To specify specifc benefit scenarios
Code identifying eligibility or benefit information
Code specifying periods
Total number of periods
Percentage expressed as a decimal (e.g., 0.0 through 1.0 represents 0% through 100%)
Monetary amount
SBI05 represents a single benefit amount or minimum benefit amount dependent upon the code sent in SBI01.
Monetary amount
SBI06 represents a remaining benefit amount or maximum benefit amount dependent upon the code sent in SBI01.
Number identifying the level to which the benefits are assigned or limited
A description or number that identifies the plan or coverage
Code indicating a Yes or No condition or response
SBI09 is the triggering event indicator. A "Y" indicates that a triggering event has occurred, an "N" indicates no triggering event has occurred, a "U" indicates it cannot be determined if a triggering event occurred.
Code indicating a Yes or No condition or response
SBI10 is the single use benefit indicator. A "Y" indicates that the benefit is a single use per period (one time use), an "N" indicates an exhaustive benefit (used until benefit or benefit amount is '0') a "U" indicates it's unknown if the benefit is of single use or exhaustive type.
Monetary amount
SBI11 amount represents the tiered benefit dollar amount.