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*********************** Updated:05/16/2008 Copyright © 1996-2008 Management Systems Consulting, Inc. | | | REF | ![]() | | Rendering Provider Identification | . | | Pos: 040 | Max: 10 | | Detail - Optional | | Loop: 2100 | Elements: 2 | |
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To specify identifying information Element Summary: | | | | | | | | | | | | | | _Ref_ | Id | _________Element Name__________ | Req | Type | Min/Max | | | | | REF01 | 128 | Reference Identification Qualifier | M | ID | 2/3 | | | | | | | Description: Code qualifying the Reference Identification | | | | | | Code | Name_______________________________ | | | | | | 1A | Blue Cross Provider Number | | | | | | 1B | Blue Shield Provider Number | | | | | | 1C | Medicare Provider Number | | | | | | 1D | Medicaid Provider Number | | | | | | 1G | Provider UPIN Number | | | | | | 1H | CHAMPUS Identification Number | | | | | | D3 | National Association of Boards of Pharmacy Number | | | | | | G2 | Provider Commercial Number | | | | | | | Description: A unique number assigned to a provider by a commercial insurer | | | REF02 | 127 | Reference Identification | C | AN | 1/30 | | | | | | | Description: Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier |
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