REF

Service Provider Supplemental Identification

Pos: 180	Max: 7
Detail - Optional
Loop: 2010E	Elements: 2

Ref

Id

Element Name

Req

Type

Min/Max

Usage

REF01

128

Reference Identification Qualifier
Description: Code qualifying the Reference Identification

M

ID

2/3

Required

Code

Name

1G

Provider UPIN Number

1J

Facility ID Number

EI

Employer's Identification Number

Not used if NM108 = 24.

N5

Provider Plan Network Identification Number

N7

Facility Network Identification Number

SY

Social Security Number

NOT ADVISED The social security number may not be used for Medicare. Not used if NM108 = 34.

ZH

Carrier Assigned Reference Number

Use for the provider ID as assigned by the UMO identified in Loop 2000A.

REF02

127

Reference Identification
Description: Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
Industry: Service Provider Supplemental Identifier

C

AN

1/30

Required

1.

R0203 - At least one of REF02,REF03 is required

1.

REF04 contains data relating to the value cited in REF02.

Notes:

1. Use this segment only when necessary to provide supplemental identifiers to identify the service provider. Use the NM1 segment for the primary identifier.

Example:

REF*1G*12345~