LS

Dependent Eligibility or Benefit Information

Pos: 330	Max: 1
Detail - Optional
Loop: LS	Elements: 1

Ref

Id

Element Name

Req

Type

Min/Max

Usage

LS01

447

Loop Identifier Code
Description: The loop ID number given on the transaction set diagram is the value for this data element in segments LS and LE
This data element must have the value of “2120".

M

AN

1/6

Required

1.

One loop may be nested contained within another loop, provided the inner nested loop terminates before the outer loop. When specified by the standard setting body as mandatory, this segment in combination with "LE", must be used. It is not to be used if not specifically set forth for use. The loop identifier in the loop header and trailer must be identical. The value for the identifier is the loop ID of the required loop segment. The loop ID number is given on the transaction set diagram in the appropriate ASC X12 version/release.

1.

See Figures Appendix for an explanation of the use of the LS and LE segments.

Notes:

1. Use this segment to identify the beginning of the Dependent Benefit Related Entity Name loop. Because both the subscriber’s name loop and this loop begin with NM1 segments, the LS and LE segments are used to differentiate these two loops. Required if Loop 2120D is used.

Example:

LS*2120~