REF

Rendering Provider Information

Pos: 100	Max: 10
Detail - Optional
Loop: 2110	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

1A

Blue Cross Provider Number

1B

Blue Shield Provider Number

1C

Medicare Provider Number

1D

Medicaid Provider Number

1G

Provider UPIN Number

1H

CHAMPUS Identification Number

1J

Facility ID Number

SY

Social Security Number

TJ

Federal Taxpayer's Identification Number

HPI

Health Care Financing Administration National Provider Identifier

CODE SOURCE:

537: Health Care Financing Administration National Provider Identifier

REF02

127

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

C

AN

1/30

Required

ExternalCodeList

Name: 537

Description: Health Care Financing Administration National Provider Identifier

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 REF segment for reference numbers specific to the service identified by the SVC segment. The provider-related reference number at this level should be the rendering provider number, but only if the provider number is specific to this particular service line.

Example:

REF*HPI*12345678~