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X12 Transaction

X12 Transaction

Table

Data Element NumberData TypeMinimum LengthMaximum LengthData Element Name
100ID33Currency Code
1004ID12Percent Qualifier
1005ID44Hierarchical Structure Code
1018R115Exponent
102ID11Ownership Code
1028AN138Claim Submitters Identifier
1029ID12Claim Status Code
103AN35Packaging Code
1032ID12Claim Filing Indicator Code
1033ID12Claim Adjustment Group Code
1034ID15Claim Adjustment Reason Code
1035AN135Name Last or Organization Name
1036AN125Name First
1037AN125Name Middle
1038AN110Name Prefix
1039AN110Name Suffix
1048ID13Business Function Code
1065ID11Entity Type Qualifier
1066ID12Citizenship Status Code
1067ID11Marital Status Code
1068ID11Gender Code
1069ID22Individual Relationship Code
107ID12Payment Method Code
1073ID11Yes/No Condition or Response Code
1074ID22Type of Real Estate Asset Code
1095N044Year
1109ID11Race or Ethnicity Code
1129ID12Adjustment Reason Code Characteristic
1130ID11Primary or Contingent Code
1136ID22Code Category
1137AN115Medical Code Value
1138ID11Payer Responsibility Sequence Number Code
1143ID11Coordination of Benefits Code
1146ID11Disability Type Code
1149ID46Occupation Code
1154ID11Work Intensity Code
116ID315Postal Code
1161ID12Product Option Code
1165ID11Confidentiality Code
1166ID22Contract Type Code
1167R16Sample Selection Modulus
1176ID23Employment Class Code
118R19Rate
1186ID22Type of Income Code
1187ID22Type of Account Code
1188ID22Type of Personal or Business Asset Code
1201ID11Information Status Code
1202ID11Flexible Spending Account Selection Code
1203ID23Maintenance Reason Code
1204AN150Plan Coverage Description
1205ID23Insurance Line Code
1207ID33Coverage Level Code
1209ID11Underwriting Decision Code
1211ID23Drug House Code
1212ID11Health-Related Code
1213ID11Current Health Condition Code
1214AN15Salary Grade
1215ID11Identification Card Type Code
1216ID11Benefit Status Code
1218ID11Medicare Plan Code
1219ID12Consolidated Omnibus Budget Reconciliation Act (COBRA) Qualifying
1220ID11Student Status Code
1221ID13Provider Code
1222AN13Provider Specialty Code
1223ID33Provider Organization Code
1224ID22Contribution Code
123N016Number of Received Transaction Sets
124AN215124
1250ID23Date Time Period Format Qualifier
1251AN135Date Time Period
1253ID36Immunization Type Code
1254ID12Immunization Status Code
127AN130Reference Identification
1270ID13Code List Qualifier Code
1271AN130Industry Code
128ID23Reference Identification Qualifier
1295ID12Participant Status Code
1296AN16Special Processing Type
1303ID12Use of Language Indicator
1314ID11Admission Source Code
1315ID11Admission Type Code
1316ID11Ambulance Transport Code
1317ID11Ambulance Transport Reason Code
1318ID11Approval Code
1319ID12Basis of Cost Determination Code
1320ID11Basis of Days Supply Determination Code
1321ID22Condition Indicator
1322ID11Certification Type Code
1325ID11Claim Frequency Type Code
1327ID11Copay Status Code
1328N012Diagnosis Code Pointer
1329ID11Dispense as Written Code
1330ID22Dosage Form Code
1331AN12Facility Code Value
1332ID12Facility Code Qualifier
1333ID12Record Format Code
1334ID11Health Care Professional Shortage Area Code
1335ID11Insulin Dependent Code
1336ID13Insurance Type Code
1337ID11Level of Care Code
1338ID13Level of Service Code
1339AN22Procedure Modifier
1340ID12Multiple Procedure Code
1341AN12National or Local Assigned Review Value
1342ID11Nature of Condition Code
1343ID12Non-Institutional Claim Type Code
1344ID11Non-Visit Code
1345ID11Nursing Home Residential Status Code
1346ID11Nutrient Administration Method Code
1347ID11Nutrient Administration Technique Code
1348ID11Oxygen Equipment Type Code
1349ID11Oxygen Test Condition Code
1350ID11Oxygen Test Findings Code
1351ID11Patient Signature Source Code
1352ID12Patient Status Code
1354ID14Diagnosis Related Group (DRG) Code
1355ID22Prescription Denial Override Code
1356ID11Prescription Origin Code
1357ID11Prior Authorization Type Code
1358ID11Prosthesis
1359ID11Provider Accept Assignment Code
1360ID11Provider Agreement Code
1361ID13Oral Cavity Designation Code
1362ID23Related-Causes Code
1363ID11Release of Information Code
1364ID12Review Code
1365ID12Service Type Code
1366ID23Special Program Code
1367ID23Subluxation Level Code
1368ID12Tooth Status Code
1369ID12Tooth Surface Code
1370ID11Unit Dose Code
1371R110Unit Rate
1373ID24Measurement Method or Device
1382ID11Oxygen Delivery System Code
1383ID22Claim Submission Reason Code
1384ID11Patient Location Code
1390ID12Eligibility or Benefit Information
1403ID11Implant Type Code
1404ID11Implant Status Code
142AN215Application Senders Code
1429ID12Construction Type
143ID33Transaction Set Identifier Code
1470N019Number
1473ID22Pricing Methodology
1476ID11Language Proficiency Indicator
151AN120Authority
1514ID12Delay Reason Code
1525ID12Request Category Code
1526ID12Policy Compliance Code
1527ID12Exception Code
1528N012Composite Data Element Position in Composite
156ID22State or Province Code
166AN155Address Information
1685ID12Tax Treatment Code
1687R115Earnings Rate of Pay
1705AN135Implementation Convention Reference
183R18Volume
184ID11Volume Unit Qualifier
188ID11Weight Unit Code
19AN230City Name
2N016Number of Accepted Transaction Sets
212R117Unit Price
22AN130Commodity Code
23ID11Commodity Code Qualifier
234AN148Product/Service ID
235ID22Product/Service ID Qualifier
236ID33Price Identifier Code
26ID23Country Code
28N019Group Control Number
29DT68Date
30TM44Time
280R410Exchange Rate
289N012Multiple Price Quantity
305ID12Transaction Handling Code
306ID12Action Code
309ID12Location Qualifier
310AN130Location Identifier
324AN122Purchase Order Number
328AN130Release Number
329AN49Transaction Set Control Number
332R16Percent
337TM48Time
338R16Terms Discount Percent
349ID11Item Description Type
350AN120Assigned Identification
352AN180Description
353ID22Transaction Set Purpose Code
354N016Number of Line Items
355ID22Unit or Basis for Measurement Code
358R110Quantity Invoiced
363ID33Note Reference Code
364AN180Communication Number
365ID22Communication Number Qualifier
366ID22Contact Function Code
373DT88Date
374ID33Date/Time Qualifier
380R115Quantity
426ID22Adjustment Reason Code
429AN116Check Number
443AN120Contact Inquiry Reference
447AN16Loop Identifier Code
449AN180Fixed Format Information
455ID12Responsible Agency Code
478ID11Credit/Debit Flag Code
479ID22Functional Identifier Code
480AN112Version / Release / Industry Identifier Code
481ID12Trace Type Code
482ID22Payment Action Code
499AN110Condition Value
506ID22(DFI) ID Number Qualifier
507AN312(DFI) Identification Number
508AN135Account Number
509AN1010Originating Company Identifier
510AN99Originating Company Supplemental Code
522ID13Amount Qualifier Code
539AN125Vehicle Identification Number
554N016Assigned Number
559ID22Agency Qualifier Code
569ID13Account Number Qualifier
584ID22Employment Status Code
591ID33Payment Method Code
594ID11Frequency Code
609N019Count
61AN130Free-Form Message
610N2115Amount
615ID12Time Period Qualifier
616N013Number of Periods
623ID22Time Code
628AN112Hierarchical ID Number
639ID22Basis of Unit Price Code
640ID22Transaction Type Code
648ID33Price Multiplier Qualifier
649R110Multiplier
65R18Height
659ID12Basis of Verification Code
66ID12Identification Code Qualifier
662ID11Relationship Code
669ID33Currency Market/Exchange Code
67AN280Identification Code
672ID22Resource Authorization Code
673ID22Quantity Qualifier
675ID22Schedule Type Qualifier
676ID11Schedule Quantity Qualifier
678ID12Ship/Delivery or Calendar Pattern Code
679ID11Ship/Delivery Pattern Time Code
680ID11Forecast Qualifier
681ID11Forecast Timing Qualifier
687ID22Class of Trade Code
689ID22Occupancy Code
704ID12Paperwork/Report Action Code
706ID22Entity Relationship Code
715ID11Functional Group Acknowledgment Code
716ID13Functional Group Syntax Error Code
717ID11Transaction Set Acknowledgment Code
718ID13Transaction Set Syntax Error Code
719N016Segment Position in Transaction Set
720ID13Segment Syntax Error Code
721ID23Segment ID Code
722N012Element Position in Segment
723ID13Data Element Syntax Error Code
724AN199Copy of Bad Data Element
725N014Data Element Reference Number
734AN112Hierarchical Parent ID Number
735ID12Hierarchical Level Code
736ID11Hierarchical Child Code
737ID22Measurement Reference ID Code
738ID13Measurement Qualifier
739R120Measurement Value
740R120Range Minimum
741R120Range Maximum
750ID23Product/Process Characteristic Code
751AN112Product Description Code
752ID22Surface/Layer/Position Code
754AN17Packaging Description Code
755ID22Report Type Code
756ID12Report Transmission Code
757N012Report Copies Needed
782R118Monetary Amount
786ID22Security Level Code
799AN130Version Identifier
81R110Weight
812ID110Payment Format Code
819ID23Language Code
82R18Length
821ID33Safety Characteristic/Hazard Code
822AN115Source Subqualifier
875ID33Maintenance Type Code
889ID11Follow-up Action Code
9ID22Late Reason Code
901ID22Reject Reason Code
921ID22Discipline Type Code
923ID11Prognosis Code
93AN160Name
933AN1264Free-Form Message Text
934ID22Printer Carriage Control Code
935ID22Measurement Significance Code
936ID22Measurement Attribute Code
954R110Percent
96N0110Number of Included Segments
97N01697
98ID23Entity Identifier Code
I01ID22I01
I02AN1010I02
I03ID22I03
I04AN1010I04
I05ID22I05
I06AN1515I06
I07AN1515I07
I08DT66I08
I09TM44I09
I10ID11I10
I11ID55I11
I12N099I12
I13ID11I13
I14ID11I14
I15AN11I15
I16N015I16
I17ID11I17
I18ID33I18