D94A

ALLOWANCE OR CHARGE

To identify allowance or charge details.

Segment structure

5463       ALLOWANCE OR CHARGE QUALIFIER                      M   an1..3
C552       ALLOWANCE/CHARGE INFORMATION                       C
   1230    Allowance or charge number                         C   an1..35
   5189    Charge/allowance description, coded                C   an1..3
           Charge/allowance description, code                 d
   030     4471  SETTLEMENT, CODED                            C   an1..3
1227       CALCULATION SEQUENCE INDICATOR, CODED              C   an1..3
C214       SPECIAL SERVICES IDENTIFICATION                    C
   7161    Special services, coded                            M   an1..3
Code       list qualifier                          C an..     3
Code       list responsible agency, coded          C an..     3
Special    service                              C an..3       5