| Parent File | Name | Number | Package |
|---|---|---|---|
| IIV RESPONSE(#365) | GROUP PROVIDER INFO | 365.04 | Integrated Billing |
| Field # | Name | Loc | Type | Details |
|---|---|---|---|---|
| .01 | SEQUENCE | 0;1 | NUMBER |
|
| .02 | PROVIDER CODE | 0;2 | POINTER TO X12 271 PROVIDER CODE FILE (#365.024) | X12 271 PROVIDER CODE(#365.024)
|
| .03 | PROV REFERENCE ID | 0;3 | FREE TEXT |
|