| Parent File | Name | Number | Package | 
|---|---|---|---|
| INSURANCE COMPANY(#36) | 277EDI ID NUMBER | 36.017 | Integrated Billing | 
| Field # | Name | Loc | Type | Details | 
|---|---|---|---|---|
| .01 | 277EDI ID NUMBER | 0;1 | FREE TEXT | 
  | 
| .02 | 277DATE EDI ID NUMBER | 0;2 | DATE | 
  | 
| .03 | 277EDI TYPE | 0;3 | SET | 
 
  | 
| .04 | 277EDI ID NUMBER ON FILE | 0;4 | FREE TEXT | 
  |