PRV Provider Information

To specify the identifying characteristics of a provider

Position: PRV-01 · Element: 1221 · Name: Provider Code · Type: Identifier (ID) · Requirement: Mandatory · Min: 1 · Max: 3 · Repeat: -

Code indentifying the type of provider

P0506: If either PRV-05 or PRV-06 is present, then the other is required

Position: PRV-02 · Element: 128 · Name: Reference Number Qualifier · Type: Identifier (ID) · Requirement: Mandatory · Min: 2 · Max: 2 · Repeat: -

Code qualifying the Reference Number.

Position: PRV-03 · Element: 127 · Name: Reference Number · Type: String (AN) · Requirement: Mandatory · Min: 1 · Max: 30 · Repeat: -

Reference number or identification number as defined for a particular Transaction Set, or as specified by the Reference Number Qualifier.

Position: PRV-04 · Element: 156 · Name: State or Province Code · Type: Identifier (ID) · Requirement: Optional · Min: 2 · Max: 2 · Repeat: -

Code (Standard State/Province) as defined by appropriate government agency.

Position: PRV-05 · Element: 559 · Name: Agency Qualifier Code · Type: Identifier (ID) · Requirement: Conditional · Min: 2 · Max: 2 · Repeat: -

Code identifying the agency assigning the code values.

PRV05 qualifies PRV06.

Position: PRV-06 · Element: 1222 · Name: Provider Specialty Code · Type: String (AN) · Requirement: Conditional · Min: 1 · Max: 3 · Repeat: -

Code indicating the primary specialty of the provider, as defined by the receiver

Position: PRV-07 · Element: 1223 · Name: Provider Organization Code · Type: Identifier (ID) · Requirement: Optional · Min: 3 · Max: 3 · Repeat: -

Code identifying the organizational structure of a provider