EQ Eligibility or Benefit Inquiry
To specify inquired eligibility or benefit information
Position
Element
Name
Type
Requirement
Min
Max
Repeat
Code identifying the classification of service
R0102: At least one of EQ-01 or EQ-02 is required
Position of data in the repeating data element conveys no significance.
Code identifying the type/source of the descriptive number used in Product/Service ID (234)
C003-01 qualifies C003-02 and C003-08.
Identifying number for a product or service
If C003-08 is used, then C003-02 represents the beginning value in the range in which the code occurs.
This identifies special circumstances related to the performance of the service, as defined by trading partners
C003-03 modifies the value in C003-02 and C003-08.
This identifies special circumstances related to the performance of the service, as defined by trading partners
C003-04 modifies the value in C003-02 and C003-08.
This identifies special circumstances related to the performance of the service, as defined by trading partners
C003-05 modifies the value in C003-02 and C003-08.
This identifies special circumstances related to the performance of the service, as defined by trading partners
C003-06 modifies the value in C003-02 and C003-08.
A free-form description to clarify the related data elements and their content
C003-07 is the description of the procedure identified in C003-02.
Identifying number for a product or service
C003-08 represents the ending value in the range in which the code occurs.
Code indicating the level of coverage being provided for this insured
Code identifying the type of insurance policy within a specific insurance program
A pointer to the diagnosis code in the order of importance to this service
C004-01 identifies the primary diagnosis code for this service line.
A pointer to the diagnosis code in the order of importance to this service
C004-02 identifies the second diagnosis code for this service line.
A pointer to the diagnosis code in the order of importance to this service
C004-03 identifies the third diagnosis code for this service line.
A pointer to the diagnosis code in the order of importance to this service
C004-04 identifies the fourth diagnosis code for this service line.