ALCALLOWANCE OR CHARGE

To identify allowance or charge details.
5463
ALLOWANCE OR CHARGE CODE QUALIFIER
Mandatory an 0..3
Code qualifying an allowance or charge.
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C552
ALLOWANCE/CHARGE INFORMATION
Conditional Min: 0 Max: 1
Identification of allowance/charge information by number and/or code.
1230
Allowance or charge identifier
Conditional an 0..35
To identify an allowance or charge.
5189
Allowance or charge identification code
Conditional an 0..3
Code specifying the identification of an allowance or charge.
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4471
SETTLEMENT MEANS CODE
Conditional an 0..3
Code specifying the means of settlement.
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1227
CALCULATION SEQUENCE CODE
Conditional an 0..3
Code specifying a calculation sequence.
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C214
SPECIAL SERVICES IDENTIFICATION
Conditional Min: 0 Max: 1
Identification of a special service by a code from a specified source or by description.
7161
Special service description code
Conditional an 0..3
Code specifying a special service.
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1131
Code list identification code
Conditional an 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
Conditional an 0..3
Code specifying the agency responsible for a code list.
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7160
Special service description
Conditional an 0..35
Free form description of a special service.
7160
Special service description
Conditional an 0..35
Free form description of a special service.