facility name and location of EDI loop 2310C , 2310A

by

Electronic Data Interchange – Institutional & Dental Claims


837 Health Care Claim Submissions


INSTITUTIONAL
Loop
 Segments/Data Elements
Billing Provider
Loop 2010aa
 NPI: NM108 = XX and NM109 = NPI
Tax ID: REF01 = EI and REF02 = Tax ID Legacy ID not mandated for use.
Pay-To Provider
Loop 2010ab
 NPI: NM108 = XX and NM109 = NPI
Tax ID: REF01 = EI and REF02 = Tax ID Legacy ID not mandated for use.
Attending Provider
Loop 2310a
 NPI: NM108 = XX and NM109 = NPI Tax ID not mandated for use.
Legacy ID not mandated for use.
Operating Physician Name
Loop 2310b
 NPI: NM108 = XX and NM109 = NPI Tax ID not mandated for use.
Legacy ID not mandated for use.
Other Provider Name
Loop 2310c
 NPI: NM108 = XX and NM109 = NPI Tax ID not mandated for use.
Legacy ID not mandated for use.
Service Facility Name
Loop 2310e
 NPI: NM108 = XX and NM109 = NPI Tax ID not mandated for use.
Legacy ID not mandated for use.
Attending Physician Name
Loop 2420a
 NPI: NM108 = XX and NM109 = NPI Tax ID not mandated for use.
Legacy ID not mandated for use.
Operating Physician Name
Loop 2420b
 NPI: NM108 = XX and NM109 = NPI Tax ID not mandated for use.
Legacy ID not mandated for use.
Other Provider Name
Loop 2420c
 NPI: NM108 = XX and NM109 = NPI Tax ID not mandated for use.
Legacy ID not mandated for use.
DENTAL
Loop
 Segments/Data Elements
Billing Provider
Loop 2010AA
 NPI: NM108 = XX and NM109 = NPI
Tax ID: REF01 = EI and REF02 = Tax ID Legacy ID not mandated for use
Pay-To Provider
Loop 2010AB
 NPI: NM108 = XX and NM109 = NPI
Tax ID: REF01 = EI and REF02 = Tax ID Legacy ID not mandated for use
Rendering Provider
Loop 2310B
 NPI: NM108 = XX and NM109 = NPI Tax ID not mandated for use
Legacy ID not mandated for use
Referring Provider
Loop 2310A
 NPI: NM108 = XX and NM109 = NPI Tax ID not mandated for use
Legacy ID not mandated for use
Service Facility Location
Loop 2310C
 NPI: NM108 = XX and NM109 = NPI Tax ID not mandated for use
Legacy ID not mandated for use