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Updated:05/16/2008

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PRV
Provider Information .
Pos: 090 Max: 1
Detail - Optional
Loop: 2100D Elements: 3
.

To specify the identifying characteristics of a provider

Element Summary:

           
 _Ref_Id_________Element Name__________ReqTypeMin/Max  
 PRV011221Provider CodeMID1/3  
   Description: Code identifying the type of provider
    CodeName_______________________________
   HHospital
   RRural Health Clinic
   ADAdmitting
   ATAttending
   BIBilling
   COConsulting
   CVCovering
   HHHome Health Care
   LALaboratory
   OTOther Physician
   P1Pharmacist
   P2Pharmacy
   PCPrimary Care Physician
   PEPerforming
   RFReferring
   SBSubmitting
   SKSkilled Nursing Facility
   SUSupervising
 PRV02128Reference Identification QualifierMID2/3  
   Description: Code qualifying the Reference Identification
    CodeName_______________________________
   9KServicer
   D3National Association of Boards of Pharmacy Number
   EIEmployer's Identification Number
   SYSocial Security Number
   TJFederal Taxpayer's Identification Number
   ZZMutually Defined
   HPIHealth Care Financing Administration National Provider Identifier
 PRV03127Reference IdentificationMAN1/30  
   Description: Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier


Transaction Set

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Copyright © 1996-2008  Management Systems Consulting, Inc.
Last modified: May 16, 2008