REF |
Payer Secondary Identification Number |
|
||||||
|
Ref |
Id |
Element Name |
Req |
Type |
Min/Max |
Usage |
|
REF01 |
128 |
Reference Identification Qualifier
|
M |
ID |
2/3 |
Required |
|
Code |
Name |
||
|
2U |
Payer Identification Number
|
||
|
FY |
Claim Office Number |
||
|
NF |
National Association of Insurance Commissioners (NAIC) Code
|
||
|
TJ |
Federal Taxpayer's Identification Number |
|
REF02 |
127 |
Reference Identification
|
C |
AN |
1/30 |
Required |
|
ExternalCodeList |
|
Name: 245 |
|
Description: National Association of Insurance Commissioners (NAIC) Code |
1. |
R0203 - At least one of REF02,REF03 is required |
1. |
REF04 contains data relating to the value cited in REF02. |
Notes: |
1. Required if additional identification numbers are necessary to adjudicate the claim/encounter. |
Example: |
REF*2U*435261708~ |