ELECTRONIC PLAN TYPE (29) IB PROVIDER ID # TYPE (355.97)
Name
Value
NAME
ELECTRONIC PLAN TYPE
SOURCE LEVEL MINIMUM
FACILITY - ALL PROV
X12 CODE
1J
VALID FOR PERFORMING PROVIDER
NO
ALLOWABLE FORM TYPE
INSTITUTIONAL
ACTIVE
YES
PROVIDER'S OWN ID
NO
STORED OUTSIDE OF BILLING
NO
BILLING PROVIDER PRIMARY ID
YES
