837P Companion Guide - Peach State Health Plan Peach State ...

HI08 S Health Care CodeInformationHI08-01 R Diagnosis Type Code BF: DiagnosisICD-9 CodesHI08-02 R Diagnosis CodeHI08-03 R Date Time PeriodFormat QualifierHI08-04 N/A Date Time Period Not UsedHI08-05 N/A Monetary Amount Not UsedHI08-06 N/A Quantity Not UsedHI08-07 N/A Version Identifier Not UsedHI09 N/A Health Care Code Not UsedInformationHI10 N/A Health Care Code Not UsedInformationHI11 N/A Health Care Code Not UsedInformationHI12 N/A Health Care CodeInformationNot UsedSegment NameSegment IDLoop IDUsageSegment NotesElement UsageIDReferring Provider NameNM12310ASituationalGuideDescription/ValidValues70CommentsNM101 R Entity Identifier Code DN: Referring ProviderP3: Primary Care ProviderNM102 R Entity Type Qualifier 1: Person2: Non-Person EntityNM103 R Referring Provider Required of NM102=1 (person).Last NameNM104 S Referring Provider