stupidedi 1.3.23 → 1.4.0

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Files changed (2005) hide show
  1. checksums.yaml +4 -4
  2. data/README.md +4 -4
  3. data/Rakefile +17 -92
  4. data/bin/edi-ed +8 -12
  5. data/bin/edi-obfuscate +8 -9
  6. data/bin/edi-pp +31 -25
  7. data/doc/{Transcribing.md → Defining.md} +0 -0
  8. data/doc/{unwritten/Parsing.md → Parsing.md} +0 -0
  9. data/doc/{unwritten/Tokenizing.md → Tokenizing.md} +0 -0
  10. data/doc/{unwritten/Validating.md → Validating.md} +0 -0
  11. data/lib/ruby/array.rb +1 -4
  12. data/lib/ruby/blank.rb +0 -3
  13. data/lib/ruby/exception.rb +13 -33
  14. data/lib/ruby/hash.rb +0 -2
  15. data/lib/ruby/module.rb +1 -3
  16. data/lib/ruby/object.rb +0 -13
  17. data/lib/ruby/string.rb +12 -3
  18. data/lib/ruby/to_d.rb +20 -25
  19. data/lib/ruby/to_date.rb +0 -3
  20. data/lib/ruby/to_time.rb +0 -3
  21. data/lib/ruby/try.rb +0 -3
  22. data/lib/stupidedi.rb +27 -41
  23. data/lib/stupidedi/builder.rb +3 -22
  24. data/lib/stupidedi/color.rb +4 -6
  25. data/lib/stupidedi/config.rb +77 -69
  26. data/lib/stupidedi/config/code_list_config.rb +0 -2
  27. data/lib/stupidedi/config/editor_config.rb +0 -2
  28. data/lib/stupidedi/config/functional_group_config.rb +3 -2
  29. data/lib/stupidedi/config/interchange_config.rb +5 -6
  30. data/lib/stupidedi/config/transaction_set_config.rb +17 -48
  31. data/lib/stupidedi/contrib.rb +41 -6
  32. data/lib/stupidedi/editor.rb +0 -3
  33. data/lib/stupidedi/editor/00401.rb +0 -3
  34. data/lib/stupidedi/editor/004010.rb +4 -8
  35. data/lib/stupidedi/editor/004010/N4.rb +0 -4
  36. data/lib/stupidedi/editor/00501.rb +0 -3
  37. data/lib/stupidedi/editor/005010.rb +5 -9
  38. data/lib/stupidedi/editor/005010/N4.rb +0 -4
  39. data/lib/stupidedi/editor/X12.rb +0 -5
  40. data/lib/stupidedi/editor/X222-HC837.rb +0 -5
  41. data/lib/stupidedi/editor/abstract_ed.rb +0 -2
  42. data/lib/stupidedi/editor/claim_ack.rb +0 -2
  43. data/lib/stupidedi/editor/implementation_ack.rb +2 -3
  44. data/lib/stupidedi/editor/interchange_ack.rb +0 -2
  45. data/lib/stupidedi/editor/result.rb +1 -6
  46. data/lib/stupidedi/editor/result_set.rb +1 -3
  47. data/lib/stupidedi/editor/transaction_set_ed.rb +23 -19
  48. data/lib/stupidedi/editor/transmission_ed.rb +0 -3
  49. data/lib/stupidedi/either.rb +0 -5
  50. data/lib/stupidedi/exceptions/invalid_element_error.rb +0 -2
  51. data/lib/stupidedi/exceptions/invalid_schema_error.rb +0 -2
  52. data/lib/stupidedi/exceptions/output_error.rb +0 -2
  53. data/lib/stupidedi/exceptions/parse_error.rb +0 -2
  54. data/lib/stupidedi/exceptions/stupidedi_error.rb +0 -2
  55. data/lib/stupidedi/exceptions/tokenize_error.rb +0 -2
  56. data/lib/stupidedi/exceptions/zipper_error.rb +0 -2
  57. data/lib/stupidedi/guides.rb +7 -3
  58. data/lib/stupidedi/inspect.rb +1 -4
  59. data/lib/stupidedi/interchanges.rb +11 -0
  60. data/lib/stupidedi/interchanges/00200.rb +12 -0
  61. data/lib/stupidedi/interchanges/00200/element_defs.rb +104 -0
  62. data/lib/stupidedi/interchanges/00200/interchange_def.rb +59 -0
  63. data/lib/stupidedi/interchanges/00200/segment_defs.rb +12 -0
  64. data/lib/stupidedi/interchanges/00200/segment_defs/IEA.rb +17 -0
  65. data/lib/stupidedi/interchanges/00200/segment_defs/ISA.rb +31 -0
  66. data/lib/stupidedi/interchanges/00200/segment_defs/TA1.rb +20 -0
  67. data/lib/stupidedi/interchanges/00300.rb +12 -0
  68. data/lib/stupidedi/interchanges/00300/element_defs.rb +105 -0
  69. data/lib/stupidedi/interchanges/00300/interchange_def.rb +59 -0
  70. data/lib/stupidedi/interchanges/00300/segment_defs.rb +12 -0
  71. data/lib/stupidedi/interchanges/00300/segment_defs/IEA.rb +17 -0
  72. data/lib/stupidedi/interchanges/00300/segment_defs/ISA.rb +31 -0
  73. data/lib/stupidedi/interchanges/00300/segment_defs/TA1.rb +20 -0
  74. data/lib/stupidedi/interchanges/00400.rb +12 -0
  75. data/lib/stupidedi/interchanges/00400/element_defs.rb +97 -0
  76. data/lib/stupidedi/interchanges/00400/interchange_def.rb +59 -0
  77. data/lib/stupidedi/interchanges/00400/segment_defs.rb +12 -0
  78. data/lib/stupidedi/interchanges/00400/segment_defs/IEA.rb +17 -0
  79. data/lib/stupidedi/interchanges/00400/segment_defs/ISA.rb +31 -0
  80. data/lib/stupidedi/interchanges/00400/segment_defs/TA1.rb +20 -0
  81. data/lib/stupidedi/interchanges/00401.rb +12 -0
  82. data/lib/stupidedi/interchanges/00401/element_defs.rb +96 -0
  83. data/lib/stupidedi/interchanges/00401/interchange_def.rb +59 -0
  84. data/lib/stupidedi/interchanges/00401/segment_defs.rb +12 -0
  85. data/lib/stupidedi/interchanges/00401/segment_defs/IEA.rb +17 -0
  86. data/lib/stupidedi/interchanges/00401/segment_defs/ISA.rb +31 -0
  87. data/lib/stupidedi/interchanges/00401/segment_defs/TA1.rb +20 -0
  88. data/lib/stupidedi/interchanges/00501.rb +12 -0
  89. data/lib/stupidedi/interchanges/00501/element_defs.rb +130 -0
  90. data/lib/stupidedi/interchanges/00501/interchange_def.rb +59 -0
  91. data/lib/stupidedi/interchanges/00501/segment_defs.rb +12 -0
  92. data/lib/stupidedi/interchanges/00501/segment_defs/IEA.rb +17 -0
  93. data/lib/stupidedi/interchanges/00501/segment_defs/ISA.rb +31 -0
  94. data/lib/stupidedi/interchanges/00501/segment_defs/ISB.rb +15 -0
  95. data/lib/stupidedi/interchanges/00501/segment_defs/ISE.rb +15 -0
  96. data/lib/stupidedi/interchanges/00501/segment_defs/TA1.rb +20 -0
  97. data/lib/stupidedi/interchanges/00501/segment_defs/TA3.rb +15 -0
  98. data/lib/stupidedi/interchanges/element_types.rb +11 -0
  99. data/lib/stupidedi/interchanges/element_types/separator_val.rb +79 -0
  100. data/lib/stupidedi/interchanges/element_types/special_val.rb +48 -0
  101. data/lib/stupidedi/parser.rb +32 -0
  102. data/lib/stupidedi/parser/builder_dsl.rb +289 -0
  103. data/lib/stupidedi/parser/constraint_table.rb +488 -0
  104. data/lib/stupidedi/parser/generation.rb +147 -0
  105. data/lib/stupidedi/parser/identifier_stack.rb +248 -0
  106. data/lib/stupidedi/parser/instruction.rb +112 -0
  107. data/lib/stupidedi/parser/instruction_table.rb +222 -0
  108. data/lib/stupidedi/parser/navigation.rb +786 -0
  109. data/lib/stupidedi/parser/state_machine.rb +62 -0
  110. data/lib/stupidedi/parser/states/abstract_state.rb +325 -0
  111. data/lib/stupidedi/parser/states/failure_state.rb +69 -0
  112. data/lib/stupidedi/parser/states/functional_group_state.rb +98 -0
  113. data/lib/stupidedi/parser/states/initial_state.rb +62 -0
  114. data/lib/stupidedi/parser/states/interchange_state.rb +93 -0
  115. data/lib/stupidedi/parser/states/loop_state.rb +80 -0
  116. data/lib/stupidedi/parser/states/table_state.rb +94 -0
  117. data/lib/stupidedi/parser/states/transaction_set_state.rb +118 -0
  118. data/lib/stupidedi/parser/states/transmission_state.rb +59 -0
  119. data/lib/stupidedi/parser/tokenization.rb +195 -0
  120. data/lib/stupidedi/reader.rb +0 -2
  121. data/lib/stupidedi/reader/input.rb +0 -3
  122. data/lib/stupidedi/reader/input/abstract_input.rb +4 -6
  123. data/lib/stupidedi/reader/input/delegated_input.rb +0 -5
  124. data/lib/stupidedi/reader/input/file_input.rb +10 -11
  125. data/lib/stupidedi/reader/position.rb +13 -8
  126. data/lib/stupidedi/reader/result.rb +5 -5
  127. data/lib/stupidedi/reader/segment_dict.rb +0 -3
  128. data/lib/stupidedi/reader/separators.rb +5 -4
  129. data/lib/stupidedi/reader/stream_reader.rb +3 -6
  130. data/lib/stupidedi/reader/token_reader.rb +0 -5
  131. data/lib/stupidedi/reader/tokens/component_element_tok.rb +4 -4
  132. data/lib/stupidedi/reader/tokens/composite_element_tok.rb +6 -5
  133. data/lib/stupidedi/reader/tokens/repeated_element_tok.rb +9 -2
  134. data/lib/stupidedi/reader/tokens/segment_tok.rb +7 -5
  135. data/lib/stupidedi/reader/tokens/simple_element_tok.rb +2 -4
  136. data/lib/stupidedi/schema.rb +17 -20
  137. data/lib/stupidedi/schema/abstract_def.rb +4 -6
  138. data/lib/stupidedi/schema/abstract_element_def.rb +35 -0
  139. data/lib/stupidedi/schema/abstract_element_use.rb +38 -0
  140. data/lib/stupidedi/schema/abstract_use.rb +6 -4
  141. data/lib/stupidedi/schema/code_list.rb +6 -5
  142. data/lib/stupidedi/schema/component_element_use.rb +74 -0
  143. data/lib/stupidedi/schema/composite_element_def.rb +103 -0
  144. data/lib/stupidedi/schema/composite_element_use.rb +73 -0
  145. data/lib/stupidedi/schema/element_req.rb +1 -4
  146. data/lib/stupidedi/schema/functional_group_def.rb +9 -3
  147. data/lib/stupidedi/schema/interchange_def.rb +9 -3
  148. data/lib/stupidedi/schema/loop_def.rb +11 -9
  149. data/lib/stupidedi/schema/repeat_count.rb +0 -3
  150. data/lib/stupidedi/schema/segment_def.rb +6 -4
  151. data/lib/stupidedi/schema/segment_req.rb +2 -3
  152. data/lib/stupidedi/schema/segment_use.rb +1 -4
  153. data/lib/stupidedi/schema/simple_element_def.rb +51 -0
  154. data/lib/stupidedi/schema/simple_element_use.rb +81 -0
  155. data/lib/stupidedi/schema/syntax_note.rb +1 -12
  156. data/lib/stupidedi/schema/table_def.rb +55 -18
  157. data/lib/stupidedi/schema/transaction_set_def.rb +25 -4
  158. data/lib/stupidedi/sets.rb +0 -3
  159. data/lib/stupidedi/transaction_sets.rb +14 -0
  160. data/lib/stupidedi/transaction_sets/002001.rb +11 -0
  161. data/lib/stupidedi/transaction_sets/002001/implementations.rb +23 -0
  162. data/lib/stupidedi/transaction_sets/002001/implementations/FA997.rb +66 -0
  163. data/lib/stupidedi/transaction_sets/002001/implementations/PO830.rb +160 -0
  164. data/lib/stupidedi/transaction_sets/002001/implementations/SH856.rb +190 -0
  165. data/lib/stupidedi/transaction_sets/002001/standards.rb +14 -0
  166. data/lib/stupidedi/transaction_sets/002001/standards/FA997.rb +31 -0
  167. data/lib/stupidedi/transaction_sets/002001/standards/PO830.rb +45 -0
  168. data/lib/stupidedi/transaction_sets/002001/standards/SH856.rb +38 -0
  169. data/lib/stupidedi/transaction_sets/003010.rb +11 -0
  170. data/lib/stupidedi/transaction_sets/003010/implementations.rb +24 -0
  171. data/lib/stupidedi/transaction_sets/003010/implementations/PC860.rb +140 -0
  172. data/lib/stupidedi/transaction_sets/003010/implementations/PO850.rb +132 -0
  173. data/lib/stupidedi/transaction_sets/003010/implementations/PS830.rb +150 -0
  174. data/lib/stupidedi/transaction_sets/003010/implementations/RA820.rb +158 -0
  175. data/lib/stupidedi/transaction_sets/003010/standards.rb +15 -0
  176. data/lib/stupidedi/transaction_sets/003010/standards/PC860.rb +49 -0
  177. data/lib/stupidedi/transaction_sets/003010/standards/PO850.rb +49 -0
  178. data/lib/stupidedi/transaction_sets/003010/standards/PS830.rb +49 -0
  179. data/lib/stupidedi/transaction_sets/003010/standards/RA820.rb +40 -0
  180. data/lib/stupidedi/transaction_sets/003040.rb +12 -0
  181. data/lib/stupidedi/transaction_sets/003040/implementations.rb +21 -0
  182. data/lib/stupidedi/transaction_sets/003040/implementations/WA142.rb +153 -0
  183. data/lib/stupidedi/transaction_sets/003040/standards.rb +12 -0
  184. data/lib/stupidedi/transaction_sets/003040/standards/WA142.rb +53 -0
  185. data/lib/stupidedi/transaction_sets/003050.rb +12 -0
  186. data/lib/stupidedi/transaction_sets/003050/implementations.rb +21 -0
  187. data/lib/stupidedi/transaction_sets/003050/implementations/PO850.rb +77 -0
  188. data/lib/stupidedi/transaction_sets/003050/standards.rb +12 -0
  189. data/lib/stupidedi/transaction_sets/003050/standards/PO850.rb +41 -0
  190. data/lib/stupidedi/transaction_sets/004010.rb +12 -0
  191. data/lib/stupidedi/transaction_sets/004010/implementations.rb +38 -0
  192. data/lib/stupidedi/transaction_sets/004010/implementations/AR943.rb +72 -0
  193. data/lib/stupidedi/transaction_sets/004010/implementations/FA997.rb +65 -0
  194. data/lib/stupidedi/transaction_sets/004010/implementations/GF990.rb +40 -0
  195. data/lib/stupidedi/transaction_sets/004010/implementations/IM210.rb +221 -0
  196. data/lib/stupidedi/transaction_sets/004010/implementations/OW940.rb +98 -0
  197. data/lib/stupidedi/transaction_sets/004010/implementations/PO850.rb +108 -0
  198. data/lib/stupidedi/transaction_sets/004010/implementations/PS830.rb +143 -0
  199. data/lib/stupidedi/transaction_sets/004010/implementations/QM214.rb +106 -0
  200. data/lib/stupidedi/transaction_sets/004010/implementations/RE944.rb +63 -0
  201. data/lib/stupidedi/transaction_sets/004010/implementations/SH856.rb +156 -0
  202. data/lib/stupidedi/transaction_sets/004010/implementations/SM204.rb +391 -0
  203. data/lib/stupidedi/transaction_sets/004010/implementations/SQ866.rb +103 -0
  204. data/lib/stupidedi/transaction_sets/004010/implementations/SS862.rb +154 -0
  205. data/lib/stupidedi/transaction_sets/004010/implementations/SW945.rb +99 -0
  206. data/lib/stupidedi/transaction_sets/004010/implementations/X091A1-HP835.rb +481 -0
  207. data/lib/stupidedi/transaction_sets/004010/standards.rb +28 -0
  208. data/lib/stupidedi/transaction_sets/004010/standards/AR943.rb +34 -0
  209. data/lib/stupidedi/transaction_sets/004010/standards/FA997.rb +31 -0
  210. data/lib/stupidedi/transaction_sets/004010/standards/GF990.rb +21 -0
  211. data/lib/stupidedi/transaction_sets/004010/standards/HP835.rb +61 -0
  212. data/lib/stupidedi/transaction_sets/004010/standards/IM210.rb +47 -0
  213. data/lib/stupidedi/transaction_sets/004010/standards/OW940.rb +43 -0
  214. data/lib/stupidedi/transaction_sets/004010/standards/PO850.rb +50 -0
  215. data/lib/stupidedi/transaction_sets/004010/standards/PR855.rb +35 -0
  216. data/lib/stupidedi/transaction_sets/004010/standards/PS830.rb +43 -0
  217. data/lib/stupidedi/transaction_sets/004010/standards/QM214.rb +41 -0
  218. data/lib/stupidedi/transaction_sets/004010/standards/RE944.rb +34 -0
  219. data/lib/stupidedi/transaction_sets/004010/standards/SC832.rb +37 -0
  220. data/lib/stupidedi/transaction_sets/004010/standards/SH856.rb +40 -0
  221. data/lib/stupidedi/transaction_sets/004010/standards/SM204.rb +85 -0
  222. data/lib/stupidedi/transaction_sets/004010/standards/SQ866.rb +32 -0
  223. data/lib/stupidedi/transaction_sets/004010/standards/SS862.rb +42 -0
  224. data/lib/stupidedi/transaction_sets/004010/standards/SW945.rb +43 -0
  225. data/lib/stupidedi/transaction_sets/005010.rb +11 -0
  226. data/lib/stupidedi/transaction_sets/005010/implementations.rb +88 -0
  227. data/lib/stupidedi/transaction_sets/005010/implementations/X212-HR276.rb +329 -0
  228. data/lib/stupidedi/transaction_sets/005010/implementations/X214-HN277.rb +356 -0
  229. data/lib/stupidedi/transaction_sets/005010/implementations/X220-BE834.rb +15 -0
  230. data/lib/stupidedi/transaction_sets/005010/implementations/X220A1-BE834.rb +623 -0
  231. data/lib/stupidedi/transaction_sets/005010/implementations/X221-HP835.rb +15 -0
  232. data/lib/stupidedi/transaction_sets/005010/implementations/X221A1-HP835.rb +556 -0
  233. data/lib/stupidedi/transaction_sets/005010/implementations/X222-HC837.rb +15 -0
  234. data/lib/stupidedi/transaction_sets/005010/implementations/X222-HC837P.rb +15 -0
  235. data/lib/stupidedi/transaction_sets/005010/implementations/X222A1-HC837.rb +2033 -0
  236. data/lib/stupidedi/transaction_sets/005010/implementations/X222A1-HC837P.rb +15 -0
  237. data/lib/stupidedi/transaction_sets/005010/implementations/X223-HC837.rb +15 -0
  238. data/lib/stupidedi/transaction_sets/005010/implementations/X223-HC837I.rb +15 -0
  239. data/lib/stupidedi/transaction_sets/005010/implementations/X223A1-HC837.rb +15 -0
  240. data/lib/stupidedi/transaction_sets/005010/implementations/X223A2-HC837.rb +2390 -0
  241. data/lib/stupidedi/transaction_sets/005010/implementations/X223A3-HC837.rb +2595 -0
  242. data/lib/stupidedi/transaction_sets/005010/implementations/X231-FA999.rb +15 -0
  243. data/lib/stupidedi/transaction_sets/005010/implementations/X231A1-FA999.rb +106 -0
  244. data/lib/stupidedi/transaction_sets/005010/implementations/X279-HB271.rb +749 -0
  245. data/lib/stupidedi/transaction_sets/005010/implementations/X279-HS270.rb +533 -0
  246. data/lib/stupidedi/transaction_sets/005010/implementations/X279A1-HB271.rb +751 -0
  247. data/lib/stupidedi/transaction_sets/005010/implementations/X279A1-HS270.rb +533 -0
  248. data/lib/stupidedi/transaction_sets/005010/standards.rb +22 -0
  249. data/lib/stupidedi/transaction_sets/005010/standards/BE834.rb +171 -0
  250. data/lib/stupidedi/transaction_sets/005010/standards/FA997.rb +31 -0
  251. data/lib/stupidedi/transaction_sets/005010/standards/FA999.rb +35 -0
  252. data/lib/stupidedi/transaction_sets/005010/standards/HB271.rb +95 -0
  253. data/lib/stupidedi/transaction_sets/005010/standards/HC837.rb +161 -0
  254. data/lib/stupidedi/transaction_sets/005010/standards/HI278.rb +62 -0
  255. data/lib/stupidedi/transaction_sets/005010/standards/HN277.rb +71 -0
  256. data/lib/stupidedi/transaction_sets/005010/standards/HP835.rb +65 -0
  257. data/lib/stupidedi/transaction_sets/005010/standards/HR276.rb +54 -0
  258. data/lib/stupidedi/transaction_sets/005010/standards/HS270.rb +50 -0
  259. data/lib/stupidedi/transaction_sets/005010/standards/RA820.rb +238 -0
  260. data/lib/stupidedi/transaction_sets/builder.rb +184 -0
  261. data/lib/stupidedi/transaction_sets/common.rb +8 -0
  262. data/lib/stupidedi/transaction_sets/common/implementations.rb +11 -0
  263. data/lib/stupidedi/transaction_sets/common/implementations/element_reqs.rb +37 -0
  264. data/lib/stupidedi/transaction_sets/common/implementations/segment_reqs.rb +31 -0
  265. data/lib/stupidedi/transaction_sets/validation.rb +9 -0
  266. data/lib/stupidedi/transaction_sets/validation/ambiguity.rb +391 -0
  267. data/lib/stupidedi/transaction_sets/validation/implementation.rb +12 -0
  268. data/lib/stupidedi/values.rb +0 -1
  269. data/lib/stupidedi/values/abstract_element_val.rb +0 -4
  270. data/lib/stupidedi/values/abstract_val.rb +3 -4
  271. data/lib/stupidedi/values/composite_element_val.rb +3 -8
  272. data/lib/stupidedi/values/functional_group_val.rb +3 -4
  273. data/lib/stupidedi/values/interchange_val.rb +3 -4
  274. data/lib/stupidedi/values/invalid_envelope_val.rb +2 -6
  275. data/lib/stupidedi/values/invalid_segment_val.rb +16 -9
  276. data/lib/stupidedi/values/loop_val.rb +3 -4
  277. data/lib/stupidedi/values/repeated_element_val.rb +5 -7
  278. data/lib/stupidedi/values/segment_val.rb +7 -11
  279. data/lib/stupidedi/values/segment_val_group.rb +0 -4
  280. data/lib/stupidedi/values/simple_element_val.rb +2 -7
  281. data/lib/stupidedi/values/table_val.rb +3 -4
  282. data/lib/stupidedi/values/transaction_set_val.rb +3 -4
  283. data/lib/stupidedi/values/transmission_val.rb +5 -5
  284. data/lib/stupidedi/version.rb +1 -2
  285. data/lib/stupidedi/versions.rb +11 -3
  286. data/lib/stupidedi/versions/002001.rb +14 -0
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  2000. data/spec/support/node.rb +0 -41
  2001. data/spec/support/quickcheck.rb +0 -303
  2002. data/spec/support/quickcheck/characters.rb +0 -33
  2003. data/spec/support/quickcheck/property.rb +0 -105
  2004. data/spec/support/quickcheck/serialized_edi.rb +0 -400
  2005. data/spec/support/rcov.rb +0 -41
@@ -0,0 +1,15 @@
1
+ # frozen_string_literal: true
2
+ module Stupidedi
3
+ module TransactionSets
4
+ module FiftyTen
5
+ module Implementations
6
+ module X222A1
7
+ warn "DEPRECATION WARNING: #{self}::HC837P is deprecated, use X22A1::HC837 instead"
8
+
9
+ # @deprecated Use HC837 instead
10
+ HC837P = HC837
11
+ end
12
+ end
13
+ end
14
+ end
15
+ end
@@ -0,0 +1,15 @@
1
+ # frozen_string_literal: true
2
+ module Stupidedi
3
+ module TransactionSets
4
+ module FiftyTen
5
+ module Implementations
6
+ module X223
7
+ warn "DEPRECATION WARNING: #{self}::HC837 is deprecated, use X223A2::HC837 instead"
8
+
9
+ # @deprecated Use X223A2::HC837 instead
10
+ HC837 = X223A2::HC837
11
+ end
12
+ end
13
+ end
14
+ end
15
+ end
@@ -0,0 +1,15 @@
1
+ # frozen_string_literal: true
2
+ module Stupidedi
3
+ module TransactionSets
4
+ module FiftyTen
5
+ module Implementations
6
+ module X223
7
+ warn "DEPRECATION WARNING: #{self}::HC837I is deprecated, use X223A2::HC837 instead"
8
+
9
+ # @deprecated Use X223A2::HC837 instead
10
+ HC837I = X223A2::HC837
11
+ end
12
+ end
13
+ end
14
+ end
15
+ end
@@ -0,0 +1,15 @@
1
+ # frozen_string_literal: true
2
+ module Stupidedi
3
+ module TransactionSets
4
+ module FiftyTen
5
+ module Implementations
6
+ module X223A1
7
+ warn "DEPRECATION WARNING: #{self}::HC837 is deprecated, use X223A2::HC837 instead"
8
+
9
+ # @deprecated Use X223A2::HC837 instead
10
+ HC837 = X223A2::HC837
11
+ end
12
+ end
13
+ end
14
+ end
15
+ end
@@ -0,0 +1,2390 @@
1
+ # frozen_string_literal: true
2
+ module Stupidedi
3
+ module TransactionSets
4
+ module FiftyTen
5
+ module Implementations
6
+ module X223A2
7
+ b = Builder
8
+ d = Schema
9
+ r = SegmentReqs
10
+ e = ElementReqs
11
+ s = SegmentDefs
12
+
13
+ loop2300 =
14
+ d::LoopDef.build("2300 CLAIM INFORMATION", d::RepeatCount.bounded(100),
15
+ b::Segment(1300, s::CLM, "Claim Information", r::Situational, d::RepeatCount.bounded(1),
16
+ b::Element(e::Required, "Patient Control Number", b::MaxLength(20)),
17
+ b::Element(e::Required, "Total Claim Charge Amount"),
18
+ b::Element(e::NotUsed, "Claim Filing Indicator Code"),
19
+ b::Element(e::NotUsed, "Non-Institutional Claim Type Code"),
20
+ b::Element(e::Required, "HEALTH CARE SERVICE LOCATION INFORMATION",
21
+ b::Element(e::Required, "Facility Type Code"),
22
+ b::Element(e::Required, "Facility Code Qualifier", b::Values("A")),
23
+ b::Element(e::Required, "Claim Frequency Code")),
24
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code"),
25
+ b::Element(e::Required, "Assignment or Plan Participation Code", b::Values("A", "B", "C")),
26
+ b::Element(e::Required, "Benefits Assignment Certification Indicator", b::Values("N", "W", "Y")),
27
+ b::Element(e::Required, "Release of Information Code", b::Values("I", "Y")),
28
+ b::Element(e::NotUsed, "Patient Signature Source Code"),
29
+ b::Element(e::NotUsed, "RELATED CAUSES INFORMATION"),
30
+ b::Element(e::NotUsed, "Special Program Code"),
31
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code"),
32
+ b::Element(e::NotUsed, "Level of Service Code"),
33
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code"),
34
+ b::Element(e::NotUsed, "Provider Agreement Code"),
35
+ b::Element(e::NotUsed, "Claim Status Code"),
36
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code"),
37
+ b::Element(e::NotUsed, "Claim Submission Reason Code"),
38
+ b::Element(e::Situational, "Delay Reason Code", b::Values("1", "2", "3", "4", "5", "6", "7", "8", "9", "10", "11", "15"))),
39
+ b::Segment(1350, s::DTP, "Discharge Hour", r::Situational, d::RepeatCount.bounded(1),
40
+ b::Element(e::Required, "Date Time Qualifier", b::Values("096")),
41
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("TM")),
42
+ b::Element(e::Required, "Discharge Time")),
43
+ b::Segment(1350, s::DTP, "Statement Dates", r::Required, d::RepeatCount.bounded(1),
44
+ b::Element(e::Required, "Date Time Qualifier", b::Values("434")),
45
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("RD8")),
46
+ b::Element(e::Required, "Statement From and To Date")),
47
+ b::Segment(1350, s::DTP, "Admission Date/Hour", r::Situational, d::RepeatCount.bounded(1),
48
+ b::Element(e::Required, "Date Time Qualifier", b::Values("435")),
49
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8", "DT")),
50
+ b::Element(e::Required, "Admission Date and Hour")),
51
+ b::Segment(1350, s::DTP, "Date - Repricer Received Date", r::Situational, d::RepeatCount.bounded(1),
52
+ b::Element(e::Required, "Date Time Qualifier", b::Values("050")),
53
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8")),
54
+ b::Element(e::Required, "Repricer Received Date")),
55
+ b::Segment(1400, s::CL1, "Institutional Claim Code", r::Required, d::RepeatCount.bounded(1),
56
+ b::Element(e::Required, "Admission Type Code"),
57
+ b::Element(e::Situational, "Admission Source Code"),
58
+ b::Element(e::Required, "Patient Status Code"),
59
+ b::Element(e::NotUsed, "Nursing Home Residential Status Code")),
60
+ b::Segment(1550, s::PWK, "Claim Supplemental Information", r::Situational, d::RepeatCount.bounded(10),
61
+ b::Element(e::Required, "Report Type Code", b::Values("03", "04", "05", "06", "07", "08", "09", "10", "11", "13", "15", "21", "A3", "A4", "AM", "AS", "B2", "B3", "B4", "BR", "BS", "BT", "CB", "CK", "CT", "D2", "DA", "DB", "DG", "DJ", "DS", "EB", "HC", "HR", "I5", "IR", "LA", "M1", "MT", "NN", "OB", "OC", "OD", "OE", "OX", "OZ", "P4", "P5", "PE", "PN", "PO", "PQ", "PY", "PZ", "RB", "RR", "RT", "RX", "SG", "V5", "XP")),
62
+ b::Element(e::Required, "Attachment Transmission Code", b::Values("AA", "BM", "EL", "EM", "FT", "FX")),
63
+ b::Element(e::NotUsed, "Report Copies Needed"),
64
+ b::Element(e::NotUsed, "Entity Identifier Code"),
65
+ b::Element(e::Situational, "Identification Code Qualifier", b::Values("AC")),
66
+ b::Element(e::Situational, "Attachment Control Number", b::MaxLength(50)),
67
+ b::Element(e::NotUsed, "Description"),
68
+ b::Element(e::NotUsed, "ACTIONS INDICATED"),
69
+ b::Element(e::NotUsed, "Request Category Code")),
70
+ b::Segment(1600, s::CN1, "Contract Information", r::Situational, d::RepeatCount.bounded(1),
71
+ b::Element(e::Required, "Contract Type Code", b::Values("01", "02", "03", "04", "05", "06", "09")),
72
+ b::Element(e::Situational, "Contract Amount"),
73
+ b::Element(e::Situational, "Contract Percentage"),
74
+ b::Element(e::Situational, "Contract Code"),
75
+ b::Element(e::Situational, "Terms Discount Percentage"),
76
+ b::Element(e::Situational, "Contract Version Identifier")),
77
+ b::Segment(1750, s::AMT, "Patient Estimated Amount Due", r::Situational, d::RepeatCount.bounded(1),
78
+ b::Element(e::Required, "Amount Qualifier Code", b::Values("F3")),
79
+ b::Element(e::Required, "Patient Responsibility Amount"),
80
+ b::Element(e::NotUsed, "Credit/Debit Flag Code")),
81
+ b::Segment(1800, s::REF, "Service Authorization Exception Code", r::Situational, d::RepeatCount.bounded(1),
82
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("4N")),
83
+ b::Element(e::Required, "Service Authorization Exception Code", b::Values("1", "2", "3", "4", "5", "6", "7")),
84
+ b::Element(e::NotUsed, "Description"),
85
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
86
+ b::Segment(1800, s::REF, "Referral Number", r::Situational, d::RepeatCount.bounded(1),
87
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("9F")),
88
+ b::Element(e::Required, "Referral Number"),
89
+ b::Element(e::NotUsed, "Description"),
90
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
91
+ b::Segment(1800, s::REF, "Prior Authorization", r::Situational, d::RepeatCount.bounded(1),
92
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("G1")),
93
+ b::Element(e::Required, "Prior Authorization Number"),
94
+ b::Element(e::NotUsed, "Description"),
95
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
96
+ b::Segment(1800, s::REF, "Payer Claim Control Number", r::Situational, d::RepeatCount.bounded(1),
97
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("F8")),
98
+ b::Element(e::Required, "Payer Claim Control Number"),
99
+ b::Element(e::NotUsed, "Description"),
100
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
101
+ b::Segment(1800, s::REF, "Repriced Claim Number", r::Situational, d::RepeatCount.bounded(1),
102
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("9A")),
103
+ b::Element(e::Required, "Repriced Claim Reference Number"),
104
+ b::Element(e::NotUsed, "Description"),
105
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
106
+ b::Segment(1800, s::REF, "Adjusted Repriced Claim Number", r::Situational, d::RepeatCount.bounded(1),
107
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("9C")),
108
+ b::Element(e::Required, "Adjusted Repriced Claim Reference Number"),
109
+ b::Element(e::NotUsed, "Description"),
110
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
111
+ b::Segment(1800, s::REF, "Investigational Device Exemption Number", r::Situational, d::RepeatCount.bounded(5),
112
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("LX")),
113
+ b::Element(e::Required, "Investigational Device Exemption Identifier"),
114
+ b::Element(e::NotUsed, "Description"),
115
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
116
+ b::Segment(1800, s::REF, "Claim Identifier for Transmission Intermediaries", r::Situational, d::RepeatCount.bounded(1),
117
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("D9")),
118
+ b::Element(e::Required, "Value Added Network Trace Number", b::MaxLength(20)),
119
+ b::Element(e::NotUsed, "Description"),
120
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
121
+ b::Segment(1800, s::REF, "Auto Accident State", r::Situational, d::RepeatCount.bounded(1),
122
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("LU")),
123
+ b::Element(e::Required, "Auto Accident State or Province Code"),
124
+ b::Element(e::NotUsed, "Description"),
125
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
126
+ b::Segment(1800, s::REF, "Medical Record Number", r::Situational, d::RepeatCount.bounded(1),
127
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("EA")),
128
+ b::Element(e::Required, "Medical Record Number"),
129
+ b::Element(e::NotUsed, "Description"),
130
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
131
+ b::Segment(1800, s::REF, "Demonstration Project Identifier", r::Situational, d::RepeatCount.bounded(1),
132
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("P4")),
133
+ b::Element(e::Required, "Demonstration Project Identifier"),
134
+ b::Element(e::NotUsed, "Description"),
135
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
136
+ b::Segment(1800, s::REF, "Peer Review Organization (PRO) Approval Number", r::Situational, d::RepeatCount.bounded(1),
137
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("G4")),
138
+ b::Element(e::Required, "Peer Review Authorization Number"),
139
+ b::Element(e::NotUsed, "Description"),
140
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
141
+ b::Segment(1850, s::K3, "File Information", r::Situational, d::RepeatCount.bounded(10),
142
+ b::Element(e::Required, "Fixed Format Information"),
143
+ b::Element(e::NotUsed, "Record Format Code"),
144
+ b::Element(e::NotUsed, "COMPOSITE UNIT OF MEASURE")),
145
+ b::Segment(1900, s::NTE, "Claim Note", r::Situational, d::RepeatCount.bounded(10),
146
+ b::Element(e::Required, "Note Reference Code", b::Values("ALG", "DCP", "DGN", "DME", "MED", "NTR", "ODT", "RHB", "RLH", "RNH", "SET", "SFM", "SPT", "UPI")),
147
+ b::Element(e::Required, "Claim Note Text")),
148
+ b::Segment(1900, s::NTE, "Billing Note", r::Situational, d::RepeatCount.bounded(1),
149
+ b::Element(e::Required, "Note Reference Code", b::Values("ADD")),
150
+ b::Element(e::Required, "Billing Note Text")),
151
+ b::Segment(2200, s::CRC, "EPSDT Referral", r::Situational, d::RepeatCount.bounded(1),
152
+ b::Element(e::Required, "Code Category", b::Values("ZZ")),
153
+ b::Element(e::Required, "Certification Condition Indicator", b::Values("Y", "N")),
154
+ b::Element(e::Required, "Condition Code", b::Values("AV", "NU", "S2", "ST")),
155
+ b::Element(e::Situational, "Condition Code", b::Values("AV", "NU", "S2", "ST")),
156
+ b::Element(e::Situational, "Condition Code", b::Values("AV", "NU", "S2", "ST")),
157
+ b::Element(e::NotUsed, "Condition Indicator"),
158
+ b::Element(e::NotUsed, "Condition Indicator")),
159
+ b::Segment(2310, s::HI, "Principal Diagnosis", r::Required, d::RepeatCount.bounded(1),
160
+ b::Element(e::Required, "HEALTH CARE CODE INFORMATION",
161
+ b::Element(e::Required, "Code List Qualifier", b::Values("ABK", "BK")),
162
+ b::Element(e::Required, "Principal Diagnosis Code"),
163
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
164
+ b::Element(e::NotUsed, "Date Time Period"),
165
+ b::Element(e::NotUsed, "Monetary Amount"),
166
+ b::Element(e::NotUsed, "Quantity"),
167
+ b::Element(e::NotUsed, "Version Identifier"),
168
+ b::Element(e::NotUsed, "Industry Code"),
169
+ b::Element(e::Situational, "Yes/No Condition or Response Code", b::Values("N", "U", "W", "Y"))),
170
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
171
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
172
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
173
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
174
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
175
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
176
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
177
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
178
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
179
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
180
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION")),
181
+ b::Segment(2310, s::HI, "Admitting Diagnosis", r::Situational, d::RepeatCount.bounded(1),
182
+ b::Element(e::Required, "HEALTH CARE CODE INFORMATION",
183
+ b::Element(e::Required, "Code List Qualifier", b::Values("ABJ", "BJ")),
184
+ b::Element(e::Required, "Admitting Diagnosis Code"),
185
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
186
+ b::Element(e::NotUsed, "Date Time Period"),
187
+ b::Element(e::NotUsed, "Monetary Amount"),
188
+ b::Element(e::NotUsed, "Quantity"),
189
+ b::Element(e::NotUsed, "Version Identifier"),
190
+ b::Element(e::NotUsed, "Industry Code"),
191
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
192
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
193
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
194
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
195
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
196
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
197
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
198
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
199
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
200
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
201
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
202
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION")),
203
+ b::Segment(2310, s::HI, "Patient's Reason For Visit", r::Situational, d::RepeatCount.bounded(1),
204
+ b::Element(e::Required, "HEALTH CARE CODE INFORMATION",
205
+ b::Element(e::Required, "Code List Qualifier", b::Values("APR", "PR")),
206
+ b::Element(e::Required, "Patient Reason For Visit"),
207
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
208
+ b::Element(e::NotUsed, "Date Time Period"),
209
+ b::Element(e::NotUsed, "Monetary Amount"),
210
+ b::Element(e::NotUsed, "Quantity"),
211
+ b::Element(e::NotUsed, "Version Identifier"),
212
+ b::Element(e::NotUsed, "Industry Code"),
213
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
214
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
215
+ b::Element(e::Required, "Code List Qualifier", b::Values("APR", "PR")),
216
+ b::Element(e::Required, "Patient Reason For Visit"),
217
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
218
+ b::Element(e::NotUsed, "Date Time Period"),
219
+ b::Element(e::NotUsed, "Monetary Amount"),
220
+ b::Element(e::NotUsed, "Quantity"),
221
+ b::Element(e::NotUsed, "Version Identifier"),
222
+ b::Element(e::NotUsed, "Industry Code"),
223
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
224
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
225
+ b::Element(e::Required, "Code List Qualifier", b::Values("APR", "PR")),
226
+ b::Element(e::Required, "Patient Reason For Visit"),
227
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
228
+ b::Element(e::NotUsed, "Date Time Period"),
229
+ b::Element(e::NotUsed, "Monetary Amount"),
230
+ b::Element(e::NotUsed, "Quantity"),
231
+ b::Element(e::NotUsed, "Version Identifier"),
232
+ b::Element(e::NotUsed, "Industry Code"),
233
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
234
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
235
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
236
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
237
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
238
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
239
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
240
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
241
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
242
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION")),
243
+ b::Segment(2310, s::HI, "External Cause of Injury", r::Situational, d::RepeatCount.bounded(1),
244
+ b::Element(e::Required, "HEALTH CARE CODE INFORMATION",
245
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("ABN", "BN")),
246
+ b::Element(e::Required, "External Cause of Injury Code"),
247
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
248
+ b::Element(e::NotUsed, "Date Time Period"),
249
+ b::Element(e::NotUsed, "Monetary Amount"),
250
+ b::Element(e::NotUsed, "Quantity"),
251
+ b::Element(e::NotUsed, "Version Identifier"),
252
+ b::Element(e::NotUsed, "Industry Code"),
253
+ b::Element(e::Situational, "Present on Admission Indicator", b::Values("N", "U", "W", "Y"))),
254
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
255
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("ABN", "BN")),
256
+ b::Element(e::Required, "External Cause of Injury Code"),
257
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
258
+ b::Element(e::NotUsed, "Date Time Period"),
259
+ b::Element(e::NotUsed, "Monetary Amount"),
260
+ b::Element(e::NotUsed, "Quantity"),
261
+ b::Element(e::NotUsed, "Version Identifier"),
262
+ b::Element(e::NotUsed, "Industry Code"),
263
+ b::Element(e::Situational, "Present on Admission Indicator", b::Values("N", "U", "W", "Y"))),
264
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
265
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("ABN", "BN")),
266
+ b::Element(e::Required, "External Cause of Injury Code"),
267
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
268
+ b::Element(e::NotUsed, "Date Time Period"),
269
+ b::Element(e::NotUsed, "Monetary Amount"),
270
+ b::Element(e::NotUsed, "Quantity"),
271
+ b::Element(e::NotUsed, "Version Identifier"),
272
+ b::Element(e::NotUsed, "Industry Code"),
273
+ b::Element(e::Situational, "Present on Admission Indicator", b::Values("N", "U", "W", "Y"))),
274
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
275
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("ABN", "BN")),
276
+ b::Element(e::Required, "External Cause of Injury Code"),
277
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
278
+ b::Element(e::NotUsed, "Date Time Period"),
279
+ b::Element(e::NotUsed, "Monetary Amount"),
280
+ b::Element(e::NotUsed, "Quantity"),
281
+ b::Element(e::NotUsed, "Version Identifier"),
282
+ b::Element(e::NotUsed, "Industry Code"),
283
+ b::Element(e::Situational, "Present on Admission Indicator", b::Values("N", "U", "W", "Y"))),
284
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
285
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("ABN", "BN")),
286
+ b::Element(e::Required, "External Cause of Injury Code"),
287
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
288
+ b::Element(e::NotUsed, "Date Time Period"),
289
+ b::Element(e::NotUsed, "Monetary Amount"),
290
+ b::Element(e::NotUsed, "Quantity"),
291
+ b::Element(e::NotUsed, "Version Identifier"),
292
+ b::Element(e::NotUsed, "Industry Code"),
293
+ b::Element(e::Situational, "Present on Admission Indicator", b::Values("N", "U", "W", "Y"))),
294
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
295
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("ABN", "BN")),
296
+ b::Element(e::Required, "External Cause of Injury Code"),
297
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
298
+ b::Element(e::NotUsed, "Date Time Period"),
299
+ b::Element(e::NotUsed, "Monetary Amount"),
300
+ b::Element(e::NotUsed, "Quantity"),
301
+ b::Element(e::NotUsed, "Version Identifier"),
302
+ b::Element(e::NotUsed, "Industry Code"),
303
+ b::Element(e::Situational, "Present on Admission Indicator", b::Values("N", "U", "W", "Y"))),
304
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
305
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("ABN", "BN")),
306
+ b::Element(e::Required, "External Cause of Injury Code"),
307
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
308
+ b::Element(e::NotUsed, "Date Time Period"),
309
+ b::Element(e::NotUsed, "Monetary Amount"),
310
+ b::Element(e::NotUsed, "Quantity"),
311
+ b::Element(e::NotUsed, "Version Identifier"),
312
+ b::Element(e::NotUsed, "Industry Code"),
313
+ b::Element(e::Situational, "Present on Admission Indicator", b::Values("N", "U", "W", "Y"))),
314
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
315
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("ABN", "BN")),
316
+ b::Element(e::Required, "External Cause of Injury Code"),
317
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
318
+ b::Element(e::NotUsed, "Date Time Period"),
319
+ b::Element(e::NotUsed, "Monetary Amount"),
320
+ b::Element(e::NotUsed, "Quantity"),
321
+ b::Element(e::NotUsed, "Version Identifier"),
322
+ b::Element(e::NotUsed, "Industry Code"),
323
+ b::Element(e::Situational, "Present on Admission Indicator", b::Values("N", "U", "W", "Y"))),
324
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
325
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("ABN", "BN")),
326
+ b::Element(e::Required, "External Cause of Injury Code"),
327
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
328
+ b::Element(e::NotUsed, "Date Time Period"),
329
+ b::Element(e::NotUsed, "Monetary Amount"),
330
+ b::Element(e::NotUsed, "Quantity"),
331
+ b::Element(e::NotUsed, "Version Identifier"),
332
+ b::Element(e::NotUsed, "Industry Code"),
333
+ b::Element(e::Situational, "Present on Admission Indicator", b::Values("N", "U", "W", "Y"))),
334
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
335
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("ABN", "BN")),
336
+ b::Element(e::Required, "External Cause of Injury Code"),
337
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
338
+ b::Element(e::NotUsed, "Date Time Period"),
339
+ b::Element(e::NotUsed, "Monetary Amount"),
340
+ b::Element(e::NotUsed, "Quantity"),
341
+ b::Element(e::NotUsed, "Version Identifier"),
342
+ b::Element(e::NotUsed, "Industry Code"),
343
+ b::Element(e::Situational, "Present on Admission Indicator", b::Values("N", "U", "W", "Y"))),
344
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
345
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("ABN", "BN")),
346
+ b::Element(e::Required, "External Cause of Injury Code"),
347
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
348
+ b::Element(e::NotUsed, "Date Time Period"),
349
+ b::Element(e::NotUsed, "Monetary Amount"),
350
+ b::Element(e::NotUsed, "Quantity"),
351
+ b::Element(e::NotUsed, "Version Identifier"),
352
+ b::Element(e::NotUsed, "Industry Code"),
353
+ b::Element(e::Situational, "Present on Admission Indicator", b::Values("N", "U", "W", "Y"))),
354
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
355
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("ABN", "BN")),
356
+ b::Element(e::Required, "External Cause of Injury Code"),
357
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
358
+ b::Element(e::NotUsed, "Date Time Period"),
359
+ b::Element(e::NotUsed, "Monetary Amount"),
360
+ b::Element(e::NotUsed, "Quantity"),
361
+ b::Element(e::NotUsed, "Version Identifier"),
362
+ b::Element(e::NotUsed, "Industry Code"),
363
+ b::Element(e::Situational, "Present on Admission Indicator", b::Values("N", "U", "W", "Y")))),
364
+ b::Segment(2310, s::HI, "Diagnosis Related Group (DRG) Information", r::Situational, d::RepeatCount.bounded(1),
365
+ b::Element(e::Required, "HEALTH CARE CODE INFORMATION",
366
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("DR")),
367
+ b::Element(e::Required, "Diagnosis Related Group (DRG) Code"),
368
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
369
+ b::Element(e::NotUsed, "Date Time Period"),
370
+ b::Element(e::NotUsed, "Monetary Amount"),
371
+ b::Element(e::NotUsed, "Quantity"),
372
+ b::Element(e::NotUsed, "Version Identifier"),
373
+ b::Element(e::NotUsed, "Industry Code"),
374
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
375
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
376
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
377
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
378
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
379
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
380
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
381
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
382
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
383
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
384
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
385
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION")),
386
+ b::Segment(2310, s::HI, "Other Diagnosis Information", r::Situational, d::RepeatCount.bounded(2),
387
+ b::Element(e::Required, "HEALTH CARE CODE INFORMATION",
388
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("ABF", "BF")),
389
+ b::Element(e::Required, "Other Diagnosis"),
390
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
391
+ b::Element(e::NotUsed, "Date Time Period"),
392
+ b::Element(e::NotUsed, "Monetary Amount"),
393
+ b::Element(e::NotUsed, "Quantity"),
394
+ b::Element(e::NotUsed, "Version Identifier"),
395
+ b::Element(e::NotUsed, "Industry Code"),
396
+ b::Element(e::Situational, "Present on Admission Indicator", b::Values("N", "U", "W", "Y"))),
397
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
398
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("ABF", "BF")),
399
+ b::Element(e::Required, "Other Diagnosis"),
400
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
401
+ b::Element(e::NotUsed, "Date Time Period"),
402
+ b::Element(e::NotUsed, "Monetary Amount"),
403
+ b::Element(e::NotUsed, "Quantity"),
404
+ b::Element(e::NotUsed, "Version Identifier"),
405
+ b::Element(e::NotUsed, "Industry Code"),
406
+ b::Element(e::Situational, "Present on Admission Indicator", b::Values("N", "U", "W", "Y"))),
407
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
408
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("ABF", "BF")),
409
+ b::Element(e::Required, "Other Diagnosis"),
410
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
411
+ b::Element(e::NotUsed, "Date Time Period"),
412
+ b::Element(e::NotUsed, "Monetary Amount"),
413
+ b::Element(e::NotUsed, "Quantity"),
414
+ b::Element(e::NotUsed, "Version Identifier"),
415
+ b::Element(e::NotUsed, "Industry Code"),
416
+ b::Element(e::Situational, "Present on Admission Indicator", b::Values("N", "U", "W", "Y"))),
417
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
418
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("ABF", "BF")),
419
+ b::Element(e::Required, "Other Diagnosis"),
420
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
421
+ b::Element(e::NotUsed, "Date Time Period"),
422
+ b::Element(e::NotUsed, "Monetary Amount"),
423
+ b::Element(e::NotUsed, "Quantity"),
424
+ b::Element(e::NotUsed, "Version Identifier"),
425
+ b::Element(e::NotUsed, "Industry Code"),
426
+ b::Element(e::Situational, "Present on Admission Indicator", b::Values("N", "U", "W", "Y"))),
427
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
428
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("ABF", "BF")),
429
+ b::Element(e::Required, "Other Diagnosis"),
430
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
431
+ b::Element(e::NotUsed, "Date Time Period"),
432
+ b::Element(e::NotUsed, "Monetary Amount"),
433
+ b::Element(e::NotUsed, "Quantity"),
434
+ b::Element(e::NotUsed, "Version Identifier"),
435
+ b::Element(e::NotUsed, "Industry Code"),
436
+ b::Element(e::Situational, "Present on Admission Indicator", b::Values("N", "U", "W", "Y"))),
437
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
438
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("ABF", "BF")),
439
+ b::Element(e::Required, "Other Diagnosis"),
440
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
441
+ b::Element(e::NotUsed, "Date Time Period"),
442
+ b::Element(e::NotUsed, "Monetary Amount"),
443
+ b::Element(e::NotUsed, "Quantity"),
444
+ b::Element(e::NotUsed, "Version Identifier"),
445
+ b::Element(e::NotUsed, "Industry Code"),
446
+ b::Element(e::Situational, "Present on Admission Indicator", b::Values("N", "U", "W", "Y"))),
447
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
448
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("ABF", "BF")),
449
+ b::Element(e::Required, "Other Diagnosis"),
450
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
451
+ b::Element(e::NotUsed, "Date Time Period"),
452
+ b::Element(e::NotUsed, "Monetary Amount"),
453
+ b::Element(e::NotUsed, "Quantity"),
454
+ b::Element(e::NotUsed, "Version Identifier"),
455
+ b::Element(e::NotUsed, "Industry Code"),
456
+ b::Element(e::Situational, "Present on Admission Indicator", b::Values("N", "U", "W", "Y"))),
457
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
458
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("ABF", "BF")),
459
+ b::Element(e::Required, "Other Diagnosis"),
460
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
461
+ b::Element(e::NotUsed, "Date Time Period"),
462
+ b::Element(e::NotUsed, "Monetary Amount"),
463
+ b::Element(e::NotUsed, "Quantity"),
464
+ b::Element(e::NotUsed, "Version Identifier"),
465
+ b::Element(e::NotUsed, "Industry Code"),
466
+ b::Element(e::Situational, "Present on Admission Indicator", b::Values("N", "U", "W", "Y"))),
467
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
468
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("ABF", "BF")),
469
+ b::Element(e::Required, "Other Diagnosis"),
470
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
471
+ b::Element(e::NotUsed, "Date Time Period"),
472
+ b::Element(e::NotUsed, "Monetary Amount"),
473
+ b::Element(e::NotUsed, "Quantity"),
474
+ b::Element(e::NotUsed, "Version Identifier"),
475
+ b::Element(e::NotUsed, "Industry Code"),
476
+ b::Element(e::Situational, "Present on Admission Indicator", b::Values("N", "U", "W", "Y"))),
477
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
478
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("ABF", "BF")),
479
+ b::Element(e::Required, "Other Diagnosis"),
480
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
481
+ b::Element(e::NotUsed, "Date Time Period"),
482
+ b::Element(e::NotUsed, "Monetary Amount"),
483
+ b::Element(e::NotUsed, "Quantity"),
484
+ b::Element(e::NotUsed, "Version Identifier"),
485
+ b::Element(e::NotUsed, "Industry Code"),
486
+ b::Element(e::Situational, "Present on Admission Indicator", b::Values("N", "U", "W", "Y"))),
487
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
488
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("ABF", "BF")),
489
+ b::Element(e::Required, "Other Diagnosis"),
490
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
491
+ b::Element(e::NotUsed, "Date Time Period"),
492
+ b::Element(e::NotUsed, "Monetary Amount"),
493
+ b::Element(e::NotUsed, "Quantity"),
494
+ b::Element(e::NotUsed, "Version Identifier"),
495
+ b::Element(e::NotUsed, "Industry Code"),
496
+ b::Element(e::Situational, "Present on Admission Indicator", b::Values("N", "U", "W", "Y"))),
497
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
498
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("ABF", "BF")),
499
+ b::Element(e::Required, "Other Diagnosis"),
500
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
501
+ b::Element(e::NotUsed, "Date Time Period"),
502
+ b::Element(e::NotUsed, "Monetary Amount"),
503
+ b::Element(e::NotUsed, "Quantity"),
504
+ b::Element(e::NotUsed, "Version Identifier"),
505
+ b::Element(e::NotUsed, "Industry Code"),
506
+ b::Element(e::Situational, "Present on Admission Indicator", b::Values("N", "U", "W", "Y")))),
507
+ b::Segment(2310, s::HI, "Principal Procedure Information", r::Situational, d::RepeatCount.bounded(1),
508
+ b::Element(e::Required, "HEALTH CARE CODE INFORMATION",
509
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BBR", "BR", "CAH")),
510
+ b::Element(e::Required, "Principal Procedure Code"),
511
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8")),
512
+ b::Element(e::Required, "Principal Procedure Date"),
513
+ b::Element(e::NotUsed, "Monetary Amount"),
514
+ b::Element(e::NotUsed, "Quantity"),
515
+ b::Element(e::NotUsed, "Version Identifier"),
516
+ b::Element(e::NotUsed, "Industry Code"),
517
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
518
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
519
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
520
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
521
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
522
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
523
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
524
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
525
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
526
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
527
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION"),
528
+ b::Element(e::NotUsed, "HEALTH CARE CODE INFORMATION")),
529
+ b::Segment(2310, s::HI, "Other Procedure Information", r::Situational, d::RepeatCount.bounded(2),
530
+ b::Element(e::Required, "HEALTH CARE CODE INFORMATION",
531
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BBQ", "BQ")),
532
+ b::Element(e::Required, "Procedure Code"),
533
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8")),
534
+ b::Element(e::Required, "Procedure Date"),
535
+ b::Element(e::NotUsed, "Monetary Amount"),
536
+ b::Element(e::NotUsed, "Quantity"),
537
+ b::Element(e::NotUsed, "Version Identifier"),
538
+ b::Element(e::NotUsed, "Industry Code"),
539
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
540
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
541
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BBQ", "BQ")),
542
+ b::Element(e::Required, "Procedure Code"),
543
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8")),
544
+ b::Element(e::Required, "Procedure Date"),
545
+ b::Element(e::NotUsed, "Monetary Amount"),
546
+ b::Element(e::NotUsed, "Quantity"),
547
+ b::Element(e::NotUsed, "Version Identifier"),
548
+ b::Element(e::NotUsed, "Industry Code"),
549
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
550
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
551
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BBQ", "BQ")),
552
+ b::Element(e::Required, "Procedure Code"),
553
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8")),
554
+ b::Element(e::Required, "Procedure Date"),
555
+ b::Element(e::NotUsed, "Monetary Amount"),
556
+ b::Element(e::NotUsed, "Quantity"),
557
+ b::Element(e::NotUsed, "Version Identifier"),
558
+ b::Element(e::NotUsed, "Industry Code"),
559
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
560
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
561
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BBQ", "BQ")),
562
+ b::Element(e::Required, "Procedure Code"),
563
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8")),
564
+ b::Element(e::Required, "Procedure Date"),
565
+ b::Element(e::NotUsed, "Monetary Amount"),
566
+ b::Element(e::NotUsed, "Quantity"),
567
+ b::Element(e::NotUsed, "Version Identifier"),
568
+ b::Element(e::NotUsed, "Industry Code"),
569
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
570
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
571
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BBQ", "BQ")),
572
+ b::Element(e::Required, "Procedure Code"),
573
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8")),
574
+ b::Element(e::Required, "Procedure Date"),
575
+ b::Element(e::NotUsed, "Monetary Amount"),
576
+ b::Element(e::NotUsed, "Quantity"),
577
+ b::Element(e::NotUsed, "Version Identifier"),
578
+ b::Element(e::NotUsed, "Industry Code"),
579
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
580
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
581
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BBQ", "BQ")),
582
+ b::Element(e::Required, "Procedure Code"),
583
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8")),
584
+ b::Element(e::Required, "Procedure Date"),
585
+ b::Element(e::NotUsed, "Monetary Amount"),
586
+ b::Element(e::NotUsed, "Quantity"),
587
+ b::Element(e::NotUsed, "Version Identifier"),
588
+ b::Element(e::NotUsed, "Industry Code"),
589
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
590
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
591
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BBQ", "BQ")),
592
+ b::Element(e::Required, "Procedure Code"),
593
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8")),
594
+ b::Element(e::Required, "Procedure Date"),
595
+ b::Element(e::NotUsed, "Monetary Amount"),
596
+ b::Element(e::NotUsed, "Quantity"),
597
+ b::Element(e::NotUsed, "Version Identifier"),
598
+ b::Element(e::NotUsed, "Industry Code"),
599
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
600
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
601
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BBQ", "BQ")),
602
+ b::Element(e::Required, "Procedure Code"),
603
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8")),
604
+ b::Element(e::Required, "Procedure Date"),
605
+ b::Element(e::NotUsed, "Monetary Amount"),
606
+ b::Element(e::NotUsed, "Quantity"),
607
+ b::Element(e::NotUsed, "Version Identifier"),
608
+ b::Element(e::NotUsed, "Industry Code"),
609
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
610
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
611
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BBQ", "BQ")),
612
+ b::Element(e::Required, "Procedure Code"),
613
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8")),
614
+ b::Element(e::Required, "Procedure Date"),
615
+ b::Element(e::NotUsed, "Monetary Amount"),
616
+ b::Element(e::NotUsed, "Quantity"),
617
+ b::Element(e::NotUsed, "Version Identifier"),
618
+ b::Element(e::NotUsed, "Industry Code"),
619
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
620
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
621
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BBQ", "BQ")),
622
+ b::Element(e::Required, "Procedure Code"),
623
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8")),
624
+ b::Element(e::Required, "Procedure Date"),
625
+ b::Element(e::NotUsed, "Monetary Amount"),
626
+ b::Element(e::NotUsed, "Quantity"),
627
+ b::Element(e::NotUsed, "Version Identifier"),
628
+ b::Element(e::NotUsed, "Industry Code"),
629
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
630
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
631
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BBQ", "BQ")),
632
+ b::Element(e::Required, "Procedure Code"),
633
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8")),
634
+ b::Element(e::Required, "Procedure Date"),
635
+ b::Element(e::NotUsed, "Monetary Amount"),
636
+ b::Element(e::NotUsed, "Quantity"),
637
+ b::Element(e::NotUsed, "Version Identifier"),
638
+ b::Element(e::NotUsed, "Industry Code"),
639
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
640
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
641
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BBQ", "BQ")),
642
+ b::Element(e::Required, "Procedure Code"),
643
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8")),
644
+ b::Element(e::Required, "Procedure Date"),
645
+ b::Element(e::NotUsed, "Monetary Amount"),
646
+ b::Element(e::NotUsed, "Quantity"),
647
+ b::Element(e::NotUsed, "Version Identifier"),
648
+ b::Element(e::NotUsed, "Industry Code"),
649
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code"))),
650
+ b::Segment(2310, s::HI, "Occurrence Span Information", r::Situational, d::RepeatCount.bounded(2),
651
+ b::Element(e::Required, "HEALTH CLAIM CODE INFORMATION",
652
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BI")),
653
+ b::Element(e::Required, "Occurrence Span Code"),
654
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("RD8")),
655
+ b::Element(e::Required, "Occurrence Span Code Date"),
656
+ b::Element(e::NotUsed, "Monetary Amount"),
657
+ b::Element(e::NotUsed, "Quantity"),
658
+ b::Element(e::NotUsed, "Version Identifier"),
659
+ b::Element(e::NotUsed, "Industry Code"),
660
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
661
+ b::Element(e::Situational, "HEALTH CLAIM CODE INFORMATION",
662
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BI")),
663
+ b::Element(e::Required, "Occurrence Span Code"),
664
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("RD8")),
665
+ b::Element(e::Required, "Occurrence Span Code Date"),
666
+ b::Element(e::NotUsed, "Monetary Amount"),
667
+ b::Element(e::NotUsed, "Quantity"),
668
+ b::Element(e::NotUsed, "Version Identifier"),
669
+ b::Element(e::NotUsed, "Industry Code"),
670
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
671
+ b::Element(e::Situational, "HEALTH CLAIM CODE INFORMATION",
672
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BI")),
673
+ b::Element(e::Required, "Occurrence Span Code"),
674
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("RD8")),
675
+ b::Element(e::Required, "Occurrence Span Code Date"),
676
+ b::Element(e::NotUsed, "Monetary Amount"),
677
+ b::Element(e::NotUsed, "Quantity"),
678
+ b::Element(e::NotUsed, "Version Identifier"),
679
+ b::Element(e::NotUsed, "Industry Code"),
680
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
681
+ b::Element(e::Situational, "HEALTH CLAIM CODE INFORMATION",
682
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BI")),
683
+ b::Element(e::Required, "Occurrence Span Code"),
684
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("RD8")),
685
+ b::Element(e::Required, "Occurrence Span Code Date"),
686
+ b::Element(e::NotUsed, "Monetary Amount"),
687
+ b::Element(e::NotUsed, "Quantity"),
688
+ b::Element(e::NotUsed, "Version Identifier"),
689
+ b::Element(e::NotUsed, "Industry Code"),
690
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
691
+ b::Element(e::Situational, "HEALTH CLAIM CODE INFORMATION",
692
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BI")),
693
+ b::Element(e::Required, "Occurrence Span Code"),
694
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("RD8")),
695
+ b::Element(e::Required, "Occurrence Span Code Date"),
696
+ b::Element(e::NotUsed, "Monetary Amount"),
697
+ b::Element(e::NotUsed, "Quantity"),
698
+ b::Element(e::NotUsed, "Version Identifier"),
699
+ b::Element(e::NotUsed, "Industry Code"),
700
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
701
+ b::Element(e::Situational, "HEALTH CLAIM CODE INFORMATION",
702
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BI")),
703
+ b::Element(e::Required, "Occurrence Span Code"),
704
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("RD8")),
705
+ b::Element(e::Required, "Occurrence Span Code Date"),
706
+ b::Element(e::NotUsed, "Monetary Amount"),
707
+ b::Element(e::NotUsed, "Quantity"),
708
+ b::Element(e::NotUsed, "Version Identifier"),
709
+ b::Element(e::NotUsed, "Industry Code"),
710
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
711
+ b::Element(e::Situational, "HEALTH CLAIM CODE INFORMATION",
712
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BI")),
713
+ b::Element(e::Required, "Occurrence Span Code"),
714
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("RD8")),
715
+ b::Element(e::Required, "Occurrence Span Code Date"),
716
+ b::Element(e::NotUsed, "Monetary Amount"),
717
+ b::Element(e::NotUsed, "Quantity"),
718
+ b::Element(e::NotUsed, "Version Identifier"),
719
+ b::Element(e::NotUsed, "Industry Code"),
720
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
721
+ b::Element(e::Situational, "HEALTH CLAIM CODE INFORMATION",
722
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BI")),
723
+ b::Element(e::Required, "Occurrence Span Code"),
724
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("RD8")),
725
+ b::Element(e::Required, "Occurrence Span Code Date"),
726
+ b::Element(e::NotUsed, "Monetary Amount"),
727
+ b::Element(e::NotUsed, "Quantity"),
728
+ b::Element(e::NotUsed, "Version Identifier"),
729
+ b::Element(e::NotUsed, "Industry Code"),
730
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
731
+ b::Element(e::Situational, "HEALTH CLAIM CODE INFORMATION",
732
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BI")),
733
+ b::Element(e::Required, "Occurrence Span Code"),
734
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("RD8")),
735
+ b::Element(e::Required, "Occurrence Span Code Date"),
736
+ b::Element(e::NotUsed, "Monetary Amount"),
737
+ b::Element(e::NotUsed, "Quantity"),
738
+ b::Element(e::NotUsed, "Version Identifier"),
739
+ b::Element(e::NotUsed, "Industry Code"),
740
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
741
+ b::Element(e::Situational, "HEALTH CLAIM CODE INFORMATION",
742
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BI")),
743
+ b::Element(e::Required, "Occurrence Span Code"),
744
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("RD8")),
745
+ b::Element(e::Required, "Occurrence Span Code Date"),
746
+ b::Element(e::NotUsed, "Monetary Amount"),
747
+ b::Element(e::NotUsed, "Quantity"),
748
+ b::Element(e::NotUsed, "Version Identifier"),
749
+ b::Element(e::NotUsed, "Industry Code"),
750
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
751
+ b::Element(e::Situational, "HEALTH CLAIM CODE INFORMATION",
752
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BI")),
753
+ b::Element(e::Required, "Occurrence Span Code"),
754
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("RD8")),
755
+ b::Element(e::Required, "Occurrence Span Code Date"),
756
+ b::Element(e::NotUsed, "Monetary Amount"),
757
+ b::Element(e::NotUsed, "Quantity"),
758
+ b::Element(e::NotUsed, "Version Identifier"),
759
+ b::Element(e::NotUsed, "Industry Code"),
760
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
761
+ b::Element(e::Situational, "HEALTH CLAIM CODE INFORMATION",
762
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BI")),
763
+ b::Element(e::Required, "Occurrence Span Code"),
764
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("RD8")),
765
+ b::Element(e::Required, "Occurrence Span Code Date"),
766
+ b::Element(e::NotUsed, "Monetary Amount"),
767
+ b::Element(e::NotUsed, "Quantity"),
768
+ b::Element(e::NotUsed, "Version Identifier"),
769
+ b::Element(e::NotUsed, "Industry Code"),
770
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code"))),
771
+ b::Segment(2310, s::HI, "Occurrence Information", r::Situational, d::RepeatCount.bounded(2),
772
+ b::Element(e::Required, "HEALTH CARE CODE INFORMATION",
773
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BH")),
774
+ b::Element(e::Required, "Occurrence Code"),
775
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8")),
776
+ b::Element(e::Required, "Occurrence Code Date"),
777
+ b::Element(e::NotUsed, "Monetary Amount"),
778
+ b::Element(e::NotUsed, "Quantity"),
779
+ b::Element(e::NotUsed, "Version Identifier"),
780
+ b::Element(e::NotUsed, "Industy Code"),
781
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
782
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
783
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BH")),
784
+ b::Element(e::Required, "Occurrence Code"),
785
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8")),
786
+ b::Element(e::Required, "Occurrence Code Date"),
787
+ b::Element(e::NotUsed, "Monetary Amount"),
788
+ b::Element(e::NotUsed, "Quantity"),
789
+ b::Element(e::NotUsed, "Version Identifier"),
790
+ b::Element(e::NotUsed, "Industy Code"),
791
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
792
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
793
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BH")),
794
+ b::Element(e::Required, "Occurrence Code"),
795
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8")),
796
+ b::Element(e::Required, "Occurrence Code Date"),
797
+ b::Element(e::NotUsed, "Monetary Amount"),
798
+ b::Element(e::NotUsed, "Quantity"),
799
+ b::Element(e::NotUsed, "Version Identifier"),
800
+ b::Element(e::NotUsed, "Industy Code"),
801
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
802
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
803
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BH")),
804
+ b::Element(e::Required, "Occurrence Code"),
805
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8")),
806
+ b::Element(e::Required, "Occurrence Code Date"),
807
+ b::Element(e::NotUsed, "Monetary Amount"),
808
+ b::Element(e::NotUsed, "Quantity"),
809
+ b::Element(e::NotUsed, "Version Identifier"),
810
+ b::Element(e::NotUsed, "Industy Code"),
811
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
812
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
813
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BH")),
814
+ b::Element(e::Required, "Occurrence Code"),
815
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8")),
816
+ b::Element(e::Required, "Occurrence Code Date"),
817
+ b::Element(e::NotUsed, "Monetary Amount"),
818
+ b::Element(e::NotUsed, "Quantity"),
819
+ b::Element(e::NotUsed, "Version Identifier"),
820
+ b::Element(e::NotUsed, "Industy Code"),
821
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
822
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
823
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BH")),
824
+ b::Element(e::Required, "Occurrence Code"),
825
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8")),
826
+ b::Element(e::Required, "Occurrence Code Date"),
827
+ b::Element(e::NotUsed, "Monetary Amount"),
828
+ b::Element(e::NotUsed, "Quantity"),
829
+ b::Element(e::NotUsed, "Version Identifier"),
830
+ b::Element(e::NotUsed, "Industy Code"),
831
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
832
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
833
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BH")),
834
+ b::Element(e::Required, "Occurrence Code"),
835
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8")),
836
+ b::Element(e::Required, "Occurrence Code Date"),
837
+ b::Element(e::NotUsed, "Monetary Amount"),
838
+ b::Element(e::NotUsed, "Quantity"),
839
+ b::Element(e::NotUsed, "Version Identifier"),
840
+ b::Element(e::NotUsed, "Industy Code"),
841
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
842
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
843
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BH")),
844
+ b::Element(e::Required, "Occurrence Code"),
845
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8")),
846
+ b::Element(e::Required, "Occurrence Code Date"),
847
+ b::Element(e::NotUsed, "Monetary Amount"),
848
+ b::Element(e::NotUsed, "Quantity"),
849
+ b::Element(e::NotUsed, "Version Identifier"),
850
+ b::Element(e::NotUsed, "Industy Code"),
851
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
852
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
853
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BH")),
854
+ b::Element(e::Required, "Occurrence Code"),
855
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8")),
856
+ b::Element(e::Required, "Occurrence Code Date"),
857
+ b::Element(e::NotUsed, "Monetary Amount"),
858
+ b::Element(e::NotUsed, "Quantity"),
859
+ b::Element(e::NotUsed, "Version Identifier"),
860
+ b::Element(e::NotUsed, "Industy Code"),
861
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
862
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
863
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BH")),
864
+ b::Element(e::Required, "Occurrence Code"),
865
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8")),
866
+ b::Element(e::Required, "Occurrence Code Date"),
867
+ b::Element(e::NotUsed, "Monetary Amount"),
868
+ b::Element(e::NotUsed, "Quantity"),
869
+ b::Element(e::NotUsed, "Version Identifier"),
870
+ b::Element(e::NotUsed, "Industy Code"),
871
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
872
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
873
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BH")),
874
+ b::Element(e::Required, "Occurrence Code"),
875
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8")),
876
+ b::Element(e::Required, "Occurrence Code Date"),
877
+ b::Element(e::NotUsed, "Monetary Amount"),
878
+ b::Element(e::NotUsed, "Quantity"),
879
+ b::Element(e::NotUsed, "Version Identifier"),
880
+ b::Element(e::NotUsed, "Industy Code"),
881
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
882
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
883
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BH")),
884
+ b::Element(e::Required, "Occurrence Code"),
885
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8")),
886
+ b::Element(e::Required, "Occurrence Code Date"),
887
+ b::Element(e::NotUsed, "Monetary Amount"),
888
+ b::Element(e::NotUsed, "Quantity"),
889
+ b::Element(e::NotUsed, "Version Identifier"),
890
+ b::Element(e::NotUsed, "Industy Code"),
891
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code"))),
892
+ b::Segment(2310, s::HI, "Value Information", r::Situational, d::RepeatCount.bounded(2),
893
+ b::Element(e::Required, "HEALTH CARE CODE INFORMATION",
894
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BE")),
895
+ b::Element(e::Required, "Value Code"),
896
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
897
+ b::Element(e::NotUsed, "Date Time Period"),
898
+ b::Element(e::Required, "Value Code Amount"),
899
+ b::Element(e::NotUsed, "Quantity"),
900
+ b::Element(e::NotUsed, "Version Identifier"),
901
+ b::Element(e::NotUsed, "Industry Code"),
902
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
903
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
904
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BE")),
905
+ b::Element(e::Required, "Value Code"),
906
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
907
+ b::Element(e::NotUsed, "Date Time Period"),
908
+ b::Element(e::Required, "Value Code Amount"),
909
+ b::Element(e::NotUsed, "Quantity"),
910
+ b::Element(e::NotUsed, "Version Identifier"),
911
+ b::Element(e::NotUsed, "Industry Code"),
912
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
913
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
914
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BE")),
915
+ b::Element(e::Required, "Value Code"),
916
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
917
+ b::Element(e::NotUsed, "Date Time Period"),
918
+ b::Element(e::Required, "Value Code Amount"),
919
+ b::Element(e::NotUsed, "Quantity"),
920
+ b::Element(e::NotUsed, "Version Identifier"),
921
+ b::Element(e::NotUsed, "Industry Code"),
922
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
923
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
924
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BE")),
925
+ b::Element(e::Required, "Value Code"),
926
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
927
+ b::Element(e::NotUsed, "Date Time Period"),
928
+ b::Element(e::Required, "Value Code Amount"),
929
+ b::Element(e::NotUsed, "Quantity"),
930
+ b::Element(e::NotUsed, "Version Identifier"),
931
+ b::Element(e::NotUsed, "Industry Code"),
932
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
933
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
934
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BE")),
935
+ b::Element(e::Required, "Value Code"),
936
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
937
+ b::Element(e::NotUsed, "Date Time Period"),
938
+ b::Element(e::Required, "Value Code Amount"),
939
+ b::Element(e::NotUsed, "Quantity"),
940
+ b::Element(e::NotUsed, "Version Identifier"),
941
+ b::Element(e::NotUsed, "Industry Code"),
942
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
943
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
944
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BE")),
945
+ b::Element(e::Required, "Value Code"),
946
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
947
+ b::Element(e::NotUsed, "Date Time Period"),
948
+ b::Element(e::Required, "Value Code Amount"),
949
+ b::Element(e::NotUsed, "Quantity"),
950
+ b::Element(e::NotUsed, "Version Identifier"),
951
+ b::Element(e::NotUsed, "Industry Code"),
952
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
953
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
954
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BE")),
955
+ b::Element(e::Required, "Value Code"),
956
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
957
+ b::Element(e::NotUsed, "Date Time Period"),
958
+ b::Element(e::Required, "Value Code Amount"),
959
+ b::Element(e::NotUsed, "Quantity"),
960
+ b::Element(e::NotUsed, "Version Identifier"),
961
+ b::Element(e::NotUsed, "Industry Code"),
962
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
963
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
964
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BE")),
965
+ b::Element(e::Required, "Value Code"),
966
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
967
+ b::Element(e::NotUsed, "Date Time Period"),
968
+ b::Element(e::Required, "Value Code Amount"),
969
+ b::Element(e::NotUsed, "Quantity"),
970
+ b::Element(e::NotUsed, "Version Identifier"),
971
+ b::Element(e::NotUsed, "Industry Code"),
972
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
973
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
974
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BE")),
975
+ b::Element(e::Required, "Value Code"),
976
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
977
+ b::Element(e::NotUsed, "Date Time Period"),
978
+ b::Element(e::Required, "Value Code Amount"),
979
+ b::Element(e::NotUsed, "Quantity"),
980
+ b::Element(e::NotUsed, "Version Identifier"),
981
+ b::Element(e::NotUsed, "Industry Code"),
982
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
983
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
984
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BE")),
985
+ b::Element(e::Required, "Value Code"),
986
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
987
+ b::Element(e::NotUsed, "Date Time Period"),
988
+ b::Element(e::Required, "Value Code Amount"),
989
+ b::Element(e::NotUsed, "Quantity"),
990
+ b::Element(e::NotUsed, "Version Identifier"),
991
+ b::Element(e::NotUsed, "Industry Code"),
992
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
993
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
994
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BE")),
995
+ b::Element(e::Required, "Value Code"),
996
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
997
+ b::Element(e::NotUsed, "Date Time Period"),
998
+ b::Element(e::Required, "Value Code Amount"),
999
+ b::Element(e::NotUsed, "Quantity"),
1000
+ b::Element(e::NotUsed, "Version Identifier"),
1001
+ b::Element(e::NotUsed, "Industry Code"),
1002
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
1003
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
1004
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BE")),
1005
+ b::Element(e::Required, "Value Code"),
1006
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
1007
+ b::Element(e::NotUsed, "Date Time Period"),
1008
+ b::Element(e::Required, "Value Code Amount"),
1009
+ b::Element(e::NotUsed, "Quantity"),
1010
+ b::Element(e::NotUsed, "Version Identifier"),
1011
+ b::Element(e::NotUsed, "Industry Code"),
1012
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code"))),
1013
+ b::Segment(2310, s::HI, "Condition Information", r::Situational, d::RepeatCount.bounded(2),
1014
+ b::Element(e::Required, "HEALTH CARE CODE INFORMATION",
1015
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BG")),
1016
+ b::Element(e::Required, "Condition Code"),
1017
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
1018
+ b::Element(e::NotUsed, "Date Time Period"),
1019
+ b::Element(e::NotUsed, "Monetary Amount"),
1020
+ b::Element(e::NotUsed, "Quantity"),
1021
+ b::Element(e::NotUsed, "Version Identifier"),
1022
+ b::Element(e::NotUsed, "Industry Code"),
1023
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
1024
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
1025
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BG")),
1026
+ b::Element(e::Required, "Condition Code"),
1027
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
1028
+ b::Element(e::NotUsed, "Date Time Period"),
1029
+ b::Element(e::NotUsed, "Monetary Amount"),
1030
+ b::Element(e::NotUsed, "Quantity"),
1031
+ b::Element(e::NotUsed, "Version Identifier"),
1032
+ b::Element(e::NotUsed, "Industry Code"),
1033
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
1034
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
1035
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BG")),
1036
+ b::Element(e::Required, "Condition Code"),
1037
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
1038
+ b::Element(e::NotUsed, "Date Time Period"),
1039
+ b::Element(e::NotUsed, "Monetary Amount"),
1040
+ b::Element(e::NotUsed, "Quantity"),
1041
+ b::Element(e::NotUsed, "Version Identifier"),
1042
+ b::Element(e::NotUsed, "Industry Code"),
1043
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
1044
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
1045
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BG")),
1046
+ b::Element(e::Required, "Condition Code"),
1047
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
1048
+ b::Element(e::NotUsed, "Date Time Period"),
1049
+ b::Element(e::NotUsed, "Monetary Amount"),
1050
+ b::Element(e::NotUsed, "Quantity"),
1051
+ b::Element(e::NotUsed, "Version Identifier"),
1052
+ b::Element(e::NotUsed, "Industry Code"),
1053
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
1054
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
1055
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BG")),
1056
+ b::Element(e::Required, "Condition Code"),
1057
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
1058
+ b::Element(e::NotUsed, "Date Time Period"),
1059
+ b::Element(e::NotUsed, "Monetary Amount"),
1060
+ b::Element(e::NotUsed, "Quantity"),
1061
+ b::Element(e::NotUsed, "Version Identifier"),
1062
+ b::Element(e::NotUsed, "Industry Code"),
1063
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
1064
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
1065
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BG")),
1066
+ b::Element(e::Required, "Condition Code"),
1067
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
1068
+ b::Element(e::NotUsed, "Date Time Period"),
1069
+ b::Element(e::NotUsed, "Monetary Amount"),
1070
+ b::Element(e::NotUsed, "Quantity"),
1071
+ b::Element(e::NotUsed, "Version Identifier"),
1072
+ b::Element(e::NotUsed, "Industry Code"),
1073
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
1074
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
1075
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BG")),
1076
+ b::Element(e::Required, "Condition Code"),
1077
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
1078
+ b::Element(e::NotUsed, "Date Time Period"),
1079
+ b::Element(e::NotUsed, "Monetary Amount"),
1080
+ b::Element(e::NotUsed, "Quantity"),
1081
+ b::Element(e::NotUsed, "Version Identifier"),
1082
+ b::Element(e::NotUsed, "Industry Code"),
1083
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
1084
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
1085
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BG")),
1086
+ b::Element(e::Required, "Condition Code"),
1087
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
1088
+ b::Element(e::NotUsed, "Date Time Period"),
1089
+ b::Element(e::NotUsed, "Monetary Amount"),
1090
+ b::Element(e::NotUsed, "Quantity"),
1091
+ b::Element(e::NotUsed, "Version Identifier"),
1092
+ b::Element(e::NotUsed, "Industry Code"),
1093
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
1094
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
1095
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BG")),
1096
+ b::Element(e::Required, "Condition Code"),
1097
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
1098
+ b::Element(e::NotUsed, "Date Time Period"),
1099
+ b::Element(e::NotUsed, "Monetary Amount"),
1100
+ b::Element(e::NotUsed, "Quantity"),
1101
+ b::Element(e::NotUsed, "Version Identifier"),
1102
+ b::Element(e::NotUsed, "Industry Code"),
1103
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
1104
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
1105
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BG")),
1106
+ b::Element(e::Required, "Condition Code"),
1107
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
1108
+ b::Element(e::NotUsed, "Date Time Period"),
1109
+ b::Element(e::NotUsed, "Monetary Amount"),
1110
+ b::Element(e::NotUsed, "Quantity"),
1111
+ b::Element(e::NotUsed, "Version Identifier"),
1112
+ b::Element(e::NotUsed, "Industry Code"),
1113
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
1114
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
1115
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BG")),
1116
+ b::Element(e::Required, "Condition Code"),
1117
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
1118
+ b::Element(e::NotUsed, "Date Time Period"),
1119
+ b::Element(e::NotUsed, "Monetary Amount"),
1120
+ b::Element(e::NotUsed, "Quantity"),
1121
+ b::Element(e::NotUsed, "Version Identifier"),
1122
+ b::Element(e::NotUsed, "Industry Code"),
1123
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
1124
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
1125
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("BG")),
1126
+ b::Element(e::Required, "Condition Code"),
1127
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
1128
+ b::Element(e::NotUsed, "Date Time Period"),
1129
+ b::Element(e::NotUsed, "Monetary Amount"),
1130
+ b::Element(e::NotUsed, "Quantity"),
1131
+ b::Element(e::NotUsed, "Version Identifier"),
1132
+ b::Element(e::NotUsed, "Industry Code"),
1133
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code"))),
1134
+ b::Segment(2310, s::HI, "Treatment Code Information", r::Situational, d::RepeatCount.bounded(2),
1135
+ b::Element(e::Required, "HEALTH CARE CODE INFORMATION",
1136
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("TC")),
1137
+ b::Element(e::Required, "Treatment Code"),
1138
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
1139
+ b::Element(e::NotUsed, "Date Time Period"),
1140
+ b::Element(e::NotUsed, "Monetary Amount"),
1141
+ b::Element(e::NotUsed, "Quantity"),
1142
+ b::Element(e::NotUsed, "Version Identifier"),
1143
+ b::Element(e::NotUsed, "Industry Code"),
1144
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
1145
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
1146
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("TC")),
1147
+ b::Element(e::Required, "Treatment Code"),
1148
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
1149
+ b::Element(e::NotUsed, "Date Time Period"),
1150
+ b::Element(e::NotUsed, "Monetary Amount"),
1151
+ b::Element(e::NotUsed, "Quantity"),
1152
+ b::Element(e::NotUsed, "Version Identifier"),
1153
+ b::Element(e::NotUsed, "Industry Code"),
1154
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
1155
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
1156
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("TC")),
1157
+ b::Element(e::Required, "Treatment Code"),
1158
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
1159
+ b::Element(e::NotUsed, "Date Time Period"),
1160
+ b::Element(e::NotUsed, "Monetary Amount"),
1161
+ b::Element(e::NotUsed, "Quantity"),
1162
+ b::Element(e::NotUsed, "Version Identifier"),
1163
+ b::Element(e::NotUsed, "Industry Code"),
1164
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
1165
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
1166
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("TC")),
1167
+ b::Element(e::Required, "Treatment Code"),
1168
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
1169
+ b::Element(e::NotUsed, "Date Time Period"),
1170
+ b::Element(e::NotUsed, "Monetary Amount"),
1171
+ b::Element(e::NotUsed, "Quantity"),
1172
+ b::Element(e::NotUsed, "Version Identifier"),
1173
+ b::Element(e::NotUsed, "Industry Code"),
1174
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
1175
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
1176
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("TC")),
1177
+ b::Element(e::Required, "Treatment Code"),
1178
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
1179
+ b::Element(e::NotUsed, "Date Time Period"),
1180
+ b::Element(e::NotUsed, "Monetary Amount"),
1181
+ b::Element(e::NotUsed, "Quantity"),
1182
+ b::Element(e::NotUsed, "Version Identifier"),
1183
+ b::Element(e::NotUsed, "Industry Code"),
1184
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
1185
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
1186
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("TC")),
1187
+ b::Element(e::Required, "Treatment Code"),
1188
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
1189
+ b::Element(e::NotUsed, "Date Time Period"),
1190
+ b::Element(e::NotUsed, "Monetary Amount"),
1191
+ b::Element(e::NotUsed, "Quantity"),
1192
+ b::Element(e::NotUsed, "Version Identifier"),
1193
+ b::Element(e::NotUsed, "Industry Code"),
1194
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
1195
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
1196
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("TC")),
1197
+ b::Element(e::Required, "Treatment Code"),
1198
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
1199
+ b::Element(e::NotUsed, "Date Time Period"),
1200
+ b::Element(e::NotUsed, "Monetary Amount"),
1201
+ b::Element(e::NotUsed, "Quantity"),
1202
+ b::Element(e::NotUsed, "Version Identifier"),
1203
+ b::Element(e::NotUsed, "Industry Code"),
1204
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
1205
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
1206
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("TC")),
1207
+ b::Element(e::Required, "Treatment Code"),
1208
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
1209
+ b::Element(e::NotUsed, "Date Time Period"),
1210
+ b::Element(e::NotUsed, "Monetary Amount"),
1211
+ b::Element(e::NotUsed, "Quantity"),
1212
+ b::Element(e::NotUsed, "Version Identifier"),
1213
+ b::Element(e::NotUsed, "Industry Code"),
1214
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
1215
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
1216
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("TC")),
1217
+ b::Element(e::Required, "Treatment Code"),
1218
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
1219
+ b::Element(e::NotUsed, "Date Time Period"),
1220
+ b::Element(e::NotUsed, "Monetary Amount"),
1221
+ b::Element(e::NotUsed, "Quantity"),
1222
+ b::Element(e::NotUsed, "Version Identifier"),
1223
+ b::Element(e::NotUsed, "Industry Code"),
1224
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
1225
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
1226
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("TC")),
1227
+ b::Element(e::Required, "Treatment Code"),
1228
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
1229
+ b::Element(e::NotUsed, "Date Time Period"),
1230
+ b::Element(e::NotUsed, "Monetary Amount"),
1231
+ b::Element(e::NotUsed, "Quantity"),
1232
+ b::Element(e::NotUsed, "Version Identifier"),
1233
+ b::Element(e::NotUsed, "Industry Code"),
1234
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
1235
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
1236
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("TC")),
1237
+ b::Element(e::Required, "Treatment Code"),
1238
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
1239
+ b::Element(e::NotUsed, "Date Time Period"),
1240
+ b::Element(e::NotUsed, "Monetary Amount"),
1241
+ b::Element(e::NotUsed, "Quantity"),
1242
+ b::Element(e::NotUsed, "Version Identifier"),
1243
+ b::Element(e::NotUsed, "Industry Code"),
1244
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
1245
+ b::Element(e::Situational, "HEALTH CARE CODE INFORMATION",
1246
+ b::Element(e::Required, "Code List Qualifier Code", b::Values("TC")),
1247
+ b::Element(e::Required, "Treatment Code"),
1248
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
1249
+ b::Element(e::NotUsed, "Date Time Period"),
1250
+ b::Element(e::NotUsed, "Monetary Amount"),
1251
+ b::Element(e::NotUsed, "Quantity"),
1252
+ b::Element(e::NotUsed, "Version Identifier"),
1253
+ b::Element(e::NotUsed, "Industry Code"),
1254
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code"))),
1255
+ b::Segment(2410, s::HCP, "Claim Pricing/Repricing Information", r::Situational, d::RepeatCount.bounded(1),
1256
+ b::Element(e::Required, "Pricing Methodology", b::Values("00", "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14")),
1257
+ b::Element(e::Required, "Repriced Allowed Amount"),
1258
+ b::Element(e::Situational, "Repriced Saving Amount"),
1259
+ b::Element(e::Situational, "Repricing Organization Identifier"),
1260
+ b::Element(e::Situational, "Repricing Per Diem or Flat Rate Amount"),
1261
+ b::Element(e::Situational, "Repriced Approved DRG Code"),
1262
+ b::Element(e::Situational, "Repriced Approved Amount"),
1263
+ b::Element(e::Situational, "Repriced Approved Revenue Code"),
1264
+ b::Element(e::NotUsed, "Product/Service Qualifier"),
1265
+ b::Element(e::NotUsed, "Product/Service ID"),
1266
+ b::Element(e::Situational, "Unit or Basis of Measurement Code", b::Values("DA", "UN")),
1267
+ b::Element(e::Situational, "Repriced Approved Service Unit Count"),
1268
+ b::Element(e::Situational, "Reject Reason Code", b::Values("T1", "T2", "T3", "T4", "T5", "T6")),
1269
+ b::Element(e::Situational, "Policy Compliance Code", b::Values("1", "2", "3", "4", "5")),
1270
+ b::Element(e::Situational, "Exception Code", b::Values("1", "2", "3", "4", "5", "6"))),
1271
+
1272
+ d::LoopDef.build("2310A ATTENDING PROVIDER NAME", d::RepeatCount.bounded(1),
1273
+ b::Segment(2500, s::NM1, "Attending Provider Name", r::Situational, d::RepeatCount.bounded(1),
1274
+ b::Element(e::Required, "Entity Identifier Code", b::Values("71")),
1275
+ b::Element(e::Required, "Entity Type Qualifier", b::Values("1")),
1276
+ b::Element(e::Required, "Attending Provider Last Name"),
1277
+ b::Element(e::Situational, "Attending Provider First Name"),
1278
+ b::Element(e::Situational, "Attending Provider Middle Name or Initial"),
1279
+ b::Element(e::NotUsed, "Name Prefix"),
1280
+ b::Element(e::Situational, "Attending Provider Name Suffix"),
1281
+ b::Element(e::Situational, "Identification Code Qualifier", b::Values("XX")),
1282
+ b::Element(e::Situational, "Attending Provider Primary Identifier"),
1283
+ b::Element(e::NotUsed, "Entity Relationship Code"),
1284
+ b::Element(e::NotUsed, "Entity Identifier Code"),
1285
+ b::Element(e::NotUsed, "Name Last or Organization Name")),
1286
+ b::Segment(2550, s::PRV, "Attending Provider Specialty Information", r::Situational, d::RepeatCount.bounded(1),
1287
+ b::Element(e::Required, "Provider Code", b::Values("AT")),
1288
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("PXC")),
1289
+ b::Element(e::Required, "Provider Taxonomy Code"),
1290
+ b::Element(e::NotUsed, "State or Province Code"),
1291
+ b::Element(e::NotUsed, "PROVIDER SPECIALITY INFORMATION"),
1292
+ b::Element(e::NotUsed, "Provider Organization Code")),
1293
+ b::Segment(2710, s::REF, "Attending Provider Secondary Information", r::Situational, d::RepeatCount.bounded(3),
1294
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("0B", "1G", "G2")),
1295
+ b::Element(e::Required, "Referring Provider Secondary Identifier"),
1296
+ b::Element(e::NotUsed, "Description"),
1297
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER"))),
1298
+
1299
+ d::LoopDef.build("2310B OPERATING PHYSICIAN NAME", d::RepeatCount.bounded(1),
1300
+ b::Segment(2500, s::NM1, "Operating Physician Name", r::Situational, d::RepeatCount.bounded(1),
1301
+ b::Element(e::Required, "Entity Identifier Code", b::Values("72")),
1302
+ b::Element(e::Required, "Entity Type Qualifier", b::Values("1")),
1303
+ b::Element(e::Required, "Attending Provider Last Name"),
1304
+ b::Element(e::Situational, "Attending Provider First Name"),
1305
+ b::Element(e::Situational, "Attending Provider Middle Name or Initial"),
1306
+ b::Element(e::NotUsed, "Name Prefix"),
1307
+ b::Element(e::Situational, "Attending Provider Name Suffix"),
1308
+ b::Element(e::Situational, "Identification Code Qualifier", b::Values("XX")),
1309
+ b::Element(e::Situational, "Attending Provider Primary Identifier"),
1310
+ b::Element(e::NotUsed, "Entity Relationship Code"),
1311
+ b::Element(e::NotUsed, "Entity Identifier Code"),
1312
+ b::Element(e::NotUsed, "Name Last or Organization Name")),
1313
+ b::Segment(2710, s::REF, "Operating Physician Secondary Identification", r::Situational, d::RepeatCount.bounded(4),
1314
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("0B", "1G", "G2", "LU")),
1315
+ b::Element(e::Required, "Reference Physician Secondary Identifier"),
1316
+ b::Element(e::NotUsed, "Description"),
1317
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER"))),
1318
+
1319
+ d::LoopDef.build("2310C OTHER OPERATING PHYSICIAN NAME", d::RepeatCount.bounded(1),
1320
+ b::Segment(2500, s::NM1, "Other Operating Physician Name", r::Situational, d::RepeatCount.bounded(1),
1321
+ b::Element(e::Required, "Entity Identifier Code", b::Values("ZZ")),
1322
+ b::Element(e::Required, "Entity Type Qualifier", b::Values("1")),
1323
+ b::Element(e::Required, "Other Operating Physician Last Name"),
1324
+ b::Element(e::Situational, "Other Operating Physician First Name"),
1325
+ b::Element(e::Situational, "Other Operating Physician Middle Name or Initial"),
1326
+ b::Element(e::NotUsed, "Name Prefix"),
1327
+ b::Element(e::Situational, "Other Operating Physician Name Suffix"),
1328
+ b::Element(e::Situational, "Identification Code Qualifier", b::Values("XX")),
1329
+ b::Element(e::Situational, "Other Operating Physician Identifier"),
1330
+ b::Element(e::NotUsed, "Entity Relationship Code"),
1331
+ b::Element(e::NotUsed, "Entity Identifier Code"),
1332
+ b::Element(e::NotUsed, "Name Last or Organization Name")),
1333
+ b::Segment(2710, s::REF, "Other Operating Physician Secondary Identification", r::Situational, d::RepeatCount.bounded(4),
1334
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("0B", "1G", "G2", "LU")),
1335
+ b::Element(e::Required, "Other Provider Secondary Identifier"),
1336
+ b::Element(e::NotUsed, "Description"),
1337
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER"))),
1338
+
1339
+ d::LoopDef.build("2310D RENDERING PROVIDER NAME", d::RepeatCount.bounded(1),
1340
+ b::Segment(2500, s::NM1, "Rendering Provider Name", r::Situational, d::RepeatCount.bounded(1),
1341
+ b::Element(e::Required, "Entity Identifier Code", b::Values("82")),
1342
+ b::Element(e::Required, "Entity Type Qualifier", b::Values("1")),
1343
+ b::Element(e::Required, "Rendering Provider Last Name"),
1344
+ b::Element(e::Situational, "Rendering Provider First Name"),
1345
+ b::Element(e::Situational, "Rendering Provider Middle Name or Initial"),
1346
+ b::Element(e::NotUsed, "Name Prefix"),
1347
+ b::Element(e::Situational, "Rendering Provider Name Suffix"),
1348
+ b::Element(e::Situational, "Identification Code Qualifier", b::Values("XX")),
1349
+ b::Element(e::Situational, "Rendering Provider Identifier"),
1350
+ b::Element(e::NotUsed, "Entity Relationship Code"),
1351
+ b::Element(e::NotUsed, "Entity Identifier Code"),
1352
+ b::Element(e::NotUsed, "Name Last or Organization Name")),
1353
+ b::Segment(2710, s::REF, "Rendering Provider Secondary Identification", r::Situational, d::RepeatCount.bounded(4),
1354
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("0B", "1G", "G2", "LU")),
1355
+ b::Element(e::Required, "Rendering Provider Secondary Identifier"),
1356
+ b::Element(e::NotUsed, "Description"),
1357
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER"))),
1358
+
1359
+ d::LoopDef.build("2310E SERVICE FACILITY LOCATION NAME", d::RepeatCount.bounded(1),
1360
+ b::Segment(2500, s::NM1, "Service Facility Location Name", r::Situational, d::RepeatCount.bounded(1),
1361
+ b::Element(e::Required, "Entity Identifier Code", b::Values("77")),
1362
+ b::Element(e::Required, "Entity Type Qualifier", b::Values("2")),
1363
+ b::Element(e::Required, "Laboratory or Facility Name"),
1364
+ b::Element(e::NotUsed, "Name First"),
1365
+ b::Element(e::NotUsed, "Name Middle"),
1366
+ b::Element(e::NotUsed, "Name Prefix"),
1367
+ b::Element(e::NotUsed, "Name Suffix"),
1368
+ b::Element(e::Situational, "Identification Code Qualifier", b::Values("XX")),
1369
+ b::Element(e::Situational, "Laboratory or Facility Primary Identifier"),
1370
+ b::Element(e::NotUsed, "Entity Relationship Code"),
1371
+ b::Element(e::NotUsed, "Entity Identifier Code"),
1372
+ b::Element(e::NotUsed, "Name Last or Organization Name")),
1373
+ b::Segment(2650, s::N3, "Service Facility Location Address", r::Required, d::RepeatCount.bounded(1),
1374
+ b::Element(e::Required, "Laboratory or Facility Address Line"),
1375
+ b::Element(e::Situational, "Laboratory or Facility Address Line")),
1376
+ b::Segment(2700, s::N4, "Service Facility Location City, State, ZIP Code", r::Required, d::RepeatCount.bounded(1),
1377
+ b::Element(e::Required, "Laboratory or Facility City Name"),
1378
+ b::Element(e::Situational, "Laboratory or Facility State or Province Code"),
1379
+ b::Element(e::Situational, "Laboratory or Facility Postal Zone or ZIP Code"),
1380
+ b::Element(e::Situational, "Country Code"),
1381
+ b::Element(e::NotUsed, "Location Qualifier"),
1382
+ b::Element(e::NotUsed, "Location Identifier"),
1383
+ b::Element(e::Situational, "Country Subdivision Code")),
1384
+ b::Segment(2710, s::REF, "Service Facility Location Secondary Identification", r::Situational, d::RepeatCount.bounded(3),
1385
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("0B", "G2", "LU")),
1386
+ b::Element(e::Required, "Laboratory or Facility Secondary Identifier"),
1387
+ b::Element(e::NotUsed, "Description"),
1388
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER"))),
1389
+
1390
+ d::LoopDef.build("2310F REFERRING PROVIDER NAME", d::RepeatCount.bounded(1),
1391
+ b::Segment(2500, s::NM1, "Referring Provider Name", r::Situational, d::RepeatCount.bounded(1),
1392
+ b::Element(e::Required, "Entity Identifier Code", b::Values("DN")),
1393
+ b::Element(e::Required, "Entity Type Qualifier", b::Values("1")),
1394
+ b::Element(e::Required, "Referring Provider Last Name"),
1395
+ b::Element(e::Situational, "Referring Provider First Name"),
1396
+ b::Element(e::Situational, "Referring Provider Middle Name or Initial"),
1397
+ b::Element(e::NotUsed, "Name Prefix"),
1398
+ b::Element(e::Situational, "Referring Provider Name Suffix"),
1399
+ b::Element(e::Situational, "Identification Code Qualifier", b::Values("XX")),
1400
+ b::Element(e::Situational, "Identification Code"),
1401
+ b::Element(e::NotUsed, "Entity Relationship Code"),
1402
+ b::Element(e::NotUsed, "Entity Identifier Code"),
1403
+ b::Element(e::NotUsed, "Name Last or Organization Name")),
1404
+ b::Segment(2710, s::REF, "Referring Provider Secondary Identification", r::Situational, d::RepeatCount.bounded(3),
1405
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("0B", "1G", "G2")),
1406
+ b::Element(e::Required, "Referring Provider Secondary Identifier"),
1407
+ b::Element(e::NotUsed, "Description"),
1408
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER"))),
1409
+
1410
+ d::LoopDef.build("2320 OTHER SUBSCRIBER INFORMATION", d::RepeatCount.bounded(10),
1411
+ b::Segment(2900, s::SBR, "Other Subscriber Information", r::Situational, d::RepeatCount.bounded(1),
1412
+ b::Element(e::Required, "Payer Responsibility Sequence Number", b::Values("A", "B", "C", "D", "E", "F", "G", "H", "P", "S", "T", "U")),
1413
+ b::Element(e::Required, "Individual Relationship Code", b::Values("01", "18", "19", "20", "21", "39", "40", "53", "G8")),
1414
+ b::Element(e::Situational, "Insured Group or Policy Number"),
1415
+ b::Element(e::Situational, "Other Insured Group Name"),
1416
+ b::Element(e::NotUsed, "Insurance Type Code"),
1417
+ b::Element(e::NotUsed, "Coordination of Benefits Code"),
1418
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code"),
1419
+ b::Element(e::NotUsed, "Employment Status Code"),
1420
+ b::Element(e::Situational, "Claim Filing Indicator Code", b::Values("11", "12", "13", "14", "15", "16", "17", "AM", "BL", "CH", "CI", "DS", "FI", "HM", "LM", "MA", "MB", "MC", "OF", "TV", "VA", "WC", "ZZ"))),
1421
+ b::Segment(2950, s::CAS, "Claim Level Adjustments", r::Situational, d::RepeatCount.bounded(5),
1422
+ b::Element(e::Required, "Claim Adjustment Group Code", b::Values("CO", "CR", "OA", "PI", "PR")),
1423
+ b::Element(e::Required, "Adjustment Reason Code"),
1424
+ b::Element(e::Required, "Adjustment Amount"),
1425
+ b::Element(e::Situational, "Adjustment Quantity"),
1426
+ b::Element(e::Situational, "Adjustment Reason Code"),
1427
+ b::Element(e::Situational, "Adjustment Amount"),
1428
+ b::Element(e::Situational, "Adjustment Quantity"),
1429
+ b::Element(e::Situational, "Adjustment Reason Code"),
1430
+ b::Element(e::Situational, "Adjustment Amount"),
1431
+ b::Element(e::Situational, "Adjustment Quantity"),
1432
+ b::Element(e::Situational, "Adjustment Reason Code"),
1433
+ b::Element(e::Situational, "Adjustment Amount"),
1434
+ b::Element(e::Situational, "Adjustment Quantity"),
1435
+ b::Element(e::Situational, "Adjustment Reason Code"),
1436
+ b::Element(e::Situational, "Adjustment Amount"),
1437
+ b::Element(e::Situational, "Adjustment Quantity"),
1438
+ b::Element(e::Situational, "Adjustment Reason Code"),
1439
+ b::Element(e::Situational, "Adjustment Amount"),
1440
+ b::Element(e::Situational, "Adjustment Quantity")),
1441
+ b::Segment(3000, s::AMT, "Coordination of Benefits (COB) Payer Paid Amount", r::Situational, d::RepeatCount.bounded(1),
1442
+ b::Element(e::Required, "Amount Qualifier Code", b::Values("D")),
1443
+ b::Element(e::Required, "Payer Paid Amount"),
1444
+ b::Element(e::NotUsed, "Credit/Debit Flag")),
1445
+ b::Segment(3000, s::AMT, "Remaining Patient Liability", r::Situational, d::RepeatCount.bounded(1),
1446
+ b::Element(e::Required, "Amount Qualifier Code", b::Values("EAF")),
1447
+ b::Element(e::Required, "Remaining Patient Liability"),
1448
+ b::Element(e::NotUsed, "Credit/Debit Flag")),
1449
+ b::Segment(3000, s::AMT, "Coordination of Benefits (COB) Total Non-Covered Amount", r::Situational, d::RepeatCount.bounded(1),
1450
+ b::Element(e::Required, "Amount Qualifier Code", b::Values("A8")),
1451
+ b::Element(e::Required, "Non-Covered Charge Amount"),
1452
+ b::Element(e::NotUsed, "Credit/Debit Flag Code")),
1453
+ b::Segment(3100, s::OI, "Other Insurance Coverage Information", r::Required, d::RepeatCount.bounded(1),
1454
+ b::Element(e::NotUsed, "Claim Filing Indicator Code"),
1455
+ b::Element(e::NotUsed, "Claim Submission Reason Code"),
1456
+ b::Element(e::Required, "Benefits Assignment Certification Indicator", b::Values("N", "W", "Y")),
1457
+ b::Element(e::NotUsed, "Patient Signature Source Code"),
1458
+ b::Element(e::NotUsed, "Provider Agreement Code"),
1459
+ b::Element(e::Required, "Release of Information Code", b::Values("I", "Y"))),
1460
+ b::Segment(3150, s::MIA, "Inpatient Adjudication Information", r::Situational, d::RepeatCount.bounded(1),
1461
+ b::Element(e::Required, "Covered Days or Visits Count"),
1462
+ b::Element(e::NotUsed, "Monetary Amount"),
1463
+ b::Element(e::Situational, "Lifetime Psychiatric Days Count"),
1464
+ b::Element(e::Situational, "Claim DRG Amount"),
1465
+ b::Element(e::Situational, "Claim Payment Remark Code"),
1466
+ b::Element(e::Situational, "Claim Disproportionate Share Amount"),
1467
+ b::Element(e::Situational, "Claim MSP Pass-through Amount"),
1468
+ b::Element(e::Situational, "Claim PPS Capital Amount"),
1469
+ b::Element(e::Situational, "PPS-Capital FSP DRG Amount"),
1470
+ b::Element(e::Situational, "PPS-Capital HSP DRG Amount"),
1471
+ b::Element(e::Situational, "PPS-Capital DSH DRG Amount"),
1472
+ b::Element(e::Situational, "Old Capital Amount"),
1473
+ b::Element(e::Situational, "PPS-Capital IME Amount"),
1474
+ b::Element(e::Situational, "PPS-Operating Hospital Specific DRG Amount"),
1475
+ b::Element(e::Situational, "Cost Report Day Count"),
1476
+ b::Element(e::Situational, "PPS-Operating Federal Specific DRG Amount"),
1477
+ b::Element(e::Situational, "Claim PPS Capital Outlier Amount"),
1478
+ b::Element(e::Situational, "Claim Indirect Teaching Amount"),
1479
+ b::Element(e::Situational, "Non-Payable Professional Component Billed Amount"),
1480
+ b::Element(e::Situational, "Claim Payment Remark Code"),
1481
+ b::Element(e::Situational, "Claim Payment Remark Code"),
1482
+ b::Element(e::Situational, "Claim Payment Remark Code"),
1483
+ b::Element(e::Situational, "Claim Payment Remark Code"),
1484
+ b::Element(e::Situational, "PPS-Capital Exception Amount")),
1485
+ b::Segment(3200, s::MOA, "Outpatient Adjudication Information", r::Situational, d::RepeatCount.bounded(1),
1486
+ b::Element(e::Situational, "Reimbursement Rate"),
1487
+ b::Element(e::Situational, "HCPCS Payable Amount"),
1488
+ b::Element(e::Situational, "Claim Payment Remark Code"),
1489
+ b::Element(e::Situational, "Claim Payment Remark Code"),
1490
+ b::Element(e::Situational, "Claim Payment Remark Code"),
1491
+ b::Element(e::Situational, "Claim Payment Remark Code"),
1492
+ b::Element(e::Situational, "Claim Payment Remark Code"),
1493
+ b::Element(e::Situational, "End Stage Renal Disease Payment Amount"),
1494
+ b::Element(e::Situational, "Non-Payable Professional Component Billed Amount")),
1495
+
1496
+ d::LoopDef.build("2330A OTHER SUBSCRIBER NAME", d::RepeatCount.bounded(1),
1497
+ b::Segment(3250, s::NM1, "Other Subscriber Name", r::Required, d::RepeatCount.bounded(1),
1498
+ b::Element(e::Required, "Entity Identifier Code", b::Values("IL")),
1499
+ b::Element(e::Required, "Entity Type Qualifier", b::Values("1", "2")),
1500
+ b::Element(e::Required, "Other Insured Last Name"),
1501
+ b::Element(e::Situational, "Other Insured First Name"),
1502
+ b::Element(e::Situational, "Other Insured Middle Name"),
1503
+ b::Element(e::NotUsed, "Name Prefix"),
1504
+ b::Element(e::Situational, "Other Insured Name Suffix"),
1505
+ b::Element(e::Required, "Identification Code Qualifier", b::Values("II", "MI")),
1506
+ b::Element(e::Required, "Other Insured Identifier"),
1507
+ b::Element(e::NotUsed, "Entity Relationship Code"),
1508
+ b::Element(e::NotUsed, "Entity Identifier Code"),
1509
+ b::Element(e::NotUsed, "Name Last or Organization Name")),
1510
+ b::Segment(3320, s::N3, "Other Subscriber Address", r::Situational, d::RepeatCount.bounded(1),
1511
+ b::Element(e::Required, "Other Insured Address Line"),
1512
+ b::Element(e::Situational, "Other Insured Address Line")),
1513
+ b::Segment(3400, s::N4, "Other Subscriber City, State, ZIP Code", r::Situational, d::RepeatCount.bounded(1),
1514
+ b::Element(e::Required, "Other Insured City Name"),
1515
+ b::Element(e::Situational, "Other Insured State or Province Code"),
1516
+ b::Element(e::Situational, "Other Insured Postal Zone or ZIP Code"),
1517
+ b::Element(e::Situational, "Country Code"),
1518
+ b::Element(e::NotUsed, "Location Qualifier"),
1519
+ b::Element(e::NotUsed, "Location Identifier"),
1520
+ b::Element(e::Situational, "Country Subdivision Code")),
1521
+ b::Segment(3550, s::REF, "Other Subscriber Secondary Identification", r::Situational, d::RepeatCount.bounded(2),
1522
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("SY")),
1523
+ b::Element(e::Required, "Other Insured Additional Identifier"),
1524
+ b::Element(e::NotUsed, "Description"),
1525
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER"))),
1526
+
1527
+ d::LoopDef.build("2330B OTHER PAYER NAME", d::RepeatCount.bounded(1),
1528
+ b::Segment(3250, s::NM1, "Other Payer Name", r::Required, d::RepeatCount.bounded(1),
1529
+ b::Element(e::Required, "Entity Identifier Code", b::Values("PR")),
1530
+ b::Element(e::Required, "Entity Type Qualifier", b::Values("2")),
1531
+ b::Element(e::Required, "Other Payer Last or Organization Name"),
1532
+ b::Element(e::NotUsed, "Name First"),
1533
+ b::Element(e::NotUsed, "Name Middle"),
1534
+ b::Element(e::NotUsed, "Name Prefix"),
1535
+ b::Element(e::NotUsed, "Name Suffix"),
1536
+ b::Element(e::Required, "Identification Code Qualifier", b::Values("PI", "XV")),
1537
+ b::Element(e::Required, "Other Payer Primary Identifier"),
1538
+ b::Element(e::NotUsed, "Entity Relationship Code"),
1539
+ b::Element(e::NotUsed, "Entity Identifier Code"),
1540
+ b::Element(e::NotUsed, "Name Last or Organization Name")),
1541
+ b::Segment(3320, s::N3, "Other Payer Address", r::Situational, d::RepeatCount.bounded(1),
1542
+ b::Element(e::Required, "Other Payer Address Line"),
1543
+ b::Element(e::Situational, "Other Payer Address Line")),
1544
+ b::Segment(3400, s::N4, "Other Payer City, State, ZIP Code", r::Situational, d::RepeatCount.bounded(1),
1545
+ b::Element(e::Required, "Other Payer City Name"),
1546
+ b::Element(e::Situational, "Other Payer State Code"),
1547
+ b::Element(e::Situational, "Other Payer Postal Zone or ZIP Code"),
1548
+ b::Element(e::Situational, "Country Code"),
1549
+ b::Element(e::NotUsed, "Location Qualifier"),
1550
+ b::Element(e::NotUsed, "Location Identifier"),
1551
+ b::Element(e::Situational, "Country Subdivision Code")),
1552
+ b::Segment(3500, s::DTP, "Claim Check or Remittance Date", r::Situational, d::RepeatCount.bounded(1),
1553
+ b::Element(e::Required, "Date Time Qualifier", b::Values("573")),
1554
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8")),
1555
+ b::Element(e::Required, "Adjudication or Payment Date")),
1556
+ b::Segment(3550, s::REF, "Other Payer Secondary Identifier", r::Situational, d::RepeatCount.bounded(2),
1557
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("2U", "EI", "FY", "NF")),
1558
+ b::Element(e::Required, "Other Payer Secondary Identifier"),
1559
+ b::Element(e::NotUsed, "Description"),
1560
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
1561
+ b::Segment(3550, s::REF, "Other Payer Prior Authorization Number", r::Situational, d::RepeatCount.bounded(1),
1562
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("G1")),
1563
+ b::Element(e::Required, "Other Payer Prior Authorization Number"),
1564
+ b::Element(e::NotUsed, "Description"),
1565
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
1566
+ b::Segment(3550, s::REF, "Other Payer Referral Number", r::Situational, d::RepeatCount.bounded(1),
1567
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("9F")),
1568
+ b::Element(e::Required, "Other Payer Prior Authorization or Referral Number"),
1569
+ b::Element(e::NotUsed, "Description"),
1570
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
1571
+ b::Segment(3550, s::REF, "Other Payer Claim Adjustment Indicator", r::Situational, d::RepeatCount.bounded(1),
1572
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("T4")),
1573
+ b::Element(e::Required, "Other Payer Claim Adjustment Indicator", b::Values("Y")),
1574
+ b::Element(e::NotUsed, "Description"),
1575
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
1576
+ b::Segment(3550, s::REF, "Other Payer Claim Control Number", r::Situational, d::RepeatCount.bounded(1),
1577
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("F8")),
1578
+ b::Element(e::Required, "Other Payer's Claim Control Number"),
1579
+ b::Element(e::NotUsed, "Description"),
1580
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER"))),
1581
+
1582
+ d::LoopDef.build("2330C OTHER PAYER ATTENDING PROVIDER", d::RepeatCount.bounded(1),
1583
+ b::Segment(3250, s::NM1, "Other Payer Attending Provider", r::Situational, d::RepeatCount.bounded(1),
1584
+ b::Element(e::Required, "Entity Identifier Code", b::Values("71")),
1585
+ b::Element(e::Required, "Entity Type Qualifier", b::Values("1")),
1586
+ b::Element(e::NotUsed, "Name Last"),
1587
+ b::Element(e::NotUsed, "Name First"),
1588
+ b::Element(e::NotUsed, "Name Middle"),
1589
+ b::Element(e::NotUsed, "Name Prefix"),
1590
+ b::Element(e::NotUsed, "Name Suffix"),
1591
+ b::Element(e::NotUsed, "Identification Code Qualifier"),
1592
+ b::Element(e::NotUsed, "Identification Code"),
1593
+ b::Element(e::NotUsed, "Entity Relationship Code"),
1594
+ b::Element(e::NotUsed, "Entity Identifier Code"),
1595
+ b::Element(e::NotUsed, "Name Last or Organization Name")),
1596
+ b::Segment(3550, s::REF, "Other Payer Attending Provider Secondary Identification", r::Required, d::RepeatCount.bounded(4),
1597
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("0B", "1G", "G2", "LU")),
1598
+ b::Element(e::Required, "Other Payer Attending Provider Identifier"),
1599
+ b::Element(e::NotUsed, "Description"),
1600
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER"))),
1601
+
1602
+ d::LoopDef.build("2330D OTHER PAYER OPERATING PHYSICIAN", d::RepeatCount.bounded(1),
1603
+ b::Segment(3250, s::NM1, "Other Payer Operating Physician", r::Situational, d::RepeatCount.bounded(1),
1604
+ b::Element(e::Required, "Entity Identifier Code", b::Values("72")),
1605
+ b::Element(e::Required, "Entity Type Qualifier", b::Values("1")),
1606
+ b::Element(e::NotUsed, "Name Last"),
1607
+ b::Element(e::NotUsed, "Name First"),
1608
+ b::Element(e::NotUsed, "Name Middle"),
1609
+ b::Element(e::NotUsed, "Name Prefix"),
1610
+ b::Element(e::NotUsed, "Name Suffix"),
1611
+ b::Element(e::NotUsed, "Identification Code Qualifier"),
1612
+ b::Element(e::NotUsed, "Identification Code"),
1613
+ b::Element(e::NotUsed, "Entity Relationship Code"),
1614
+ b::Element(e::NotUsed, "Entity Identifier Code"),
1615
+ b::Element(e::NotUsed, "Name Last or Organization Name")),
1616
+ b::Segment(3550, s::REF, "Other Payer Operating Physician Secondary Identification", r::Required, d::RepeatCount.bounded(4),
1617
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("0B", "1G", "G2", "LU")),
1618
+ b::Element(e::Required, "Other Payer Operating Provider Secondary Identifier"),
1619
+ b::Element(e::NotUsed, "Description"),
1620
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER"))),
1621
+
1622
+ d::LoopDef.build("2330E OTHER PAYER OTHER OPERATING PHYSICIAN", d::RepeatCount.bounded(1),
1623
+ b::Segment(3250, s::NM1, "Other Payer Other Operating Physician", r::Situational, d::RepeatCount.bounded(1),
1624
+ b::Element(e::Required, "Entity Identifier Code", b::Values("ZZ")),
1625
+ b::Element(e::Required, "Entity Type Qualifier", b::Values("1")),
1626
+ b::Element(e::NotUsed, "Name Last"),
1627
+ b::Element(e::NotUsed, "Name First"),
1628
+ b::Element(e::NotUsed, "Name Middle"),
1629
+ b::Element(e::NotUsed, "Name Prefix"),
1630
+ b::Element(e::NotUsed, "Name Suffix"),
1631
+ b::Element(e::NotUsed, "Identification Code Qualifier"),
1632
+ b::Element(e::NotUsed, "Identification Code"),
1633
+ b::Element(e::NotUsed, "Entity Relationship Code"),
1634
+ b::Element(e::NotUsed, "Entity Identifier Code"),
1635
+ b::Element(e::NotUsed, "Name Last or Organization Name")),
1636
+ b::Segment(3550, s::REF, "Other Payer Other Operating Physician Secondary Identification", r::Required, d::RepeatCount.bounded(4),
1637
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("0B", "1G", "G2", "LU")),
1638
+ b::Element(e::Required, "Other Payer Other Operating Physician Secondary Identifier"),
1639
+ b::Element(e::NotUsed, "Description"),
1640
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER"))),
1641
+
1642
+ d::LoopDef.build("2330F OTHER PAYER SERVICE FACILITY LOCATION", d::RepeatCount.bounded(1),
1643
+ b::Segment(3250, s::NM1, "Other Payer Service Facility Location", r::Situational, d::RepeatCount.bounded(1),
1644
+ b::Element(e::Required, "Entity Identifier Code", b::Values("77")),
1645
+ b::Element(e::Required, "Entity Type Qualifier", b::Values("2")),
1646
+ b::Element(e::NotUsed, "Name Last"),
1647
+ b::Element(e::NotUsed, "Name First"),
1648
+ b::Element(e::NotUsed, "Name Middle"),
1649
+ b::Element(e::NotUsed, "Name Prefix"),
1650
+ b::Element(e::NotUsed, "Name Suffix"),
1651
+ b::Element(e::NotUsed, "Identification Code Qualifier"),
1652
+ b::Element(e::NotUsed, "Identification Code"),
1653
+ b::Element(e::NotUsed, "Entity Relationship Code"),
1654
+ b::Element(e::NotUsed, "Entity Identifier Code"),
1655
+ b::Element(e::NotUsed, "Name Last or Organization Name")),
1656
+ b::Segment(3550, s::REF, "Other Payer Supervising Provider Secondary Identification", r::Required, d::RepeatCount.bounded(3),
1657
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("0B", "G2", "LU")),
1658
+ b::Element(e::Required, "Other Payer Service Facility Location Identifier"),
1659
+ b::Element(e::NotUsed, "Description"),
1660
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER"))),
1661
+
1662
+ d::LoopDef.build("2330G OTHER PAYER RENDERING PROVIDER NAME", d::RepeatCount.bounded(1),
1663
+ b::Segment(3250, s::NM1, "Other Payer Rendering Provider Name", r::Situational, d::RepeatCount.bounded(1),
1664
+ b::Element(e::Required, "Entity Identifier Code", b::Values("82")),
1665
+ b::Element(e::Required, "Entity Type Qualifier", b::Values("1")),
1666
+ b::Element(e::NotUsed, "Name Last or Organization Name"),
1667
+ b::Element(e::NotUsed, "Name First"),
1668
+ b::Element(e::NotUsed, "Name Middle"),
1669
+ b::Element(e::NotUsed, "Name Prefix"),
1670
+ b::Element(e::NotUsed, "Name Suffix"),
1671
+ b::Element(e::NotUsed, "Identification Code Qualifier"),
1672
+ b::Element(e::NotUsed, "Identification Code"),
1673
+ b::Element(e::NotUsed, "Entity Relationship Code"),
1674
+ b::Element(e::NotUsed, "Entity Identifier Code"),
1675
+ b::Element(e::NotUsed, "Name Last or Organization Name")),
1676
+ b::Segment(3550, s::REF, "Other Payer Rendering Provider Secondary Identification", r::Required, d::RepeatCount.bounded(4),
1677
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("0B", "1G", "G2", "LU")),
1678
+ b::Element(e::Required, "Other Payer Rendering Provider Secondary Identifier"),
1679
+ b::Element(e::NotUsed, "Description"),
1680
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER"))),
1681
+
1682
+ d::LoopDef.build("2330H OTHER PAYER REFERRING PROVIDER", d::RepeatCount.bounded(1),
1683
+ b::Segment(3250, s::NM1, "Other Payer Referring Provider", r::Situational, d::RepeatCount.bounded(1),
1684
+ b::Element(e::Required, "Entity Identifier Code", b::Values("DN")),
1685
+ b::Element(e::Required, "Entity Type Qualifier", b::Values("1")),
1686
+ b::Element(e::NotUsed, "Name Last or Organization Name"),
1687
+ b::Element(e::NotUsed, "Name First"),
1688
+ b::Element(e::NotUsed, "Name Middle"),
1689
+ b::Element(e::NotUsed, "Name Prefix"),
1690
+ b::Element(e::NotUsed, "Name Suffix"),
1691
+ b::Element(e::NotUsed, "Identification Code Qualifier"),
1692
+ b::Element(e::NotUsed, "Identification Code"),
1693
+ b::Element(e::NotUsed, "Entity Relationship Code"),
1694
+ b::Element(e::NotUsed, "Entity Identifier Code"),
1695
+ b::Element(e::NotUsed, "Name Last or Organization Name")),
1696
+ b::Segment(3550, s::REF, "Other Payer Referring Provider Secondary Identification", r::Required, d::RepeatCount.bounded(3),
1697
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("0B", "1G", "G2")),
1698
+ b::Element(e::Required, "Other Payer Referring Provider Identifier"),
1699
+ b::Element(e::NotUsed, "Description"),
1700
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER"))),
1701
+
1702
+ d::LoopDef.build("2330I OTHER PAYER BILLING PROVIDER", d::RepeatCount.bounded(1),
1703
+ b::Segment(3250, s::NM1, "Other Payer Billing Provider", r::Situational, d::RepeatCount.bounded(1),
1704
+ b::Element(e::Required, "Entity Identifier Code", b::Values("85")),
1705
+ b::Element(e::Required, "Entity Type Qualifier", b::Values("2")),
1706
+ b::Element(e::NotUsed, "Name Last or Organization Name"),
1707
+ b::Element(e::NotUsed, "Name First"),
1708
+ b::Element(e::NotUsed, "Name Middle"),
1709
+ b::Element(e::NotUsed, "Name Prefix"),
1710
+ b::Element(e::NotUsed, "Name Suffix"),
1711
+ b::Element(e::NotUsed, "Identification Code Qualifier"),
1712
+ b::Element(e::NotUsed, "Identification Code"),
1713
+ b::Element(e::NotUsed, "Entity Relationship Code"),
1714
+ b::Element(e::NotUsed, "Entity Identifier Code"),
1715
+ b::Element(e::NotUsed, "Name Last or Organization Name")),
1716
+ b::Segment(3550, s::REF, "Other Payer Billing Provider Secondary Information", r::Required, d::RepeatCount.bounded(2),
1717
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("G2", "LU")),
1718
+ b::Element(e::Required, "Other Payer Billing Provider Identifier"),
1719
+ b::Element(e::NotUsed, "Description"),
1720
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER")))),
1721
+
1722
+ d::LoopDef.build("2400 SERVICE LINE NUMBER", d::RepeatCount.bounded(999),
1723
+ b::Segment(3650, s::LX, "Service Line Number", r::Required, d::RepeatCount.bounded(1),
1724
+ b::Element(e::Required, "Assigned Number")),
1725
+ b::Segment(3750, s::SV2, "Institutional Service Line", r::Required, d::RepeatCount.bounded(1),
1726
+ b::Element(e::Required, "Service Line Revenue Code"),
1727
+ b::Element(e::Situational, "COMPOSITE MEDICAL PROCEDURE IDENTIFIER",
1728
+ b::Element(e::Required, "Product or Service ID Qualifier", b::Values("ER", "HC", "HP", "IV", "WK")),
1729
+ b::Element(e::Required, "Procedure Code"),
1730
+ b::Element(e::Situational, "Procedure Modifier"),
1731
+ b::Element(e::Situational, "Procedure Modifier"),
1732
+ b::Element(e::Situational, "Procedure Modifier"),
1733
+ b::Element(e::Situational, "Procedure Modifier"),
1734
+ b::Element(e::Situational, "Description"),
1735
+ b::Element(e::NotUsed, "Product/Service ID")),
1736
+ b::Element(e::Required, "Line Item Charge Amount"),
1737
+ b::Element(e::Required, "Unit or Basis for Measurement Code", b::Values("DA", "UN")),
1738
+ b::Element(e::Required, "Service Unit Count"),
1739
+ b::Element(e::NotUsed, "Unit Rate"),
1740
+ b::Element(e::Situational, "Line Item Denied Charge or Non-Covered Charge Amount"),
1741
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code"),
1742
+ b::Element(e::NotUsed, "Nursing Home Residential Status Code"),
1743
+ b::Element(e::NotUsed, "Level of Care Code")),
1744
+ b::Segment(4200, s::PWK, "Line Supplemental Information", r::Situational, d::RepeatCount.bounded(10),
1745
+ b::Element(e::Required, "Attachment Report Type Code", b::Values("03", "04", "05", "06", "07", "08", "09", "10", "11", "13", "15", "21", "A3", "A4", "AM", "AS", "B2", "B3", "B4", "BR", "BS", "BT", "CB", "CK", "CT", "D2", "DA", "DB", "DG", "DJ", "DS", "EB", "HC", "HR", "I5", "IR", "LA", "M1", "MT", "NN", "OB", "OC", "OD", "OE", "OX", "OZ", "P4", "P5", "PE", "PN", "PO", "PQ", "PY", "PZ", "RB", "RR", "RT", "RX", "SG", "V5", "XP")),
1746
+ b::Element(e::Required, "Attachment Transmission Code", b::Values("AA", "BM", "EL", "EM", "FT", "FX")),
1747
+ b::Element(e::NotUsed, "Report Copies Needed"),
1748
+ b::Element(e::NotUsed, "Entity Identifier Code"),
1749
+ b::Element(e::Situational, "Identification Code Qualifier", b::Values("AC")),
1750
+ b::Element(e::Situational, "Attachment Control Number", b::MaxLength(50)),
1751
+ b::Element(e::NotUsed, "Description"),
1752
+ b::Element(e::NotUsed, "ACTIONS INDICATED"),
1753
+ b::Element(e::NotUsed, "Request Category Code")),
1754
+ b::Segment(4550, s::DTP, "Date - Service Date", r::Situational, d::RepeatCount.bounded(1),
1755
+ b::Element(e::Required, "Date Time Qualifier", b::Values("472")),
1756
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8", "RD8")),
1757
+ b::Element(e::Required, "Service Date")),
1758
+ b::Segment(4700, s::REF, "Line Item Control Number", r::Situational, d::RepeatCount.bounded(1),
1759
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("6R")),
1760
+ b::Element(e::Required, "Line Item Control Number", b::MaxLength(30)),
1761
+ b::Element(e::NotUsed, "Description"),
1762
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
1763
+ b::Segment(4700, s::REF, "Repriced Line Item Reference Number", r::Situational, d::RepeatCount.bounded(1),
1764
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("9B")),
1765
+ b::Element(e::Required, "Repriced Line Item Reference Number"),
1766
+ b::Element(e::NotUsed, "Description"),
1767
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
1768
+ b::Segment(4700, s::REF, "Adjusted Repriced Line Item Reference Number", r::Situational, d::RepeatCount.bounded(1),
1769
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("9D")),
1770
+ b::Element(e::Required, "Adjusted Repriced Line Item Reference Number"),
1771
+ b::Element(e::NotUsed, "Description"),
1772
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
1773
+ b::Segment(4750, s::AMT, "Service Tax Amount", r::Situational, d::RepeatCount.bounded(1),
1774
+ b::Element(e::Required, "Amount Qualifier Code", b::Values("GT")),
1775
+ b::Element(e::Required, "Service Tax Amount"),
1776
+ b::Element(e::NotUsed, "Credit/Debit Flag Code")),
1777
+ b::Segment(4750, s::AMT, "Facility Tax Amount", r::Situational, d::RepeatCount.bounded(1),
1778
+ b::Element(e::Required, "Amount Qualifier Code", b::Values("N8")),
1779
+ b::Element(e::Required, "Facility Tax Amount"),
1780
+ b::Element(e::NotUsed, "Credit/Debit Flag Code")),
1781
+ b::Segment(4850, s::NTE, "Third Party Organization Notes", r::Situational, d::RepeatCount.bounded(1),
1782
+ b::Element(e::Required, "Note Reference Code", b::Values("TPO")),
1783
+ b::Element(e::Required, "Line Note Text")),
1784
+ b::Segment(4920, s::HCP, "Line Pricing/Repricing Information", r::Situational, d::RepeatCount.bounded(1),
1785
+ b::Element(e::Required, "Pricing Methodology", b::Values("00", "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14")),
1786
+ b::Element(e::Required, "Monetary Amount"),
1787
+ b::Element(e::Situational, "Monetary Amount"),
1788
+ b::Element(e::Situational, "Reference Identification"),
1789
+ b::Element(e::Situational, "Rate"),
1790
+ b::Element(e::Situational, "Reference Identification"),
1791
+ b::Element(e::Situational, "Monetary Amount"),
1792
+ b::Element(e::Situational, "Product/Service ID"),
1793
+ b::Element(e::Situational, "Product or Service ID Qualifier", b::Values("ER", "HC", "HP", "IV", "WK")),
1794
+ b::Element(e::Situational, "Repriced Approved HCPCS Code"),
1795
+ b::Element(e::Situational, "Unit or Basis for Measurement Code", b::Values("DA", "UN")),
1796
+ b::Element(e::Situational, "Quantity", b::MaxLength(8), b::MaxPrecision(3)),
1797
+ b::Element(e::Situational, "Reject Reason Code", b::Values("T1", "T2", "T3", "T4", "T5", "T6")),
1798
+ b::Element(e::Situational, "Policy Compliance Code", b::Values("1", "2", "3", "4", "5")),
1799
+ b::Element(e::Situational, "Exception Code", b::Values("1", "2", "3", "4", "5", "6"))),
1800
+
1801
+ d::LoopDef.build("2410 DRUG IDENTIFICATION", d::RepeatCount.bounded(1),
1802
+ b::Segment(4930, s::LIN, "Drug Identification", r::Situational, d::RepeatCount.bounded(1),
1803
+ b::Element(e::NotUsed, "Assigned Identification"),
1804
+ b::Element(e::Required, "Product or Service ID Qualifier", b::Values("N4")),
1805
+ b::Element(e::Required, "National Drug Code"),
1806
+ b::Element(e::NotUsed, "Product/Service ID Qualifier"),
1807
+ b::Element(e::NotUsed, "Product/Service ID"),
1808
+ b::Element(e::NotUsed, "Product/Service ID Qualifier"),
1809
+ b::Element(e::NotUsed, "Product/Service ID"),
1810
+ b::Element(e::NotUsed, "Product/Service ID Qualifier"),
1811
+ b::Element(e::NotUsed, "Product/Service ID"),
1812
+ b::Element(e::NotUsed, "Product/Service ID Qualifier"),
1813
+ b::Element(e::NotUsed, "Product/Service ID"),
1814
+ b::Element(e::NotUsed, "Product/Service ID Qualifier"),
1815
+ b::Element(e::NotUsed, "Product/Service ID"),
1816
+ b::Element(e::NotUsed, "Product/Service ID Qualifier"),
1817
+ b::Element(e::NotUsed, "Product/Service ID"),
1818
+ b::Element(e::NotUsed, "Product/Service ID Qualifier"),
1819
+ b::Element(e::NotUsed, "Product/Service ID"),
1820
+ b::Element(e::NotUsed, "Product/Service ID Qualifier"),
1821
+ b::Element(e::NotUsed, "Product/Service ID"),
1822
+ b::Element(e::NotUsed, "Product/Service ID Qualifier"),
1823
+ b::Element(e::NotUsed, "Product/Service ID"),
1824
+ b::Element(e::NotUsed, "Product/Service ID Qualifier"),
1825
+ b::Element(e::NotUsed, "Product/Service ID"),
1826
+ b::Element(e::NotUsed, "Product/Service ID Qualifier"),
1827
+ b::Element(e::NotUsed, "Product/Service ID"),
1828
+ b::Element(e::NotUsed, "Product/Service ID Qualifier"),
1829
+ b::Element(e::NotUsed, "Product/Service ID"),
1830
+ b::Element(e::NotUsed, "Product/Service ID Qualifier"),
1831
+ b::Element(e::NotUsed, "Product/Service ID"),
1832
+ b::Element(e::NotUsed, "Product/Service ID Qualifier"),
1833
+ b::Element(e::NotUsed, "Product/Service ID")),
1834
+ b::Segment(4940, s::CTP, "Drug Quantity", r::Required, d::RepeatCount.bounded(1),
1835
+ b::Element(e::NotUsed, "Class of Trade Code"),
1836
+ b::Element(e::NotUsed, "Price Identifier Code"),
1837
+ b::Element(e::NotUsed, "Unit Price"),
1838
+ b::Element(e::Required, "National Drug Unit Count"),
1839
+ b::Element(e::Required, "COMPOSITE UNIT OF MEASURE",
1840
+ b::Element(e::Required, "Code Qualifier", b::Values("F2", "GR", "ME", "ML", "UN")),
1841
+ b::Element(e::NotUsed, "Exponent"),
1842
+ b::Element(e::NotUsed, "Multiplier"),
1843
+ b::Element(e::NotUsed, "Unit or Basis for Measurement Code"),
1844
+ b::Element(e::NotUsed, "Exponent"),
1845
+ b::Element(e::NotUsed, "Multiplier"),
1846
+ b::Element(e::NotUsed, "Unit or Basis for Measurement Code"),
1847
+ b::Element(e::NotUsed, "Exponent"),
1848
+ b::Element(e::NotUsed, "Multiplier"),
1849
+ b::Element(e::NotUsed, "Unit or Basis for Measurement Code"),
1850
+ b::Element(e::NotUsed, "Exponent"),
1851
+ b::Element(e::NotUsed, "Multiplier"),
1852
+ b::Element(e::NotUsed, "Unit or Basis for Measurement Code"),
1853
+ b::Element(e::NotUsed, "Exponent"),
1854
+ b::Element(e::NotUsed, "Multiplier")),
1855
+ b::Element(e::NotUsed, "Price Multiplier Qualifier"),
1856
+ b::Element(e::NotUsed, "Multiplier"),
1857
+ b::Element(e::NotUsed, "Monetary Amount"),
1858
+ b::Element(e::NotUsed, "Basis of Unit Price Code"),
1859
+ b::Element(e::NotUsed, "Condition Value"),
1860
+ b::Element(e::NotUsed, "Multiple Price Quantity")),
1861
+ b::Segment(4950, s::REF, "Prescription or Compound Drug Association Number", r::Situational, d::RepeatCount.bounded(1),
1862
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("VY", "XZ")),
1863
+ b::Element(e::Required, "Prescription Number"),
1864
+ b::Element(e::NotUsed, "Description"),
1865
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER"))),
1866
+
1867
+ d::LoopDef.build("2420A OPERATING PHYSICIAN NAME", d::RepeatCount.bounded(1),
1868
+ b::Segment(5000, s::NM1, "Operating Physician Name", r::Situational, d::RepeatCount.bounded(1),
1869
+ b::Element(e::Required, "Entity Identifier Code", b::Values("72")),
1870
+ b::Element(e::Required, "Entity Type Qualifier", b::Values("1")),
1871
+ b::Element(e::Required, "Operating Physician Last Name"),
1872
+ b::Element(e::Situational, "Operating Physician First Name"),
1873
+ b::Element(e::Situational, "Operating Physician Middle Name or Initial"),
1874
+ b::Element(e::NotUsed, "Name Prefix"),
1875
+ b::Element(e::Situational, "Operating Physician Suffix"),
1876
+ b::Element(e::Situational, "Identification Code Qualifier", b::Values("XX")),
1877
+ b::Element(e::Situational, "Operating Physician Primary Identifier"),
1878
+ b::Element(e::NotUsed, "Entity Relationship Code"),
1879
+ b::Element(e::NotUsed, "Entity Identifier Code"),
1880
+ b::Element(e::NotUsed, "Name Last or Organization Name")),
1881
+ b::Segment(5250, s::REF, "Operating Physician Secondary Identification", r::Situational, d::RepeatCount.bounded(20),
1882
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("0B", "1G", "G2", "LU")),
1883
+ b::Element(e::Required, "Operating Physician Secondary Identifier"),
1884
+ b::Element(e::NotUsed, "Description"),
1885
+ b::Element(e::Situational, "REFERENCE IDENTIFIER",
1886
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("2U")),
1887
+ b::Element(e::Required, "Other Payer Primary Identifier"),
1888
+ b::Element(e::NotUsed, "Reference Identification Qualifier"),
1889
+ b::Element(e::NotUsed, "Reference Identification"),
1890
+ b::Element(e::NotUsed, "Reference Identification Qualifier"),
1891
+ b::Element(e::NotUsed, "Reference Identification")))),
1892
+
1893
+ d::LoopDef.build("2420B OTHER OPERATING PHYSICIAN NAME", d::RepeatCount.bounded(1),
1894
+ b::Segment(5000, s::NM1, "Other Operating Physician Name", r::Situational, d::RepeatCount.bounded(1),
1895
+ b::Element(e::Required, "Entity Identifier Code", b::Values("ZZ")),
1896
+ b::Element(e::Required, "Entity Type Qualifier", b::Values("1")),
1897
+ b::Element(e::Required, "Other Operating Physician Last Name"),
1898
+ b::Element(e::Situational, "Other Operating Physician First Name"),
1899
+ b::Element(e::Situational, "Other Operating Physician Middle Name or Initial"),
1900
+ b::Element(e::NotUsed, "Name Prefix"),
1901
+ b::Element(e::Situational, "Other Operating Physician Name Suffix"),
1902
+ b::Element(e::Situational, "Identification Code Qualifier", b::Values("XX")),
1903
+ b::Element(e::Situational, "Other Operating Physician Identifier"),
1904
+ b::Element(e::NotUsed, "Entity Relationship Code"),
1905
+ b::Element(e::NotUsed, "Entity Identifier Code"),
1906
+ b::Element(e::NotUsed, "Name Last or Organization Name")),
1907
+ b::Segment(5250, s::REF, "Other Operating Physician Secondary Identification", r::Situational, d::RepeatCount.bounded(20),
1908
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("0B", "1G", "G2", "LU")),
1909
+ b::Element(e::Required, "Other Provider Secondary Identifier"),
1910
+ b::Element(e::NotUsed, "Description"),
1911
+ b::Element(e::Situational, "REFERENCE IDENTIFIER",
1912
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("2U")),
1913
+ b::Element(e::Required, "Other Payer Primary Identifier"),
1914
+ b::Element(e::NotUsed, "Reference Identifier Qualifier"),
1915
+ b::Element(e::NotUsed, "Reference Identifier"),
1916
+ b::Element(e::NotUsed, "Reference Identifier Qualifier"),
1917
+ b::Element(e::NotUsed, "Reference Identifier")))),
1918
+
1919
+ d::LoopDef.build("2420C RENDERING PROVIDER NAME", d::RepeatCount.bounded(1),
1920
+ b::Segment(5000, s::NM1, "Rendering Provider Name", r::Situational, d::RepeatCount.bounded(1),
1921
+ b::Element(e::Required, "Entity Identifier Code", b::Values("82")),
1922
+ b::Element(e::Required, "Entity Type Qualifier", b::Values("1")),
1923
+ b::Element(e::Required, "Rendering Provider Last Name"),
1924
+ b::Element(e::Situational, "Rendering Provider First Name"),
1925
+ b::Element(e::Situational, "Rendering Provider Middle Name or Initial"),
1926
+ b::Element(e::NotUsed, "Name Prefix"),
1927
+ b::Element(e::Situational, "Rendering Provider Name Suffix"),
1928
+ b::Element(e::Situational, "Identification Code Qualifier", b::Values("XX")),
1929
+ b::Element(e::Situational, "Rendering Provider Identifier"),
1930
+ b::Element(e::NotUsed, "Entity Relationship Code"),
1931
+ b::Element(e::NotUsed, "Entity Identifier Code"),
1932
+ b::Element(e::NotUsed, "Name Last or Organization Name")),
1933
+ b::Segment(5250, s::REF, "Rendering Provider Secondary Identification", r::Situational, d::RepeatCount.bounded(20),
1934
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("0B", "1G", "G2", "LU")),
1935
+ b::Element(e::Required, "Rendering Provider Secondary Identifier"),
1936
+ b::Element(e::NotUsed, "Description"),
1937
+ b::Element(e::Situational, "REFERENCE IDENTIFIER",
1938
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("2U")),
1939
+ b::Element(e::Required, "Other Payer Primary Identifier"),
1940
+ b::Element(e::NotUsed, "Reference Identification Qualifier"),
1941
+ b::Element(e::NotUsed, "Reference Identification"),
1942
+ b::Element(e::NotUsed, "Reference Identification Qualifier"),
1943
+ b::Element(e::NotUsed, "Reference Identification")))),
1944
+
1945
+ d::LoopDef.build("2420D REFERRING PROVIDER NAME", d::RepeatCount.bounded(1),
1946
+ b::Segment(5000, s::NM1, "Referring Provider Name", r::Situational, d::RepeatCount.bounded(1),
1947
+ b::Element(e::Required, "Entity Identifier Code", b::Values("DN")),
1948
+ b::Element(e::Required, "Entity Type Qualifier", b::Values("1")),
1949
+ b::Element(e::Required, "Referring Provider Last Name"),
1950
+ b::Element(e::Situational, "Referring Provider First Name"),
1951
+ b::Element(e::Situational, "Referring Provider Middle Name or Initial"),
1952
+ b::Element(e::NotUsed, "Name Prefix"),
1953
+ b::Element(e::Situational, "Referring Provider Name Suffix"),
1954
+ b::Element(e::Situational, "Identification Code Qualifier", b::Values("XX")),
1955
+ b::Element(e::Situational, "Referring Provider Identifier"),
1956
+ b::Element(e::NotUsed, "Entity Relationship Code"),
1957
+ b::Element(e::NotUsed, "Entity Identifier Code"),
1958
+ b::Element(e::NotUsed, "Name Last or Organization Name")),
1959
+ b::Segment(5250, s::REF, "Referring Provider Secondary Identification", r::Situational, d::RepeatCount.bounded(20),
1960
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("0B", "1G", "G2")),
1961
+ b::Element(e::Required, "Referring Provider Secondary Identifier"),
1962
+ b::Element(e::NotUsed, "Description"),
1963
+ b::Element(e::Situational, "REFERENCE IDENTIFIER",
1964
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("2U")),
1965
+ b::Element(e::Required, "Other Payer Primary Identifier"),
1966
+ b::Element(e::NotUsed, "Reference Identification Qualifier"),
1967
+ b::Element(e::NotUsed, "Reference Identification"),
1968
+ b::Element(e::NotUsed, "Reference Identification Qualifier"),
1969
+ b::Element(e::NotUsed, "Reference Identification")))),
1970
+
1971
+ d::LoopDef.build("2430 LINE ADJUDICATION INFORMATION", d::RepeatCount.bounded(15),
1972
+ b::Segment(5400, s::SVD, "Line Adjudication Information", r::Situational, d::RepeatCount.bounded(1),
1973
+ b::Element(e::Required, "Other Payer Primary Identifier"),
1974
+ b::Element(e::Required, "Service Line Paid Amount"),
1975
+ b::Element(e::Situational, "COMPOSITE MEDICAL PROCEDURE IDENTIFIER",
1976
+ b::Element(e::Required, "Product or Service ID Qualifier", b::Values("ER", "HC", "HP", "IV", "WK")),
1977
+ b::Element(e::Required, "Procedure Code"),
1978
+ b::Element(e::Situational, "Procedure Modifier"),
1979
+ b::Element(e::Situational, "Procedure Modifier"),
1980
+ b::Element(e::Situational, "Procedure Modifier"),
1981
+ b::Element(e::Situational, "Procedure Modifier"),
1982
+ b::Element(e::Situational, "Procedure Code Description"),
1983
+ b::Element(e::NotUsed, "Product/Service ID")),
1984
+ b::Element(e::Required, "Service Line Revenue Code"),
1985
+ b::Element(e::Required, "Paid Service Unit Count", b::MaxLength(8), b::MaxPrecision(3)),
1986
+ b::Element(e::Situational, "Bundled Line Number")),
1987
+ b::Segment(5450, s::CAS, "Line Adjustment", r::Situational, d::RepeatCount.bounded(5),
1988
+ b::Element(e::Required, "Claim Adjustment Group Code", b::Values("CO", "CR", "OA", "PI", "PR")),
1989
+ b::Element(e::Required, "Adjustment Reason Code"),
1990
+ b::Element(e::Required, "Adjustment Amount"),
1991
+ b::Element(e::Situational, "Adjustment Quantity"),
1992
+ b::Element(e::Situational, "Adjustment Reason Code"),
1993
+ b::Element(e::Situational, "Adjustment Amount"),
1994
+ b::Element(e::Situational, "Adjustment Quantity"),
1995
+ b::Element(e::Situational, "Adjustment Reason Code"),
1996
+ b::Element(e::Situational, "Adjustment Amount"),
1997
+ b::Element(e::Situational, "Adjustment Quantity"),
1998
+ b::Element(e::Situational, "Adjustment Reason Code"),
1999
+ b::Element(e::Situational, "Adjustment Amount"),
2000
+ b::Element(e::Situational, "Adjustment Quantity"),
2001
+ b::Element(e::Situational, "Adjustment Reason Code"),
2002
+ b::Element(e::Situational, "Adjustment Amount"),
2003
+ b::Element(e::Situational, "Adjustment Quantity"),
2004
+ b::Element(e::Situational, "Adjustment Reason Code"),
2005
+ b::Element(e::Situational, "Adjustment Amount"),
2006
+ b::Element(e::Situational, "Adjustment Quantity")),
2007
+ b::Segment(5500, s::DTP, "Line Check or Remittance Date", r::Required, d::RepeatCount.bounded(1),
2008
+ b::Element(e::Required, "Date Time Qualifier", b::Values("573")),
2009
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8")),
2010
+ b::Element(e::Required, "Adjudication or Payment Date")),
2011
+ b::Segment(5505, s::AMT, "Remaining Patient Liability", r::Situational, d::RepeatCount.bounded(1),
2012
+ b::Element(e::Required, "Amount Qualifier Code", b::Values("EAF")),
2013
+ b::Element(e::Required, "Remaining Patient Liability"),
2014
+ b::Element(e::NotUsed, "Credit/Debit Flag Code")))))
2015
+
2016
+ HC837 = b.build("HC", "837", "",
2017
+ d::TableDef.header("1 - Header",
2018
+ b::Segment(50, s::ST, "Transaction Set Header", r::Required, d::RepeatCount.bounded(1),
2019
+ b::Element(e::Required, "Transaction Set Identifier Code", b::Values("837")),
2020
+ b::Element(e::Required, "Transaction Set Control Number"),
2021
+ b::Element(e::Required, "Version, Release or Industry Identifier")),
2022
+ b::Segment(100, s::BHT, "Beginning of Hierarchical Transaction", r::Required, d::RepeatCount.bounded(1),
2023
+ b::Element(e::Required, "Hierarchical Structure Code", b::Values("0019")),
2024
+ b::Element(e::Required, "Transaction Set Purpose Code", b::Values("00", "18")),
2025
+ b::Element(e::Required, "Originator Application Transaction Identifier", b::MaxLength(30)),
2026
+ b::Element(e::Required, "Transaction Set Creation Date"),
2027
+ b::Element(e::Required, "Transaction Set Creation Time"),
2028
+ b::Element(e::Required, "Claim Identifier", b::Values("31", "CH", "RP"))),
2029
+
2030
+ d::LoopDef.build("1000A SUBMITTER NAME", d::RepeatCount.bounded(1),
2031
+ b::Segment(200, s::NM1, "Submitter Name", r::Required, d::RepeatCount.bounded(1),
2032
+ b::Element(e::Required, "Entity Identifier Code", b::Values("41")),
2033
+ b::Element(e::Required, "Entity Type Qualifier", b::Values("1", "2")),
2034
+ b::Element(e::Required, "Submitter Last or Organization Name"),
2035
+ b::Element(e::Situational, "Submitter First Name"),
2036
+ b::Element(e::Situational, "Submitter Middle Name or Initial"),
2037
+ b::Element(e::NotUsed, "Name Prefix"),
2038
+ b::Element(e::NotUsed, "Name Suffix"),
2039
+ b::Element(e::Required, "Identification Qualifier Code", b::Values("46")),
2040
+ b::Element(e::Required, "Submitter Identifier"),
2041
+ b::Element(e::NotUsed, "Entity Relationship Code"),
2042
+ b::Element(e::NotUsed, "Entity Identifier Code"),
2043
+ b::Element(e::NotUsed, "Name Last or Organization Name")),
2044
+ b::Segment(450, s::PER, "Submitter EDI Contact Information", r::Required, d::RepeatCount.bounded(2),
2045
+ b::Element(e::Required, "Contact Function Code", b::Values("IC")),
2046
+ b::Element(e::Situational, "Submitter Contact Name"),
2047
+ b::Element(e::Required, "Communication Number Qualifier", b::Values("EM", "FX", "TE")),
2048
+ b::Element(e::Required, "Communication Number"),
2049
+ b::Element(e::Situational, "Communication Number Qualifier", b::Values("EM", "EX", "FX", "TE")),
2050
+ b::Element(e::Situational, "Communication Number"),
2051
+ b::Element(e::Situational, "Communication Number Qualifier", b::Values("EM", "EX", "FX", "TE")),
2052
+ b::Element(e::Situational, "Communication Number"),
2053
+ b::Element(e::NotUsed, "Contact Inquiry Reference"))),
2054
+
2055
+ d::LoopDef.build("1000B RECEIVER NAME", d::RepeatCount.bounded(1),
2056
+ b::Segment(200, s::NM1, "Receiver Name", r::Required, d::RepeatCount.bounded(1),
2057
+ b::Element(e::Required, "Entity Identifier Code", b::Values("40")),
2058
+ b::Element(e::Required, "Entity Type Qualifier", b::Values("2")),
2059
+ b::Element(e::Required, "Receiver Name"),
2060
+ b::Element(e::NotUsed, "Name First"),
2061
+ b::Element(e::NotUsed, "Name Last"),
2062
+ b::Element(e::NotUsed, "Name Prefix"),
2063
+ b::Element(e::NotUsed, "Name Suffix"),
2064
+ b::Element(e::Required, "Identification Code Qualifier", b::Values("46")),
2065
+ b::Element(e::Required, "Receiver Primary Identifier"),
2066
+ b::Element(e::NotUsed, "Entity Relationship Code"),
2067
+ b::Element(e::NotUsed, "Entity Identifier Code"),
2068
+ b::Element(e::NotUsed, "Name Last or Organization Name")))),
2069
+
2070
+ d::TableDef.detail("2 - Billing Provider Detail",
2071
+ d::LoopDef.build("2000A BILLING PROVIDER HIERARCHICAL LEVEL", d::RepeatCount.unbounded,
2072
+ b::Segment(10, s::HL, "Billing Provider Hierarchical Level", r::Required, d::RepeatCount.bounded(1),
2073
+ b::Element(e::Required, "Hierarchical ID Number"),
2074
+ b::Element(e::NotUsed, "Hierarchical Parent ID Number"),
2075
+ b::Element(e::Required, "Hierarchical Level Code", b::Values("20")),
2076
+ b::Element(e::Required, "Hierachical Child Code", b::Values("1"))),
2077
+ b::Segment(30, s::PRV, "Billing Provider Specialty Information", r::Situational, d::RepeatCount.bounded(1),
2078
+ b::Element(e::Required, "Provider Code", b::Values("BI")),
2079
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("PXC")),
2080
+ b::Element(e::Required, "Provider Taxonomy Code"),
2081
+ b::Element(e::NotUsed, "State or Province Code"),
2082
+ b::Element(e::NotUsed, "PROVIDER SPECIALTY INFORMATION"),
2083
+ b::Element(e::NotUsed, "Provider Organization Code")),
2084
+ b::Segment(100, s::CUR, "Foreign Currency Information", r::Situational, d::RepeatCount.bounded(1),
2085
+ b::Element(e::Required, "Entity Identifier Code", b::Values("85")),
2086
+ b::Element(e::Required, "Currency Code"),
2087
+ b::Element(e::NotUsed, "Exchange Rate"),
2088
+ b::Element(e::NotUsed, "Entity Identifier Code"),
2089
+ b::Element(e::NotUsed, "Currency Code"),
2090
+ b::Element(e::NotUsed, "Currency Market/Exchange Code"),
2091
+ b::Element(e::NotUsed, "Date/Time Qualifier"),
2092
+ b::Element(e::NotUsed, "Date"),
2093
+ b::Element(e::NotUsed, "Time"),
2094
+ b::Element(e::NotUsed, "Date/Time Qualifier"),
2095
+ b::Element(e::NotUsed, "Date"),
2096
+ b::Element(e::NotUsed, "Time"),
2097
+ b::Element(e::NotUsed, "Date/Time Qualifier"),
2098
+ b::Element(e::NotUsed, "Date"),
2099
+ b::Element(e::NotUsed, "Time"),
2100
+ b::Element(e::NotUsed, "Date/Time Qualifier"),
2101
+ b::Element(e::NotUsed, "Date"),
2102
+ b::Element(e::NotUsed, "Time"),
2103
+ b::Element(e::NotUsed, "Date/Time Qualifier"),
2104
+ b::Element(e::NotUsed, "Date"),
2105
+ b::Element(e::NotUsed, "Time")),
2106
+
2107
+ d::LoopDef.build("2010AA BILLING PROVIDER NAME", d::RepeatCount.bounded(1),
2108
+ b::Segment(150, s::NM1, "Billing Provider Name", r::Required, d::RepeatCount.bounded(1),
2109
+ b::Element(e::Required, "Entity Identifier Code", b::Values("85")),
2110
+ b::Element(e::Required, "Entity Type Qualifier", b::Values("2")),
2111
+ b::Element(e::Required, "Billing Provider Organizational Name"),
2112
+ b::Element(e::NotUsed, "Name First"),
2113
+ b::Element(e::NotUsed, "Name Middle"),
2114
+ b::Element(e::NotUsed, "Name Prefix"),
2115
+ b::Element(e::NotUsed, "Name Suffix"),
2116
+ b::Element(e::Situational, "Identification Code Qualifier", b::Values("XX")),
2117
+ b::Element(e::Situational, "Billing Provider Identifier"),
2118
+ b::Element(e::NotUsed, "Entity Relationship Code"),
2119
+ b::Element(e::NotUsed, "Entity Identifier Code"),
2120
+ b::Element(e::NotUsed, "Name Last or Organization Name")),
2121
+ b::Segment(250, s::N3, "Billing Provider Address", r::Required, d::RepeatCount.bounded(1),
2122
+ b::Element(e::Required, "Billing Provider Address Line"),
2123
+ b::Element(e::Situational, "Billing Provider Address Line")),
2124
+ b::Segment(300, s::N4, "Billing Provider City, State, ZIP Code", r::Required, d::RepeatCount.bounded(1),
2125
+ b::Element(e::Required, "Billing Provider City Name"),
2126
+ b::Element(e::Situational, "Billing Provider State or Province Code"),
2127
+ b::Element(e::Situational, "Billing Provider Postal Zone or ZIP Code"),
2128
+ b::Element(e::Situational, "Country Code"),
2129
+ b::Element(e::NotUsed, "Location Qualifier"),
2130
+ b::Element(e::NotUsed, "Location Identifier"),
2131
+ b::Element(e::Situational, "Country Subdivision Code")),
2132
+ b::Segment(350, s::REF, "Billing Provider Tax Identification", r::Required, d::RepeatCount.bounded(1),
2133
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("EI")),
2134
+ b::Element(e::Required, "Billing Provider Tax Identification Number"),
2135
+ b::Element(e::NotUsed, "Description"),
2136
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
2137
+ b::Segment(400, s::PER, "Billing Provider Contact Information", r::Situational, d::RepeatCount.bounded(2),
2138
+ b::Element(e::Required, "Contact Function Code", b::Values("IC")),
2139
+ b::Element(e::Situational, "Billing Provider Contact Name"),
2140
+ b::Element(e::Required, "Communication Number Qualifier", b::Values("EM", "FX", "TE")),
2141
+ b::Element(e::Required, "Communication Number"),
2142
+ b::Element(e::Situational, "Communication Number Qualifier", b::Values("EM", "EX", "FX", "TE")),
2143
+ b::Element(e::Situational, "Communication Number"),
2144
+ b::Element(e::Situational, "Communication Number Qualifier", b::Values("EM", "EX", "FX", "TE")),
2145
+ b::Element(e::Situational, "Communication Number"),
2146
+ b::Element(e::NotUsed, "Contact Inquiry Reference"))),
2147
+
2148
+ d::LoopDef.build("2010AB PAY-TO ADDRESS NAME", d::RepeatCount.bounded(1),
2149
+ b::Segment(150, s::NM1, "Pay-to Address Name", r::Situational, d::RepeatCount.bounded(1),
2150
+ b::Element(e::Required, "Entity Identifier Code", b::Values("87")),
2151
+ b::Element(e::Required, "Entity Type Qualifier", b::Values("2")),
2152
+ b::Element(e::NotUsed, "Name Last or Organizational Name"),
2153
+ b::Element(e::NotUsed, "Name First"),
2154
+ b::Element(e::NotUsed, "Name Middle"),
2155
+ b::Element(e::NotUsed, "Name Prefix"),
2156
+ b::Element(e::NotUsed, "Name Suffix"),
2157
+ b::Element(e::NotUsed, "Identification Code Qualifier"),
2158
+ b::Element(e::NotUsed, "Identifier Code"),
2159
+ b::Element(e::NotUsed, "Entity Relationship Code"),
2160
+ b::Element(e::NotUsed, "Entity Identifier Code"),
2161
+ b::Element(e::NotUsed, "Name Last or Organization Name")),
2162
+ b::Segment(250, s::N3, "Pay-to Address - ADDRESS", r::Required, d::RepeatCount.bounded(1),
2163
+ b::Element(e::Required, "Pay-To Address Line"),
2164
+ b::Element(e::Situational, "Pay-To Address Line")),
2165
+ b::Segment(300, s::N4, "Pay-To Address City, State, ZIP Code", r::Required, d::RepeatCount.bounded(1),
2166
+ b::Element(e::Required, "Pay-to Address City Name"),
2167
+ b::Element(e::Situational, "Pay-to Address State Code"),
2168
+ b::Element(e::Situational, "Pay-to Address Postal Zone or ZIP Code"),
2169
+ b::Element(e::Situational, "Country Code"),
2170
+ b::Element(e::NotUsed, "Location Qualifier"),
2171
+ b::Element(e::NotUsed, "Location Identifier"),
2172
+ b::Element(e::Situational, "Country Subdivision Code"))),
2173
+
2174
+ d::LoopDef.build("2010AC PAY-TO PLAN NAME", d::RepeatCount.bounded(1),
2175
+ b::Segment(150, s::NM1, "Pay-To Plan Name", r::Situational, d::RepeatCount.bounded(1),
2176
+ b::Element(e::Required, "Entity Identifier Code", b::Values("PE")),
2177
+ b::Element(e::Required, "Entity Type Qualifier", b::Values("2")),
2178
+ b::Element(e::Required, "Pay-To Plan Organizational Name"),
2179
+ b::Element(e::NotUsed, "Name First"),
2180
+ b::Element(e::NotUsed, "Name Middle"),
2181
+ b::Element(e::NotUsed, "Name Prefix"),
2182
+ b::Element(e::NotUsed, "Name Suffix"),
2183
+ b::Element(e::Required, "Identification Code Qualifier", b::Values("PI", "XV")),
2184
+ b::Element(e::Required, "Pay-To Plan Primary Identifier"),
2185
+ b::Element(e::NotUsed, "Entity Relationship Code"),
2186
+ b::Element(e::NotUsed, "Entity Identifier Code"),
2187
+ b::Element(e::NotUsed, "Name Last or Organization Name")),
2188
+ b::Segment(250, s::N3, "Pay-to Plan Address", r::Required, d::RepeatCount.bounded(1),
2189
+ b::Element(e::Required, "Pay-To Plan Address Line"),
2190
+ b::Element(e::Situational, "Pay-To Plan Address Line")),
2191
+ b::Segment(300, s::N4, "Pay-To Plan City, State, ZIP Code", r::Required, d::RepeatCount.bounded(1),
2192
+ b::Element(e::Required, "Pay-to Plan City Name"),
2193
+ b::Element(e::Situational, "Pay-to Plan State or Province Code"),
2194
+ b::Element(e::Situational, "Pay-to Plan Postal Zone or ZIP Code"),
2195
+ b::Element(e::Situational, "Country Code"),
2196
+ b::Element(e::NotUsed, "Location Qualifier"),
2197
+ b::Element(e::NotUsed, "Location Identifier"),
2198
+ b::Element(e::Situational, "Country Subdivision Code")),
2199
+ b::Segment(350, s::REF, "Pay-to Plan Secondary Identification", r::Situational, d::RepeatCount.bounded(1),
2200
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("2U", "FY", "NF")),
2201
+ b::Element(e::Required, "Pay-to Plan Secondary Identifier"),
2202
+ b::Element(e::NotUsed, "Description"),
2203
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
2204
+ b::Segment(350, s::REF, "Pay-to Plan Tax Identification Number", r::Required, d::RepeatCount.bounded(1),
2205
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("EI")),
2206
+ b::Element(e::Required, "Pay-to Plan Tax Identification Number"),
2207
+ b::Element(e::NotUsed, "Description"),
2208
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER"))))),
2209
+
2210
+ d::TableDef.detail("2 - Subscriber Detail",
2211
+ d::LoopDef.build("2000B SUBSCRIBER HIERARCHICAL LEVEL", d::RepeatCount.unbounded,
2212
+ b::Segment(10, s::HL, "Subscriber Hierarchical Level", r::Required, d::RepeatCount.bounded(1),
2213
+ b::Element(e::Required, "Hierarchical ID Number"),
2214
+ b::Element(e::Required, "Hierarchical Parent ID Number"),
2215
+ b::Element(e::Required, "Hierarchical Level Code", b::Values("22")),
2216
+ b::Element(e::Required, "Hierachical Child Code", b::Values("0", "1"))),
2217
+ b::Segment(50, s::SBR, "Subscriber Information", r::Required, d::RepeatCount.bounded(1),
2218
+ b::Element(e::Required, "Payer Responsibility Sequence Number Code", b::Values("A", "B", "C", "D", "E", "F", "G", "H", "P", "S", "T", "U")),
2219
+ b::Element(e::Situational, "Individual Relationship Code", b::Values("18")),
2220
+ b::Element(e::Situational, "Subscriber Group or Policy Number"),
2221
+ b::Element(e::Situational, "Subscriber Group Name"),
2222
+ b::Element(e::NotUsed, "Insurance Type Code"),
2223
+ b::Element(e::NotUsed, "Coordination of Benefits Code"),
2224
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code"),
2225
+ b::Element(e::NotUsed, "Employment Status Code"),
2226
+ b::Element(e::Situational, "Claim Filing Indicator Code", b::Values("11", "12", "13", "14", "15", "16", "17", "AM", "BL", "CH", "CI", "DS", "FI", "HM", "LM", "MA", "MB", "MC", "OF", "TV", "VA", "WC", "ZZ"))),
2227
+
2228
+ d::LoopDef.build("2010BA SUBSCRIBER NAME", d::RepeatCount.bounded(1),
2229
+ b::Segment(150, s::NM1, "Subscriber Name", r::Required, d::RepeatCount.bounded(1),
2230
+ b::Element(e::Required, "Entity Identifier Code", b::Values("IL")),
2231
+ b::Element(e::Required, "Entity Type Qualifier", b::Values("1", "2")),
2232
+ b::Element(e::Required, "Subscriber Last Name"),
2233
+ b::Element(e::Situational, "Subscriber First Name"),
2234
+ b::Element(e::Situational, "Subscriber Middle Name or Initial"),
2235
+ b::Element(e::NotUsed, "Name Prefix"),
2236
+ b::Element(e::Situational, "Subscriber Name Suffix"),
2237
+ b::Element(e::Situational, "Identification Code Qualifier", b::Values("II", "MI")),
2238
+ b::Element(e::Situational, "Subscriber Primary Identifier"),
2239
+ b::Element(e::NotUsed, "Entity Relationship Code"),
2240
+ b::Element(e::NotUsed, "Entity Identifier Code"),
2241
+ b::Element(e::NotUsed, "Name Last or Organization Name")),
2242
+ b::Segment(250, s::N3, "Subscriber Address", r::Situational, d::RepeatCount.bounded(1),
2243
+ b::Element(e::Required, "Subscriber Address Line"),
2244
+ b::Element(e::Situational, "Subscriber Address Line")),
2245
+ b::Segment(300, s::N4, "Subscriber City, State, ZIP Code", r::Situational, d::RepeatCount.bounded(1),
2246
+ b::Element(e::Required, "Subscriber City Name"),
2247
+ b::Element(e::Situational, "Subscriber State Code"),
2248
+ b::Element(e::Situational, "Subscriber Postal Zone or ZIP Code"),
2249
+ b::Element(e::Situational, "Country Code"),
2250
+ b::Element(e::NotUsed, "Location Qualifier"),
2251
+ b::Element(e::NotUsed, "Location Identifier"),
2252
+ b::Element(e::Situational, "Country Subdivision Code")),
2253
+ b::Segment(320, s::DMG, "Subscriber Demographic Information", r::Situational, d::RepeatCount.bounded(1),
2254
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8")),
2255
+ b::Element(e::Required, "Subscriber Birth Date"),
2256
+ b::Element(e::Required, "Subscriber Gender Code", b::Values("F", "M", "U")),
2257
+ b::Element(e::NotUsed, "Marital Status Code"),
2258
+ b::Element(e::NotUsed, "COMPOSITE RACE OR ETHNICITY INFORMATION"),
2259
+ b::Element(e::NotUsed, "Citizenship Status Code"),
2260
+ b::Element(e::NotUsed, "Country Code"),
2261
+ b::Element(e::NotUsed, "Basis of Verification Code"),
2262
+ b::Element(e::NotUsed, "Quantity"),
2263
+ b::Element(e::NotUsed, "Code List Qualifier Code"),
2264
+ b::Element(e::NotUsed, "Industry Code")),
2265
+ b::Segment(350, s::REF, "Subscriber Secondary Identification", r::Situational, d::RepeatCount.bounded(1),
2266
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("SY")),
2267
+ b::Element(e::Required, "Subscriber Supplemental Identifier"),
2268
+ b::Element(e::NotUsed, "Description"),
2269
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
2270
+ b::Segment(350, s::REF, "Property and Casualty Claim Number", r::Situational, d::RepeatCount.bounded(1),
2271
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("Y4")),
2272
+ b::Element(e::Required, "Property Casualty Claim Number"),
2273
+ b::Element(e::NotUsed, "Description"),
2274
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER"))),
2275
+
2276
+ d::LoopDef.build("2010BB PAYER NAME", d::RepeatCount.bounded(10),
2277
+ b::Segment(150, s::NM1, "Payer Name", r::Required, d::RepeatCount.bounded(1),
2278
+ b::Element(e::Required, "Entity Identifier Code", b::Values("PR")),
2279
+ b::Element(e::Required, "Entity Type Qualifier", b::Values("2")),
2280
+ b::Element(e::Required, "Payer Name"),
2281
+ b::Element(e::NotUsed, "Name First"),
2282
+ b::Element(e::NotUsed, "Name Middle"),
2283
+ b::Element(e::NotUsed, "Name Prefix"),
2284
+ b::Element(e::NotUsed, "Name Suffix"),
2285
+ b::Element(e::Required, "Identification Code Qualifier", b::Values("PI", "XV")),
2286
+ b::Element(e::Required, "Payer Identifier"),
2287
+ b::Element(e::NotUsed, "Entity Relationship Code"),
2288
+ b::Element(e::NotUsed, "Entity Identifier Code"),
2289
+ b::Element(e::NotUsed, "Name Last or Organization Name")),
2290
+ b::Segment(250, s::N3, "Payer Address", r::Situational, d::RepeatCount.bounded(1),
2291
+ b::Element(e::Required, "Payer Address Line"),
2292
+ b::Element(e::Situational, "Payer Address Line")),
2293
+ b::Segment(300, s::N4, "Payer City, State, ZIP Code", r::Situational, d::RepeatCount.bounded(1),
2294
+ b::Element(e::Required, "Payer City Name"),
2295
+ b::Element(e::Situational, "Payer State Code"),
2296
+ b::Element(e::Situational, "Payer Postal Zone or ZIP Code"),
2297
+ b::Element(e::Situational, "Country Code"),
2298
+ b::Element(e::NotUsed, "Location Qualifier"),
2299
+ b::Element(e::NotUsed, "Location Identifier"),
2300
+ b::Element(e::Situational, "Country Subdivision Code")),
2301
+ b::Segment(350, s::REF, "Payer Secondary Identification", r::Situational, d::RepeatCount.bounded(3),
2302
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("2U", "EI", "FY", "NF")),
2303
+ b::Element(e::Required, "Payer Additional Identifier"),
2304
+ b::Element(e::NotUsed, "Description"),
2305
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
2306
+ b::Segment(350, s::REF, "Billing Provider Secondary Identification", r::Situational, d::RepeatCount.bounded(1),
2307
+ b::Element(e::Required, "Reference Identification Qualifier", b::Values("G2", "LU")),
2308
+ b::Element(e::Required, "Billing Provider Secondary Identifier"),
2309
+ b::Element(e::NotUsed, "Description"),
2310
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER"))),
2311
+
2312
+ loop2300)),
2313
+
2314
+ d::TableDef.detail("2 - Patient Detail",
2315
+ d::LoopDef.build("2000C PATIENT HIERARCHICAL LEVEL", d::RepeatCount.unbounded,
2316
+ b::Segment(10, s::HL, "Patient Hierachical Level", r::Situational, d::RepeatCount.bounded(1),
2317
+ b::Element(e::Required, "Hierarchical ID Number"),
2318
+ b::Element(e::Required, "Hierarchical Parent ID Number"),
2319
+ b::Element(e::Required, "Hierarchical Level Code", b::Values("23")),
2320
+ b::Element(e::Required, "Hierarchical Child Code", b::Values("0"))),
2321
+ b::Segment(70, s::PAT, "Patient Information", r::Required, d::RepeatCount.bounded(1),
2322
+ b::Element(e::Required, "Individual Relationship Code", b::Values("01", "19", "20", "21", "39", "40", "53", "G8")),
2323
+ b::Element(e::NotUsed, "Patient Location Code"),
2324
+ b::Element(e::NotUsed, "Employment Status Code"),
2325
+ b::Element(e::NotUsed, "Student Status Code"),
2326
+ b::Element(e::NotUsed, "Date Time Period Format Qualifier"),
2327
+ b::Element(e::NotUsed, "Date Time Period"),
2328
+ b::Element(e::NotUsed, "Unit Basis for Measurement Code"),
2329
+ b::Element(e::NotUsed, "Weight"),
2330
+ b::Element(e::NotUsed, "Yes/No Condition or Response Code")),
2331
+
2332
+ d::LoopDef.build("2010CA PATIENT NAME", d::RepeatCount.bounded(1),
2333
+ b::Segment(150, s::NM1, "Patient Name", r::Required, d::RepeatCount.bounded(1),
2334
+ b::Element(e::Required, "Entity Qualifier Code", b::Values("QC")),
2335
+ b::Element(e::Required, "Entity Type Qualifier", b::Values("1")),
2336
+ b::Element(e::Required, "Patient Last Name"),
2337
+ b::Element(e::Situational, "Patient First Name"),
2338
+ b::Element(e::Situational, "Patient Middle Name or Initial"),
2339
+ b::Element(e::NotUsed, "Name Prefix"),
2340
+ b::Element(e::Situational, "Patient Name Suffix"),
2341
+ b::Element(e::NotUsed, "Identification Code Qualifier"),
2342
+ b::Element(e::NotUsed, "Identification Code"),
2343
+ b::Element(e::NotUsed, "Entity Relationship Code"),
2344
+ b::Element(e::NotUsed, "Entity Identifier Code"),
2345
+ b::Element(e::NotUsed, "Name Last or Organization Name")),
2346
+ b::Segment(250, s::N3, "Patient Address", r::Required, d::RepeatCount.bounded(1),
2347
+ b::Element(e::Required, "Patient Address Line"),
2348
+ b::Element(e::Situational, "Patient Address Line")),
2349
+ b::Segment(300, s::N4, "Patient City, State, ZIP Code", r::Required, d::RepeatCount.bounded(1),
2350
+ b::Element(e::Required, "Patient City Name"),
2351
+ b::Element(e::Situational, "Patient State Code"),
2352
+ b::Element(e::Situational, "Patient Postal Zone or ZIP Code"),
2353
+ b::Element(e::Situational, "Country Code"),
2354
+ b::Element(e::NotUsed, "Location Qualifier"),
2355
+ b::Element(e::NotUsed, "Location Identifier"),
2356
+ b::Element(e::Situational, "Country Subdivision Code")),
2357
+ b::Segment(320, s::DMG, "Patient Demographic Information", r::Required, d::RepeatCount.bounded(1),
2358
+ b::Element(e::Required, "Date Time Period Format Qualifier", b::Values("D8")),
2359
+ b::Element(e::Required, "Patient Birth Date"),
2360
+ b::Element(e::Required, "Patient Gender Code", b::Values("F", "M", "U")),
2361
+ b::Element(e::NotUsed, "Marital Status Code"),
2362
+ b::Element(e::NotUsed, "COMPOSITE RACE OR ETHNICITY INFORMATION"),
2363
+ b::Element(e::NotUsed, "Citizenship Status Code"),
2364
+ b::Element(e::NotUsed, "Country Code"),
2365
+ b::Element(e::NotUsed, "Basis of Verification Code"),
2366
+ b::Element(e::NotUsed, "Quantity"),
2367
+ b::Element(e::NotUsed, "Code List Qualifier Code"),
2368
+ b::Element(e::NotUsed, "Industry Code")),
2369
+ b::Segment(350, s::REF, "Property and Casualty Claim Number", r::Situational, d::RepeatCount.bounded(1),
2370
+ b::Element(e::Required, "Reference Identifier Qualifier", b::Values("Y4")),
2371
+ b::Element(e::Required, "Property Casualty Claim Number"),
2372
+ b::Element(e::NotUsed, "Description"),
2373
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER")),
2374
+ b::Segment(350, s::REF, "Property and Casualty Patient Identifier", r::Situational, d::RepeatCount.bounded(1),
2375
+ b::Element(e::Required, "Reference Identifier Qualifier", b::Values("1W", "SY")),
2376
+ b::Element(e::Required, "Property Casualty Claim Number"),
2377
+ b::Element(e::NotUsed, "Description"),
2378
+ b::Element(e::NotUsed, "REFERENCE IDENTIFIER"))),
2379
+
2380
+ loop2300)),
2381
+
2382
+ d::TableDef.summary("3 - Summary",
2383
+ b::Segment(5550, s::SE, "Transaction Set Trailer", r::Required, d::RepeatCount.bounded(1),
2384
+ b::Element(e::Required, "Transaction Segment Count"),
2385
+ b::Element(e::Required, "Transaction Set Control Number"))))
2386
+ end
2387
+ end
2388
+ end
2389
+ end
2390
+ end