00558

Value Amount & Code

2001-02-02
Components: <value code (IS)> ^ <value amount (NM)>

Definition: The pair in this field can repeat up to twelve times. UB92 fields 39a, 39b, 39c, 39d, 40a, 40b, 40c, 40d, 41a, 41b, 41c, and 41d. Refer to user-defined table 0153 - Value code for suggested values. This field is defined by HCFA or other regulatory agencies.

Length≤11
2 components
1O-value code
2O-value amount