837P (Professional Claim) CSV Data Dictionary

Unique payment identifier assigned by the converter

Transaction set identifier code

Converted X12 EDI file name

Transaction set control number

Transaction set purpose code

Originator application transaction id

Transaction creation date time

Claim or encounter identifier type

Patient control number

Charge amount

Place of service as a string constant (enum)

Place of service code for professional/dental claims or UB facility code for institutional claims

View codes and descriptions

Frequency type code

View codes and descriptions

Provider signature indicator

Assignment participation code

Assignment certification indicator

Release of information code

Delay reason code

Billing provider

The insured (subscriber)

Patient if different from the the insured (subscriber)

The earliest service date from service lines

The latest service date from service lines

Onset of current illness or injury date

Initial treatment date

Last seen date

Acute manifestation date

Accident date

Last menstrual period date

Last xray date

Hearing and vision prescription date

Assumed care date

Relinquished care date

Admission date for ambulance claims

Discharge date

Patient paid amount

Service authorization exception code

Referral number

Prior authorization number

Payer claim control number

Clearinghouse trace number

Repriced reference number

Adjusted repriced reference number

Medical record number

Demonstration project identifier

Free-form comments or instructions. All note segments are concatenated together into this field

Deprecated: Use the 'notes' list instead

Diags

View codes and descriptions

Anesthesia procedure

View codes and descriptions

Conditions

View codes and descriptions

Attachments

Referring provider

Rendering provider

Service facility

Supervising provider

Ambulance pick up

Ambulance drop off

Other subscribers and their payer's information

Service lines

Control number

Procedure

View codes and descriptions

Charge amount

Unit type

Unit count

Place of service

Place of service code

Diag pointers

Emergency indicator

Epsdt indicator

Family planning indicator

Copay status code

Service period start date

Service period end date. If not provided in EDI (single day), it is set to 'serviceDateFrom'

Prescription date

Begin therapy date

Last seen date

Test performed date

Last xray date

Initial treatment date

Prior authorization

Referral number

Repriced reference number

Adjusted repriced reference number

Note

Deprecated: Use list of note objects instead

Third party note

Drug

View codes and descriptions

Drug quantity

Drug unit type

Prescription number

Attachments

Rendering provider

Purchased service provider

Service facility

Supervising provider

Referring provider

Ordering provider

Ambulance pick up

Ambulance drop off

Payer responsibility sequence

Values:

EIGHT(E), ELEVEN(H), FIVE(B), FOUR(A), NINE(F), PRIMARY(P), SECONDARY(S), SEVEN(D), SIX(C), TEN(G), TERTIARY(T), UNCONFIRMED(N), UNKNOWN(U)

Relationship type

Values:

CADAVER_DONOR(40), CHILD(19), EMPLOYEE(20), LIFE_PARTNER(53), ORGAN_DONOR(39), OTHER(G8), SELF(18), SPOUSE(1), UNKNOWN(21)

Group or policy number

Group name

Claim filing indicator code

Insurance plan type

Values:

AUTOMOBILE_MEDICAL(AM), BCBS(BL), CHAMPUS(CH), COMMERCIAL(CI), EPO(14), FEDERAL_EMPLOYEE_PROGRAM(FI), HMO(HM), HMO_MEDICARE(16), INDEMNITY_INSURANCE(15), MEDICAID(MC), MEDICARE_A(MA), MEDICARE_B(MB), MUTUALLY_DEFINED(ZZ), OTHER_FEDERAL(OF), OTHER_NON_FEDERAL(11), POS(13), PPO(12), VETERAN_AFFAIRS(VA), WORKERS_COMPENSATION(WC)

Person

Death date

Patient weight in pounds

Pregnancy indicator

Property casualty claim number

Payer

Relationship type

Values:

CADAVER_DONOR(40), CHILD(19), EMPLOYEE(20), LIFE_PARTNER(53), ORGAN_DONOR(39), OTHER(G8), SELF(18), SPOUSE(1), UNKNOWN(21)

Person

Death date

Patient weight in pounds

Pregnancy indicator

Payer responsibility sequence

Values:

EIGHT(E), ELEVEN(H), FIVE(B), FOUR(A), NINE(F), PRIMARY(P), SECONDARY(S), SEVEN(D), SIX(C), TEN(G), TERTIARY(T), UNCONFIRMED(N), UNKNOWN(U)

Relationship type

Values:

CADAVER_DONOR(40), CHILD(19), EMPLOYEE(20), LIFE_PARTNER(53), ORGAN_DONOR(39), OTHER(G8), SELF(18), SPOUSE(1), UNKNOWN(21)

Group or policy number

Group name

Coordination of benefits code, post-adjudicated claims only

Claim filing indicator code

Insurance plan type

Values:

AUTOMOBILE_MEDICAL(AM), BCBS(BL), CHAMPUS(CH), COMMERCIAL(CI), EPO(14), FEDERAL_EMPLOYEE_PROGRAM(FI), HMO(HM), HMO_MEDICARE(16), INDEMNITY_INSURANCE(15), MEDICAID(MC), MEDICARE_A(MA), MEDICARE_B(MB), MUTUALLY_DEFINED(ZZ), OTHER_FEDERAL(OF), OTHER_NON_FEDERAL(11), POS(13), PPO(12), VETERAN_AFFAIRS(VA), WORKERS_COMPENSATION(WC)

Person

Claim-level adjustments from this payer

Payer paid amount

Non covered amount

Remaining patient liability amount

Assignment certification indicator

Since: v2.14.10

Patient signature source code

Since: v2.14.10

Release of information code

Since: v2.14.10

Outpatient adjudication

Payer prior authorization number

Payer referral number

Payer claim control number

Payer

Patient's information; post-adjudicated claims only

Other payer's providers

Entity role

View codes and descriptions

Type of this entity: 'BUSINESS' for organization, 'INDIVIDUAL' for person

Values:

BUSINESS(2), INDIVIDUAL(1)

Identification type, e.g., NPI or EIN. This is a qualifier code translated to a string constant (enum)

View codes and descriptions

Identifier

Tax id

Type of taxId

Values:

SSN, EIN, TAX_ID

Since: v2.14.10

Organization name or person last name

First name

Middle name

Name suffix

Since: v2.14.10

Address

Contacts

Other identifications

Provider's specialty information (taxonomy). Populated only for billing, rendering, operating providers.

View codes and descriptions

Birth date

Gender

Values:

FEMALE(F), MALE(M), UNKNOWN(U)

Function code

Name

Contact numbers

Type of contact number

Values:

ALTERNATE_PHONE, BEEPER, CELL_PHONE, EMAIL, EXTENSION, FAX, HOME_PHONE, PHONE, UNKNOWN, URL, WORK_PHONE

Number

Line

Line2

City

State code

Zip code

Country code

Modifiers

Healthcare code subtype, such as CPT, HCPCS, ICD_10, NDC

Healthcare code

Code description

Report type code

Report transmission code

Control number

Code qualifying the reference identification

Type of reference; qualifier code as a string constant (enum)

View codes and descriptions

Reference identification