Segment Modifiers:
X - Distinguishing Identifier Suffix
nn - Segment Iteration (only after first iterartion)
nn - Element Repeat Iteration (only after first iterartion)

GSHDR - GROUP HEADER

GSHDR	GS	Functional Group Header
02		GSHDR_GS02_APP_SNDR_CD	String	Application Senders Code
03		GSHDR_GS03_APP_RCV_CD	String	Application Receivers Code
04		GSHDR_GS04_D8	Date/Time	Date
05		GSHDR_GS05_TM	Time	Time
06		GSHDR_GS06_GCN	Integer	Group Control Number

STHDR - TRANSACTION SET HEADER

STHDR	ST	Transaction Set Header
02		STHDR_ST02_TCN	String	Transaction Set Control Number
03		STHDR_ST03_IMP_CONV_REF_ID	String	Implementation Convention Reference Identifier

STHDR	BGN	Beginning Segment
02		STHDR_BGN02_TS_ID_CD	String	Transaction Set Identifier Code
03		STHDR_BGN03_TS_CRTN_D8	Date/Time	Transaction Set Creation Date
04		STHDR_BGN04_TS_CRTN_TM	Time	Transaction Set Creation Time
06		STHDR_BGN06_REF_ICN	String	Referenced Interchange Control Number
08		STHDR_BGN08_ACTN_CD	String	Action Code

L1000A - SUBMITTER NAME

L1000A	N1	Submitter Name
02		L1000A_N102_SBM_NM	String	Submitter Name
04		L1000A_N104_DUNS_NR	String	D-U-N-S Number, Dun and Bradstreet
04		L1000A_N104_DUNS4_NR	String	D-U-N-S+4, D-U-N-S Number with Four Character Suffix
04		L1000A_N104_EMPLR_ID_NR	String	Employers Identification Number
04		L1000A_N104_ETIN	String	Electronic Transmitter Identification Number (ETIN)
04		L1000A_N104_STAT_ASGND_NR	String	State or Province Assigned Number
04		L1000A_N104_INS_ASGND_ID	String	Insurance Company Assigned Identification Number
04		L1000A_N104_TAX_ID	String	Federal Taxpayers Identification Number
04		L1000A_N104_PAYR_ID	String	Payor Identification
04		L1000A_N104_MDCR_MDCD_PLANID	String	Centers for Medicare and Medicaid Services Plan ID
04		L1000A_N104_NPI	String	Centers for Medicare and Medicaid Services National Provider Identifier

L1000A	REF	Submitter Secondary Identifier
02		L1000A_REF_BRNCH_ID	String	Branch Identifier

L1000A	PER	Submitter EDI Contact Information	Iterated: [01-02]
02		L1000A_nnPER02_SBM_CON_NM	String	Submitter Contact Name
04		L1000A_nnPER04_EMAIL	String	Electronic Mail
04		L1000A_nnPER04_FAX	String	Facsimile
04		L1000A_nnPER04_PHN_NR	String	Telephone
06		L1000A_nnPER06_EMAIL	String	Electronic Mail
06		L1000A_nnPER06_PHN_EXT	String	Telephone Extension
06		L1000A_nnPER06_FAX	String	Facsimile
06		L1000A_nnPER06_PHN_NR	String	Telephone
08		L1000A_nnPER08_EMAIL	String	Electronic Mail
08		L1000A_nnPER08_PHN_EXT	String	Telephone Extension
08		L1000A_nnPER08_FAX	String	Facsimile
08		L1000A_nnPER08_PHN_NR	String	Telephone

L1000B - RECEIVER NAME

L1000B	N1	Receiver Name
02		L1000B_N102_RCV_NM	String	Reciever Name
04		L1000B_N104_DUNS_NR	String	D-U-N-S Number, Dun and Bradstreet
04		L1000B_N104_DUNS4_NR	String	D-U-N-S+4, D-U-N-S Number with Four Character Suffix
04		L1000B_N104_EMPLR_ID_NR	String	Employers Identification Number
04		L1000B_N104_ETIN	String	Electronic Transmitter Identification Number (ETIN)
04		L1000B_N104_STAT_ASGND_NR	String	State or Province Assigned Number
04		L1000B_N104_INS_ASGND_ID	String	Insurance Company Assigned Identification Number
04		L1000B_N104_TAX_ID	String	Federal Taxpayers Identification Number
04		L1000B_N104_PAYR_ID	String	Payor Identification
04		L1000B_N104_MDCR_MDCD_PLANID	String	Centers for Medicare and Medicaid Services Plan ID
04		L1000B_N104_NPI	String	Centers for Medicare and Medicaid Services National Provider Identifier

L2000 - ORIGINAL TRANSACTION IDENTIFICATION

L2000	OTI	Original Transaction Identification
01		L2000_OTI01_APP_ACK_CD	String	Application Acknowledgment Code
03		L2000_OTI03_BATCH_NR	String	Batch Number
03		L2000_OTI03_ITM_NR	String	Item Number
03		L2000_OTI03_TRAN_REF_NR	String	Transaction Reference Number
06		L2000_OTI06_FUNC_GRP_CRTN_D8	Date/Time	Functional Group Creation Date
07		L2000_OTI07_FUNC_GRP_CRTN_TM	Time	Functional Group Creation Time
08		L2000_OTI08_FUNC_GRP_CTL_NR	Integer	Functional Group Control Number
09		L2000_OTI09_TCN	String	Transaction Set Control Number
10		L2000_OTI10_TS_ID_CD	String	Transaction Set Identifier Code
11		L2000_OTI11_VERS_RLS_IND_ID	String	Version Release Industry Identifier

L2000	REF	Exchange Report Document Control Number	Iterated: [01-99]
02		L2000_nnREF_SYS_NR	String	System Number
02		L2000_nnREF_STAT_LIC_NR	String	State License Number
02		L2000_nnREF_SUB_NR	String	Subscriber Number
02		L2000_nnREF_MORTG_ID	String	Mortgage Identification Number
02		L2000_nnREF_ACCT_NR	String	Account Number
02		L2000_nnREF_MSTR_ACCT_NR	String	Master Account Number
02		L2000_nnREF_CLT_RPT_CAT	String	Client Reporting Category
02		L2000_nnREF_PLAN_NR	String	Plan Number
02		L2000_nnREF_BLCS_PVR_NR	String	Blue Cross Provider Number
02		L2000_nnREF_BLSH_PROV_NR	String	Blue Shield Provider Number
02		L2000_nnREF_MDCR_PVR_NR	String	Medicare Provider Number
02		L2000_nnREF_MDCD_PVR_NR	String	Medicaid Provider Number
02		L2000_nnREF_DENT_LIC_NR	String	Dentist License Number
02		L2000_nnREF_ANAS_LIC_NR	String	Anesthesia License Number
02		L2000_nnREF_UPIN	String	Provider UPIN Number
02		L2000_nnREF_CHAMPUS_ID	String	CHAMPUS Identification Number
02		L2000_nnREF_FAC_ID	String	Facility ID Number
02		L2000_nnREF_PYR_CLM_NR	String	Payors Claim Number
02		L2000_nnREF_GRP_POLCY_NR	String	Group or Policy Number
02		L2000_nnREF_APG_NR	String	Ambulatory Patient Group (APG) Number
02		L2000_nnREF_MEM_ID	String	Member Identification Number
02		L2000_nnREF_CLNT_NR	String	Client Number
02		L2000_nnREF_EMPLE_ID_NR	String	Employee Identification Number
02		L2000_nnREF_INVC_NR	String	Consolidated Invoice Number
02		L2000_nnREF_TRCK_NR	String	Tracking Number
02		L2000_nnREF_PYR_ID	String	Payer Identification Number
02		L2000_nnREF_LNDR_CS_NR	String	Lender Case Number
02		L2000_nnREF_MSTR_PLCY_NR	String	Master Policy Number
02		L2000_nnREF_CASE_NR	String	Case Number
02		L2000_nnREF_OFFC_NR	String	Office Number
02		L2000_nnREF_FAM_UNT_NR	String	Family Unit Number
02		L2000_nnREF_PIN	String	Personal Identification Number
02		L2000_nnREF_SP_PMT_REF_NR	String	Special Payment Reference Number
02		L2000_nnREF_COMPLNT	String	Complaint
02		L2000_nnREF_INCDNT	String	Incident
02		L2000_nnREF_ACCT_SFX	String	Account Suffix Code
02		L2000_nnREF_CLMNT_NR	String	Claimant Number
02		L2000_nnREF_GRP_NR	String	Group Number
02		L2000_nnREF_PRV_CTL_NR	String	Provider Control Number
02		L2000_nnREF_SCH_REF_NR	String	Schedule Reference Number
02		L2000_nnREF_SUB_AUTH_NR	String	Subscriber Authorization Number
02		L2000_nnREF_LST_MTL	String	List of Materials
02		L2000_nnREF_FUNC_CAT	String	Functional Category
02		L2000_nnREF_ASSEM_NR	String	Assembly Number
02		L2000_nnREF_BNK_SEC_ID	String	Bank Assigned Security Identifier
02		L2000_nnREF_TRNS_CAT	String	Transaction Category or Type
02		L2000_nnREF_FILE_ID_NR	String	File Identification Number
02		L2000_nnREF_REP_CLM_ID	String	Repriced Claim Reference Number
02		L2000_nnREF_REP_LIN_ITM	String	Repriced Line Item Reference Number
02		L2000_nnREF_ADJ_REP_CLM_ID	String	Adjusted Repriced Claim Reference Number
02		L2000_nnREF_ADJ_REP_LIN_ITM	String	Adjusted Repriced Line Item Reference Number
02		L2000_nnREF_SERVCR	String	Servicer
02		L2000_nnREF_INVSTR	String	Investor
02		L2000_nnREF_JOB_NR	String	Job Order Number
02		L2000_nnREF_HLTH_INS_ACCT	String	Health Insurance Account Number
02		L2000_nnREF_AGNT_NR	String	Agent Number
02		L2000_nnREF_ACC_SRC_PRC_ID	String	Acceptable Source Purchaser ID
02		L2000_nnREF_MSTR_PROP_NR	String	Master Property Number
02		L2000_nnREF_HLTH_INS_PLCY	String	Health Insurance Policy Number
02		L2000_nnREF_PPO_NR	String	Preferred Provider Organization Number
02		L2000_nnREF_LIF_INS_PLCY	String	Life Insurance Policy Number
02		L2000_nnREF_RET_PLN_PLCY	String	Retirement Plan Policy Number
02		L2000_nnREF_AUTH_NR	String	Authorization Number
02		L2000_nnREF_BILL_TYP	String	Billing Type
02		L2000_nnREF_HMO_CD_NR	String	Health Maintenance Organization Code Number
02		L2000_nnREF_SALS_OFC_NR	String	Broker or Sales Office Number
02		L2000_nnREF_BATCH_NR	String	Batch Number
02		L2000_nnREF_CLSS_CONT	String	Class of Contract Code
02		L2000_nnREF_CHK_NR	String	Check Number
02		L2000_nnREF_CASLT_REP_NR	String	Casualty Report Number
02		L2000_nnREF_CNTRCT_NR	String	Contract Number
02		L2000_nnREF_NABP_NR	String	National Council for Prescription Drug Programs Pharmacy Number
02		L2000_nnREF_LOSS_REP_NR	String	Loss Report Number
02		L2000_nnREF_CLM_NR	String	Claim Number
02		L2000_nnREF_DOC_ID_CD	String	Document Identification Code
02		L2000_nnREF_DEPT_AGCY_NR	String	Department/Agency Number
02		L2000_nnREF_CLMT_CLM_NR	String	Claimants Claim Number
02		L2000_nnREF_ATTCH_CD	String	Attachment Code
02		L2000_nnREF_MED_REC_ID	String	Medical Record Identification Number
02		L2000_nnREF_EMPLR_ID_NR	String	Employers Identification Number
02		L2000_nnREF_PATNT_ACCT_NR	String	Patient Account Number
02		L2000_nnREF_ELEC_PIN	String	Electronic device pin number
02		L2000_nnREF_ELEC_PMT_REF_NR	String	Electronic Payment Reference Number
02		L2000_nnREF_SUB_ID_NR	String	Submitter Identification Number
02		L2000_nnREF_REC_ID_NR	String	Receiver Identification Number
02		L2000_nnREF_MAMM_CERT	String	Mammography Certification Number
02		L2000_nnREF_VERS_CD	String	Version Code - Local
02		L2000_nnREF_FAC_CERT_ID	String	Facility Certification Number
02		L2000_nnREF_MDCR_VRS_CD	String	Medicare Version Code
02		L2000_nnREF_HIC_NR	String	Health Insurance Claim (HIC) Number
02		L2000_nnREF_ORIG_REF_NR	String	Original Reference Number
02		L2000_nnREF_CLINC_NR	String	Clinic Number
02		L2000_nnREF_FILE_ID	String	File Identifier
02		L2000_nnREF_LIN_ITM	String	Line Item Control Number
02		L2000_nnREF_CLM_OFC_NR	String	Claim Office Number
02		L2000_nnREF_PRIOR_AUTH	String	Prior Authorization Number
02		L2000_nnREF_PVR_COMM_NR	String	Provider Commercial Number
02		L2000_nnREF_PREF_BEN_ID_NR	String	Predetermination of Benefits Identification Number
02		L2000_nnREF_PPO_APPR_NR	String	Peer Review Organization (PRO) Approval Number
02		L2000_nnREF_PVR_SIT_NR	String	Provider Site Number
02		L2000_nnREF_HIN	String	Health Industry Number (HIN)
02		L2000_nnREF_ID_CRD_NR	String	Identity Card Number
02		L2000_nnREF_MDCR_MDCD	String	Centers for Medicare and Medicaid Services National Provider Identifier
02		L2000_nnREF_ISSU_NR	String	Issue Number
02		L2000_nnREF_INS_PLCY_NR	String	Insurance Policy Number
02		L2000_nnREF_SIC_CD	String	Standard Industry Classification (SIC) Code
02		L2000_nnREF_INSP_RPT_NR	String	Inspection Report Number
02		L2000_nnREF_ITM_NR	String	Item Number
02		L2000_nnREF_USER_ID	String	User Identification
02		L2000_nnREF_CERT	String	Certification
02		L2000_nnREF_LEAS_NR	String	Lease Number
02		L2000_nnREF_LOAN_NR	String	Loan Number
02		L2000_nnREF_LOC_NR	String	Location Number
02		L2000_nnREF_QUAL_PRD_LST	String	Qualified Products List
02		L2000_nnREF_LNDR_ACCT_NR	String	Lender Account Number
02		L2000_nnREF_MSG_ADD	String	Message Address or ID
02		L2000_nnREF_PRV_PLN_ID	String	Provider Plan Network Identification Number
02		L2000_nnREF_PLN_NET_ID	String	Plan Network Identification Number
02		L2000_nnREF_FAC_NET_ID	String	Facility Network Identification Number
02		L2000_nnREF_NAIC	String	National Association of Insurance Commissioners (NAIC) Code
02		L2000_nnREF_MDCD_ID_NR	String	Medicaid Recipient Identification Number
02		L2000_nnREF_PROD_NR	String	Product Number
02		L2000_nnREF_PROJCT_CD	String	Project Code
02		L2000_nnREF_PROD_GRP	String	Product Group
02		L2000_nnREF_PART_NR	String	Part Number
02		L2000_nnREF_POLCY_NR	String	Policy Number
02		L2000_nnREF_PAYEE_ID	String	Payee Identification
02		L2000_nnREF_PRIOR_ID	String	Prior Identifier Number
02		L2000_nnREF_PROP_CAS_NR	String	Property Control Number
02		L2000_nnREF_UNIT_NR	String	Unit Number
02		L2000_nnREF_RAT_CD_NR	String	Rate code number
02		L2000_nnREF_SPEC_NR	String	Specification Number
02		L2000_nnREF_STORE_NR	String	Store Number
02		L2000_nnREF_SSN	String	Social Security Number
02		L2000_nnREF_SIGNL_CD	String	Signal Code
02		L2000_nnREF_AFF_SUB_CD	String	Affected Subsystem Code
02		L2000_nnREF_TAX_ID	String	Federal Taxpayers Identification Number
02		L2000_nnREF_TRAN_REF_NR	String	Transaction Reference Number
02		L2000_nnREF_TERMNL_CD	String	Terminal Code
02		L2000_nnREF_TAX_XMPT_NR	String	Tax Exempt Number
02		L2000_nnREF_USIN	String	Unique Supplier Identification Number (USIN)
02		L2000_nnREF_MORTG_NR	String	Mortgage Number
02		L2000_nnREF_VOLM_NR	String	Volume Number
02		L2000_nnREF_VENDR_ABB_CD	String	Vendor Abbreviation Code
02		L2000_nnREF_VENDR_PROD_NR	String	Vendor Product Number
02		L2000_nnREF_VENDR_ID	String	Vendor ID Number
02		L2000_nnREF_MTR_VEH_ID	String	Motor Vehicle ID Number
02		L2000_nnREF_VESSEL	String	Vessel
02		L2000_nnREF_PROV_CLM_NR	String	Provider Claim Number
02		L2000_nnREF_LAB_IMP_AMD	String	Clinical Laboratory Improvement Amendment Number
02		L2000_nnREF_SIA_PRV_NR	String	State Industrial Accident Provider Number
02		L2000_nnREF_AGNCY_CLM_NR	String	Agency Claim Number
02		L2000_nnREF_FED_HS_CS_NR	String	Federal Housing Administration Case Number
02		L2000_nnREF_VET_CS_NR	String	Veterans Affairs Case Number
02		L2000_nnREF_CRR_AS_REF_NR	String	Carrier Assigned Reference Number
02		L2000_nnREF_SOFT_APP_NR	String	Software Application Number
02		L2000_nnREF_MUTLY_DEF	String	Mutually Defined

L2000	DTM	Date Time Reference
02		L2000_DTM02_INVC_D8	Date Timestamp	Invoice
02		L2000_DTM02_EFF_D8	Date Timestamp	Effective
02		L2000_DTM02_PRCS_D8	Date Timestamp	Process
02		L2000_DTM02_SHPD_D8	Date Timestamp	Shipped
02		L2000_DTM02_EST_DELVY_D8	Date Timestamp	Estimated Delivery
02		L2000_DTM02_DELVD_D8	Date Timestamp	Delivered
02		L2000_DTM02_EXP_D8	Date Timestamp	Expiration
02		L2000_DTM02_RCVD_D8	Date Timestamp	Received
02		L2000_DTM02_INQURY_D8	Date Timestamp	Inquiry
02		L2000_DTM02_RPT_STRT_D8	Date Timestamp	Report Start
02		L2000_DTM02_RPT_END_D8	Date Timestamp	Report End
02		L2000_DTM02_DISCHG_D8	Date Timestamp	Discharge
02		L2000_DTM02_TS_CREATN_D8	Date Timestamp	Transaction Creation
02		L2000_DTM02_ISSU_D8	Date Timestamp	Issue
02		L2000_DTM02_TST_PERF_D8	Date Timestamp	Test Performed
02		L2000_DTM02_LOSS_D8	Date Timestamp	Loss
02		L2000_DTM02_SVC_PER_STRT_D8	Date Timestamp	Service Period Start
02		L2000_DTM02_SVC_PER_END_D8	Date Timestamp	Service Period End
02		L2000_DTM02_INVC_PER_STRT_D8	Date Timestamp	Invoice Period Start
02		L2000_DTM02_INVC_PER_END_D8	Date Timestamp	Invoice Period End
02		L2000_DTM02_PRD_STRT_D8	Date Timestamp	Period Start
02		L2000_DTM02_PRD_END_D8	Date Timestamp	Period End
02		L2000_DTM02_CMPLTN_D8	Date Timestamp	Completion
02		L2000_DTM02_LEAS_TERM_STRT_D8	Date Timestamp	Lease Term Start
02		L2000_DTM02_LEAS_TERM_END_D8	Date Timestamp	Lease Term End
02		L2000_DTM02_CLM_PRD_STRT_D8	Date Timestamp	Claim Statement Period Start
02		L2000_DTM02_CLM_PRD_END_D8	Date Timestamp	Claim Statement Period End
02		L2000_DTM02_ACTL_STRT_D8	Date Timestamp	Actual Start
02		L2000_DTM02_EST_COMPLTN_D8	Date Timestamp	Estimated Completion
02		L2000_DTM02_EMP_OR_HIRE_D8	Date Timestamp	Employment or Hire
02		L2000_DTM02_RETRMNT_D8	Date Timestamp	Retirement
02		L2000_DTM02_DIS_RET_WRK_D8	Date Timestamp	Initial Disability Period Return To Work
02		L2000_DTM02_INI_DISB_LSTWRK_D8	Date Timestamp	Initial Disability Period Last Day Worked
02		L2000_DTM02_ENRL_SIG_D8	Date Timestamp	Enrollment Signature Date
02		L2000_DTM02_COBRA_EVNT_D8	Date Timestamp	Consolidated Omnibus Budget Reconciliation Act (COBRA) Qualifying Event
02		L2000_DTM02_MNT_EFF_D8	Date Timestamp	Maintenance Effective
02		L2000_DTM02_LAST_VST_D8	Date Timestamp	Latest Visit or Consultation
02		L2000_DTM02_ELIG_D8	Date Timestamp	Eligibility
02		L2000_DTM02_CLOSNG_DT_D8	Date Timestamp	Date of Closing
02		L2000_DTM02_CYCL_D8	Date Timestamp	Cycle
02		L2000_DTM02_REFRL_DT_D8	Date Timestamp	Referral Date
02		L2000_DTM02_EMP_BGN_D8	Date Timestamp	Employment Begin
02		L2000_DTM02_EMP_END_D8	Date Timestamp	Employment End
02		L2000_DTM02_MDCR_BGN_D8	Date Timestamp	Medicare Begin
02		L2000_DTM02_MDCR_END_D8	Date Timestamp	Medicare End
02		L2000_DTM02_COBRA_BEGN_D8	Date Timestamp	Consolidated Omnibus Budget Reconciliation Act (COBRA) Begin
02		L2000_DTM02_COBRA_END_D8	Date Timestamp	Consolidated Omnibus Budget Reconciliation Act (COBRA) End
02		L2000_DTM02_COBRA_BGN_D8	Date Timestamp	Coordination of Benefits Begin
02		L2000_DTM02_COB_END_D8	Date Timestamp	Coordination of Benefits End
02		L2000_DTM02_BNFT_BGN_D8	Date Timestamp	Benefit Begin
02		L2000_DTM02_BNFT_END_D8	Date Timestamp	Benefit End
02		L2000_DTM02_EDU_BGN_D8	Date Timestamp	Education Begin
02		L2000_DTM02_EDU_END_D8	Date Timestamp	Education End
02		L2000_DTM02_ELIG_BGN_D8	Date Timestamp	Eligibility Begin
02		L2000_DTM02_ELIG_END_D8	Date Timestamp	Eligibility End
02		L2000_DTM02_INI_DISBTY_STRT_D8	Date Timestamp	Initial Disability Period Start
02		L2000_DTM02_INI_DISBTY_END_D8	Date Timestamp	Initial Disability Period End
02		L2000_DTM02_ACTL_DEPT_DT_D8	Date Timestamp	Actual Departure Date
02		L2000_DTM02_ACTL_ARVL_DT_D8	Date Timestamp	Actual Arrival Date
02		L2000_DTM02_ADJ_HIR_D8	Date Timestamp	Adjusted Hire
02		L2000_DTM02_PMT_CMM_D8	Date Timestamp	Payment Commencement
02		L2000_DTM02_PLN_SUSP_D8	Date Timestamp	Plan Participation Suspension
02		L2000_DTM02_REHR_D8	Date Timestamp	Rehire
02		L2000_DTM02_PRODCTN_D8	Date Timestamp	Production
02		L2000_DTM02_CURR_SYMPTM_D8	Date Timestamp	Onset of Current Symptoms or Illness
02		L2000_DTM02_STMNT_D8	Date Timestamp	Statement
02		L2000_DTM02_ADMSN_D8	Date Timestamp	Admission
02		L2000_DTM02_SIML_SYMPTM_D8	Date Timestamp	Onset of Similar Symptoms or Illness
02		L2000_DTM02_ACCDNT_D8	Date Timestamp	Accident
02		L2000_DTM02_PRIOR_PCMT_D8	Date Timestamp	Prior Placement
02		L2000_DTM02_REPLCMT_D8	Date Timestamp	Replacement
02		L2000_DTM02_APPL_PLCMT_D8	Date Timestamp	Appliance Placement
02		L2000_DTM02_ACUTE_D8	Date Timestamp	Acute Manifestation of a Chronic Condition
02		L2000_DTM02_INIT_TRTMT_D8	Date Timestamp	Initial Treatment
02		L2000_DTM02_XRAY_D8	Date Timestamp	Last X-Ray
02		L2000_DTM02_SRGY_D8	Date Timestamp	Surgery
02		L2000_DTM02_LAST_CERT_D8	Date Timestamp	Last Certification
02		L2000_DTM02_BGN_THRPY_D8	Date Timestamp	Begin Therapy
02		L2000_DTM02_RX_D8	Date Timestamp	Prescription
02		L2000_DTM02_SVC_D8	Date Timestamp	Service
02		L2000_DTM02_MDCD_BGN_D8	Date Timestamp	Medicaid Begin
02		L2000_DTM02_MDCD_END_D8	Date Timestamp	Medicaid End
02		L2000_DTM02_GAS_TEST_D8	Date Timestamp	Arterial Blood Gas Test
02		L2000_DTM02_OXY_TEST_D8	Date Timestamp	Oxygen Saturation Test
02		L2000_DTM02_MENS_PERD_D8	Date Timestamp	Last Menstrual Period
02		L2000_DTM02_INJRY_BEGN_D8	Date Timestamp	Injury Begin
02		L2000_DTM02_INJRY_END_D8	Date Timestamp	Injury End
02		L2000_DTM02_INSPCTD_D8	Date Timestamp	Inspected
02		L2000_DTM02_CLM_DT_D8	Date Timestamp	Date of Claim
02		L2000_DTM02_PLCY_EFF_D8	Date Timestamp	Policy Effective
02		L2000_DTM02_PLCY_EXP_D8	Date Timestamp	Policy Expiration
02		L2000_DTM02_PRM_PD_D8	Date Timestamp	Last Premium Paid Date
02		L2000_DTM02_LOAN_DT_D8	Date Timestamp	Date of Loan
02		L2000_DTM02_DT_CLM_PD_D8	Date Timestamp	Date Claim Paid
02		L2000_DTM02_REPT_PERD_D8	Date Timestamp	Report Period
02		L2000_DTM02_CERT_RVSN_D8	Date Timestamp	Certification Revision
02		L2000_DTM02_PAID_DT_D8	Date Timestamp	Date Paid
02		L2000_DTM02_HEMOHEMA_D8	Date Timestamp	Most Recent Hemoglobin or Hematocrit or Both
02		L2000_DTM02_CREATINE_D8	Date Timestamp	Most Recent Serum Creatine
02		L2000_DTM02_POSTD_D8	Date Timestamp	Posted
02		L2000_DTM02_EXAM_D8	Date Timestamp	Examination
02		L2000_DTM02_REQST_D8	Date Timestamp	Request
02		L2000_DTM02_ORDR_D8	Date Timestamp	Order
02		L2000_DTM02_DOC_DT_D8	Date Timestamp	Document Date
02		L2000_DTM02_EST_DOB_D8	Date Timestamp	Estimated Date of Birth
02		L2000_DTM02_INCDNT_D8	Date Timestamp	Incident
02		L2000_DTM02_MUTLY_DEF_D8	Date Timestamp	Mutually Defined

L2000	AMT	Monetary Amount Information
02		L2000_AMT02_LIN_ITM_TOT	Date Timestamp	Line Item Total
02		L2000_AMT02_BATCH_TOT	Date Timestamp	Batch Total
02		L2000_AMT02_TOT_INVC_AMT	Date Timestamp	Total Invoice Amount
02		L2000_AMT02_MORTG	Date Timestamp	Mortgage
02		L2000_AMT02_NONOP_FXD_ASTS	Date Timestamp	Non-operational Fixed Assets
02		L2000_AMT02_DMGS	Date Timestamp	Damages
02		L2000_AMT02_SVC	Date Timestamp	Services
02		L2000_AMT02_SHAR_PREM_CAP	Date Timestamp	Share Premium Capital
02		L2000_AMT02_NONCVD_CHG_ACTL	Date Timestamp	Noncovered Charges - Actual
02		L2000_AMT02_ALLOCTD	Date Timestamp	Allocated
02		L2000_AMT02_APPRVD_AMT	Date Timestamp	Approved Amount
02		L2000_AMT02_COVG_AMT	Date Timestamp	Coverage Amount
02		L2000_AMT02_BENE_AMT	Date Timestamp	Benefit Amount
02		L2000_AMT02_ALLWD_ACTL	Date Timestamp	Allowed - Actual
02		L2000_AMT02_DED_EST	Date Timestamp	Deductible - Estimated
02		L2000_AMT02_COINS_ACTL	Date Timestamp	Co-insurance - Actual
02		L2000_AMT02_ADJ	Date Timestamp	Adjustments
02		L2000_AMT02_ADJ_INSRD_LSS_AMT	Date Timestamp	Adjusted Insured Loss Amount
02		L2000_AMT02_COPAY_AMT	Date Timestamp	Co-Payment Amount
02		L2000_AMT02_CLM_AMT_DUE_EST	Date Timestamp	Claim Amount Due - Estimated
02		L2000_AMT02_SUMM_AMT	Date Timestamp	Summary Amount
02		L2000_AMT02_FUNDS_HELD_INSRD	Date Timestamp	Funds Held for Insured
02		L2000_AMT02_PAYR_AMT_PD	Date Timestamp	Payor Amount Paid
02		L2000_AMT02_DED_AMT	Date Timestamp	Deductible Amount
02		L2000_AMT02_DISCT_AMT	Date Timestamp	Discount Amount
02		L2000_AMT02_DED_WAIVD	Date Timestamp	Deductible Waived
02		L2000_AMT02_PER_DAY_LIM	Date Timestamp	Per Day Limit
02		L2000_AMT02_PAT_RESP_ACTL	Date Timestamp	Patient Responsibility - Actual
02		L2000_AMT02_PAT_RESP_EST	Date Timestamp	Patient Responsibility - Estimated
02		L2000_AMT02_POSTG_CLMD	Date Timestamp	Postage Claimed
02		L2000_AMT02_PT_AMT_PD	Date Timestamp	Patient Amount Paid
02		L2000_AMT02_SALES_TAX	Date Timestamp	Sales Tax
02		L2000_AMT02_GDS_SVCS_TAX	Date Timestamp	Goods and Services Tax
02		L2000_AMT02_TOT_CHG	Date Timestamp	Total Charge
02		L2000_AMT02_INTRST	Date Timestamp	Interest
02		L2000_AMT02_NET_PD_AMT	Date Timestamp	Net Paid Amount
02		L2000_AMT02_DDCTN_AMT	Date Timestamp	Deduction Amount
02		L2000_AMT02_MARKUP_AMT	Date Timestamp	Markup Amount
02		L2000_AMT02_MAX_AMT	Date Timestamp	Maximum Amount
02		L2000_AMT02_NET_WRTH	Date Timestamp	Net Worth
02		L2000_AMT02_MISC_TAX	Date Timestamp	Miscellaneous Taxes
02		L2000_AMT02_NET_BILL	Date Timestamp	Net Billed
02		L2000_AMT02_NEG_LEDGR_BAL	Date Timestamp	Negative Ledger Balance
02		L2000_AMT02_PREM_AMT	Date Timestamp	Premium Amount
02		L2000_AMT02_PAYOFF	Date Timestamp	Payoff
02		L2000_AMT02_PRI_INVC_TOT	Date Timestamp	Prior Gross Invoice Total
02		L2000_AMT02_SPENDOWN	Date Timestamp	Spend Down
02		L2000_AMT02_REPAIR	Date Timestamp	Repair
02		L2000_AMT02_SUPPLMTL	Date Timestamp	Supplemental
02		L2000_AMT02_TAX	Date Timestamp	Tax
02		L2000_AMT02_TOT_CLM_B4_TAX	Date Timestamp	Total Claim Before Taxes
02		L2000_AMT02_TOT_SUB_CHGS	Date Timestamp	Total Submitted Charges
02		L2000_AMT02_TOT_PMT_AMT	Date Timestamp	Total payment amount
02		L2000_AMT02_TOT_TRANS_AMT	Date Timestamp	Total Transaction Amount
02		L2000_AMT02_DENIED	Date Timestamp	Denied
02		L2000_AMT02_IN_PROCS	Date Timestamp	In Process
02		L2000_AMT02_RETRND	Date Timestamp	Returned
02		L2000_AMT02_MDCRMDCD_PMTCAT1	Date Timestamp	Federal Medicare or Medicaid Payment Mandate - Category 1
02		L2000_AMT02_MDCRMDCD_PMTCAT2	Date Timestamp	Federal Medicare or Medicaid Payment Mandate - Category 2
02		L2000_AMT02_MDCRMDCD_PMTCAT3	Date Timestamp	Federal Medicare or Medicaid Payment Mandate - Category 3
02		L2000_AMT02_MDCRMDCD_PMTCAT4	Date Timestamp	Federal Medicare or Medicaid Payment Mandate - Category 4
02		L2000_AMT02_MCRMCD_PMTCAT5	Date Timestamp	Federal Medicare or Medicaid Payment Mandate - Category 5
02		L2000_AMT02_MUTLY_DEF	Date Timestamp	Mutually Defined

L2000	QTY	Quantity Information
02		L2000_QTY02_DISCRT_QTY	Date Timestamp	Discrete Quantity
02		L2000_QTY02_CUMU_QTY	Date Timestamp	Cumulative Quantity
02		L2000_QTY02_SCRAP_ALWD	Date Timestamp	Scrap allowed
02		L2000_QTY02_SEGMT	Date Timestamp	Segments
02		L2000_QTY02_FUNC_GRP	Date Timestamp	Functional Groups
02		L2000_QTY02_TS	Date Timestamp	Transaction Sets
02		L2000_QTY02_TOT_DEBTS	Date Timestamp	Total Debits
02		L2000_QTY02_TOT_CRED	Date Timestamp	Total Credits
02		L2000_QTY02_NR_BTCHS	Date Timestamp	Number of Batches
02		L2000_QTY02_NR_CHKS	Date Timestamp	Number of Checks
02		L2000_QTY02_TOT_TRANS	Date Timestamp	Total transactions
02		L2000_QTY02_ACK_QTY	Date Timestamp	Acknowledged Quantity
02		L2000_QTY02_UNACK_QTY	Date Timestamp	Unacknowledged Quantity
02		L2000_QTY02_AGE_MOD_UN	Date Timestamp	Age Modifying Units
02		L2000_QTY02_COVD_ACTL	Date Timestamp	Covered - Actual
02		L2000_QTY02_COINS_ACTL	Date Timestamp	Co-insured - Actual
02		L2000_QTY02_USE_XTRACRP_CIRC	Date Timestamp	Use of Extracorporeal Circulation
02		L2000_QTY02_EMGNCY_MOD_UN	Date Timestamp	Emergency Modifying Units
02		L2000_QTY02_INVCS	Date Timestamp	Invoices
02		L2000_QTY02_USE_HYPOTHRM	Date Timestamp	Use of Hypothermia
02		L2000_QTY02_USE_HYPOTENS	Date Timestamp	Use of Hypotension
02		L2000_QTY02_USE_HYPRBRC	Date Timestamp	Use of Hyperbaric Pressurization
02		L2000_QTY02_HR	Date Timestamp	Hours
02		L2000_QTY02_LFTM_RSRV_ACTL	Date Timestamp	Life-time Reserve - Actual
02		L2000_QTY02_LFTM_RSRV_EST	Date Timestamp	Life-time Reserve - Estimated
02		L2000_QTY02_NR_NONCOV_DYS	Date Timestamp	Number of Non-covered Days
02		L2000_QTY02_NONCOV_EST	Date Timestamp	Non-Covered - Estimated
02		L2000_QTY02_NR_MEM	Date Timestamp	Number of Members
02		L2000_QTY02_NOTREP_BLD_UN	Date Timestamp	Not Replaced Blood Units
02		L2000_QTY02_OUTLIER_DYS	Date Timestamp	Outlier Days
02		L2000_QTY02_PHYS_STAT_3	Date Timestamp	Physical Status III
02		L2000_QTY02_PHYS_STAT_4	Date Timestamp	Physical Status IV
02		L2000_QTY02_PHYS_STAT_5	Date Timestamp	Physical Status V
02		L2000_QTY02_NR_SVC_PROC	Date Timestamp	Number of Services or Procedures
02		L2000_QTY02_RX	Date Timestamp	Prescription
02		L2000_QTY02_SWAN_GANZ	Date Timestamp	Swan-Ganz
02		L2000_QTY02_TOT	Date Timestamp	Total
02		L2000_QTY02_VIST	Date Timestamp	Visits
02		L2000_QTY02_MDCRMDCD_PMTCAT1	Date Timestamp	Federal Medicare or Medicaid Payment Mandate - Category 1
02		L2000_QTY02_MDCRMDCD_PMTCAT2	Date Timestamp	Federal Medicare or Medicaid Payment Mandate - Category 2
02		L2000_QTY02_MDCRMDCD_PMTCAT3	Date Timestamp	Federal Medicare or Medicaid Payment Mandate - Category 3
02		L2000_QTY02_MDCRMDCD_PMTCAT4	Date Timestamp	Federal Medicare or Medicaid Payment Mandate - Category 4
02		L2000_QTY02_MCRMCD_PMTCAT5	Date Timestamp	Federal Medicare or Medicaid Payment Mandate - Category 5

L2000	NM1	Individual Name or Organizational Name	Iterated: [01-06]
03		L2000_nnNM103_PERSN_LNM	String	Person Last Name
03		L2000_nnNM103_NONPSNENT_NM	String	Non-Person Entity Name
04		L2000_nnNM104_ADDL_REF_FNM	String	Additional Reference First Name
05		L2000_nnNM105_ADDL_REF_MNM	String	Additional Reference Middle Name
08		L2000_nnNM108_ID_CD_QUAL	String	Identification Code Qualifier
09		L2000_nnNM109_ID_CD	String	Identification Code

L2100 - ERROR OR INFORMATIONAL MESSAGE LOCATION

L2100	TED	Error of Informational Message Location
03		L2100_TED03_SEG_ID_CD	String	Segment ID Code
04		L2100_TED04_SEG_POS_IN_TS	Integer	Segment Position in Transaction Set
05		L2100_TED05_POS_IN_SEG	String	Position in Segment
07		L2100_TED07_COPY_BAD_DATA_ELE	String	Copy of Bad Data Element
08		L2100_TED08_DATA_ELE_NEW_CONT	String	Data Element New Content

L2100	CTX	Situational Context Location	Iterated: [01-10]
01		L2100_nnCTX01_CONTXT_NM	String	Context Name
02		L2100_nnCTX02_CONTXT_SEG_ID_CD	String	Context Segment ID Code
03		L2100_nnCTX03_CNTXT_SEG_POS_TS	Integer	Context Segment Position in Transaction Set
04		L2100_nnCTX04_CONTXT_LP_ID_CD	String	Context Loop Identifier Code
05		L2100_nnCTX05_POS_IN_SEG	String	Position in Segment
06		L2100_nnCTX06_CONT_ELE_REF_NR	Integer	Context Data Element Reference Number

L2100X - ERROR OR INFORMATIONAL MESSAGE LOCATION - RED CUTOUT

L2100X	RED	Error or Informational Message
01		L2100X_RED01_ERR_DESC	String	Error Description
06		L2100X_RED06_INS_BUS_APP_ERR	String	Insurance Business Process Application Error Code

STHDR	SE	Transaction Set Trailer
01		STHDR_SE01_TS_SEG_CT	Integer	Transaction Segment Count
02		STHDR_SE02_TCN	String	Transaction Set Control Number

GSHDR	GE	Functional Group Trailer
01		GSHDR_GE01_NR_TS_INCLUDED	Integer	Number of Transaction Sets Included
02		GSHDR_GE02_GCN	Integer	Group Control Number