Medisoft Loop Segment
Loop 1000A Segment N2: Additional Submitter Name Information
Loop 1000A Segment NM1: Submitter Name
Loop 1000A Segment PER: Submitter EDI Contact Information
Loop 1000B Segment N2: Additional Receiver Name Information
Loop 1000B Segment NM1: Receiver Name
Loop 2000A Segment CUR: Foreign Currency Information
Loop 2000A Segment HL: Billing/Pay-to Provider Hierarchical Level
Loop 2000A Segment PRV: Billing/Pay-to Provider Specialty
Loop 2000B Segment HL: Subscriber Hierarchical Level
Loop 2000B Segment PAT: Patient Information
Loop 2000B Segment SBR: Subscriber Information
Loop 2000C Segment HL: Patient Hierarchical Level
Loop 2000C Segment PAT: Patient Information
Loop 2010AA Segment N2: Additional Billing Provider Name
Loop 2010AA Segment N3: Billing Provider Address
Loop 2010AA Segment N4: Billing Provider City/State/Zip
Loop 2010AA Segment NM1: Billing Provider Name
Loop 2010AA Segment PER: Billing Provider Contact Info
Loop 2010AA Segment REF: Billing Provider Secondary ID
Loop 2010AA Segment REF: Credit/Debit Card Billing Info
Loop 2010AB Segment N2: Additional Pay-to Provider Name
Loop 2010AB Segment N3: Pay-to Provider Address
Loop 2010AB Segment N4: Pay-to Provider City/State/Zip
Loop 2010AB Segment NM1: Pay-to Provider Name
Loop 2010AB Segment REF: Pay-to Provider Secondary ID
Loop 2010BA Segment DMG: Subscriber Demographic Info
Loop 2010BA Segment N3: Subscriber Address
Loop 2010BA Segment N4: Subscriber City/State/Zip
Loop 2010BA Segment N2: Additional Subscriber Name Info
Loop 2010BA Segment NM1: Subscriber Name
Loop 2010BA Segment REF: Property and Casualty Claim Number
Loop 2010BA Segment REF: Subscriber Secondary ID
Loop 2010BB Segment N2: Additional Payer Name Info
Loop 2010BB Segment N3: Payer Address
Loop 2010BB Segment N4: Payer City/State/Zip
Loop 2010BB Segment NM1: Payer Name
Loop 2010BB Segment REF: Payer Secondary ID
Loop 2010BC Segment N2: Additional Responsible Party Name
Loop 2010BC Segment N3: Responsible Party Address
Loop 2010BC Segment N4: Responsible Party City/State/Zip
Loop 2010BC Segment NM1: Responsible Party Name
Loop 2010BD Segment N2: Additional Credit/Debit Cardholder Name
Loop 2010BD Segment NM1: Credit/Debit Cardholder Name
Loop 2010BD Segment REF: Credit/Debit Card Info
Loop 2010CA Segment DMG: Patient Demographic Info
Loop 2010CA Segment N2: Additional Patient Name Info
Loop 2010CA Segment N3: Patient Address
Loop 2010CA Segment N4: Patient City/State/Zip
Loop 2010CA Segment NM1: Patient Name
Loop 2010CA Segment REF: Patient Secondary ID
Loop 2010CA Segment REF: Property and Casualty Claim Number
Loop 2300 Segment AMT: Credit/Debit Card Max. Amount
Loop 2300 Segment AMT: Patient Amount Paid
Loop 2300 Segment AMT: Total Purchased Service Amount
Loop 2300 Segment CLM: Claim Information
Loop 2300 Segment CN1: Contract Information
Loop 2300 Segment CR1: Ambulance Transport Information
Loop 2300 Segment CR2: Spinal Manipulation Service
Loop 2300 Segment CRC: Ambulance Certification
Loop 2300 Segment CRC: EPSDT Referral
Loop 2300 Segment CRC: Homebound Indicator
Loop 2300 Segment CRC: Patient Condition Info - Vision
Loop 2300 Segment DTP: Assumed Care Date
Loop 2300 Segment DTP: Date Admitted
Loop 2300 Segment DTP: Date Authorized Return to Work
Loop 2300 Segment DTP: Date Disability Begin
Loop 2300 Segment DTP: Date Disability End
Loop 2300 Segment DTP: Date Discharge
Loop 2300 Segment DTP: Date Last Seen
Loop 2300 Segment DTP: Date Last Worked
Loop 2300 Segment DTP: Date of Accident
Loop 2300 Segment DTP: Date of Acute Manifestation
Loop 2300 Segment DTP: Date of Last Menstrual Period
Loop 2300 Segment DTP: Date of Last X-Ray
Loop 2300 Segment DTP: Date Similar Illness/Symptoms Onset
Loop 2300 Segment DTP: Estimated Date of Birth
Loop 2300 Segment DTP: Hearing & Vision Prescription Date
Loop 2300 Segment DTP: Initial Treatment Date
Loop 2300 Segment DTP: Onset of Current Illness/Symptom
Loop 2300 Segment DTP: Order Date
Loop 2300 Segment DTP: Referral Date
Loop 2300 Segment DTP: Relinquished Care Date
Loop 2300 Segment HCP: Claim Pricing/Repricing Info
Loop 2300 Segment HI: Health Care Diagnosis Code
Loop 2300 Segment KS: File Information
Loop 2300 Segment NTE: Claim Note
Loop 2300 Segment PWK: Claim Supplemental Info
Loop 2300 Segment REF: Adjusted Repriced Claim Number
Loop 2300 Segment REF: Ambulatory Patient Group
Loop 2300 Segment REF: Claim ID for Clearinghouses
Loop 2300 Segment REF: CLIA Number
Loop 2300 Segment REF: Demonstration Project ID
Loop 2300 Segment REF: Investigational Device Exemption Number
Loop 2300 Segment REF: Mammography Certification Number
Loop 2300 Segment REF: Medical Record Number
Loop 2300 Segment REF: Original Reference Number
Loop 2300 Segment REF: Prior Auth. Or Referral Number
Loop 2300 Segment REF: Repriced Claim Number
Loop 2300 Segment REF: Service Authorization Exception
Loop 2305 Segment CR7: Home Health Care Plan Info
Loop 2305 Segment HSD: Health Care Services Delivery
Loop 2310A Segment N2: Additional Referring Provider Name Info
Loop 2310A Segment NM1: Referring Provider Name
Loop 2310A Segment PRV: Referring Provider Specialty Info
Loop 2310A Segment REF: Referring Provider Secondary ID
Loop 2310B Segment N2: Additional Rendering Provider Name
Loop 2310B Segment NM1: Rendering Provider Name
Loop 2310B Segment PRV: Rendering Provider Specialty Info
Loop 2310B Segment REF: Rendering Provider Secondary ID
Loop 2310C Segment NM1: Purchased Service Provider Name
Loop 2310C Segment REF: Purchased Service Provider Secondary ID
Loop 2310D Segment N2: Additional Service Facility Location Name
Loop 2310D Segment N3: Service Facility Location Address
Loop 2310D Segment N4: Service Facility Location City/State/Zip
Loop 2310D Segment NM1: Service Facility Location
Loop 2310D Segment REF: Service Facility Location Secondary ID
Loop 2310E Segment N2: Additional Supervising Provider Name
Loop 2310E Segment NM1: Supervising Provider Name
Loop 2310E Segment REF: Supervising Provider Secondary ID
Loop 2320 Segment AMT: Coordination of Benefits Allowed Amount
Loop 2320 Segment AMT: Coordination of Benefits Approved Amount
Loop 2320 Segment AMT: Coordination of Benefits Covered Amount
Loop 2320 Segment AMT: Coordination of Benefits Discount Amount
Loop 2320 Segment AMT: Coordination of Benefits Patient Paid Amount
Loop 2320 Segment AMT: Coordination of Benefits Patient Responsibility Amount
Loop 2320 Segment AMT: Coordination of Benefits Payer Paid Amount
Loop 2320 Segment AMT: Coordination of Benefits Per Day Limit Amount
Loop 2320 Segment AMT: Coordination of Benefits Tax Amount
Loop 2320 Segment AMT: Coordination of Benefits Total Claim Before Taxes Amount
Loop 2320 Segment CAS: Claim Level Adjustments
Loop 2320 Segment DMG: Subscriber Demographic Info
Loop 2320 Segment MOA: Medicare Outpatient Adjudication Info
Loop 2320 Segment OI: Other Insurance Coverage Info
Loop 2320 Segment SBR: Other Subscriber Information
Loop 2330A Segment N2: Other Subscriber Name
Loop 2330A Segment N3: Other Subscriber Address
Loop 2330A Segment N4: Other Subscriber City/State/Zip
Loop 2330A Segment NM1: Other Subscriber Name
Loop 2330A Segment REF: Other Subscriber Secondary ID
Loop 2330B Segment DTP: Claim Adjudication Date
Loop 2330B Segment N2: Other Payer Name
Loop 2330B Segment NM1: Other Payer Name
Loop 2330B Segment PER: Other Payer Contact Info
Loop 2330B Segment REF: Other Payer Claim Adjustment Indicator
Loop 2330B Segment REF: Other Payer Prior Authorization or Referral Number
Loop 2330B Segment REF: Other Payer Secondary ID
Loop 2330C Segment NM1: Other Payer Patient Information
Loop 2330C Segment REF: Other Payer Patient ID
Loop 2330D Segment NM1: Other Payer Referring Provider
Loop2330D Segment REF: Other Payer Referring Provider ID
Loop 2330E Segment NM1: Other Payer Rendering Provider
Loop 2330E Segment REF: Other Payer Rendering Provider Secondary ID
Loop 2330F Segment NM1: Other Payer Purchased Service Provider
Loop 2330F Segment REF: Other Payer Purchased Service Provider ID
Loop 2330G Segment NM1: Other Payer Service Facility Location
Loop 2330G Segment REF: Other Payer Service Facility Location
Loop 2330H Segment NM1: Other Payer Supervising Provider
Loop 2330H Segment REF: Other Payer Supervising Provider ID
Loop 2400 Segment AMT: Approved Amount
Loop 2400 Segment AMT: Postage Claimed Amount
Loop 2400 Segment AMT: Sales Tax Amount
Loop 2400 Segment CN1: Contract Information
Loop 2400 Segment CR1: Ambulance Transport Info
Loop 2400 Segment CR2: Spinal Manipulation Service
Loop 2400 Segment CR3: Durable Medical Equipment Cert.
Loop 2400 Segment CR5: Home Oxygen Therapy Info
Loop 2400 Segment CRC: Ambulance Certification
Loop 2400 Segment CRC: DMERC Condition Indicator
Loop 2400 Segment CRC: Hospice Employee Indicator
Loop 2400 Segment DTP: Acute Manifestation Date
Loop 2400 Segment DTP: Begin Therapy Date
Loop 2400 Segment DTP: Certification Revision Date
Loop 2400 Segment DTP: Date Last Seen
Loop 2400 Segment DTP: Initial Treatment Date
Loop 2400 Segment DTP: Last Certification Date
Loop 2400 Segment DTP: Last X-Ray Date
Loop 2400 Segment DTP: Onset of Current Symptom/Illness Date
Loop 2400 Segment DTP: Order Date
Loop 2400 Segment DTP: Oxygen Saturation/Arterial Blood Gas Test Date
Loop 2400 Segment DTP: Referral Date
Loop 2400 Segment DTP: Service Date
Loop 2400 Segment DTP: Shipped Date
Loop 2400 Segment DTP: Similar Symptom/Illness Onset Date
Loop 2400 Segment DTP: Test Date
Loop 2400 Segment HCP: Line Pricing/Repricing Info
Loop 2400 Segment HSD: Health Care Services Delivery
Loop 2400 Segment K3: File Information
Loop 2400 Segment LX: Service Line
Loop 2400 Segment MEA: Test Result
Loop 2400 Segment NTE: Line Note
Loop 2400 Segment PS1: Purchased Service Info
Loop 2400 Segment PWK: DMERC CMN Indicator
Loop 2400 Segment QTY: Anesthesia Modifying Units
Loop 2400 Segment REF: Adjusted Repriced Line Item Reference No.
Loop 2400 Segment REF: Ambulatory Patient Group
Loop 2400 Segment REF: CLIA ID
Loop 2400 Segment REF: Immunization Batch No.
Loop 2400 Segment REF: Line Item Control Number
Loop 2400 Segment REF: Mammography Certification No.
Loop 2400 Segment REF: Oxygen Flow Rate
Loop 2400 Segment REF: Prior Authorization or Referral No.
Loop 2400 Segment REF: Referring CLIA Facility ID
Loop 2400 Segment REF: Repriced Line Item Reference No.
Loop 2400 Segment REF: Universal Product Number
Loop 2400 Segment SV1: Professional Service
Loop 2400 Segment SV4: Prescription Number
Loop 2410 Segment CTP: Pricing Information
Loop 2410 Segment LIN: Drug Identification
Loop 2420A Segment N2: Additional Rendering Provider Name Info
Loop 2420A Segment NM1: Rendering Provider Name
Loop 2420A Segment PRV: Rendering Provider Specialty Info
Loop 2420A Segment REF: Rendering Provider Secondary ID
Loop 2420B Segment NM1: Purchased Service Provider Name
Loop 2420B Segment REF: Purchased Service Provider Secondary ID
Loop 2420C Segment N2: Additional Service Facility Location Name
Loop 2420C Segment N3: Service Facility Location Address
Loop 2420C Segment N4: Service Facility City/State/Zip
Loop 2420C Segment NM1: Service Facility Location
Loop 2420C Segment REF: Service Facility Location Secondary ID
Loop 2420D Segment N2: Additional Supervising Provider Name Info
Loop 2420D Segment NM1: Supervising Provider Name
Loop 2420D Segment REF: Supervising Provider Secondary ID
Loop 2420E Segment N2: Additional Ordering Provider Name
Loop 2420E Segment N3: Ordering Provider Address
Loop 2420E Segment N4: Ordering Provider City/State/Zip
Loop 2420E Segment NM1: Ordering Provider Name
Loop 2420E Segment PER: Ordering Provider Contact Info
Loop 2420E Segment REF: Ordering Provider Secondary ID
Loop 2420F Segment N2: Additional Referring Provider Name
Loop 2420F Segment NM1: Referring Provider Name
Loop 2420F Segment PRV: Referring Provider Specialty
Loop 2420F Segment REF: Referring Provider Secondary ID
Loop 2420G Segment NM1: Other Payer Prior Auth or Referral No.
Loop 2420G Segment REF: Other Payer Prior Auth or Referral No.
Loop 2430 Segment CAS: Line Adjustment
Loop 2430 Segment DTP: Line Adjudication Date
Loop 2430 Segment SVD: Line Adjudication Info
Loop 2440 Segment FRM: Supporting Documentation
Loop 2440 Segment LQ: Form Identification Code