CHB Chargeback Information

To define elements associated with a charge to unemployment insurance tax account

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Position

Element

Name

Type

Requirement

Min

Max

Repeat

Location Qualifier

Identifier (ID)

Conditional

1

2

1

Code identifying type of location

P0102: If either CHB-01 or CHB-02 is present, then the other is required

Location Identifier

String (AN)

Conditional

1

30

1

Code which identifies a specific location

Reason Stopped Work Code

Identifier (ID)

Optional

2

2

1

Code identifying reason claimant stopped working

Claim Type Code

Identifier (ID)

Optional

1

2

1

Code identifying the basis and type of a legal claim

Claim Status Code

Identifier (ID)

Optional

1

2

1

Code identifying the status of an entire claim as assigned by the payor, claim review organization or repricing organization

Entity Identifier Code

Identifier (ID)

Optional

2

3

1

Code identifying an organizational entity, a physical location, property or an individual

CHB06 may be used to identify the type of employer.

Credit/Debit Flag Code

Identifier (ID)

Optional

1

1

1

Code indicating whether amount is a credit or debit

Industry Code

String (AN)

Optional

1

30

1

Code indicating a code from a specific industry code list

CHB08 is a code assigned by an employment security agency.

Allowance or Charge Indicator Code

Identifier (ID)

Optional

1

1

1

Code indicating an allowance or charge for the service specified