1. Recipient ID.
2. Social Security Number.
3. Medicare ID.
4. Last Name, First Name, and Date of Birth.
Dates
Response Data
Benefits
The following information is based on a generic “Health Benefit Plan Coverage - 30” inquiry.
Basically, no changes were observed between the 4010 and the 5010 271 response.
However, it should be noted the monetary amounts used in the EB07 segment may be
returned as zero.
By default, the inquiry uses a generic “Health Benefit Plan Coverage – 30” service type.
Service type codes 4, 12, 18, 23, 24, 25, 28, 30, 33, 34, 35, 41, 42, 56, 60, 71, 81, 93,
94, 98, A8, AB, AD, AE, AF, AI, AL, AM, AO are also supported. All other service type codes
return as if “30” was sent in the inquiry.