id	description	section	req	max_loop	max_usage	pos
BPR	Beginning Segment For Payment Order/Remittance Advice	H	M	0	1	1
NTE	Note/Special Instruction	H	O	0	999999	2
TRN	Trace	H	O	0	1	3
CUR	Currency	H	O	0	1	4
REF	Reference Information	H	O	0	999999	5
DTM	Date/Time Reference	H	O	0	999999	6
N1	Party Identification	H	O	200	1	7
N2	Additional Name Information	H	O	0	999999	8
N3	Party Location	H	O	0	999999	9
N4	Geographic Location	H	O	0	1	10
REF	Reference Information	H	O	0	999999	11
PER	Administrative Communications Contact	H	O	0	999999	12
RDM	Remittance Delivery Method	H	O	0	1	13
DTM	Date/Time Reference	H	O	0	1	14
LX	Transaction Set Line Number	D	O	999999	1	15
TS3	Transaction Statistics	D	O	0	1	16
TS2	Transaction Supplemental Statistics	D	O	0	1	17
CLP	Claim Level Data	D	M	999999	1	18
CAS	Claims Adjustment	D	O	0	99	19
NM1	Individual Or Organizational Name	D	M	0	9	20
MIA	Medicare Inpatient Adjudication	D	O	0	1	21
MOA	Medicare Outpatient Adjudication	D	O	0	1	22
REF	Reference Information	D	O	0	99	23
DTM	Date/Time Reference	D	O	0	9	24
PER	Administrative Communications Contact	D	O	0	3	25
AMT	Monetary Amount Information	D	O	0	20	26
QTY	Quantity Information	D	O	0	20	27
SVC	Service Information	D	O	999	1	28
DTM	Date/Time Reference	D	O	0	9	29
CAS	Claims Adjustment	D	O	0	99	30
REF	Reference Information	D	O	0	99	31
AMT	Monetary Amount Information	D	O	0	20	32
QTY	Quantity Information	D	O	0	20	33
LQ	Industry Code Identification	D	O	0	99	34
PLB	Provider Level Adjustment	S	O	0	999999	35