),
+                b::Element(e::Required,    "Additional Payee Identifier"),
+                b::Element(e::NotUsed,     "Description"),
+                b::Element(e::NotUsed,     "REFERENCE IDENTIFIER")))),
+
+          d::TableDef.detail("Table 2 - Detail",
+            d::LoopDef.build("2000 HEADER NUMBER",
+              d::RepeatCount.bounded(1),
+              b::Segment(30, s::LX, "Header Number",
+                r::Situational, d::RepeatCount.bounded(1),
+                b::Element(e::Required,    "Assigned Number")),
+              b::Segment(50, s::TS3, "Provider Summary Information",
+                r::Situational, d::RepeatCount.bounded(1),
+                b::Element(e::Required,    "Provider Identifier"),
+                b::Element(e::Required,    "Facility Type Code"),
+                b::Element(e::Required,    "Fiscal Period Date"),
+                b::Element(e::Required,    "Total Claim Count"),
+                b::Element(e::Required,    "Total Claim Charge Amount"),
+                b::Element(e::Situational, "Total Covered Charge Amount"),
+                b::Element(e::Situational, "Total Noncovered Charge Amount"),
+                b::Element(e::Situational, "Total Denied Charge Amount"),
+                b::Element(e::Situational, "Total Provider Payment Amount"),
+                b::Element(e::Situational, "Total Interest Amount"),
+                b::Element(e::Situational, "Total Contractual Adjustment Amount"),
+                b::Element(e::Situational, "Total Gramm-Rudman Reduction Amount"),
+                b::Element(e::Situational, "Total MSP Payer Amount"),
+                b::Element(e::Situational, "Total Blood Deductible Amount"),
+                b::Element(e::Situational, "Total Non-Lab Charge Amount"),
+                b::Element(e::Situational, "Total Coinsurance Amount"),
+                b::Element(e::Situational, "Total HCPCS Reported Charge Amount"),
+                b::Element(e::Situational, "Total HCPCS Payable Amount"),
+                b::Element(e::Situational, "Total Deductible Amount"),
+                b::Element(e::Situational, "Total Professional Component Amount"),
+                b::Element(e::Situational, "Total MSP Patient Liability Met Amount"),
+                b::Element(e::Situational, "Total Patient Reimbursement Amount"),
+                b::Element(e::Situational, "Total PIP Claim Count"),
+                b::Element(e::Situational, "Total PIP Adjustment Amount")),
+              b::Segment(70, s::TS2, "Provider Supplemental Summary Information",
+                r::Situational, d::RepeatCount.bounded(1),
+                b::Element(e::Situational,  "Total DRG Amount"),
+                b::Element(e::Situational,  "Total Federal Specific Amount"),
+                b::Element(e::Situational,  "Total Hospital Specific Amount"),
+                b::Element(e::Situational,  "Total Disproportionate Share Amount"),
+                b::Element(e::Situational,  "Total Capital Amount"),
+                b::Element(e::Situational,  "Total Indirect Medical Education Amount"),
+                b::Element(e::Situational,  "Total Outlier Day Count"),
+                b::Element(e::Situational,  "Total Day Outlier Amount"),
+                b::Element(e::Situational,  "Total Cost Outlier Amount"),
+                b::Element(e::Situational,  "Average DRG Length of Stay"),
+                b::Element(e::Situational,  "Total Discharge Count"),
+                b::Element(e::Situational,  "Total Cost Report Day Count"),
+                b::Element(e::Situational,  "Total Covered Day Count"),
+                b::Element(e::Situational,  "Total Noncovered Day Count"),
+                b::Element(e::Situational,  "Total MSP Pass-Through Amount"),
+                b::Element(e::Situational,  "Average DRG Weight"),
+                b::Element(e::Situational,  "Total PPS Capital FSP DRG Amount"),
+                b::Element(e::Situational,  "Total PPS Capital HSP DRG Amount"),
+                b::Element(e::Situational,  "Total PPS DSH DRG Amount")),
+
+              d::LoopDef.build("2100 CLAIM PAYMENT INFORMATION",
+                d::RepeatCount.unbounded,
+                b::Segment( 100, s::CLP, "Claim Payment Information",
+                  r::Required, d::RepeatCount.bounded(1),
+                  b::Element(e::Required,    "Patient Control Number"),
+                  b::Element(e::Required,    "Claim Status Code", b::Values("1", "2", "3", "4", "5", "10", "13", "15", "16", "17", "19", "20", "21", "22", "23", "25", "27")),
+                  b::Element(e::Required,    "Total Claim Charge Amount"),
+                  b::Element(e::Required,    "Claim Payment Amount"),
+                  b::Element(e::Situational, "Patient Responsibility Amount"),
+                  b::Element(e::Required,    "Claim Filing Indicator Code", b::Values("12", "13", "14", "15", "16", "AM", "CH", "DS", "HM", "LM", "MA", "MB", "MC", "OF", "TV", "VA", "WC")),
+                  b::Element(e::Situational, "Payer Claim Control Number"),
+                  b::Element(e::Situational, "Facility Type Code"),
+                  b::Element(e::Situational, "Claim Frequency Code"),
+                  b::Element(e::NotUsed,     "Patient Status Code"),
+                  b::Element(e::Situational, "Diagnosis Related Group (DRG) Code"),
+                  b::Element(e::Situational, "Diagnosis Related Group (DRG) Weight"),
+                  b::Element(e::Situational, "Discharge Fraction")),
+                b::Segment( 200, s::CAS, "Claim Adjustment",
+                  r::Situational, d::RepeatCount.bounded(99),
+                  b::Element(e::Required,    "Claim Adjustment Group Code", b::Values("CO", "CR", "OA", "PI", "PR")),
+                  b::Element(e::Required,    "Adjustment Reason Code"),
+                  b::Element(e::Required,    "Adjustment Amount"),
+                  b::Element(e::Situational, "Adjustment Quantity"),
+                  b::Element(e::Situational, "Adjustment Reason Code"),
+                  b::Element(e::Situational, "Adjustment Amount"),
+                  b::Element(e::Situational, "Adjustment Quantity"),
+                  b::Element(e::Situational, "Adjustment Reason Code"),
+                  b::Element(e::Situational, "Adjustment Amount"),
+                  b::Element(e::Situational, "Adjustment Quantity"),
+                  b::Element(e::Situational, "Adjustment Reason Code"),
+                  b::Element(e::Situational, "Adjustment Amount"),
+                  b::Element(e::Situational, "Adjustment Quantity"),
+                  b::Element(e::Situational, "Adjustment Reason Code"),
+                  b::Element(e::Situational, "Adjustment Amount"),
+                  b::Element(e::Situational, "Adjustment Quantity"),
+                  b::Element(e::Situational, "Adjustment Reason Code"),
+                  b::Element(e::Situational, "Adjustment Amount"),
+                  b::Element(e::Situational, "Adjustment Quantity")),
+                b::Segment( 300, s::NM1, "Patient Name",
+                  r::Required, d::RepeatCount.bounded(1),
+                  b::Element(e::Required,    "Entity Identifier Code", b::Values("QC")),
+                  b::Element(e::Required,    "Entity Type Qualifier", b::Values("1")),
+                  b::Element(e::Required,    "Patient Last Name"),
+                  b::Element(e::Required,    "Patient First Name"),
+                  b::Element(e::Situational, "Patient Middle Name or Initial"),
+                  b::Element(e::NotUsed,     "Name Prefix"),
+                  b::Element(e::Situational, "Patient Name Suffix"),
+                  b::Element(e::Situational, "Identification Code Qualifier", b::Values("34", "HN", "II", "MI", "MR")),
+                  b::Element(e::Situational, "Patient Identifier"),
+                  b::Element(e::NotUsed,     "Entity Relationship Code"),
+                  b::Element(e::NotUsed,     "Entity Identifier Code")),
+                b::Segment( 300, s::NM1, "Insured Name",
+                  r::Situational, d::RepeatCount.bounded(1),
+                  b::Element(e::Required,    "Entity Identifier Code", b::Values("IL")),
+                  b::Element(e::Required,    "Entity Type Qualifier", b::Values("1", "2")),
+                  b::Element(e::Situational, "Subscriber Last Name"),
+                  b::Element(e::Situational, "Subscriber First Name"),
+                  b::Element(e::Situational, "Subscriber Middle Name or Initial"),
+                  b::Element(e::NotUsed,     "Name Prefix"),
+                  b::Element(e::Situational, "Subscriber Name Suffix"),
+                  b::Element(e::Required,    "Identification Code Qualifier", b::Values("34", "HN", "MI")),
+                  b::Element(e::Required,    "Subscriber Identifier"),
+                  b::Element(e::NotUsed,     "Entity Relationship Code"),
+                  b::Element(e::NotUsed,     "Entity Identifier Code")),
+                b::Segment( 300, s::NM1, "Corrected Patient/Insured Name",
+                  r::Situational, d::RepeatCount.bounded(1),
+                  b::Element(e::Required,    "Entity Identifier Code", b::Values("74")),
+                  b::Element(e::Required,    "Entity Type Qualifier", b::Values("1", "2")),
+                  b::Element(e::Situational, "Corrected Patient or Insured Last Name"),
+                  b::Element(e::Situational, "Corrected Patient or Insured First Name"),
+                  b::Element(e::Situational, "Corrected Patient or Insured Middle Name or Initial"),
+                  b::Element(e::NotUsed,     "Name Prefix"),
+                  b::Element(e::Situational, "Corrected Patient or Insured Name Suffix"),
+                  b::Element(e::Situational, "Identification Code Qualifier", b::Values("C")),
+                  b::Element(e::Situational, "Corrected Insured Identification Indicator"),
+                  b::Element(e::NotUsed,     "Entity Relationship Code"),
+                  b::Element(e::NotUsed,     "Entity Identifier Code")),
+                b::Segment( 300, s::NM1, "Service Provider Name",
+                  r::Situational, d::RepeatCount.bounded(1),
+                  b::Element(e::Required,    "Entity Identifier Code", b::Values("82")),
+                  b::Element(e::Required,    "Entity Type Qualifier", b::Values("1", "2")),
+                  b::Element(e::Situational, "Rendering Provider Last or Organization Name"),
+                  b::Element(e::Situational, "Rendering Provider First Name"),
+                  b::Element(e::Situational, "Rendering Provider Middle Name or Initial"),
+                  b::Element(e::NotUsed,     "Name Prefix"),
+                  b::Element(e::Situational, "Rendering Provider Name Suffix"),
+                  b::Element(e::Required,    "Identification Code Qualifier", b::Values("BD", "BS", "FI", "MC", "PC", "SL", "UP", "XX")),
+                  b::Element(e::Required,    "Rendering Provider Identifier"),
+                  b::Element(e::NotUsed,     "Entity Relationship Code"),
+                  b::Element(e::NotUsed,     "Entity Identifier Code")),
+                b::Segment( 300, s::NM1, "Crossover Carrier Name",
+                  r::Situational, d::RepeatCount.bounded(1),
+                  b::Element(e::Required,    "Entity Identifier Code", b::Values("TT")),
+                  b::Element(e::Required,    "Entity Type Qualifier", b::Values("2")),
+                  b::Element(e::Required,    "Coordination of Benefits Carrier Name"),
+                  b::Element(e::NotUsed,     "Name First"),
+                  b::Element(e::NotUsed,     "Name Middle"),
+                  b::Element(e::NotUsed,     "Name Prefix"),
+                  b::Element(e::NotUsed,     "Name Suffix"),
+                  b::Element(e::Required,    "Identification Code Qualifier", b::Values("AD", "FI", "NI", "PI", "PP", "XV")),
+                  b::Element(e::Required,    "Coordination of Benefits Carrient Identifier"),
+                  b::Element(e::NotUsed,     "Entity Relationship Code"),
+                  b::Element(e::NotUsed,     "Entity Identifier Code")),
+                b::Segment( 300, s::NM1, "Corrected Priority Payer Name",
+                  r::Situational, d::RepeatCount.bounded(1),
+                  b::Element(e::Required,    "Entity Identifier Code", b::Values("PR")),
+                  b::Element(e::Required,    "Entity Type Qualifier", b::Values("2")),
+                  b::Element(e::Required,    "Corrected Priority Payer Name"),
+                  b::Element(e::NotUsed,     "Name First"),
+                  b::Element(e::NotUsed,     "Name Middle"),
+                  b::Element(e::NotUsed,     "Name Prefix"),
+                  b::Element(e::NotUsed,     "Name Suffix"),
+                  b::Element(e::Required,    "Identification Code Qualifier", b::Values("AD", "FI", "NI", "PI", "PP", "XV")),
+                  b::Element(e::Required,    "Corrected Priority Payer Identification Number"),
+                  b::Element(e::NotUsed,     "Entity Relationship Code"),
+                  b::Element(e::NotUsed,     "Entity Identifier Code")),
+                b::Segment( 330, s::MIA, "Inpatient Adjudication Information",
+                  r::Situational, d::RepeatCount.bounded(1),
+                  b::Element(e::Required,    "Covered Days or Visits Count"),
+                  b::Element(e::Situational, "PPS Operating Outlier Amount"),
+                  b::Element(e::Situational, "Lifetime Psychiatric Days Count"),
+                  b::Element(e::Situational, "Claim DRG Amount"),
+                  b::Element(e::Situational, "Remark Code"),
+                  b::Element(e::Situational, "Claim Disproportionate Share Amount"),
+                  b::Element(e::Situational, "Claim MSP Pass-Through Amount"),
+                  b::Element(e::Situational, "Claim PPS Capital Amount"),
+                  b::Element(e::Situational, "PPS-Capital FSP DRG Amount"),
+                  b::Element(e::Situational, "PPS-Capital HSP DRG Amount"),
+                  b::Element(e::Situational, "PPS-Capital DSH DRG Amount"),
+                  b::Element(e::Situational, "Old Capital Amount"),
+                  b::Element(e::Situational, "PPS-Capital IME Amount"),
+                  b::Element(e::Situational, "PPS-Operating Hospital Specific DRG Amount"),
+                  b::Element(e::Situational, "Cost Report Day Count"),
+                  b::Element(e::Situational, "PPS-Operating Federal Specific DRG Amount"),
+                  b::Element(e::Situational, "Claim PPS Capital Outlier Amount"),
+                  b::Element(e::Situational, "Claim Indirect Teaching Amount"),
+                  b::Element(e::Situational, "Nonpayable Professional Component Amount"),
+                  b::Element(e::Situational, "Remark Code"),
+                  b::Element(e::Situational, "Remark Code"),
+                  b::Element(e::Situational, "Remark Code"),
+                  b::Element(e::Situational, "Remark Code"),
+                  b::Element(e::Situational, "PPS-Capital Exception Amount")),
+                b::Segment( 350, s::MOA, "Outpatient Adjudication Information",
+                  r::Situational, d::RepeatCount.bounded(1),
+                  b::Element(e::Situational, "Reimbursement Rate"),
+                  b::Element(e::Situational, "Claim HCPCS Payable Amount"),
+                  b::Element(e::Situational, "Remark Code"),
+                  b::Element(e::Situational, "Remark Code"),
+                  b::Element(e::Situational, "Remark Code"),
+                  b::Element(e::Situational, "Remark Code"),
+                  b::Element(e::Situational, "Remark Code"),
+                  b::Element(e::Situational, "Claim ESRD Payment Amount"),
+                  b::Element(e::Situational, "Nonpayable Professional Component Amount")),
+                b::Segment( 400, s::REF, "Other Claim Related Identification",
+                  r::Situational, d::RepeatCount.bounded(5),
+                  b::Element(e::Required,    "Reference Identification Qualifier", b::Values("1L", "1W", "9A", "9C", "A6", "BB", "CE", "EA", "F8", "G1", "G3", "IG", "SY")),
+                  b::Element(e::Required,    "Other Claim Related Identifier"),
+                  b::Element(e::NotUsed,     "Description"),
+                  b::Element(e::NotUsed,     "REFERENCE IDENTIFIER")),
+                b::Segment( 400, s::REF, "Rendering Provider Identification",
+                  r::Situational, d::RepeatCount.bounded(10),
+                  b::Element(e::Required,    "Reference Identification Qualifier", b::Values("1A", "1B", "1C", "1D", "1G", "1H", "D3", "G2")),
+                  b::Element(e::Required,    "Rendering Provider Secondary Identifier"),
+                  b::Element(e::NotUsed,     "Description"),
+                  b::Element(e::NotUsed,     "REFERENCE IDENTIFIER")),
+                b::Segment( 500, s::DTM, "Claim Date",
+                  r::Situational, d::RepeatCount.bounded(4),
+                  b::Element(e::Required,    "Date/Time Qualifier", b::Values("036", "050", "232", "233")),
+                  b::Element(e::Required,    "Claim Date"),
+                  b::Element(e::NotUsed,     "Time"),
+                  b::Element(e::NotUsed,     "Time Code"),
+                  b::Element(e::NotUsed,     "Date Time Period Format Qualifier"),
+                  b::Element(e::NotUsed,     "Date Time Period")),
+                b::Segment( 600, s::PER, "Claim Contact Information",
+                  r::Situational, d::RepeatCount.bounded(2),
+                  b::Element(e::Required,    "Contact Function Code", b::Values("CX")),
+                  b::Element(e::Situational, "Claim Contact Name"),
+                  b::Element(e::Situational, "Communication Number Qualifier", b::Values("EM", "FX", "TE")),
+                  b::Element(e::Situational, "Claim Contact Communication Number"),
+                  b::Element(e::Situational, "Communication Number Qualifier", b::Values("EM", "EX", "FX", "TE")),
+                  b::Element(e::Situational, "Claim Contact Communication Number"),
+                  b::Element(e::Situational, "Communication Number Qualifier", b::Values("EX")),
+                  b::Element(e::Situational, "Claim Contact Communication Number Extension"),
+                  b::Element(e::NotUsed,     "Contact Inquiry Reference")),
+                b::Segment( 620, s::AMT, "Claim Supplemental Information",
+                  r::Situational, d::RepeatCount.bounded(13),
+                  b::Element(e::Required,    "Amount Qualifier Code", b::Values("AU", "D8", "DY", "F5", "I", "NL", "T", "T2", "ZK", "ZL", "ZM", "ZN", "ZO", "ZZ")),
+                  b::Element(e::Required,    "Claim Supplemental Information Amount"),
+                  b::Element(e::NotUsed,     "Credit/Debit Flag Code")),
+                b::Segment( 640, s::QTY, "Claim Supplemental Information Quantity",
+                  r::Situational, d::RepeatCount.bounded(14),
+                  b::Element(e::Required,    "Quantity Qualifier", b::Values("CA", "CD", "LA", "LE", "NA", "NE", "NR", "OU", "PS", "VS", "ZK", "ZL", "ZM", "ZN", "ZO")),
+                  b::Element(e::Required,    "Claim Supplemental Information Quantity"),
+                  b::Element(e::NotUsed,     "COMPOSITE UNIT OF MEASURE"),
+                  b::Element(e::NotUsed,     "Free-Form Information")),
+
+                d::LoopDef.build("2110 SERVICE PAYMENT INFORMATION",
+                  d::RepeatCount.bounded(999),
+                  b::Segment( 700, s::SVC, "Service Payment Information",
+                    r::Situational, d::RepeatCount.bounded(1),
+                    b::Element(e::Required,    "COMPOSITE MEDICAL PROCEDURE IDENTIFIER",
+                      b::Element(e::Required,    "Product or Service ID Qualifier", b::Values("AD", "ER", "HC", "ID", "IV", "N1", "N2", "N3", "N4", "ND", "NU", "RB", "ZZ")),
+                      b::Element(e::Required,    "Procedure Code"),
+                      b::Element(e::Situational, "Procedure Modifier"),
+                      b::Element(e::Situational, "Procedure Modifier"),
+                      b::Element(e::Situational, "Procedure Modifier"),
+                      b::Element(e::Situational, "Procedure Modifier"),
+                      b::Element(e::Situational, "Procedure Code Description")),
+                    b::Element(e::Required,    "Line Item Charge Amount"),
+                    b::Element(e::Required,    "Line Item Provider Payment Amount"),
+                    b::Element(e::Situational, "National Uniform Billing Committee Revenue Code"),
+                    b::Element(e::Situational, "Units of Service Paid Count"),
+                    b::Element(e::Situational, "COMPOSITE MEDICAL PROCEDURE IDENTIFIER",
+                      b::Element(e::Required,    "Product or Service ID Qualifier", b::Values("AD", "ER", "HC", "ID", "IV", "N1", "N2", "N3", "N4", "ND", "NU", "RB", "ZZ")),
+                      b::Element(e::Required,    "Procedure Code"),
+                      b::Element(e::Situational, "Procedure Modifier"),
+                      b::Element(e::Situational, "Procedure Modifier"),
+                      b::Element(e::Situational, "Procedure Modifier"),
+                      b::Element(e::Situational, "Procedure Modifier"),
+                      b::Element(e::Situational,     "Procedure Code Description")),
+                    b::Element(e::Situational, "Original Units of Service Count")),
+                  b::Segment( 800, s::DTM, "Service Date",
+                    r::Situational, d::RepeatCount.bounded(2),
+                    b::Element(e::Required,    "Date/Time Qualifier", b::Values("150", "151", "472")),
+                    b::Element(e::Required,    "Service Date"),
+                    b::Element(e::NotUsed,     "Time"),
+                    b::Element(e::NotUsed,     "Time Code"),
+                    b::Element(e::NotUsed,     "Date Time Period Format Qualifier"),
+                    b::Element(e::NotUsed,     "Date Time Period")),
+                  b::Segment( 900, s::CAS, "Service Adjustment",
+                    r::Situational, d::RepeatCount.bounded(99),
+                    b::Element(e::Required,    "Claim Adjustment Group Code", b::Values("CO", "CR", "OA", "PI", "PR")),
+                    b::Element(e::Required,    "Adjustment Reason Code"),
+                    b::Element(e::Required,    "Adjustment Amount", b::MaxLength(10)),
+                    b::Element(e::Situational, "Adjustment Quantity"),
+                    b::Element(e::Situational, "Adjustment Reason Code"),
+                    b::Element(e::Situational, "Adjustment Amount", b::MaxLength(10)),
+                    b::Element(e::Situational, "Adjustment Quantity"),
+                    b::Element(e::Situational, "Adjustment Reason Code"),
+                    b::Element(e::Situational, "Adjustment Amount", b::MaxLength(10)),
+                    b::Element(e::Situational, "Adjustment Quantity"),
+                    b::Element(e::Situational, "Adjustment Reason Code"),
+                    b::Element(e::Situational, "Adjustment Amount", b::MaxLength(10)),
+                    b::Element(e::Situational, "Adjustment Quantity"),
+                    b::Element(e::Situational, "Adjustment Reason Code"),
+                    b::Element(e::Situational, "Adjustment Amount", b::MaxLength(10)),
+                    b::Element(e::Situational, "Adjustment Quantity"),
+                    b::Element(e::Situational, "Adjustment Reason Code"),
+                    b::Element(e::Situational, "Adjustment Amount", b::MaxLength(10)),
+                    b::Element(e::Situational, "Adjustment Quantity")),
+                  b::Segment(1000, s::REF, "Service Identification",
+                    r::Situational, d::RepeatCount.bounded(8),
+                    b::Element(e::Required,    "Reference Identification Qualifier", b::Values("1S", "6R", "BB", "E9", "G1", "G3", "LU", "RB")),
+                    b::Element(e::Required,    "Provider Identifier"),
+                    b::Element(e::NotUsed,     "Description"),
+                    b::Element(e::NotUsed,     "REFERENCE IDENTIFIER")),
+                  b::Segment(1000, s::REF, "Rendering Provider Information",
+                    r::Situational, d::RepeatCount.bounded(10),
+                    b::Element(e::Required,    "Reference Identification Qualifier", b::Values("1A", "1B", "1C", "1D", "1G", "1H", "1J", "HPI", "SY", "TJ")),
+                    b::Element(e::Required,    "Rendering Provider Identifier"),
+                    b::Element(e::NotUsed,     "Description"),
+                    b::Element(e::NotUsed,     "REFERENCE IDENTIFIER")),
+                  b::Segment(1100, s::AMT, "Service Supplemental Amount",
+                    r::Situational, d::RepeatCount.bounded(9),
+                    b::Element(e::Required,    "Amount Qualifier Code", b::Values("B6", "DY", "KH", "NE", "T", "T2", "ZK", "ZL", "ZM", "ZN", "ZO")),
+                    b::Element(e::Required,    "Service Supplemental Amount", b::MaxLength(10)),
+                    b::Element(e::NotUsed,     "Credit/Debit Flag Code")),
+                  b::Segment(1200, s::QTY, "Service Supplemental Quantity",
+                    r::Situational, d::RepeatCount.bounded(6),
+                    b::Element(e::Required,    "Quantity Qualifier", b::Values("NE", "ZK", "ZL", "ZM", "ZN", "ZO")),
+                    b::Element(e::Required,    "Service Supplemental Quantity Count"),
+                    b::Element(e::NotUsed,     "COMPOSITE UNIT OF MEASURE"),
+                    b::Element(e::NotUsed,     "Free-Form Information")),
+                  b::Segment(1300, s::LQ, "Health Care Remark Codes",
+                    r::Situational, d::RepeatCount.bounded(99),
+                    b::Element(e::Required,    "Code List Qualifier Code", b::Values("HE", "RX")),
+                    b::Element(e::Required,    "Remark Code")))))),
+
+          d::TableDef.summary("Table 3 - Summary",
+            b::Segment(100, s::PLB, "Provider Adjustment",
+              r::Situational, d::RepeatCount.unbounded,
+              b::Element(e::Required,    "Provider Identifier"),
+              b::Element(e::Required,    "Fiscal Period Date"),
+              b::Element(e::Required,    "ADJUSTMENT IDENTIFIER",
+                b::Element(e::Required,    "Adjustment Reason Code", b::Values("50", "51", "72", "90", "AM", "AP", "B2", "B3", "BD", "BN", "C5", "CR", "CS", "CT", "CV", "CW", "DM", "E3", "FB", "FC", "GO", "IP", "IR", "IS", "J1", "L3", "L6", "LE", "LS", "OA", "OB", "PI", "PL", "RA", "RE", "SL", "TL", "WO", "WU", "ZZ")),
+                b::Element(e::Situational, "Provider Adjustment Identifier")),
+              b::Element(e::Required,    "Provider Adjustment Amount", b::MaxLength(10)),
+              b::Element(e::Situational, "ADJUSTMENT IDENTIFIER",
+                b::Element(e::Required,    "Adjustment Reason Code", b::Values("50", "51", "72", "90", "AM", "AP", "B2", "B3", "BD", "BN", "C5", "CR", "CS", "CT", "CV", "CW", "DM", "E3", "FB", "FC", "GO", "IP", "IR", "IS", "J1", "L3", "L6", "LE", "LS", "OA", "OB", "PI", "PL", "RA", "RE", "SL", "TL", "WO", "WU", "ZZ")),
+                b::Element(e::Situational, "Provider Adjustment Identifier")),
+              b::Element(e::Situational, "Provider Adjustment Amount", b::MaxLength(10)),
+              b::Element(e::Situational, "ADJUSTMENT IDENTIFIER",
+                b::Element(e::Required,    "Adjustment Reason Code", b::Values("50", "51", "72", "90", "AM", "AP", "B2", "B3", "BD", "BN", "C5", "CR", "CS", "CT", "CV", "CW", "DM", "E3", "FB", "FC", "GO", "IP", "IR", "IS", "J1", "L3", "L6", "LE", "LS", "OA", "OB", "PI", "PL", "RA", "RE", "SL", "TL", "WO", "WU", "ZZ")),
+                b::Element(e::Situational, "Provider Adjustment Identifier")),
+              b::Element(e::Situational, "Provider Adjustment Amount", b::MaxLength(10)),
+              b::Element(e::Situational, "ADJUSTMENT IDENTIFIER",
+                b::Element(e::Required,    "Adjustment Reason Code", b::Values("50", "51", "72", "90", "AM", "AP", "B2", "B3", "BD", "BN", "C5", "CR", "CS", "CT", "CV", "CW", "DM", "E3", "FB", "FC", "GO", "IP", "IR", "IS", "J1", "L3", "L6", "LE", "LS", "OA", "OB", "PI", "PL", "RA", "RE", "SL", "TL", "WO", "WU", "ZZ")),
+                b::Element(e::Situational, "Provider Adjustment Identifier")),
+              b::Element(e::Situational, "Provider Adjustment Amount", b::MaxLength(10)),
+              b::Element(e::Situational, "ADJUSTMENT IDENTIFIER",
+                b::Element(e::Required,    "Adjustment Reason Code", b::Values("50", "51", "72", "90", "AM", "AP", "B2", "B3", "BD", "BN", "C5", "CR", "CS", "CT", "CV", "CW", "DM", "E3", "FB", "FC", "GO", "IP", "IR", "IS", "J1", "L3", "L6", "LE", "LS", "OA", "OB", "PI", "PL", "RA", "RE", "SL", "TL", "WO", "WU", "ZZ")),
+                b::Element(e::Situational, "Provider Adjustment Identifier")),
+              b::Element(e::Situational, "Provider Adjustment Amount", b::MaxLength(10)),
+              b::Element(e::Situational, "ADJUSTMENT IDENTIFIER",
+                b::Element(e::Required,    "Adjustment Reason Code", b::Values("50", "51", "72", "90", "AM", "AP", "B2", "B3", "BD", "BN", "C5", "CR", "CS", "CT", "CV", "CW", "DM", "E3", "FB", "FC", "GO", "IP", "IR", "IS", "J1", "L3", "L6", "LE", "LS", "OA", "OB", "PI", "PL", "RA", "RE", "SL", "TL", "WO", "WU", "ZZ")),
+                b::Element(e::Situational, "Provider Adjustment Identifier")),
+              b::Element(e::Situational, "Provider Adjustment Amount", b::MaxLength(10))),
+            b::Segment(200, s::SE, "Transaction Set Trailer",
+              r::Required, d::RepeatCount.bounded(1),
+              b::Element(e::Required,    "Transaction Segment Count"),
+              b::Element(e::Required,    "Transaction Set Control Number"))))
+
+      end
+    end
+  end
+end