1. Subscriber ID, Patient Last Name, Patient First Name, Patient Date of Birth, Patient Group Number,
and Relationship to Subscriber.
Dates
Response Data
Benefits
The following information is based on a generic “Health Benefit Plan Coverage - 30” inquiry.
The 5010 response now uses service type codes for Physician Office Visit Sick – BY,
Physician Office Visit Well – BZ, and Urgent Care – UC.
Additional service types being returned include: A8, A9, AA, AB, AC, AD, AE, AF, AG,
AH, AI, AJ, AK, AL, AM, AO, AQ, BA, BB, BC, BD, BE, BF, BG, BH, BI, BJ, BK, BL, BM,
BN, BP, BQ, BR, BS, BT, BU, BV, BW, BX, BY, BZ, DM, GF, and UC.