E025 Basis of service information

To identify the basis of service including the type, date and charge.

Position: 010 · Element: 9641 · Name: Service basis code qualifier · Type: String (AN) · Requirement: Mandatory · Min: 1 · Max: 3 · Repeat: -

Code qualifying the basis on which a service is performed.

Position: 020 · Element: 7135 · Name: Product identifier · Type: String (AN) · Requirement: Mandatory · Min: 1 · Max: 35 · Repeat: -

To identify a product.

Position: 030 · Element: 1131 · Name: Code list identification code · Type: String (AN) · Requirement: Conditional · Min: 1 · Max: 17 · Repeat: -

Code identifying a user or association maintained code list.

1 The codes for this data element are provided by the code list responsible agency defined in data element 3055.

Position: 040 · Element: 2380 · Name: Date or time or period text · Type: String (AN) · Requirement: Conditional · Min: 1 · Max: 35 · Repeat: -

The value of a date, a date and time, a time or of a period in a specified representation.

Position: 050 · Element: 2379 · Name: Date or time or period format code · Type: String (AN) · Requirement: Conditional · Min: 1 · Max: 3 · Repeat: -

Code specifying the representation of a date, time or period.

Position: 060 · Element: 5004 · Name: Monetary amount · Type: Numeric (N) · Requirement: Conditional · Min: 1 · Max: 35 · Repeat: -

To specify a monetary amount.