Loop Qualifiers
xx - Loop Iteration Prefix
xxyy - Outer Loop Iteration and Inner Loop Iteration
yy / yyy - Loop Value Qualifier
xxyy / xxyyy - Loop Iteration and Value Qualifier

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

ISA - GROUP HEADERS

ISA

Interchange Control Header

ISA_ISA02_NO_AUTH_NFO

String

No Authorization Information Present

ISA_ISA02_ADDL_DATA_ID

String

Additional Data Identification

ISA_ISA04_NO_SEC_NFO

String

No Security Information Present

ISA_ISA04_PSSWD

String

Password

ISA_ISA06_DUN_BRDST

String

Dun and Brandstreet

ISA_ISA06_DUN_BRDST_SFX

String

Duns Plus Suffix

ISA_ISA06_HIN

String

Health Industry Number

ISA_ISA06_CARR_ID

String

Carrier Identification Number as assigned by Health Care Financing Administration

ISA_ISA06_HCFA_FIIN

String

Fiscal Intermediary Identification Number as assigned by Health Care Financing Administration

ISA_ISA06_HCFA_ID

String

Medicare Provider and Supplier Identification Number as assigned by Health Care Financing Administration

ISA_ISA06_TAX_ID

String

US Federal Tax Identification Number

ISA_ISA06_NAIC_CD

String

National Association of Insurance Commissioners Company Code

ISA_ISA06_MUTLY_DEF

String

Mutually Defined

ISA_ISA08_DUN_BRDST

String

Dun and Brandstreet

ISA_ISA08_DUN_BRDST_SFX

String

Duns Plus Suffix

ISA_ISA08_HIN

String

Health Industry Number

ISA_ISA08_CARR_ID

String

Carrier Identification Number as assigned by Health Care Financing Administration

ISA_ISA08_HCFA_FIIN

String

Fiscal Intermediary Identification Number as assigned by Health Care Financing Administration

ISA_ISA08_HCFA_ID

String

Medicare Provider and Supplier Identification Number as assigned by Health Care Financing Administration

ISA_ISA08_TAX_ID

String

US Federal Tax Identification Number

ISA_ISA08_NAIC_CD

String

National Association of Insurance Commissioners Company Code

ISA_ISA08_MUTLY_DEF

String

Mutually Defined

ISA_ISA09_INTCHG_DT

Date (YYMMDD)

Interchange Date

ISA_ISA10_INTCHG_TM

Time (HHMM)

Interchange Time

ISA_ISA11_REPTN_SEP

String

Repetition Separator

ISA_ISA12_ICN_VERS_NR

String

Interchang Control Version Number

ISA_ISA13_ICN

Integer

Interchange Control Number

ISA_ISA14_ACK_REQ

String

Acknowledgment Requested

ISA_ISA15_ICN_USG_IND

String

Interchange Usage Indicator

ISA_ISA16_COMP_ELE_SEP

String

Component Element Separator

GSHDR - GROUP HEADER

GSHDR

Functional Group Header

GSHDR_GS02_APP_SNDR_CD

String

Application Senders Code

GSHDR_GS03_APP_RCV_CD

String

Application Receivers Code

GSHDR_GS04_D8

Date (YYYYMMDD)

Date

GSHDR_GS05_TM

Time (HHMM)

Time

GSHDR_GS05_TM8

Time (HHMMSSCC)

Time

GSHDR_GS06_GCN

Integer

Group Control Number

STHDR - TRANSACTION SET HEADER

STHDR

Transaction Set Header

STHDR_ST02_TCN

String

Transaction Set Control Number

STHDR_ST03_IMP_CONV_REF_ID

String

Implementation Convention Reference Identifier

STHDR

BGN

Beginning Segment

STHDR_BGN02_TS_ID_CD

String

Transaction Set Identifier Code

STHDR_BGN03_TS_CRTN_D8

Date (YYYYMMDD)

Transaction Set Creation Date

STHDR_BGN04_TS_CRTN_TM

Time (HHMM)

Transaction Set Creation Time

STHDR_BGN04_TS_CRTN_TM8

Time (HHMMSSCC)

Transaction Set Creation Time

STHDR_BGN06_REF_ICN

String

Referenced Interchange Control Number

STHDR_BGN08_ACTN_CD

String

Action Code

L1000A - SUBMITTER NAME

L1000A

Submitter Name

L1000A_N102_SBM_NM

String

Submitter Name

L1000A_N104_DUNS_NR

String

D-U-N-S Number, Dun and Bradstreet

L1000A_N104_DUNS4_NR

String

D-U-N-S+4, D-U-N-S Number with Four Character Suffix

L1000A_N104_EMPLR_ID_NR

String

Employers Identification Number

L1000A_N104_ETIN

String

Electronic Transmitter Identification Number (ETIN)

L1000A_N104_STAT_ASGND_NR

String

State or Province Assigned Number

L1000A_N104_INS_ASGND_ID

String

Insurance Company Assigned Identification Number

L1000A_N104_TAX_ID

String

Federal Taxpayers Identification Number

L1000A_N104_PAYR_ID

String

Payor Identification

L1000A_N104_MDCR_MDCD_PLANID

String

Centers for Medicare and Medicaid Services Plan ID

L1000A_N104_NPI

String

Centers for Medicare and Medicaid Services National Provider Identifier

L1000A

REF

Submitter Secondary Identifier

L1000A_REF_BRNCH_ID

String

Branch Identifier

L1000A

PER

Submitter EDI Contact Information

L1000A_nnPER02_SBM_CON_NM

String

Submitter Contact Name

L1000A_nnPER04_EMAIL

String

Electronic Mail

L1000A_nnPER04_FAX

String

Facsimile

L1000A_nnPER04_PHN_NR

String

Telephone

L1000A_nnPER06_EMAIL

String

Electronic Mail

L1000A_nnPER06_PHN_EXT

String

Telephone Extension

L1000A_nnPER06_FAX

String

Facsimile

L1000A_nnPER06_PHN_NR

String

Telephone

L1000A_nnPER08_EMAIL

String

Electronic Mail

L1000A_nnPER08_PHN_EXT

String

Telephone Extension

L1000A_nnPER08_FAX

String

Facsimile

L1000A_nnPER08_PHN_NR

String

Telephone

L1000B - RECEIVER NAME

L1000B

Receiver Name

L1000B_N102_RCV_NM

String

Reciever Name

L1000B_N104_DUNS_NR

String

D-U-N-S Number, Dun and Bradstreet

L1000B_N104_DUNS4_NR

String

D-U-N-S+4, D-U-N-S Number with Four Character Suffix

L1000B_N104_EMPLR_ID_NR

String

Employers Identification Number

L1000B_N104_ETIN

String

Electronic Transmitter Identification Number (ETIN)

L1000B_N104_STAT_ASGND_NR

String

State or Province Assigned Number

L1000B_N104_INS_ASGND_ID

String

Insurance Company Assigned Identification Number

L1000B_N104_TAX_ID

String

Federal Taxpayers Identification Number

L1000B_N104_PAYR_ID

String

Payor Identification

L1000B_N104_MDCR_MDCD_PLANID

String

Centers for Medicare and Medicaid Services Plan ID

L1000B_N104_NPI

String

Centers for Medicare and Medicaid Services National Provider Identifier

L2000 - ORIGINAL TRANSACTION IDENTIFICATION

L2000

OTI

Original Transaction Identification

L2000_OTI01_APP_ACK_CD

String

Application Acknowledgment Code

L2000_OTI03_BATCH_NR

String

Batch Number

L2000_OTI03_ITM_NR

String

Item Number

L2000_OTI03_TRAN_REF_NR

String

Transaction Reference Number

L2000_OTI06_FUNC_GRP_CRTN_D8

Date (YYYYMMDD)

Functional Group Creation Date

L2000_OTI07_FUNC_GRP_CRTN_TM

Time (HHMM)

Functional Group Creation Time

L2000_OTI07_FUNC_GRP_CRTN_TM8

Time (HHMMSSCC)

Functional Group Creation Time

L2000_OTI08_FUNC_GRP_CTL_NR

Integer

Functional Group Control Number

L2000_OTI09_TCN

String

Transaction Set Control Number

L2000_OTI10_TS_ID_CD

String

Transaction Set Identifier Code

L2000_OTI11_VERS_RLS_IND_ID

String

Version Release Industry Identifier

L2000

REF

Exchange Report Document Control Number

Iterated: [01-99]

L2000_nnREF_SYS_NR

String

System Number

L2000_nnREF_STAT_LIC_NR

String

State License Number

L2000_nnREF_SUB_NR

String

Subscriber Number

L2000_nnREF_MORTG_ID

String

Mortgage Identification Number

L2000_nnREF_ACCT_NR

String

Account Number

L2000_nnREF_MSTR_ACCT_NR

String

Master Account Number

L2000_nnREF_CLT_RPT_CAT

String

Client Reporting Category

L2000_nnREF_PLAN_NR

String

Plan Number

L2000_nnREF_BLCS_PVR_NR

String

Blue Cross Provider Number

L2000_nnREF_BLSH_PROV_NR

String

Blue Shield Provider Number

L2000_nnREF_MDCR_PVR_NR

String

Medicare Provider Number

L2000_nnREF_MDCD_PVR_NR

String

Medicaid Provider Number

L2000_nnREF_DENT_LIC_NR

String

Dentist License Number

L2000_nnREF_ANAS_LIC_NR

String

Anesthesia License Number

L2000_nnREF_UPIN

String

Provider UPIN Number

L2000_nnREF_CHAMPUS_ID

String

CHAMPUS Identification Number

L2000_nnREF_FAC_ID

String

Facility ID Number

L2000_nnREF_PYR_CLM_NR

String

Payors Claim Number

L2000_nnREF_GRP_POLCY_NR

String

Group or Policy Number

L2000_nnREF_APG_NR

String

Ambulatory Patient Group (APG) Number

L2000_nnREF_MEM_ID

String

Member Identification Number

L2000_nnREF_CLNT_NR

String

Client Number

L2000_nnREF_EMPLE_ID_NR

String

Employee Identification Number

L2000_nnREF_INVC_NR

String

Consolidated Invoice Number

L2000_nnREF_TRCK_NR

String

Tracking Number

L2000_nnREF_PYR_ID

String

Payer Identification Number

L2000_nnREF_LNDR_CS_NR

String

Lender Case Number

L2000_nnREF_MSTR_PLCY_NR

String

Master Policy Number

L2000_nnREF_CASE_NR

String

Case Number

L2000_nnREF_OFFC_NR

String

Office Number

L2000_nnREF_FAM_UNT_NR

String

Family Unit Number

L2000_nnREF_PIN

String

Personal Identification Number

L2000_nnREF_SP_PMT_REF_NR

String

Special Payment Reference Number

L2000_nnREF_COMPLNT

String

Complaint

L2000_nnREF_INCDNT

String

Incident

L2000_nnREF_ACCT_SFX

String

Account Suffix Code

L2000_nnREF_CLMNT_NR

String

Claimant Number

L2000_nnREF_GRP_NR

String

Group Number

L2000_nnREF_PRV_CTL_NR

String

Provider Control Number

L2000_nnREF_SCH_REF_NR

String

Schedule Reference Number

L2000_nnREF_SUB_AUTH_NR

String

Subscriber Authorization Number

L2000_nnREF_LST_MTL

String

List of Materials

L2000_nnREF_FUNC_CAT

String

Functional Category

L2000_nnREF_ASSEM_NR

String

Assembly Number

L2000_nnREF_BNK_SEC_ID

String

Bank Assigned Security Identifier

L2000_nnREF_TRNS_CAT

String

Transaction Category or Type

L2000_nnREF_FILE_ID_NR

String

File Identification Number

L2000_nnREF_REP_CLM_ID

String

Repriced Claim Reference Number

L2000_nnREF_REP_LIN_ITM

String

Repriced Line Item Reference Number

L2000_nnREF_ADJ_REP_CLM_ID

String

Adjusted Repriced Claim Reference Number

L2000_nnREF_ADJ_REP_LIN_ITM

String

Adjusted Repriced Line Item Reference Number

L2000_nnREF_SERVCR

String

Servicer

L2000_nnREF_INVSTR

String

Investor

L2000_nnREF_JOB_NR

String

Job Order Number

L2000_nnREF_HLTH_INS_ACCT

String

Health Insurance Account Number

L2000_nnREF_AGNT_NR

String

Agent Number

L2000_nnREF_ACC_SRC_PRC_ID

String

Acceptable Source Purchaser ID

L2000_nnREF_MSTR_PROP_NR

String

Master Property Number

L2000_nnREF_HLTH_INS_PLCY

String

Health Insurance Policy Number

L2000_nnREF_PPO_NR

String

Preferred Provider Organization Number

L2000_nnREF_LIF_INS_PLCY

String

Life Insurance Policy Number

L2000_nnREF_RET_PLN_PLCY

String

Retirement Plan Policy Number

L2000_nnREF_AUTH_NR

String

Authorization Number

L2000_nnREF_BILL_TYP

String

Billing Type

L2000_nnREF_HMO_CD_NR

String

Health Maintenance Organization Code Number

L2000_nnREF_SALS_OFC_NR

String

Broker or Sales Office Number

L2000_nnREF_BATCH_NR

String

Batch Number

L2000_nnREF_CLSS_CONT

String

Class of Contract Code

L2000_nnREF_CHK_NR

String

Check Number

L2000_nnREF_CASLT_REP_NR

String

Casualty Report Number

L2000_nnREF_CNTRCT_NR

String

Contract Number

L2000_nnREF_NABP_NR

String

National Council for Prescription Drug Programs Pharmacy Number

L2000_nnREF_LOSS_REP_NR

String

Additional Reference Identification Number

L2000_nnREF_CLM_NR

String

Claim Number

L2000_nnREF_DOC_ID_CD

String

Document Identification Code

L2000_nnREF_DEPT_AGCY_NR

String

Department/Agency Number

L2000_nnREF_CLMT_CLM_NR

String

Claimants Claim Number

L2000_nnREF_ATTCH_CD

String

Attachment Code

L2000_nnREF_MED_REC_ID

String

Medical Record Identification Number

L2000_nnREF_EMPLR_ID_NR

String

Employers Identification Number

L2000_nnREF_PATNT_ACCT_NR

String

Patient Account Number

L2000_nnREF_ELEC_PIN

String

Electronic device pin number

L2000_nnREF_ELEC_PMT_REF_NR

String

Electronic Payment Reference Number

L2000_nnREF_SUB_ID_NR

String

Submitter Identification Number

L2000_nnREF_REC_ID_NR

String

Receiver Identification Number

L2000_nnREF_MAMM_CERT

String

Mammography Certification Number

L2000_nnREF_VERS_CD

String

Version Code - Local

L2000_nnREF_FAC_CERT_ID

String

Facility Certification Number

L2000_nnREF_MDCR_VRS_CD

String

Medicare Version Code

L2000_nnREF_HIC_NR

String

Health Insurance Claim (HIC) Number

L2000_nnREF_ORIG_REF_NR

String

Original Reference Number

L2000_nnREF_CLINC_NR

String

Clinic Number

L2000_nnREF_FILE_ID

String

File Identifier

L2000_nnREF_LIN_ITM

String

Line Item Control Number

L2000_nnREF_CLM_OFC_NR

String

Claim Office Number

L2000_nnREF_PRIOR_AUTH

String

Prior Authorization Number

L2000_nnREF_PVR_COMM_NR

String

Provider Commercial Number

L2000_nnREF_PREF_BEN_ID_NR

String

Predetermination of Benefits Identification Number

L2000_nnREF_PPO_APPR_NR

String

Peer Review Organization (PRO) Approval Number

L2000_nnREF_PVR_SIT_NR

String

Provider Site Number

L2000_nnREF_HIN

String

Health Industry Number (HIN)

L2000_nnREF_ID_CRD_NR

String

Identity Card Number

L2000_nnREF_MDCR_MDCD

String

Centers for Medicare and Medicaid Services National Provider Identifier

L2000_nnREF_ISSU_NR

String

Issue Number

L2000_nnREF_INS_PLCY_NR

String

Insurance Policy Number

L2000_nnREF_SIC_CD

String

Standard Industry Classification (SIC) Code

L2000_nnREF_INSP_RPT_NR

String

Inspection Report Number

L2000_nnREF_ITM_NR

String

Item Number

L2000_nnREF_USER_ID

String

User Identification

L2000_nnREF_CERT

String

Certification

L2000_nnREF_LEAS_NR

String

Lease Number

L2000_nnREF_LOAN_NR

String

Loan Number

L2000_nnREF_LOC_NR

String

Location Number

L2000_nnREF_QUAL_PRD_LST

String

Qualified Products List

L2000_nnREF_LNDR_ACCT_NR

String

Lender Account Number

L2000_nnREF_MSG_ADD

String

Message Address or ID

L2000_nnREF_PRV_PLN_ID

String

Provider Plan Network Identification Number

L2000_nnREF_PLN_NET_ID

String

Plan Network Identification Number

L2000_nnREF_FAC_NET_ID

String

Facility Network Identification Number

L2000_nnREF_NAIC

String

National Association of Insurance Commissioners (NAIC) Code

L2000_nnREF_MDCD_ID_NR

String

Medicaid Recipient Identification Number

L2000_nnREF_PROD_NR

String

Product Number

L2000_nnREF_PROJCT_CD

String

Project Code

L2000_nnREF_PROD_GRP

String

Product Group

L2000_nnREF_PART_NR

String

Part Number

L2000_nnREF_POLCY_NR

String

Policy Number

L2000_nnREF_PAYEE_ID

String

Payee Identification

L2000_nnREF_PRIOR_ID

String

Prior Identifier Number

L2000_nnREF_PROP_CAS_NR

String

Property Control Number

L2000_nnREF_UNIT_NR

String

Unit Number

L2000_nnREF_RAT_CD_NR

String

Rate code number

L2000_nnREF_SPEC_NR

String

Specification Number

L2000_nnREF_STORE_NR

String

Store Number

L2000_nnREF_SSN

String

Social Security Number

L2000_nnREF_SIGNL_CD

String

Signal Code

L2000_nnREF_AFF_SUB_CD

String

Affected Subsystem Code

L2000_nnREF_TAX_ID

String

Federal Taxpayers Identification Number

L2000_nnREF_TRAN_REF_NR

String

Transaction Reference Number

L2000_nnREF_TERMNL_CD

String

Terminal Code

L2000_nnREF_TAX_XMPT_NR

String

Tax Exempt Number

L2000_nnREF_USIN

String

Unique Supplier Identification Number (USIN)

L2000_nnREF_MORTG_NR

String

Mortgage Number

L2000_nnREF_VOLM_NR

String

Volume Number

L2000_nnREF_VENDR_ABB_CD

String

Vendor Abbreviation Code

L2000_nnREF_VENDR_PROD_NR

String

Vendor Product Number

L2000_nnREF_VENDR_ID

String

Vendor ID Number

L2000_nnREF_MTR_VEH_ID

String

Motor Vehicle ID Number

L2000_nnREF_VESSEL

String

Vessel

L2000_nnREF_PROV_CLM_NR

String

Provider Claim Number

L2000_nnREF_LAB_IMP_AMD

String

Clinical Laboratory Improvement Amendment Number

L2000_nnREF_SIA_PRV_NR

String

State Industrial Accident Provider Number

L2000_nnREF_AGNCY_CLM_NR

String

Agency Claim Number

L2000_nnREF_FED_HS_CS_NR

String

Federal Housing Administration Case Number

L2000_nnREF_VET_CS_NR

String

Veterans Affairs Case Number

L2000_nnREF_CRR_AS_REF_NR

String

Carrier Assigned Reference Number

L2000_nnREF_SOFT_APP_NR

String

Software Application Number

L2000_nnREF_MUTLY_DEF

String

Mutually Defined

L2000

DTM

Date Time Reference

L2000_DTM02_INVC

DateTime

Invoice

L2000_DTM02_EFF

DateTime

Effective

L2000_DTM02_PRCS

DateTime

Process

L2000_DTM02_SHPD

DateTime

Shipped

L2000_DTM02_EST_DELVY

DateTime

Estimated Delivery

L2000_DTM02_DELVD

DateTime

Delivered

L2000_DTM02_EXP

DateTime

Expiration

L2000_DTM02_RCVD

DateTime

Received

L2000_DTM02_INQURY

DateTime

Inquiry

L2000_DTM02_RPT_STRT

DateTime

Report Start

L2000_DTM02_RPT_END

DateTime

Report End

L2000_DTM02_DISCHG

DateTime

Discharge

L2000_DTM02_TS_CREATN

DateTime

Transaction Creation

L2000_DTM02_ISSU

DateTime

Issue

L2000_DTM02_TST_PERF

DateTime

Test Performed

L2000_DTM02_LOSS

DateTime

Loss

L2000_DTM02_SVC_PER_STRT

DateTime

Service Period Start

L2000_DTM02_SVC_PER_END

DateTime

Service Period End

L2000_DTM02_INVC_PER_STRT

DateTime

Invoice Period Start

L2000_DTM02_INVC_PER_END

DateTime

Invoice Period End

L2000_DTM02_PRD_STRT

DateTime

Period Start

L2000_DTM02_PRD_END

DateTime

Period End

L2000_DTM02_CMPLTN

DateTime

Completion

L2000_DTM02_LEAS_TERM_STRT

DateTime

Lease Term Start

L2000_DTM02_LEAS_TERM_END

DateTime

Lease Term End

L2000_DTM02_CLM_PRD_STRT

DateTime

Claim Statement Period Start

L2000_DTM02_CLM_PRD_END

DateTime

Claim Statement Period End

L2000_DTM02_ACTL_STRT

DateTime

Actual Start

L2000_DTM02_EST_COMPLTN

DateTime

Estimated Completion

L2000_DTM02_EMP_OR_HIRE

DateTime

Employment or Hire

L2000_DTM02_RETRMNT

DateTime

Retirement

L2000_DTM02_DIS_RET_WRK

DateTime

Initial Disability Period Return To Work

L2000_DTM02_INI_DISB_LSTWRK

DateTime

Initial Disability Period Last Day Worked

L2000_DTM02_ENRL_SIG

DateTime

Enrollment Signature Date

L2000_DTM02_COBRA_EVNT

DateTime

Consolidated Omnibus Budget Reconciliation Act (COBRA) Qualifying Event

L2000_DTM02_MNT_EFF

DateTime

Maintenance Effective

L2000_DTM02_LAST_VST

DateTime

Latest Visit or Consultation

L2000_DTM02_ELIG

DateTime

Eligibility

L2000_DTM02_CLOSNG_DT

DateTime

Date of Closing

L2000_DTM02_CYCL

DateTime

Cycle

L2000_DTM02_REFRL_DT

DateTime

Referral Date

L2000_DTM02_EMP_BGN

DateTime

Employment Begin

L2000_DTM02_EMP_END

DateTime

Employment End

L2000_DTM02_MDCR_BGN

DateTime

Medicare Begin

L2000_DTM02_MDCR_END

DateTime

Medicare End

L2000_DTM02_COBRA_BEGN

DateTime

Consolidated Omnibus Budget Reconciliation Act (COBRA) Begin

L2000_DTM02_COBRA_END

DateTime

Consolidated Omnibus Budget Reconciliation Act (COBRA) End

L2000_DTM02_COBRA_BGN

DateTime

Coordination of Benefits Begin

L2000_DTM02_COB_END

DateTime

Coordination of Benefits End

L2000_DTM02_BNFT_BGN

DateTime

Benefit Begin

L2000_DTM02_BNFT_END

DateTime

Benefit End

L2000_DTM02_EDU_BGN

DateTime

Education Begin

L2000_DTM02_EDU_END

DateTime

Education End

L2000_DTM02_ELIG_BGN

DateTime

Eligibility Begin

L2000_DTM02_ELIG_END

DateTime

Eligibility End

L2000_DTM02_INI_DISBTY_STRT

DateTime

Initial Disability Period Start

L2000_DTM02_INI_DISBTY_END

DateTime

Initial Disability Period End

L2000_DTM02_ACTL_DEPT_DT

DateTime

Actual Departure Date

L2000_DTM02_ACTL_ARVL_DT

DateTime

Actual Arrival Date

L2000_DTM02_ADJ_HIR

DateTime

Adjusted Hire

L2000_DTM02_PMT_CMM

DateTime

Payment Commencement

L2000_DTM02_PLN_SUSP

DateTime

Plan Participation Suspension

L2000_DTM02_REHR

DateTime

Rehire

L2000_DTM02_PRODCTN

DateTime

Production

L2000_DTM02_CURR_SYMPTM

DateTime

Onset of Current Symptoms or Illness

L2000_DTM02_STMNT

DateTime

Statement

L2000_DTM02_ADMSN

DateTime

Admission

L2000_DTM02_SIML_SYMPTM

DateTime

Onset of Similar Symptoms or Illness

L2000_DTM02_ACCDNT

DateTime

Accident

L2000_DTM02_PRIOR_PCMT

DateTime

Prior Placement

L2000_DTM02_REPLCMT

DateTime

Replacement

L2000_DTM02_APPL_PLCMT

DateTime

Appliance Placement

L2000_DTM02_ACUTE

DateTime

Acute Manifestation of a Chronic Condition

L2000_DTM02_INIT_TRTMT

DateTime

Initial Treatment

L2000_DTM02_XRAY

DateTime

Last X-Ray

L2000_DTM02_SRGY

DateTime

Surgery

L2000_DTM02_LAST_CERT

DateTime

Last Certification

L2000_DTM02_BGN_THRPY

DateTime

Begin Therapy

L2000_DTM02_RX

DateTime

Prescription

L2000_DTM02_SVC

DateTime

Service

L2000_DTM02_MDCD_BGN

DateTime

Medicaid Begin

L2000_DTM02_MDCD_END

DateTime

Medicaid End

L2000_DTM02_GAS_TEST

DateTime

Arterial Blood Gas Test

L2000_DTM02_OXY_TEST

DateTime

Oxygen Saturation Test

L2000_DTM02_MENS_PERD

DateTime

Last Menstrual Period

L2000_DTM02_INJRY_BEGN

DateTime

Injury Begin

L2000_DTM02_INJRY_END

DateTime

Injury End

L2000_DTM02_INSPCTD

DateTime

Inspected

L2000_DTM02_CLM_DT

DateTime

Date of Claim

L2000_DTM02_PLCY_EFF

DateTime

Policy Effective

L2000_DTM02_PLCY_EXP

DateTime

Policy Expiration

L2000_DTM02_PRM_PD

DateTime

Last Premium Paid Date

L2000_DTM02_LOAN_DT

DateTime

Date of Loan

L2000_DTM02_DT_CLM_PD

DateTime

Date Claim Paid

L2000_DTM02_REPT_PERD

DateTime

Report Period

L2000_DTM02_CERT_RVSN

DateTime

Certification Revision

L2000_DTM02_PAID_DT

DateTime

Date Paid

L2000_DTM02_HEMOHEMA

DateTime

Most Recent Hemoglobin or Hematocrit or Both

L2000_DTM02_CREATINE

DateTime

Most Recent Serum Creatine

L2000_DTM02_POSTD

DateTime

Posted

L2000_DTM02_EXAM

DateTime

Examination

L2000_DTM02_REQST

DateTime

Request

L2000_DTM02_ORDR

DateTime

Order

L2000_DTM02_DOC_DT

DateTime

Document Date

L2000_DTM02_EST_DOB

DateTime

Estimated Date of Birth

L2000_DTM02_INCDNT

DateTime

Incident

L2000_DTM02_MUTLY_DEF

DateTime

Mutually Defined

L2000

AMT

Monetary Amount Information

L2000_AMT02_LIN_ITM_TOT

Number

Line Item Total

L2000_AMT02_BATCH_TOT

Number

Batch Total

L2000_AMT02_TOT_INVC_AMT

Number

Total Invoice Amount

L2000_AMT02_MORTG

Number

Mortgage

L2000_AMT02_NONOP_FXD_ASTS

Number

Non-operational Fixed Assets

L2000_AMT02_DMGS

Number

Damages

L2000_AMT02_SVC

Number

Services

L2000_AMT02_SHAR_PREM_CAP

Number

Share Premium Capital

L2000_AMT02_NONCVD_CHG_ACTL

Number

Noncovered Charges - Actual

L2000_AMT02_ALLOCTD

Number

Allocated

L2000_AMT02_APPRVD_AMT

Number

Approved Amount

L2000_AMT02_COVG_AMT

Number

Coverage Amount

L2000_AMT02_BENE_AMT

Number

Benefit Amount

L2000_AMT02_ALLWD_ACTL

Number

Allowed - Actual

L2000_AMT02_DED_EST

Number

Deductible - Estimated

L2000_AMT02_COINS_ACTL

Number

Co-insurance - Actual

L2000_AMT02_ADJ

Number

Adjustments

L2000_AMT02_ADJ_INSRD_LSS_AMT

Number

Adjusted Insured Loss Amount

L2000_AMT02_COPAY_AMT

Number

Co-Payment Amount

L2000_AMT02_CLM_AMT_DUE_EST

Number

Claim Amount Due - Estimated

L2000_AMT02_SUMM_AMT

Number

Summary Amount

L2000_AMT02_FUNDS_HELD_INSRD

Number

Funds Held for Insured

L2000_AMT02_PAYR_AMT_PD

Number

Payor Amount Paid

L2000_AMT02_DED_AMT

Number

Deductible Amount

L2000_AMT02_DISCT_AMT

Number

Additional Reference Amount

L2000_AMT02_DED_WAIVD

Number

Deductible Waived

L2000_AMT02_PER_DAY_LIM

Number

Per Day Limit

L2000_AMT02_PAT_RESP_ACTL

Number

Patient Responsibility - Actual

L2000_AMT02_PAT_RESP_EST

Number

Patient Responsibility - Estimated

L2000_AMT02_POSTG_CLMD

Number

Postage Claimed

L2000_AMT02_PT_AMT_PD

Number

Patient Amount Paid

L2000_AMT02_SALES_TAX

Number

Sales Tax

L2000_AMT02_GDS_SVCS_TAX

Number

Goods and Services Tax

L2000_AMT02_TOT_CHG

Number

Total Charge

L2000_AMT02_INTRST

Number

Interest

L2000_AMT02_NET_PD_AMT

Number

Net Paid Amount

L2000_AMT02_DDCTN_AMT

Number

Deduction Amount

L2000_AMT02_MARKUP_AMT

Number

Markup Amount

L2000_AMT02_MAX_AMT

Number

Maximum Amount

L2000_AMT02_NET_WRTH

Number

Net Worth

L2000_AMT02_MISC_TAX

Number

Miscellaneous Taxes

L2000_AMT02_NET_BILL

Number

Net Billed

L2000_AMT02_NEG_LEDGR_BAL

Number

Negative Ledger Balance

L2000_AMT02_PREM_AMT

Number

Premium Amount

L2000_AMT02_PAYOFF

Number

Payoff

L2000_AMT02_PRI_INVC_TOT

Number

Prior Gross Invoice Total

L2000_AMT02_SPENDOWN

Number

Spend Down

L2000_AMT02_REPAIR

Number

Repair

L2000_AMT02_SUPPLMTL

Number

Supplemental

L2000_AMT02_TAX

Number

Tax

L2000_AMT02_TOT_CLM_B4_TAX

Number

Total Claim Before Taxes

L2000_AMT02_TOT_SUB_CHGS

Number

Total Submitted Charges

L2000_AMT02_TOT_PMT_AMT

Number

Total payment amount

L2000_AMT02_TOT_TRANS_AMT

Number

Total Transaction Amount

L2000_AMT02_DENIED

Number

Denied

L2000_AMT02_IN_PROCS

Number

In Process

L2000_AMT02_RETRND

Number

Returned

L2000_AMT02_MDCRMDCD_PMTCAT1

Number

Federal Medicare or Medicaid Payment Mandate - Category 1

L2000_AMT02_MDCRMDCD_PMTCAT2

Number

Federal Medicare or Medicaid Payment Mandate - Category 2

L2000_AMT02_MDCRMDCD_PMTCAT3

Number

Federal Medicare or Medicaid Payment Mandate - Category 3

L2000_AMT02_MDCRMDCD_PMTCAT4

Number

Federal Medicare or Medicaid Payment Mandate - Category 4

L2000_AMT02_MCRMCD_PMTCAT5

Number

Federal Medicare or Medicaid Payment Mandate - Category 5

L2000_AMT02_MUTLY_DEF

Number

Mutually Defined

L2000

QTY

Quantity Information

L2000_QTY02_DISCRT_QTY

Number

Discrete Quantity

L2000_QTY02_CUMU_QTY

Number

Cumulative Quantity

L2000_QTY02_SCRAP_ALWD

Number

Scrap allowed

L2000_QTY02_SEGMT

Number

Segments

L2000_QTY02_FUNC_GRP

Number

Functional Groups

L2000_QTY02_TS

Number

Transaction Sets

L2000_QTY02_TOT_DEBTS

Number

Total Debits

L2000_QTY02_TOT_CRED

Number

Total Credits

L2000_QTY02_NR_BTCHS

Number

Number of Batches

L2000_QTY02_NR_CHKS

Number

Number of Checks

L2000_QTY02_TOT_TRANS

Number

Total transactions

L2000_QTY02_ACK_QTY

Number

Acknowledged Quantity

L2000_QTY02_UNACK_QTY

Number

Unacknowledged Quantity

L2000_QTY02_AGE_MOD_UN

Number

Age Modifying Units

L2000_QTY02_COVD_ACTL

Number

Covered - Actual

L2000_QTY02_COINS_ACTL

Number

Co-insured - Actual

L2000_QTY02_USE_XTRACRP_CIRC

Number

Use of Extracorporeal Circulation

L2000_QTY02_EMGNCY_MOD_UN

Number

Emergency Modifying Units

L2000_QTY02_INVCS

Number

Invoices

L2000_QTY02_USE_HYPOTHRM

Number

Use of Hypothermia

L2000_QTY02_USE_HYPOTENS

Number

Use of Hypotension

L2000_QTY02_USE_HYPRBRC

Number

Use of Hyperbaric Pressurization

L2000_QTY02_HR

Number

Hours

L2000_QTY02_LFTM_RSRV_ACTL

Number

Life-time Reserve - Actual

L2000_QTY02_LFTM_RSRV_EST

Number

Life-time Reserve - Estimated

L2000_QTY02_NR_NONCOV_DYS

Number

Number of Non-covered Days

L2000_QTY02_NONCOV_EST

Number

Non-Covered - Estimated

L2000_QTY02_NR_MEM

Number

Number of Members

L2000_QTY02_NOTREP_BLD_UN

Number

Not Replaced Blood Units

L2000_QTY02_OUTLIER_DYS

Number

Outlier Days

L2000_QTY02_PHYS_STAT_3

Number

Physical Status III

L2000_QTY02_PHYS_STAT_4

Number

Physical Status IV

L2000_QTY02_PHYS_STAT_5

Number

Physical Status V

L2000_QTY02_NR_SVC_PROC

Number

Number of Services or Procedures

L2000_QTY02_RX

Number

Prescription

L2000_QTY02_SWAN_GANZ

Number

Swan-Ganz

L2000_QTY02_TOT

Number

Total

L2000_QTY02_VIST

Number

Visits

L2000_QTY02_MDCRMDCD_PMTCAT1

Number

Federal Medicare or Medicaid Payment Mandate - Category 1

L2000_QTY02_MDCRMDCD_PMTCAT2

Number

Federal Medicare or Medicaid Payment Mandate - Category 2

L2000_QTY02_MDCRMDCD_PMTCAT3

Number

Federal Medicare or Medicaid Payment Mandate - Category 3

L2000_QTY02_MDCRMDCD_PMTCAT4

Number

Federal Medicare or Medicaid Payment Mandate - Category 4

L2000_QTY02_MCRMCD_PMTCAT5

Number

Federal Medicare or Medicaid Payment Mandate - Category 5

L2000

NM1

Individual Name or Organizational Name

Dependent

Contracted Service Provider

Applicant

Health Maintenance Organization (HMO)

Kidney Dialysis Unit

Preferred Provider Organization (PPO)

Franchisor

Provider

University School or College

Physician Clinic or Group Practice

Laboratory

Third-Party Administrator

Miscellaneous Health Care Facility

Partnership

Service Supplier

Postal Mailing Address

Employer

Obstetrics and Gynecology Family

Receiver

Submitter

Estimator

Repairing Outlet

Prior Incorrect Insured

Attending Physician

Operating Physician

Other Physician

Corrected Insured

Service Location

Hospital

Rendering Provider

Billing Provider

Pay-to Provider

Payment Address

AAP

Employee

ACV

Information Source

Agent/Agency

Airline

Account Of

Business Partner

Beneficiary

Broker

Billing Service

Claimant

Claim Administrator

Ordering Physician

Referring Provider

Supervising Physician

Person or Other Entity Legally Responsible for a Child

Electronic Filer

Executor of Estate

ENR

Enroller

EXS

Ex-Spouse

Employee Name

Facility

Forwarder

Guardian

Gateway Provider

Group

Treatment Facility

Paying Agent

Owner

Subscriber

IAE

Member

Insured or Subscriber

Insurer

Independent Adjuster

Power of Attorney

Receiver Site

Contact

Lessor

Independent Lab

Lender

Lessee

Educational Institution

Mortgage Insurer

Primary Physician

Doctor of Optometry

Owner of Property or Unit

Primary Insured or Subscriber

Primary Care Provider

Prior Insurance Carrier

Plan Sponsor

Payee

Payer

PRP

Primary Payer

Party performing certification

Pharmacy

Purchase Service Provider

Patient

Responsible Party

Policyholder

Physician

Dentist

Group Practice

Requester

Remit To

Custodial Parent

SEP

Secondary Payer

Service Provider

Supplier/Manufacturer

Testing Laboratory

Transmitter

Transfer To

TTP

Tertiary Payer

Third Party Administrator

Vehicle

Vendor

Utilization Management Organization

Managed Care Organization

Mutually Defined

L2000_nnNM1yy03_PERSN_LNM

String

Person Last Name

L2000_nnNM1yy03_NONPSNENT_NM

String

Non-Person Entity Name

L2000_nnNM1yy04_ADDL_REF_FNM

String

Additional Reference First Name

L2000_nnNM1yy05_ADDL_REF_MNM

String

Additional Reference Middle Name

L2000_nnNM1yy08_ID_CD_QUAL

String

Identification Code Qualifier

L2000_nnNM1yy09_ID_CD

String

Identification Code

L2100 - ERROR OR INFORMATIONAL MESSAGE LOCATION

L2100

TED

Error of Informational Message Location

L2100_TED03_SEG_ID_CD

String

Segment ID Code

L2100_TED04_SEG_POS_IN_TS

Integer

Segment Position in Transaction Set

L2100_TED05_POS_IN_SEG

String

Position in Segment

L2100_TED07_COPY_BAD_DATA_ELE

String

Copy of Bad Data Element

L2100_TED08_DATA_ELE_NEW_CONT

String

Data Element New Content

L2100

CTX

Situational Context Location

L2100_nnCTX01_CONTXT_NM

String

Context Name

L2100_nnCTX02_CONTXT_SEG_ID_CD

String

Context Segment ID Code

L2100_nnCTX03_CNTXT_SEG_POS_TS

Integer

Context Segment Position in Transaction Set

L2100_nnCTX04_CONTXT_LP_ID_CD

String

Context Loop Identifier Code

L2100_nnCTX05_POS_IN_SEG

String

Position in Segment

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

L2100X_RED01_ERR_DESC

String

Error Description

L2100X_RED06_INS_BUS_APP_ERR

String

Insurance Business Process Application Error Code

STHDR

Transaction Set Trailer

STHDR_SE01_TS_SEG_CT

Integer

Transaction Segment Count

STHDR_SE02_TCN

String

Transaction Set Control Number

GSHDR

Functional Group Trailer

GSHDR_GE01_NR_TS_INCLUDED

Integer

Number of Transaction Sets Included

GSHDR_GE02_GCN

Integer

Group Control Number

ISA

IEA

Interchange Control Trailer

ISA_IEA01_NR_INC_FUNC_GRP

Integer

Number of Included Functional Groups

ISA_IEA02_ICN

Integer

Interchange Control Number