Code identifying eligibility or benefit information

All EB01 values qualify EB06 through EB10. Position of data in the repeating data element conveys no significance.

Code indicating the level of coverage being provided for this insured

Position of data in the repeating data element conveys no significance.

Code identifying the type of insurance policy within a specific insurance program for eligibility purposes.

A description or number that identifies the plan or coverage

Code specifying periods

Monetary amount

Percentage expressed as a decimal (e.g., 0.0 through 1.0 represents 0% through 100%)

Code specifying the type of quantity

Numeric value of quantity

Code indicating a Yes or No condition or response

EB11 is the authorization or certification indicator. A "Y" value indicates that an authorization or certification is required per plan provisions. An "N" value indicates that an authorization or certification is not required per plan provisions. A "U" value indicates it is unknown whether the plan provisions require an authorization or certification.

Code identifying a health plan network status.

Position of data in the repeating composite data element conveys no significance.

A pointer to the diagnosis code in the order of importance to this service

The first pointer designates the primary diagnosis and remaining diagnosis pointers indicate declining level of importance.

Code indicating a Yes or No condition or response

A "Y" indicates benefits are shared across Service Type Codes and Procedure Codes; an "N" indicates benefits are not shared.

Code indicating the type of heath care service review required for the service.