REF

Requester Supplemental Identification

Pos: 180	Max: 8
Detail - Optional
Loop: 2010B	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

CT

Contract Number

For use only when the HCFA National Provider Identifier is mandated. Must be sent if required in the contract between the requester identified in Loop 2000B and the UMO identified in Loop 2000A.

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 requester/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: Requester 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 if necessary to provide supplemental identifiers to further identify the requester. Use the NM1 segment for the primary identifier.

Example:

REF*1G*123456~