| Parent File | Name | Number | Package | 
|---|---|---|---|
| HCS REVIEW TRANSMISSION(#356.22) | HI SEGMENTS | 356.22107 | Integrated Billing | 
| Field # | Name | Loc | Type | Details | 
|---|---|---|---|---|
| .01 | HI SEQUENCE | 0;1 | NUMBER | 
  | 
| .02 | CODE LIST QUALIFIER CODE | 0;2 | POINTER TO X12 278 DIAGNOSIS TYPE FILE (#356.006) | X12 278 DIAGNOSIS TYPE(#356.006)
  | 
| .03 | INDUSTRY CODE | 0;3 | FREE TEXT | 
  | 
| .04 | DATE | 0;4 | DATE | 
  |