EDI 837 All Fields — Data Dictionary

This page documents every column in the “All Fields” output produced by the Client‑Side EDI 837 converter, including a high‑level EDI segment/element source for each field.

The 530-column schema is exhaustive for the converter's public All Fields projection, with explicit subtype and occurrence boundaries; it is not exhaustive for the X12 implementation guides.

Download the 837 All Fields Data Map

Full CSV/Excel mapping of every All Fields column, including source segments. No PHI.

Column Definitions

Applies to Client‑Side EDI 837 “All Fields” format
Column EDI Source Description
FileNameN/A (converter input metadata)Name of the input EDI file.
TransactionTypeST03Exact implementation routing: X222A1 = 837P, X223A2 = 837I, X224A2 = 837D; unsupported versions are reported conservatively as 837.
RecordTypeN/A (converter)CLAIM or LINE. Service rows are emitted before their claim row.
ClaimIndexN/A (converter)One-based physical CLM occurrence within the parsed input.
LineIndexN/A (converter)One-based mapped service occurrence within the claim; blank on CLAIM rows.
TransactionControlNumberST02Transaction-set control number from the enclosing ST segment.
ISA_ControlNumberISA13Interchange control number from the enclosing ISA envelope.
GS_ControlNumberGS06Functional-group control number from the enclosing GS envelope.
ST_ControlNumberST02Transaction-set control number, retained under the structural All Fields name.
1000A_submitter_id1000A NM1*41, NM108/NM109Submitter identifier, preserved with its qualifier when present.
1000A_submitter_name1000A NM1*41, NM103-NM105Submitter organization or person name.
1000A_address11000A N301Submitter address line 1.
1000A_address21000A N302Submitter address line 2.
1000A_city1000A N401Submitter city.
1000A_state1000A N402Submitter state/province code.
1000A_zip1000A N403Submitter postal code.
1000A_PER_1_name1000A PER, PER02Submitter contact name, bounded communication occurrence 1 of 3.
1000A_PER_1_comm_qual1000A PER, PER03/PER05/PER07Submitter communication qualifier, bounded communication occurrence 1 of 3.
1000A_PER_1_comm1000A PER, PER04/PER06/PER08Submitter communication value, bounded communication occurrence 1 of 3.
1000A_PER_2_name1000A PER, PER02Submitter contact name, bounded communication occurrence 2 of 3.
1000A_PER_2_comm_qual1000A PER, PER03/PER05/PER07Submitter communication qualifier, bounded communication occurrence 2 of 3.
1000A_PER_2_comm1000A PER, PER04/PER06/PER08Submitter communication value, bounded communication occurrence 2 of 3.
1000A_PER_3_name1000A PER, PER02Submitter contact name, bounded communication occurrence 3 of 3.
1000A_PER_3_comm_qual1000A PER, PER03/PER05/PER07Submitter communication qualifier, bounded communication occurrence 3 of 3.
1000A_PER_3_comm1000A PER, PER04/PER06/PER08Submitter communication value, bounded communication occurrence 3 of 3.
1000B_receiver_id1000B NM1*40, NM108/NM109Receiver identifier, preserved with its qualifier when present.
1000B_receiver_name1000B NM1*40, NM103-NM105Receiver organization or person name.
1000B_address11000B N301Receiver address line 1.
1000B_address21000B N302Receiver address line 2.
1000B_city1000B N401Receiver city.
1000B_state1000B N402Receiver state/province code.
1000B_zip1000B N403Receiver postal code.
2010AA_id2010AA NM1*85, NM108/NM109Billing Provider identifier, preserved with its qualifier when present.
2010AA_name2010AA NM1*85, NM103-NM105Billing Provider organization or person name.
2010AA_tax_id2010AA REF02 when REF01=EI or TJBilling provider tax identifier; no other REF qualifier populates this column.
2010AA_taxonomy2010AA PRV03 when PRV02=PXC; subordinate REF*PXC fallbackBilling provider taxonomy code from the supported taxonomy source.
2010AA_address12010AA N301Billing Provider address line 1.
2010AA_address22010AA N302Billing Provider address line 2.
2010AA_city2010AA N401Billing Provider city.
2010AA_state2010AA N402Billing Provider state/province code.
2010AA_zip2010AA N403Billing Provider postal code.
2010AA_contact_1_comm_qual2010AA PER, PER03/PER05/PER07Billing Provider communication qualifier, bounded communication occurrence 1 of 3.
2010AA_contact_1_comm2010AA PER, PER04/PER06/PER08Billing Provider communication value, bounded communication occurrence 1 of 3.
2010AA_contact_2_comm_qual2010AA PER, PER03/PER05/PER07Billing Provider communication qualifier, bounded communication occurrence 2 of 3.
2010AA_contact_2_comm2010AA PER, PER04/PER06/PER08Billing Provider communication value, bounded communication occurrence 2 of 3.
2010AA_contact_3_comm_qual2010AA PER, PER03/PER05/PER07Billing Provider communication qualifier, bounded communication occurrence 3 of 3.
2010AA_contact_3_comm2010AA PER, PER04/PER06/PER08Billing Provider communication value, bounded communication occurrence 3 of 3.
2010AB_id2010AB NM1*87, NM108/NM109Pay-To Provider identifier, preserved with its qualifier when present.
2010AB_name2010AB NM1*87, NM103-NM105Pay-To Provider organization or person name.
2010AB_address12010AB N301Pay-To Provider address line 1.
2010AB_address22010AB N302Pay-To Provider address line 2.
2010AB_city2010AB N401Pay-To Provider city.
2010AB_state2010AB N402Pay-To Provider state/province code.
2010AB_zip2010AB N403Pay-To Provider postal code.
2010BA_member_id2010BA NM1*IL, NM108/NM109Primary Subscriber identifier, preserved with its qualifier when present.
2010BA_last2010BA NM1*IL, NM103Primary Subscriber last name.
2010BA_first2010BA NM1*IL, NM104Primary Subscriber first name.
2010BA_middle2010BA NM1*IL, NM105Primary Subscriber middle name.
2010BA_dob2010BA DMG02 (DMG01=D8)Primary Subscriber birth date, normalized from CCYYMMDD to YYYY-MM-DD when valid.
2010BA_gender2010BA DMG03Primary Subscriber gender code.
2010BA_address12010BA N301Primary Subscriber address line 1.
2010BA_address22010BA N302Primary Subscriber address line 2.
2010BA_city2010BA N401Primary Subscriber city.
2010BA_state2010BA N402Primary Subscriber state/province code.
2010BA_zip2010BA N403Primary Subscriber postal code.
2010BB_id2010BB NM1*PR, NM108/NM109Primary Payer identifier, preserved with its qualifier when present.
2010BB_name2010BB NM1*PR, NM103-NM105Primary Payer organization or person name.
2010BB_address12010BB N301Primary Payer address line 1.
2010BB_address22010BB N302Primary Payer address line 2.
2010BB_city2010BB N401Primary Payer city.
2010BB_state2010BB N402Primary Payer state/province code.
2010BB_zip2010BB N403Primary Payer postal code.
2010CA_last2010CA NM1*QC, NM103Dependent Patient last name. Blank when no dependent-patient loop exists; subscriber data is not substituted.
2010CA_first2010CA NM1*QC, NM104Dependent Patient first name. Blank when no dependent-patient loop exists; subscriber data is not substituted.
2010CA_middle2010CA NM1*QC, NM105Dependent Patient middle name. Blank when no dependent-patient loop exists; subscriber data is not substituted.
2010CA_dob2010CA DMG02 (DMG01=D8)Dependent Patient birth date, normalized from CCYYMMDD to YYYY-MM-DD when valid. Blank when no dependent-patient loop exists.
2010CA_gender2010CA DMG03Dependent Patient gender code. Blank when no dependent-patient loop exists.
2010CA_address12010CA N301Dependent Patient address line 1.
2010CA_address22010CA N302Dependent Patient address line 2.
2010CA_city2010CA N401Dependent Patient city.
2010CA_state2010CA N402Dependent Patient state/province code.
2010CA_zip2010CA N403Dependent Patient postal code.
2300_CLM01_claim_id2300 CLM01Submitter's claim/patient control number.
2300_CLM02_claim_charge2300 CLM02Claim total billed amount as sent.
2300_CLM05_1_facility_type2300 CLM05-1Facility type/place-of-service component.
2300_CLM05_3_frequency2300 CLM05-3Claim frequency component.
2300_tobDerived from CLM05-1 and CLM05-3Compatibility/convenience value formed from mapped facility and frequency components; not a separate X12 element or exhaustive guide interpretation.
2300_DTP_434_statement_from2300 DTP*434, DTP03 D8 or RD8 startStatement-period start date.
2300_DTP_435_statement_to2300 DTP*434, DTP03 RD8 end (D8 repeats)Statement-period end from the same DTP*434 value. The column's historical 435 name is retained for schema compatibility; DTP*435 is not read.
2300_DTP_431_onset2300 DTP*431, DTP03 D8Onset date normalized to YYYY-MM-DD when valid.
2300_DTP_454_initial_treatment2300 DTP*454, DTP03 D8Initial treatment date normalized to YYYY-MM-DD when valid.
2300_DTP_304_last_seen2300 DTP*304, DTP03 D8Last-seen date normalized to YYYY-MM-DD when valid.
2300_DTP_439_accident2300 DTP*439, DTP03 D8Accident date normalized to YYYY-MM-DD when valid.
2300_DTP_438_accident_hour2300 DTP*438, DTP03Accident hour/time value as sent.
2300_DTP_484_lmp2300 DTP*484, DTP03 D8Last menstrual period date normalized to YYYY-MM-DD when valid.
2300_REF_1_qual2300 REF01, source occurrence 1Claim-level REF qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_REF_1_value2300 REF02, source occurrence 1Claim-level REF value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_REF_2_qual2300 REF01, source occurrence 2Claim-level REF qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_REF_2_value2300 REF02, source occurrence 2Claim-level REF value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_REF_3_qual2300 REF01, source occurrence 3Claim-level REF qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_REF_3_value2300 REF02, source occurrence 3Claim-level REF value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_REF_4_qual2300 REF01, source occurrence 4Claim-level REF qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_REF_4_value2300 REF02, source occurrence 4Claim-level REF value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_REF_5_qual2300 REF01, source occurrence 5Claim-level REF qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_REF_5_value2300 REF02, source occurrence 5Claim-level REF value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_REF_6_qual2300 REF01, source occurrence 6Claim-level REF qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_REF_6_value2300 REF02, source occurrence 6Claim-level REF value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_REF_7_qual2300 REF01, source occurrence 7Claim-level REF qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_REF_7_value2300 REF02, source occurrence 7Claim-level REF value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_REF_8_qual2300 REF01, source occurrence 8Claim-level REF qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_REF_8_value2300 REF02, source occurrence 8Claim-level REF value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_REF_9_qual2300 REF01, source occurrence 9Claim-level REF qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_REF_9_value2300 REF02, source occurrence 9Claim-level REF value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_REF_10_qual2300 REF01, source occurrence 10Claim-level REF qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_REF_10_value2300 REF02, source occurrence 10Claim-level REF value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_AMT_1_qual2300 AMT01, source occurrence 1Claim-level AMT qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_AMT_1_amount2300 AMT02, source occurrence 1Claim-level AMT amount; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_AMT_2_qual2300 AMT01, source occurrence 2Claim-level AMT qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_AMT_2_amount2300 AMT02, source occurrence 2Claim-level AMT amount; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_AMT_3_qual2300 AMT01, source occurrence 3Claim-level AMT qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_AMT_3_amount2300 AMT02, source occurrence 3Claim-level AMT amount; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_AMT_4_qual2300 AMT01, source occurrence 4Claim-level AMT qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_AMT_4_amount2300 AMT02, source occurrence 4Claim-level AMT amount; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_AMT_5_qual2300 AMT01, source occurrence 5Claim-level AMT qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_AMT_5_amount2300 AMT02, source occurrence 5Claim-level AMT amount; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_AMT_6_qual2300 AMT01, source occurrence 6Claim-level AMT qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_AMT_6_amount2300 AMT02, source occurrence 6Claim-level AMT amount; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_AMT_7_qual2300 AMT01, source occurrence 7Claim-level AMT qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_AMT_7_amount2300 AMT02, source occurrence 7Claim-level AMT amount; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_AMT_8_qual2300 AMT01, source occurrence 8Claim-level AMT qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_AMT_8_amount2300 AMT02, source occurrence 8Claim-level AMT amount; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_AMT_9_qual2300 AMT01, source occurrence 9Claim-level AMT qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_AMT_9_amount2300 AMT02, source occurrence 9Claim-level AMT amount; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_AMT_10_qual2300 AMT01, source occurrence 10Claim-level AMT qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_AMT_10_amount2300 AMT02, source occurrence 10Claim-level AMT amount; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_QTY_1_qual2300 QTY01, source occurrence 1Claim-level QTY qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_QTY_1_value2300 QTY02, source occurrence 1Claim-level QTY value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_QTY_2_qual2300 QTY01, source occurrence 2Claim-level QTY qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_QTY_2_value2300 QTY02, source occurrence 2Claim-level QTY value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_QTY_3_qual2300 QTY01, source occurrence 3Claim-level QTY qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_QTY_3_value2300 QTY02, source occurrence 3Claim-level QTY value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_QTY_4_qual2300 QTY01, source occurrence 4Claim-level QTY qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_QTY_4_value2300 QTY02, source occurrence 4Claim-level QTY value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_QTY_5_qual2300 QTY01, source occurrence 5Claim-level QTY qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_QTY_5_value2300 QTY02, source occurrence 5Claim-level QTY value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_QTY_6_qual2300 QTY01, source occurrence 6Claim-level QTY qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_QTY_6_value2300 QTY02, source occurrence 6Claim-level QTY value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_QTY_7_qual2300 QTY01, source occurrence 7Claim-level QTY qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_QTY_7_value2300 QTY02, source occurrence 7Claim-level QTY value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_QTY_8_qual2300 QTY01, source occurrence 8Claim-level QTY qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_QTY_8_value2300 QTY02, source occurrence 8Claim-level QTY value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_QTY_9_qual2300 QTY01, source occurrence 9Claim-level QTY qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_QTY_9_value2300 QTY02, source occurrence 9Claim-level QTY value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_QTY_10_qual2300 QTY01, source occurrence 10Claim-level QTY qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_QTY_10_value2300 QTY02, source occurrence 10Claim-level QTY value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_NTE_1_qual2300 NTE01, source occurrence 1Claim-level NTE qual; Smart Mapping exposes the first 5 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_NTE_1_text2300 NTE02, source occurrence 1Claim-level NTE text; Smart Mapping exposes the first 5 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_NTE_2_qual2300 NTE01, source occurrence 2Claim-level NTE qual; Smart Mapping exposes the first 5 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_NTE_2_text2300 NTE02, source occurrence 2Claim-level NTE text; Smart Mapping exposes the first 5 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_NTE_3_qual2300 NTE01, source occurrence 3Claim-level NTE qual; Smart Mapping exposes the first 5 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_NTE_3_text2300 NTE02, source occurrence 3Claim-level NTE text; Smart Mapping exposes the first 5 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_NTE_4_qual2300 NTE01, source occurrence 4Claim-level NTE qual; Smart Mapping exposes the first 5 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_NTE_4_text2300 NTE02, source occurrence 4Claim-level NTE text; Smart Mapping exposes the first 5 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_NTE_5_qual2300 NTE01, source occurrence 5Claim-level NTE qual; Smart Mapping exposes the first 5 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_NTE_5_text2300 NTE02, source occurrence 5Claim-level NTE text; Smart Mapping exposes the first 5 source occurrences in order. Additional occurrences remain available only in Raw output.
2300_prior_auth2300 REF02; first REF01=G1, then X4First supported claim prior-authorization/referral reference.
2300_med_rec_num2300 REF02; first REF01=EA, then MRFirst supported claim medical-record reference.
2300_HI_DX_1_qual2300 HI, HI composite 1; qualifiers ABK/ABF/BK/BFDiagnosis qual, supported diagnosis occurrence 1 of 12. Other HI qualifier families do not populate diagnosis columns.
2300_HI_DX_1_code2300 HI, HI composite 2; qualifiers ABK/ABF/BK/BFDiagnosis code, supported diagnosis occurrence 1 of 12. Other HI qualifier families do not populate diagnosis columns.
2300_HI_DX_2_qual2300 HI, HI composite 1; qualifiers ABK/ABF/BK/BFDiagnosis qual, supported diagnosis occurrence 2 of 12. Other HI qualifier families do not populate diagnosis columns.
2300_HI_DX_2_code2300 HI, HI composite 2; qualifiers ABK/ABF/BK/BFDiagnosis code, supported diagnosis occurrence 2 of 12. Other HI qualifier families do not populate diagnosis columns.
2300_HI_DX_3_qual2300 HI, HI composite 1; qualifiers ABK/ABF/BK/BFDiagnosis qual, supported diagnosis occurrence 3 of 12. Other HI qualifier families do not populate diagnosis columns.
2300_HI_DX_3_code2300 HI, HI composite 2; qualifiers ABK/ABF/BK/BFDiagnosis code, supported diagnosis occurrence 3 of 12. Other HI qualifier families do not populate diagnosis columns.
2300_HI_DX_4_qual2300 HI, HI composite 1; qualifiers ABK/ABF/BK/BFDiagnosis qual, supported diagnosis occurrence 4 of 12. Other HI qualifier families do not populate diagnosis columns.
2300_HI_DX_4_code2300 HI, HI composite 2; qualifiers ABK/ABF/BK/BFDiagnosis code, supported diagnosis occurrence 4 of 12. Other HI qualifier families do not populate diagnosis columns.
2300_HI_DX_5_qual2300 HI, HI composite 1; qualifiers ABK/ABF/BK/BFDiagnosis qual, supported diagnosis occurrence 5 of 12. Other HI qualifier families do not populate diagnosis columns.
2300_HI_DX_5_code2300 HI, HI composite 2; qualifiers ABK/ABF/BK/BFDiagnosis code, supported diagnosis occurrence 5 of 12. Other HI qualifier families do not populate diagnosis columns.
2300_HI_DX_6_qual2300 HI, HI composite 1; qualifiers ABK/ABF/BK/BFDiagnosis qual, supported diagnosis occurrence 6 of 12. Other HI qualifier families do not populate diagnosis columns.
2300_HI_DX_6_code2300 HI, HI composite 2; qualifiers ABK/ABF/BK/BFDiagnosis code, supported diagnosis occurrence 6 of 12. Other HI qualifier families do not populate diagnosis columns.
2300_HI_DX_7_qual2300 HI, HI composite 1; qualifiers ABK/ABF/BK/BFDiagnosis qual, supported diagnosis occurrence 7 of 12. Other HI qualifier families do not populate diagnosis columns.
2300_HI_DX_7_code2300 HI, HI composite 2; qualifiers ABK/ABF/BK/BFDiagnosis code, supported diagnosis occurrence 7 of 12. Other HI qualifier families do not populate diagnosis columns.
2300_HI_DX_8_qual2300 HI, HI composite 1; qualifiers ABK/ABF/BK/BFDiagnosis qual, supported diagnosis occurrence 8 of 12. Other HI qualifier families do not populate diagnosis columns.
2300_HI_DX_8_code2300 HI, HI composite 2; qualifiers ABK/ABF/BK/BFDiagnosis code, supported diagnosis occurrence 8 of 12. Other HI qualifier families do not populate diagnosis columns.
2300_HI_DX_9_qual2300 HI, HI composite 1; qualifiers ABK/ABF/BK/BFDiagnosis qual, supported diagnosis occurrence 9 of 12. Other HI qualifier families do not populate diagnosis columns.
2300_HI_DX_9_code2300 HI, HI composite 2; qualifiers ABK/ABF/BK/BFDiagnosis code, supported diagnosis occurrence 9 of 12. Other HI qualifier families do not populate diagnosis columns.
2300_HI_DX_10_qual2300 HI, HI composite 1; qualifiers ABK/ABF/BK/BFDiagnosis qual, supported diagnosis occurrence 10 of 12. Other HI qualifier families do not populate diagnosis columns.
2300_HI_DX_10_code2300 HI, HI composite 2; qualifiers ABK/ABF/BK/BFDiagnosis code, supported diagnosis occurrence 10 of 12. Other HI qualifier families do not populate diagnosis columns.
2300_HI_DX_11_qual2300 HI, HI composite 1; qualifiers ABK/ABF/BK/BFDiagnosis qual, supported diagnosis occurrence 11 of 12. Other HI qualifier families do not populate diagnosis columns.
2300_HI_DX_11_code2300 HI, HI composite 2; qualifiers ABK/ABF/BK/BFDiagnosis code, supported diagnosis occurrence 11 of 12. Other HI qualifier families do not populate diagnosis columns.
2300_HI_DX_12_qual2300 HI, HI composite 1; qualifiers ABK/ABF/BK/BFDiagnosis qual, supported diagnosis occurrence 12 of 12. Other HI qualifier families do not populate diagnosis columns.
2300_HI_DX_12_code2300 HI, HI composite 2; qualifiers ABK/ABF/BK/BFDiagnosis code, supported diagnosis occurrence 12 of 12. Other HI qualifier families do not populate diagnosis columns.
2300_HI_PR_1_qual837I 2300 HI, HI composite 1; qualifiers BR/BO/BPInstitutional procedure qual, supported occurrence 1 of 6. Blank for other subtypes and unsupported HI qualifier families.
2300_HI_PR_1_code837I 2300 HI, HI composite 2; qualifiers BR/BO/BPInstitutional procedure code, supported occurrence 1 of 6. Blank for other subtypes and unsupported HI qualifier families.
2300_HI_PR_1_date837I 2300 HI, HI composite 4 when composite 3=D8; qualifiers BR/BO/BPInstitutional procedure date, supported occurrence 1 of 6. Blank for other subtypes and unsupported HI qualifier families.
2300_HI_PR_2_qual837I 2300 HI, HI composite 1; qualifiers BR/BO/BPInstitutional procedure qual, supported occurrence 2 of 6. Blank for other subtypes and unsupported HI qualifier families.
2300_HI_PR_2_code837I 2300 HI, HI composite 2; qualifiers BR/BO/BPInstitutional procedure code, supported occurrence 2 of 6. Blank for other subtypes and unsupported HI qualifier families.
2300_HI_PR_2_date837I 2300 HI, HI composite 4 when composite 3=D8; qualifiers BR/BO/BPInstitutional procedure date, supported occurrence 2 of 6. Blank for other subtypes and unsupported HI qualifier families.
2300_HI_PR_3_qual837I 2300 HI, HI composite 1; qualifiers BR/BO/BPInstitutional procedure qual, supported occurrence 3 of 6. Blank for other subtypes and unsupported HI qualifier families.
2300_HI_PR_3_code837I 2300 HI, HI composite 2; qualifiers BR/BO/BPInstitutional procedure code, supported occurrence 3 of 6. Blank for other subtypes and unsupported HI qualifier families.
2300_HI_PR_3_date837I 2300 HI, HI composite 4 when composite 3=D8; qualifiers BR/BO/BPInstitutional procedure date, supported occurrence 3 of 6. Blank for other subtypes and unsupported HI qualifier families.
2300_HI_PR_4_qual837I 2300 HI, HI composite 1; qualifiers BR/BO/BPInstitutional procedure qual, supported occurrence 4 of 6. Blank for other subtypes and unsupported HI qualifier families.
2300_HI_PR_4_code837I 2300 HI, HI composite 2; qualifiers BR/BO/BPInstitutional procedure code, supported occurrence 4 of 6. Blank for other subtypes and unsupported HI qualifier families.
2300_HI_PR_4_date837I 2300 HI, HI composite 4 when composite 3=D8; qualifiers BR/BO/BPInstitutional procedure date, supported occurrence 4 of 6. Blank for other subtypes and unsupported HI qualifier families.
2300_HI_PR_5_qual837I 2300 HI, HI composite 1; qualifiers BR/BO/BPInstitutional procedure qual, supported occurrence 5 of 6. Blank for other subtypes and unsupported HI qualifier families.
2300_HI_PR_5_code837I 2300 HI, HI composite 2; qualifiers BR/BO/BPInstitutional procedure code, supported occurrence 5 of 6. Blank for other subtypes and unsupported HI qualifier families.
2300_HI_PR_5_date837I 2300 HI, HI composite 4 when composite 3=D8; qualifiers BR/BO/BPInstitutional procedure date, supported occurrence 5 of 6. Blank for other subtypes and unsupported HI qualifier families.
2300_HI_PR_6_qual837I 2300 HI, HI composite 1; qualifiers BR/BO/BPInstitutional procedure qual, supported occurrence 6 of 6. Blank for other subtypes and unsupported HI qualifier families.
2300_HI_PR_6_code837I 2300 HI, HI composite 2; qualifiers BR/BO/BPInstitutional procedure code, supported occurrence 6 of 6. Blank for other subtypes and unsupported HI qualifier families.
2300_HI_PR_6_date837I 2300 HI, HI composite 4 when composite 3=D8; qualifiers BR/BO/BPInstitutional procedure date, supported occurrence 6 of 6. Blank for other subtypes and unsupported HI qualifier families.
2310_rendering_id2310 supported rendering loop (P: NM1*82; I: NM1*82; D: NM1*82), NM109 when NM108=XXQualified NPI for the rendering; secondary REF identifiers are not promoted to NPI. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_rendering_name2310 supported rendering loop (P: NM1*82; I: NM1*82; D: NM1*82), NM103-NM105Rendering name. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_rendering_taxonomy2310 supported rendering loop (P: NM1*82; I: NM1*82; D: NM1*82), PRV03 when PRV02=PXC; subordinate REF*PXC fallbackRendering taxonomy. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_rendering_address12310 supported rendering loop (P: NM1*82; I: NM1*82; D: NM1*82), N301Rendering address line 1. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_rendering_address22310 supported rendering loop (P: NM1*82; I: NM1*82; D: NM1*82), N302Rendering address line 2. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_rendering_city2310 supported rendering loop (P: NM1*82; I: NM1*82; D: NM1*82), N401Rendering city. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_rendering_state2310 supported rendering loop (P: NM1*82; I: NM1*82; D: NM1*82), N402Rendering state/province code. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_rendering_zip2310 supported rendering loop (P: NM1*82; I: NM1*82; D: NM1*82), N403Rendering postal code. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_referring_id2310 supported referring loop (P: NM1*DN; I: NM1*DN; D: NM1*DN), NM109 when NM108=XXQualified NPI for the referring; secondary REF identifiers are not promoted to NPI. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_referring_name2310 supported referring loop (P: NM1*DN; I: NM1*DN; D: NM1*DN), NM103-NM105Referring name. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_referring_taxonomy2310 supported referring loop (P: NM1*DN; I: NM1*DN; D: NM1*DN), PRV03 when PRV02=PXC; subordinate REF*PXC fallbackReferring taxonomy. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_referring_address12310 supported referring loop (P: NM1*DN; I: NM1*DN; D: NM1*DN), N301Referring address line 1. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_referring_address22310 supported referring loop (P: NM1*DN; I: NM1*DN; D: NM1*DN), N302Referring address line 2. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_referring_city2310 supported referring loop (P: NM1*DN; I: NM1*DN; D: NM1*DN), N401Referring city. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_referring_state2310 supported referring loop (P: NM1*DN; I: NM1*DN; D: NM1*DN), N402Referring state/province code. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_referring_zip2310 supported referring loop (P: NM1*DN; I: NM1*DN; D: NM1*DN), N403Referring postal code. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_supervising_id2310 supported supervising loop (P: NM1*DQ), NM109 when NM108=XXQualified NPI for the supervising; secondary REF identifiers are not promoted to NPI. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_supervising_name2310 supported supervising loop (P: NM1*DQ), NM103-NM105Supervising name. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_supervising_taxonomy2310 supported supervising loop (P: NM1*DQ), PRV03 when PRV02=PXC; subordinate REF*PXC fallbackSupervising taxonomy. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_supervising_address12310 supported supervising loop (P: NM1*DQ), N301Supervising address line 1. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_supervising_address22310 supported supervising loop (P: NM1*DQ), N302Supervising address line 2. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_supervising_city2310 supported supervising loop (P: NM1*DQ), N401Supervising city. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_supervising_state2310 supported supervising loop (P: NM1*DQ), N402Supervising state/province code. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_supervising_zip2310 supported supervising loop (P: NM1*DQ), N403Supervising postal code. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_service_facility_id2310 supported service facility loop (P/I/D: NM1*77), NM109 when NM108=XXQualified NPI for the service facility; secondary REF identifiers are not promoted to NPI. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_service_facility_name2310 supported service facility loop (P/I/D: NM1*77), NM103-NM105Service Facility name. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_service_facility_taxonomy2310 supported service facility loop (P/I/D: NM1*77), PRV03 when PRV02=PXC; subordinate REF*PXC fallbackService Facility taxonomy. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_service_facility_address12310 supported service facility loop (P/I/D: NM1*77), N301Service Facility address line 1. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_service_facility_address22310 supported service facility loop (P/I/D: NM1*77), N302Service Facility address line 2. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_service_facility_city2310 supported service facility loop (P/I/D: NM1*77), N401Service Facility city. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_service_facility_state2310 supported service facility loop (P/I/D: NM1*77), N402Service Facility state/province code. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_service_facility_zip2310 supported service facility loop (P/I/D: NM1*77), N403Service Facility postal code. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_attending_id2310 supported attending loop (I: NM1*71), NM109 when NM108=XXQualified NPI for the attending; secondary REF identifiers are not promoted to NPI. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_attending_name2310 supported attending loop (I: NM1*71), NM103-NM105Attending name. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_attending_taxonomy2310 supported attending loop (I: NM1*71), PRV03 when PRV02=PXC; subordinate REF*PXC fallbackAttending taxonomy. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_attending_address12310 supported attending loop (I: NM1*71), N301Attending address line 1. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_attending_address22310 supported attending loop (I: NM1*71), N302Attending address line 2. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_attending_city2310 supported attending loop (I: NM1*71), N401Attending city. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_attending_state2310 supported attending loop (I: NM1*71), N402Attending state/province code. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_attending_zip2310 supported attending loop (I: NM1*71), N403Attending postal code. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_operating_id2310 supported operating loop (I: NM1*72), NM109 when NM108=XXQualified NPI for the operating; secondary REF identifiers are not promoted to NPI. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_operating_name2310 supported operating loop (I: NM1*72), NM103-NM105Operating name. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_operating_taxonomy2310 supported operating loop (I: NM1*72), PRV03 when PRV02=PXC; subordinate REF*PXC fallbackOperating taxonomy. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_operating_address12310 supported operating loop (I: NM1*72), N301Operating address line 1. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_operating_address22310 supported operating loop (I: NM1*72), N302Operating address line 2. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_operating_city2310 supported operating loop (I: NM1*72), N401Operating city. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_operating_state2310 supported operating loop (I: NM1*72), N402Operating state/province code. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_operating_zip2310 supported operating loop (I: NM1*72), N403Operating postal code. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_other_id2310 supported other loop (I: NM1*ZZ), NM109 when NM108=XXQualified NPI for the other; secondary REF identifiers are not promoted to NPI. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_other_name2310 supported other loop (I: NM1*ZZ), NM103-NM105Other name. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_other_taxonomy2310 supported other loop (I: NM1*ZZ), PRV03 when PRV02=PXC; subordinate REF*PXC fallbackOther taxonomy. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_other_address12310 supported other loop (I: NM1*ZZ), N301Other address line 1. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_other_address22310 supported other loop (I: NM1*ZZ), N302Other address line 2. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_other_city2310 supported other loop (I: NM1*ZZ), N401Other city. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_other_state2310 supported other loop (I: NM1*ZZ), N402Other state/province code. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2310_other_zip2310 supported other loop (I: NM1*ZZ), N403Other postal code. Mapped only for the listed subtype/role combinations at claim scope; blank otherwise.
2320_1_other_payer_paid_amt2320 AMT02 when AMT01=DCOB other-payer paid amount, other-subscriber loop 1 of 3. Additional loops are not projected into Smart Mapping.
2320_1_other_payer_seq2320 SBR01COB payer responsibility sequence, other-subscriber loop 1 of 3. Additional loops are not projected into Smart Mapping.
2320_1_benefits_assign_ind2320 OI03COB benefits-assignment indicator, other-subscriber loop 1 of 3. Additional loops are not projected into Smart Mapping.
2330_1_payer_id2330 NM1*PR, NM109COB other payer identifier, corresponding other-payer loop 1 of 3.
2330_1_payer_name2330 NM1*PR, NM103COB other payer name, corresponding other-payer loop 1 of 3.
2330_1_address12330 N301COB other payer address line 1, corresponding other-payer loop 1 of 3.
2330_1_address22330 N302COB other payer address line 2, corresponding other-payer loop 1 of 3.
2330_1_city2330 N401COB other payer city, corresponding other-payer loop 1 of 3.
2330_1_state2330 N402COB other payer state/province code, corresponding other-payer loop 1 of 3.
2330_1_zip2330 N403COB other payer postal code, corresponding other-payer loop 1 of 3.
2320_2_other_payer_paid_amt2320 AMT02 when AMT01=DCOB other-payer paid amount, other-subscriber loop 2 of 3. Additional loops are not projected into Smart Mapping.
2320_2_other_payer_seq2320 SBR01COB payer responsibility sequence, other-subscriber loop 2 of 3. Additional loops are not projected into Smart Mapping.
2320_2_benefits_assign_ind2320 OI03COB benefits-assignment indicator, other-subscriber loop 2 of 3. Additional loops are not projected into Smart Mapping.
2330_2_payer_id2330 NM1*PR, NM109COB other payer identifier, corresponding other-payer loop 2 of 3.
2330_2_payer_name2330 NM1*PR, NM103COB other payer name, corresponding other-payer loop 2 of 3.
2330_2_address12330 N301COB other payer address line 1, corresponding other-payer loop 2 of 3.
2330_2_address22330 N302COB other payer address line 2, corresponding other-payer loop 2 of 3.
2330_2_city2330 N401COB other payer city, corresponding other-payer loop 2 of 3.
2330_2_state2330 N402COB other payer state/province code, corresponding other-payer loop 2 of 3.
2330_2_zip2330 N403COB other payer postal code, corresponding other-payer loop 2 of 3.
2320_3_other_payer_paid_amt2320 AMT02 when AMT01=DCOB other-payer paid amount, other-subscriber loop 3 of 3. Additional loops are not projected into Smart Mapping.
2320_3_other_payer_seq2320 SBR01COB payer responsibility sequence, other-subscriber loop 3 of 3. Additional loops are not projected into Smart Mapping.
2320_3_benefits_assign_ind2320 OI03COB benefits-assignment indicator, other-subscriber loop 3 of 3. Additional loops are not projected into Smart Mapping.
2330_3_payer_id2330 NM1*PR, NM109COB other payer identifier, corresponding other-payer loop 3 of 3.
2330_3_payer_name2330 NM1*PR, NM103COB other payer name, corresponding other-payer loop 3 of 3.
2330_3_address12330 N301COB other payer address line 1, corresponding other-payer loop 3 of 3.
2330_3_address22330 N302COB other payer address line 2, corresponding other-payer loop 3 of 3.
2330_3_city2330 N401COB other payer city, corresponding other-payer loop 3 of 3.
2330_3_state2330 N402COB other payer state/province code, corresponding other-payer loop 3 of 3.
2330_3_zip2330 N403COB other payer postal code, corresponding other-payer loop 3 of 3.
2400_LX_indexN/A (converter service occurrence)One-based mapped SV1/SV2/SV3 occurrence within the claim; this is not source LX01.
2400_SV1_proc_qual837P SV101-1Professional product/service ID qualifier; blank for other subtypes.
2400_SV1_proc_code837P SV101-2Professional procedure code; blank for other subtypes.
2400_SV1_mod1837P SV101-3Professional procedure modifier 1; blank for other subtypes.
2400_SV1_mod2837P SV101-4Professional procedure modifier 2; blank for other subtypes.
2400_SV1_mod3837P SV101-5Professional procedure modifier 3; blank for other subtypes.
2400_SV1_mod4837P SV101-6Professional procedure modifier 4; blank for other subtypes.
2400_SV1_charge837P SV102Professional line billed amount; blank for other subtypes.
2400_SV1_units837P SV104Professional line units; blank for other subtypes.
2400_SV1_pos837P SV105Professional line place-of-service code; blank for other subtypes.
2400_SV1_diag_ptr1837P SV107-1Professional diagnosis pointer 1; blank for other subtypes.
2400_SV1_diag_ptr2837P SV107-2Professional diagnosis pointer 2; blank for other subtypes.
2400_SV1_diag_ptr3837P SV107-3Professional diagnosis pointer 3; blank for other subtypes.
2400_SV1_diag_ptr4837P SV107-4Professional diagnosis pointer 4; blank for other subtypes.
2400_SV2_rev_code837I SV201Institutional revenue code; blank for other subtypes.
2400_SV2_proc_code837I SV202-2Institutional procedure code; component 1 is accepted as a compatibility fallback when the qualifier is omitted. Blank for other subtypes.
2400_SV2_charge837I SV203Institutional line billed amount; blank for other subtypes.
2400_SV2_units837I SV205Institutional line units; blank for other subtypes.
2400_SV3_proc_code837D SV301-2Dental procedure code; component 1 is accepted as a compatibility fallback when the qualifier is omitted. Blank for other subtypes.
2400_SV3_tooth837D TOO02 following SV3Dental tooth identifiers in source order, joined with ' | ' when repeated. Blank for other subtypes.
2400_SV3_surface837D TOO03 following SV3Dental tooth-surface values in source order, joined with ' | ' when repeated. Blank for other subtypes.
2400_SV3_charge837D SV302Dental line billed amount; blank for other subtypes.
2400_SV3_units837D SV306Dental line quantity; blank for other subtypes.
2400_DTP_472_from2400 DTP*472, DTP03 D8 or RD8 startActual-service date or range start; blank when DTP*472 is absent.
2400_DTP_472_to2400 DTP*472, DTP03 RD8 end (D8 repeats)Actual-service range end; a D8 date is repeated; blank when DTP*472 is absent.
2400_REF_1_qual2400 REF01, source occurrence 1Service-level REF qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_REF_1_value2400 REF02, source occurrence 1Service-level REF value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_REF_2_qual2400 REF01, source occurrence 2Service-level REF qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_REF_2_value2400 REF02, source occurrence 2Service-level REF value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_REF_3_qual2400 REF01, source occurrence 3Service-level REF qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_REF_3_value2400 REF02, source occurrence 3Service-level REF value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_REF_4_qual2400 REF01, source occurrence 4Service-level REF qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_REF_4_value2400 REF02, source occurrence 4Service-level REF value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_REF_5_qual2400 REF01, source occurrence 5Service-level REF qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_REF_5_value2400 REF02, source occurrence 5Service-level REF value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_REF_6_qual2400 REF01, source occurrence 6Service-level REF qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_REF_6_value2400 REF02, source occurrence 6Service-level REF value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_REF_7_qual2400 REF01, source occurrence 7Service-level REF qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_REF_7_value2400 REF02, source occurrence 7Service-level REF value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_REF_8_qual2400 REF01, source occurrence 8Service-level REF qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_REF_8_value2400 REF02, source occurrence 8Service-level REF value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_REF_9_qual2400 REF01, source occurrence 9Service-level REF qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_REF_9_value2400 REF02, source occurrence 9Service-level REF value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_REF_10_qual2400 REF01, source occurrence 10Service-level REF qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_REF_10_value2400 REF02, source occurrence 10Service-level REF value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_AMT_1_qual2400 AMT01, source occurrence 1Service-level AMT qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_AMT_1_amount2400 AMT02, source occurrence 1Service-level AMT amount; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_AMT_2_qual2400 AMT01, source occurrence 2Service-level AMT qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_AMT_2_amount2400 AMT02, source occurrence 2Service-level AMT amount; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_AMT_3_qual2400 AMT01, source occurrence 3Service-level AMT qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_AMT_3_amount2400 AMT02, source occurrence 3Service-level AMT amount; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_AMT_4_qual2400 AMT01, source occurrence 4Service-level AMT qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_AMT_4_amount2400 AMT02, source occurrence 4Service-level AMT amount; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_AMT_5_qual2400 AMT01, source occurrence 5Service-level AMT qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_AMT_5_amount2400 AMT02, source occurrence 5Service-level AMT amount; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_AMT_6_qual2400 AMT01, source occurrence 6Service-level AMT qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_AMT_6_amount2400 AMT02, source occurrence 6Service-level AMT amount; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_AMT_7_qual2400 AMT01, source occurrence 7Service-level AMT qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_AMT_7_amount2400 AMT02, source occurrence 7Service-level AMT amount; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_AMT_8_qual2400 AMT01, source occurrence 8Service-level AMT qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_AMT_8_amount2400 AMT02, source occurrence 8Service-level AMT amount; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_AMT_9_qual2400 AMT01, source occurrence 9Service-level AMT qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_AMT_9_amount2400 AMT02, source occurrence 9Service-level AMT amount; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_AMT_10_qual2400 AMT01, source occurrence 10Service-level AMT qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_AMT_10_amount2400 AMT02, source occurrence 10Service-level AMT amount; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_QTY_1_qual2400 QTY01, source occurrence 1Service-level QTY qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_QTY_1_value2400 QTY02, source occurrence 1Service-level QTY value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_QTY_2_qual2400 QTY01, source occurrence 2Service-level QTY qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_QTY_2_value2400 QTY02, source occurrence 2Service-level QTY value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_QTY_3_qual2400 QTY01, source occurrence 3Service-level QTY qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_QTY_3_value2400 QTY02, source occurrence 3Service-level QTY value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_QTY_4_qual2400 QTY01, source occurrence 4Service-level QTY qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_QTY_4_value2400 QTY02, source occurrence 4Service-level QTY value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_QTY_5_qual2400 QTY01, source occurrence 5Service-level QTY qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_QTY_5_value2400 QTY02, source occurrence 5Service-level QTY value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_QTY_6_qual2400 QTY01, source occurrence 6Service-level QTY qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_QTY_6_value2400 QTY02, source occurrence 6Service-level QTY value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_QTY_7_qual2400 QTY01, source occurrence 7Service-level QTY qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_QTY_7_value2400 QTY02, source occurrence 7Service-level QTY value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_QTY_8_qual2400 QTY01, source occurrence 8Service-level QTY qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_QTY_8_value2400 QTY02, source occurrence 8Service-level QTY value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_QTY_9_qual2400 QTY01, source occurrence 9Service-level QTY qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_QTY_9_value2400 QTY02, source occurrence 9Service-level QTY value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_QTY_10_qual2400 QTY01, source occurrence 10Service-level QTY qual; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_QTY_10_value2400 QTY02, source occurrence 10Service-level QTY value; Smart Mapping exposes the first 10 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_NTE_1_qual2400 NTE01, source occurrence 1Service-level NTE qual; Smart Mapping exposes the first 5 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_NTE_1_text2400 NTE02, source occurrence 1Service-level NTE text; Smart Mapping exposes the first 5 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_NTE_2_qual2400 NTE01, source occurrence 2Service-level NTE qual; Smart Mapping exposes the first 5 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_NTE_2_text2400 NTE02, source occurrence 2Service-level NTE text; Smart Mapping exposes the first 5 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_NTE_3_qual2400 NTE01, source occurrence 3Service-level NTE qual; Smart Mapping exposes the first 5 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_NTE_3_text2400 NTE02, source occurrence 3Service-level NTE text; Smart Mapping exposes the first 5 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_NTE_4_qual2400 NTE01, source occurrence 4Service-level NTE qual; Smart Mapping exposes the first 5 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_NTE_4_text2400 NTE02, source occurrence 4Service-level NTE text; Smart Mapping exposes the first 5 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_NTE_5_qual2400 NTE01, source occurrence 5Service-level NTE qual; Smart Mapping exposes the first 5 source occurrences in order. Additional occurrences remain available only in Raw output.
2400_NTE_5_text2400 NTE02, source occurrence 5Service-level NTE text; Smart Mapping exposes the first 5 source occurrences in order. Additional occurrences remain available only in Raw output.
2420_rendering_id2420 supported rendering loop (P/I/D: NM1*82), NM109 when NM108=XXQualified NPI for the rendering; secondary REF identifiers are not promoted to NPI. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_rendering_name2420 supported rendering loop (P/I/D: NM1*82), NM103-NM105Rendering name. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_rendering_taxonomy2420 supported rendering loop (P/I/D: NM1*82), PRV03 when PRV02=PXC; subordinate REF*PXC fallbackRendering taxonomy. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_rendering_address12420 supported rendering loop (P/I/D: NM1*82), N301Rendering address line 1. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_rendering_address22420 supported rendering loop (P/I/D: NM1*82), N302Rendering address line 2. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_rendering_city2420 supported rendering loop (P/I/D: NM1*82), N401Rendering city. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_rendering_state2420 supported rendering loop (P/I/D: NM1*82), N402Rendering state/province code. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_rendering_zip2420 supported rendering loop (P/I/D: NM1*82), N403Rendering postal code. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_ordering_id2420 supported ordering loop (P: NM1*DK), NM109 when NM108=XXQualified NPI for the ordering; secondary REF identifiers are not promoted to NPI. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_ordering_name2420 supported ordering loop (P: NM1*DK), NM103-NM105Ordering name. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_ordering_taxonomy2420 supported ordering loop (P: NM1*DK), PRV03 when PRV02=PXC; subordinate REF*PXC fallbackOrdering taxonomy. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_ordering_address12420 supported ordering loop (P: NM1*DK), N301Ordering address line 1. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_ordering_address22420 supported ordering loop (P: NM1*DK), N302Ordering address line 2. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_ordering_city2420 supported ordering loop (P: NM1*DK), N401Ordering city. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_ordering_state2420 supported ordering loop (P: NM1*DK), N402Ordering state/province code. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_ordering_zip2420 supported ordering loop (P: NM1*DK), N403Ordering postal code. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_referring_id2420 supported referring loop (P/I/D: NM1*DN), NM109 when NM108=XXQualified NPI for the referring; secondary REF identifiers are not promoted to NPI. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_referring_name2420 supported referring loop (P/I/D: NM1*DN), NM103-NM105Referring name. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_referring_taxonomy2420 supported referring loop (P/I/D: NM1*DN), PRV03 when PRV02=PXC; subordinate REF*PXC fallbackReferring taxonomy. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_referring_address12420 supported referring loop (P/I/D: NM1*DN), N301Referring address line 1. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_referring_address22420 supported referring loop (P/I/D: NM1*DN), N302Referring address line 2. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_referring_city2420 supported referring loop (P/I/D: NM1*DN), N401Referring city. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_referring_state2420 supported referring loop (P/I/D: NM1*DN), N402Referring state/province code. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_referring_zip2420 supported referring loop (P/I/D: NM1*DN), N403Referring postal code. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_supervising_id2420 supported supervising loop (P: NM1*DQ), NM109 when NM108=XXQualified NPI for the supervising; secondary REF identifiers are not promoted to NPI. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_supervising_name2420 supported supervising loop (P: NM1*DQ), NM103-NM105Supervising name. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_supervising_taxonomy2420 supported supervising loop (P: NM1*DQ), PRV03 when PRV02=PXC; subordinate REF*PXC fallbackSupervising taxonomy. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_supervising_address12420 supported supervising loop (P: NM1*DQ), N301Supervising address line 1. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_supervising_address22420 supported supervising loop (P: NM1*DQ), N302Supervising address line 2. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_supervising_city2420 supported supervising loop (P: NM1*DQ), N401Supervising city. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_supervising_state2420 supported supervising loop (P: NM1*DQ), N402Supervising state/province code. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_supervising_zip2420 supported supervising loop (P: NM1*DQ), N403Supervising postal code. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_service_facility_id2420 supported service facility loop (P: NM1*77), NM109 when NM108=XXQualified NPI for the service facility; secondary REF identifiers are not promoted to NPI. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_service_facility_name2420 supported service facility loop (P: NM1*77), NM103-NM105Service Facility name. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_service_facility_taxonomy2420 supported service facility loop (P: NM1*77), PRV03 when PRV02=PXC; subordinate REF*PXC fallbackService Facility taxonomy. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_service_facility_address12420 supported service facility loop (P: NM1*77), N301Service Facility address line 1. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_service_facility_address22420 supported service facility loop (P: NM1*77), N302Service Facility address line 2. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_service_facility_city2420 supported service facility loop (P: NM1*77), N401Service Facility city. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_service_facility_state2420 supported service facility loop (P: NM1*77), N402Service Facility state/province code. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2420_service_facility_zip2420 supported service facility loop (P: NM1*77), N403Service Facility postal code. Mapped only for the listed subtype/role combinations at service scope; blank otherwise.
2430_SVD_1_payer_id2430 SVD01, SVD occurrence 1Other Payer Identifier for adjudication set 1 of 5; mapped for all supported subtypes. Additional SVD sets are not projected into Smart Mapping.
2430_SVD_1_paid_amount2430 SVD02, SVD occurrence 1Signed Service-Line Paid Amount for adjudication set 1 of 5; mapped for all supported subtypes. Additional SVD sets are not projected into Smart Mapping.
2430_SVD_1_line_proc_code2430 SVD03-2, SVD occurrence 1Adjudicated Procedure Code for adjudication set 1 of 5; mapped for all supported subtypes. Additional SVD sets are not projected into Smart Mapping.
2430_SVD_1_rev_code2430 SVD04, SVD occurrence 1Adjudicated Revenue Code for adjudication set 1 of 5; mapped for 837I only. Additional SVD sets are not projected into Smart Mapping.
2430_DTP_1_adjudication_date2430 DTP*573 DTP03 (D8), SVD occurrence 1Adjudication date for SVD set 1 of 5; RD8 and unrelated DTP qualifiers do not populate this column.
2430_CAS_1_adj1_group2430 CAS01, SVD set 1CAS group for adjustment pair 1 of 5 in SVD set 1. CAS quantities are not declared in the public All Fields schema.
2430_CAS_1_adj1_reason2430 CAS02, SVD set 1CAS reason for adjustment pair 1 of 5 in SVD set 1. CAS quantities are not declared in the public All Fields schema.
2430_CAS_1_adj1_amount2430 CAS03, SVD set 1CAS amount for adjustment pair 1 of 5 in SVD set 1. CAS quantities are not declared in the public All Fields schema.
2430_CAS_1_adj2_group2430 CAS01, SVD set 1CAS group for adjustment pair 2 of 5 in SVD set 1. CAS quantities are not declared in the public All Fields schema.
2430_CAS_1_adj2_reason2430 CAS05, SVD set 1CAS reason for adjustment pair 2 of 5 in SVD set 1. CAS quantities are not declared in the public All Fields schema.
2430_CAS_1_adj2_amount2430 CAS06, SVD set 1CAS amount for adjustment pair 2 of 5 in SVD set 1. CAS quantities are not declared in the public All Fields schema.
2430_CAS_1_adj3_group2430 CAS01, SVD set 1CAS group for adjustment pair 3 of 5 in SVD set 1. CAS quantities are not declared in the public All Fields schema.
2430_CAS_1_adj3_reason2430 CAS08, SVD set 1CAS reason for adjustment pair 3 of 5 in SVD set 1. CAS quantities are not declared in the public All Fields schema.
2430_CAS_1_adj3_amount2430 CAS09, SVD set 1CAS amount for adjustment pair 3 of 5 in SVD set 1. CAS quantities are not declared in the public All Fields schema.
2430_CAS_1_adj4_group2430 CAS01, SVD set 1CAS group for adjustment pair 4 of 5 in SVD set 1. CAS quantities are not declared in the public All Fields schema.
2430_CAS_1_adj4_reason2430 CAS11, SVD set 1CAS reason for adjustment pair 4 of 5 in SVD set 1. CAS quantities are not declared in the public All Fields schema.
2430_CAS_1_adj4_amount2430 CAS12, SVD set 1CAS amount for adjustment pair 4 of 5 in SVD set 1. CAS quantities are not declared in the public All Fields schema.
2430_CAS_1_adj5_group2430 CAS01, SVD set 1CAS group for adjustment pair 5 of 5 in SVD set 1. CAS quantities are not declared in the public All Fields schema.
2430_CAS_1_adj5_reason2430 CAS14, SVD set 1CAS reason for adjustment pair 5 of 5 in SVD set 1. CAS quantities are not declared in the public All Fields schema.
2430_CAS_1_adj5_amount2430 CAS15, SVD set 1CAS amount for adjustment pair 5 of 5 in SVD set 1. CAS quantities are not declared in the public All Fields schema.
2430_SVD_2_payer_id2430 SVD01, SVD occurrence 2Other Payer Identifier for adjudication set 2 of 5; mapped for all supported subtypes. Additional SVD sets are not projected into Smart Mapping.
2430_SVD_2_paid_amount2430 SVD02, SVD occurrence 2Signed Service-Line Paid Amount for adjudication set 2 of 5; mapped for all supported subtypes. Additional SVD sets are not projected into Smart Mapping.
2430_SVD_2_line_proc_code2430 SVD03-2, SVD occurrence 2Adjudicated Procedure Code for adjudication set 2 of 5; mapped for all supported subtypes. Additional SVD sets are not projected into Smart Mapping.
2430_SVD_2_rev_code2430 SVD04, SVD occurrence 2Adjudicated Revenue Code for adjudication set 2 of 5; mapped for 837I only. Additional SVD sets are not projected into Smart Mapping.
2430_DTP_2_adjudication_date2430 DTP*573 DTP03 (D8), SVD occurrence 2Adjudication date for SVD set 2 of 5; RD8 and unrelated DTP qualifiers do not populate this column.
2430_CAS_2_adj1_group2430 CAS01, SVD set 2CAS group for adjustment pair 1 of 5 in SVD set 2. CAS quantities are not declared in the public All Fields schema.
2430_CAS_2_adj1_reason2430 CAS02, SVD set 2CAS reason for adjustment pair 1 of 5 in SVD set 2. CAS quantities are not declared in the public All Fields schema.
2430_CAS_2_adj1_amount2430 CAS03, SVD set 2CAS amount for adjustment pair 1 of 5 in SVD set 2. CAS quantities are not declared in the public All Fields schema.
2430_CAS_2_adj2_group2430 CAS01, SVD set 2CAS group for adjustment pair 2 of 5 in SVD set 2. CAS quantities are not declared in the public All Fields schema.
2430_CAS_2_adj2_reason2430 CAS05, SVD set 2CAS reason for adjustment pair 2 of 5 in SVD set 2. CAS quantities are not declared in the public All Fields schema.
2430_CAS_2_adj2_amount2430 CAS06, SVD set 2CAS amount for adjustment pair 2 of 5 in SVD set 2. CAS quantities are not declared in the public All Fields schema.
2430_CAS_2_adj3_group2430 CAS01, SVD set 2CAS group for adjustment pair 3 of 5 in SVD set 2. CAS quantities are not declared in the public All Fields schema.
2430_CAS_2_adj3_reason2430 CAS08, SVD set 2CAS reason for adjustment pair 3 of 5 in SVD set 2. CAS quantities are not declared in the public All Fields schema.
2430_CAS_2_adj3_amount2430 CAS09, SVD set 2CAS amount for adjustment pair 3 of 5 in SVD set 2. CAS quantities are not declared in the public All Fields schema.
2430_CAS_2_adj4_group2430 CAS01, SVD set 2CAS group for adjustment pair 4 of 5 in SVD set 2. CAS quantities are not declared in the public All Fields schema.
2430_CAS_2_adj4_reason2430 CAS11, SVD set 2CAS reason for adjustment pair 4 of 5 in SVD set 2. CAS quantities are not declared in the public All Fields schema.
2430_CAS_2_adj4_amount2430 CAS12, SVD set 2CAS amount for adjustment pair 4 of 5 in SVD set 2. CAS quantities are not declared in the public All Fields schema.
2430_CAS_2_adj5_group2430 CAS01, SVD set 2CAS group for adjustment pair 5 of 5 in SVD set 2. CAS quantities are not declared in the public All Fields schema.
2430_CAS_2_adj5_reason2430 CAS14, SVD set 2CAS reason for adjustment pair 5 of 5 in SVD set 2. CAS quantities are not declared in the public All Fields schema.
2430_CAS_2_adj5_amount2430 CAS15, SVD set 2CAS amount for adjustment pair 5 of 5 in SVD set 2. CAS quantities are not declared in the public All Fields schema.
2430_SVD_3_payer_id2430 SVD01, SVD occurrence 3Other Payer Identifier for adjudication set 3 of 5; mapped for all supported subtypes. Additional SVD sets are not projected into Smart Mapping.
2430_SVD_3_paid_amount2430 SVD02, SVD occurrence 3Signed Service-Line Paid Amount for adjudication set 3 of 5; mapped for all supported subtypes. Additional SVD sets are not projected into Smart Mapping.
2430_SVD_3_line_proc_code2430 SVD03-2, SVD occurrence 3Adjudicated Procedure Code for adjudication set 3 of 5; mapped for all supported subtypes. Additional SVD sets are not projected into Smart Mapping.
2430_SVD_3_rev_code2430 SVD04, SVD occurrence 3Adjudicated Revenue Code for adjudication set 3 of 5; mapped for 837I only. Additional SVD sets are not projected into Smart Mapping.
2430_DTP_3_adjudication_date2430 DTP*573 DTP03 (D8), SVD occurrence 3Adjudication date for SVD set 3 of 5; RD8 and unrelated DTP qualifiers do not populate this column.
2430_CAS_3_adj1_group2430 CAS01, SVD set 3CAS group for adjustment pair 1 of 5 in SVD set 3. CAS quantities are not declared in the public All Fields schema.
2430_CAS_3_adj1_reason2430 CAS02, SVD set 3CAS reason for adjustment pair 1 of 5 in SVD set 3. CAS quantities are not declared in the public All Fields schema.
2430_CAS_3_adj1_amount2430 CAS03, SVD set 3CAS amount for adjustment pair 1 of 5 in SVD set 3. CAS quantities are not declared in the public All Fields schema.
2430_CAS_3_adj2_group2430 CAS01, SVD set 3CAS group for adjustment pair 2 of 5 in SVD set 3. CAS quantities are not declared in the public All Fields schema.
2430_CAS_3_adj2_reason2430 CAS05, SVD set 3CAS reason for adjustment pair 2 of 5 in SVD set 3. CAS quantities are not declared in the public All Fields schema.
2430_CAS_3_adj2_amount2430 CAS06, SVD set 3CAS amount for adjustment pair 2 of 5 in SVD set 3. CAS quantities are not declared in the public All Fields schema.
2430_CAS_3_adj3_group2430 CAS01, SVD set 3CAS group for adjustment pair 3 of 5 in SVD set 3. CAS quantities are not declared in the public All Fields schema.
2430_CAS_3_adj3_reason2430 CAS08, SVD set 3CAS reason for adjustment pair 3 of 5 in SVD set 3. CAS quantities are not declared in the public All Fields schema.
2430_CAS_3_adj3_amount2430 CAS09, SVD set 3CAS amount for adjustment pair 3 of 5 in SVD set 3. CAS quantities are not declared in the public All Fields schema.
2430_CAS_3_adj4_group2430 CAS01, SVD set 3CAS group for adjustment pair 4 of 5 in SVD set 3. CAS quantities are not declared in the public All Fields schema.
2430_CAS_3_adj4_reason2430 CAS11, SVD set 3CAS reason for adjustment pair 4 of 5 in SVD set 3. CAS quantities are not declared in the public All Fields schema.
2430_CAS_3_adj4_amount2430 CAS12, SVD set 3CAS amount for adjustment pair 4 of 5 in SVD set 3. CAS quantities are not declared in the public All Fields schema.
2430_CAS_3_adj5_group2430 CAS01, SVD set 3CAS group for adjustment pair 5 of 5 in SVD set 3. CAS quantities are not declared in the public All Fields schema.
2430_CAS_3_adj5_reason2430 CAS14, SVD set 3CAS reason for adjustment pair 5 of 5 in SVD set 3. CAS quantities are not declared in the public All Fields schema.
2430_CAS_3_adj5_amount2430 CAS15, SVD set 3CAS amount for adjustment pair 5 of 5 in SVD set 3. CAS quantities are not declared in the public All Fields schema.
2430_SVD_4_payer_id2430 SVD01, SVD occurrence 4Other Payer Identifier for adjudication set 4 of 5; mapped for all supported subtypes. Additional SVD sets are not projected into Smart Mapping.
2430_SVD_4_paid_amount2430 SVD02, SVD occurrence 4Signed Service-Line Paid Amount for adjudication set 4 of 5; mapped for all supported subtypes. Additional SVD sets are not projected into Smart Mapping.
2430_SVD_4_line_proc_code2430 SVD03-2, SVD occurrence 4Adjudicated Procedure Code for adjudication set 4 of 5; mapped for all supported subtypes. Additional SVD sets are not projected into Smart Mapping.
2430_SVD_4_rev_code2430 SVD04, SVD occurrence 4Adjudicated Revenue Code for adjudication set 4 of 5; mapped for 837I only. Additional SVD sets are not projected into Smart Mapping.
2430_DTP_4_adjudication_date2430 DTP*573 DTP03 (D8), SVD occurrence 4Adjudication date for SVD set 4 of 5; RD8 and unrelated DTP qualifiers do not populate this column.
2430_CAS_4_adj1_group2430 CAS01, SVD set 4CAS group for adjustment pair 1 of 5 in SVD set 4. CAS quantities are not declared in the public All Fields schema.
2430_CAS_4_adj1_reason2430 CAS02, SVD set 4CAS reason for adjustment pair 1 of 5 in SVD set 4. CAS quantities are not declared in the public All Fields schema.
2430_CAS_4_adj1_amount2430 CAS03, SVD set 4CAS amount for adjustment pair 1 of 5 in SVD set 4. CAS quantities are not declared in the public All Fields schema.
2430_CAS_4_adj2_group2430 CAS01, SVD set 4CAS group for adjustment pair 2 of 5 in SVD set 4. CAS quantities are not declared in the public All Fields schema.
2430_CAS_4_adj2_reason2430 CAS05, SVD set 4CAS reason for adjustment pair 2 of 5 in SVD set 4. CAS quantities are not declared in the public All Fields schema.
2430_CAS_4_adj2_amount2430 CAS06, SVD set 4CAS amount for adjustment pair 2 of 5 in SVD set 4. CAS quantities are not declared in the public All Fields schema.
2430_CAS_4_adj3_group2430 CAS01, SVD set 4CAS group for adjustment pair 3 of 5 in SVD set 4. CAS quantities are not declared in the public All Fields schema.
2430_CAS_4_adj3_reason2430 CAS08, SVD set 4CAS reason for adjustment pair 3 of 5 in SVD set 4. CAS quantities are not declared in the public All Fields schema.
2430_CAS_4_adj3_amount2430 CAS09, SVD set 4CAS amount for adjustment pair 3 of 5 in SVD set 4. CAS quantities are not declared in the public All Fields schema.
2430_CAS_4_adj4_group2430 CAS01, SVD set 4CAS group for adjustment pair 4 of 5 in SVD set 4. CAS quantities are not declared in the public All Fields schema.
2430_CAS_4_adj4_reason2430 CAS11, SVD set 4CAS reason for adjustment pair 4 of 5 in SVD set 4. CAS quantities are not declared in the public All Fields schema.
2430_CAS_4_adj4_amount2430 CAS12, SVD set 4CAS amount for adjustment pair 4 of 5 in SVD set 4. CAS quantities are not declared in the public All Fields schema.
2430_CAS_4_adj5_group2430 CAS01, SVD set 4CAS group for adjustment pair 5 of 5 in SVD set 4. CAS quantities are not declared in the public All Fields schema.
2430_CAS_4_adj5_reason2430 CAS14, SVD set 4CAS reason for adjustment pair 5 of 5 in SVD set 4. CAS quantities are not declared in the public All Fields schema.
2430_CAS_4_adj5_amount2430 CAS15, SVD set 4CAS amount for adjustment pair 5 of 5 in SVD set 4. CAS quantities are not declared in the public All Fields schema.
2430_SVD_5_payer_id2430 SVD01, SVD occurrence 5Other Payer Identifier for adjudication set 5 of 5; mapped for all supported subtypes. Additional SVD sets are not projected into Smart Mapping.
2430_SVD_5_paid_amount2430 SVD02, SVD occurrence 5Signed Service-Line Paid Amount for adjudication set 5 of 5; mapped for all supported subtypes. Additional SVD sets are not projected into Smart Mapping.
2430_SVD_5_line_proc_code2430 SVD03-2, SVD occurrence 5Adjudicated Procedure Code for adjudication set 5 of 5; mapped for all supported subtypes. Additional SVD sets are not projected into Smart Mapping.
2430_SVD_5_rev_code2430 SVD04, SVD occurrence 5Adjudicated Revenue Code for adjudication set 5 of 5; mapped for 837I only. Additional SVD sets are not projected into Smart Mapping.
2430_DTP_5_adjudication_date2430 DTP*573 DTP03 (D8), SVD occurrence 5Adjudication date for SVD set 5 of 5; RD8 and unrelated DTP qualifiers do not populate this column.
2430_CAS_5_adj1_group2430 CAS01, SVD set 5CAS group for adjustment pair 1 of 5 in SVD set 5. CAS quantities are not declared in the public All Fields schema.
2430_CAS_5_adj1_reason2430 CAS02, SVD set 5CAS reason for adjustment pair 1 of 5 in SVD set 5. CAS quantities are not declared in the public All Fields schema.
2430_CAS_5_adj1_amount2430 CAS03, SVD set 5CAS amount for adjustment pair 1 of 5 in SVD set 5. CAS quantities are not declared in the public All Fields schema.
2430_CAS_5_adj2_group2430 CAS01, SVD set 5CAS group for adjustment pair 2 of 5 in SVD set 5. CAS quantities are not declared in the public All Fields schema.
2430_CAS_5_adj2_reason2430 CAS05, SVD set 5CAS reason for adjustment pair 2 of 5 in SVD set 5. CAS quantities are not declared in the public All Fields schema.
2430_CAS_5_adj2_amount2430 CAS06, SVD set 5CAS amount for adjustment pair 2 of 5 in SVD set 5. CAS quantities are not declared in the public All Fields schema.
2430_CAS_5_adj3_group2430 CAS01, SVD set 5CAS group for adjustment pair 3 of 5 in SVD set 5. CAS quantities are not declared in the public All Fields schema.
2430_CAS_5_adj3_reason2430 CAS08, SVD set 5CAS reason for adjustment pair 3 of 5 in SVD set 5. CAS quantities are not declared in the public All Fields schema.
2430_CAS_5_adj3_amount2430 CAS09, SVD set 5CAS amount for adjustment pair 3 of 5 in SVD set 5. CAS quantities are not declared in the public All Fields schema.
2430_CAS_5_adj4_group2430 CAS01, SVD set 5CAS group for adjustment pair 4 of 5 in SVD set 5. CAS quantities are not declared in the public All Fields schema.
2430_CAS_5_adj4_reason2430 CAS11, SVD set 5CAS reason for adjustment pair 4 of 5 in SVD set 5. CAS quantities are not declared in the public All Fields schema.
2430_CAS_5_adj4_amount2430 CAS12, SVD set 5CAS amount for adjustment pair 4 of 5 in SVD set 5. CAS quantities are not declared in the public All Fields schema.
2430_CAS_5_adj5_group2430 CAS01, SVD set 5CAS group for adjustment pair 5 of 5 in SVD set 5. CAS quantities are not declared in the public All Fields schema.
2430_CAS_5_adj5_reason2430 CAS14, SVD set 5CAS reason for adjustment pair 5 of 5 in SVD set 5. CAS quantities are not declared in the public All Fields schema.
2430_CAS_5_adj5_amount2430 CAS15, SVD set 5CAS amount for adjustment pair 5 of 5 in SVD set 5. CAS quantities are not declared in the public All Fields schema.

Notes

  • Supported routing: 005010X222A1 (837P), 005010X223A2 (837I), and 005010X224A2 (837D). Other ST03 values are labeled generic 837 and expose shared claim context without subtype service mapping.
  • Row and subtype model: one LINE row per mapped SV1, SV2, or SV3, followed by its CLAIM row. Professional-only, institutional-only, and dental-only columns are intentionally blank outside their subtype.
  • Aggregation: claim, subscriber, payer, and provider context can repeat on LINE and CLAIM rows. Use Record Type and the Summary view when aggregating claim or service amounts.
  • Bounded public projection: claim/service REF, AMT, and QTY expose 10 occurrences; NTE exposes 5; diagnoses expose 12; institutional procedures expose 6; COB exposes 3 other-payer loops; and service adjudication exposes 5 SVD sets with 5 CAS reason/amount pairs each. Later source occurrences remain available only in Raw output.
  • Provider and patient scope: provider roles are limited to the subtype/loop combinations stated per column. Only NM108=XX becomes a provider NPI; secondary REF identifiers do not. Subscriber data is not substituted for an absent 2010CA patient loop.
  • Not currently mapped in Smart Mapping: 2410 drug identification/pricing, PWK, CRC, CN1, K3, and CAS quantities. Use Raw output when those source elements must be retained.
  • Subtype component limits: 837I SV202 qualifier/modifiers and SV204 measurement; 837D SV301 qualifier, SV303-SV305, and SV307-SV311; and SVD qualifiers/modifiers are not currently mapped in Smart Mapping.
  • Privacy: when de-identification is enabled, it protects mapped Key/All, editor, and download surfaces. Raw Mode intentionally retains the original EDI.
  • This dictionary is exhaustive for the converter's current 530 declared All Fields columns, not for every element permitted by the X12 implementation guides.
Parse an EDI 837 into structured fields.
Looking for the key fields layout? See the EDI 837 Key Fields data dictionary.