Draft| Used by 0 transactions and 1 template, Uses 2 templates | ||||||||||||||||||||
|
| Item | DT | Card | Conf | Description | Label |
|---|---|---|---|---|---|
| hl7v2:GP2.1 | IS | 0 … 1 | Revenue Code | GP2_ ment | |
| @Item | 0 … 1 | F | 1600 | ||
| @Type | 0 … 1 | F | IS | ||
| @Table | 0 … 1 | F | HL70456 | ||
| @LongName | 0 … 1 | F | Revenue Code | ||
| hl7v2:GP2.2 | NM | 0 … 1 | Number of Service Units | GP2_ment | |
| @Item | 0 … 1 | F | 1604 | ||
| @Type | 0 … 1 | F | NM | ||
| @LongName | 0 … 1 | F | Number of Service Units | ||
| hl7v2:GP2.3 | CP | 0 … 1 | Charge Contains 2.16.840.1.113883.3.1937.99.60.4.15.8 (DYNAMIC) | GP2_ment | |
| @Item | 0 … 1 | F | 1605 | ||
| @Type | 0 … 1 | F | CP | ||
| @LongName | 0 … 1 | F | Charge | ||
| hl7v2:GP2.4 | IS | 0 … 1 | Reimbursement Action Code | GP2_ment | |
| @Item | 0 … 1 | F | 1606 | ||
| @Type | 0 … 1 | F | IS | ||
| @Table | 0 … 1 | F | HL70459 | ||
| @LongName | 0 … 1 | F | Reimbursement Action Code | ||
| hl7v2:GP2.5 | IS | 0 … 1 | Denial or Rejection Code | GP2_ment | |
| @Item | 0 … 1 | F | 1607 | ||
| @Type | 0 … 1 | F | IS | ||
| @Table | 0 … 1 | F | HL70460 | ||
| @LongName | 0 … 1 | F | Denial or Rejection Code | ||
| hl7v2:GP2.6 | IS | 0 … * | OCE Edit Code | GP2_ment | |
| @Item | 0 … 1 | F | 1608 | ||
| @Type | 0 … 1 | F | IS | ||
| @Table | 0 … 1 | F | HL70458 | ||
| @LongName | 0 … 1 | F | OCE Edit Code | ||
| hl7v2:GP2.7 | CE | 0 … 1 | Ambulatory Payment Classification Code Contains 2.16.840.1.113883.3.1937.99.60.4.15.5 (DYNAMIC) | GP2_ment | |
| @Item | 0 … 1 | F | 1609 | ||
| @Type | 0 … 1 | F | CE | ||
| @Table | 0 … 1 | F | HL70466 | ||
| @LongName | 0 … 1 | F | Ambulatory Payment Classification Code | ||
| hl7v2:GP2.8 | IS | 0 … * | Modifier Edit Code | GP2_ment | |
| @Item | 0 … 1 | F | 1610 | ||
| @Type | 0 … 1 | F | IS | ||
| @Table | 0 … 1 | F | HL70467 | ||
| @LongName | 0 … 1 | F | Modifier Edit Code | ||
| hl7v2:GP2.9 | IS | 0 … 1 | Payment Adjustment Code | GP2_ment | |
| @Item | 0 … 1 | F | 1611 | ||
| @Type | 0 … 1 | F | IS | ||
| @Table | 0 … 1 | F | HL70468 | ||
| @LongName | 0 … 1 | F | Payment Adjustment Code | ||
| hl7v2:GP2.10 | IS | 0 … 1 | Packaging Status Code | GP2_ment | |
| @Item | 0 … 1 | F | 1617 | ||
| @Type | 0 … 1 | F | IS | ||
| @Table | 0 … 1 | F | HL70469 | ||
| @LongName | 0 … 1 | F | Packaging Status Code | ||
| hl7v2:GP2.11 | CP | 0 … 1 | Expected CMS Payment Amount Contains 2.16.840.1.113883.3.1937.99.60.4.15.8 (DYNAMIC) | GP2_ment | |
| @Item | 0 … 1 | F | 1618 | ||
| @Type | 0 … 1 | F | CP | ||
| @LongName | 0 … 1 | F | Expected CMS Payment Amount | ||
| hl7v2:GP2.12 | IS | 0 … 1 | Reimbursement Type Code | GP2_ment | |
| @Item | 0 … 1 | F | 1619 | ||
| @Type | 0 … 1 | F | IS | ||
| @Table | 0 … 1 | F | HL70470 | ||
| @LongName | 0 … 1 | F | Reimbursement Type Code | ||
| hl7v2:GP2.13 | CP | 0 … 1 | Co-Pay Amount Contains 2.16.840.1.113883.3.1937.99.60.4.15.8 (DYNAMIC) | GP2_ment | |
| @Item | 0 … 1 | F | 1620 | ||
| @Type | 0 … 1 | F | CP | ||
| @LongName | 0 … 1 | F | Co-Pay Amount | ||
| hl7v2:GP2.14 | NM | 0 … 1 | Pay Rate per Service Unit | GP2_ment | |
| @Item | 0 … 1 | F | 1621 | ||
| @Type | 0 … 1 | F | NM | ||
| @LongName | 0 … 1 | F | Pay Rate per Service Unit | ||