Basic Claim Information - Automotive

Basic Claim Information - Automotive (F12) defines 8 elements and 6 semantic notes. Sign up free or login to view the full segment and download it in Markdown or console (text) formats.

Elements

127 F12-01

Reference Identification

Alphanumeric (AN) R Required 1/80

127 F12-02

Reference Identification

Alphanumeric (AN) R Required 1/80

373 F12-03

Date

Date (DT) R Required 8/8

475 F12-04

Credit/Debit Adjustment Number

Alphanumeric (AN) R Required 1/22

373 F12-05

Date

Date (DT) R Required 8/8

543 F12-06

Labor Rate

Numeric - Two Decimals (N2) R Required 3/6

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