Optional
_businessOptional
_focalCoverage to be used for adjudication
Optional
_prePrior authorization reference number
Optional
_sequenceInsurance instance identifier
Optional
businessAdditional provider contract number
Optional
claimAdjudication results
Insurance information
Optional
extensionAdditional content defined by implementations
Coverage to be used for adjudication
Optional
idUnique id for inter-element referencing
Optional
identifierPre-assigned Claim number
Optional
modifierExtensions that cannot be ignored even if unrecognized
Optional
prePrior authorization reference number
Insurance instance identifier
Additional provider contract number