D95A

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
4471       SETTLEMENT, CODED                                  C   an1..3
1227       CALCULATION SEQUENCE INDICATOR, CODED              C   an1..3
C214       SPECIAL SERVICES IDENTIFICATION                    C
   7161    Special services, coded                            C   an1..3
   1131    Code list qualifier                                C   an1..3
   3055    Code list responsible agency, coded                C   an1..3
   7160    Special service                                    C   an1..35