REF

Adjusted Repriced Claim Number

Pos: 180	Max: 1
Detail - Optional
Loop: 2300	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

9C

Adjusted Repriced Claim Reference Number

REF02

127

Reference Identification
Description: Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
Industry: Adjusted Repriced Claim Reference Number

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. Used only by repricers as needed. This information is specific to the destination payer reported in the 2010BB loop.

Example:

REF*9C*RP44444444~