stupidedi 1.2.17 → 1.2.18
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- checksums.yaml +4 -4
- data/README.md +1 -1
- data/bin/edi-pp +1 -1
- data/lib/stupidedi/config.rb +3 -0
- data/lib/stupidedi/contrib/004010/guides.rb +1 -0
- data/lib/stupidedi/contrib/004010/transaction_set_defs.rb +3 -0
- data/lib/stupidedi/contrib/004010/transaction_set_defs/PR855.rb +35 -0
- data/lib/stupidedi/contrib/004010/transaction_set_defs/SH856.rb +26 -12
- data/lib/stupidedi/guides/005010.rb +4 -0
- data/lib/stupidedi/guides/005010/X212-HR276.rb +387 -0
- data/lib/stupidedi/guides/005010/guide_builder.rb +2 -2
- data/lib/stupidedi/version.rb +1 -1
- data/lib/stupidedi/versions/functional_groups/004010/element_defs.rb +6 -1
- data/lib/stupidedi/versions/functional_groups/004010/element_types/time_val.rb +1 -0
- data/lib/stupidedi/versions/functional_groups/004010/segment_defs.rb +9 -0
- data/lib/stupidedi/versions/functional_groups/004010/segment_defs/BAK.rb +24 -0
- data/lib/stupidedi/versions/functional_groups/004010/segment_defs/PRF.rb +20 -0
- data/lib/stupidedi/versions/functional_groups/004010/segment_defs/TD4.rb +26 -0
- data/lib/stupidedi/versions/functional_groups/004010/segment_defs/TD5.rb +2 -2
- data/lib/stupidedi/versions/functional_groups/005010/element_defs.rb +6 -3
- data/spec/examples/integration/parsing/005010/X091A1-HP835.example +94 -0
- data/spec/examples/integration/parsing/005010/X212-HR276.example +152 -0
- data/spec/examples/integration/parsing/005010/X221-HP835.example +386 -0
- data/spec/examples/integration/parsing/005010/X222-HC837.example +257 -0
- data/spec/fixtures/PR855/1-good-v4010.txt +11 -0
- data/spec/fixtures/PR855/2-good-v4010.txt +17 -0
- data/spec/fixtures/SH856/2-good.txt +31 -0
- data/spec/support/matchers/navigation_matchers.rb +0 -1
- metadata +17 -3
- data/spec/examples/integration/parsing.example +0 -674
checksums.yaml
CHANGED
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@@ -1,7 +1,7 @@
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1
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---
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SHA256:
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-
metadata.gz:
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data.tar.gz:
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metadata.gz: e34a8e41d60b6bb5fe3eb04f3ca7f0488ca045ff8395db0634b52770f234251c
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4
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data.tar.gz: 065f865f6a7c4d128500bd089d66e4c8c439e041e1a185957c5fe0249f8cdfa8
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SHA512:
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metadata.gz:
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data.tar.gz:
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metadata.gz: 56fed9ac0fdbb889e228be5a33c84d84f38bae2f7bba4c54ef4e547b4096a2a52720adae3d2db77e7c9310417ff23771a24b81711268a132d8d433545c202439
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7
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data.tar.gz: e835b0a90b46bf60d964b391cb6d51ec18d158a04a4a4b0114626469db40f5fff382cd80cb240d012a57f1aa21684a6a0b034c67bb90ed701d68cbde354740ff
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data/README.md
CHANGED
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@@ -1,5 +1,5 @@
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1
1
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# Stupidedi
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2
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-
[](http://travis-ci.org/irobayna/stupidedi) [](http://travis-ci.org/irobayna/stupidedi) [](http://badge.fury.io/gh/irobayna%2Fstupidedi) [](https://codeclimate.com/github/irobayna/stupidedi) [](http://inch-ci.org/github/irobayna/stupidedi)
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data/bin/edi-pp
CHANGED
data/lib/stupidedi/config.rb
CHANGED
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@@ -98,6 +98,7 @@ module Stupidedi
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98
98
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base.customize do |c|
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99
99
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c.transaction_set.customize do |x|
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100
100
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x.register("004010", "HP", "835") { Stupidedi::Versions::FunctionalGroups::FortyTen::TransactionSetDefs::HP835 }
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101
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+
x.register("005010", "HR", "276") { Stupidedi::Versions::FunctionalGroups::FiftyTen::TransactionSetDefs::HR276 }
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101
102
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x.register("005010", "HN", "277") { Stupidedi::Versions::FunctionalGroups::FiftyTen::TransactionSetDefs::HN277 }
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102
103
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x.register("005010", "BE", "834") { Stupidedi::Versions::FunctionalGroups::FiftyTen::TransactionSetDefs::BE834 }
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103
104
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x.register("005010", "HP", "835") { Stupidedi::Versions::FunctionalGroups::FiftyTen::TransactionSetDefs::HP835 }
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@@ -105,6 +106,7 @@ module Stupidedi
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105
106
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x.register("005010", "FA", "999") { Stupidedi::Versions::FunctionalGroups::FiftyTen::TransactionSetDefs::FA999 }
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106
107
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107
108
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x.register("004010X091A1", "HP", "835") { Stupidedi::Guides::FortyTen::X091A1::HP835 }
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109
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+
x.register("005010X212", "HR", "276") { Stupidedi::Guides::FiftyTen::X212::HR276 }
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108
110
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x.register("005010X214", "HN", "277") { Stupidedi::Guides::FiftyTen::X214::HN277 }
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109
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x.register("005010X220", "BE", "834") { Stupidedi::Guides::FiftyTen::X220::BE834 }
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x.register("005010X221", "HP", "835") { Stupidedi::Guides::FiftyTen::X221::HP835 }
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@@ -128,6 +130,7 @@ module Stupidedi
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128
130
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base.customize do |c|
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129
131
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c.transaction_set.customize do |x|
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130
132
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x.register("004010", "PO", "850") { Stupidedi::Contrib::FortyTen::TransactionSetDefs::PO850 }
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133
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+
x.register("004010", "PR", "855") { Stupidedi::Contrib::FortyTen::TransactionSetDefs::PR855 }
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134
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x.register("004010", "OW", "940") { Stupidedi::Contrib::FortyTen::TransactionSetDefs::OW940 }
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x.register("004010", "AR", "943") { Stupidedi::Contrib::FortyTen::TransactionSetDefs::AR943 }
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x.register("004010", "RE", "944") { Stupidedi::Contrib::FortyTen::TransactionSetDefs::RE944 }
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@@ -10,6 +10,7 @@ module Stupidedi
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10
10
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11
11
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autoload :IM210, "stupidedi/contrib/004010/guides/IM210"
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12
12
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autoload :PO850, "stupidedi/contrib/004010/guides/PO850"
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13
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+
autoload :PR855, "stupidedi/contrib/004010/guides/PR855"
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14
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autoload :OW940, "stupidedi/contrib/004010/guides/OW940"
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autoload :AR943, "stupidedi/contrib/004010/guides/AR943"
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16
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autoload :RE944, "stupidedi/contrib/004010/guides/RE944"
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@@ -10,6 +10,9 @@ module Stupidedi
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10
10
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autoload :PO850, # Purchase Order
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11
11
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"stupidedi/contrib/004010/transaction_set_defs/PO850"
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12
12
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13
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+
autoload :PR855, # Purchase Order
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14
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+
"stupidedi/contrib/004010/transaction_set_defs/PR855"
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15
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+
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13
16
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autoload :OW940, # Warehouse Shipping Order
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14
17
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"stupidedi/contrib/004010/transaction_set_defs/OW940"
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15
18
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@@ -0,0 +1,35 @@
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1
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+
# frozen_string_literal: true
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2
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module Stupidedi
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3
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+
module Contrib
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4
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+
module FortyTen
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5
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module TransactionSetDefs
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6
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+
d = Schema
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7
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+
r = SegmentReqs
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8
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s = SegmentDefs
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9
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+
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10
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PR855 = d::TransactionSetDef.build("PR", "855",
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11
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"Purchase Order Ack",
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12
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+
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13
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+
d::TableDef.header("Table 1 - Header",
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14
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+
s:: ST.use( 10, r::Mandatory, d::RepeatCount.bounded(1)),
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15
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+
s::BAK.use( 20, r::Mandatory, d::RepeatCount.bounded(1)),
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16
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+
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17
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+
d::LoopDef.build("N1", d::RepeatCount.bounded(200),
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18
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+
s:: N1.use( 310, r::Optional, d::RepeatCount.bounded(1)),
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19
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+
s:: N3.use( 330, r::Optional, d::RepeatCount.bounded(2)),
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20
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+
s:: N4.use( 340, r::Optional, d::RepeatCount.unbounded),
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21
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+
s::REF.use( 350, r::Optional, d::RepeatCount.bounded(12)))),
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22
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+
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23
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+
d::TableDef.header("Table 2 - Detail",
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24
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+
d::LoopDef.build("PO1", d::RepeatCount.bounded(10000),
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25
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+
s::PO1.use( 10, r::Mandatory, d::RepeatCount.bounded(1)))),
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26
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+
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27
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+
d::TableDef.header("Table 3 - Summary",
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28
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+
d::LoopDef.build("CTT", d::RepeatCount.bounded(1),
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29
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+
s::CTT.use( 10, r::Optional, d::RepeatCount.bounded(1))),
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30
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+
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31
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+
s:: SE.use( 30, r::Optional, d::RepeatCount.bounded(1))))
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32
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+
end
|
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33
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+
end
|
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34
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+
end
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35
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+
end
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@@ -11,24 +11,38 @@ module Stupidedi
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11
11
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SH856 = d::TransactionSetDef.build("SH", "856", "Ship Notice/Manifest",
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12
12
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13
13
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d::TableDef.header("Table 1 - Header",
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14
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-
s:: ST.use(
|
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15
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-
s::BSN.use(
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16
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-
s::DTM.use(
|
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14
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+
s:: ST.use( 10, r::Mandatory, d::RepeatCount.bounded(1)),
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15
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+
s::BSN.use( 20, r::Mandatory, d::RepeatCount.bounded(1)),
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16
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+
s::DTM.use( 40, r::Optional, d::RepeatCount.bounded(10))
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17
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+
),
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17
18
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18
19
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d::TableDef.detail("Table 2 - Detail",
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19
20
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d::LoopDef.build("HL", d::RepeatCount.bounded(200000),
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20
|
-
s:: HL.use(
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21
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-
s::
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22
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-
s::
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23
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-
s::
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24
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-
s::
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25
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-
s::
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26
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-
s::
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27
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-
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21
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+
s:: HL.use( 10, r::Mandatory, d::RepeatCount.bounded(1)),
|
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22
|
+
s::MEA.use( 80, r::Optional, d::RepeatCount.bounded(40)),
|
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23
|
+
s::TD1.use(110, r::Optional, d::RepeatCount.bounded(20)),
|
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24
|
+
s::TD5.use(120, r::Optional, d::RepeatCount.bounded(12)),
|
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25
|
+
s::TD3.use(130, r::Optional, d::RepeatCount.bounded(12)),
|
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26
|
+
s::TD4.use(140, r::Optional, d::RepeatCount.bounded(5)),
|
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27
|
+
s::REF.use(150, r::Optional, d::RepeatCount.unbounded),
|
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28
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+
),
|
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29
|
+
d::LoopDef.build("N1", d::RepeatCount.bounded(200),
|
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30
|
+
s:: N1.use( 310, r::Optional, d::RepeatCount.bounded(1)),
|
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31
|
+
s:: N3.use( 330, r::Optional, d::RepeatCount.bounded(2)),
|
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32
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+
s:: N4.use( 340, r::Optional, d::RepeatCount.unbounded),
|
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33
|
+
s::REF.use( 350, r::Optional, d::RepeatCount.bounded(12))),
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34
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+
d::LoopDef.build("HL", d::RepeatCount.bounded(200),
|
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35
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+
s:: N1.use( 310, r::Optional, d::RepeatCount.bounded(1)),
|
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36
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+
s:: N1.use( 310, r::Optional, d::RepeatCount.bounded(1)),
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37
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+
s::REF.use( 350, r::Optional, d::RepeatCount.bounded(12))),
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38
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+
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39
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+
),
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28
40
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29
41
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d::TableDef.summary("Table 4 - Summary",
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30
42
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s::CTT.use(100, r::Optional, d::RepeatCount.bounded(1)),
|
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31
|
-
s:: SE.use(200, r::Mandatory, d::RepeatCount.bounded(1))
|
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43
|
+
s:: SE.use(200, r::Mandatory, d::RepeatCount.bounded(1))
|
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44
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+
)
|
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45
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)
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32
46
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33
47
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end
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34
48
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end
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@@ -13,6 +13,10 @@ module Stupidedi
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13
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autoload :ElementReqs, "stupidedi/guides/005010/element_reqs"
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14
14
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autoload :GuideBuilder, "stupidedi/guides/005010/guide_builder"
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15
15
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16
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+
module X212
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17
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+
autoload :HR276, "stupidedi/guides/005010/X212-HR276"
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18
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+
end
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19
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+
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16
20
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module X214
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17
21
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autoload :HN277, "stupidedi/guides/005010/X214-HN277"
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18
22
|
end
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@@ -0,0 +1,387 @@
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1
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+
# frozen_string_literal: true
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2
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module Stupidedi
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3
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+
using Refinements
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4
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+
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|
5
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+
module Guides
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6
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+
module FiftyTen
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7
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module X212
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8
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+
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9
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+
b = GuideBuilder
|
|
10
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+
d = Schema
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|
11
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+
r = SegmentReqs
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12
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+
e = ElementReqs
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|
13
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+
s = Versions::FunctionalGroups::FiftyTen::SegmentDefs
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14
|
+
t = Versions::FunctionalGroups::FiftyTen::TransactionSetDefs
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15
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+
|
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16
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+
#
|
|
17
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+
# Health Care Claim Request
|
|
18
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+
#
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19
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+
HR276 = b.build(t::HR276,
|
|
20
|
+
d::TableDef.header("Table 1 - Header",
|
|
21
|
+
b::Segment(100, s::ST, "Transaction Set Header",
|
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22
|
+
r::Required, d::RepeatCount.bounded(1),
|
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23
|
+
b::Element(e::Required, "Transaction Set Identifier Code", b::Values("276")),
|
|
24
|
+
b::Element(e::Required, "Transaction Set Control Number"),
|
|
25
|
+
b::Element(e::Required, "Version, Release, or Industry Identifier", b::Values("005010X212"))),
|
|
26
|
+
|
|
27
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+
b::Segment(200, s::BHT, "Beginning of Hierarchical Transaction",
|
|
28
|
+
r::Required, d::RepeatCount.bounded(1),
|
|
29
|
+
b::Element(e::Required, "Hierarchical Structure Code", b::Values("0010")),
|
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30
|
+
b::Element(e::Required, "Transaction Set Purpose Code", b::Values("13")),
|
|
31
|
+
b::Element(e::Required, "Reference Identification"),
|
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32
|
+
b::Element(e::Required, "Transaction Set Creation Date"),
|
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33
|
+
b::Element(e::Required, "Transaction Set Creation Time"),
|
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34
|
+
b::Element(e::NotUsed, "Transaction Type Code"))),
|
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35
|
+
|
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36
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+
d::TableDef.detail("Table 2 - Information Source Detail",
|
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37
|
+
d::LoopDef.build("2000A INFORMATION SOURCE LEVEL",
|
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38
|
+
d::RepeatCount.bounded(1),
|
|
39
|
+
b::Segment(100, s::HL, "Information Source Level",
|
|
40
|
+
r::Required, d::RepeatCount.bounded(1),
|
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41
|
+
b::Element(e::Required, "Hierarchical ID Number"),
|
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42
|
+
b::Element(e::NotUsed, "Hierarchical Parent ID Number"),
|
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43
|
+
b::Element(e::Required, "Hierarchical Level Code", b::Values("20")),
|
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44
|
+
b::Element(e::Required, "Hierachical Child Code", b::Values("1"))),
|
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45
|
+
|
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46
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+
d::LoopDef.build("2100A PAYER NAME",
|
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47
|
+
d::RepeatCount.bounded(1),
|
|
48
|
+
b::Segment(500, s::NM1, "Payer Name",
|
|
49
|
+
r::Required, d::RepeatCount.bounded(1),
|
|
50
|
+
b::Element(e::Required, "Entity Identifier Code", b::Values("PR")),
|
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51
|
+
b::Element(e::Required, "Entity Type Qualifier", b::Values("2")),
|
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52
|
+
b::Element(e::Required, "Payer Name"),
|
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53
|
+
b::Element(e::NotUsed, "Name First"),
|
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54
|
+
b::Element(e::NotUsed, "Name Middle"),
|
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55
|
+
b::Element(e::NotUsed, "Name Prefix"),
|
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56
|
+
b::Element(e::NotUsed, "Name Suffix"),
|
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57
|
+
b::Element(e::Required, "Identification Code Qualifier", b::Values("PI", "XV")),
|
|
58
|
+
b::Element(e::Required, "Payer Identifier"),
|
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59
|
+
b::Element(e::NotUsed, "Entity Relationship Code"),
|
|
60
|
+
b::Element(e::NotUsed, "Entity Identifier Code"),
|
|
61
|
+
b::Element(e::NotUsed, "Name Last or Organization Name"))))),
|
|
62
|
+
|
|
63
|
+
d::TableDef.detail("Table 2 - Information Receiver Detail",
|
|
64
|
+
d::LoopDef.build("2000B INFORMATION RECEIVER LEVEL",
|
|
65
|
+
d::RepeatCount.bounded(1),
|
|
66
|
+
b::Segment(100, s::HL, "Information Receiver Level",
|
|
67
|
+
r::Required, d::RepeatCount.bounded(1),
|
|
68
|
+
b::Element(e::Required, "Hierarchical ID Number"),
|
|
69
|
+
b::Element(e::Required, "Hierarchical Parent ID Number"),
|
|
70
|
+
b::Element(e::Required, "Hierarchical Level Code", b::Values("21")),
|
|
71
|
+
b::Element(e::Required, "Hierachical Child Code", b::Values("1"))),
|
|
72
|
+
|
|
73
|
+
d::LoopDef.build("2100B INFORMATION RECEIVER NAME",
|
|
74
|
+
d::RepeatCount.bounded(1),
|
|
75
|
+
b::Segment(500, s::NM1, "Information Receiver Name",
|
|
76
|
+
r::Required, d::RepeatCount.bounded(1),
|
|
77
|
+
b::Element(e::Required, "Entity Identifier Code", b::Values("41")),
|
|
78
|
+
b::Element(e::Required, "Entity Type Qualifier", b::Values("1", "2")),
|
|
79
|
+
b::Element(e::Situational, "Information Receiver Last or Organization Name"),
|
|
80
|
+
b::Element(e::Situational, "Information Receiver First Name"),
|
|
81
|
+
b::Element(e::Situational, "Information Receiver Middle Name"),
|
|
82
|
+
b::Element(e::NotUsed, "Name Prefix"),
|
|
83
|
+
b::Element(e::NotUsed, "Name Suffix"),
|
|
84
|
+
b::Element(e::Required, "Identification Code Qualifier", b::Values("46")),
|
|
85
|
+
b::Element(e::Required, "Information Receiver Identification Number"),
|
|
86
|
+
b::Element(e::NotUsed, "Entity Relationship Code"),
|
|
87
|
+
b::Element(e::NotUsed, "Entity Identifier Code"),
|
|
88
|
+
b::Element(e::NotUsed, "Name Last or Organization Name"))))),
|
|
89
|
+
|
|
90
|
+
d::TableDef.detail("Table 2 - Service Provider Detail",
|
|
91
|
+
d::LoopDef.build("2000C SERVICE PROVIDER LEVEL",
|
|
92
|
+
d::RepeatCount.bounded(1),
|
|
93
|
+
b::Segment(100, s::HL, "Billing Provider of Service Level",
|
|
94
|
+
r::Required, d::RepeatCount.bounded(1),
|
|
95
|
+
b::Element(e::Required, "Hierarchical ID Number"),
|
|
96
|
+
b::Element(e::Required, "Hierarchical Parent ID Number"),
|
|
97
|
+
b::Element(e::Required, "Hierarchical Level Code", b::Values("19")),
|
|
98
|
+
b::Element(e::Required, "Hierachical Child Code", b::Values("1"))),
|
|
99
|
+
|
|
100
|
+
d::LoopDef.build("2100C PROVIDER NAME",
|
|
101
|
+
d::RepeatCount.bounded(2),
|
|
102
|
+
b::Segment(500, s::NM1, "Billing Provider Name",
|
|
103
|
+
r::Required, d::RepeatCount.bounded(1),
|
|
104
|
+
b::Element(e::Required, "Entity Identifier Code", b::Values("1P")),
|
|
105
|
+
b::Element(e::Required, "Entity Type Qualifier", b::Values("1", "2")),
|
|
106
|
+
b::Element(e::Situational, "Provider Last or Organization Name"),
|
|
107
|
+
b::Element(e::Situational, "Provider First Name"),
|
|
108
|
+
b::Element(e::Situational, "Provider Middle Name"),
|
|
109
|
+
b::Element(e::NotUsed, "Name Prefix"),
|
|
110
|
+
b::Element(e::Situational, "Provider Name Suffix"),
|
|
111
|
+
b::Element(e::Required, "Identification Code Qualifier", b::Values("FI", "SV", "XX")),
|
|
112
|
+
b::Element(e::Required, "Provider Identifier"),
|
|
113
|
+
b::Element(e::NotUsed, "Entity Relationship Code"),
|
|
114
|
+
b::Element(e::NotUsed, "Entity Identifier Code"),
|
|
115
|
+
b::Element(e::NotUsed, "Name Last or Organization Name"))))),
|
|
116
|
+
|
|
117
|
+
d::TableDef.detail("Table 2 - Subscriber Detail",
|
|
118
|
+
d::LoopDef.build("2000D SUBSCRIBER LEVEL",
|
|
119
|
+
d::RepeatCount.bounded(1),
|
|
120
|
+
b::Segment(100, s::HL, "Subscriber Level",
|
|
121
|
+
r::Required, d::RepeatCount.bounded(1),
|
|
122
|
+
b::Element(e::Required, "Hierarchical ID Number"),
|
|
123
|
+
b::Element(e::Required, "Hierarchical Parent ID Number"),
|
|
124
|
+
b::Element(e::Required, "Hierarchical Level Code", b::Values("22")),
|
|
125
|
+
b::Element(e::Required, "Hierachical Child Code", b::Values("0", "1"))),
|
|
126
|
+
|
|
127
|
+
b::Segment(400, s::DMG, "Subscriber Demographic Information",
|
|
128
|
+
r::Situational, d::RepeatCount.bounded(1),
|
|
129
|
+
b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8")),
|
|
130
|
+
b::Element(e::Required, "Subscriber Birth Date"),
|
|
131
|
+
b::Element(e::Situational, "Subscriber Gender Code", b::Values("F", "M")),
|
|
132
|
+
b::Element(e::NotUsed, "Marital Status Code"),
|
|
133
|
+
b::Element(e::NotUsed, "COMPOSITE RACE OR ETHNICITY INFORMATION"),
|
|
134
|
+
b::Element(e::NotUsed, "Citizenship Status Code"),
|
|
135
|
+
b::Element(e::NotUsed, "Country Code"),
|
|
136
|
+
b::Element(e::NotUsed, "Basis of Verification Code"),
|
|
137
|
+
b::Element(e::NotUsed, "Quantity"),
|
|
138
|
+
b::Element(e::NotUsed, "Code LIst Qualifier Code"),
|
|
139
|
+
b::Element(e::NotUsed, "Industry Code")),
|
|
140
|
+
|
|
141
|
+
d::LoopDef.build("2100D SUBSCRIBER NAME",
|
|
142
|
+
d::RepeatCount.bounded(1),
|
|
143
|
+
b::Segment(500, s::NM1, "Subscriber Name",
|
|
144
|
+
r::Required, d::RepeatCount.bounded(1),
|
|
145
|
+
b::Element(e::Required, "Entity Identifier Code", b::Values("IL")),
|
|
146
|
+
b::Element(e::Required, "Entity Type Qualifier", b::Values("1", "2")),
|
|
147
|
+
b::Element(e::Required, "Subscriber Last Name"),
|
|
148
|
+
b::Element(e::Situational, "Subscriber First Name",),
|
|
149
|
+
b::Element(e::Situational, "Subscriber Middle Name or Initial"),
|
|
150
|
+
b::Element(e::NotUsed, "Name Prefix"),
|
|
151
|
+
b::Element(e::Situational, "Subscriber Name Suffix"),
|
|
152
|
+
b::Element(e::Required, "Identification Code Qualifier", b::Values("24", "II", "MI")),
|
|
153
|
+
b::Element(e::Required, "Subscriber Identifier"),
|
|
154
|
+
b::Element(e::NotUsed, "Entity Relationship Code"),
|
|
155
|
+
b::Element(e::NotUsed, "Entity Identifier Code"),
|
|
156
|
+
b::Element(e::NotUsed, "Name Last or Organization Name"))),
|
|
157
|
+
|
|
158
|
+
d::LoopDef.build("2200D CLAIM STATUS TRACKING NUMBER",
|
|
159
|
+
d::RepeatCount.unbounded,
|
|
160
|
+
b::Segment( 900, s::TRN, "Claim Status Tracking Number",
|
|
161
|
+
r::Situational, d::RepeatCount.bounded(1),
|
|
162
|
+
b::Element(e::Required, "Trace Type Code", b::Values("1")),
|
|
163
|
+
b::Element(e::Required, "Current Transaction Trace Number"),
|
|
164
|
+
b::Element(e::NotUsed, "Originating Company Identifier"),
|
|
165
|
+
b::Element(e::NotUsed, "Reference Identification")),
|
|
166
|
+
b::Segment(1000, s::REF, "Payer Claim Control Number",
|
|
167
|
+
r::Situational, d::RepeatCount.bounded(1),
|
|
168
|
+
b::Element(e::Required, "Reference Identification Qualifier", b::Values("1K")),
|
|
169
|
+
b::Element(e::Required, "Payer Claim Control Number"),
|
|
170
|
+
b::Element(e::NotUsed, "Description"),
|
|
171
|
+
b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
|
|
172
|
+
b::Segment(1000, s::REF, "Institutional Bill Type Identification",
|
|
173
|
+
r::Situational, d::RepeatCount.bounded(1),
|
|
174
|
+
b::Element(e::Required, "Reference Identification Qualifier", b::Values("BLT")),
|
|
175
|
+
b::Element(e::Required, "Bill Type Identifier"),
|
|
176
|
+
b::Element(e::NotUsed, "Description"),
|
|
177
|
+
b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
|
|
178
|
+
b::Segment(1000, s::REF, "Application or Location System Identifier",
|
|
179
|
+
r::Situational, d::RepeatCount.bounded(1),
|
|
180
|
+
b::Element(e::Required, "Reference Identification Qualifier", b::Values("LU")),
|
|
181
|
+
b::Element(e::Required, "Application or Location System Identifier"),
|
|
182
|
+
b::Element(e::NotUsed, "Description"),
|
|
183
|
+
b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
|
|
184
|
+
b::Segment(1000, s::REF, "Group Number",
|
|
185
|
+
r::Situational, d::RepeatCount.bounded(1),
|
|
186
|
+
b::Element(e::Required, "Reference Identification Qualifier", b::Values("6P")),
|
|
187
|
+
b::Element(e::Required, "Group Number"),
|
|
188
|
+
b::Element(e::NotUsed, "Description"),
|
|
189
|
+
b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
|
|
190
|
+
b::Segment(1000, s::REF, "Patient Control Number",
|
|
191
|
+
r::Situational, d::RepeatCount.bounded(1),
|
|
192
|
+
b::Element(e::Required, "Reference Identification Qualifier", b::Values("EJ")),
|
|
193
|
+
b::Element(e::Required, "Patient Control Number"),
|
|
194
|
+
b::Element(e::NotUsed, "Description"),
|
|
195
|
+
b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
|
|
196
|
+
b::Segment(1000, s::REF, "Pharmacy Prescription Number",
|
|
197
|
+
r::Situational, d::RepeatCount.bounded(1),
|
|
198
|
+
b::Element(e::Required, "Reference Identification Qualifier", b::Values("XZ")),
|
|
199
|
+
b::Element(e::Required, "Pharmacy Prescription Number"),
|
|
200
|
+
b::Element(e::NotUsed, "Description"),
|
|
201
|
+
b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
|
|
202
|
+
b::Segment(1000, s::REF, "Claim Identification Number for Clearinghouses and Other Transmission Intermediaries",
|
|
203
|
+
r::Situational, d::RepeatCount.bounded(1),
|
|
204
|
+
b::Element(e::Required, "Reference Identification Qualifier", b::Values("D9")),
|
|
205
|
+
b::Element(e::Required, "Clearinghouse Trace Number"),
|
|
206
|
+
b::Element(e::NotUsed, "Description"),
|
|
207
|
+
b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
|
|
208
|
+
b::Segment(1100, s::AMT, "Institutional Bill Type Identification",
|
|
209
|
+
r::Situational, d::RepeatCount.bounded(1),
|
|
210
|
+
b::Element(e::Required, "Amount Qualifier Code", b::Values("T3")),
|
|
211
|
+
b::Element(e::Required, "Total Claim Charge Amount"),
|
|
212
|
+
b::Element(e::NotUsed, "Credit/Debit Flag Code")),
|
|
213
|
+
b::Segment(1200, s::DTP, "Claim Level Service Date",
|
|
214
|
+
r::Situational, d::RepeatCount.bounded(1),
|
|
215
|
+
b::Element(e::Required, "Date Time Qualifier", b::Values("472")),
|
|
216
|
+
b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8", "RD8")),
|
|
217
|
+
b::Element(e::Required, "Claim Service Period")),
|
|
218
|
+
d::LoopDef.build("2210D SERVICE LINE INFORMATION",
|
|
219
|
+
d::RepeatCount.unbounded,
|
|
220
|
+
b::Segment(1300, s::SVC, "Service Line Information",
|
|
221
|
+
r::Situational, d::RepeatCount.bounded(1),
|
|
222
|
+
b::Element(e::Required, "COMPOSITE MEDICAL PROCEDURE IDENTIFIER",
|
|
223
|
+
b::Element(e::Required, "Product or Service ID Qualifier", b::Values("AD", "ER", "HC", "HP", "IV", "N4", "NU", "WK")),
|
|
224
|
+
b::Element(e::Required, "Procedure Code"),
|
|
225
|
+
b::Element(e::Situational, "Procedure Modifier"),
|
|
226
|
+
b::Element(e::Situational, "Procedure Modifier"),
|
|
227
|
+
b::Element(e::Situational, "Procedure Modifier"),
|
|
228
|
+
b::Element(e::Situational, "Procedure Modifier"),
|
|
229
|
+
b::Element(e::NotUsed, "Description"),
|
|
230
|
+
b::Element(e::NotUsed, "Product/Service ID")),
|
|
231
|
+
b::Element(e::Required, "Line Item Charge Amount"),
|
|
232
|
+
b::Element(e::NotUsed, "Monetary Amount"),
|
|
233
|
+
b::Element(e::Situational, "Revenue Code"),
|
|
234
|
+
b::Element(e::NotUsed, "Quantity"),
|
|
235
|
+
b::Element(e::NotUsed, "COMPOSITE MEDICAL PROCEDURE IDENTIFIER"),
|
|
236
|
+
b::Element(e::Situational, "Units of Service Count")),
|
|
237
|
+
b::Segment(1400, s::REF, "Service Line Item Identification",
|
|
238
|
+
r::Situational, d::RepeatCount.bounded(1),
|
|
239
|
+
b::Element(e::Required, "Reference Identification Qualifier", b::Values("FJ")),
|
|
240
|
+
b::Element(e::Required, "Line Item Control Number"),
|
|
241
|
+
b::Element(e::NotUsed, "Description"),
|
|
242
|
+
b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
|
|
243
|
+
b::Segment(1500, s::DTP, "Service Line Date",
|
|
244
|
+
r::Required, d::RepeatCount.bounded(1),
|
|
245
|
+
b::Element(e::Required, "Date Time Qualifier", b::Values("472")),
|
|
246
|
+
b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8", "RD8")),
|
|
247
|
+
b::Element(e::Required, "Service Line Date")))))),
|
|
248
|
+
|
|
249
|
+
d::TableDef.detail("Table 2 - Dependent Detail",
|
|
250
|
+
d::LoopDef.build("2000E DEPENDENT LEVEL",
|
|
251
|
+
d::RepeatCount.bounded(1),
|
|
252
|
+
b::Segment(100, s::HL, "Dependent Level",
|
|
253
|
+
r::Situational, d::RepeatCount.bounded(1),
|
|
254
|
+
b::Element(e::Required, "Hierarchical ID Number"),
|
|
255
|
+
b::Element(e::Required, "Hierarchical Parent ID Number"),
|
|
256
|
+
b::Element(e::Required, "Hierarchical Level Code", b::Values("23")),
|
|
257
|
+
b::Element(e::NotUsed, "Hierachical Child Code")),
|
|
258
|
+
b::Segment(400, s::DMG, "Dependent Demographic Information",
|
|
259
|
+
r::Required, d::RepeatCount.bounded(1),
|
|
260
|
+
b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8")),
|
|
261
|
+
b::Element(e::Required, "Patient Birth Date"),
|
|
262
|
+
b::Element(e::Situational, "Patient Gender Code", b::Values("F", "M")),
|
|
263
|
+
b::Element(e::NotUsed, "Marital Status Code"),
|
|
264
|
+
b::Element(e::NotUsed, "COMPOSITE RACE OR ETHNICITY INFORMATION"),
|
|
265
|
+
b::Element(e::NotUsed, "Citizenship Status Code"),
|
|
266
|
+
b::Element(e::NotUsed, "Country Code"),
|
|
267
|
+
b::Element(e::NotUsed, "Basis of Verification Code"),
|
|
268
|
+
b::Element(e::NotUsed, "Quantity"),
|
|
269
|
+
b::Element(e::NotUsed, "Code LIst Qualifier Code"),
|
|
270
|
+
b::Element(e::NotUsed, "Industry Code"))),
|
|
271
|
+
|
|
272
|
+
d::LoopDef.build("2100E DEPENDENT NAME",
|
|
273
|
+
d::RepeatCount.bounded(1),
|
|
274
|
+
b::Segment(500, s::NM1, "Dependent Name",
|
|
275
|
+
r::Required, d::RepeatCount.bounded(1),
|
|
276
|
+
b::Element(e::Required, "Entity Identifier Code", b::Values("QC")),
|
|
277
|
+
b::Element(e::Required, "Entity Type Qualifier", b::Values("1")),
|
|
278
|
+
b::Element(e::Required, "Patient Last Name"),
|
|
279
|
+
b::Element(e::Situational, "Patient First Name"),
|
|
280
|
+
b::Element(e::Situational, "Patient Middle Name or Initial"),
|
|
281
|
+
b::Element(e::NotUsed, "Name Prefix"),
|
|
282
|
+
b::Element(e::Situational, "Patient Name Suffix"),
|
|
283
|
+
b::Element(e::NotUsed, "Identification Code Qualifier"),
|
|
284
|
+
b::Element(e::NotUsed, "Identification Code"),
|
|
285
|
+
b::Element(e::NotUsed, "Entity Relationship Code"),
|
|
286
|
+
b::Element(e::NotUsed, "Entity Identifier Code"),
|
|
287
|
+
b::Element(e::NotUsed, "Name Last or Organization Name"))),
|
|
288
|
+
|
|
289
|
+
d::LoopDef.build("2200E CLAIM STATUS TRACKING NUMBER",
|
|
290
|
+
d::RepeatCount.unbounded,
|
|
291
|
+
b::Segment( 900, s::TRN, "Claim Status Tracking Number",
|
|
292
|
+
r::Required, d::RepeatCount.bounded(1),
|
|
293
|
+
b::Element(e::Required, "Trace Type Code", b::Values("1")),
|
|
294
|
+
b::Element(e::Required, "Current Transaction Trace Number"),
|
|
295
|
+
b::Element(e::NotUsed, "Originating Company Identifier"),
|
|
296
|
+
b::Element(e::NotUsed, "Reference Identification")),
|
|
297
|
+
b::Segment(1000, s::REF, "Payer Claim Control Number",
|
|
298
|
+
r::Situational, d::RepeatCount.bounded(1),
|
|
299
|
+
b::Element(e::Required, "Reference Identification Qualifier", b::Values("1K")),
|
|
300
|
+
b::Element(e::Required, "Payer Claim Control Number"),
|
|
301
|
+
b::Element(e::NotUsed, "Description"),
|
|
302
|
+
b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
|
|
303
|
+
b::Segment(1000, s::REF, "Institutional Bill Type Identification",
|
|
304
|
+
r::Situational, d::RepeatCount.bounded(1),
|
|
305
|
+
b::Element(e::Required, "Reference Identification Qualifier", b::Values("BLT")),
|
|
306
|
+
b::Element(e::Required, "Bill Type Identifier"),
|
|
307
|
+
b::Element(e::NotUsed, "Description"),
|
|
308
|
+
b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
|
|
309
|
+
b::Segment(1000, s::REF, "Application or Location System Identifier",
|
|
310
|
+
r::Situational, d::RepeatCount.bounded(1),
|
|
311
|
+
b::Element(e::Required, "Reference Identification Qualifier", b::Values("LU")),
|
|
312
|
+
b::Element(e::Required, "Application or Location System Identifier"),
|
|
313
|
+
b::Element(e::NotUsed, "Description"),
|
|
314
|
+
b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
|
|
315
|
+
b::Segment(1000, s::REF, "Group Number",
|
|
316
|
+
r::Situational, d::RepeatCount.bounded(1),
|
|
317
|
+
b::Element(e::Required, "Reference Identification Qualifier", b::Values("6P")),
|
|
318
|
+
b::Element(e::Required, "Group Number"),
|
|
319
|
+
b::Element(e::NotUsed, "Description"),
|
|
320
|
+
b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
|
|
321
|
+
b::Segment(1000, s::REF, "Patient Control Number",
|
|
322
|
+
r::Situational, d::RepeatCount.bounded(1),
|
|
323
|
+
b::Element(e::Required, "Reference Identification Qualifier", b::Values("EJ")),
|
|
324
|
+
b::Element(e::Required, "Patient Control Number"),
|
|
325
|
+
b::Element(e::NotUsed, "Description"),
|
|
326
|
+
b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
|
|
327
|
+
b::Segment(1000, s::REF, "Pharmacy Prescription Number",
|
|
328
|
+
r::Situational, d::RepeatCount.bounded(1),
|
|
329
|
+
b::Element(e::Required, "Reference Identification Qualifier", b::Values("XZ")),
|
|
330
|
+
b::Element(e::Required, "Pharmacy Prescription Number"),
|
|
331
|
+
b::Element(e::NotUsed, "Description"),
|
|
332
|
+
b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
|
|
333
|
+
b::Segment(1000, s::REF, "Claim Identification Number for Clearinghouses and Other Transmission Intermediaries",
|
|
334
|
+
r::Situational, d::RepeatCount.bounded(1),
|
|
335
|
+
b::Element(e::Required, "Reference Identification Qualifier", b::Values("D9")),
|
|
336
|
+
b::Element(e::Required, "Clearinghouse Trace Number"),
|
|
337
|
+
b::Element(e::NotUsed, "Description"),
|
|
338
|
+
b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
|
|
339
|
+
b::Segment(1100, s::AMT, "Claim Submitted Charges",
|
|
340
|
+
r::Situational, d::RepeatCount.bounded(1),
|
|
341
|
+
b::Element(e::Required, "Amount Qualifier Code", b::Values("T3")),
|
|
342
|
+
b::Element(e::Required, "Total Claim Charge Amount"),
|
|
343
|
+
b::Element(e::NotUsed, "Credit/Debit Flag Code")),
|
|
344
|
+
b::Segment(1200, s::DTP, "Claim Service Date",
|
|
345
|
+
r::Situational, d::RepeatCount.bounded(1),
|
|
346
|
+
b::Element(e::Required, "Date Time Qualifier", b::Values("472")),
|
|
347
|
+
b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8", "RD8")),
|
|
348
|
+
b::Element(e::Required, "Claim Service Period")),
|
|
349
|
+
d::LoopDef.build("2210E SERVICE LINE INFORMATION",
|
|
350
|
+
d::RepeatCount.unbounded,
|
|
351
|
+
b::Segment(1300, s::SVC, "Service Line Information",
|
|
352
|
+
r::Situational, d::RepeatCount.bounded(1),
|
|
353
|
+
b::Element(e::Required, "COMPOSITE MEDICAL PROCEDURE IDENTIFIER",
|
|
354
|
+
b::Element(e::Required, "Product or Service ID Qualifier", b::Values("AD", "ER", "HC", "HP", "IV", "N4", "NU", "WK")),
|
|
355
|
+
b::Element(e::Required, "Procedure Code"),
|
|
356
|
+
b::Element(e::Situational, "Procedure Modifier"),
|
|
357
|
+
b::Element(e::Situational, "Procedure Modifier"),
|
|
358
|
+
b::Element(e::Situational, "Procedure Modifier"),
|
|
359
|
+
b::Element(e::Situational, "Procedure Modifier"),
|
|
360
|
+
b::Element(e::NotUsed, "Description"),
|
|
361
|
+
b::Element(e::NotUsed, "Product/Service ID")),
|
|
362
|
+
b::Element(e::Required, "Line Item Charge Amount"),
|
|
363
|
+
b::Element(e::NotUsed, "Monetary Amount"),
|
|
364
|
+
b::Element(e::Situational, "Revenue Code"),
|
|
365
|
+
b::Element(e::NotUsed, "Quantity"),
|
|
366
|
+
b::Element(e::NotUsed, "COMPOSITE MEDICAL PROCEDURE IDENTIFIER"),
|
|
367
|
+
b::Element(e::Situational, "Units of Service Count")),
|
|
368
|
+
b::Segment(1400, s::REF, "Service Line Item Identification",
|
|
369
|
+
r::Situational, d::RepeatCount.bounded(1),
|
|
370
|
+
b::Element(e::Required, "Reference Identification Qualifier", b::Values("FJ")),
|
|
371
|
+
b::Element(e::Required, "Line Item Control Number"),
|
|
372
|
+
b::Element(e::NotUsed, "Description"),
|
|
373
|
+
b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
|
|
374
|
+
b::Segment(1500, s::DTP, "Service Line Date",
|
|
375
|
+
r::Required, d::RepeatCount.bounded(1),
|
|
376
|
+
b::Element(e::Required, "Date Time Qualifier", b::Values("472")),
|
|
377
|
+
b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8", "RD8")),
|
|
378
|
+
b::Element(e::Required, "Service Line Date"))))),
|
|
379
|
+
d::TableDef.detail("Table 3 - Summary",
|
|
380
|
+
b::Segment(1600, s::SE, "Transaction Set Trailer",
|
|
381
|
+
r::Required, d::RepeatCount.bounded(1),
|
|
382
|
+
b::Element(e::Required, "Transaction Segment Count"),
|
|
383
|
+
b::Element(e::Required, "Transaction Set Control Number"))))
|
|
384
|
+
end
|
|
385
|
+
end
|
|
386
|
+
end
|
|
387
|
+
end
|