<?xml version="1.0"?>
<!--
######################################################################
# Copyright (c) 2001-2005 Kalamazoo Community Mental Health Services,
#   John Holland <jholland@kazoocmh.org> <john@zoner.org>
# All rights reserved.
#
# This software is licensed as described in the file LICENSE.txt, which
# you should have received as part of this distribution.
#
######################################################################

#    $Id: 837.4010.X096.A1.xml,v 1.14 2005/07/22 02:59:32 johnholland Exp $
-->
<transaction>
  <id>837</id>
  <name>HIPAA Health Care Claim: Institutional X096A1-837</name>
  <loop xid="ISA_LOOP" type="explicit">
    <name>Interchange Control Header</name>
    <usage>R</usage>
    <pos>001</pos>
    <repeat>&gt;1</repeat>
    <segment xid="ISA">
      <name>Interchange Control Header</name>
      <usage>R</usage>
      <pos>010</pos>
      <max_use>1</max_use>
      <element xid="ISA01">
        <data_ele>I01</data_ele>
        <name>Authorization Information Qualifier</name>
        <usage>R</usage>
        <seq>01</seq>
        <data_type>ID</data_type>
        <min_len>2</min_len>
        <max_len>2</max_len>
        <valid_codes>
          <code>00</code>
          <code>03</code>
        </valid_codes>
      </element>
      <element xid="ISA02">
        <data_ele>I02</data_ele>
        <name>Authorization Information</name>
        <usage>R</usage>
        <seq>02</seq>
        <data_type>AN</data_type>
        <min_len>10</min_len>
        <max_len>10</max_len>
      </element>
      <element xid="ISA03">
        <data_ele>I03</data_ele>
        <name>Security Information Qualifier</name>
        <usage>R</usage>
        <seq>03</seq>
        <data_type>ID</data_type>
        <min_len>2</min_len>
        <max_len>2</max_len>
        <valid_codes>
          <code>00</code>
          <code>01</code>
        </valid_codes>
      </element>
      <element xid="ISA04">
        <data_ele>I04</data_ele>
        <name>Security Information</name>
        <usage>R</usage>
        <seq>04</seq>
        <data_type>AN</data_type>
        <min_len>10</min_len>
        <max_len>10</max_len>
      </element>
      <element xid="ISA05">
        <data_ele>I05</data_ele>
        <name>Interchange ID Qualifier</name>
        <usage>R</usage>
        <seq>05</seq>
        <data_type>ID</data_type>
        <min_len>2</min_len>
        <max_len>2</max_len>
        <valid_codes>
          <code>01</code>
          <code>14</code>
          <code>20</code>
          <code>27</code>
          <code>28</code>
          <code>29</code>
          <code>30</code>
          <code>33</code>
          <code>ZZ</code>
        </valid_codes>
      </element>
      <element xid="ISA06">
        <data_ele>I06</data_ele>
        <name>Interchange Sender ID</name>
        <usage>R</usage>
        <seq>06</seq>
        <data_type>AN</data_type>
        <min_len>15</min_len>
        <max_len>15</max_len>
      </element>
      <element xid="ISA07">
        <data_ele>I05</data_ele>
        <name>Interchange ID Qualifier</name>
        <usage>R</usage>
        <seq>07</seq>
        <data_type>ID</data_type>
        <min_len>2</min_len>
        <max_len>2</max_len>
        <valid_codes>
          <code>01</code>
          <code>14</code>
          <code>20</code>
          <code>27</code>
          <code>28</code>
          <code>29</code>
          <code>30</code>
          <code>33</code>
          <code>ZZ</code>
        </valid_codes>
      </element>
      <element xid="ISA08">
        <data_ele>I07</data_ele>
        <name>Interchange Receiver ID</name>
        <usage>R</usage>
        <seq>08</seq>
        <data_type>AN</data_type>
        <min_len>15</min_len>
        <max_len>15</max_len>
      </element>
      <element xid="ISA09">
        <data_ele>I08</data_ele>
        <name>Interchange Date</name>
        <usage>R</usage>
        <seq>09</seq>
        <data_type>DT</data_type>
        <min_len>6</min_len>
        <max_len>6</max_len>
        <valid_codes>
          <code/>
        </valid_codes>
      </element>
      <element xid="ISA10">
        <data_ele>I09</data_ele>
        <name>Interchange Time</name>
        <usage>R</usage>
        <seq>10</seq>
        <data_type>TM</data_type>
        <min_len>4</min_len>
        <max_len>4</max_len>
        <valid_codes>
          <code/>
        </valid_codes>
      </element>
      <element xid="ISA11">
        <data_ele>I10</data_ele>
        <name>Interchange Control Standards Identifier</name>
        <usage>R</usage>
        <seq>11</seq>
        <data_type>ID</data_type>
        <min_len>1</min_len>
        <max_len>1</max_len>
        <valid_codes>
          <code>U</code>
        </valid_codes>
      </element>
      <element xid="ISA12">
        <data_ele>I11</data_ele>
        <name>Interchange Control Version Number</name>
        <usage>R</usage>
        <seq>12</seq>
        <data_type>ID</data_type>
        <min_len>5</min_len>
        <max_len>5</max_len>
        <valid_codes>
          <code>00401</code>
        </valid_codes>
      </element>
      <element xid="ISA13">
        <data_ele>I12</data_ele>
        <name>Interchange Control Number</name>
        <usage>R</usage>
        <seq>13</seq>
        <data_type>N0</data_type>
        <min_len>9</min_len>
        <max_len>9</max_len>
      </element>
      <element xid="ISA14">
        <data_ele>I13</data_ele>
        <name>Acknowledgment Requested</name>
        <usage>R</usage>
        <seq>14</seq>
        <data_type>ID</data_type>
        <min_len>1</min_len>
        <max_len>1</max_len>
        <valid_codes>
          <code>0</code>
          <code>1</code>
        </valid_codes>
      </element>
      <element xid="ISA15">
        <data_ele>I14</data_ele>
        <name>Usage Indicator</name>
        <usage>R</usage>
        <seq>15</seq>
        <data_type>ID</data_type>
        <min_len>1</min_len>
        <max_len>1</max_len>
        <valid_codes>
          <code>P</code>
          <code>T</code>
        </valid_codes>
      </element>
      <element xid="ISA16">
        <data_ele>I15</data_ele>
        <name>Component Element Separator</name>
        <usage>R</usage>
        <seq>16</seq>
        <data_type>AN</data_type>
        <min_len>1</min_len>
        <max_len>1</max_len>
      </element>
    </segment>
<!--End of ISA segment-->
    <loop xid="GS_LOOP" type="explicit">
      <name>Functional Group Header</name>
      <usage>R</usage>
      <pos>020</pos>
      <repeat>&gt;1</repeat>
      <segment xid="GS">
        <name>Functional Group Header</name>
        <usage>R</usage>
        <pos>010</pos>
        <max_use>1</max_use>
        <element xid="GS01">
          <data_ele>479</data_ele>
          <name>Functional Identifier Code</name>
          <usage>R</usage>
          <seq>01</seq>
          <data_type>ID</data_type>
          <min_len>2</min_len>
          <max_len>2</max_len>
          <valid_codes>
            <code>HC</code>
          </valid_codes>
        </element>
        <element xid="GS02">
          <data_ele>142</data_ele>
          <name>Application Sender's Code</name>
          <usage>R</usage>
          <seq>02</seq>
          <data_type>AN</data_type>
          <min_len>2</min_len>
          <max_len>15</max_len>
        </element>
        <element xid="GS03">
          <data_ele>124</data_ele>
          <name>Application Receiver's Code</name>
          <usage>R</usage>
          <seq>03</seq>
          <data_type>AN</data_type>
          <min_len>2</min_len>
          <max_len>15</max_len>
        </element>
        <element xid="GS04">
          <data_ele>373</data_ele>
          <name>Date</name>
          <usage>R</usage>
          <seq>04</seq>
          <data_type>DT</data_type>
          <min_len>8</min_len>
          <max_len>8</max_len>
          <valid_codes>
            <code/>
          </valid_codes>
        </element>
        <element xid="GS05">
          <data_ele>337</data_ele>
          <name>Time</name>
          <usage>R</usage>
          <seq>05</seq>
          <data_type>TM</data_type>
          <min_len>4</min_len>
          <max_len>8</max_len>
          <valid_codes>
            <code/>
          </valid_codes>
        </element>
        <element xid="GS06">
          <data_ele>28</data_ele>
          <name>Group Control Number</name>
          <usage>R</usage>
          <seq>06</seq>
          <data_type>N0</data_type>
          <min_len>1</min_len>
          <max_len>9</max_len>
        </element>
        <element xid="GS07">
          <data_ele>455</data_ele>
          <name>Responsible Agency Code</name>
          <usage>R</usage>
          <seq>07</seq>
          <data_type>ID</data_type>
          <min_len>1</min_len>
          <max_len>2</max_len>
          <valid_codes>
            <code>X</code>
          </valid_codes>
        </element>
        <element xid="GS08">
          <data_ele>480</data_ele>
          <name>Version / Release / Industry Identifier Code</name>
          <usage>R</usage>
          <seq>08</seq>
          <data_type>AN</data_type>
          <min_len>1</min_len>
          <max_len>12</max_len>
          <valid_codes>
            <code>004010X096A1</code>
          </valid_codes>
        </element>
      </segment>
<!--End of GS segment-->
      <loop xid="ST_LOOP" type="explicit">
        <name>Transaction Set Header</name>
        <usage>R</usage>
        <pos>020</pos>
        <repeat>&gt;1</repeat>
        <segment xid="ST">
          <name>Transaction Set Header</name>
          <usage>R</usage>
          <pos>005</pos>
          <max_use>1</max_use>
          <element xid="ST01">
            <data_ele>143</data_ele>
            <name>Transaction Set Identifier Code</name>
            <usage>R</usage>
            <seq>01</seq>
            <data_type>ID</data_type>
            <min_len>3</min_len>
            <max_len>3</max_len>
            <valid_codes>
              <code>837</code>
            </valid_codes>
          </element>
          <element xid="ST02">
            <data_ele>329</data_ele>
            <name>Transaction Set Control Number</name>
            <usage>R</usage>
            <seq>02</seq>
            <data_type>AN</data_type>
            <min_len>4</min_len>
            <max_len>9</max_len>
          </element>
        </segment>
<!--End of ST segment-->
        <loop xid="HEADER" type="wrapper">
          <name>Table 1 - Header</name>
          <usage>R</usage>
          <pos>010</pos>
          <repeat>1</repeat>
          <segment xid="BHT">
            <name>Beginning of Hierarchical Transaction</name>
            <usage>R</usage>
            <pos>010</pos>
            <max_use>1</max_use>
            <element xid="BHT01">
              <data_ele>1005</data_ele>
              <name>Hierarchical Structure Code</name>
              <usage>R</usage>
              <seq>01</seq>
              <data_type>ID</data_type>
              <min_len>4</min_len>
              <max_len>4</max_len>
              <valid_codes>
                <code>0019</code>
              </valid_codes>
            </element>
            <element xid="BHT02">
              <data_ele>353</data_ele>
              <name>Transaction Set Purpose Code</name>
              <usage>R</usage>
              <seq>02</seq>
              <data_type>ID</data_type>
              <min_len>2</min_len>
              <max_len>2</max_len>
              <valid_codes>
                <code>00</code>
                <code>18</code>
              </valid_codes>
            </element>
            <element xid="BHT03">
              <data_ele>127</data_ele>
              <name>Originator Application Transaction Identifier</name>
              <usage>R</usage>
              <seq>03</seq>
              <data_type>AN</data_type>
              <min_len>1</min_len>
              <max_len>30</max_len>
            </element>
            <element xid="BHT04">
              <data_ele>373</data_ele>
              <name>Transaction Set Creation Date</name>
              <usage>R</usage>
              <seq>04</seq>
              <data_type>DT</data_type>
              <min_len>8</min_len>
              <max_len>8</max_len>
              <valid_codes>
                <code/>
              </valid_codes>
            </element>
            <element xid="BHT05">
              <data_ele>337</data_ele>
              <name>Transaction Set Creation Time</name>
              <usage>R</usage>
              <seq>05</seq>
              <data_type>TM</data_type>
              <min_len>4</min_len>
              <max_len>8</max_len>
            </element>
            <element xid="BHT06">
              <data_ele>640</data_ele>
              <name>Claim or Encounter Identifier</name>
              <usage>R</usage>
              <seq>06</seq>
              <data_type>ID</data_type>
              <min_len>2</min_len>
              <max_len>2</max_len>
              <valid_codes>
                <code>CH</code>
                <code>RP</code>
              </valid_codes>
            </element>
          </segment>
<!--End of BHT segment-->
          <segment xid="REF">
            <name>Transaction Type Identification</name>
            <usage>R</usage>
            <pos>015</pos>
            <max_use>1</max_use>
            <element xid="REF01">
              <data_ele>128</data_ele>
              <name>Reference Identification Qualifier</name>
              <usage>R</usage>
              <seq>01</seq>
              <data_type>ID</data_type>
              <min_len>2</min_len>
              <max_len>3</max_len>
              <valid_codes>
                <code>87</code>
              </valid_codes>
            </element>
            <element xid="REF02">
              <data_ele>127</data_ele>
              <name>Transmission Type Code</name>
              <usage>R</usage>
              <seq>02</seq>
              <data_type>AN</data_type>
              <min_len>1</min_len>
              <max_len>30</max_len>
              <valid_codes>
                <code>004010X096DA1</code>
                <code>004010X096A1</code>
              </valid_codes>
            </element>
            <element xid="REF03">
              <data_ele>352</data_ele>
              <name>Description</name>
              <usage>N</usage>
              <seq>03</seq>
              <data_type>AN</data_type>
              <min_len>1</min_len>
              <max_len>80</max_len>
            </element>
            <composite>
              <data_ele>C040</data_ele>
              <name>Reference Identifier</name>
              <usage>N</usage>
              <seq>04</seq>
            </composite>
          </segment>
<!--End of REF segment-->
          <loop xid="1000A">
            <name>Submitter Name</name>
            <usage>R</usage>
            <pos>020</pos>
            <repeat>1</repeat>
            <segment xid="NM1">
              <name>Submitter Name</name>
              <usage>R</usage>
              <pos>020</pos>
              <max_use>1</max_use>
              <element xid="NM101">
                <data_ele>98</data_ele>
                <name>Entity Identifier Code</name>
                <usage>R</usage>
                <seq>01</seq>
                <data_type>ID</data_type>
                <min_len>2</min_len>
                <max_len>3</max_len>
                <valid_codes>
                  <code>41</code>
                </valid_codes>
              </element>
              <element xid="NM102">
                <data_ele>1065</data_ele>
                <name>Entity Type Qualifier</name>
                <usage>R</usage>
                <seq>02</seq>
                <data_type>ID</data_type>
                <min_len>1</min_len>
                <max_len>1</max_len>
                <valid_codes>
                  <code>1</code>
                  <code>2</code>
                </valid_codes>
              </element>
              <element xid="NM103">
                <data_ele>1035</data_ele>
                <name>Submitter Last or Organization Name</name>
                <usage>R</usage>
                <seq>03</seq>
                <data_type>AN</data_type>
                <min_len>1</min_len>
                <max_len>35</max_len>
              </element>
              <element xid="NM104">
                <data_ele>1036</data_ele>
                <name>Submitter First Name</name>
                <usage>S</usage>
                <seq>04</seq>
                <data_type>AN</data_type>
                <min_len>1</min_len>
                <max_len>25</max_len>
              </element>
              <element xid="NM105">
                <data_ele>1037</data_ele>
                <name>Submitter Middle Name</name>
                <usage>S</usage>
                <seq>05</seq>
                <data_type>AN</data_type>
                <min_len>1</min_len>
                <max_len>25</max_len>
              </element>
              <element xid="NM106">
                <data_ele>1038</data_ele>
                <name>Name Prefix</name>
                <usage>N</usage>
                <seq>06</seq>
                <data_type>AN</data_type>
                <min_len>1</min_len>
                <max_len>10</max_len>
              </element>
              <element xid="NM107">
                <data_ele>1039</data_ele>
                <name>Name Suffix</name>
                <usage>N</usage>
                <seq>07</seq>
                <data_type>AN</data_type>
                <min_len>1</min_len>
                <max_len>10</max_len>
              </element>
              <element xid="NM108">
                <data_ele>66</data_ele>
                <name>Identification Code Qualifier</name>
                <usage>R</usage>
                <seq>08</seq>
                <data_type>ID</data_type>
                <min_len>1</min_len>
                <max_len>2</max_len>
                <valid_codes>
                  <code>46</code>
                </valid_codes>
              </element>
              <element xid="NM109">
                <data_ele>67</data_ele>
                <name>Submitter Identifier</name>
                <usage>R</usage>
                <seq>09</seq>
                <data_type>AN</data_type>
                <min_len>2</min_len>
                <max_len>80</max_len>
              </element>
              <element xid="NM110">
                <data_ele>706</data_ele>
                <name>Entity Relationship Code</name>
                <usage>N</usage>
                <seq>10</seq>
                <data_type>ID</data_type>
                <min_len>2</min_len>
                <max_len>2</max_len>
              </element>
              <element xid="NM111">
                <data_ele>98</data_ele>
                <name>Entity Identifier Code</name>
                <usage>N</usage>
                <seq>11</seq>
                <data_type>ID</data_type>
                <min_len>2</min_len>
                <max_len>3</max_len>
              </element>
            </segment>
<!--End of NM1 segment-->
            <segment xid="PER">
              <name>Submitter EDI Contact Information</name>
              <usage>R</usage>
              <pos>045</pos>
              <max_use>2</max_use>
              <element xid="PER01">
                <data_ele>366</data_ele>
                <name>Contact Function Code</name>
                <usage>R</usage>
                <seq>01</seq>
                <data_type>ID</data_type>
                <min_len>2</min_len>
                <max_len>2</max_len>
                <valid_codes>
                  <code>IC</code>
                </valid_codes>
              </element>
              <element xid="PER02">
                <data_ele>93</data_ele>
                <name>Submitter Contact Name</name>
                <usage>R</usage>
                <seq>02</seq>
                <data_type>AN</data_type>
                <min_len>1</min_len>
                <max_len>60</max_len>
              </element>
              <element xid="PER03">
                <data_ele>365</data_ele>
                <name>Communication Number Qualifier</name>
                <usage>R</usage>
                <seq>03</seq>
                <data_type>ID</data_type>
                <min_len>2</min_len>
                <max_len>2</max_len>
                <valid_codes>
                  <code>ED</code>
                  <code>EM</code>
                  <code>FX</code>
                  <code>TE</code>
                </valid_codes>
              </element>
              <element xid="PER04">
                <data_ele>364</data_ele>
                <name>Communication Number</name>
                <usage>R</usage>
                <seq>04</seq>
                <data_type>AN</data_type>
                <min_len>1</min_len>
                <max_len>80</max_len>
              </element>
              <element xid="PER05">
                <data_ele>365</data_ele>
                <name>Communication Number Qualifier</name>
                <usage>S</usage>
                <seq>05</seq>
                <data_type>ID</data_type>
                <min_len>2</min_len>
                <max_len>2</max_len>
                <valid_codes>
                  <code>ED</code>
                  <code>EM</code>
                  <code>EX</code>
                  <code>FX</code>
                  <code>TE</code>
                </valid_codes>
              </element>
              <element xid="PER06">
                <data_ele>364</data_ele>
                <name>Communication Number</name>
                <usage>S</usage>
                <seq>06</seq>
                <data_type>AN</data_type>
                <min_len>1</min_len>
                <max_len>80</max_len>
              </element>
              <element xid="PER07">
                <data_ele>365</data_ele>
                <name>Communication Number Qualifier</name>
                <usage>S</usage>
                <seq>07</seq>
                <data_type>ID</data_type>
                <min_len>2</min_len>
                <max_len>2</max_len>
                <valid_codes>
                  <code>ED</code>
                  <code>EM</code>
                  <code>EX</code>
                  <code>FX</code>
                  <code>TE</code>
                </valid_codes>
              </element>
              <element xid="PER08">
                <data_ele>364</data_ele>
                <name>Communication Number</name>
                <usage>S</usage>
                <seq>08</seq>
                <data_type>AN</data_type>
                <min_len>1</min_len>
                <max_len>80</max_len>
              </element>
              <element xid="PER09">
                <data_ele>443</data_ele>
                <name>Contact Inquiry Reference</name>
                <usage>N</usage>
                <seq>09</seq>
                <data_type>AN</data_type>
                <min_len>1</min_len>
                <max_len>20</max_len>
              </element>
            </segment>
<!--End of PER segment-->
          </loop>
<!--End of 1000A loop-->
          <loop xid="1000B">
            <name>Receiver Name</name>
            <usage>R</usage>
            <pos>020</pos>
            <repeat>1</repeat>
            <segment xid="NM1">
              <name>Receiver Name</name>
              <usage>R</usage>
              <pos>020</pos>
              <max_use>1</max_use>
              <element xid="NM101">
                <data_ele>98</data_ele>
                <name>Entity Identifier Code</name>
                <usage>R</usage>
                <seq>01</seq>
                <data_type>ID</data_type>
                <min_len>2</min_len>
                <max_len>3</max_len>
                <valid_codes>
                  <code>40</code>
                </valid_codes>
              </element>
              <element xid="NM102">
                <data_ele>1065</data_ele>
                <name>Entity Type Qualifier</name>
                <usage>R</usage>
                <seq>02</seq>
                <data_type>ID</data_type>
                <min_len>1</min_len>
                <max_len>1</max_len>
                <valid_codes>
                  <code>2</code>
                </valid_codes>
              </element>
              <element xid="NM103">
                <data_ele>1035</data_ele>
                <name>Receiver Name</name>
                <usage>R</usage>
                <seq>03</seq>
                <data_type>AN</data_type>
                <min_len>1</min_len>
                <max_len>35</max_len>
              </element>
              <element xid="NM104">
                <data_ele>1036</data_ele>
                <name>Name First</name>
                <usage>N</usage>
                <seq>04</seq>
                <data_type>AN</data_type>
                <min_len>1</min_len>
                <max_len>25</max_len>
              </element>
              <element xid="NM105">
                <data_ele>1037</data_ele>
                <name>Name Middle</name>
                <usage>N</usage>
                <seq>05</seq>
                <data_type>AN</data_type>
                <min_len>1</min_len>
                <max_len>25</max_len>
              </element>
              <element xid="NM106">
                <data_ele>1038</data_ele>
                <name>Name Prefix</name>
                <usage>N</usage>
                <seq>06</seq>
                <data_type>AN</data_type>
                <min_len>1</min_len>
                <max_len>10</max_len>
              </element>
              <element xid="NM107">
                <data_ele>1039</data_ele>
                <name>Name Suffix</name>
                <usage>N</usage>
                <seq>07</seq>
                <data_type>AN</data_type>
                <min_len>1</min_len>
                <max_len>10</max_len>
              </element>
              <element xid="NM108">
                <data_ele>66</data_ele>
                <name>Information Receiver Identification Number</name>
                <usage>R</usage>
                <seq>08</seq>
                <data_type>ID</data_type>
                <min_len>1</min_len>
                <max_len>2</max_len>
                <valid_codes>
                  <code>46</code>
                </valid_codes>
              </element>
              <element xid="NM109">
                <data_ele>67</data_ele>
                <name>Receiver Primary Identifier</name>
                <usage>R</usage>
                <seq>09</seq>
                <data_type>AN</data_type>
                <min_len>2</min_len>
                <max_len>80</max_len>
              </element>
              <element xid="NM110">
                <data_ele>706</data_ele>
                <name>Entity Relationship Code</name>
                <usage>N</usage>
                <seq>10</seq>
                <data_type>ID</data_type>
                <min_len>2</min_len>
                <max_len>2</max_len>
              </element>
              <element xid="NM111">
                <data_ele>98</data_ele>
                <name>Entity Identifier Code</name>
                <usage>N</usage>
                <seq>11</seq>
                <data_type>ID</data_type>
                <min_len>2</min_len>
                <max_len>3</max_len>
              </element>
            </segment>
<!--End of NM1 segment-->
          </loop>
<!--End of 1000B loop-->
        </loop>
<!--End of HEADER loop-->
        <loop xid="DETAIL" type="wrapper">
          <name>Table 2 - Detail</name>
          <usage>S</usage>
          <pos>020</pos>
          <repeat>&gt;1</repeat>
          <loop xid="2000A">
            <name>Billing/Pay-To Provider Hierarchical Level</name>
            <usage>R</usage>
            <pos>001</pos>
            <repeat>&gt;1</repeat>
            <segment xid="HL">
              <name>Billing/Pay-To Provider Hierarchical Level</name>
              <usage>R</usage>
              <pos>001</pos>
              <max_use>1</max_use>
              <element xid="HL01">
                <data_ele>628</data_ele>
                <name>Hierarchical ID Number</name>
                <usage>R</usage>
                <seq>01</seq>
                <data_type>AN</data_type>
                <min_len>1</min_len>
                <max_len>12</max_len>
              </element>
              <element xid="HL02">
                <data_ele>734</data_ele>
                <name>Hierarchical Parent ID Number</name>
                <usage>N</usage>
                <seq>02</seq>
                <data_type>AN</data_type>
                <min_len>1</min_len>
                <max_len>12</max_len>
              </element>
              <element xid="HL03">
                <data_ele>735</data_ele>
                <name>Hierarchical Level Code</name>
                <usage>R</usage>
                <seq>03</seq>
                <data_type>ID</data_type>
                <min_len>1</min_len>
                <max_len>2</max_len>
                <valid_codes>
                  <code>20</code>
                </valid_codes>
              </element>
              <element xid="HL04">
                <data_ele>736</data_ele>
                <name>Hierarchical Child Code</name>
                <usage>R</usage>
                <seq>04</seq>
                <data_type>ID</data_type>
                <min_len>1</min_len>
                <max_len>1</max_len>
                <valid_codes>
                  <code>1</code>
                </valid_codes>
              </element>
            </segment>
<!--End of HL segment-->
            <segment xid="PRV">
              <name>Billing/Pay-To Provider Specialty Information</name>
              <usage>S</usage>
              <pos>003</pos>
              <max_use>1</max_use>
              <element xid="PRV01">
                <data_ele>1221</data_ele>
                <name>Provider Code</name>
                <usage>R</usage>
                <seq>01</seq>
                <data_type>ID</data_type>
                <min_len>1</min_len>
                <max_len>3</max_len>
                <valid_codes>
                  <code>BI</code>
                  <code>PT</code>
                </valid_codes>
              </element>
              <element xid="PRV02">
                <data_ele>128</data_ele>
                <name>Reference Identification Qualifier</name>
                <usage>R</usage>
                <seq>02</seq>
                <data_type>ID</data_type>
                <min_len>2</min_len>
                <max_len>3</max_len>
                <valid_codes>
                  <code>ZZ</code>
                </valid_codes>
              </element>
              <element xid="PRV03">
                <data_ele>127</data_ele>
                <name>Provider Taxonomy Code</name>
                <usage>R</usage>
                <seq>03</seq>
                <data_type>AN</data_type>
                <min_len>1</min_len>
                <max_len>30</max_len>
<!--<valid_codes external="prov_taxonomy"/>-->
              </element>
              <element xid="PRV04">
                <data_ele>156</data_ele>
                <name>State or Province Code</name>
                <usage>N</usage>
                <seq>04</seq>
                <data_type>ID</data_type>
                <min_len>2</min_len>
                <max_len>2</max_len>
                <valid_codes external="states"/>
              </element>
              <composite>
                <data_ele>C035</data_ele>
                <name>Provider Specialty Information</name>
                <usage>N</usage>
                <seq>05</seq>
              </composite>
              <element xid="PRV06">
                <data_ele>1223</data_ele>
                <name>Provider Organization Code</name>
                <usage>N</usage>
                <seq>06</seq>
                <data_type>ID</data_type>
                <min_len>3</min_len>
                <max_len>3</max_len>
              </element>
            </segment>
<!--End of PRV segment-->
            <segment xid="CUR">
              <name>Foreign Currency Information</name>
              <usage>S</usage>
              <pos>010</pos>
              <max_use>1</max_use>
              <element xid="CUR01">
                <data_ele>98</data_ele>
                <name>Entity Identifier Code</name>
                <usage>R</usage>
                <seq>01</seq>
                <data_type>ID</data_type>
                <min_len>2</min_len>
                <max_len>3</max_len>
                <valid_codes>
                  <code>85</code>
                </valid_codes>
              </element>
              <element xid="CUR02">
                <data_ele>100</data_ele>
                <name>Currency Code</name>
                <usage>R</usage>
                <seq>02</seq>
                <data_type>ID</data_type>
                <min_len>3</min_len>
                <max_len>3</max_len>
                <valid_codes external="currency"/>
              </element>
              <element xid="CUR03">
                <data_ele>280</data_ele>
                <name>Exchange Rate</name>
                <usage>N</usage>
                <seq>03</seq>
                <data_type>R</data_type>
                <min_len>4</min_len>
                <max_len>10</max_len>
              </element>
              <element xid="CUR04">
                <data_ele>98</data_ele>
                <name>Entity Identifier Code</name>
                <usage>N</usage>
                <seq>04</seq>
                <data_type>ID</data_type>
                <min_len>2</min_len>
                <max_len>3</max_len>
              </element>
              <element xid="CUR05">
                <data_ele>100</data_ele>
                <name>Currency Code</name>
                <usage>N</usage>
                <seq>05</seq>
                <data_type>ID</data_type>
                <min_len>3</min_len>
                <max_len>3</max_len>
                <valid_codes external="currency"/>
              </element>
              <element xid="CUR06">
                <data_ele>669</data_ele>
                <name>Currency Market/Exchange Code</name>
                <usage>N</usage>
                <seq>06</seq>
                <data_type>ID</data_type>
                <min_len>3</min_len>
                <max_len>3</max_len>
              </element>
              <element xid="CUR07">
                <data_ele>374</data_ele>
                <name>Date/Time Qualifier</name>
                <usage>N</usage>
                <seq>07</seq>
                <data_type>ID</data_type>
                <min_len>3</min_len>
                <max_len>3</max_len>
              </element>
              <element xid="CUR08">
                <data_ele>373</data_ele>
                <name>Date</name>
                <usage>N</usage>
                <seq>08</seq>
                <data_type>DT</data_type>
                <min_len>8</min_len>
                <max_len>8</max_len>
              </element>
              <element xid="CUR09">
                <data_ele>337</data_ele>
                <name>Time</name>
                <usage>N</usage>
                <seq>09</seq>
                <data_type>TM</data_type>
                <min_len>4</min_len>
                <max_len>8</max_len>
              </element>
              <element xid="CUR10">
                <data_ele>374</data_ele>
                <name>Date/Time Qualifier</name>
                <usage>N</usage>
                <seq>10</seq>
                <data_type>ID</data_type>
                <min_len>3</min_len>
                <max_len>3</max_len>
              </element>
              <element xid="CUR11">
                <data_ele>373</data_ele>
                <name>Date</name>
                <usage>N</usage>
                <seq>11</seq>
                <data_type>DT</data_type>
                <min_len>8</min_len>
                <max_len>8</max_len>
              </element>
              <element xid="CUR12">
                <data_ele>337</data_ele>
                <name>Time</name>
                <usage>N</usage>
                <seq>12</seq>
                <data_type>TM</data_type>
                <min_len>4</min_len>
                <max_len>8</max_len>
              </element>
              <element xid="CUR13">
                <data_ele>374</data_ele>
                <name>Date/Time Qualifier</name>
                <usage>N</usage>
                <seq>13</seq>
                <data_type>ID</data_type>
                <min_len>3</min_len>
                <max_len>3</max_len>
              </element>
              <element xid="CUR14">
                <data_ele>373</data_ele>
                <name>Date</name>
                <usage>N</usage>
                <seq>14</seq>
                <data_type>DT</data_type>
                <min_len>8</min_len>
                <max_len>8</max_len>
              </element>
              <element xid="CUR15">
                <data_ele>337</data_ele>
                <name>Time</name>
                <usage>N</usage>
                <seq>15</seq>
                <data_type>TM</data_type>
                <min_len>4</min_len>
                <max_len>8</max_len>
              </element>
              <element xid="CUR16">
                <data_ele>374</data_ele>
                <name>Date/Time Qualifier</name>
                <usage>N</usage>
                <seq>16</seq>
                <data_type>ID</data_type>
                <min_len>3</min_len>
                <max_len>3</max_len>
              </element>
              <element xid="CUR17">
                <data_ele>373</data_ele>
                <name>Date</name>
                <usage>N</usage>
                <seq>17</seq>
                <data_type>DT</data_type>
                <min_len>8</min_len>
                <max_len>8</max_len>
              </element>
              <element xid="CUR18">
                <data_ele>337</data_ele>
                <name>Time</name>
                <usage>N</usage>
                <seq>18</seq>
                <data_type>TM</data_type>
                <min_len>4</min_len>
                <max_len>8</max_len>
              </element>
              <element xid="CUR19">
                <data_ele>374</data_ele>
                <name>Date/Time Qualifier</name>
                <usage>N</usage>
                <seq>19</seq>
                <data_type>ID</data_type>
                <min_len>3</min_len>
                <max_len>3</max_len>
              </element>
              <element xid="CUR20">
                <data_ele>373</data_ele>
                <name>Date</name>
                <usage>N</usage>
                <seq>20</seq>
                <data_type>DT</data_type>
                <min_len>8</min_len>
                <max_len>8</max_len>
              </element>
              <element xid="CUR21">
                <data_ele>337</data_ele>
                <name>Time</name>
                <usage>N</usage>
                <seq>21</seq>
                <data_type>TM</data_type>
                <min_len>4</min_len>
                <max_len>8</max_len>
              </element>
            </segment>
<!--End of CUR segment-->
            <loop xid="2010AA">
              <name>Billing Provider Name</name>
              <usage>R</usage>
              <pos>015</pos>
              <repeat>1</repeat>
              <segment xid="NM1">
                <name>Billing Provider Name</name>
                <usage>R</usage>
                <pos>015</pos>
                <max_use>1</max_use>
                <element xid="NM101">
                  <data_ele>98</data_ele>
                  <name>Entity Identifier Code</name>
                  <usage>R</usage>
                  <seq>01</seq>
                  <data_type>ID</data_type>
                  <min_len>2</min_len>
                  <max_len>3</max_len>
                  <valid_codes>
                    <code>85</code>
                  </valid_codes>
                </element>
                <element xid="NM102">
                  <data_ele>1065</data_ele>
                  <name>Entity Type Qualifier</name>
                  <usage>R</usage>
                  <seq>02</seq>
                  <data_type>ID</data_type>
                  <min_len>1</min_len>
                  <max_len>1</max_len>
                  <valid_codes>
                    <code>2</code>
                  </valid_codes>
                </element>
                <element xid="NM103">
                  <data_ele>1035</data_ele>
                  <name>Billing Provider Last or Organizational Name</name>
                  <usage>R</usage>
                  <seq>03</seq>
                  <data_type>AN</data_type>
                  <min_len>1</min_len>
                  <max_len>35</max_len>
                </element>
                <element xid="NM104">
                  <data_ele>1036</data_ele>
                  <name>Name First</name>
                  <usage>N</usage>
                  <seq>04</seq>
                  <data_type>AN</data_type>
                  <min_len>1</min_len>
                  <max_len>25</max_len>
                </element>
                <element xid="NM105">
                  <data_ele>1037</data_ele>
                  <name>Name Middle</name>
                  <usage>N</usage>
                  <seq>05</seq>
                  <data_type>AN</data_type>
                  <min_len>1</min_len>
                  <max_len>25</max_len>
                </element>
                <element xid="NM106">
                  <data_ele>1038</data_ele>
                  <name>Name Prefix</name>
                  <usage>N</usage>
                  <seq>06</seq>
                  <data_type>AN</data_type>
                  <min_len>1</min_len>
                  <max_len>10</max_len>
                </element>
                <element xid="NM107">
                  <data_ele>1039</data_ele>
                  <name>Name Suffix</name>
                  <usage>N</usage>
                  <seq>07</seq>
                  <data_type>AN</data_type>
                  <min_len>1</min_len>
                  <max_len>10</max_len>
                </element>
                <element xid="NM108">
                  <data_ele>66</data_ele>
                  <name>Identification Code Qualifier</name>
                  <usage>R</usage>
                  <seq>08</seq>
                  <data_type>ID</data_type>
                  <min_len>1</min_len>
                  <max_len>2</max_len>
                  <valid_codes>
                    <code>24</code>
                    <code>34</code>
                    <code>XX</code>
                  </valid_codes>
                </element>
                <element xid="NM109">
                  <data_ele>67</data_ele>
                  <name>Billing Provider Identifier</name>
                  <usage>R</usage>
                  <seq>09</seq>
                  <data_type>AN</data_type>
                  <min_len>2</min_len>
                  <max_len>80</max_len>
                </element>
                <element xid="NM110">
                  <data_ele>706</data_ele>
                  <name>Entity Relationship Code</name>
                  <usage>N</usage>
                  <seq>10</seq>
                  <data_type>ID</data_type>
                  <min_len>2</min_len>
                  <max_len>2</max_len>
                </element>
                <element xid="NM111">
                  <data_ele>98</data_ele>
                  <name>Entity Identifier Code</name>
                  <usage>N</usage>
                  <seq>11</seq>
                  <data_type>ID</data_type>
                  <min_len>2</min_len>
                  <max_len>3</max_len>
                </element>
              </segment>
<!--End of NM1 segment-->
              <segment xid="N3">
                <name>Billing Provider Address</name>
                <usage>R</usage>
                <pos>025</pos>
                <max_use>1</max_use>
                <element xid="N301">
                  <data_ele>166</data_ele>
                  <name>Billing Provider Address Line</name>
                  <usage>R</usage>
                  <seq>01</seq>
                  <data_type>AN</data_type>
                  <min_len>1</min_len>
                  <max_len>55</max_len>
                </element>
                <element xid="N302">
                  <data_ele>166</data_ele>
                  <name>Billing Provider Address Line</name>
                  <usage>S</usage>
                  <seq>02</seq>
                  <data_type>AN</data_type>
                  <min_len>1</min_len>
                  <max_len>55</max_len>
                </element>
              </segment>
<!--End of N3 segment-->
              <segment xid="N4">
                <name>Billing Provider City/State/ZIP Code</name>
                <usage>R</usage>
                <pos>030</pos>
                <max_use>1</max_use>
                <element xid="N401">
                  <data_ele>19</data_ele>
                  <name>Billing Provider City Name</name>
                  <usage>R</usage>
                  <seq>01</seq>
                  <data_type>AN</data_type>
                  <min_len>2</min_len>
                  <max_len>30</max_len>
                </element>
                <element xid="N402">
                  <data_ele>156</data_ele>
                  <name>Billing Provider State or Province Code</name>
                  <usage>R</usage>
                  <seq>02</seq>
                  <data_type>ID</data_type>
                  <min_len>2</min_len>
                  <max_len>2</max_len>
                  <valid_codes external="states"/>
                </element>
                <element xid="N403">
                  <data_ele>116</data_ele>
                  <name>Billing Provider Postal Zone or ZIP Code</name>
                  <usage>R</usage>
                  <seq>03</seq>
                  <data_type>ID</data_type>
                  <min_len>3</min_len>
                  <max_len>15</max_len>
                </element>
                <element xid="N404">
                  <data_ele>26</data_ele>
                  <name>Country Code</name>
                  <usage>S</usage>
                  <seq>04</seq>
                  <data_type>ID</data_type>
                  <min_len>2</min_len>
                  <max_len>3</max_len>
                  <valid_codes external="country"/>
                </element>
                <element xid="N405">
                  <data_ele>309</data_ele>
                  <name>Location Qualifier</name>
                  <usage>N</usage>
                  <seq>05</seq>
                  <data_type>ID</data_type>
                  <min_len>1</min_len>
                  <max_len>2</max_len>
                </element>
                <element xid="N406">
                  <data_ele>310</data_ele>
                  <name>Location Identifier</name>
                  <usage>N</usage>
                  <seq>06</seq>
                  <data_type>AN</data_type>
                  <min_len>1</min_len>
                  <max_len>30</max_len>
                </element>
              </segment>
<!--End of N4 segment-->
              <segment xid="REF">
                <name>Billing Provider Secondary Identification</name>
                <usage>S</usage>
                <pos>035</pos>
                <max_use>8</max_use>
                <element xid="REF01">
                  <data_ele>128</data_ele>
                  <name>Reference Identification Qualifier</name>
                  <usage>R</usage>
                  <seq>01</seq>
                  <data_type>ID</data_type>
                  <min_len>2</min_len>
                  <max_len>3</max_len>
                  <valid_codes>
                    <code>0B</code>
                    <code>1A</code>
                    <code>1B</code>
                    <code>1C</code>
                    <code>1D</code>
                    <code>1G</code>
                    <code>1H</code>
                    <code>1J</code>
                    <code>B3</code>
                    <code>BQ</code>
                    <code>EI</code>
                    <code>FH</code>
                    <code>G2</code>
                    <code>G5</code>
                    <code>LU</code>
                    <code>SY</code>
                    <code>X5</code>
                  </valid_codes>
                </element>
                <element xid="REF02">
                  <data_ele>127</data_ele>
                  <name>Billing Provider Additional Identifier</name>
                  <usage>R</usage>
                  <seq>02</seq>
                  <data_type>AN</data_type>
                  <min_len>1</min_len>
                  <max_len>30</max_len>
                </element>
                <element xid="REF03">
                  <data_ele>352</data_ele>
                  <name>Description</name>
                  <usage>N</usage>
                  <seq>03</seq>
                  <data_type>AN</data_type>
                  <min_len>1</min_len>
                  <max_len>80</max_len>
                </element>
                <composite>
                  <data_ele>C040</data_ele>
                  <name>Reference Identifier</name>
                  <usage>N</usage>
                  <seq>04</seq>
                </composite>
              </segment>
<!--End of REF segment-->
              <segment xid="REF">
                <name>Credit/Debit Card Billing Information</name>
                <usage>S</usage>
                <pos>035</pos>
                <max_use>8</max_use>
                <element xid="REF01">
                  <data_ele>128</data_ele>
                  <name>Reference Identification Qualifier</name>
                  <usage>R</usage>
                  <seq>01</seq>
                  <data_type>ID</data_type>
                  <min_len>2</min_len>
                  <max_len>3</max_len>
                  <valid_codes>
                    <code>06</code>
                    <code>8U</code>
                    <code>EM</code>
                    <code>IJ</code>
                    <code>LU</code>
                    <code>RB</code>
                    <code>ST</code>
                    <code>TT</code>
                  </valid_codes>
                </element>
                <element xid="REF02">
                  <data_ele>127</data_ele>
                  <name>Billing Provider Credit Card Identifier</name>
                  <usage>R</usage>
                  <seq>02</seq>
                  <data_type>AN</data_type>
                  <min_len>1</min_len>
                  <max_len>30</max_len>
                </element>
                <element xid="REF03">
                  <data_ele>352</data_ele>
                  <name>Description</name>
                  <usage>N</usage>
                  <seq>03</seq>
                  <data_type>AN</data_type>
                  <min_len>1</min_len>
                  <max_len>80</max_len>
                </element>
                <composite>
                  <data_ele>C040</data_ele>
                  <name>Reference Identifier</name>
                  <usage>N</usage>
                  <seq>04</seq>
                </composite>
              </segment>
<!--End of REF segment-->
              <segment xid="PER">
                <name>Billing Provider Contact Information</name>
                <usage>S</usage>
                <pos>040</pos>
                <max_use>2</max_use>
                <element xid="PER01">
                  <data_ele>366</data_ele>
                  <name>Contact Function Code</name>
                  <usage>R</usage>
                  <seq>01</seq>
                  <data_type>ID</data_type>
                  <min_len>2</min_len>
                  <max_len>2</max_len>
                  <valid_codes>
                    <code>IC</code>
                  </valid_codes>
                </element>
                <element xid="PER02">
                  <data_ele>93</data_ele>
                  <name>Billing Provider Contact Name</name>
                  <usage>R</usage>
                  <seq>02</seq>
                  <data_type>AN</data_type>
                  <min_len>1</min_len>
                  <max_len>60</max_len>
                </element>
                <element xid="PER03">
                  <data_ele>365</data_ele>
                  <name>Communication Number Qualifier</name>
                  <usage>R</usage>
                  <seq>03</seq>
                  <data_type>ID</data_type>
                  <min_len>2</min_len>
                  <max_len>2</max_len>
                  <valid_codes>
                    <code>EM</code>
                    <code>FX</code>
                    <code>TE</code>
                  </valid_codes>
                </element>
                <element xid="PER04">
                  <data_ele>364</data_ele>
                  <name>Communication Number</name>
                  <usage>R</usage>
                  <seq>04</seq>
                  <data_type>AN</data_type>
                  <min_len>1</min_len>
                  <max_len>80</max_len>
                </element>
                <element xid="PER05">
                  <data_ele>365</data_ele>
                  <name>Communication Number Qualifier</name>
                  <usage>S</usage>
                  <seq>05</seq>
                  <data_type>ID</data_type>
                  <min_len>2</min_len>
                  <max_len>2</max_len>
                  <valid_codes>
                    <code>EM</code>
                    <code>EX</code>
                    <code>FX</code>
                    <code>TE</code>
                  </valid_codes>
                </element>
                <element xid="PER06">
                  <data_ele>364</data_ele>
                  <name>Communication Number</name>
                  <usage>S</usage>
                  <seq>06</seq>
                  <data_type>AN</data_type>
                  <min_len>1</min_len>
                  <max_len>80</max_len>
                </element>
                <element xid="PER07">
                  <data_ele>365</data_ele>
                  <name>Communication Number Qualifier</name>
                  <usage>S</usage>
                  <seq>07</seq>
                  <data_type>ID</data_type>
                  <min_len>2</min_len>
                  <max_len>2</max_len>
                  <valid_codes>
                    <code>EM</code>
                    <code>EX</code>
                    <code>FX</code>
                    <code>TE</code>
                  </valid_codes>
                </element>
                <element xid="PER08">
                  <data_ele>364</data_ele>
                  <name>Communication Number</name>
                  <usage>S</usage>
                  <seq>08</seq>
                  <data_type>AN</data_type>
                  <min_len>1</min_len>
                  <max_len>80</max_len>
                </element>
                <element xid="PER09">
                  <data_ele>443</data_ele>
                  <name>Contact Inquiry Reference</name>
                  <usage>N</usage>
                  <seq>09</seq>
                  <data_type>AN</data_type>
                  <min_len>1</min_len>
                  <max_len>20</max_len>
                </element>
              </segment>
<!--End of PER segment-->
            </loop>
<!--End of 2010AA loop-->
            <loop xid="2010AB">
              <name>Pay-To Provider Name</name>
              <usage>S</usage>
              <pos>015</pos>
              <repeat>1</repeat>
              <segment xid="NM1">
                <name>Pay-To Provider Name</name>
                <usage>R</usage>
                <pos>015</pos>
                <max_use>1</max_use>
                <element xid="NM101">
                  <data_ele>98</data_ele>
                  <name>Entity Identifier Code</name>
                  <usage>R</usage>
                  <seq>01</seq>
                  <data_type>ID</data_type>
                  <min_len>2</min_len>
                  <max_len>3</max_len>
                  <valid_codes>
                    <code>87</code>
                  </valid_codes>
                </element>
                <element xid="NM102">
                  <data_ele>1065</data_ele>
                  <name>Entity Type Qualifier</name>
                  <usage>R</usage>
                  <seq>02</seq>
                  <data_type>ID</data_type>
                  <min_len>1</min_len>
                  <max_len>1</max_len>
                  <valid_codes>
                    <code>2</code>
                  </valid_codes>
                </element>
                <element xid="NM103">
                  <data_ele>1035</data_ele>
                  <name>Pay-to Provider Last or Organizational Name</name>
                  <usage>R</usage>
                  <seq>03</seq>
                  <data_type>AN</data_type>
                  <min_len>1</min_len>
                  <max_len>35</max_len>
                </element>
                <element xid="NM104">
                  <data_ele>1036</data_ele>
                  <name>Name First</name>
                  <usage>N</usage>
                  <seq>04</seq>
                  <data_type>AN</data_type>
                  <min_len>1</min_len>
                  <max_len>25</max_len>
                </element>
                <element xid="NM105">
                  <data_ele>1037</data_ele>
                  <name>Name Middle</name>
                  <usage>N</usage>
                  <seq>05</seq>
                  <data_type>AN</data_type>
                  <min_len>1</min_len>
                  <max_len>25</max_len>
                </element>
                <element xid="NM106">
                  <data_ele>1038</data_ele>
                  <name>Name Prefix</name>
                  <usage>N</usage>
                  <seq>06</seq>
                  <data_type>AN</data_type>
                  <min_len>1</min_len>
                  <max_len>10</max_len>
                </element>
                <element xid="NM107">
                  <data_ele>1039</data_ele>
                  <name>Name Suffix</name>
                  <usage>N</usage>
                  <seq>07</seq>
                  <data_type>AN</data_type>
                  <min_len>1</min_len>
                  <max_len>10</max_len>
                </element>
                <element xid="NM108">
                  <data_ele>66</data_ele>
                  <name>Identification Code Qualifier</name>
                  <usage>R</usage>
                  <seq>08</seq>
                  <data_type>ID</data_type>
                  <min_len>1</min_len>
                  <max_len>2</max_len>
                  <valid_codes>
                    <code>24</code>
                    <code>34</code>
                    <code>XX</code>
                  </valid_codes>
                </element>
                <element xid="NM109">
                  <data_ele>67</data_ele>
                  <name>Pay-to Provider Identifier</name>
                  <usage>R</usage>
                  <seq>09</seq>
                  <data_type>AN</data_type>
                  <min_len>2</min_len>
                  <max_len>80</max_len>
                </element>
                <element xid="NM110">
                  <data_ele>706</data_ele>
                  <name>Entity Relationship Code</name>
                  <usage>N</usage>
                  <seq>10</seq>
                  <data_type>ID</data_type>
                  <min_len>2</min_len>
                  <max_len>2</max_len>
                </element>
                <element xid="NM111">
                  <data_ele>98</data_ele>
                  <name>Entity Identifier Code</name>
                  <usage>N</usage>
                  <seq>11</seq>
                  <data_type>ID</data_type>
                  <min_len>2</min_len>
                  <max_len>3</max_len>
                </element>
              </segment>
<!--End of NM1 segment-->
              <segment xid="N3">
                <name>Pay-To Provider Address</name>
                <usage>R</usage>
                <pos>025</pos>
                <max_use>1</max_use>
                <element xid="N301">
                  <data_ele>166</data_ele>
                  <name>Pay-to Provider Address Line</name>
                  <usage>R</usage>
                  <seq>01</seq>
                  <data_type>AN</data_type>
                  <min_len>1</min_len>
                  <max_len>55</max_len>
                </element>
                <element xid="N302">
                  <data_ele>166</data_ele>
                  <name>Pay-to Provider Address Line</name>
                  <usage>S</usage>
                  <seq>02</seq>
                  <data_type>AN</data_type>
                  <min_len>1</min_len>
                  <max_len>55</max_len>
                </element>
              </segment>
<!--End of N3 segment-->
              <segment xid="N4">
                <name>Pay-To Provider City/State/ZIP Code</name>
                <usage>R</usage>
                <pos>030</pos>
                <max_use>1</max_use>
                <element xid="N401">
                  <data_ele>19</data_ele>
                  <name>Pay-to Provider City Name</name>
                  <usage>R</usage>
                  <seq>01</seq>
                  <data_type>AN</data_type>
                  <min_len>2</min_len>
                  <max_len>30</max_len>
                </element>
                <element xid="N402">
                  <data_ele>156</data_ele>
                  <name>Pay-to Provider State Code</name>
                  <usage>R</usage>
                  <seq>02</seq>
                  <data_type>ID</data_type>
                  <min_len>2</min_len>
                  <max_len>2</max_len>
                  <valid_codes external="states"/>
                </element>
                <element xid="N403">
                  <data_ele>116</data_ele>
                  <name>Pay-to Provider Postal Zone or ZIP Code</name>
                  <usage>R</usage>
                  <seq>03</seq>
                  <data_type>ID</data_type>
                  <min_len>3</min_len>
                  <max_len>15</max_len>
                </element>
                <element xid="N404">
                  <data_ele>26</data_ele>
                  <name>Pay-to Provider Country Code</name>
                  <usage>S</usage>
                  <seq>04</seq>
                  <data_type>ID</data_type>
                  <min_len>2</min_len>
                  <max_len>3</max_len>
                  <valid_codes external="country"/>
                </element>
                <element xid="N405">
                  <data_ele>309</data_ele>
                  <name>Location Qualifier</name>
                  <usage>N</usage>
                  <seq>05</seq>
                  <data_type>ID</data_type>
                  <min_len>1</min_len>
                  <max_len>2</max_len>
                </element>
                <element xid="N406">
                  <data_ele>310</data_ele>
                  <name>Location Identifier</name>
                  <usage>N</usage>
                  <seq>06</seq>
                  <data_type>AN</data_type>
                  <min_len>1</min_len>
                  <max_len>30</max_len>
                </element>
              </segment>
<!--End of N4 segment-->
              <segment xid="REF">
                <name>Pay-To Provider Secondary Identification</name>
                <usage>S</usage>
                <pos>035</pos>
                <max_use>5</max_use>
                <element xid="REF01">
                  <data_ele>128</data_ele>
                  <name>Reference Identification Qualifier</name>
                  <usage>R</usage>
                  <seq>01</seq>
                  <data_type>ID</data_type>
                  <min_len>2</min_len>
                  <max_len>3</max_len>
                  <valid_codes>
                    <code>0B</code>
                    <code>1A</code>
                    <code>1B</code>
                    <code>1C</code>
                    <code>1D</code>
                    <code>1G</code>
                    <code>1H</code>
                    <code>1J</code>
                    <code>B3</code>
                    <code>BQ</code>
                    <code>EI</code>
                    <code>FH</code>
                    <code>G2</code>
                    <code>G5</code>
                    <code>LU</code>
                    <code>SY</code>
                    <code>X5</code>
                  </valid_codes>
                </element>
                <element xid="REF02">
                  <data_ele>127</data_ele>
                  <name>Pay-to Provider Additional Identifier</name>
                  <usage>R</usage>
                  <seq>02</seq>
                  <data_type>AN</data_type>
                  <min_len>1</min_len>
                  <max_len>30</max_len>
                </element>
                <element xid="REF03">
                  <data_ele>352</data_ele>
                  <name>Description</name>
                  <usage>N</usage>
                  <seq>03</seq>
                  <data_type>AN</data_type>
                  <min_len>1</min_len>
                  <max_len>80</max_len>
                </element>
                <composite>
                  <data_ele>C040</data_ele>
                  <name>Reference Identifier</name>
                  <usage>N</usage>
                  <seq>04</seq>
                </composite>
              </segment>
<!--End of REF segment-->
            </loop>
<!--End of 2010AB loop-->
            <loop xid="2000B">
              <name>Subscriber Hierarchichal Level</name>
              <usage>R</usage>
              <pos>020</pos>
              <repeat>&gt;1</repeat>
              <segment xid="HL">
                <name>Subscriber Hierarchical Level</name>
                <usage>R</usage>
                <pos>001</pos>
                <max_use>1</max_use>
                <element xid="HL01">
                  <data_ele>628</data_ele>
                  <name>Hierarchical ID Number</name>
                  <usage>R</usage>
                  <seq>01</seq>
                  <data_type>AN</data_type>
                  <min_len>1</min_len>
                  <max_len>12</max_len>
                </element>
                <element xid="HL02">
                  <data_ele>734</data_ele>
                  <name>Hierarchical Parent ID Number</name>
                  <usage>R</usage>
                  <seq>02</seq>
                  <data_type>AN</data_type>
                  <min_len>1</min_len>
                  <max_len>12</max_len>
                </element>
                <element xid="HL03">
                  <data_ele>735</data_ele>
                  <name>Hierarchical Level Code</name>
                  <usage>R</usage>
                  <seq>03</seq>
                  <data_type>ID</data_type>
                  <min_len>1</min_len>
                  <max_len>2</max_len>
                  <valid_codes>
                    <code>22</code>
                  </valid_codes>
                </element>
                <element xid="HL04">
                  <data_ele>736</data_ele>
                  <name>Hierarchical Child Code</name>
                  <usage>R</usage>
                  <seq>04</seq>
                  <data_type>ID</data_type>
                  <min_len>1</min_len>
                  <max_len>1</max_len>
                  <valid_codes>
                    <code>0</code>
                    <code>1</code>
                  </valid_codes>
                </element>
              </segment>
<!--End of HL segment-->
              <segment xid="SBR">
                <name>Subscriber Information</name>
                <usage>R</usage>
                <pos>005</pos>
                <max_use>1</max_use>
                <element xid="SBR01">
                  <data_ele>1138</data_ele>
                  <name>Payer Responsibility Sequence Number Code</name>
                  <usage>R</usage>
                  <seq>01</seq>
                  <data_type>ID</data_type>
                  <min_len>1</min_len>
                  <max_len>1</max_len>
                  <valid_codes>
                    <code>P</code>
                    <code>S</code>
                    <code>T</code>
                  </valid_codes>
                </element>
                <element xid="SBR02">
                  <data_ele>1069</data_ele>
                  <name>Patients Relationship to Insured</name>
                  <usage>S</usage>
                  <seq>02</seq>
                  <data_type>ID</data_type>
                  <min_len>2</min_len>
                  <max_len>2</max_len>
                  <valid_codes>
                    <code>18</code>
                  </valid_codes>
                </element>
                <element xid="SBR03">
                  <data_ele>127</data_ele>
                  <name>Insured Group or Policy Number</name>
                  <usage>S</usage>
                  <seq>03</seq>
                  <data_type>AN</data_type>
                  <min_len>1</min_len>
                  <max_len>30</max_len>
                </element>
                <element xid="SBR04">
                  <data_ele>93</data_ele>
                  <name>Insured Group Name</name>
                  <usage>S</usage>
                  <seq>04</seq>
                  <data_type>AN</data_type>
                  <min_len>1</min_len>
                  <max_len>60</max_len>
                </element>
                <element xid="SBR05">
                  <data_ele>1336</data_ele>
                  <name>Insurance Type Code</name>
                  <usage>N</usage>
                  <seq>05</seq>
                  <data_type>ID</data_type>
                  <min_len>1</min_len>
                  <max_len>3</max_len>
                </element>
                <element xid="SBR06">
                  <data_ele>1143</data_ele>
                  <name>Coordination of Benefits Code</name>
                  <usage>N</usage>
                  <seq>06</seq>
                  <data_type>ID</data_type>
                  <min_len>1</min_len>
                  <max_len>1</max_len>
                </element>
                <element xid="SBR07">
                  <data_ele>1073</data_ele>
                  <name>Yes/No Condition or Response Code</name>
                  <usage>N</usage>
                  <seq>07</seq>
                  <data_type>ID</data_type>
                  <min_len>1</min_len>
                  <max_len>1</max_len>
                </element>
                <element xid="SBR08">
                  <data_ele>584</data_ele>
                  <name>Employment Status Code</name>
                  <usage>N</usage>
                  <seq>08</seq>
                  <data_type>ID</data_type>
                  <min_len>2</min_len>
                  <max_len>2</max_len>
                </element>
                <element xid="SBR09">
                  <data_ele>1032</data_ele>
                  <name>Claim Filing Indicator Code</name>
                  <usage>S</usage>
                  <seq>09</seq>
                  <data_type>ID</data_type>
                  <min_len>1</min_len>
                  <max_len>2</max_len>
                  <valid_codes>
                    <code>09</code>
                    <code>10</code>
                    <code>11</code>
                    <code>12</code>
                    <code>13</code>
                    <code>14</code>
                    <code>15</code>
                    <code>16</code>
                    <code>AM</code>
                    <code>BL</code>
                    <code>CH</code>
                    <code>CI</code>
                    <code>DS</code>
                    <code>HM</code>
                    <code>LI</code>
                    <code>LM</code>
                    <code>MA</code>
                    <code>MB</code>
                    <code>MC</code>
                    <code>OF</code>
                    <code>TV</code>
                    <code>VA</code>
                    <code>WC</code>
                    <code>ZZ</code>
                  </valid_codes>
                </element>
              </segment>
<!--End of SBR segment-->
              <loop xid="2010BA">
                <name>Subscriber Name</name>
                <usage>R</usage>
                <pos>015</pos>
                <repeat>1</repeat>
                <segment xid="NM1">
                  <name>Subscriber Name</name>
                  <usage>R</usage>
                  <pos>015</pos>
                  <max_use>1</max_use>
                  <element xid="NM101">
                    <data_ele>98</data_ele>
                    <name>Entity Identifier Code</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>IL</code>
                    </valid_codes>
                  </element>
                  <element xid="NM102">
                    <data_ele>1065</data_ele>
                    <name>Entity Type Qualifier</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                    <valid_codes>
                      <code>1</code>
                      <code>2</code>
                    </valid_codes>
                  </element>
                  <element xid="NM103">
                    <data_ele>1035</data_ele>
                    <name>Subscriber Last Name</name>
                    <usage>R</usage>
                    <seq>03</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>35</max_len>
                  </element>
                  <element xid="NM104">
                    <data_ele>1036</data_ele>
                    <name>Subscriber First Name</name>
                    <usage>S</usage>
                    <seq>04</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>25</max_len>
                  </element>
                  <element xid="NM105">
                    <data_ele>1037</data_ele>
                    <name>Subscriber Middle Name</name>
                    <usage>S</usage>
                    <seq>05</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>25</max_len>
                  </element>
                  <element xid="NM106">
                    <data_ele>1038</data_ele>
                    <name>Name Prefix</name>
                    <usage>N</usage>
                    <seq>06</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>10</max_len>
                  </element>
                  <element xid="NM107">
                    <data_ele>1039</data_ele>
                    <name>Subscriber Name Suffix</name>
                    <usage>S</usage>
                    <seq>07</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>10</max_len>
                  </element>
                  <element xid="NM108">
                    <data_ele>66</data_ele>
                    <name>Identification Code Qualifier</name>
                    <usage>S</usage>
                    <seq>08</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>MI</code>
                      <code>ZZ</code>
                    </valid_codes>
                  </element>
                  <element xid="NM109">
                    <data_ele>67</data_ele>
                    <name>Subscriber Primary Identifier</name>
                    <usage>S</usage>
                    <seq>09</seq>
                    <data_type>AN</data_type>
                    <min_len>2</min_len>
                    <max_len>80</max_len>
                  </element>
                  <element xid="NM110">
                    <data_ele>706</data_ele>
                    <name>Entity Relationship Code</name>
                    <usage>N</usage>
                    <seq>10</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                  </element>
                  <element xid="NM111">
                    <data_ele>98</data_ele>
                    <name>Entity Identifier Code</name>
                    <usage>N</usage>
                    <seq>11</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                  </element>
                </segment>
<!--End of NM1 segment-->
                <segment xid="N3">
                  <name>Subscriber Address</name>
                  <usage>S</usage>
                  <pos>025</pos>
                  <max_use>1</max_use>
                  <element xid="N301">
                    <data_ele>166</data_ele>
                    <name>Subscriber Address Line</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>55</max_len>
                  </element>
                  <element xid="N302">
                    <data_ele>166</data_ele>
                    <name>Subscriber Address Line</name>
                    <usage>S</usage>
                    <seq>02</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>55</max_len>
                  </element>
                </segment>
<!--End of N3 segment-->
                <segment xid="N4">
                  <name>Subscriber City/State/ZIP Code</name>
                  <usage>S</usage>
                  <pos>030</pos>
                  <max_use>1</max_use>
                  <element xid="N401">
                    <data_ele>19</data_ele>
                    <name>Subscriber City Name</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>AN</data_type>
                    <min_len>2</min_len>
                    <max_len>30</max_len>
                  </element>
                  <element xid="N402">
                    <data_ele>156</data_ele>
                    <name>Subscriber State Code</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                    <valid_codes external="states"/>
                  </element>
                  <element xid="N403">
                    <data_ele>116</data_ele>
                    <name>Subscriber Postal Zone or ZIP Code</name>
                    <usage>R</usage>
                    <seq>03</seq>
                    <data_type>ID</data_type>
                    <min_len>3</min_len>
                    <max_len>15</max_len>
                  </element>
                  <element xid="N404">
                    <data_ele>26</data_ele>
                    <name>Country Code</name>
                    <usage>S</usage>
                    <seq>04</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                    <valid_codes external="country"/>
                  </element>
                  <element xid="N405">
                    <data_ele>309</data_ele>
                    <name>Location Qualifier</name>
                    <usage>N</usage>
                    <seq>05</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>2</max_len>
                  </element>
                  <element xid="N406">
                    <data_ele>310</data_ele>
                    <name>Location Identifier</name>
                    <usage>N</usage>
                    <seq>06</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>30</max_len>
                  </element>
                </segment>
<!--End of N4 segment-->
                <segment xid="DMG">
                  <name>Subscriber Demographic Information</name>
                  <usage>S</usage>
                  <pos>032</pos>
                  <max_use>1</max_use>
                  <element xid="DMG01">
                    <data_ele>1250</data_ele>
                    <name>Date Time Period Format Qualifier</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>D8</code>
                    </valid_codes>
                  </element>
                  <element xid="DMG02">
                    <data_ele>1251</data_ele>
                    <name>Subscriber Birth Date</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>35</max_len>
                  </element>
                  <element xid="DMG03">
                    <data_ele>1068</data_ele>
                    <name>Subscriber Gender Code</name>
                    <usage>R</usage>
                    <seq>03</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                    <valid_codes>
                      <code>F</code>
                      <code>M</code>
                      <code>U</code>
                    </valid_codes>
                  </element>
                  <element xid="DMG04">
                    <data_ele>1067</data_ele>
                    <name>Marital Status Code</name>
                    <usage>N</usage>
                    <seq>04</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                  </element>
                  <element xid="DMG05">
                    <data_ele>1109</data_ele>
                    <name>Race or Ethnicity Code</name>
                    <usage>N</usage>
                    <seq>05</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                  </element>
                  <element xid="DMG06">
                    <data_ele>1066</data_ele>
                    <name>Citizenship Status Code</name>
                    <usage>N</usage>
                    <seq>06</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>2</max_len>
                  </element>
                  <element xid="DMG07">
                    <data_ele>26</data_ele>
                    <name>Country Code</name>
                    <usage>N</usage>
                    <seq>07</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                    <valid_codes external="country"/>
                  </element>
                  <element xid="DMG08">
                    <data_ele>659</data_ele>
                    <name>Basis of Verification Code</name>
                    <usage>N</usage>
                    <seq>08</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>2</max_len>
                  </element>
                  <element xid="DMG09">
                    <data_ele>380</data_ele>
                    <name>Quantity</name>
                    <usage>N</usage>
                    <seq>09</seq>
                    <data_type>R</data_type>
                    <min_len>1</min_len>
                    <max_len>15</max_len>
                  </element>
                </segment>
<!--End of DMG segment-->
                <segment xid="REF">
                  <name>Subscriber Secondary Identification</name>
                  <usage>S</usage>
                  <pos>035</pos>
                  <max_use>4</max_use>
                  <element xid="REF01">
                    <data_ele>128</data_ele>
                    <name>Reference Identification Qualifier</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>1W</code>
                      <code>23</code>
                      <code>IG</code>
                      <code>SY</code>
                    </valid_codes>
                  </element>
                  <element xid="REF02">
                    <data_ele>127</data_ele>
                    <name>Subscriber Supplemental Identifier</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>30</max_len>
                  </element>
                  <element xid="REF03">
                    <data_ele>352</data_ele>
                    <name>Description</name>
                    <usage>N</usage>
                    <seq>03</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>80</max_len>
                  </element>
                  <composite>
                    <data_ele>C040</data_ele>
                    <name>Reference Identifier</name>
                    <usage>N</usage>
                    <seq>04</seq>
                  </composite>
                </segment>
<!--End of REF segment-->
                <segment xid="REF">
                  <name>Property and Casualty Claim Number</name>
                  <usage>S</usage>
                  <pos>035</pos>
                  <max_use>1</max_use>
                  <element xid="REF01">
                    <data_ele>128</data_ele>
                    <name>Reference Identification Qualifier</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>Y4</code>
                    </valid_codes>
                  </element>
                  <element xid="REF02">
                    <data_ele>127</data_ele>
                    <name>Property Casualty Claim Number</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>30</max_len>
                  </element>
                  <element xid="REF03">
                    <data_ele>352</data_ele>
                    <name>Description</name>
                    <usage>N</usage>
                    <seq>03</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>80</max_len>
                  </element>
                  <composite>
                    <data_ele>C040</data_ele>
                    <name>Reference Identifier</name>
                    <usage>N</usage>
                    <seq>04</seq>
                  </composite>
                </segment>
<!--End of REF segment-->
              </loop>
<!--End of 2010BA loop-->
              <loop xid="2010BB">
                <name>Credit/Debit Card Account Holder Name</name>
                <usage>S</usage>
                <pos>015</pos>
                <repeat>1</repeat>
                <segment xid="NM1">
                  <name>Credit/Debit Card Account Holder Name</name>
                  <usage>R</usage>
                  <pos>015</pos>
                  <max_use>1</max_use>
                  <element xid="NM101">
                    <data_ele>98</data_ele>
                    <name>Entity Identifier Code</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>AO</code>
                    </valid_codes>
                  </element>
                  <element xid="NM102">
                    <data_ele>1065</data_ele>
                    <name>Entity Type Qualifier</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                    <valid_codes>
                      <code>1</code>
                      <code>2</code>
                    </valid_codes>
                  </element>
                  <element xid="NM103">
                    <data_ele>1035</data_ele>
                    <name>Credit or Debit Card Holder Last or Organizational Name</name>
                    <usage>R</usage>
                    <seq>03</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>35</max_len>
                  </element>
                  <element xid="NM104">
                    <data_ele>1036</data_ele>
                    <name>Credit or Debit Card Holder First Name</name>
                    <usage>S</usage>
                    <seq>04</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>25</max_len>
                  </element>
                  <element xid="NM105">
                    <data_ele>1037</data_ele>
                    <name>Credit or Debit Card Holder Middle Name</name>
                    <usage>S</usage>
                    <seq>05</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>25</max_len>
                  </element>
                  <element xid="NM106">
                    <data_ele>1038</data_ele>
                    <name>Name Prefix</name>
                    <usage>N</usage>
                    <seq>06</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>10</max_len>
                  </element>
                  <element xid="NM107">
                    <data_ele>1039</data_ele>
                    <name>Credit or Debit Card Holder Name Suffix</name>
                    <usage>S</usage>
                    <seq>07</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>10</max_len>
                  </element>
                  <element xid="NM108">
                    <data_ele>66</data_ele>
                    <name>Identification Code Qualifier</name>
                    <usage>R</usage>
                    <seq>08</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>MI</code>
                    </valid_codes>
                  </element>
                  <element xid="NM109">
                    <data_ele>67</data_ele>
                    <name>Credit or Debit Card Number</name>
                    <usage>R</usage>
                    <seq>09</seq>
                    <data_type>AN</data_type>
                    <min_len>2</min_len>
                    <max_len>80</max_len>
                  </element>
                  <element xid="NM110">
                    <data_ele>706</data_ele>
                    <name>Entity Relationship Code</name>
                    <usage>N</usage>
                    <seq>10</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                  </element>
                  <element xid="NM111">
                    <data_ele>98</data_ele>
                    <name>Entity Identifier Code</name>
                    <usage>N</usage>
                    <seq>11</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                  </element>
                </segment>
<!--End of NM1 segment-->
                <segment xid="REF">
                  <name>Credit/Debit Card Information</name>
                  <usage>S</usage>
                  <pos>035</pos>
                  <max_use>2</max_use>
                  <element xid="REF01">
                    <data_ele>128</data_ele>
                    <name>Reference Identification Qualifier</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>AB</code>
                      <code>BB</code>
                    </valid_codes>
                  </element>
                  <element xid="REF02">
                    <data_ele>127</data_ele>
                    <name>Credit or Debit Card Authorization Number</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>30</max_len>
                  </element>
                  <element xid="REF03">
                    <data_ele>352</data_ele>
                    <name>Description</name>
                    <usage>N</usage>
                    <seq>03</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>80</max_len>
                  </element>
                  <composite>
                    <data_ele>C040</data_ele>
                    <name>Reference Identifier</name>
                    <usage>N</usage>
                    <seq>04</seq>
                  </composite>
                </segment>
<!--End of REF segment-->
              </loop>
<!--End of 2010BB loop-->
              <loop xid="2010BC">
                <name>Payer Name</name>
                <usage>R</usage>
                <pos>015</pos>
                <repeat>1</repeat>
                <segment xid="NM1">
                  <name>Payer Name</name>
                  <usage>R</usage>
                  <pos>015</pos>
                  <max_use>1</max_use>
                  <element xid="NM101">
                    <data_ele>98</data_ele>
                    <name>Entity Identifier Code</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>PR</code>
                    </valid_codes>
                  </element>
                  <element xid="NM102">
                    <data_ele>1065</data_ele>
                    <name>Entity Type Qualifier</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                    <valid_codes>
                      <code>2</code>
                    </valid_codes>
                  </element>
                  <element xid="NM103">
                    <data_ele>1035</data_ele>
                    <name>Payer Name</name>
                    <usage>R</usage>
                    <seq>03</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>35</max_len>
                  </element>
                  <element xid="NM104">
                    <data_ele>1036</data_ele>
                    <name>Name First</name>
                    <usage>N</usage>
                    <seq>04</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>25</max_len>
                  </element>
                  <element xid="NM105">
                    <data_ele>1037</data_ele>
                    <name>Name Middle</name>
                    <usage>N</usage>
                    <seq>05</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>25</max_len>
                  </element>
                  <element xid="NM106">
                    <data_ele>1038</data_ele>
                    <name>Name Prefix</name>
                    <usage>N</usage>
                    <seq>06</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>10</max_len>
                  </element>
                  <element xid="NM107">
                    <data_ele>1039</data_ele>
                    <name>Name Suffix</name>
                    <usage>N</usage>
                    <seq>07</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>10</max_len>
                  </element>
                  <element xid="NM108">
                    <data_ele>66</data_ele>
                    <name>Identification Code Qualifier</name>
                    <usage>R</usage>
                    <seq>08</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>PI</code>
                      <code>XV</code>
                    </valid_codes>
                  </element>
                  <element xid="NM109">
                    <data_ele>67</data_ele>
                    <name>Payer Identifier</name>
                    <usage>R</usage>
                    <seq>09</seq>
                    <data_type>AN</data_type>
                    <min_len>2</min_len>
                    <max_len>80</max_len>
                  </element>
                  <element xid="NM110">
                    <data_ele>706</data_ele>
                    <name>Entity Relationship Code</name>
                    <usage>N</usage>
                    <seq>10</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                  </element>
                  <element xid="NM111">
                    <data_ele>98</data_ele>
                    <name>Entity Identifier Code</name>
                    <usage>N</usage>
                    <seq>11</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                  </element>
                </segment>
<!--End of NM1 segment-->
                <segment xid="N3">
                  <name>Payer Address</name>
                  <usage>S</usage>
                  <pos>025</pos>
                  <max_use>1</max_use>
                  <element xid="N301">
                    <data_ele>166</data_ele>
                    <name>Payer Address Line</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>55</max_len>
                  </element>
                  <element xid="N302">
                    <data_ele>166</data_ele>
                    <name>Payer Address Line</name>
                    <usage>S</usage>
                    <seq>02</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>55</max_len>
                  </element>
                </segment>
<!--End of N3 segment-->
                <segment xid="N4">
                  <name>Payer City/State/ZIP Code</name>
                  <usage>S</usage>
                  <pos>030</pos>
                  <max_use>1</max_use>
                  <element xid="N401">
                    <data_ele>19</data_ele>
                    <name>Payer City Name</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>AN</data_type>
                    <min_len>2</min_len>
                    <max_len>30</max_len>
                  </element>
                  <element xid="N402">
                    <data_ele>156</data_ele>
                    <name>Payer State Code</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                    <valid_codes external="states"/>
                  </element>
                  <element xid="N403">
                    <data_ele>116</data_ele>
                    <name>Payer Postal Zone or ZIP Code</name>
                    <usage>R</usage>
                    <seq>03</seq>
                    <data_type>ID</data_type>
                    <min_len>3</min_len>
                    <max_len>15</max_len>
                  </element>
                  <element xid="N404">
                    <data_ele>26</data_ele>
                    <name>Payer Country Code</name>
                    <usage>S</usage>
                    <seq>04</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                    <valid_codes external="country"/>
                  </element>
                  <element xid="N405">
                    <data_ele>309</data_ele>
                    <name>Location Qualifier</name>
                    <usage>N</usage>
                    <seq>05</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>2</max_len>
                  </element>
                  <element xid="N406">
                    <data_ele>310</data_ele>
                    <name>Location Identifier</name>
                    <usage>N</usage>
                    <seq>06</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>30</max_len>
                  </element>
                </segment>
<!--End of N4 segment-->
                <segment xid="REF">
                  <name>Payer Secondary Identification</name>
                  <usage>S</usage>
                  <pos>035</pos>
                  <max_use>3</max_use>
                  <element xid="REF01">
                    <data_ele>128</data_ele>
                    <name>Reference Identification Qualifier</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>2U</code>
                      <code>FY</code>
                      <code>NF</code>
                      <code>TJ</code>
                    </valid_codes>
                  </element>
                  <element xid="REF02">
                    <data_ele>127</data_ele>
                    <name>Payer Additional Identifier</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>30</max_len>
                  </element>
                  <element xid="REF03">
                    <data_ele>352</data_ele>
                    <name>Description</name>
                    <usage>N</usage>
                    <seq>03</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>80</max_len>
                  </element>
                  <composite>
                    <data_ele>C040</data_ele>
                    <name>Reference Identifier</name>
                    <usage>N</usage>
                    <seq>04</seq>
                  </composite>
                </segment>
<!--End of REF segment-->
              </loop>
<!--End of 2010BC loop-->
              <loop xid="2010BD">
                <name>Responsible Party Name</name>
                <usage>S</usage>
                <pos>015</pos>
                <repeat>1</repeat>
                <segment xid="NM1">
                  <name>Responsible Party Name</name>
                  <usage>R</usage>
                  <pos>015</pos>
                  <max_use>1</max_use>
                  <element xid="NM101">
                    <data_ele>98</data_ele>
                    <name>Entity Identifier Code</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>QD</code>
                    </valid_codes>
                  </element>
                  <element xid="NM102">
                    <data_ele>1065</data_ele>
                    <name>Entity Type Qualifier</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                    <valid_codes>
                      <code>1</code>
                      <code>2</code>
                    </valid_codes>
                  </element>
                  <element xid="NM103">
                    <data_ele>1035</data_ele>
                    <name>Responsible Party Last or Organization Name</name>
                    <usage>R</usage>
                    <seq>03</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>35</max_len>
                  </element>
                  <element xid="NM104">
                    <data_ele>1036</data_ele>
                    <name>Responsible Party First Name</name>
                    <usage>S</usage>
                    <seq>04</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>25</max_len>
                  </element>
                  <element xid="NM105">
                    <data_ele>1037</data_ele>
                    <name>Responsible Party Middle Name</name>
                    <usage>S</usage>
                    <seq>05</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>25</max_len>
                  </element>
                  <element xid="NM106">
                    <data_ele>1038</data_ele>
                    <name>Name Prefix</name>
                    <usage>N</usage>
                    <seq>06</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>10</max_len>
                  </element>
                  <element xid="NM107">
                    <data_ele>1039</data_ele>
                    <name>Responsible Party Suffix Name</name>
                    <usage>S</usage>
                    <seq>07</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>10</max_len>
                  </element>
                  <element xid="NM108">
                    <data_ele>66</data_ele>
                    <name>Identification Code Qualifier</name>
                    <usage>N</usage>
                    <seq>08</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>2</max_len>
                  </element>
                  <element xid="NM109">
                    <data_ele>67</data_ele>
                    <name>Identification Code</name>
                    <usage>N</usage>
                    <seq>09</seq>
                    <data_type>AN</data_type>
                    <min_len>2</min_len>
                    <max_len>80</max_len>
                  </element>
                  <element xid="NM110">
                    <data_ele>706</data_ele>
                    <name>Entity Relationship Code</name>
                    <usage>N</usage>
                    <seq>10</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                  </element>
                  <element xid="NM111">
                    <data_ele>98</data_ele>
                    <name>Entity Identifier Code</name>
                    <usage>N</usage>
                    <seq>11</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                  </element>
                </segment>
<!--End of NM1 segment-->
                <segment xid="N3">
                  <name>Responsible Party Address</name>
                  <usage>R</usage>
                  <pos>025</pos>
                  <max_use>1</max_use>
                  <element xid="N301">
                    <data_ele>166</data_ele>
                    <name>Responsible Party Address Line</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>55</max_len>
                  </element>
                  <element xid="N302">
                    <data_ele>166</data_ele>
                    <name>Responsible Party Address Line</name>
                    <usage>S</usage>
                    <seq>02</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>55</max_len>
                  </element>
                </segment>
<!--End of N3 segment-->
                <segment xid="N4">
                  <name>Responsible Party City/State/ZIP Code</name>
                  <usage>R</usage>
                  <pos>030</pos>
                  <max_use>1</max_use>
                  <element xid="N401">
                    <data_ele>19</data_ele>
                    <name>Responsible Party City Name</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>AN</data_type>
                    <min_len>2</min_len>
                    <max_len>30</max_len>
                  </element>
                  <element xid="N402">
                    <data_ele>156</data_ele>
                    <name>Responsible Party State Code</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                    <valid_codes external="states"/>
                  </element>
                  <element xid="N403">
                    <data_ele>116</data_ele>
                    <name>Responsible Party Postal Zone or ZIP Code</name>
                    <usage>R</usage>
                    <seq>03</seq>
                    <data_type>ID</data_type>
                    <min_len>3</min_len>
                    <max_len>15</max_len>
                  </element>
                  <element xid="N404">
                    <data_ele>26</data_ele>
                    <name>Responsible Party Country Code</name>
                    <usage>S</usage>
                    <seq>04</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                    <valid_codes external="country"/>
                  </element>
                  <element xid="N405">
                    <data_ele>309</data_ele>
                    <name>Location Qualifier</name>
                    <usage>N</usage>
                    <seq>05</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>2</max_len>
                  </element>
                  <element xid="N406">
                    <data_ele>310</data_ele>
                    <name>Location Identifier</name>
                    <usage>N</usage>
                    <seq>06</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>30</max_len>
                  </element>
                </segment>
<!--End of N4 segment-->
              </loop>
<!--End of 2010BD loop-->
              <loop xid="2300">
                <name>Claim Information</name>
                <usage>S</usage>
                <pos>130</pos>
                <repeat>100</repeat>
                <segment xid="CLM">
                  <name>Claim Information</name>
                  <usage>R</usage>
                  <pos>130</pos>
                  <max_use>1</max_use>
                  <element xid="CLM01">
                    <data_ele>1028</data_ele>
                    <name>Patient Account Number</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>38</max_len>
                  </element>
                  <element xid="CLM02">
                    <data_ele>782</data_ele>
                    <name>Total Claim Charge Amount</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>R</data_type>
                    <min_len>1</min_len>
                    <max_len>18</max_len>
                  </element>
                  <element xid="CLM03">
                    <data_ele>1032</data_ele>
                    <name>Claim Filing Indicator Code</name>
                    <usage>N</usage>
                    <seq>03</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>2</max_len>
                  </element>
                  <element xid="CLM04">
                    <data_ele>1343</data_ele>
                    <name>Non-Institutional Claim Type Code</name>
                    <usage>N</usage>
                    <seq>04</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>2</max_len>
                  </element>
                  <composite>
                    <data_ele>C023</data_ele>
                    <name>Type of Bill</name>
                    <usage>R</usage>
                    <seq>05</seq>
                    <element xid="CLM05-01">
                      <data_ele>1331</data_ele>
                      <name>Facility Type Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code/>
                      </valid_codes>
                    </element>
                    <element xid="CLM05-02">
                      <data_ele>1332</data_ele>
                      <name>Facility Code Qualifier</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>A</code>
                      </valid_codes>
                    </element>
                    <element xid="CLM05-03">
                      <data_ele>1325</data_ele>
                      <name>Claim Frequency Code</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                      <valid_codes>
                        <code>0</code>
                        <code>1</code>
                        <code>2</code>
                        <code>3</code>
                        <code>4</code>
                        <code>5</code>
                        <code>6</code>
                        <code>7</code>
                        <code>8</code>
                        <code>9</code>
                        <code>A</code>
                        <code>B</code>
                        <code>C</code>
                        <code>D</code>
                        <code>E</code>
                        <code>F</code>
                        <code>G</code>
                        <code>H</code>
                        <code>I</code>
                        <code>J</code>
                        <code>K</code>
                        <code>L</code>
                        <code>M</code>
                        <code>N</code>
                        <code>O</code>
                        <code>X</code>
                        <code>Y</code>
                        <code>Z </code>
                      </valid_codes>
                    </element>
                  </composite>
                  <element xid="CLM06">
                    <data_ele>1073</data_ele>
                    <name>Provider or Supplier Signature Indicator</name>
                    <usage>R</usage>
                    <seq>06</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                    <valid_codes>
                      <code>N</code>
                      <code>Y</code>
                    </valid_codes>
                  </element>
                  <element xid="CLM07">
                    <data_ele>1359</data_ele>
                    <name>Medicare Assignment Code</name>
                    <usage>S</usage>
                    <seq>07</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                    <valid_codes>
                      <code>A</code>
                      <code>C</code>
                    </valid_codes>
                  </element>
                  <element xid="CLM08">
                    <data_ele>1073</data_ele>
                    <name>Benefits Assignment Certification Indicator</name>
                    <usage>R</usage>
                    <seq>08</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                    <valid_codes>
                      <code>N</code>
                      <code>Y</code>
                    </valid_codes>
                  </element>
                  <element xid="CLM09">
                    <data_ele>1363</data_ele>
                    <name>Release of Information Code</name>
                    <usage>R</usage>
                    <seq>09</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                    <valid_codes>
                      <code>A</code>
                      <code>I</code>
                      <code>M</code>
                      <code>N</code>
                      <code>O</code>
                      <code>Y</code>
                    </valid_codes>
                  </element>
                  <element xid="CLM10">
                    <data_ele>1351</data_ele>
                    <name>Patient Signature Source Code</name>
                    <usage>N</usage>
                    <seq>10</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                  </element>
                  <composite>
                    <data_ele>C024</data_ele>
                    <name>Property and Casualty Related Causes Codes</name>
                    <usage>N</usage>
                    <seq>11</seq>
                  </composite>
                  <element xid="CLM12">
                    <data_ele>1366</data_ele>
                    <name>Special Program Indicator</name>
                    <usage>N</usage>
                    <seq>12</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>01</code>
                      <code>02</code>
                      <code>03</code>
                      <code>05</code>
                      <code>07</code>
                      <code>08</code>
                      <code>09</code>
                    </valid_codes>
                  </element>
                  <element xid="CLM13">
                    <data_ele>1073</data_ele>
                    <name>Yes/No Condition or Response Code</name>
                    <usage>N</usage>
                    <seq>13</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                  </element>
                  <element xid="CLM14">
                    <data_ele>1338</data_ele>
                    <name>Level of Service Code</name>
                    <usage>N</usage>
                    <seq>14</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>3</max_len>
                  </element>
                  <element xid="CLM15">
                    <data_ele>1073</data_ele>
                    <name>Yes/No Condition or Response Code</name>
                    <usage>N</usage>
                    <seq>15</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                  </element>
                  <element xid="CLM16">
                    <data_ele>1360</data_ele>
                    <name>Provider Agreement Code</name>
                    <usage>N</usage>
                    <seq>16</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                  </element>
                  <element xid="CLM07">
                    <data_ele>1029</data_ele>
                    <name>Claim Status Code</name>
                    <usage>N</usage>
                    <seq>7</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>2</max_len>
                  </element>
                  <element xid="CLM18">
                    <data_ele>1073</data_ele>
                    <name>Explanation of Benefits Indicator</name>
                    <usage>R</usage>
                    <seq>18</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                    <valid_codes>
                      <code>N</code>
                      <code>Y</code>
                    </valid_codes>
                  </element>
                  <element xid="CLM19">
                    <data_ele>1383</data_ele>
                    <name>Claim Submission Reason Code</name>
                    <usage>N</usage>
                    <seq>19</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                  </element>
                  <element xid="CLM20">
                    <data_ele>1514</data_ele>
                    <name>Delay Reason Code</name>
                    <usage>S</usage>
                    <seq>20</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>1</code>
                      <code>2</code>
                      <code>3</code>
                      <code>4</code>
                      <code>5</code>
                      <code>6</code>
                      <code>7</code>
                      <code>8</code>
                      <code>9</code>
                      <code>10</code>
                      <code>11</code>
                    </valid_codes>
                  </element>
                </segment>
<!--End of CLM segment-->
                <segment xid="DTP">
                  <name>Discharge Hour</name>
                  <usage>S</usage>
                  <pos>135</pos>
                  <max_use>1</max_use>
                  <element xid="DTP01">
                    <data_ele>374</data_ele>
                    <name>Date Time Qualifier</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>3</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>096</code>
                    </valid_codes>
                  </element>
                  <element xid="DTP02">
                    <data_ele>1250</data_ele>
                    <name>Date Time Period Format Qualifier</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>TM</code>
                    </valid_codes>
                  </element>
                  <element xid="DTP03">
                    <data_ele>1251</data_ele>
                    <name>Discharge Hour</name>
                    <usage>R</usage>
                    <seq>03</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>35</max_len>
                  </element>
                </segment>
<!--End of DTP segment-->
                <segment xid="DTP">
                  <name>Statement Dates</name>
                  <usage>R</usage>
                  <pos>135</pos>
                  <max_use>1</max_use>
                  <element xid="DTP01">
                    <data_ele>374</data_ele>
                    <name>Date Time Qualifier</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>3</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>434</code>
                    </valid_codes>
                  </element>
                  <element xid="DTP02">
                    <data_ele>1250</data_ele>
                    <name>Date Time Period Format Qualifier</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>D8</code>
                      <code>RD8</code>
                    </valid_codes>
                  </element>
                  <element xid="DTP03">
                    <data_ele>1251</data_ele>
                    <name>Statement From or To Date</name>
                    <usage>R</usage>
                    <seq>03</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>35</max_len>
                  </element>
                </segment>
<!--End of DTP segment-->
                <segment xid="DTP">
                  <name>Admission Date/Hour</name>
                  <usage>S</usage>
                  <pos>135</pos>
                  <max_use>1</max_use>
                  <element xid="DTP01">
                    <data_ele>374</data_ele>
                    <name>Date Time Qualifier</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>3</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>435</code>
                    </valid_codes>
                  </element>
                  <element xid="DTP02">
                    <data_ele>1250</data_ele>
                    <name>Date Time Period Format Qualifier</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>DT</code>
                    </valid_codes>
                  </element>
                  <element xid="DTP03">
                    <data_ele>1251</data_ele>
                    <name>Admission Date and Hour</name>
                    <usage>R</usage>
                    <seq>03</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>35</max_len>
                  </element>
                </segment>
<!--End of DTP segment-->
                <segment xid="CL1">
                  <name>Institutional Claim Code</name>
                  <usage>S</usage>
                  <pos>140</pos>
                  <max_use>1</max_use>
                  <element xid="CL101">
                    <data_ele>1315</data_ele>
                    <name>Admission Type Code</name>
                    <usage>S</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                  </element>
                  <element xid="CL102">
                    <data_ele>1314</data_ele>
                    <name>Admission Source Code</name>
                    <usage>S</usage>
                    <seq>02</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                  </element>
                  <element xid="CL103">
                    <data_ele>1352</data_ele>
                    <name>Patient Status Code</name>
                    <usage>S</usage>
                    <seq>03</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>2</max_len>
                  </element>
                  <element xid="CL104">
                    <data_ele>1345</data_ele>
                    <name>Nursing Home Residential Status Code</name>
                    <usage>N</usage>
                    <seq>04</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                  </element>
                </segment>
<!--End of CL1 segment-->
                <segment xid="PWK">
                  <name>Claim Supplemental Information</name>
                  <usage>S</usage>
                  <pos>155</pos>
                  <max_use>10</max_use>
                  <element xid="PWK01">
                    <data_ele>755</data_ele>
                    <name>Attachment Report Type Code</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>AS</code>
                      <code>B2</code>
                      <code>B3</code>
                      <code>B4</code>
                      <code>CT</code>
                      <code>DA</code>
                      <code>DG</code>
                      <code>DS</code>
                      <code>EB</code>
                      <code>MT</code>
                      <code>NN</code>
                      <code>OB</code>
                      <code>OZ</code>
                      <code>PN</code>
                      <code>PO</code>
                      <code>PZ</code>
                      <code>RB</code>
                      <code>RR</code>
                      <code>RT</code>
                    </valid_codes>
                  </element>
                  <element xid="PWK02">
                    <data_ele>756</data_ele>
                    <name>Attachment Transmission Code</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>AA</code>
                      <code>BM</code>
                      <code>EL</code>
                      <code>EM</code>
                      <code>FX</code>
                    </valid_codes>
                  </element>
                  <element xid="PWK03">
                    <data_ele>757</data_ele>
                    <name>Report Copies Needed</name>
                    <usage>N</usage>
                    <seq>03</seq>
                    <data_type>N0</data_type>
                    <min_len>1</min_len>
                    <max_len>2</max_len>
                  </element>
                  <element xid="PWK04">
                    <data_ele>98</data_ele>
                    <name>Entity Identifier Code</name>
                    <usage>N</usage>
                    <seq>04</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                  </element>
                  <element xid="PWK05">
                    <data_ele>66</data_ele>
                    <name>Identification Code Qualifier</name>
                    <usage>S</usage>
                    <seq>05</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>AC</code>
                    </valid_codes>
                  </element>
                  <element xid="PWK06">
                    <data_ele>67</data_ele>
                    <name>Attachment Control Number</name>
                    <usage>S</usage>
                    <seq>06</seq>
                    <data_type>AN</data_type>
                    <min_len>2</min_len>
                    <max_len>80</max_len>
                  </element>
                  <element xid="PWK07">
                    <data_ele>352</data_ele>
                    <name>Attachment Description</name>
                    <usage>S</usage>
                    <seq>07</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>80</max_len>
                  </element>
                  <composite>
                    <data_ele>C002</data_ele>
                    <name>Actions Indicated</name>
                    <usage>N</usage>
                    <seq>08</seq>
                  </composite>
                  <element xid="PWK09">
                    <data_ele>1525</data_ele>
                    <name>Request Category Code</name>
                    <usage>N</usage>
                    <seq>09</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>2</max_len>
                  </element>
                </segment>
<!--End of PWK segment-->
                <segment xid="CN1">
                  <name>Contract Information</name>
                  <usage>S</usage>
                  <pos>160</pos>
                  <max_use>1</max_use>
                  <element xid="CN101">
                    <data_ele>1166</data_ele>
                    <name>Contract Type Code</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>01</code>
                      <code>02</code>
                      <code>03</code>
                      <code>04</code>
                      <code>05</code>
                      <code>06</code>
                      <code>09</code>
                    </valid_codes>
                  </element>
                  <element xid="CN102">
                    <data_ele>782</data_ele>
                    <name>Contract Amount</name>
                    <usage>S</usage>
                    <seq>02</seq>
                    <data_type>R</data_type>
                    <min_len>1</min_len>
                    <max_len>18</max_len>
                  </element>
                  <element xid="CN103">
                    <data_ele>332</data_ele>
                    <name>Contract Percentage</name>
                    <usage>S</usage>
                    <seq>03</seq>
                    <data_type>R</data_type>
                    <min_len>1</min_len>
                    <max_len>6</max_len>
                  </element>
                  <element xid="CN104">
                    <data_ele>127</data_ele>
                    <name>Contract Code</name>
                    <usage>S</usage>
                    <seq>04</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>30</max_len>
                  </element>
                  <element xid="CN105">
                    <data_ele>338</data_ele>
                    <name>Terms Discount Percentage</name>
                    <usage>S</usage>
                    <seq>05</seq>
                    <data_type>R</data_type>
                    <min_len>1</min_len>
                    <max_len>6</max_len>
                  </element>
                  <element xid="CN106">
                    <data_ele>799</data_ele>
                    <name>Contract Version Identifier</name>
                    <usage>S</usage>
                    <seq>06</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>30</max_len>
                  </element>
                </segment>
<!--End of CN1 segment-->
                <segment xid="AMT">
                  <name>Payer Estimated Amount Due</name>
                  <usage>S</usage>
                  <pos>175</pos>
                  <max_use>1</max_use>
                  <element xid="AMT01">
                    <data_ele>522</data_ele>
                    <name>Amount Qualifier Code</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>C5</code>
                    </valid_codes>
                  </element>
                  <element xid="AMT02">
                    <data_ele>782</data_ele>
                    <name>Estimated Claim Due Amount</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>R</data_type>
                    <min_len>1</min_len>
                    <max_len>18</max_len>
                  </element>
                  <element xid="AMT03">
                    <data_ele>478</data_ele>
                    <name>Credit/Debit Flag Code</name>
                    <usage>N</usage>
                    <seq>03</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                  </element>
                </segment>
<!--End of AMT segment-->
                <segment xid="AMT">
                  <name>Patient Estimated Amount Due</name>
                  <usage>S</usage>
                  <pos>175</pos>
                  <max_use>1</max_use>
                  <element xid="AMT01">
                    <data_ele>522</data_ele>
                    <name>Amount Qualifier Code</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>F3</code>
                    </valid_codes>
                  </element>
                  <element xid="AMT02">
                    <data_ele>782</data_ele>
                    <name>Patient Responsibility Amount</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>R</data_type>
                    <min_len>1</min_len>
                    <max_len>18</max_len>
                  </element>
                  <element xid="AMT03">
                    <data_ele>478</data_ele>
                    <name>Credit/Debit Flag Code</name>
                    <usage>N</usage>
                    <seq>03</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                  </element>
                </segment>
<!--End of AMT segment-->
                <segment xid="AMT">
                  <name>Patient Paid Amount</name>
                  <usage>S</usage>
                  <pos>175</pos>
                  <max_use>1</max_use>
                  <element xid="AMT01">
                    <data_ele>522</data_ele>
                    <name>Amount Qualifier Code</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>F5</code>
                    </valid_codes>
                  </element>
                  <element xid="AMT02">
                    <data_ele>782</data_ele>
                    <name>Patient Amount Paid</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>R</data_type>
                    <min_len>1</min_len>
                    <max_len>18</max_len>
                  </element>
                  <element xid="AMT03">
                    <data_ele>478</data_ele>
                    <name>Credit/Debit Flag Code</name>
                    <usage>N</usage>
                    <seq>03</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                  </element>
                </segment>
<!--End of AMT segment-->
                <segment xid="AMT">
                  <name>Credit/Debit Card Maximum Amount</name>
                  <usage>S</usage>
                  <pos>175</pos>
                  <max_use>1</max_use>
                  <element xid="AMT01">
                    <data_ele>522</data_ele>
                    <name>Amount Qualifier Code</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>MA</code>
                    </valid_codes>
                  </element>
                  <element xid="AMT02">
                    <data_ele>782</data_ele>
                    <name>Credit or Debit Card Maximum Amount</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>R</data_type>
                    <min_len>1</min_len>
                    <max_len>18</max_len>
                  </element>
                  <element xid="AMT03">
                    <data_ele>478</data_ele>
                    <name>Credit/Debit Flag Code</name>
                    <usage>N</usage>
                    <seq>03</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                  </element>
                </segment>
<!--End of AMT segment-->
                <segment xid="REF">
                  <name>Adjusted Repriced Claim Number</name>
                  <usage>S</usage>
                  <pos>180</pos>
                  <max_use>1</max_use>
                  <element xid="REF01">
                    <data_ele>128</data_ele>
                    <name>Reference Identification Qualifier</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>9C</code>
                    </valid_codes>
                  </element>
                  <element xid="REF02">
                    <data_ele>127</data_ele>
                    <name>Adjusted Repriced Claim Reference Number</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>30</max_len>
                  </element>
                  <element xid="REF03">
                    <data_ele>352</data_ele>
                    <name>Description</name>
                    <usage>N</usage>
                    <seq>03</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>80</max_len>
                  </element>
                  <composite>
                    <data_ele>C040</data_ele>
                    <name>Reference Identifier</name>
                    <usage>N</usage>
                    <seq>04</seq>
                  </composite>
                </segment>
<!--End of REF segment-->
                <segment xid="REF">
                  <name>Repriced Claim Number</name>
                  <usage>S</usage>
                  <pos>180</pos>
                  <max_use>1</max_use>
                  <element xid="REF01">
                    <data_ele>128</data_ele>
                    <name>Reference Identification Qualifier</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>9A</code>
                    </valid_codes>
                  </element>
                  <element xid="REF02">
                    <data_ele>127</data_ele>
                    <name>Repriced Claim Reference Number</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>30</max_len>
                  </element>
                  <element xid="REF03">
                    <data_ele>352</data_ele>
                    <name>Description</name>
                    <usage>N</usage>
                    <seq>03</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>80</max_len>
                  </element>
                  <composite>
                    <data_ele>C040</data_ele>
                    <name>Reference Identifier</name>
                    <usage>N</usage>
                    <seq>04</seq>
                  </composite>
                </segment>
<!--End of REF segment-->
                <segment xid="REF">
                  <name>Claim Identification Number For Clearinghouses and Other Transmission Intermediaries</name>
                  <usage>S</usage>
                  <pos>180</pos>
                  <max_use>1</max_use>
                  <element xid="REF01">
                    <data_ele>128</data_ele>
                    <name>Reference Identification Qualifier</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>D9</code>
                    </valid_codes>
                  </element>
                  <element xid="REF02">
                    <data_ele>127</data_ele>
                    <name>Value Added Network Trace Number</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>30</max_len>
                  </element>
                  <element xid="REF03">
                    <data_ele>352</data_ele>
                    <name>Description</name>
                    <usage>N</usage>
                    <seq>03</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>80</max_len>
                  </element>
                  <composite>
                    <data_ele>C040</data_ele>
                    <name>Reference Identifier</name>
                    <usage>N</usage>
                    <seq>04</seq>
                  </composite>
                </segment>
<!--End of REF segment-->
                <segment xid="REF">
                  <name>Document Identification Code</name>
                  <usage>S</usage>
                  <pos>180</pos>
                  <max_use>2</max_use>
                  <element xid="REF01">
                    <data_ele>128</data_ele>
                    <name>Reference Identification Qualifier</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>DD</code>
                    </valid_codes>
                  </element>
                  <element xid="REF02">
                    <data_ele>127</data_ele>
                    <name>Document Control Identifier</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>30</max_len>
                  </element>
                  <element xid="REF03">
                    <data_ele>352</data_ele>
                    <name>Description</name>
                    <usage>N</usage>
                    <seq>03</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>80</max_len>
                  </element>
                  <composite>
                    <data_ele>C040</data_ele>
                    <name>Reference Identifier</name>
                    <usage>N</usage>
                    <seq>04</seq>
                  </composite>
                </segment>
<!--End of REF segment-->
                <segment xid="REF">
                  <name>Original Reference Number (ICN/DCN)</name>
                  <usage>S</usage>
                  <pos>180</pos>
                  <max_use>1</max_use>
                  <element xid="REF01">
                    <data_ele>128</data_ele>
                    <name>Reference Identification Qualifier</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>F8</code>
                    </valid_codes>
                  </element>
                  <element xid="REF02">
                    <data_ele>127</data_ele>
                    <name>Claim Original Reference Number</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>30</max_len>
                  </element>
                  <element xid="REF03">
                    <data_ele>352</data_ele>
                    <name>Description</name>
                    <usage>N</usage>
                    <seq>03</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>80</max_len>
                  </element>
                  <composite>
                    <data_ele>C040</data_ele>
                    <name>Reference Identifier</name>
                    <usage>N</usage>
                    <seq>04</seq>
                  </composite>
                </segment>
<!--End of REF segment-->
                <segment xid="REF">
                  <name>Investigational Device Exemption Number</name>
                  <usage>S</usage>
                  <pos>180</pos>
                  <max_use>1</max_use>
                  <element xid="REF01">
                    <data_ele>128</data_ele>
                    <name>Reference Identification Qualifier</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>LX</code>
                    </valid_codes>
                  </element>
                  <element xid="REF02">
                    <data_ele>127</data_ele>
                    <name>Investigational Device Exemption Identifier</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>30</max_len>
                  </element>
                  <element xid="REF03">
                    <data_ele>352</data_ele>
                    <name>Description</name>
                    <usage>N</usage>
                    <seq>03</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>80</max_len>
                  </element>
                  <composite>
                    <data_ele>C040</data_ele>
                    <name>Reference Identifier</name>
                    <usage>N</usage>
                    <seq>04</seq>
                  </composite>
                </segment>
<!--End of REF segment-->
                <segment xid="REF">
                  <name>Service Authorization Exception Code</name>
                  <usage>S</usage>
                  <pos>180</pos>
                  <max_use>1</max_use>
                  <element xid="REF01">
                    <data_ele>128</data_ele>
                    <name>Reference Identification Qualifier</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>4N</code>
                    </valid_codes>
                  </element>
                  <element xid="REF02">
                    <data_ele>127</data_ele>
                    <name>Service Authorization Exception Code</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>30</max_len>
                    <valid_codes>
                      <code>1</code>
                      <code>2</code>
                      <code>3</code>
                      <code>4</code>
                      <code>5</code>
                      <code>6</code>
                      <code>7</code>
                    </valid_codes>
                  </element>
                  <element xid="REF03">
                    <data_ele>352</data_ele>
                    <name>Description</name>
                    <usage>N</usage>
                    <seq>03</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>80</max_len>
                  </element>
                  <composite>
                    <data_ele>C040</data_ele>
                    <name>Reference Identifier</name>
                    <usage>N</usage>
                    <seq>04</seq>
                  </composite>
                </segment>
<!--End of REF segment-->
                <segment xid="REF">
                  <name>Peer Review Organization (PRO) Approval Number</name>
                  <usage>S</usage>
                  <pos>180</pos>
                  <max_use>1</max_use>
                  <element xid="REF01">
                    <data_ele>128</data_ele>
                    <name>Reference Identification Qualifier</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>G4</code>
                    </valid_codes>
                  </element>
                  <element xid="REF02">
                    <data_ele>127</data_ele>
                    <name>Peer Review Authorization Number</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>30</max_len>
                  </element>
                  <element xid="REF03">
                    <data_ele>352</data_ele>
                    <name>Description</name>
                    <usage>N</usage>
                    <seq>03</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>80</max_len>
                  </element>
                  <composite>
                    <data_ele>C040</data_ele>
                    <name>Reference Identifier</name>
                    <usage>N</usage>
                    <seq>04</seq>
                  </composite>
                </segment>
<!--End of REF segment-->
                <segment xid="REF">
                  <name>Prior Authorization or Referral Number</name>
                  <usage>S</usage>
                  <pos>180</pos>
                  <max_use>2</max_use>
                  <element xid="REF01">
                    <data_ele>128</data_ele>
                    <name>Reference Identification Qualifier</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>9F</code>
                      <code>G1</code>
                    </valid_codes>
                  </element>
                  <element xid="REF02">
                    <data_ele>127</data_ele>
                    <name>Prior Authorization Number</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>30</max_len>
                  </element>
                  <element xid="REF03">
                    <data_ele>352</data_ele>
                    <name>Description</name>
                    <usage>N</usage>
                    <seq>03</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>80</max_len>
                  </element>
                  <composite>
                    <data_ele>C040</data_ele>
                    <name>Reference Identifier</name>
                    <usage>N</usage>
                    <seq>04</seq>
                  </composite>
                </segment>
<!--End of REF segment-->
                <segment xid="REF">
                  <name>Medical Record Number</name>
                  <usage>S</usage>
                  <pos>180</pos>
                  <max_use>1</max_use>
                  <element xid="REF01">
                    <data_ele>128</data_ele>
                    <name>Reference Identification Qualifier</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>EA</code>
                    </valid_codes>
                  </element>
                  <element xid="REF02">
                    <data_ele>127</data_ele>
                    <name>Medical Record Number</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>30</max_len>
                  </element>
                  <element xid="REF03">
                    <data_ele>352</data_ele>
                    <name>Description</name>
                    <usage>N</usage>
                    <seq>03</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>80</max_len>
                  </element>
                  <composite>
                    <data_ele>C040</data_ele>
                    <name>Reference Identifier</name>
                    <usage>N</usage>
                    <seq>04</seq>
                  </composite>
                </segment>
<!--End of REF segment-->
                <segment xid="REF">
                  <name>Demonstration Project Identifier</name>
                  <usage>S</usage>
                  <pos>180</pos>
                  <max_use>1</max_use>
                  <element xid="REF01">
                    <data_ele>128</data_ele>
                    <name>Reference Identification Qualifier</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>P4</code>
                    </valid_codes>
                  </element>
                  <element xid="REF02">
                    <data_ele>127</data_ele>
                    <name>Demonstration Project Identifier</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>30</max_len>
                  </element>
                  <element xid="REF03">
                    <data_ele>352</data_ele>
                    <name>Description</name>
                    <usage>N</usage>
                    <seq>03</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>80</max_len>
                  </element>
                  <composite>
                    <data_ele>C040</data_ele>
                    <name>Reference Identifier</name>
                    <usage>N</usage>
                    <seq>04</seq>
                  </composite>
                </segment>
<!--End of REF segment-->
                <segment xid="K3">
                  <name>File Information</name>
                  <usage>S</usage>
                  <pos>185</pos>
                  <max_use>10</max_use>
                  <element xid="K301">
                    <data_ele>449</data_ele>
                    <name>Fixed Format Information</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>80</max_len>
                  </element>
                  <element xid="K302">
                    <data_ele>1333</data_ele>
                    <name>Record Format Code</name>
                    <usage>N</usage>
                    <seq>02</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>2</max_len>
                  </element>
                  <composite>
                    <data_ele>C001</data_ele>
                    <name>Composite Unit of Measure</name>
                    <usage>N</usage>
                    <seq>03</seq>
                  </composite>
                </segment>
<!--End of K3 segment-->
                <segment xid="NTE">
                  <name>Claim Note</name>
                  <usage>S</usage>
                  <pos>190</pos>
                  <max_use>10</max_use>
                  <element xid="NTE01">
                    <data_ele>363</data_ele>
                    <name>Note Reference Code</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>3</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>ALG</code>
                      <code>DCP</code>
                      <code>DGN</code>
                      <code>DME</code>
                      <code>MED</code>
                      <code>NTR</code>
                      <code>ODT</code>
                      <code>RHB</code>
                      <code>RLH</code>
                      <code>RNH</code>
                      <code>SET</code>
                      <code>SFM</code>
                      <code>SPT</code>
                      <code>UPI</code>
                    </valid_codes>
                  </element>
                  <element xid="NTE02">
                    <data_ele>352</data_ele>
                    <name>Claim Note Text</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>80</max_len>
                  </element>
                </segment>
<!--End of NTE segment-->
                <segment xid="NTE">
                  <name>Billing Note</name>
                  <usage>S</usage>
                  <pos>190</pos>
                  <max_use>1</max_use>
                  <element xid="NTE01">
                    <data_ele>363</data_ele>
                    <name>Note Reference Code</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>3</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>ADD</code>
                    </valid_codes>
                  </element>
                  <element xid="NTE02">
                    <data_ele>352</data_ele>
                    <name>Billing Note Text</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>80</max_len>
                  </element>
                </segment>
<!--End of NTE segment-->
                <segment xid="CR6">
                  <name>Home Health Care Information</name>
                  <usage>S</usage>
                  <pos>216</pos>
                  <max_use>1</max_use>
                  <element xid="CR601">
                    <data_ele>923</data_ele>
                    <name>Prognosis Indicator</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                    <valid_codes>
                      <code>1</code>
                      <code>2</code>
                      <code>3</code>
                      <code>4</code>
                      <code>5</code>
                      <code>6</code>
                      <code>7</code>
                      <code>8</code>
                    </valid_codes>
                  </element>
                  <element xid="CR602">
                    <data_ele>373</data_ele>
                    <name>Service From Date</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>DT</data_type>
                    <min_len>8</min_len>
                    <max_len>8</max_len>
                    <valid_codes>
                      <code/>
                    </valid_codes>
                  </element>
                  <element xid="CR603">
                    <data_ele>1250</data_ele>
                    <name>Date Time Period Format Qualifier</name>
                    <usage>S</usage>
                    <seq>03</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>RD8</code>
                    </valid_codes>
                  </element>
                  <element xid="CR604">
                    <data_ele>1251</data_ele>
                    <name>Home Health Certification Period</name>
                    <usage>S</usage>
                    <seq>04</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>35</max_len>
                  </element>
                  <element xid="CR605">
                    <data_ele>373</data_ele>
                    <name>Diagnosis Date</name>
                    <usage>R</usage>
                    <seq>05</seq>
                    <data_type>DT</data_type>
                    <min_len>8</min_len>
                    <max_len>8</max_len>
                    <valid_codes>
                      <code/>
                    </valid_codes>
                  </element>
                  <element xid="CR606">
                    <data_ele>1073</data_ele>
                    <name>Skilled Nursing Facility Indicator</name>
                    <usage>R</usage>
                    <seq>06</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                    <valid_codes>
                      <code>N</code>
                      <code>U</code>
                      <code>Y</code>
                    </valid_codes>
                  </element>
                  <element xid="CR607">
                    <data_ele>1073</data_ele>
                    <name>Medicare Coverage Indicator</name>
                    <usage>R</usage>
                    <seq>07</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                    <valid_codes>
                      <code>N</code>
                      <code>Y</code>
                    </valid_codes>
                  </element>
                  <element xid="CR608">
                    <data_ele>1322</data_ele>
                    <name>Certification Type Indicator</name>
                    <usage>R</usage>
                    <seq>08</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                    <valid_codes>
                      <code>I</code>
                      <code>R</code>
                      <code>S</code>
                    </valid_codes>
                  </element>
                  <element xid="CR609">
                    <data_ele>373</data_ele>
                    <name>Surgery Date</name>
                    <usage>S</usage>
                    <seq>09</seq>
                    <data_type>DT</data_type>
                    <min_len>8</min_len>
                    <max_len>8</max_len>
                    <valid_codes>
                      <code/>
                    </valid_codes>
                  </element>
                  <element xid="CR610">
                    <data_ele>235</data_ele>
                    <name>Product or Service ID Qualifier</name>
                    <usage>S</usage>
                    <seq>10</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>HC</code>
                      <code>ID</code>
                    </valid_codes>
                  </element>
                  <element xid="CR611">
                    <data_ele>1137</data_ele>
                    <name>Surgical Procedure Code</name>
                    <usage>S</usage>
                    <seq>11</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>15</max_len>
                  </element>
                  <element xid="CR612">
                    <data_ele>373</data_ele>
                    <name>Physician Order Date</name>
                    <usage>S</usage>
                    <seq>12</seq>
                    <data_type>DT</data_type>
                    <min_len>8</min_len>
                    <max_len>8</max_len>
                    <valid_codes>
                      <code/>
                    </valid_codes>
                  </element>
                  <element xid="CR613">
                    <data_ele>373</data_ele>
                    <name>Last Visit Date</name>
                    <usage>S</usage>
                    <seq>13</seq>
                    <data_type>DT</data_type>
                    <min_len>8</min_len>
                    <max_len>8</max_len>
                    <valid_codes>
                      <code/>
                    </valid_codes>
                  </element>
                  <element xid="CR614">
                    <data_ele>373</data_ele>
                    <name>Physician Contact Date</name>
                    <usage>S</usage>
                    <seq>14</seq>
                    <data_type>DT</data_type>
                    <min_len>8</min_len>
                    <max_len>8</max_len>
                    <valid_codes>
                      <code/>
                    </valid_codes>
                  </element>
                  <element xid="CR615">
                    <data_ele>1250</data_ele>
                    <name>Date Time Period Format Qualifier</name>
                    <usage>S</usage>
                    <seq>15</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                    <valid_codes>
                      <code>RD8</code>
                    </valid_codes>
                  </element>
                  <element xid="CR616">
                    <data_ele>1251</data_ele>
                    <name>Last Admission Period</name>
                    <usage>S</usage>
                    <seq>16</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>35</max_len>
                  </element>
                  <element xid="CR617">
                    <data_ele>1384</data_ele>
                    <name>Patient Discharge Facility Type Code</name>
                    <usage>R</usage>
                    <seq>17</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                    <valid_codes>
                      <code>A</code>
                      <code>B</code>
                      <code>C</code>
                      <code>D</code>
                      <code>E</code>
                      <code>F</code>
                      <code>G</code>
                      <code>H</code>
                      <code>L</code>
                      <code>M</code>
                      <code>O</code>
                      <code>R</code>
                      <code>S</code>
                      <code>T</code>
                    </valid_codes>
                  </element>
                  <element xid="CR618">
                    <data_ele>373</data_ele>
                    <name>Diagnosis Date</name>
                    <usage>S</usage>
                    <seq>18</seq>
                    <data_type>DT</data_type>
                    <min_len>8</min_len>
                    <max_len>8</max_len>
                    <valid_codes>
                      <code/>
                    </valid_codes>
                  </element>
                  <element xid="CR619">
                    <data_ele>373</data_ele>
                    <name>Diagnosis Date</name>
                    <usage>S</usage>
                    <seq>19</seq>
                    <data_type>DT</data_type>
                    <min_len>8</min_len>
                    <max_len>8</max_len>
                    <valid_codes>
                      <code/>
                    </valid_codes>
                  </element>
                  <element xid="CR620">
                    <data_ele>373</data_ele>
                    <name>Diagnosis Date</name>
                    <usage>S</usage>
                    <seq>20</seq>
                    <data_type>DT</data_type>
                    <min_len>8</min_len>
                    <max_len>8</max_len>
                    <valid_codes>
                      <code/>
                    </valid_codes>
                  </element>
                  <element xid="CR621">
                    <data_ele>373</data_ele>
                    <name>Diagnosis Date</name>
                    <usage>S</usage>
                    <seq>21</seq>
                    <data_type>DT</data_type>
                    <min_len>8</min_len>
                    <max_len>8</max_len>
                    <valid_codes>
                      <code/>
                    </valid_codes>
                  </element>
                </segment>
<!--End of CR6 segment-->
                <segment xid="CRC">
                  <name>Home Health Functional Limitations</name>
                  <usage>S</usage>
                  <pos>220</pos>
                  <max_use>3</max_use>
                  <element xid="CRC01">
                    <data_ele>1136</data_ele>
                    <name>Code Category</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>75</code>
                    </valid_codes>
                  </element>
                  <element xid="CRC02">
                    <data_ele>1073</data_ele>
                    <name>Certification Condition Indicator</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                    <valid_codes>
                      <code>N</code>
                      <code>Y</code>
                    </valid_codes>
                  </element>
                  <element xid="CRC03">
                    <data_ele>1321</data_ele>
                    <name>Functional Limitation Code</name>
                    <usage>R</usage>
                    <seq>03</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>AA</code>
                      <code>AL</code>
                      <code>BL</code>
                      <code>CO</code>
                      <code>DY</code>
                      <code>EL</code>
                      <code>HL</code>
                      <code>LB</code>
                      <code>OL</code>
                      <code>PA</code>
                      <code>SL</code>
                    </valid_codes>
                  </element>
                  <element xid="CRC04">
                    <data_ele>1321</data_ele>
                    <name>Functional Limitation Code</name>
                    <usage>S</usage>
                    <seq>04</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>AA</code>
                      <code>AL</code>
                      <code>BL</code>
                      <code>CO</code>
                      <code>DY</code>
                      <code>EL</code>
                      <code>HL</code>
                      <code>LB</code>
                      <code>OL</code>
                      <code>PA</code>
                      <code>SL</code>
                    </valid_codes>
                  </element>
                  <element xid="CRC05">
                    <data_ele>1321</data_ele>
                    <name>Functional Limitation Code</name>
                    <usage>S</usage>
                    <seq>05</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>AA</code>
                      <code>AL</code>
                      <code>BL</code>
                      <code>CO</code>
                      <code>DY</code>
                      <code>EL</code>
                      <code>HL</code>
                      <code>LB</code>
                      <code>OL</code>
                      <code>PA</code>
                      <code>SL</code>
                    </valid_codes>
                  </element>
                  <element xid="CRC06">
                    <data_ele>1321</data_ele>
                    <name>Functional Limitation Code</name>
                    <usage>S</usage>
                    <seq>06</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>AA</code>
                      <code>AL</code>
                      <code>BL</code>
                      <code>CO</code>
                      <code>DY</code>
                      <code>EL</code>
                      <code>HL</code>
                      <code>LB</code>
                      <code>OL</code>
                      <code>PA</code>
                      <code>SL</code>
                    </valid_codes>
                  </element>
                  <element xid="CRC07">
                    <data_ele>1321</data_ele>
                    <name>Functional Limitation Code</name>
                    <usage>S</usage>
                    <seq>07</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>AA</code>
                      <code>AL</code>
                      <code>BL</code>
                      <code>CO</code>
                      <code>DY</code>
                      <code>EL</code>
                      <code>HL</code>
                      <code>LB</code>
                      <code>OL</code>
                      <code>PA</code>
                      <code>SL</code>
                    </valid_codes>
                  </element>
                </segment>
<!--End of CRC segment-->
                <segment xid="CRC">
                  <name>Home Health Activities Permitted</name>
                  <usage>S</usage>
                  <pos>220</pos>
                  <max_use>3</max_use>
                  <element xid="CRC01">
                    <data_ele>1136</data_ele>
                    <name>Certification Condition Indicator</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>76</code>
                    </valid_codes>
                  </element>
                  <element xid="CRC02">
                    <data_ele>1073</data_ele>
                    <name> Functional Limitation Code</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                    <valid_codes>
                      <code>N</code>
                      <code>Y</code>
                    </valid_codes>
                  </element>
                  <element xid="CRC03">
                    <data_ele>1321</data_ele>
                    <name>Activities Permitted Code</name>
                    <usage>R</usage>
                    <seq>03</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>BR</code>
                      <code>CA</code>
                      <code>CB</code>
                      <code>CR</code>
                      <code>EP</code>
                      <code>IH</code>
                      <code>NR</code>
                      <code>PW</code>
                      <code>TR</code>
                      <code>UT</code>
                      <code>WA</code>
                      <code>WR</code>
                    </valid_codes>
                  </element>
                  <element xid="CRC04">
                    <data_ele>1321</data_ele>
                    <name>Activities Permitted Code</name>
                    <usage>S</usage>
                    <seq>04</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>BR</code>
                      <code>CA</code>
                      <code>CB</code>
                      <code>CR</code>
                      <code>EP</code>
                      <code>IH</code>
                      <code>NR</code>
                      <code>PW</code>
                      <code>TR</code>
                      <code>UT</code>
                      <code>WA</code>
                      <code>WR</code>
                    </valid_codes>
                  </element>
                  <element xid="CRC05">
                    <data_ele>1321</data_ele>
                    <name>Activities Permitted Code</name>
                    <usage>S</usage>
                    <seq>05</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>BR</code>
                      <code>CA</code>
                      <code>CB</code>
                      <code>CR</code>
                      <code>EP</code>
                      <code>IH</code>
                      <code>NR</code>
                      <code>PW</code>
                      <code>TR</code>
                      <code>UT</code>
                      <code>WA</code>
                      <code>WR</code>
                    </valid_codes>
                  </element>
                  <element xid="CRC06">
                    <data_ele>1321</data_ele>
                    <name>Activities Permitted Code</name>
                    <usage>S</usage>
                    <seq>06</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>BR</code>
                      <code>CA</code>
                      <code>CB</code>
                      <code>CR</code>
                      <code>EP</code>
                      <code>IH</code>
                      <code>NR</code>
                      <code>PW</code>
                      <code>TR</code>
                      <code>UT</code>
                      <code>WA</code>
                      <code>WR</code>
                    </valid_codes>
                  </element>
                  <element xid="CRC07">
                    <data_ele>1321</data_ele>
                    <name>Activities Permitted Code</name>
                    <usage>S</usage>
                    <seq>07</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>BR</code>
                      <code>CA</code>
                      <code>CB</code>
                      <code>CR</code>
                      <code>EP</code>
                      <code>IH</code>
                      <code>NR</code>
                      <code>PW</code>
                      <code>TR</code>
                      <code>UT</code>
                      <code>WA</code>
                      <code>WR</code>
                    </valid_codes>
                  </element>
                </segment>
<!--End of CRC segment-->
                <segment xid="CRC">
                  <name>Home Health Mental Status</name>
                  <usage>S</usage>
                  <pos>220</pos>
                  <max_use>2</max_use>
                  <element xid="CRC01">
                    <data_ele>1136</data_ele>
                    <name>Certification Condition Indicator</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>77</code>
                    </valid_codes>
                  </element>
                  <element xid="CRC02">
                    <data_ele>1073</data_ele>
                    <name>Functional Limitation Code</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                    <valid_codes>
                      <code>N</code>
                      <code>Y</code>
                    </valid_codes>
                  </element>
                  <element xid="CRC03">
                    <data_ele>1321</data_ele>
                    <name>Mental Status Code</name>
                    <usage>R</usage>
                    <seq>03</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>AG</code>
                      <code>CM</code>
                      <code>DI</code>
                      <code>DP</code>
                      <code>FO</code>
                      <code>LE</code>
                      <code>MC</code>
                      <code>OT</code>
                    </valid_codes>
                  </element>
                  <element xid="CRC04">
                    <data_ele>1321</data_ele>
                    <name>Mental Status Code</name>
                    <usage>S</usage>
                    <seq>04</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>AG</code>
                      <code>CM</code>
                      <code>DI</code>
                      <code>DP</code>
                      <code>FO</code>
                      <code>LE</code>
                      <code>MC</code>
                      <code>OT</code>
                    </valid_codes>
                  </element>
                  <element xid="CRC05">
                    <data_ele>1321</data_ele>
                    <name>Mental Status Code</name>
                    <usage>S</usage>
                    <seq>05</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>AG</code>
                      <code>CM</code>
                      <code>DI</code>
                      <code>DP</code>
                      <code>FO</code>
                      <code>LE</code>
                      <code>MC</code>
                      <code>OT</code>
                    </valid_codes>
                  </element>
                  <element xid="CRC06">
                    <data_ele>1321</data_ele>
                    <name>Mental Status Code</name>
                    <usage>S</usage>
                    <seq>06</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>AG</code>
                      <code>CM</code>
                      <code>DI</code>
                      <code>DP</code>
                      <code>FO</code>
                      <code>LE</code>
                      <code>MC</code>
                      <code>OT</code>
                    </valid_codes>
                  </element>
                  <element xid="CRC07">
                    <data_ele>1321</data_ele>
                    <name>Mental Status Code</name>
                    <usage>S</usage>
                    <seq>07</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>AG</code>
                      <code>CM</code>
                      <code>DI</code>
                      <code>DP</code>
                      <code>FO</code>
                      <code>LE</code>
                      <code>MC</code>
                      <code>OT</code>
                    </valid_codes>
                  </element>
                </segment>
<!--End of CRC segment-->
                <segment xid="HI">
                  <name>Principal, Admitting, E-Code and Patient Reason for Visit Diagnosis Information</name>
                  <usage>S</usage>
                  <pos>231</pos>
                  <max_use>1</max_use>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <element xid="HI01-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BK</code>
                      </valid_codes>
                    </element>
                    <element xid="HI01-02">
                      <data_ele>1271</data_ele>
                      <name>Industry Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI01-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI01-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI01-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI01-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI01-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>02</seq>
                    <element xid="HI02-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BJ</code>
                        <code>ZZ</code>
                      </valid_codes>
                    </element>
                    <element xid="HI02-02">
                      <data_ele>1271</data_ele>
                      <name>Industry Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI02-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI02-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI02-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI02-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI02-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>03</seq>
                    <element xid="HI03-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BN</code>
                      </valid_codes>
                    </element>
                    <element xid="HI03-02">
                      <data_ele>1271</data_ele>
                      <name>Industry Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI03-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI03-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI03-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI03-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI03-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>N</usage>
                    <seq>04</seq>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>N</usage>
                    <seq>05</seq>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>N</usage>
                    <seq>06</seq>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>N</usage>
                    <seq>07</seq>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>N</usage>
                    <seq>08</seq>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>N</usage>
                    <seq>09</seq>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>N</usage>
                    <seq>10</seq>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>N</usage>
                    <seq>11</seq>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>N</usage>
                    <seq>12</seq>
                  </composite>
                </segment>
<!--End of HI segment-->
                <segment xid="HI">
                  <name>Diagnosis Related Group (DRG) Information</name>
                  <usage>S</usage>
                  <pos>231</pos>
                  <max_use>1</max_use>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <element xid="HI01-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>DR</code>
                      </valid_codes>
                    </element>
                    <element xid="HI01-02">
                      <data_ele>1271</data_ele>
                      <name>Diagnosis Related Group (DRG) Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI01-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI01-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI01-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI01-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI01-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>N</usage>
                    <seq>02</seq>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>N</usage>
                    <seq>03</seq>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>N</usage>
                    <seq>04</seq>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>N</usage>
                    <seq>05</seq>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>N</usage>
                    <seq>06</seq>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>N</usage>
                    <seq>07</seq>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>N</usage>
                    <seq>08</seq>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>N</usage>
                    <seq>09</seq>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>N</usage>
                    <seq>10</seq>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>N</usage>
                    <seq>11</seq>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>N</usage>
                    <seq>12</seq>
                  </composite>
                </segment>
<!--End of HI segment-->
                <segment xid="HI">
                  <name>Other Diagnosis Information</name>
                  <usage>S</usage>
                  <pos>231</pos>
                  <max_use>2</max_use>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <element xid="HI01-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BF</code>
                      </valid_codes>
                    </element>
                    <element xid="HI01-02">
                      <data_ele>1271</data_ele>
                      <name>Other Diagnosis</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI01-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI01-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI01-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI01-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI01-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>02</seq>
                    <element xid="HI02-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BF</code>
                      </valid_codes>
                    </element>
                    <element xid="HI02-02">
                      <data_ele>1271</data_ele>
                      <name>Other Diagnosis</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI02-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI02-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI02-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI02-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI02-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>03</seq>
                    <element xid="HI03-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BF</code>
                      </valid_codes>
                    </element>
                    <element xid="HI03-02">
                      <data_ele>1271</data_ele>
                      <name>Other Diagnosis</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI03-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI03-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI03-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI03-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI03-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
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                      <max_len>3</max_len>
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                      <max_len>35</max_len>
                    </element>
                    <element xid="HI04-05">
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                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI04-06">
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                      <name>Quantity</name>
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                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI04-07">
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                      <name>Version Identifier</name>
                      <usage>N</usage>
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                      <data_type>AN</data_type>
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                      <max_len>30</max_len>
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                  <composite>
                    <data_ele>C022</data_ele>
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                    <usage>S</usage>
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                    <element xid="HI05-01">
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                      <usage>R</usage>
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                      <data_type>ID</data_type>
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                      <max_len>3</max_len>
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                      <usage>R</usage>
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                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI05-03">
                      <data_ele>1250</data_ele>
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                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
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                    </element>
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                      <max_len>18</max_len>
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                    <element xid="HI05-06">
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                      <data_type>R</data_type>
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                      <max_len>15</max_len>
                    </element>
                    <element xid="HI05-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>06</seq>
                    <element xid="HI06-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BF</code>
                      </valid_codes>
                    </element>
                    <element xid="HI06-02">
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                      <name>Other Diagnosis</name>
                      <usage>R</usage>
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                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI06-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
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                      <data_type>ID</data_type>
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                      <max_len>3</max_len>
                    </element>
                    <element xid="HI06-04">
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                      <usage>N</usage>
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                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI06-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI06-06">
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                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI06-07">
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                      <usage>N</usage>
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                      <data_type>AN</data_type>
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                      <max_len>30</max_len>
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                  <composite>
                    <data_ele>C022</data_ele>
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                    <usage>S</usage>
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                      <data_type>ID</data_type>
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                      </valid_codes>
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                      <usage>R</usage>
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                      <data_type>AN</data_type>
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                    </element>
                    <element xid="HI07-03">
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                      <data_type>ID</data_type>
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                      <max_len>3</max_len>
                    </element>
                    <element xid="HI07-04">
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                    </element>
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                      <max_len>15</max_len>
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                      <usage>N</usage>
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                      <max_len>30</max_len>
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                  <composite>
                    <data_ele>C022</data_ele>
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                    <usage>S</usage>
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                      <data_type>ID</data_type>
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                      <max_len>3</max_len>
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                      <min_len>1</min_len>
                      <max_len>15</max_len>
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                      <max_len>30</max_len>
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                  <composite>
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                    <usage>S</usage>
                    <seq>10</seq>
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                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
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                      <max_len>3</max_len>
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                      <max_len>35</max_len>
                    </element>
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                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI10-06">
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                      <usage>N</usage>
                      <seq>06</seq>
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                      <max_len>15</max_len>
                    </element>
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                      <min_len>1</min_len>
                      <max_len>30</max_len>
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                  <composite>
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                    <usage>S</usage>
                    <seq>11</seq>
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                      <data_type>AN</data_type>
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                    </element>
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                      <seq>03</seq>
                      <data_type>ID</data_type>
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                      <max_len>3</max_len>
                    </element>
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                      <usage>N</usage>
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                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI11-05">
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                      <usage>N</usage>
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                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI11-06">
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                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI11-07">
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                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>12</seq>
                    <element xid="HI12-01">
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                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
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                      </valid_codes>
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                    <element xid="HI12-02">
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                      <name>Other Diagnosis</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
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                    <element xid="HI12-03">
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                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
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                      <max_len>3</max_len>
                    </element>
                    <element xid="HI12-04">
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                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI12-05">
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                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI12-06">
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                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI12-07">
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                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                </segment>
<!--End of HI segment-->
                <segment xid="HI">
                  <name>Principal Procedure Information</name>
                  <usage>S</usage>
                  <pos>231</pos>
                  <max_use>1</max_use>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <element xid="HI01-01">
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                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BP</code>
                        <code>BR</code>
                      </valid_codes>
                    </element>
                    <element xid="HI01-02">
                      <data_ele>1271</data_ele>
                      <name>Principal Procedure Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI01-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>S</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>D8</code>
                      </valid_codes>
                    </element>
                    <element xid="HI01-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI01-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI01-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI01-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>N</usage>
                    <seq>02</seq>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>N</usage>
                    <seq>03</seq>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>N</usage>
                    <seq>04</seq>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>N</usage>
                    <seq>05</seq>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>N</usage>
                    <seq>06</seq>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>N</usage>
                    <seq>07</seq>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>N</usage>
                    <seq>08</seq>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>N</usage>
                    <seq>09</seq>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>N</usage>
                    <seq>10</seq>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>N</usage>
                    <seq>11</seq>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>N</usage>
                    <seq>12</seq>
                  </composite>
                </segment>
<!--End of HI segment-->
                <segment xid="HI">
                  <name>Other Procedure Information</name>
                  <usage>S</usage>
                  <pos>231</pos>
                  <max_use>2</max_use>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <element xid="HI01-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BO</code>
                        <code>BQ</code>
                      </valid_codes>
                    </element>
                    <element xid="HI01-02">
                      <data_ele>1271</data_ele>
                      <name>Procedure Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI01-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>S</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>D8</code>
                      </valid_codes>
                    </element>
                    <element xid="HI01-04">
                      <data_ele>1251</data_ele>
                      <name>Procedure Date</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI01-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI01-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI01-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>02</seq>
                    <element xid="HI02-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BO</code>
                        <code>BQ</code>
                      </valid_codes>
                    </element>
                    <element xid="HI02-02">
                      <data_ele>1271</data_ele>
                      <name>Procedure Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI02-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>S</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>D8</code>
                      </valid_codes>
                    </element>
                    <element xid="HI02-04">
                      <data_ele>1251</data_ele>
                      <name>Procedure Date</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI02-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI02-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI02-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>03</seq>
                    <element xid="HI03-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BO</code>
                        <code>BQ</code>
                      </valid_codes>
                    </element>
                    <element xid="HI03-02">
                      <data_ele>1271</data_ele>
                      <name>Procedure Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI03-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>S</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>D8</code>
                      </valid_codes>
                    </element>
                    <element xid="HI03-04">
                      <data_ele>1251</data_ele>
                      <name>Procedure Date</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI03-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI03-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI03-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>04</seq>
                    <element xid="HI04-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BO</code>
                        <code>BQ</code>
                      </valid_codes>
                    </element>
                    <element xid="HI04-02">
                      <data_ele>1271</data_ele>
                      <name>Procedure Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI04-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>S</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>D8</code>
                      </valid_codes>
                    </element>
                    <element xid="HI04-04">
                      <data_ele>1251</data_ele>
                      <name>Procedure Date</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI04-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI04-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI04-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>05</seq>
                    <element xid="HI05-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BO</code>
                        <code>BQ</code>
                      </valid_codes>
                    </element>
                    <element xid="HI05-02">
                      <data_ele>1271</data_ele>
                      <name>Procedure Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI05-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>S</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>D8</code>
                      </valid_codes>
                    </element>
                    <element xid="HI05-04">
                      <data_ele>1251</data_ele>
                      <name>Procedure Date</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI05-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI05-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI05-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>06</seq>
                    <element xid="HI06-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BO</code>
                        <code>BQ</code>
                      </valid_codes>
                    </element>
                    <element xid="HI06-02">
                      <data_ele>1271</data_ele>
                      <name>Procedure Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI06-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>S</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>D8</code>
                      </valid_codes>
                    </element>
                    <element xid="HI06-04">
                      <data_ele>1251</data_ele>
                      <name>Procedure Date</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI06-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI06-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI06-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>07</seq>
                    <element xid="HI07-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BO</code>
                        <code>BQ</code>
                      </valid_codes>
                    </element>
                    <element xid="HI07-02">
                      <data_ele>1271</data_ele>
                      <name>Procedure Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI07-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>S</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>D8</code>
                      </valid_codes>
                    </element>
                    <element xid="HI07-04">
                      <data_ele>1251</data_ele>
                      <name>Procedure Date</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI07-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI07-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI07-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>08</seq>
                    <element xid="HI08-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BO</code>
                        <code>BQ</code>
                      </valid_codes>
                    </element>
                    <element xid="HI08-02">
                      <data_ele>1271</data_ele>
                      <name>Procedure Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI08-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>S</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>D8</code>
                      </valid_codes>
                    </element>
                    <element xid="HI08-04">
                      <data_ele>1251</data_ele>
                      <name>Procedure Date</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI08-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI08-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI08-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>09</seq>
                    <element xid="HI09-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BO</code>
                        <code>BQ</code>
                      </valid_codes>
                    </element>
                    <element xid="HI09-02">
                      <data_ele>1271</data_ele>
                      <name>Procedure Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI09-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>S</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>D8</code>
                      </valid_codes>
                    </element>
                    <element xid="HI09-04">
                      <data_ele>1251</data_ele>
                      <name>Procedure Date</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI09-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI09-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI09-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>10</seq>
                    <element xid="HI10-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BO</code>
                        <code>BQ</code>
                      </valid_codes>
                    </element>
                    <element xid="HI10-02">
                      <data_ele>1271</data_ele>
                      <name>Procedure Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI10-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>S</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>D8</code>
                      </valid_codes>
                    </element>
                    <element xid="HI10-04">
                      <data_ele>1251</data_ele>
                      <name>Procedure Date</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI10-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI10-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI10-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>11</seq>
                    <element xid="HI11-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BO</code>
                        <code>BQ</code>
                      </valid_codes>
                    </element>
                    <element xid="HI11-02">
                      <data_ele>1271</data_ele>
                      <name>Procedure Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI11-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>S</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>D8</code>
                      </valid_codes>
                    </element>
                    <element xid="HI11-04">
                      <data_ele>1251</data_ele>
                      <name>Procedure Date</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI11-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI11-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI11-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>12</seq>
                    <element xid="HI12-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BO</code>
                        <code>BQ</code>
                      </valid_codes>
                    </element>
                    <element xid="HI12-02">
                      <data_ele>1271</data_ele>
                      <name>Procedure Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI12-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>S</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>D8</code>
                      </valid_codes>
                    </element>
                    <element xid="HI12-04">
                      <data_ele>1251</data_ele>
                      <name>Procedure Date</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI12-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI12-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI12-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                </segment>
<!--End of HI segment-->
                <segment xid="HI">
                  <name>Occurrence Span Information</name>
                  <usage>S</usage>
                  <pos>231</pos>
                  <max_use>2</max_use>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <element xid="HI01-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BI</code>
                      </valid_codes>
                    </element>
                    <element xid="HI01-02">
                      <data_ele>1271</data_ele>
                      <name>Occurrence Span Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI01-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>RD8</code>
                      </valid_codes>
                    </element>
                    <element xid="HI01-04">
                      <data_ele>1251</data_ele>
                      <name>Occurrence or Occurrence Span Code Associated Date</name>
                      <usage>R</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI01-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI01-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI01-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>02</seq>
                    <element xid="HI02-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BI</code>
                      </valid_codes>
                    </element>
                    <element xid="HI02-02">
                      <data_ele>1271</data_ele>
                      <name>Occurrence Span Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI02-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>RD8</code>
                      </valid_codes>
                    </element>
                    <element xid="HI02-04">
                      <data_ele>1251</data_ele>
                      <name>Occurrence or Occurrence Span Code Associated Date</name>
                      <usage>R</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI02-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI02-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI02-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>03</seq>
                    <element xid="HI03-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BI</code>
                      </valid_codes>
                    </element>
                    <element xid="HI03-02">
                      <data_ele>1271</data_ele>
                      <name>Occurrence Span Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI03-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>RD8</code>
                      </valid_codes>
                    </element>
                    <element xid="HI03-04">
                      <data_ele>1251</data_ele>
                      <name>Occurrence or Occurrence Span Code Associated Date</name>
                      <usage>R</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI03-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI03-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI03-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>04</seq>
                    <element xid="HI04-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BI</code>
                      </valid_codes>
                    </element>
                    <element xid="HI04-02">
                      <data_ele>1271</data_ele>
                      <name>Occurrence Span Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI04-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>RD8</code>
                      </valid_codes>
                    </element>
                    <element xid="HI04-04">
                      <data_ele>1251</data_ele>
                      <name>Occurrence or Occurrence Span Code Associated Date</name>
                      <usage>R</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI04-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI04-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI04-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>05</seq>
                    <element xid="HI05-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BI</code>
                      </valid_codes>
                    </element>
                    <element xid="HI05-02">
                      <data_ele>1271</data_ele>
                      <name>Occurrence Span Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI05-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>RD8</code>
                      </valid_codes>
                    </element>
                    <element xid="HI05-04">
                      <data_ele>1251</data_ele>
                      <name>Occurrence or Occurrence Span Code Associated Date</name>
                      <usage>R</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI05-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI05-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI05-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>06</seq>
                    <element xid="HI06-01">
                      <data_ele>1270</data_ele>
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                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
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                      </valid_codes>
                    </element>
                    <element xid="HI06-02">
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                      <name>Occurrence Span Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
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                      <max_len>30</max_len>
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                    <element xid="HI06-03">
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                      <data_type>ID</data_type>
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                      <max_len>3</max_len>
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                        <code>RD8</code>
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                    </element>
                    <element xid="HI06-04">
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                      <data_type>AN</data_type>
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                      <max_len>35</max_len>
                    </element>
                    <element xid="HI06-05">
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                      <max_len>18</max_len>
                    </element>
                    <element xid="HI06-06">
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                      <data_type>R</data_type>
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                      <max_len>15</max_len>
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                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
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                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
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                    <usage>S</usage>
                    <seq>07</seq>
                    <element xid="HI07-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
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                      <max_len>3</max_len>
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                      <name>Occurrence Span Code</name>
                      <usage>R</usage>
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                      <data_type>AN</data_type>
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                      <usage>R</usage>
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                      <data_type>ID</data_type>
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                      <max_len>3</max_len>
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                        <code>RD8</code>
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                      <name>Occurrence or Occurrence Span Code Associated Date</name>
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                      <data_type>AN</data_type>
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                      <max_len>35</max_len>
                    </element>
                    <element xid="HI07-05">
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                      <data_type>R</data_type>
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                      <max_len>18</max_len>
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                    <element xid="HI07-06">
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                      <data_type>R</data_type>
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                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
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                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
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                    <usage>S</usage>
                    <seq>08</seq>
                    <element xid="HI08-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
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                      <max_len>3</max_len>
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                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
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                      <max_len>30</max_len>
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                    <element xid="HI08-03">
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                      <name>Date Time Period Format Qualifier</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
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                      <max_len>3</max_len>
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                        <code>RD8</code>
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                    <element xid="HI08-04">
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                      <name>Occurrence or Occurrence Span Code Associated Date</name>
                      <usage>R</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
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                      <max_len>35</max_len>
                    </element>
                    <element xid="HI08-05">
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                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
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                      <max_len>18</max_len>
                    </element>
                    <element xid="HI08-06">
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                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
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                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
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                  <composite>
                    <data_ele>C022</data_ele>
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                    <usage>S</usage>
                    <seq>09</seq>
                    <element xid="HI09-01">
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                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
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                      <max_len>3</max_len>
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                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
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                      <max_len>30</max_len>
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                      <name>Date Time Period Format Qualifier</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
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                      <max_len>3</max_len>
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                      <data_type>AN</data_type>
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                      <max_len>35</max_len>
                    </element>
                    <element xid="HI09-05">
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                      <usage>N</usage>
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                      <data_type>R</data_type>
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                      <max_len>18</max_len>
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                      <name>Quantity</name>
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                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
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                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
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                  <composite>
                    <data_ele>C022</data_ele>
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                    <usage>S</usage>
                    <seq>10</seq>
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                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
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                      <max_len>3</max_len>
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                      <usage>R</usage>
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                      <data_type>AN</data_type>
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                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
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                      <max_len>3</max_len>
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                    </element>
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                      <data_type>AN</data_type>
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                    </element>
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                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
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                      <usage>N</usage>
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                      <data_type>AN</data_type>
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                      <max_len>30</max_len>
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                    <usage>S</usage>
                    <seq>11</seq>
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                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
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                      <data_type>ID</data_type>
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                      <max_len>3</max_len>
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                      <data_type>AN</data_type>
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                      <usage>R</usage>
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                      <max_len>3</max_len>
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                      <seq>07</seq>
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                    <usage>S</usage>
                    <seq>12</seq>
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                      <max_len>3</max_len>
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                      <seq>06</seq>
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                      <min_len>1</min_len>
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                      <seq>07</seq>
                      <data_type>AN</data_type>
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                      <max_len>30</max_len>
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                  </composite>
                </segment>
<!--End of HI segment-->
                <segment xid="HI">
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                  <pos>231</pos>
                  <max_use>2</max_use>
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                    <usage>R</usage>
                    <seq>01</seq>
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                      <data_type>ID</data_type>
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                      <max_len>3</max_len>
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                    <usage>S</usage>
                    <seq>02</seq>
                    <element xid="HI02-01">
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                      <seq>01</seq>
                      <data_type>ID</data_type>
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                      <max_len>3</max_len>
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                      <seq>02</seq>
                      <data_type>AN</data_type>
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                      <max_len>30</max_len>
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                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
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                      <max_len>3</max_len>
                      <valid_codes>
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                    </element>
                    <element xid="HI02-04">
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                      <name>Occurrence or Occurrence Span Code Associated Date</name>
                      <usage>R</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
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                      <max_len>35</max_len>
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                    <element xid="HI02-05">
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                      <data_type>R</data_type>
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                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
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                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
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                      <max_len>30</max_len>
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                  <composite>
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                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>03</seq>
                    <element xid="HI03-01">
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                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
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                      <max_len>3</max_len>
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                      </valid_codes>
                    </element>
                    <element xid="HI12-04">
                      <data_ele>1251</data_ele>
                      <name>Occurrence or Occurrence Span Code Associated Date</name>
                      <usage>R</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI12-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI12-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI12-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                </segment>
<!--End of HI segment-->
                <segment xid="HI">
                  <name>Value Information</name>
                  <usage>S</usage>
                  <pos>231</pos>
                  <max_use>2</max_use>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <element xid="HI01-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BE</code>
                      </valid_codes>
                    </element>
                    <element xid="HI01-02">
                      <data_ele>1271</data_ele>
                      <name>Value Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI01-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI01-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI01-05">
                      <data_ele>782</data_ele>
                      <name>Value Code Associated Amount</name>
                      <usage>R</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI01-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI01-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>02</seq>
                    <element xid="HI02-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BE</code>
                      </valid_codes>
                    </element>
                    <element xid="HI02-02">
                      <data_ele>1271</data_ele>
                      <name>Value Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI02-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI02-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI02-05">
                      <data_ele>782</data_ele>
                      <name>Value Code Associated Amount</name>
                      <usage>R</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI02-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI02-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>03</seq>
                    <element xid="HI03-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BE</code>
                      </valid_codes>
                    </element>
                    <element xid="HI03-02">
                      <data_ele>1271</data_ele>
                      <name>Value Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI03-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI03-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI03-05">
                      <data_ele>782</data_ele>
                      <name>Value Code Associated Amount</name>
                      <usage>R</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI03-06">
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                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI03-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>04</seq>
                    <element xid="HI04-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BE</code>
                      </valid_codes>
                    </element>
                    <element xid="HI04-02">
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                      <name>Value Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI04-03">
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                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI04-04">
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                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI04-05">
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                      <name>Value Code Associated Amount</name>
                      <usage>R</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI04-06">
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                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI04-07">
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                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
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                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>05</seq>
                    <element xid="HI05-01">
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                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
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                      <max_len>3</max_len>
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                      </valid_codes>
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                    <element xid="HI05-02">
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                      <name>Value Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI05-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI05-04">
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                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
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                      <name>Value Code Associated Amount</name>
                      <usage>R</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
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                      <max_len>18</max_len>
                    </element>
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                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI05-07">
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                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
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                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>06</seq>
                    <element xid="HI06-01">
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                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BE</code>
                      </valid_codes>
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                    <element xid="HI06-02">
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                      <name>Value Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
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                      <max_len>30</max_len>
                    </element>
                    <element xid="HI06-03">
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                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI06-04">
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                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI06-05">
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                      <usage>R</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
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                    <element xid="HI06-06">
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                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI06-07">
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                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
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                  <composite>
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                    <usage>S</usage>
                    <seq>07</seq>
                    <element xid="HI07-01">
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                      <usage>R</usage>
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                      <data_type>ID</data_type>
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                      <max_len>3</max_len>
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                    <element xid="HI07-02">
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                    <element xid="HI07-06">
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                  <composite>
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                    <usage>S</usage>
                    <seq>08</seq>
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                      <usage>R</usage>
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                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI08-05">
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                      <seq>05</seq>
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                      <name>Quantity</name>
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                      <data_type>R</data_type>
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                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
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                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>09</seq>
                    <element xid="HI09-01">
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                      <name>Code List Qualifier Code</name>
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                      <data_type>ID</data_type>
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                    <element xid="HI09-02">
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                      <name>Value Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
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                      <max_len>30</max_len>
                    </element>
                    <element xid="HI09-03">
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                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
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                      <max_len>3</max_len>
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                    <element xid="HI09-04">
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                      <usage>N</usage>
                      <seq>04</seq>
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                      <max_len>35</max_len>
                    </element>
                    <element xid="HI09-05">
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                      <name>Value Code Associated Amount</name>
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                      <seq>05</seq>
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                      <name>Quantity</name>
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                    <element xid="HI09-07">
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                      <data_type>AN</data_type>
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                      <max_len>30</max_len>
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                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>10</seq>
                    <element xid="HI10-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BE</code>
                      </valid_codes>
                    </element>
                    <element xid="HI10-02">
                      <data_ele>1271</data_ele>
                      <name>Value Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI10-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI10-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI10-05">
                      <data_ele>782</data_ele>
                      <name>Value Code Associated Amount</name>
                      <usage>R</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI10-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI10-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>11</seq>
                    <element xid="HI11-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BE</code>
                      </valid_codes>
                    </element>
                    <element xid="HI11-02">
                      <data_ele>1271</data_ele>
                      <name>Value Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI11-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI11-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI11-05">
                      <data_ele>782</data_ele>
                      <name>Value Code Associated Amount</name>
                      <usage>R</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI11-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI11-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>12</seq>
                    <element xid="HI12-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BE</code>
                      </valid_codes>
                    </element>
                    <element xid="HI12-02">
                      <data_ele>1271</data_ele>
                      <name>Value Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI12-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI12-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI12-05">
                      <data_ele>782</data_ele>
                      <name>Value Code Associated Amount</name>
                      <usage>R</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI12-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI12-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                </segment>
<!--End of HI segment-->
                <segment xid="HI">
                  <name>Condition Information</name>
                  <usage>S</usage>
                  <pos>231</pos>
                  <max_use>2</max_use>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <element xid="HI01-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BG</code>
                      </valid_codes>
                    </element>
                    <element xid="HI01-02">
                      <data_ele>1271</data_ele>
                      <name>Condition Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                      <valid_codes>
                        <code>24</code>
                        <code>25</code>
                        <code>26</code>
                        <code>27</code>
                        <code>28</code>
                        <code>29</code>
                        <code>30</code>
                      </valid_codes>
                    </element>
                    <element xid="HI01-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI01-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI01-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI01-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI01-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>02</seq>
                    <element xid="HI02-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BG</code>
                      </valid_codes>
                    </element>
                    <element xid="HI02-02">
                      <data_ele>1271</data_ele>
                      <name>Condition Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                      <valid_codes>
                        <code>24</code>
                        <code>25</code>
                        <code>26</code>
                        <code>27</code>
                        <code>28</code>
                        <code>29</code>
                        <code>30</code>
                      </valid_codes>
                    </element>
                    <element xid="HI02-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI02-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI02-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI02-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI02-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>03</seq>
                    <element xid="HI03-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BG</code>
                      </valid_codes>
                    </element>
                    <element xid="HI03-02">
                      <data_ele>1271</data_ele>
                      <name>Condition Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                      <valid_codes>
                        <code>24</code>
                        <code>25</code>
                        <code>26</code>
                        <code>27</code>
                        <code>28</code>
                        <code>29</code>
                        <code>30</code>
                      </valid_codes>
                    </element>
                    <element xid="HI03-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI03-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI03-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI03-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI03-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>04</seq>
                    <element xid="HI04-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BG</code>
                      </valid_codes>
                    </element>
                    <element xid="HI04-02">
                      <data_ele>1271</data_ele>
                      <name>Condition Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                      <valid_codes>
                        <code>24</code>
                        <code>25</code>
                        <code>26</code>
                        <code>27</code>
                        <code>28</code>
                        <code>29</code>
                        <code>30</code>
                      </valid_codes>
                    </element>
                    <element xid="HI04-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI04-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI04-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI04-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI04-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>05</seq>
                    <element xid="HI05-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BG</code>
                      </valid_codes>
                    </element>
                    <element xid="HI05-02">
                      <data_ele>1271</data_ele>
                      <name>Condition Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                      <valid_codes>
                        <code>24</code>
                        <code>25</code>
                        <code>26</code>
                        <code>27</code>
                        <code>28</code>
                        <code>29</code>
                        <code>30</code>
                      </valid_codes>
                    </element>
                    <element xid="HI05-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI05-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI05-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI05-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI05-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>06</seq>
                    <element xid="HI06-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BG</code>
                      </valid_codes>
                    </element>
                    <element xid="HI06-02">
                      <data_ele>1271</data_ele>
                      <name>Condition Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                      <valid_codes>
                        <code>24</code>
                        <code>25</code>
                        <code>26</code>
                        <code>27</code>
                        <code>28</code>
                        <code>29</code>
                        <code>30</code>
                      </valid_codes>
                    </element>
                    <element xid="HI06-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI06-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI06-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI06-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI06-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>07</seq>
                    <element xid="HI07-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BG</code>
                      </valid_codes>
                    </element>
                    <element xid="HI07-02">
                      <data_ele>1271</data_ele>
                      <name>Condition Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                      <valid_codes>
                        <code>24</code>
                        <code>25</code>
                        <code>26</code>
                        <code>27</code>
                        <code>28</code>
                        <code>29</code>
                        <code>30</code>
                      </valid_codes>
                    </element>
                    <element xid="HI07-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI07-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI07-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI07-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI07-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>08</seq>
                    <element xid="HI08-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BG</code>
                      </valid_codes>
                    </element>
                    <element xid="HI08-02">
                      <data_ele>1271</data_ele>
                      <name>Condition Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                      <valid_codes>
                        <code>24</code>
                        <code>25</code>
                        <code>26</code>
                        <code>27</code>
                        <code>28</code>
                        <code>29</code>
                        <code>30</code>
                      </valid_codes>
                    </element>
                    <element xid="HI08-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI08-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI08-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI08-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI08-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>09</seq>
                    <element xid="HI09-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BG</code>
                      </valid_codes>
                    </element>
                    <element xid="HI09-02">
                      <data_ele>1271</data_ele>
                      <name>Condition Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                      <valid_codes>
                        <code>24</code>
                        <code>25</code>
                        <code>26</code>
                        <code>27</code>
                        <code>28</code>
                        <code>29</code>
                        <code>30</code>
                      </valid_codes>
                    </element>
                    <element xid="HI09-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI09-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI09-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI09-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI09-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>10</seq>
                    <element xid="HI10-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BG</code>
                      </valid_codes>
                    </element>
                    <element xid="HI10-02">
                      <data_ele>1271</data_ele>
                      <name>Condition Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                      <valid_codes>
                        <code>24</code>
                        <code>25</code>
                        <code>26</code>
                        <code>27</code>
                        <code>28</code>
                        <code>29</code>
                        <code>30</code>
                      </valid_codes>
                    </element>
                    <element xid="HI10-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI10-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI10-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI10-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI10-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>11</seq>
                    <element xid="HI11-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BG</code>
                      </valid_codes>
                    </element>
                    <element xid="HI11-02">
                      <data_ele>1271</data_ele>
                      <name>Condition Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                      <valid_codes>
                        <code>24</code>
                        <code>25</code>
                        <code>26</code>
                        <code>27</code>
                        <code>28</code>
                        <code>29</code>
                        <code>30</code>
                      </valid_codes>
                    </element>
                    <element xid="HI11-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI11-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI11-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI11-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI11-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>12</seq>
                    <element xid="HI12-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>BG</code>
                      </valid_codes>
                    </element>
                    <element xid="HI12-02">
                      <data_ele>1271</data_ele>
                      <name>Condition Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                      <valid_codes>
                        <code>24</code>
                        <code>25</code>
                        <code>26</code>
                        <code>27</code>
                        <code>28</code>
                        <code>29</code>
                        <code>30</code>
                      </valid_codes>
                    </element>
                    <element xid="HI12-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI12-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI12-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI12-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI12-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                </segment>
<!--End of HI segment-->
                <segment xid="HI">
                  <name>Treatment Code Information</name>
                  <usage>S</usage>
                  <pos>231</pos>
                  <max_use>2</max_use>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <element xid="HI01-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>TC</code>
                      </valid_codes>
                    </element>
                    <element xid="HI01-02">
                      <data_ele>1271</data_ele>
                      <name>Treatment Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI01-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI01-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI01-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI01-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI01-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>02</seq>
                    <element xid="HI02-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>TC</code>
                      </valid_codes>
                    </element>
                    <element xid="HI02-02">
                      <data_ele>1271</data_ele>
                      <name>Treatment Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI02-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI02-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI02-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI02-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI02-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>03</seq>
                    <element xid="HI03-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>TC</code>
                      </valid_codes>
                    </element>
                    <element xid="HI03-02">
                      <data_ele>1271</data_ele>
                      <name>Treatment Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI03-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI03-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI03-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI03-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI03-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>04</seq>
                    <element xid="HI04-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>TC</code>
                      </valid_codes>
                    </element>
                    <element xid="HI04-02">
                      <data_ele>1271</data_ele>
                      <name>Treatment Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI04-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI04-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI04-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI04-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI04-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>05</seq>
                    <element xid="HI05-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>TC</code>
                      </valid_codes>
                    </element>
                    <element xid="HI05-02">
                      <data_ele>1271</data_ele>
                      <name>Treatment Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI05-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI05-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI05-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI05-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI05-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>06</seq>
                    <element xid="HI06-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>TC</code>
                      </valid_codes>
                    </element>
                    <element xid="HI06-02">
                      <data_ele>1271</data_ele>
                      <name>Treatment Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI06-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI06-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI06-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI06-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI06-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>07</seq>
                    <element xid="HI07-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>TC</code>
                      </valid_codes>
                    </element>
                    <element xid="HI07-02">
                      <data_ele>1271</data_ele>
                      <name>Treatment Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI07-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI07-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI07-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI07-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI07-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>08</seq>
                    <element xid="HI08-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>TC</code>
                      </valid_codes>
                    </element>
                    <element xid="HI08-02">
                      <data_ele>1271</data_ele>
                      <name>Treatment Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI08-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI08-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI08-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI08-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI08-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>09</seq>
                    <element xid="HI09-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>TC</code>
                      </valid_codes>
                    </element>
                    <element xid="HI09-02">
                      <data_ele>1271</data_ele>
                      <name>Treatment Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI09-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI09-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI09-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI09-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI09-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>10</seq>
                    <element xid="HI10-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>TC</code>
                      </valid_codes>
                    </element>
                    <element xid="HI10-02">
                      <data_ele>1271</data_ele>
                      <name>Treatment Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI10-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI10-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI10-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI10-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI10-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>11</seq>
                    <element xid="HI11-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>TC</code>
                      </valid_codes>
                    </element>
                    <element xid="HI11-02">
                      <data_ele>1271</data_ele>
                      <name>Treatment Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI11-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI11-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI11-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI11-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI11-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                  <composite>
                    <data_ele>C022</data_ele>
                    <name>Health Care Code Information</name>
                    <usage>S</usage>
                    <seq>12</seq>
                    <element xid="HI12-01">
                      <data_ele>1270</data_ele>
                      <name>Code List Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>TC</code>
                      </valid_codes>
                    </element>
                    <element xid="HI12-02">
                      <data_ele>1271</data_ele>
                      <name>Treatment Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HI12-03">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HI12-04">
                      <data_ele>1251</data_ele>
                      <name>Date Time Period</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="HI12-05">
                      <data_ele>782</data_ele>
                      <name>Monetary Amount</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HI12-06">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HI12-07">
                      <data_ele>799</data_ele>
                      <name>Version Identifier</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </composite>
                </segment>
<!--End of HI segment-->
                <segment xid="QTY">
                  <name>Claim Quantity</name>
                  <usage>S</usage>
                  <pos>240</pos>
                  <max_use>4</max_use>
                  <element xid="QTY01">
                    <data_ele>673</data_ele>
                    <name>Quantity Qualifier</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>CA</code>
                      <code>CD</code>
                      <code>LA</code>
                      <code>NA</code>
                    </valid_codes>
                  </element>
                  <element xid="QTY02">
                    <data_ele>380</data_ele>
                    <name>Claim Days Count</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>R</data_type>
                    <min_len>1</min_len>
                    <max_len>15</max_len>
                  </element>
                  <composite>
                    <data_ele>C001</data_ele>
                    <name>Composite Unit of Measure</name>
                    <usage>R</usage>
                    <seq>03</seq>
                    <element xid="QTY03-01">
                      <data_ele>355</data_ele>
                      <name>Unit or Basis for Measurement Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>DA</code>
                      </valid_codes>
                    </element>
                    <element xid="QTY03-02">
                      <data_ele>1018</data_ele>
                      <name>Exponent</name>
                      <usage>N</usage>
                      <seq>02</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="QTY03-03">
                      <data_ele>649</data_ele>
                      <name>Multiplier</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>10</max_len>
                    </element>
                    <element xid="QTY03-04">
                      <data_ele>355</data_ele>
                      <name>Unit or Basis for Measurement Code</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                    </element>
                    <element xid="QTY03-05">
                      <data_ele>1018</data_ele>
                      <name>Exponent</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="QTY03-06">
                      <data_ele>649</data_ele>
                      <name>Multiplier</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>10</max_len>
                    </element>
                    <element xid="QTY03-07">
                      <data_ele>355</data_ele>
                      <name>Unit or Basis for Measurement Code</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                    </element>
                    <element xid="QTY03-08">
                      <data_ele>1018</data_ele>
                      <name>Exponent</name>
                      <usage>N</usage>
                      <seq>08</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="QTY03-09">
                      <data_ele>649</data_ele>
                      <name>Multiplier</name>
                      <usage>N</usage>
                      <seq>09</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>10</max_len>
                    </element>
                    <element xid="QTY03-10">
                      <data_ele>355</data_ele>
                      <name>Unit or Basis for Measurement Code</name>
                      <usage>N</usage>
                      <seq>10</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                    </element>
                    <element xid="QTY03-11">
                      <data_ele>1018</data_ele>
                      <name>Exponent</name>
                      <usage>N</usage>
                      <seq>11</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="QTY03-12">
                      <data_ele>649</data_ele>
                      <name>Multiplier</name>
                      <usage>N</usage>
                      <seq>12</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>10</max_len>
                    </element>
                    <element xid="QTY03-13">
                      <data_ele>355</data_ele>
                      <name>Unit or Basis for Measurement Code</name>
                      <usage>N</usage>
                      <seq>13</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                    </element>
                    <element xid="QTY03-14">
                      <data_ele>1018</data_ele>
                      <name>Exponent</name>
                      <usage>N</usage>
                      <seq>14</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="QTY03-15">
                      <data_ele>649</data_ele>
                      <name>Multiplier</name>
                      <usage>N</usage>
                      <seq>15</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>10</max_len>
                    </element>
                  </composite>
                  <element xid="QTY04">
                    <data_ele>61</data_ele>
                    <name>Free-Form Message</name>
                    <usage>N</usage>
                    <seq>04</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>30</max_len>
                  </element>
                </segment>
<!--End of QTY segment-->
                <segment xid="HCP">
                  <name>Claim Pricing/Repricing Information</name>
                  <usage>S</usage>
                  <pos>241</pos>
                  <max_use>1</max_use>
                  <element xid="HCP01">
                    <data_ele>1473</data_ele>
                    <name>Pricing Methodology</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>00</code>
                      <code>01</code>
                      <code>02</code>
                      <code>03</code>
                      <code>04</code>
                      <code>05</code>
                      <code>06</code>
                      <code>07</code>
                      <code>08</code>
                      <code>09</code>
                      <code>10</code>
                      <code>11</code>
                      <code>12</code>
                      <code>13</code>
                      <code>14</code>
                    </valid_codes>
                  </element>
                  <element xid="HCP02">
                    <data_ele>782</data_ele>
                    <name>Repriced Allowed Amount</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>R</data_type>
                    <min_len>1</min_len>
                    <max_len>18</max_len>
                  </element>
                  <element xid="HCP03">
                    <data_ele>782</data_ele>
                    <name>Repriced Saving Amount</name>
                    <usage>S</usage>
                    <seq>03</seq>
                    <data_type>R</data_type>
                    <min_len>1</min_len>
                    <max_len>18</max_len>
                  </element>
                  <element xid="HCP04">
                    <data_ele>127</data_ele>
                    <name>Repricing Organization Identifier</name>
                    <usage>S</usage>
                    <seq>04</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>30</max_len>
                  </element>
                  <element xid="HCP05">
                    <data_ele>118</data_ele>
                    <name>Repricing Per Diem or Flat Rate Amount</name>
                    <usage>S</usage>
                    <seq>05</seq>
                    <data_type>R</data_type>
                    <min_len>1</min_len>
                    <max_len>9</max_len>
                  </element>
                  <element xid="HCP06">
                    <data_ele>127</data_ele>
                    <name>Repriced Approved DRG Code</name>
                    <usage>S</usage>
                    <seq>06</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>30</max_len>
                  </element>
                  <element xid="HCP07">
                    <data_ele>782</data_ele>
                    <name>Repriced Approved Amount</name>
                    <usage>S</usage>
                    <seq>07</seq>
                    <data_type>R</data_type>
                    <min_len>1</min_len>
                    <max_len>18</max_len>
                  </element>
                  <element xid="HCP08">
                    <data_ele>234</data_ele>
                    <name>Repriced Approved Revenue Code</name>
                    <usage>S</usage>
                    <seq>08</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>48</max_len>
                  </element>
                  <element xid="HCP09">
                    <data_ele>235</data_ele>
                    <name>Product or Service ID Qualifier</name>
                    <usage>S</usage>
                    <seq>09</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>HC</code>
                    </valid_codes>
                  </element>
                  <element xid="HCP10">
                    <data_ele>234</data_ele>
                    <name>Repriced Approved HCPCS Code</name>
                    <usage>S</usage>
                    <seq>10</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>48</max_len>
                  </element>
                  <element xid="HCP11">
                    <data_ele>355</data_ele>
                    <name>Unit or Basis for Measurement Code</name>
                    <usage>S</usage>
                    <seq>11</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>DA</code>
                      <code>UN</code>
                    </valid_codes>
                  </element>
                  <element xid="HCP12">
                    <data_ele>380</data_ele>
                    <name>Repriced Approved Service Unit Count</name>
                    <usage>S</usage>
                    <seq>12</seq>
                    <data_type>R</data_type>
                    <min_len>1</min_len>
                    <max_len>15</max_len>
                  </element>
                  <element xid="HCP13">
                    <data_ele>901</data_ele>
                    <name>Rejection Message</name>
                    <usage>S</usage>
                    <seq>13</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>T1</code>
                      <code>T2</code>
                      <code>T3</code>
                      <code>T4</code>
                      <code>T5</code>
                      <code>T6</code>
                    </valid_codes>
                  </element>
                  <element xid="HCP14">
                    <data_ele>1526</data_ele>
                    <name>Policy Compliance Code</name>
                    <usage>S</usage>
                    <seq>14</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>1</code>
                      <code>2</code>
                      <code>3</code>
                      <code>4</code>
                      <code>5</code>
                    </valid_codes>
                  </element>
                  <element xid="HCP15">
                    <data_ele>1527</data_ele>
                    <name>Exception Reason Code</name>
                    <usage>S</usage>
                    <seq>15</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>1</code>
                      <code>2</code>
                      <code>3</code>
                      <code>4</code>
                      <code>5</code>
                      <code>6</code>
                    </valid_codes>
                  </element>
                </segment>
<!--End of HCP segment-->
                <loop xid="2305">
                  <name>Home Health Care Plan Information</name>
                  <usage>S</usage>
                  <pos>242</pos>
                  <repeat>6</repeat>
                  <segment xid="CR7">
                    <name>Home Health Care Plan Information</name>
                    <usage>R</usage>
                    <pos>242</pos>
                    <max_use>1</max_use>
                    <element xid="CR701">
                      <data_ele>921</data_ele>
                      <name>Discipline Type Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>AI</code>
                        <code>MS</code>
                        <code>OT</code>
                        <code>PT</code>
                        <code>SN</code>
                        <code>ST</code>
                      </valid_codes>
                    </element>
                    <element xid="CR702">
                      <data_ele>1470</data_ele>
                      <name>Visits Prior to Recertification Date Count</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>N0</data_type>
                      <min_len>1</min_len>
                      <max_len>9</max_len>
                    </element>
                    <element xid="CR703">
                      <data_ele>1470</data_ele>
                      <name>Total Visits Projected This Certification Count</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>N0</data_type>
                      <min_len>1</min_len>
                      <max_len>9</max_len>
                    </element>
                  </segment>
<!--End of CR7 segment-->
                  <segment xid="HSD">
                    <name>Health Care Services Delivery</name>
                    <usage>S</usage>
                    <pos>243</pos>
                    <max_use>12</max_use>
                    <element xid="HSD01">
                      <data_ele>673</data_ele>
                      <name>Visits</name>
                      <usage>S</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>VS</code>
                      </valid_codes>
                    </element>
                    <element xid="HSD02">
                      <data_ele>380</data_ele>
                      <name>Number of Visits</name>
                      <usage>S</usage>
                      <seq>02</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HSD03">
                      <data_ele>355</data_ele>
                      <name>Frequency Period</name>
                      <usage>S</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>DA</code>
                        <code>MO</code>
                        <code>Q1</code>
                        <code>WK</code>
                      </valid_codes>
                    </element>
                    <element xid="HSD04">
                      <data_ele>1167</data_ele>
                      <name>Frequency Count</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>6</max_len>
                    </element>
                    <element xid="HSD05">
                      <data_ele>615</data_ele>
                      <name>Duration of Visits Units</name>
                      <usage>S</usage>
                      <seq>05</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>7</code>
                        <code>35</code>
                      </valid_codes>
                    </element>
                    <element xid="HSD06">
                      <data_ele>616</data_ele>
                      <name>Duration of Visits, Number of Units</name>
                      <usage>S</usage>
                      <seq>06</seq>
                      <data_type>N0</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="HSD07">
                      <data_ele>678</data_ele>
                      <name>Ship, Delivery or Calendar Pattern Code</name>
                      <usage>S</usage>
                      <seq>07</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>1</code>
                        <code>2</code>
                        <code>3</code>
                        <code>4</code>
                        <code>5</code>
                        <code>6</code>
                        <code>7</code>
                        <code>8</code>
                        <code>9</code>
                        <code>A</code>
                        <code>B</code>
                        <code>C</code>
                        <code>D</code>
                        <code>E</code>
                        <code>F</code>
                        <code>G</code>
                        <code>H</code>
                        <code>J</code>
                        <code>K</code>
                        <code>L</code>
                        <code>N</code>
                        <code>O</code>
                        <code>S</code>
                        <code>SA</code>
                        <code>SB</code>
                        <code>SC</code>
                        <code>SD</code>
                        <code>SG</code>
                        <code>SL</code>
                        <code>SP</code>
                        <code>SX</code>
                        <code>SY</code>
                        <code>SZ</code>
                        <code>W</code>
                      </valid_codes>
                    </element>
                    <element xid="HSD08">
                      <data_ele>679</data_ele>
                      <name>Delivery Pattern Time Code</name>
                      <usage>S</usage>
                      <seq>08</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                      <valid_codes>
                        <code>D</code>
                        <code>E</code>
                        <code>F</code>
                      </valid_codes>
                    </element>
                  </segment>
<!--End of HSD segment-->
                </loop>
<!--End of 2305 loop-->
                <loop xid="2310A">
                  <name>Attending Physician Name</name>
                  <usage>S</usage>
                  <pos>250</pos>
                  <repeat>1</repeat>
                  <segment xid="NM1">
                    <name>Attending Physician Name</name>
                    <usage>R</usage>
                    <pos>250</pos>
                    <max_use>1</max_use>
                    <element xid="NM101">
                      <data_ele>98</data_ele>
                      <name>Entity Identifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>71</code>
                      </valid_codes>
                    </element>
                    <element xid="NM102">
                      <data_ele>1065</data_ele>
                      <name>Entity Type Qualifier</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                      <valid_codes>
                        <code>1</code>
                        <code>2</code>
                      </valid_codes>
                    </element>
                    <element xid="NM103">
                      <data_ele>1035</data_ele>
                      <name>Attending Physician Last Name</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="NM104">
                      <data_ele>1036</data_ele>
                      <name>Attending Physician First Name</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>25</max_len>
                    </element>
                    <element xid="NM105">
                      <data_ele>1037</data_ele>
                      <name>Attending Physician Middle Name</name>
                      <usage>S</usage>
                      <seq>05</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>25</max_len>
                    </element>
                    <element xid="NM106">
                      <data_ele>1038</data_ele>
                      <name>Name Prefix</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>10</max_len>
                    </element>
                    <element xid="NM107">
                      <data_ele>1039</data_ele>
                      <name>Attending Physician Name Suffix</name>
                      <usage>S</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>10</max_len>
                    </element>
                    <element xid="NM108">
                      <data_ele>66</data_ele>
                      <name>Identification Code Qualifier</name>
                      <usage>R</usage>
                      <seq>08</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>24</code>
                        <code>34</code>
                        <code>XX</code>
                      </valid_codes>
                    </element>
                    <element xid="NM109">
                      <data_ele>67</data_ele>
                      <name>Attending Physician Primary Identifier</name>
                      <usage>R</usage>
                      <seq>09</seq>
                      <data_type>AN</data_type>
                      <min_len>2</min_len>
                      <max_len>80</max_len>
                    </element>
                    <element xid="NM110">
                      <data_ele>706</data_ele>
                      <name>Entity Relationship Code</name>
                      <usage>N</usage>
                      <seq>10</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                    </element>
                    <element xid="NM111">
                      <data_ele>98</data_ele>
                      <name>Entity Identifier Code</name>
                      <usage>N</usage>
                      <seq>11</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                  </segment>
<!--End of NM1 segment-->
                  <segment xid="PRV">
                    <name>Attending Physician Specialty Information</name>
                    <usage>S</usage>
                    <pos>255</pos>
                    <max_use>1</max_use>
                    <element xid="PRV01">
                      <data_ele>1221</data_ele>
                      <name>Provider Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>AT</code>
                        <code>SU</code>
                      </valid_codes>
                    </element>
                    <element xid="PRV02">
                      <data_ele>128</data_ele>
                      <name>Reference Identification Qualifier</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>ZZ</code>
                      </valid_codes>
                    </element>
                    <element xid="PRV03">
                      <data_ele>127</data_ele>
                      <name>Provider Taxonomy Code</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
<!--<valid_codes external="prov_taxonomy"/>-->
                    </element>
                    <element xid="PRV04">
                      <data_ele>156</data_ele>
                      <name>State or Province Code</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes external="states"/>
                    </element>
                    <composite>
                      <data_ele>C035</data_ele>
                      <name>Provider Specialty Information</name>
                      <usage>N</usage>
                      <seq>05</seq>
                    </composite>
                    <element xid="PRV06">
                      <data_ele>1223</data_ele>
                      <name>Provider Organization Code</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>ID</data_type>
                      <min_len>3</min_len>
                      <max_len>3</max_len>
                    </element>
                  </segment>
<!--End of PRV segment-->
                  <segment xid="REF">
                    <name>Attending Physician Secondary Identification</name>
                    <usage>S</usage>
                    <pos>271</pos>
                    <max_use>5</max_use>
                    <element xid="REF01">
                      <data_ele>128</data_ele>
                      <name>Reference Identification Qualifier</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>0B</code>
                        <code>1A</code>
                        <code>1B</code>
                        <code>1C</code>
                        <code>1D</code>
                        <code>1G</code>
                        <code>1H</code>
                        <code>EI</code>
                        <code>G2</code>
                        <code>LU</code>
                        <code>N5</code>
                        <code>SY</code>
                        <code>X5</code>
                      </valid_codes>
                    </element>
                    <element xid="REF02">
                      <data_ele>127</data_ele>
                      <name>Attending Physician Secondary Identifier</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="REF03">
                      <data_ele>352</data_ele>
                      <name>Description</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>80</max_len>
                    </element>
                    <composite>
                      <data_ele>C040</data_ele>
                      <name>Reference Identifier</name>
                      <usage>N</usage>
                      <seq>04</seq>
                    </composite>
                  </segment>
<!--End of REF segment-->
                </loop>
<!--End of 2310A loop-->
                <loop xid="2310B">
                  <name>Operating Physician Name</name>
                  <usage>S</usage>
                  <pos>250</pos>
                  <repeat>1</repeat>
                  <segment xid="NM1">
                    <name>Operating Physician Name</name>
                    <usage>R</usage>
                    <pos>250</pos>
                    <max_use>1</max_use>
                    <element xid="NM101">
                      <data_ele>98</data_ele>
                      <name>Entity Identifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>72</code>
                      </valid_codes>
                    </element>
                    <element xid="NM102">
                      <data_ele>1065</data_ele>
                      <name>Entity Type Qualifier</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                      <valid_codes>
                        <code>1</code>
                      </valid_codes>
                    </element>
                    <element xid="NM103">
                      <data_ele>1035</data_ele>
                      <name>Operating Physician Last Name</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="NM104">
                      <data_ele>1036</data_ele>
                      <name>Operating Physician First Name</name>
                      <usage>R</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>25</max_len>
                    </element>
                    <element xid="NM105">
                      <data_ele>1037</data_ele>
                      <name>Operating Physician Middle Name</name>
                      <usage>S</usage>
                      <seq>05</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>25</max_len>
                    </element>
                    <element xid="NM106">
                      <data_ele>1038</data_ele>
                      <name>Name Prefix</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>10</max_len>
                    </element>
                    <element xid="NM107">
                      <data_ele>1039</data_ele>
                      <name>Operating Physician Name Suffix</name>
                      <usage>S</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>10</max_len>
                    </element>
                    <element xid="NM108">
                      <data_ele>66</data_ele>
                      <name>Identification Code Qualifier</name>
                      <usage>R</usage>
                      <seq>08</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>24</code>
                        <code>34</code>
                        <code>XX</code>
                      </valid_codes>
                    </element>
                    <element xid="NM109">
                      <data_ele>67</data_ele>
                      <name>Operating Physician Primary Identifier</name>
                      <usage>R</usage>
                      <seq>09</seq>
                      <data_type>AN</data_type>
                      <min_len>2</min_len>
                      <max_len>80</max_len>
                    </element>
                    <element xid="NM110">
                      <data_ele>706</data_ele>
                      <name>Entity Relationship Code</name>
                      <usage>N</usage>
                      <seq>10</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                    </element>
                    <element xid="NM111">
                      <data_ele>98</data_ele>
                      <name>Entity Identifier Code</name>
                      <usage>N</usage>
                      <seq>11</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                  </segment>
<!--End of NM1 segment-->
                  <segment xid="PRV">
                    <name>Operating Physician Specialty Information</name>
                    <usage>S</usage>
                    <pos>255</pos>
                    <max_use>1</max_use>
                    <element xid="PRV01">
                      <data_ele>1221</data_ele>
                      <name>Provider Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>OP</code>
                      </valid_codes>
                    </element>
                    <element xid="PRV02">
                      <data_ele>128</data_ele>
                      <name>Reference Identification Qualifier</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>ZZ</code>
                      </valid_codes>
                    </element>
                    <element xid="PRV03">
                      <data_ele>127</data_ele>
                      <name>Provider Taxonomy Code</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
<!--<valid_codes external="prov_taxonomy"/>-->
                    </element>
                    <element xid="PRV04">
                      <data_ele>156</data_ele>
                      <name>State or Province Code</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                    </element>
                    <composite>
                      <data_ele>C035</data_ele>
                      <name>Provider Specialty Information</name>
                      <usage>N</usage>
                      <seq>05</seq>
                    </composite>
                    <element xid="PRV06">
                      <data_ele>1223</data_ele>
                      <name>Provider Organization Code</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>ID</data_type>
                      <min_len>3</min_len>
                      <max_len>3</max_len>
                    </element>
                  </segment>
<!--End of PRV segment-->
                  <segment xid="REF">
                    <name>Operating Physician Secondary Identification</name>
                    <usage>S</usage>
                    <pos>271</pos>
                    <max_use>5</max_use>
                    <element xid="REF01">
                      <data_ele>128</data_ele>
                      <name>Reference Identification Qualifier</name>
                      <usage>R</usage>
                      <seq>1</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>0B</code>
                        <code>1A</code>
                        <code>1B</code>
                        <code>1C</code>
                        <code>1D</code>
                        <code>1G</code>
                        <code>1H</code>
                        <code>EI</code>
                        <code>G2</code>
                        <code>LU</code>
                        <code>N5</code>
                        <code>SY</code>
                        <code>X5</code>
                      </valid_codes>
                    </element>
                    <element xid="REF02">
                      <data_ele>127</data_ele>
                      <name>Operating Physician Secondary Identifier</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="REF03">
                      <data_ele>352</data_ele>
                      <name>Description</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>80</max_len>
                    </element>
                    <composite>
                      <data_ele>C040</data_ele>
                      <name>Reference Identifier</name>
                      <usage>N</usage>
                      <seq>04</seq>
                    </composite>
                  </segment>
<!--End of REF segment-->
                </loop>
<!--End of 2310B loop-->
                <loop xid="2310C">
                  <name>Other Provider Name</name>
                  <usage>S</usage>
                  <pos>250</pos>
                  <repeat>1</repeat>
                  <segment xid="NM1">
                    <name>Other Provider Name</name>
                    <usage>R</usage>
                    <pos>250</pos>
                    <max_use>1</max_use>
                    <element xid="NM101">
                      <data_ele>98</data_ele>
                      <name>Entity Identifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>73</code>
                      </valid_codes>
                    </element>
                    <element xid="NM102">
                      <data_ele>1065</data_ele>
                      <name>Entity Type Qualifier</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                      <valid_codes>
                        <code>1</code>
                        <code>2</code>
                      </valid_codes>
                    </element>
                    <element xid="NM103">
                      <data_ele>1035</data_ele>
                      <name>Other Physician Last Name</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="NM104">
                      <data_ele>1036</data_ele>
                      <name>Other Physician First Name</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>25</max_len>
                    </element>
                    <element xid="NM105">
                      <data_ele>1037</data_ele>
                      <name>Other Provider Middle Name</name>
                      <usage>S</usage>
                      <seq>05</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>25</max_len>
                    </element>
                    <element xid="NM106">
                      <data_ele>1038</data_ele>
                      <name>Name Prefix</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>10</max_len>
                    </element>
                    <element xid="NM107">
                      <data_ele>1039</data_ele>
                      <name>Other Provider Name Suffix</name>
                      <usage>S</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>10</max_len>
                    </element>
                    <element xid="NM108">
                      <data_ele>66</data_ele>
                      <name>Identification Code Qualifier</name>
                      <usage>R</usage>
                      <seq>08</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>24</code>
                        <code>34</code>
                        <code>XX</code>
                      </valid_codes>
                    </element>
                    <element xid="NM109">
                      <data_ele>67</data_ele>
                      <name>Other Physician Identifier</name>
                      <usage>R</usage>
                      <seq>09</seq>
                      <data_type>AN</data_type>
                      <min_len>2</min_len>
                      <max_len>80</max_len>
                    </element>
                    <element xid="NM110">
                      <data_ele>706</data_ele>
                      <name>Entity Relationship Code</name>
                      <usage>N</usage>
                      <seq>10</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                    </element>
                    <element xid="NM111">
                      <data_ele>98</data_ele>
                      <name>Entity Identifier Code</name>
                      <usage>N</usage>
                      <seq>11</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                  </segment>
<!--End of NM1 segment-->
                  <segment xid="PRV">
                    <name>Other Provider Specialty Information</name>
                    <usage>S</usage>
                    <pos>255</pos>
                    <max_use>1</max_use>
                    <element xid="PRV01">
                      <data_ele>1221</data_ele>
                      <name>Provider Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>OT</code>
                        <code>PE</code>
                      </valid_codes>
                    </element>
                    <element xid="PRV02">
                      <data_ele>128</data_ele>
                      <name>Reference Identification Qualifier</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>ZZ</code>
                      </valid_codes>
                    </element>
                    <element xid="PRV03">
                      <data_ele>127</data_ele>
                      <name>Provider Taxonomy Code</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
<!--<valid_codes external="prov_taxonomy"/>-->
                    </element>
                    <element xid="PRV04">
                      <data_ele>156</data_ele>
                      <name>State or Province Code</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                    </element>
                    <composite>
                      <data_ele>C035</data_ele>
                      <name>Provider Specialty Information</name>
                      <usage>N</usage>
                      <seq>05</seq>
                    </composite>
                    <element xid="PRV06">
                      <data_ele>1223</data_ele>
                      <name>Provider Organization Code</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>ID</data_type>
                      <min_len>3</min_len>
                      <max_len>3</max_len>
                    </element>
                  </segment>
<!--End of PRV segment-->
                  <segment xid="REF">
                    <name>Other Provider Secondary Identification</name>
                    <usage>S</usage>
                    <pos>271</pos>
                    <max_use>5</max_use>
                    <element xid="REF01">
                      <data_ele>128</data_ele>
                      <name>Reference Identification Qualifier</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>0B</code>
                        <code>1A</code>
                        <code>1B</code>
                        <code>1C</code>
                        <code>1D</code>
                        <code>1G</code>
                        <code>1H</code>
                        <code>EI</code>
                        <code>G2</code>
                        <code>LU</code>
                        <code>N5</code>
                        <code>SY</code>
                        <code>X5</code>
                      </valid_codes>
                    </element>
                    <element xid="REF02">
                      <data_ele>127</data_ele>
                      <name>Other Provider Secondary Identifier</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="REF03">
                      <data_ele>352</data_ele>
                      <name>Description</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>80</max_len>
                    </element>
                    <composite>
                      <data_ele>C040</data_ele>
                      <name>Reference Identifier</name>
                      <usage>N</usage>
                      <seq>04</seq>
                    </composite>
                  </segment>
<!--End of REF segment-->
                </loop>
<!--End of 2310C loop-->
                <loop xid="2310E">
                  <name>Service Facility Name</name>
                  <usage>S</usage>
                  <pos>250</pos>
                  <repeat>1</repeat>
                  <segment xid="NM1">
                    <name>Service Facility Name</name>
                    <usage>R</usage>
                    <pos>250</pos>
                    <max_use>1</max_use>
                    <element xid="NM101">
                      <data_ele>98</data_ele>
                      <name>Entity Identifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>FA</code>
                      </valid_codes>
                    </element>
                    <element xid="NM102">
                      <data_ele>1065</data_ele>
                      <name>Entity Type Qualifier</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                      <valid_codes>
                        <code>2</code>
                      </valid_codes>
                    </element>
                    <element xid="NM103">
                      <data_ele>1035</data_ele>
                      <name>Laboratory or Facility Name</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="NM104">
                      <data_ele>1036</data_ele>
                      <name>Name First</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>25</max_len>
                    </element>
                    <element xid="NM105">
                      <data_ele>1037</data_ele>
                      <name>Name Middle</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>25</max_len>
                    </element>
                    <element xid="NM106">
                      <data_ele>1038</data_ele>
                      <name>Name Prefix</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>10</max_len>
                    </element>
                    <element xid="NM107">
                      <data_ele>1039</data_ele>
                      <name>Name Suffix</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>10</max_len>
                    </element>
                    <element xid="NM108">
                      <data_ele>66</data_ele>
                      <name>Identification Code Qualifier</name>
                      <usage>S</usage>
                      <seq>08</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>24</code>
                        <code>34</code>
                        <code>XX</code>
                      </valid_codes>
                    </element>
                    <element xid="NM109">
                      <data_ele>67</data_ele>
                      <name>Laboratory or Facility Primary Identifier</name>
                      <usage>S</usage>
                      <seq>09</seq>
                      <data_type>AN</data_type>
                      <min_len>2</min_len>
                      <max_len>80</max_len>
                    </element>
                    <element xid="NM110">
                      <data_ele>706</data_ele>
                      <name>Entity Relationship Code</name>
                      <usage>N</usage>
                      <seq>10</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                    </element>
                    <element xid="NM111">
                      <data_ele>98</data_ele>
                      <name>Entity Identifier Code</name>
                      <usage>N</usage>
                      <seq>11</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                  </segment>
<!--End of NM1 segment-->
                  <segment xid="PRV">
                    <name>Service Facility Specialty Information</name>
                    <usage>S</usage>
                    <pos>255</pos>
                    <max_use>1</max_use>
                    <element xid="PRV01">
                      <data_ele>1221</data_ele>
                      <name>Provider Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>RP</code>
                      </valid_codes>
                    </element>
                    <element xid="PRV02">
                      <data_ele>128</data_ele>
                      <name>Reference Identification Qualifier</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>ZZ</code>
                      </valid_codes>
                    </element>
                    <element xid="PRV03">
                      <data_ele>127</data_ele>
                      <name>Provider Taxonomy Code</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
<!--<valid_codes external="prov_taxonomy"/>-->
                    </element>
                    <element xid="PRV04">
                      <data_ele>156</data_ele>
                      <name>State or Province Code</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                    </element>
                    <composite>
                      <data_ele>C035</data_ele>
                      <name>Provider Specialty Information</name>
                      <usage>N</usage>
                      <seq>05</seq>
                    </composite>
                    <element xid="PRV06">
                      <data_ele>1223</data_ele>
                      <name>Provider Organization Code</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>ID</data_type>
                      <min_len>3</min_len>
                      <max_len>3</max_len>
                    </element>
                  </segment>
<!--End of PRV segment-->
                  <segment xid="N3">
                    <name>Service Facility Address</name>
                    <usage>R</usage>
                    <pos>265</pos>
                    <max_use>1</max_use>
                    <element xid="N301">
                      <data_ele>166</data_ele>
                      <name>Laboratory or Facility Address Line</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>55</max_len>
                    </element>
                    <element xid="N302">
                      <data_ele>166</data_ele>
                      <name>Laboratory or Facility Address Line</name>
                      <usage>S</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>55</max_len>
                    </element>
                  </segment>
<!--End of N3 segment-->
                  <segment xid="N4">
                    <name>Service Facility City/State/Zip Code</name>
                    <usage>R</usage>
                    <pos>270</pos>
                    <max_use>1</max_use>
                    <element xid="N401">
                      <data_ele>19</data_ele>
                      <name>Laboratory or Facility City Name</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>AN</data_type>
                      <min_len>2</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="N402">
                      <data_ele>156</data_ele>
                      <name>Laboratory or Facility State or Province Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes external="states"/>
                    </element>
                    <element xid="N403">
                      <data_ele>116</data_ele>
                      <name>Laboratory or Facility Postal Zone or Zip Code</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>3</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="N404">
                      <data_ele>26</data_ele>
                      <name>Laboratory/Facility Country Code</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes external="country"/>
                    </element>
                    <element xid="N405">
                      <data_ele>309</data_ele>
                      <name>Location Qualifier</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                    </element>
                    <element xid="N406">
                      <data_ele>310</data_ele>
                      <name>Location Identifier</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </segment>
<!--End of N4 segment-->
                  <segment xid="REF">
                    <name>Service Facility Secondary Identification</name>
                    <usage>S</usage>
                    <pos>271</pos>
                    <max_use>5</max_use>
                    <element xid="REF01">
                      <data_ele>128</data_ele>
                      <name>Reference Identification Qualifier</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>0B</code>
                        <code>1A</code>
                        <code>1B</code>
                        <code>1C</code>
                        <code>1D</code>
                        <code>1G</code>
                        <code>1H</code>
                        <code>1J</code>
                        <code>EI</code>
                        <code>FH</code>
                        <code>G2</code>
                        <code>G5</code>
                        <code>LU</code>
                        <code>N5</code>
                        <code>X5</code>
                      </valid_codes>
                    </element>
                    <element xid="REF02">
                      <data_ele>127</data_ele>
                      <name>Laboratory or Facility Secondary Identifier</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="REF03">
                      <data_ele>352</data_ele>
                      <name>Description</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>80</max_len>
                    </element>
                    <composite>
                      <data_ele>C040</data_ele>
                      <name>Reference Identifier</name>
                      <usage>N</usage>
                      <seq>04</seq>
                    </composite>
                  </segment>
<!--End of REF segment-->
                </loop>
<!--End of 2310E loop-->
                <loop xid="2320">
                  <name>Other Subscriber Information</name>
                  <usage>S</usage>
                  <pos>290</pos>
                  <repeat>10</repeat>
                  <segment xid="SBR">
                    <name>Other Subscriber Information</name>
                    <usage>R</usage>
                    <pos>290</pos>
                    <max_use>1</max_use>
                    <element xid="SBR01">
                      <data_ele>1138</data_ele>
                      <name>Payer Responsibility Sequence Number Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                      <valid_codes>
                        <code>P</code>
                        <code>S</code>
                        <code>T</code>
                      </valid_codes>
                    </element>
                    <element xid="SBR02">
                      <data_ele>1069</data_ele>
                      <name>Individual Relationship Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>01</code>
                        <code>04</code>
                        <code>05</code>
                        <code>07</code>
                        <code>10</code>
                        <code>15</code>
                        <code>17</code>
                        <code>18</code>
                        <code>19</code>
                        <code>20</code>
                        <code>21</code>
                        <code>22</code>
                        <code>23</code>
                        <code>24</code>
                        <code>29</code>
                        <code>32</code>
                        <code>33</code>
                        <code>36</code>
                        <code>39</code>
                        <code>40</code>
                        <code>41</code>
                        <code>43</code>
                        <code>53</code>
                        <code>G8</code>
                      </valid_codes>
                    </element>
                    <element xid="SBR03">
                      <data_ele>127</data_ele>
                      <name>Insured Group or Policy Number</name>
                      <usage>S</usage>
                      <seq>03</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="SBR04">
                      <data_ele>93</data_ele>
                      <name>Other Insured Group Name</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>60</max_len>
                    </element>
                    <element xid="SBR05">
                      <data_ele>1336</data_ele>
                      <name>Insurance Type Code</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="SBR06">
                      <data_ele>1143</data_ele>
                      <name>Coordination of Benefits Code</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                    <element xid="SBR07">
                      <data_ele>1073</data_ele>
                      <name>Condition or Response Code</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                    <element xid="SBR08">
                      <data_ele>584</data_ele>
                      <name>Employment Status Code</name>
                      <usage>N</usage>
                      <seq>08</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                    </element>
                    <element xid="SBR09">
                      <data_ele>1032</data_ele>
                      <name>Claim Filing Indicator Code</name>
                      <usage>S</usage>
                      <seq>09</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>09</code>
                        <code>10</code>
                        <code>11</code>
                        <code>12</code>
                        <code>13</code>
                        <code>14</code>
                        <code>15</code>
                        <code>16</code>
                        <code>AM</code>
                        <code>BL</code>
                        <code>CH</code>
                        <code>CI</code>
                        <code>DS</code>
                        <code>HM</code>
                        <code>LI</code>
                        <code>LM</code>
                        <code>MA</code>
                        <code>MB</code>
                        <code>MC</code>
                        <code>OF</code>
                        <code>TV</code>
                        <code>VA</code>
                        <code>WC</code>
                        <code>ZZ</code>
                      </valid_codes>
                    </element>
                  </segment>
<!--End of SBR segment-->
                  <segment xid="CAS">
                    <name>Claim Level Adjustment</name>
                    <usage>S</usage>
                    <pos>295</pos>
                    <max_use>5</max_use>
                    <element xid="CAS01">
                      <data_ele>1033</data_ele>
                      <name>Claim Adjustment Group Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>CO</code>
                        <code>CR</code>
                        <code>OA</code>
                        <code>PI</code>
                        <code>PR</code>
                      </valid_codes>
                    </element>
                    <element xid="CAS02">
                      <data_ele>1034</data_ele>
                      <name>Adjustment Reason Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>5</max_len>
                      <valid_codes>
                        <code>1</code>
                        <code>2</code>
                        <code>3</code>
                        <code>4</code>
                        <code>5</code>
                        <code>6</code>
                        <code>7</code>
                        <code>8</code>
                        <code>9</code>
                        <code>10</code>
                        <code>11</code>
                        <code>12</code>
                        <code>13</code>
                        <code>14</code>
                        <code>15</code>
                        <code>16</code>
                        <code>17</code>
                        <code>18</code>
                        <code>19</code>
                        <code>20</code>
                        <code>21</code>
                        <code>22</code>
                        <code>23</code>
                        <code>24</code>
                        <code>25</code>
                        <code>26</code>
                        <code>27</code>
                        <code>28</code>
                        <code>29</code>
                        <code>30</code>
                        <code>31</code>
                        <code>32</code>
                        <code>33</code>
                        <code>34</code>
                        <code>35</code>
                        <code>36</code>
                        <code>37</code>
                        <code>38</code>
                        <code>39</code>
                        <code>40</code>
                        <code>41</code>
                        <code>42</code>
                        <code>43</code>
                        <code>44</code>
                        <code>45</code>
                        <code>46</code>
                        <code>47</code>
                        <code>48</code>
                        <code>49</code>
                        <code>50</code>
                        <code>51</code>
                        <code>52</code>
                        <code>53</code>
                        <code>54</code>
                        <code>55</code>
                        <code>56</code>
                        <code>57</code>
                        <code>58</code>
                        <code>59</code>
                        <code>60</code>
                        <code>61</code>
                        <code>62</code>
                        <code>63</code>
                        <code>64</code>
                        <code>65</code>
                        <code>66</code>
                        <code>67</code>
                        <code>68</code>
                        <code>69</code>
                        <code>70</code>
                        <code>71</code>
                        <code>72</code>
                        <code>73</code>
                        <code>74</code>
                        <code>75</code>
                        <code>76</code>
                        <code>77</code>
                        <code>78</code>
                        <code>79</code>
                        <code>80</code>
                        <code>81</code>
                        <code>82</code>
                        <code>83</code>
                        <code>84</code>
                        <code>85</code>
                        <code>86</code>
                        <code>87</code>
                        <code>88</code>
                        <code>89</code>
                        <code>90</code>
                        <code>91</code>
                        <code>92</code>
                        <code>93</code>
                        <code>94</code>
                        <code>95</code>
                        <code>96</code>
                        <code>97</code>
                        <code>98</code>
                        <code>99</code>
                        <code>100</code>
                        <code>101</code>
                        <code>102</code>
                        <code>103</code>
                        <code>104</code>
                        <code>105</code>
                        <code>106</code>
                        <code>107</code>
                        <code>108</code>
                        <code>109</code>
                        <code>110</code>
                        <code>111</code>
                        <code>112</code>
                        <code>113</code>
                        <code>114</code>
                        <code>115</code>
                        <code>116</code>
                        <code>117</code>
                        <code>118</code>
                        <code>119</code>
                        <code>120</code>
                        <code>121</code>
                        <code>122</code>
                        <code>123</code>
                        <code>124</code>
                        <code>125</code>
                        <code>126</code>
                        <code>127</code>
                        <code>128</code>
                        <code>129</code>
                        <code>130</code>
                        <code>131</code>
                        <code>132</code>
                        <code>133</code>
                        <code>134</code>
                        <code>135</code>
                        <code>136</code>
                        <code>137</code>
                        <code>138</code>
                        <code>139</code>
                        <code>140</code>
                        <code>141</code>
                        <code>142</code>
                        <code>143</code>
                        <code>144</code>
                        <code>145</code>
                        <code>146</code>
                        <code>147</code>
                        <code>148</code>
                        <code>149</code>
                        <code>150</code>
                        <code>151</code>
                        <code>152</code>
                        <code>153</code>
                        <code>154</code>
                        <code>A0</code>
                        <code>A1</code>
                        <code>A2</code>
                        <code>A3</code>
                        <code>A4</code>
                        <code>A5</code>
                        <code>A6</code>
                        <code>A7</code>
                        <code>A8</code>
                        <code>B1</code>
                        <code>B2</code>
                        <code>B3</code>
                        <code>B4</code>
                        <code>B5</code>
                        <code>B6</code>
                        <code>B7</code>
                        <code>B8</code>
                        <code>B9</code>
                        <code>B10</code>
                        <code>B11</code>
                        <code>B12</code>
                        <code>B13</code>
                        <code>B14</code>
                        <code>B15</code>
                        <code>B16</code>
                        <code>B17</code>
                        <code>B18</code>
                        <code>B19</code>
                        <code>B20</code>
                        <code>B21</code>
                        <code>B22</code>
                        <code>B23</code>
                        <code>D1</code>
                        <code>D2</code>
                        <code>D3</code>
                        <code>D4</code>
                        <code>D5</code>
                        <code>D6</code>
                        <code>D7</code>
                        <code>D8</code>
                        <code>D9</code>
                        <code>D10</code>
                        <code>D11</code>
                        <code>D12</code>
                        <code>D13</code>
                        <code>D14</code>
                        <code>D15</code>
                        <code>W1</code>
                      </valid_codes>
                    </element>
                    <element xid="CAS03">
                      <data_ele>782</data_ele>
                      <name>Adjustment Amount</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="CAS04">
                      <data_ele>380</data_ele>
                      <name>Adjustment Quantity</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="CAS05">
                      <data_ele>1034</data_ele>
                      <name>Adjustment Reason Code</name>
                      <usage>S</usage>
                      <seq>05</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>5</max_len>
                      <valid_codes>
                        <code>1</code>
                        <code>2</code>
                        <code>3</code>
                        <code>4</code>
                        <code>5</code>
                        <code>6</code>
                        <code>7</code>
                        <code>8</code>
                        <code>9</code>
                        <code>10</code>
                        <code>11</code>
                        <code>12</code>
                        <code>13</code>
                        <code>14</code>
                        <code>15</code>
                        <code>16</code>
                        <code>17</code>
                        <code>18</code>
                        <code>19</code>
                        <code>20</code>
                        <code>21</code>
                        <code>22</code>
                        <code>23</code>
                        <code>24</code>
                        <code>25</code>
                        <code>26</code>
                        <code>27</code>
                        <code>28</code>
                        <code>29</code>
                        <code>30</code>
                        <code>31</code>
                        <code>32</code>
                        <code>33</code>
                        <code>34</code>
                        <code>35</code>
                        <code>36</code>
                        <code>37</code>
                        <code>38</code>
                        <code>39</code>
                        <code>40</code>
                        <code>41</code>
                        <code>42</code>
                        <code>43</code>
                        <code>44</code>
                        <code>45</code>
                        <code>46</code>
                        <code>47</code>
                        <code>48</code>
                        <code>49</code>
                        <code>50</code>
                        <code>51</code>
                        <code>52</code>
                        <code>53</code>
                        <code>54</code>
                        <code>55</code>
                        <code>56</code>
                        <code>57</code>
                        <code>58</code>
                        <code>59</code>
                        <code>60</code>
                        <code>61</code>
                        <code>62</code>
                        <code>63</code>
                        <code>64</code>
                        <code>65</code>
                        <code>66</code>
                        <code>67</code>
                        <code>68</code>
                        <code>69</code>
                        <code>70</code>
                        <code>71</code>
                        <code>72</code>
                        <code>73</code>
                        <code>74</code>
                        <code>75</code>
                        <code>76</code>
                        <code>77</code>
                        <code>78</code>
                        <code>79</code>
                        <code>80</code>
                        <code>81</code>
                        <code>82</code>
                        <code>83</code>
                        <code>84</code>
                        <code>85</code>
                        <code>86</code>
                        <code>87</code>
                        <code>88</code>
                        <code>89</code>
                        <code>90</code>
                        <code>91</code>
                        <code>92</code>
                        <code>93</code>
                        <code>94</code>
                        <code>95</code>
                        <code>96</code>
                        <code>97</code>
                        <code>98</code>
                        <code>99</code>
                        <code>100</code>
                        <code>101</code>
                        <code>102</code>
                        <code>103</code>
                        <code>104</code>
                        <code>105</code>
                        <code>106</code>
                        <code>107</code>
                        <code>108</code>
                        <code>109</code>
                        <code>110</code>
                        <code>111</code>
                        <code>112</code>
                        <code>113</code>
                        <code>114</code>
                        <code>115</code>
                        <code>116</code>
                        <code>117</code>
                        <code>118</code>
                        <code>119</code>
                        <code>120</code>
                        <code>121</code>
                        <code>122</code>
                        <code>123</code>
                        <code>124</code>
                        <code>125</code>
                        <code>126</code>
                        <code>127</code>
                        <code>128</code>
                        <code>129</code>
                        <code>130</code>
                        <code>131</code>
                        <code>132</code>
                        <code>133</code>
                        <code>134</code>
                        <code>135</code>
                        <code>136</code>
                        <code>137</code>
                        <code>138</code>
                        <code>139</code>
                        <code>140</code>
                        <code>141</code>
                        <code>142</code>
                        <code>143</code>
                        <code>144</code>
                        <code>145</code>
                        <code>146</code>
                        <code>147</code>
                        <code>148</code>
                        <code>149</code>
                        <code>150</code>
                        <code>151</code>
                        <code>152</code>
                        <code>153</code>
                        <code>154</code>
                        <code>A0</code>
                        <code>A1</code>
                        <code>A2</code>
                        <code>A3</code>
                        <code>A4</code>
                        <code>A5</code>
                        <code>A6</code>
                        <code>A7</code>
                        <code>A8</code>
                        <code>B1</code>
                        <code>B2</code>
                        <code>B3</code>
                        <code>B4</code>
                        <code>B5</code>
                        <code>B6</code>
                        <code>B7</code>
                        <code>B8</code>
                        <code>B9</code>
                        <code>B10</code>
                        <code>B11</code>
                        <code>B12</code>
                        <code>B13</code>
                        <code>B14</code>
                        <code>B15</code>
                        <code>B16</code>
                        <code>B17</code>
                        <code>B18</code>
                        <code>B19</code>
                        <code>B20</code>
                        <code>B21</code>
                        <code>B22</code>
                        <code>B23</code>
                        <code>D1</code>
                        <code>D2</code>
                        <code>D3</code>
                        <code>D4</code>
                        <code>D5</code>
                        <code>D6</code>
                        <code>D7</code>
                        <code>D8</code>
                        <code>D9</code>
                        <code>D10</code>
                        <code>D11</code>
                        <code>D12</code>
                        <code>D13</code>
                        <code>D14</code>
                        <code>D15</code>
                        <code>W1</code>
                      </valid_codes>
                    </element>
                    <element xid="CAS06">
                      <data_ele>782</data_ele>
                      <name>Adjustment Amount</name>
                      <usage>S</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="CAS07">
                      <data_ele>380</data_ele>
                      <name>Adjustment Quantity</name>
                      <usage>S</usage>
                      <seq>07</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="CAS08">
                      <data_ele>1034</data_ele>
                      <name>Adjustment Reason Code</name>
                      <usage>S</usage>
                      <seq>08</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>5</max_len>
                      <valid_codes>
                        <code>1</code>
                        <code>2</code>
                        <code>3</code>
                        <code>4</code>
                        <code>5</code>
                        <code>6</code>
                        <code>7</code>
                        <code>8</code>
                        <code>9</code>
                        <code>10</code>
                        <code>11</code>
                        <code>12</code>
                        <code>13</code>
                        <code>14</code>
                        <code>15</code>
                        <code>16</code>
                        <code>17</code>
                        <code>18</code>
                        <code>19</code>
                        <code>20</code>
                        <code>21</code>
                        <code>22</code>
                        <code>23</code>
                        <code>24</code>
                        <code>25</code>
                        <code>26</code>
                        <code>27</code>
                        <code>28</code>
                        <code>29</code>
                        <code>30</code>
                        <code>31</code>
                        <code>32</code>
                        <code>33</code>
                        <code>34</code>
                        <code>35</code>
                        <code>36</code>
                        <code>37</code>
                        <code>38</code>
                        <code>39</code>
                        <code>40</code>
                        <code>41</code>
                        <code>42</code>
                        <code>43</code>
                        <code>44</code>
                        <code>45</code>
                        <code>46</code>
                        <code>47</code>
                        <code>48</code>
                        <code>49</code>
                        <code>50</code>
                        <code>51</code>
                        <code>52</code>
                        <code>53</code>
                        <code>54</code>
                        <code>55</code>
                        <code>56</code>
                        <code>57</code>
                        <code>58</code>
                        <code>59</code>
                        <code>60</code>
                        <code>61</code>
                        <code>62</code>
                        <code>63</code>
                        <code>64</code>
                        <code>65</code>
                        <code>66</code>
                        <code>67</code>
                        <code>68</code>
                        <code>69</code>
                        <code>70</code>
                        <code>71</code>
                        <code>72</code>
                        <code>73</code>
                        <code>74</code>
                        <code>75</code>
                        <code>76</code>
                        <code>77</code>
                        <code>78</code>
                        <code>79</code>
                        <code>80</code>
                        <code>81</code>
                        <code>82</code>
                        <code>83</code>
                        <code>84</code>
                        <code>85</code>
                        <code>86</code>
                        <code>87</code>
                        <code>88</code>
                        <code>89</code>
                        <code>90</code>
                        <code>91</code>
                        <code>92</code>
                        <code>93</code>
                        <code>94</code>
                        <code>95</code>
                        <code>96</code>
                        <code>97</code>
                        <code>98</code>
                        <code>99</code>
                        <code>100</code>
                        <code>101</code>
                        <code>102</code>
                        <code>103</code>
                        <code>104</code>
                        <code>105</code>
                        <code>106</code>
                        <code>107</code>
                        <code>108</code>
                        <code>109</code>
                        <code>110</code>
                        <code>111</code>
                        <code>112</code>
                        <code>113</code>
                        <code>114</code>
                        <code>115</code>
                        <code>116</code>
                        <code>117</code>
                        <code>118</code>
                        <code>119</code>
                        <code>120</code>
                        <code>121</code>
                        <code>122</code>
                        <code>123</code>
                        <code>124</code>
                        <code>125</code>
                        <code>126</code>
                        <code>127</code>
                        <code>128</code>
                        <code>129</code>
                        <code>130</code>
                        <code>131</code>
                        <code>132</code>
                        <code>133</code>
                        <code>134</code>
                        <code>135</code>
                        <code>136</code>
                        <code>137</code>
                        <code>138</code>
                        <code>139</code>
                        <code>140</code>
                        <code>141</code>
                        <code>142</code>
                        <code>143</code>
                        <code>144</code>
                        <code>145</code>
                        <code>146</code>
                        <code>147</code>
                        <code>148</code>
                        <code>149</code>
                        <code>150</code>
                        <code>151</code>
                        <code>152</code>
                        <code>153</code>
                        <code>154</code>
                        <code>A0</code>
                        <code>A1</code>
                        <code>A2</code>
                        <code>A3</code>
                        <code>A4</code>
                        <code>A5</code>
                        <code>A6</code>
                        <code>A7</code>
                        <code>A8</code>
                        <code>B1</code>
                        <code>B2</code>
                        <code>B3</code>
                        <code>B4</code>
                        <code>B5</code>
                        <code>B6</code>
                        <code>B7</code>
                        <code>B8</code>
                        <code>B9</code>
                        <code>B10</code>
                        <code>B11</code>
                        <code>B12</code>
                        <code>B13</code>
                        <code>B14</code>
                        <code>B15</code>
                        <code>B16</code>
                        <code>B17</code>
                        <code>B18</code>
                        <code>B19</code>
                        <code>B20</code>
                        <code>B21</code>
                        <code>B22</code>
                        <code>B23</code>
                        <code>D1</code>
                        <code>D2</code>
                        <code>D3</code>
                        <code>D4</code>
                        <code>D5</code>
                        <code>D6</code>
                        <code>D7</code>
                        <code>D8</code>
                        <code>D9</code>
                        <code>D10</code>
                        <code>D11</code>
                        <code>D12</code>
                        <code>D13</code>
                        <code>D14</code>
                        <code>D15</code>
                        <code>W1</code>
                      </valid_codes>
                    </element>
                    <element xid="CAS09">
                      <data_ele>782</data_ele>
                      <name>Adjustment Amount</name>
                      <usage>S</usage>
                      <seq>09</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="CAS10">
                      <data_ele>380</data_ele>
                      <name>Adjustment Quantity</name>
                      <usage>S</usage>
                      <seq>10</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="CAS11">
                      <data_ele>1034</data_ele>
                      <name>Adjustment Reason Code</name>
                      <usage>S</usage>
                      <seq>11</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>5</max_len>
                      <valid_codes>
                        <code>1</code>
                        <code>2</code>
                        <code>3</code>
                        <code>4</code>
                        <code>5</code>
                        <code>6</code>
                        <code>7</code>
                        <code>8</code>
                        <code>9</code>
                        <code>10</code>
                        <code>11</code>
                        <code>12</code>
                        <code>13</code>
                        <code>14</code>
                        <code>15</code>
                        <code>16</code>
                        <code>17</code>
                        <code>18</code>
                        <code>19</code>
                        <code>20</code>
                        <code>21</code>
                        <code>22</code>
                        <code>23</code>
                        <code>24</code>
                        <code>25</code>
                        <code>26</code>
                        <code>27</code>
                        <code>28</code>
                        <code>29</code>
                        <code>30</code>
                        <code>31</code>
                        <code>32</code>
                        <code>33</code>
                        <code>34</code>
                        <code>35</code>
                        <code>36</code>
                        <code>37</code>
                        <code>38</code>
                        <code>39</code>
                        <code>40</code>
                        <code>41</code>
                        <code>42</code>
                        <code>43</code>
                        <code>44</code>
                        <code>45</code>
                        <code>46</code>
                        <code>47</code>
                        <code>48</code>
                        <code>49</code>
                        <code>50</code>
                        <code>51</code>
                        <code>52</code>
                        <code>53</code>
                        <code>54</code>
                        <code>55</code>
                        <code>56</code>
                        <code>57</code>
                        <code>58</code>
                        <code>59</code>
                        <code>60</code>
                        <code>61</code>
                        <code>62</code>
                        <code>63</code>
                        <code>64</code>
                        <code>65</code>
                        <code>66</code>
                        <code>67</code>
                        <code>68</code>
                        <code>69</code>
                        <code>70</code>
                        <code>71</code>
                        <code>72</code>
                        <code>73</code>
                        <code>74</code>
                        <code>75</code>
                        <code>76</code>
                        <code>77</code>
                        <code>78</code>
                        <code>79</code>
                        <code>80</code>
                        <code>81</code>
                        <code>82</code>
                        <code>83</code>
                        <code>84</code>
                        <code>85</code>
                        <code>86</code>
                        <code>87</code>
                        <code>88</code>
                        <code>89</code>
                        <code>90</code>
                        <code>91</code>
                        <code>92</code>
                        <code>93</code>
                        <code>94</code>
                        <code>95</code>
                        <code>96</code>
                        <code>97</code>
                        <code>98</code>
                        <code>99</code>
                        <code>100</code>
                        <code>101</code>
                        <code>102</code>
                        <code>103</code>
                        <code>104</code>
                        <code>105</code>
                        <code>106</code>
                        <code>107</code>
                        <code>108</code>
                        <code>109</code>
                        <code>110</code>
                        <code>111</code>
                        <code>112</code>
                        <code>113</code>
                        <code>114</code>
                        <code>115</code>
                        <code>116</code>
                        <code>117</code>
                        <code>118</code>
                        <code>119</code>
                        <code>120</code>
                        <code>121</code>
                        <code>122</code>
                        <code>123</code>
                        <code>124</code>
                        <code>125</code>
                        <code>126</code>
                        <code>127</code>
                        <code>128</code>
                        <code>129</code>
                        <code>130</code>
                        <code>131</code>
                        <code>132</code>
                        <code>133</code>
                        <code>134</code>
                        <code>135</code>
                        <code>136</code>
                        <code>137</code>
                        <code>138</code>
                        <code>139</code>
                        <code>140</code>
                        <code>141</code>
                        <code>142</code>
                        <code>143</code>
                        <code>144</code>
                        <code>145</code>
                        <code>146</code>
                        <code>147</code>
                        <code>148</code>
                        <code>149</code>
                        <code>150</code>
                        <code>151</code>
                        <code>152</code>
                        <code>153</code>
                        <code>154</code>
                        <code>A0</code>
                        <code>A1</code>
                        <code>A2</code>
                        <code>A3</code>
                        <code>A4</code>
                        <code>A5</code>
                        <code>A6</code>
                        <code>A7</code>
                        <code>A8</code>
                        <code>B1</code>
                        <code>B2</code>
                        <code>B3</code>
                        <code>B4</code>
                        <code>B5</code>
                        <code>B6</code>
                        <code>B7</code>
                        <code>B8</code>
                        <code>B9</code>
                        <code>B10</code>
                        <code>B11</code>
                        <code>B12</code>
                        <code>B13</code>
                        <code>B14</code>
                        <code>B15</code>
                        <code>B16</code>
                        <code>B17</code>
                        <code>B18</code>
                        <code>B19</code>
                        <code>B20</code>
                        <code>B21</code>
                        <code>B22</code>
                        <code>B23</code>
                        <code>D1</code>
                        <code>D2</code>
                        <code>D3</code>
                        <code>D4</code>
                        <code>D5</code>
                        <code>D6</code>
                        <code>D7</code>
                        <code>D8</code>
                        <code>D9</code>
                        <code>D10</code>
                        <code>D11</code>
                        <code>D12</code>
                        <code>D13</code>
                        <code>D14</code>
                        <code>D15</code>
                        <code>W1</code>
                      </valid_codes>
                    </element>
                    <element xid="CAS12">
                      <data_ele>782</data_ele>
                      <name>Adjustment Amount</name>
                      <usage>S</usage>
                      <seq>12</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="CAS13">
                      <data_ele>380</data_ele>
                      <name>Adjustment Quantity</name>
                      <usage>S</usage>
                      <seq>13</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="CAS14">
                      <data_ele>1034</data_ele>
                      <name>Adjustment Reason Code</name>
                      <usage>S</usage>
                      <seq>14</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>5</max_len>
                      <valid_codes>
                        <code>1</code>
                        <code>2</code>
                        <code>3</code>
                        <code>4</code>
                        <code>5</code>
                        <code>6</code>
                        <code>7</code>
                        <code>8</code>
                        <code>9</code>
                        <code>10</code>
                        <code>11</code>
                        <code>12</code>
                        <code>13</code>
                        <code>14</code>
                        <code>15</code>
                        <code>16</code>
                        <code>17</code>
                        <code>18</code>
                        <code>19</code>
                        <code>20</code>
                        <code>21</code>
                        <code>22</code>
                        <code>23</code>
                        <code>24</code>
                        <code>25</code>
                        <code>26</code>
                        <code>27</code>
                        <code>28</code>
                        <code>29</code>
                        <code>30</code>
                        <code>31</code>
                        <code>32</code>
                        <code>33</code>
                        <code>34</code>
                        <code>35</code>
                        <code>36</code>
                        <code>37</code>
                        <code>38</code>
                        <code>39</code>
                        <code>40</code>
                        <code>41</code>
                        <code>42</code>
                        <code>43</code>
                        <code>44</code>
                        <code>45</code>
                        <code>46</code>
                        <code>47</code>
                        <code>48</code>
                        <code>49</code>
                        <code>50</code>
                        <code>51</code>
                        <code>52</code>
                        <code>53</code>
                        <code>54</code>
                        <code>55</code>
                        <code>56</code>
                        <code>57</code>
                        <code>58</code>
                        <code>59</code>
                        <code>60</code>
                        <code>61</code>
                        <code>62</code>
                        <code>63</code>
                        <code>64</code>
                        <code>65</code>
                        <code>66</code>
                        <code>67</code>
                        <code>68</code>
                        <code>69</code>
                        <code>70</code>
                        <code>71</code>
                        <code>72</code>
                        <code>73</code>
                        <code>74</code>
                        <code>75</code>
                        <code>76</code>
                        <code>77</code>
                        <code>78</code>
                        <code>79</code>
                        <code>80</code>
                        <code>81</code>
                        <code>82</code>
                        <code>83</code>
                        <code>84</code>
                        <code>85</code>
                        <code>86</code>
                        <code>87</code>
                        <code>88</code>
                        <code>89</code>
                        <code>90</code>
                        <code>91</code>
                        <code>92</code>
                        <code>93</code>
                        <code>94</code>
                        <code>95</code>
                        <code>96</code>
                        <code>97</code>
                        <code>98</code>
                        <code>99</code>
                        <code>100</code>
                        <code>101</code>
                        <code>102</code>
                        <code>103</code>
                        <code>104</code>
                        <code>105</code>
                        <code>106</code>
                        <code>107</code>
                        <code>108</code>
                        <code>109</code>
                        <code>110</code>
                        <code>111</code>
                        <code>112</code>
                        <code>113</code>
                        <code>114</code>
                        <code>115</code>
                        <code>116</code>
                        <code>117</code>
                        <code>118</code>
                        <code>119</code>
                        <code>120</code>
                        <code>121</code>
                        <code>122</code>
                        <code>123</code>
                        <code>124</code>
                        <code>125</code>
                        <code>126</code>
                        <code>127</code>
                        <code>128</code>
                        <code>129</code>
                        <code>130</code>
                        <code>131</code>
                        <code>132</code>
                        <code>133</code>
                        <code>134</code>
                        <code>135</code>
                        <code>136</code>
                        <code>137</code>
                        <code>138</code>
                        <code>139</code>
                        <code>140</code>
                        <code>141</code>
                        <code>142</code>
                        <code>143</code>
                        <code>144</code>
                        <code>145</code>
                        <code>146</code>
                        <code>147</code>
                        <code>148</code>
                        <code>149</code>
                        <code>150</code>
                        <code>151</code>
                        <code>152</code>
                        <code>153</code>
                        <code>154</code>
                        <code>A0</code>
                        <code>A1</code>
                        <code>A2</code>
                        <code>A3</code>
                        <code>A4</code>
                        <code>A5</code>
                        <code>A6</code>
                        <code>A7</code>
                        <code>A8</code>
                        <code>B1</code>
                        <code>B2</code>
                        <code>B3</code>
                        <code>B4</code>
                        <code>B5</code>
                        <code>B6</code>
                        <code>B7</code>
                        <code>B8</code>
                        <code>B9</code>
                        <code>B10</code>
                        <code>B11</code>
                        <code>B12</code>
                        <code>B13</code>
                        <code>B14</code>
                        <code>B15</code>
                        <code>B16</code>
                        <code>B17</code>
                        <code>B18</code>
                        <code>B19</code>
                        <code>B20</code>
                        <code>B21</code>
                        <code>B22</code>
                        <code>B23</code>
                        <code>D1</code>
                        <code>D2</code>
                        <code>D3</code>
                        <code>D4</code>
                        <code>D5</code>
                        <code>D6</code>
                        <code>D7</code>
                        <code>D8</code>
                        <code>D9</code>
                        <code>D10</code>
                        <code>D11</code>
                        <code>D12</code>
                        <code>D13</code>
                        <code>D14</code>
                        <code>D15</code>
                        <code>W1</code>
                      </valid_codes>
                    </element>
                    <element xid="CAS15">
                      <data_ele>782</data_ele>
                      <name>Adjustment Amount</name>
                      <usage>S</usage>
                      <seq>15</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="CAS16">
                      <data_ele>380</data_ele>
                      <name>Adjustment Quantity</name>
                      <usage>S</usage>
                      <seq>16</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="CAS17">
                      <data_ele>1034</data_ele>
                      <name>Adjustment Reason Code</name>
                      <usage>S</usage>
                      <seq>17</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>5</max_len>
                      <valid_codes>
                        <code>1</code>
                        <code>2</code>
                        <code>3</code>
                        <code>4</code>
                        <code>5</code>
                        <code>6</code>
                        <code>7</code>
                        <code>8</code>
                        <code>9</code>
                        <code>10</code>
                        <code>11</code>
                        <code>12</code>
                        <code>13</code>
                        <code>14</code>
                        <code>15</code>
                        <code>16</code>
                        <code>17</code>
                        <code>18</code>
                        <code>19</code>
                        <code>20</code>
                        <code>21</code>
                        <code>22</code>
                        <code>23</code>
                        <code>24</code>
                        <code>25</code>
                        <code>26</code>
                        <code>27</code>
                        <code>28</code>
                        <code>29</code>
                        <code>30</code>
                        <code>31</code>
                        <code>32</code>
                        <code>33</code>
                        <code>34</code>
                        <code>35</code>
                        <code>36</code>
                        <code>37</code>
                        <code>38</code>
                        <code>39</code>
                        <code>40</code>
                        <code>41</code>
                        <code>42</code>
                        <code>43</code>
                        <code>44</code>
                        <code>45</code>
                        <code>46</code>
                        <code>47</code>
                        <code>48</code>
                        <code>49</code>
                        <code>50</code>
                        <code>51</code>
                        <code>52</code>
                        <code>53</code>
                        <code>54</code>
                        <code>55</code>
                        <code>56</code>
                        <code>57</code>
                        <code>58</code>
                        <code>59</code>
                        <code>60</code>
                        <code>61</code>
                        <code>62</code>
                        <code>63</code>
                        <code>64</code>
                        <code>65</code>
                        <code>66</code>
                        <code>67</code>
                        <code>68</code>
                        <code>69</code>
                        <code>70</code>
                        <code>71</code>
                        <code>72</code>
                        <code>73</code>
                        <code>74</code>
                        <code>75</code>
                        <code>76</code>
                        <code>77</code>
                        <code>78</code>
                        <code>79</code>
                        <code>80</code>
                        <code>81</code>
                        <code>82</code>
                        <code>83</code>
                        <code>84</code>
                        <code>85</code>
                        <code>86</code>
                        <code>87</code>
                        <code>88</code>
                        <code>89</code>
                        <code>90</code>
                        <code>91</code>
                        <code>92</code>
                        <code>93</code>
                        <code>94</code>
                        <code>95</code>
                        <code>96</code>
                        <code>97</code>
                        <code>98</code>
                        <code>99</code>
                        <code>100</code>
                        <code>101</code>
                        <code>102</code>
                        <code>103</code>
                        <code>104</code>
                        <code>105</code>
                        <code>106</code>
                        <code>107</code>
                        <code>108</code>
                        <code>109</code>
                        <code>110</code>
                        <code>111</code>
                        <code>112</code>
                        <code>113</code>
                        <code>114</code>
                        <code>115</code>
                        <code>116</code>
                        <code>117</code>
                        <code>118</code>
                        <code>119</code>
                        <code>120</code>
                        <code>121</code>
                        <code>122</code>
                        <code>123</code>
                        <code>124</code>
                        <code>125</code>
                        <code>126</code>
                        <code>127</code>
                        <code>128</code>
                        <code>129</code>
                        <code>130</code>
                        <code>131</code>
                        <code>132</code>
                        <code>133</code>
                        <code>134</code>
                        <code>135</code>
                        <code>136</code>
                        <code>137</code>
                        <code>138</code>
                        <code>139</code>
                        <code>140</code>
                        <code>141</code>
                        <code>142</code>
                        <code>143</code>
                        <code>144</code>
                        <code>145</code>
                        <code>146</code>
                        <code>147</code>
                        <code>148</code>
                        <code>149</code>
                        <code>150</code>
                        <code>151</code>
                        <code>152</code>
                        <code>153</code>
                        <code>154</code>
                        <code>A0</code>
                        <code>A1</code>
                        <code>A2</code>
                        <code>A3</code>
                        <code>A4</code>
                        <code>A5</code>
                        <code>A6</code>
                        <code>A7</code>
                        <code>A8</code>
                        <code>B1</code>
                        <code>B2</code>
                        <code>B3</code>
                        <code>B4</code>
                        <code>B5</code>
                        <code>B6</code>
                        <code>B7</code>
                        <code>B8</code>
                        <code>B9</code>
                        <code>B10</code>
                        <code>B11</code>
                        <code>B12</code>
                        <code>B13</code>
                        <code>B14</code>
                        <code>B15</code>
                        <code>B16</code>
                        <code>B17</code>
                        <code>B18</code>
                        <code>B19</code>
                        <code>B20</code>
                        <code>B21</code>
                        <code>B22</code>
                        <code>B23</code>
                        <code>D1</code>
                        <code>D2</code>
                        <code>D3</code>
                        <code>D4</code>
                        <code>D5</code>
                        <code>D6</code>
                        <code>D7</code>
                        <code>D8</code>
                        <code>D9</code>
                        <code>D10</code>
                        <code>D11</code>
                        <code>D12</code>
                        <code>D13</code>
                        <code>D14</code>
                        <code>D15</code>
                        <code>W1</code>
                      </valid_codes>
                    </element>
                    <element xid="CAS18">
                      <data_ele>782</data_ele>
                      <name>Adjustment Amount</name>
                      <usage>S</usage>
                      <seq>18</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="CAS19">
                      <data_ele>380</data_ele>
                      <name>Adjustment Quantity</name>
                      <usage>S</usage>
                      <seq>19</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                  </segment>
<!--End of CAS segment-->
                  <segment xid="AMT">
                    <name>Payer Prior Payment</name>
                    <usage>S</usage>
                    <pos>300</pos>
                    <max_use>1</max_use>
                    <element xid="AMT01">
                      <data_ele>522</data_ele>
                      <name>Amount Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>C4</code>
                      </valid_codes>
                    </element>
                    <element xid="AMT02">
                      <data_ele>782</data_ele>
                      <name>Other Payer Patient Paid Amount</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="AMT03">
                      <data_ele>478</data_ele>
                      <name>Credit/Debit Flag Code</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                  </segment>
<!--End of AMT segment-->
                  <segment xid="AMT">
                    <name>Coordination of Benefits (COB) Total Allowed Amount</name>
                    <usage>S</usage>
                    <pos>300</pos>
                    <max_use>1</max_use>
                    <element xid="AMT01">
                      <data_ele>522</data_ele>
                      <name>Amount Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>B6</code>
                      </valid_codes>
                    </element>
                    <element xid="AMT02">
                      <data_ele>782</data_ele>
                      <name>Allowed Amount</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="AMT03">
                      <data_ele>478</data_ele>
                      <name>Credit/Debit Flag Code</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                  </segment>
<!--End of AMT segment-->
                  <segment xid="AMT">
                    <name>Coordination of Benefits (COB) Total Submitted Charges</name>
                    <usage>S</usage>
                    <pos>300</pos>
                    <max_use>1</max_use>
                    <element xid="AMT01">
                      <data_ele>522</data_ele>
                      <name>Amount Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>T3</code>
                      </valid_codes>
                    </element>
                    <element xid="AMT02">
                      <data_ele>782</data_ele>
                      <name>Coordination of Benefits Total Submitted Charge Amount</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="AMT03">
                      <data_ele>478</data_ele>
                      <name>Credit/Debit Flag Code</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                  </segment>
<!--End of AMT segment-->
                  <segment xid="AMT">
                    <name>Diagnostic Related Group (DRG) Outlier Amount</name>
                    <usage>S</usage>
                    <pos>300</pos>
                    <max_use>1</max_use>
                    <element xid="AMT01">
                      <data_ele>522</data_ele>
                      <name>Amount Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>ZZ</code>
                      </valid_codes>
                    </element>
                    <element xid="AMT02">
                      <data_ele>782</data_ele>
                      <name>Claim DRG Outlier Amount</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="AMT03">
                      <data_ele>478</data_ele>
                      <name>Credit/Debit Flag Code</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                  </segment>
<!--End of AMT segment-->
                  <segment xid="AMT">
                    <name>Coordination of Benefits (COB) Total Medicare Paid Amount</name>
                    <usage>S</usage>
                    <pos>300</pos>
                    <max_use>1</max_use>
                    <element xid="AMT01">
                      <data_ele>522</data_ele>
                      <name>Amount Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>N1</code>
                      </valid_codes>
                    </element>
                    <element xid="AMT02">
                      <data_ele>782</data_ele>
                      <name>Total Medicare Paid Amount</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="AMT03">
                      <data_ele>478</data_ele>
                      <name>Credit/Debit Flag Code</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                  </segment>
<!--End of AMT segment-->
                  <segment xid="AMT">
                    <name>Medicare Paid Amount - 100%</name>
                    <usage>S</usage>
                    <pos>300</pos>
                    <max_use>1</max_use>
                    <element xid="AMT01">
                      <data_ele>522</data_ele>
                      <name>Amount Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>KF</code>
                      </valid_codes>
                    </element>
                    <element xid="AMT02">
                      <data_ele>782</data_ele>
                      <name>Medicare Paid at 100% Amount</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="AMT03">
                      <data_ele>478</data_ele>
                      <name>Credit/Debit Flag Code</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                  </segment>
<!--End of AMT segment-->
                  <segment xid="AMT">
                    <name>Medicare Paid Amount - 80%</name>
                    <usage>S</usage>
                    <pos>300</pos>
                    <max_use>1</max_use>
                    <element xid="AMT01">
                      <data_ele>522</data_ele>
                      <name>Amount Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>PG</code>
                      </valid_codes>
                    </element>
                    <element xid="AMT02">
                      <data_ele>782</data_ele>
                      <name>Medicare Paid at 80% Amount</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="AMT03">
                      <data_ele>478</data_ele>
                      <name>Credit/Debit Flag Code</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                  </segment>
<!--End of AMT segment-->
                  <segment xid="AMT">
                    <name>Coordination of Benefits (COB) Medicare A Trust Fund Paid Amount</name>
                    <usage>S</usage>
                    <pos>300</pos>
                    <max_use>1</max_use>
                    <element xid="AMT01">
                      <data_ele>522</data_ele>
                      <name>Amount Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>AA</code>
                      </valid_codes>
                    </element>
                    <element xid="AMT02">
                      <data_ele>782</data_ele>
                      <name>Paid From Part A Medicare Trust Fund Amount</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="AMT03">
                      <data_ele>478</data_ele>
                      <name>Credit/Debit Flag Code</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                  </segment>
<!--End of AMT segment-->
                  <segment xid="AMT">
                    <name>Coordination of Benefits (COB) Medicare B Trust Fund Paid Amount</name>
                    <usage>S</usage>
                    <pos>300</pos>
                    <max_use>1</max_use>
                    <element xid="AMT01">
                      <data_ele>522</data_ele>
                      <name>Amount Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>B1</code>
                      </valid_codes>
                    </element>
                    <element xid="AMT02">
                      <data_ele>782</data_ele>
                      <name>Paid From Part B Medicare Trust Fund Amount</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="AMT03">
                      <data_ele>478</data_ele>
                      <name>Credit/Debit Flag Code</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                  </segment>
<!--End of AMT segment-->
                  <segment xid="AMT">
                    <name>Coordination of Benefits (COB) Total Non-Covered Amount</name>
                    <usage>S</usage>
                    <pos>300</pos>
                    <max_use>1</max_use>
                    <element xid="AMT01">
                      <data_ele>522</data_ele>
                      <name>Amount Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>A8</code>
                      </valid_codes>
                    </element>
                    <element xid="AMT02">
                      <data_ele>782</data_ele>
                      <name>Non-Covered Charge Amount</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="AMT03">
                      <data_ele>478</data_ele>
                      <name>Credit/Debit Flag Code</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                  </segment>
<!--End of AMT segment-->
                  <segment xid="AMT">
                    <name>Coordination of Benefits (COB) Total Denied Amount</name>
                    <usage>S</usage>
                    <pos>300</pos>
                    <max_use>1</max_use>
                    <element xid="AMT01">
                      <data_ele>522</data_ele>
                      <name>Amount Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>YT</code>
                      </valid_codes>
                    </element>
                    <element xid="AMT02">
                      <data_ele>782</data_ele>
                      <name>Claim Total Denied Charge Amount</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="AMT03">
                      <data_ele>478</data_ele>
                      <name>Credit/Debit Flag Code</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                  </segment>
<!--End of AMT segment-->
                  <segment xid="DMG">
                    <name>Other Subscriber Demographic Information</name>
                    <usage>S</usage>
                    <pos>305</pos>
                    <max_use>1</max_use>
                    <element xid="DMG01">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>D8</code>
                      </valid_codes>
                    </element>
                    <element xid="DMG02">
                      <data_ele>1251</data_ele>
                      <name>Other Insured Birth Date</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="DMG03">
                      <data_ele>1068</data_ele>
                      <name>Other Insured Gender Code</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                      <valid_codes>
                        <code>F</code>
                        <code>M</code>
                        <code>U</code>
                      </valid_codes>
                    </element>
                    <element xid="DMG04">
                      <data_ele>1067</data_ele>
                      <name>Marital Status Code</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                    <element xid="DMG05">
                      <data_ele>1109</data_ele>
                      <name>nicity Code</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                    <element xid="DMG06">
                      <data_ele>1066</data_ele>
                      <name>Citizenship Status Code</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                    </element>
                    <element xid="DMG07">
                      <data_ele>26</data_ele>
                      <name>Country Code</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes external="country"/>
                    </element>
                    <element xid="DMG08">
                      <data_ele>659</data_ele>
                      <name>Basis of Verification Code</name>
                      <usage>N</usage>
                      <seq>08</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                    </element>
                    <element xid="DMG09">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>09</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                  </segment>
<!--End of DMG segment-->
                  <segment xid="OI">
                    <name>Other Insurance Coverage Information</name>
                    <usage>R</usage>
                    <pos>310</pos>
                    <max_use>1</max_use>
                    <element xid="OI01">
                      <data_ele>1032</data_ele>
                      <name>Claim Filing Indicator Code</name>
                      <usage>N</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                    </element>
                    <element xid="OI02">
                      <data_ele>1383</data_ele>
                      <name>Claim Submission Reason Code</name>
                      <usage>N</usage>
                      <seq>02</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                    </element>
                    <element xid="OI03">
                      <data_ele>1073</data_ele>
                      <name>Benefits Assignment Certification Indicator</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                      <valid_codes>
                        <code>N</code>
                        <code>Y</code>
                      </valid_codes>
                    </element>
                    <element xid="OI04">
                      <data_ele>1351</data_ele>
                      <name>Patient Signature Source Code</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                    <element xid="OI05">
                      <data_ele>1360</data_ele>
                      <name>Provider Agreement Code</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                    <element xid="OI06">
                      <data_ele>1363</data_ele>
                      <name>Release of Information Code</name>
                      <usage>R</usage>
                      <seq>06</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                      <valid_codes>
                        <code>A</code>
                        <code>I</code>
                        <code>M</code>
                        <code>N</code>
                        <code>O</code>
                        <code>Y</code>
                      </valid_codes>
                    </element>
                  </segment>
<!--End of OI segment-->
                  <segment xid="MIA">
                    <name>Medicare Inpatient Adjudication Information</name>
                    <usage>S</usage>
                    <pos>315</pos>
                    <max_use>1</max_use>
                    <element xid="MIA01">
                      <data_ele>380</data_ele>
                      <name>Covered Days or Visits Count</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="MIA02">
                      <data_ele>380</data_ele>
                      <name>Lifetime Reserve Days Count</name>
                      <usage>S</usage>
                      <seq>02</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="MIA03">
                      <data_ele>380</data_ele>
                      <name>Lifetime Psychiatric Days Count</name>
                      <usage>S</usage>
                      <seq>03</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="MIA04">
                      <data_ele>782</data_ele>
                      <name>Claim DRG Amount</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="MIA05">
                      <data_ele>127</data_ele>
                      <name>Remark Code</name>
                      <usage>S</usage>
                      <seq>05</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                      <valid_codes>
                        <code>M1</code>
                        <code>M2</code>
                        <code>M3</code>
                        <code>M4</code>
                        <code>M5</code>
                        <code>M6</code>
                        <code>M7</code>
                        <code>M8</code>
                        <code>M9</code>
                        <code>M10</code>
                        <code>M11</code>
                        <code>M12</code>
                        <code>M13</code>
                        <code>M14</code>
                        <code>M15</code>
                        <code>M16</code>
                        <code>M17</code>
                        <code>M18</code>
                        <code>M19</code>
                        <code>M20</code>
                        <code>M21</code>
                        <code>M22</code>
                        <code>M23</code>
                        <code>M24</code>
                        <code>M25</code>
                        <code>M26</code>
                        <code>M27</code>
                        <code>M28</code>
                        <code>M29</code>
                        <code>M30</code>
                        <code>M31</code>
                        <code>M32</code>
                        <code>M33</code>
                        <code>M34</code>
                        <code>M35</code>
                        <code>M36</code>
                        <code>M37</code>
                        <code>M38</code>
                        <code>M39</code>
                        <code>M40</code>
                        <code>M41</code>
                        <code>M42</code>
                        <code>M43</code>
                        <code>M44</code>
                        <code>M45</code>
                        <code>M46</code>
                        <code>M47</code>
                        <code>M48</code>
                        <code>M49</code>
                        <code>M50</code>
                        <code>M51</code>
                        <code>M52</code>
                        <code>M53</code>
                        <code>M54</code>
                        <code>M55</code>
                        <code>M56</code>
                        <code>M57</code>
                        <code>M58</code>
                        <code>M59</code>
                        <code>M60</code>
                        <code>M61</code>
                        <code>M62</code>
                        <code>M63</code>
                        <code>M64</code>
                        <code>M65</code>
                        <code>M66</code>
                        <code>M67</code>
                        <code>M68</code>
                        <code>M69</code>
                        <code>M70</code>
                        <code>M71</code>
                        <code>M72</code>
                        <code>M73</code>
                        <code>M74</code>
                        <code>M75</code>
                        <code>M76</code>
                        <code>M77</code>
                        <code>M78</code>
                        <code>M79</code>
                        <code>M80</code>
                        <code>M81</code>
                        <code>M82</code>
                        <code>M83</code>
                        <code>M84</code>
                        <code>M85</code>
                        <code>M86</code>
                        <code>M87</code>
                        <code>M88</code>
                        <code>M89</code>
                        <code>M90</code>
                        <code>M91</code>
                        <code>M92</code>
                        <code>M93</code>
                        <code>M94</code>
                        <code>M95</code>
                        <code>M96</code>
                        <code>M97</code>
                        <code>M98</code>
                        <code>M99</code>
                        <code>M100</code>
                        <code>M101</code>
                        <code>M102</code>
                        <code>M103</code>
                        <code>M104</code>
                        <code>M105</code>
                        <code>M106</code>
                        <code>M107</code>
                        <code>M108</code>
                        <code>M109</code>
                        <code>M110</code>
                        <code>M111</code>
                        <code>M112</code>
                        <code>M113</code>
                        <code>M114</code>
                        <code>M115</code>
                        <code>M116</code>
                        <code>M117</code>
                        <code>M118</code>
                        <code>M119</code>
                        <code>M120</code>
                        <code>M121</code>
                        <code>M122</code>
                        <code>M123</code>
                        <code>M124</code>
                        <code>M125</code>
                        <code>M126</code>
                        <code>M127</code>
                        <code>M128</code>
                        <code>M129</code>
                        <code>M130</code>
                        <code>M131</code>
                        <code>M132</code>
                        <code>M133</code>
                        <code>M134</code>
                        <code>M135</code>
                        <code>M136</code>
                        <code>M137</code>
                        <code>M138</code>
                        <code>M139</code>
                        <code>M140</code>
                        <code>M141</code>
                        <code>M142</code>
                        <code>M143</code>
                        <code>M144</code>
                        <code>MA01</code>
                        <code>MA02</code>
                        <code>MA03</code>
                        <code>MA04</code>
                        <code>MA05</code>
                        <code>MA06</code>
                        <code>MA07</code>
                        <code>MA08</code>
                        <code>MA09</code>
                        <code>MA10</code>
                        <code>MA11</code>
                        <code>MA12</code>
                        <code>MA13</code>
                        <code>MA14</code>
                        <code>MA15</code>
                        <code>MA16</code>
                        <code>MA17</code>
                        <code>MA18</code>
                        <code>MA19</code>
                        <code>MA20</code>
                        <code>MA21</code>
                        <code>MA22</code>
                        <code>MA23</code>
                        <code>MA24</code>
                        <code>MA25</code>
                        <code>MA26</code>
                        <code>MA27</code>
                        <code>MA28</code>
                        <code>MA29</code>
                        <code>MA30</code>
                        <code>MA31</code>
                        <code>MA32</code>
                        <code>MA33</code>
                        <code>MA34</code>
                        <code>MA35</code>
                        <code>MA36</code>
                        <code>MA37</code>
                        <code>MA38</code>
                        <code>MA39</code>
                        <code>MA40</code>
                        <code>MA41</code>
                        <code>MA42</code>
                        <code>MA43</code>
                        <code>MA44</code>
                        <code>MA45</code>
                        <code>MA46</code>
                        <code>MA47</code>
                        <code>MA48</code>
                        <code>MA49</code>
                        <code>MA50</code>
                        <code>MA51</code>
                        <code>MA52</code>
                        <code>MA53</code>
                        <code>MA54</code>
                        <code>MA55</code>
                        <code>MA56</code>
                        <code>MA57</code>
                        <code>MA58</code>
                        <code>MA59</code>
                        <code>MA60</code>
                        <code>MA61</code>
                        <code>MA62</code>
                        <code>MA63</code>
                        <code>MA64</code>
                        <code>MA65</code>
                        <code>MA66</code>
                        <code>MA67</code>
                        <code>MA68</code>
                        <code>MA69</code>
                        <code>MA70</code>
                        <code>MA71</code>
                        <code>MA72</code>
                        <code>MA73</code>
                        <code>MA74</code>
                        <code>MA75</code>
                        <code>MA76</code>
                        <code>MA77</code>
                        <code>MA78</code>
                        <code>MA79</code>
                        <code>MA80</code>
                        <code>MA81</code>
                        <code>MA82</code>
                        <code>MA83</code>
                        <code>MA84</code>
                        <code>MA85</code>
                        <code>MA86</code>
                        <code>MA87</code>
                        <code>MA88</code>
                        <code>MA89</code>
                        <code>MA90</code>
                        <code>MA91</code>
                        <code>MA92</code>
                        <code>MA93</code>
                        <code>MA94</code>
                        <code>MA95</code>
                        <code>MA96</code>
                        <code>MA97</code>
                        <code>MA98</code>
                        <code>MA99</code>
                        <code>MA100</code>
                        <code>MA101</code>
                        <code>MA102</code>
                        <code>MA103</code>
                        <code>MA104</code>
                        <code>MA105</code>
                        <code>MA106</code>
                        <code>MA107</code>
                        <code>MA108</code>
                        <code>MA109</code>
                        <code>MA110</code>
                        <code>MA111</code>
                        <code>MA112</code>
                        <code>MA113</code>
                        <code>MA114</code>
                        <code>MA115</code>
                        <code>MA116</code>
                        <code>MA117</code>
                        <code>MA118</code>
                        <code>MA119</code>
                        <code>MA120</code>
                        <code>MA121</code>
                        <code>MA122</code>
                        <code>MA123</code>
                        <code>MA124</code>
                        <code>MA125</code>
                        <code>MA126</code>
                        <code>MA127</code>
                        <code>MA128</code>
                        <code>MA129</code>
                        <code>MA130</code>
                        <code>MA131</code>
                        <code>MA132</code>
                        <code>MA133</code>
                        <code>MA134</code>
                        <code>N1</code>
                        <code>N2</code>
                        <code>N3</code>
                        <code>N4</code>
                        <code>N5</code>
                        <code>N6</code>
                        <code>N7</code>
                        <code>N8</code>
                        <code>N9</code>
                        <code>N10</code>
                        <code>N11</code>
                        <code>N12</code>
                        <code>N13</code>
                        <code>N14</code>
                        <code>N15</code>
                        <code>N16</code>
                        <code>N17</code>
                        <code>N18</code>
                        <code>N19</code>
                        <code>N20</code>
                        <code>N21</code>
                        <code>N22</code>
                        <code>N23</code>
                        <code>N24</code>
                        <code>N25</code>
                        <code>N26</code>
                        <code>N27</code>
                        <code>N28</code>
                        <code>N29</code>
                        <code>N30</code>
                        <code>N31</code>
                        <code>N32</code>
                        <code>N33</code>
                        <code>N34</code>
                        <code>N35</code>
                        <code>N36</code>
                        <code>N37</code>
                        <code>N38</code>
                        <code>N39</code>
                        <code>N40</code>
                        <code>N41</code>
                        <code>N42</code>
                        <code>N43</code>
                        <code>N44</code>
                        <code>N45</code>
                        <code>N46</code>
                        <code>N47</code>
                        <code>N48</code>
                        <code>N49</code>
                        <code>N50</code>
                        <code>N51</code>
                        <code>N52</code>
                        <code>N53</code>
                        <code>N54</code>
                        <code>N55</code>
                        <code>N56</code>
                        <code>N57</code>
                        <code>N58</code>
                        <code>N59</code>
                        <code>N60</code>
                        <code>N61</code>
                        <code>N62</code>
                        <code>N63</code>
                        <code>N64</code>
                        <code>N65</code>
                        <code>N66</code>
                        <code>N67</code>
                        <code>N68</code>
                        <code>N69</code>
                        <code>N70</code>
                        <code>N71</code>
                        <code>N72</code>
                        <code>N73</code>
                        <code>N74</code>
                        <code>N75</code>
                        <code>N76</code>
                        <code>N77</code>
                        <code>N78</code>
                        <code>N79</code>
                        <code>N80</code>
                        <code>N81</code>
                        <code>N82</code>
                        <code>N83</code>
                        <code>N84</code>
                        <code>N85</code>
                        <code>N86</code>
                        <code>N87</code>
                        <code>N88</code>
                        <code>N89</code>
                        <code>N90</code>
                        <code>N91</code>
                        <code>N92</code>
                        <code>N93</code>
                        <code>N94</code>
                        <code>N95</code>
                        <code>N96</code>
                        <code>N97</code>
                        <code>N98</code>
                        <code>N99</code>
                        <code>N100</code>
                        <code>N101</code>
                        <code>N102</code>
                        <code>N103</code>
                        <code>N104</code>
                        <code>N105</code>
                        <code>N106</code>
                        <code>N107</code>
                        <code>N108</code>
                        <code>N109</code>
                        <code>N110</code>
                        <code>N111</code>
                        <code>N112</code>
                        <code>N113</code>
                        <code>N114</code>
                        <code>N115</code>
                        <code>N116</code>
                        <code>N117</code>
                        <code>N118</code>
                        <code>N119</code>
                        <code>N120</code>
                        <code>N121</code>
                        <code>N122</code>
                        <code>N123</code>
                        <code>N124</code>
                        <code>N125</code>
                        <code>N126</code>
                        <code>N127</code>
                        <code>N128</code>
                        <code>N129</code>
                        <code>N130</code>
                        <code>N131</code>
                        <code>N132</code>
                        <code>N133</code>
                        <code>N134</code>
                        <code>N135</code>
                        <code>N136</code>
                        <code>N137</code>
                        <code>N138</code>
                        <code>N139</code>
                        <code>N140</code>
                        <code>N141</code>
                        <code>N142</code>
                        <code>N143</code>
                        <code>N144</code>
                        <code>N145</code>
                        <code>N146</code>
                        <code>N147</code>
                        <code>N148</code>
                        <code>N149</code>
                        <code>N150</code>
                        <code>N151</code>
                        <code>N152</code>
                        <code>N153</code>
                        <code>N154</code>
                        <code>N155</code>
                        <code>N156 </code>
                      </valid_codes>
                    </element>
                    <element xid="MIA06">
                      <data_ele>782</data_ele>
                      <name>Claim Disproportionate Share Amount</name>
                      <usage>S</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="MIA07">
                      <data_ele>782</data_ele>
                      <name>Claim MSP Pass-through Amount</name>
                      <usage>S</usage>
                      <seq>07</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="MIA08">
                      <data_ele>782</data_ele>
                      <name>Claim PPS Capital Amount</name>
                      <usage>S</usage>
                      <seq>08</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="MIA09">
                      <data_ele>782</data_ele>
                      <name>PPS-Capital FSP DRG Amount</name>
                      <usage>S</usage>
                      <seq>09</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="MIA10">
                      <data_ele>782</data_ele>
                      <name>PPS-Capital HSP DRG Amount</name>
                      <usage>S</usage>
                      <seq>10</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="MIA11">
                      <data_ele>782</data_ele>
                      <name>PPS-Capital DSH DRG Amount</name>
                      <usage>S</usage>
                      <seq>11</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="MIA12">
                      <data_ele>782</data_ele>
                      <name>Old Capital Amount</name>
                      <usage>S</usage>
                      <seq>12</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="MIA13">
                      <data_ele>782</data_ele>
                      <name>PPS-Capital IME Amount</name>
                      <usage>S</usage>
                      <seq>13</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="MIA14">
                      <data_ele>782</data_ele>
                      <name>PPS-Operating Hospital Specific DRG Amount</name>
                      <usage>S</usage>
                      <seq>14</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="MIA15">
                      <data_ele>380</data_ele>
                      <name>Cost Report Day Count</name>
                      <usage>S</usage>
                      <seq>15</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="MIA16">
                      <data_ele>782</data_ele>
                      <name>PPS-Operating Federal Specific DRG Amount</name>
                      <usage>S</usage>
                      <seq>16</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="MIA17">
                      <data_ele>782</data_ele>
                      <name>Claim PPS Capital Outlier Amount</name>
                      <usage>S</usage>
                      <seq>17</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="MIA18">
                      <data_ele>782</data_ele>
                      <name>Claim Indirect Teaching Amount</name>
                      <usage>S</usage>
                      <seq>18</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="MIA19">
                      <data_ele>782</data_ele>
                      <name>Nonpayable Professional Component Amount</name>
                      <usage>S</usage>
                      <seq>19</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="MIA20">
                      <data_ele>127</data_ele>
                      <name>Remark Code</name>
                      <usage>S</usage>
                      <seq>20</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                      <valid_codes>
                        <code>M1</code>
                        <code>M2</code>
                        <code>M3</code>
                        <code>M4</code>
                        <code>M5</code>
                        <code>M6</code>
                        <code>M7</code>
                        <code>M8</code>
                        <code>M9</code>
                        <code>M10</code>
                        <code>M11</code>
                        <code>M12</code>
                        <code>M13</code>
                        <code>M14</code>
                        <code>M15</code>
                        <code>M16</code>
                        <code>M17</code>
                        <code>M18</code>
                        <code>M19</code>
                        <code>M20</code>
                        <code>M21</code>
                        <code>M22</code>
                        <code>M23</code>
                        <code>M24</code>
                        <code>M25</code>
                        <code>M26</code>
                        <code>M27</code>
                        <code>M28</code>
                        <code>M29</code>
                        <code>M30</code>
                        <code>M31</code>
                        <code>M32</code>
                        <code>M33</code>
                        <code>M34</code>
                        <code>M35</code>
                        <code>M36</code>
                        <code>M37</code>
                        <code>M38</code>
                        <code>M39</code>
                        <code>M40</code>
                        <code>M41</code>
                        <code>M42</code>
                        <code>M43</code>
                        <code>M44</code>
                        <code>M45</code>
                        <code>M46</code>
                        <code>M47</code>
                        <code>M48</code>
                        <code>M49</code>
                        <code>M50</code>
                        <code>M51</code>
                        <code>M52</code>
                        <code>M53</code>
                        <code>M54</code>
                        <code>M55</code>
                        <code>M56</code>
                        <code>M57</code>
                        <code>M58</code>
                        <code>M59</code>
                        <code>M60</code>
                        <code>M61</code>
                        <code>M62</code>
                        <code>M63</code>
                        <code>M64</code>
                        <code>M65</code>
                        <code>M66</code>
                        <code>M67</code>
                        <code>M68</code>
                        <code>M69</code>
                        <code>M70</code>
                        <code>M71</code>
                        <code>M72</code>
                        <code>M73</code>
                        <code>M74</code>
                        <code>M75</code>
                        <code>M76</code>
                        <code>M77</code>
                        <code>M78</code>
                        <code>M79</code>
                        <code>M80</code>
                        <code>M81</code>
                        <code>M82</code>
                        <code>M83</code>
                        <code>M84</code>
                        <code>M85</code>
                        <code>M86</code>
                        <code>M87</code>
                        <code>M88</code>
                        <code>M89</code>
                        <code>M90</code>
                        <code>M91</code>
                        <code>M92</code>
                        <code>M93</code>
                        <code>M94</code>
                        <code>M95</code>
                        <code>M96</code>
                        <code>M97</code>
                        <code>M98</code>
                        <code>M99</code>
                        <code>M100</code>
                        <code>M101</code>
                        <code>M102</code>
                        <code>M103</code>
                        <code>M104</code>
                        <code>M105</code>
                        <code>M106</code>
                        <code>M107</code>
                        <code>M108</code>
                        <code>M109</code>
                        <code>M110</code>
                        <code>M111</code>
                        <code>M112</code>
                        <code>M113</code>
                        <code>M114</code>
                        <code>M115</code>
                        <code>M116</code>
                        <code>M117</code>
                        <code>M118</code>
                        <code>M119</code>
                        <code>M120</code>
                        <code>M121</code>
                        <code>M122</code>
                        <code>M123</code>
                        <code>M124</code>
                        <code>M125</code>
                        <code>M126</code>
                        <code>M127</code>
                        <code>M128</code>
                        <code>M129</code>
                        <code>M130</code>
                        <code>M131</code>
                        <code>M132</code>
                        <code>M133</code>
                        <code>M134</code>
                        <code>M135</code>
                        <code>M136</code>
                        <code>M137</code>
                        <code>M138</code>
                        <code>M139</code>
                        <code>M140</code>
                        <code>M141</code>
                        <code>M142</code>
                        <code>M143</code>
                        <code>M144</code>
                        <code>MA01</code>
                        <code>MA02</code>
                        <code>MA03</code>
                        <code>MA04</code>
                        <code>MA05</code>
                        <code>MA06</code>
                        <code>MA07</code>
                        <code>MA08</code>
                        <code>MA09</code>
                        <code>MA10</code>
                        <code>MA11</code>
                        <code>MA12</code>
                        <code>MA13</code>
                        <code>MA14</code>
                        <code>MA15</code>
                        <code>MA16</code>
                        <code>MA17</code>
                        <code>MA18</code>
                        <code>MA19</code>
                        <code>MA20</code>
                        <code>MA21</code>
                        <code>MA22</code>
                        <code>MA23</code>
                        <code>MA24</code>
                        <code>MA25</code>
                        <code>MA26</code>
                        <code>MA27</code>
                        <code>MA28</code>
                        <code>MA29</code>
                        <code>MA30</code>
                        <code>MA31</code>
                        <code>MA32</code>
                        <code>MA33</code>
                        <code>MA34</code>
                        <code>MA35</code>
                        <code>MA36</code>
                        <code>MA37</code>
                        <code>MA38</code>
                        <code>MA39</code>
                        <code>MA40</code>
                        <code>MA41</code>
                        <code>MA42</code>
                        <code>MA43</code>
                        <code>MA44</code>
                        <code>MA45</code>
                        <code>MA46</code>
                        <code>MA47</code>
                        <code>MA48</code>
                        <code>MA49</code>
                        <code>MA50</code>
                        <code>MA51</code>
                        <code>MA52</code>
                        <code>MA53</code>
                        <code>MA54</code>
                        <code>MA55</code>
                        <code>MA56</code>
                        <code>MA57</code>
                        <code>MA58</code>
                        <code>MA59</code>
                        <code>MA60</code>
                        <code>MA61</code>
                        <code>MA62</code>
                        <code>MA63</code>
                        <code>MA64</code>
                        <code>MA65</code>
                        <code>MA66</code>
                        <code>MA67</code>
                        <code>MA68</code>
                        <code>MA69</code>
                        <code>MA70</code>
                        <code>MA71</code>
                        <code>MA72</code>
                        <code>MA73</code>
                        <code>MA74</code>
                        <code>MA75</code>
                        <code>MA76</code>
                        <code>MA77</code>
                        <code>MA78</code>
                        <code>MA79</code>
                        <code>MA80</code>
                        <code>MA81</code>
                        <code>MA82</code>
                        <code>MA83</code>
                        <code>MA84</code>
                        <code>MA85</code>
                        <code>MA86</code>
                        <code>MA87</code>
                        <code>MA88</code>
                        <code>MA89</code>
                        <code>MA90</code>
                        <code>MA91</code>
                        <code>MA92</code>
                        <code>MA93</code>
                        <code>MA94</code>
                        <code>MA95</code>
                        <code>MA96</code>
                        <code>MA97</code>
                        <code>MA98</code>
                        <code>MA99</code>
                        <code>MA100</code>
                        <code>MA101</code>
                        <code>MA102</code>
                        <code>MA103</code>
                        <code>MA104</code>
                        <code>MA105</code>
                        <code>MA106</code>
                        <code>MA107</code>
                        <code>MA108</code>
                        <code>MA109</code>
                        <code>MA110</code>
                        <code>MA111</code>
                        <code>MA112</code>
                        <code>MA113</code>
                        <code>MA114</code>
                        <code>MA115</code>
                        <code>MA116</code>
                        <code>MA117</code>
                        <code>MA118</code>
                        <code>MA119</code>
                        <code>MA120</code>
                        <code>MA121</code>
                        <code>MA122</code>
                        <code>MA123</code>
                        <code>MA124</code>
                        <code>MA125</code>
                        <code>MA126</code>
                        <code>MA127</code>
                        <code>MA128</code>
                        <code>MA129</code>
                        <code>MA130</code>
                        <code>MA131</code>
                        <code>MA132</code>
                        <code>MA133</code>
                        <code>MA134</code>
                        <code>N1</code>
                        <code>N2</code>
                        <code>N3</code>
                        <code>N4</code>
                        <code>N5</code>
                        <code>N6</code>
                        <code>N7</code>
                        <code>N8</code>
                        <code>N9</code>
                        <code>N10</code>
                        <code>N11</code>
                        <code>N12</code>
                        <code>N13</code>
                        <code>N14</code>
                        <code>N15</code>
                        <code>N16</code>
                        <code>N17</code>
                        <code>N18</code>
                        <code>N19</code>
                        <code>N20</code>
                        <code>N21</code>
                        <code>N22</code>
                        <code>N23</code>
                        <code>N24</code>
                        <code>N25</code>
                        <code>N26</code>
                        <code>N27</code>
                        <code>N28</code>
                        <code>N29</code>
                        <code>N30</code>
                        <code>N31</code>
                        <code>N32</code>
                        <code>N33</code>
                        <code>N34</code>
                        <code>N35</code>
                        <code>N36</code>
                        <code>N37</code>
                        <code>N38</code>
                        <code>N39</code>
                        <code>N40</code>
                        <code>N41</code>
                        <code>N42</code>
                        <code>N43</code>
                        <code>N44</code>
                        <code>N45</code>
                        <code>N46</code>
                        <code>N47</code>
                        <code>N48</code>
                        <code>N49</code>
                        <code>N50</code>
                        <code>N51</code>
                        <code>N52</code>
                        <code>N53</code>
                        <code>N54</code>
                        <code>N55</code>
                        <code>N56</code>
                        <code>N57</code>
                        <code>N58</code>
                        <code>N59</code>
                        <code>N60</code>
                        <code>N61</code>
                        <code>N62</code>
                        <code>N63</code>
                        <code>N64</code>
                        <code>N65</code>
                        <code>N66</code>
                        <code>N67</code>
                        <code>N68</code>
                        <code>N69</code>
                        <code>N70</code>
                        <code>N71</code>
                        <code>N72</code>
                        <code>N73</code>
                        <code>N74</code>
                        <code>N75</code>
                        <code>N76</code>
                        <code>N77</code>
                        <code>N78</code>
                        <code>N79</code>
                        <code>N80</code>
                        <code>N81</code>
                        <code>N82</code>
                        <code>N83</code>
                        <code>N84</code>
                        <code>N85</code>
                        <code>N86</code>
                        <code>N87</code>
                        <code>N88</code>
                        <code>N89</code>
                        <code>N90</code>
                        <code>N91</code>
                        <code>N92</code>
                        <code>N93</code>
                        <code>N94</code>
                        <code>N95</code>
                        <code>N96</code>
                        <code>N97</code>
                        <code>N98</code>
                        <code>N99</code>
                        <code>N100</code>
                        <code>N101</code>
                        <code>N102</code>
                        <code>N103</code>
                        <code>N104</code>
                        <code>N105</code>
                        <code>N106</code>
                        <code>N107</code>
                        <code>N108</code>
                        <code>N109</code>
                        <code>N110</code>
                        <code>N111</code>
                        <code>N112</code>
                        <code>N113</code>
                        <code>N114</code>
                        <code>N115</code>
                        <code>N116</code>
                        <code>N117</code>
                        <code>N118</code>
                        <code>N119</code>
                        <code>N120</code>
                        <code>N121</code>
                        <code>N122</code>
                        <code>N123</code>
                        <code>N124</code>
                        <code>N125</code>
                        <code>N126</code>
                        <code>N127</code>
                        <code>N128</code>
                        <code>N129</code>
                        <code>N130</code>
                        <code>N131</code>
                        <code>N132</code>
                        <code>N133</code>
                        <code>N134</code>
                        <code>N135</code>
                        <code>N136</code>
                        <code>N137</code>
                        <code>N138</code>
                        <code>N139</code>
                        <code>N140</code>
                        <code>N141</code>
                        <code>N142</code>
                        <code>N143</code>
                        <code>N144</code>
                        <code>N145</code>
                        <code>N146</code>
                        <code>N147</code>
                        <code>N148</code>
                        <code>N149</code>
                        <code>N150</code>
                        <code>N151</code>
                        <code>N152</code>
                        <code>N153</code>
                        <code>N154</code>
                        <code>N155</code>
                        <code>N156 </code>
                      </valid_codes>
                    </element>
                    <element xid="MIA21">
                      <data_ele>127</data_ele>
                      <name>Remark Code</name>
                      <usage>S</usage>
                      <seq>21</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                      <valid_codes>
                        <code>M1</code>
                        <code>M2</code>
                        <code>M3</code>
                        <code>M4</code>
                        <code>M5</code>
                        <code>M6</code>
                        <code>M7</code>
                        <code>M8</code>
                        <code>M9</code>
                        <code>M10</code>
                        <code>M11</code>
                        <code>M12</code>
                        <code>M13</code>
                        <code>M14</code>
                        <code>M15</code>
                        <code>M16</code>
                        <code>M17</code>
                        <code>M18</code>
                        <code>M19</code>
                        <code>M20</code>
                        <code>M21</code>
                        <code>M22</code>
                        <code>M23</code>
                        <code>M24</code>
                        <code>M25</code>
                        <code>M26</code>
                        <code>M27</code>
                        <code>M28</code>
                        <code>M29</code>
                        <code>M30</code>
                        <code>M31</code>
                        <code>M32</code>
                        <code>M33</code>
                        <code>M34</code>
                        <code>M35</code>
                        <code>M36</code>
                        <code>M37</code>
                        <code>M38</code>
                        <code>M39</code>
                        <code>M40</code>
                        <code>M41</code>
                        <code>M42</code>
                        <code>M43</code>
                        <code>M44</code>
                        <code>M45</code>
                        <code>M46</code>
                        <code>M47</code>
                        <code>M48</code>
                        <code>M49</code>
                        <code>M50</code>
                        <code>M51</code>
                        <code>M52</code>
                        <code>M53</code>
                        <code>M54</code>
                        <code>M55</code>
                        <code>M56</code>
                        <code>M57</code>
                        <code>M58</code>
                        <code>M59</code>
                        <code>M60</code>
                        <code>M61</code>
                        <code>M62</code>
                        <code>M63</code>
                        <code>M64</code>
                        <code>M65</code>
                        <code>M66</code>
                        <code>M67</code>
                        <code>M68</code>
                        <code>M69</code>
                        <code>M70</code>
                        <code>M71</code>
                        <code>M72</code>
                        <code>M73</code>
                        <code>M74</code>
                        <code>M75</code>
                        <code>M76</code>
                        <code>M77</code>
                        <code>M78</code>
                        <code>M79</code>
                        <code>M80</code>
                        <code>M81</code>
                        <code>M82</code>
                        <code>M83</code>
                        <code>M84</code>
                        <code>M85</code>
                        <code>M86</code>
                        <code>M87</code>
                        <code>M88</code>
                        <code>M89</code>
                        <code>M90</code>
                        <code>M91</code>
                        <code>M92</code>
                        <code>M93</code>
                        <code>M94</code>
                        <code>M95</code>
                        <code>M96</code>
                        <code>M97</code>
                        <code>M98</code>
                        <code>M99</code>
                        <code>M100</code>
                        <code>M101</code>
                        <code>M102</code>
                        <code>M103</code>
                        <code>M104</code>
                        <code>M105</code>
                        <code>M106</code>
                        <code>M107</code>
                        <code>M108</code>
                        <code>M109</code>
                        <code>M110</code>
                        <code>M111</code>
                        <code>M112</code>
                        <code>M113</code>
                        <code>M114</code>
                        <code>M115</code>
                        <code>M116</code>
                        <code>M117</code>
                        <code>M118</code>
                        <code>M119</code>
                        <code>M120</code>
                        <code>M121</code>
                        <code>M122</code>
                        <code>M123</code>
                        <code>M124</code>
                        <code>M125</code>
                        <code>M126</code>
                        <code>M127</code>
                        <code>M128</code>
                        <code>M129</code>
                        <code>M130</code>
                        <code>M131</code>
                        <code>M132</code>
                        <code>M133</code>
                        <code>M134</code>
                        <code>M135</code>
                        <code>M136</code>
                        <code>M137</code>
                        <code>M138</code>
                        <code>M139</code>
                        <code>M140</code>
                        <code>M141</code>
                        <code>M142</code>
                        <code>M143</code>
                        <code>M144</code>
                        <code>MA01</code>
                        <code>MA02</code>
                        <code>MA03</code>
                        <code>MA04</code>
                        <code>MA05</code>
                        <code>MA06</code>
                        <code>MA07</code>
                        <code>MA08</code>
                        <code>MA09</code>
                        <code>MA10</code>
                        <code>MA11</code>
                        <code>MA12</code>
                        <code>MA13</code>
                        <code>MA14</code>
                        <code>MA15</code>
                        <code>MA16</code>
                        <code>MA17</code>
                        <code>MA18</code>
                        <code>MA19</code>
                        <code>MA20</code>
                        <code>MA21</code>
                        <code>MA22</code>
                        <code>MA23</code>
                        <code>MA24</code>
                        <code>MA25</code>
                        <code>MA26</code>
                        <code>MA27</code>
                        <code>MA28</code>
                        <code>MA29</code>
                        <code>MA30</code>
                        <code>MA31</code>
                        <code>MA32</code>
                        <code>MA33</code>
                        <code>MA34</code>
                        <code>MA35</code>
                        <code>MA36</code>
                        <code>MA37</code>
                        <code>MA38</code>
                        <code>MA39</code>
                        <code>MA40</code>
                        <code>MA41</code>
                        <code>MA42</code>
                        <code>MA43</code>
                        <code>MA44</code>
                        <code>MA45</code>
                        <code>MA46</code>
                        <code>MA47</code>
                        <code>MA48</code>
                        <code>MA49</code>
                        <code>MA50</code>
                        <code>MA51</code>
                        <code>MA52</code>
                        <code>MA53</code>
                        <code>MA54</code>
                        <code>MA55</code>
                        <code>MA56</code>
                        <code>MA57</code>
                        <code>MA58</code>
                        <code>MA59</code>
                        <code>MA60</code>
                        <code>MA61</code>
                        <code>MA62</code>
                        <code>MA63</code>
                        <code>MA64</code>
                        <code>MA65</code>
                        <code>MA66</code>
                        <code>MA67</code>
                        <code>MA68</code>
                        <code>MA69</code>
                        <code>MA70</code>
                        <code>MA71</code>
                        <code>MA72</code>
                        <code>MA73</code>
                        <code>MA74</code>
                        <code>MA75</code>
                        <code>MA76</code>
                        <code>MA77</code>
                        <code>MA78</code>
                        <code>MA79</code>
                        <code>MA80</code>
                        <code>MA81</code>
                        <code>MA82</code>
                        <code>MA83</code>
                        <code>MA84</code>
                        <code>MA85</code>
                        <code>MA86</code>
                        <code>MA87</code>
                        <code>MA88</code>
                        <code>MA89</code>
                        <code>MA90</code>
                        <code>MA91</code>
                        <code>MA92</code>
                        <code>MA93</code>
                        <code>MA94</code>
                        <code>MA95</code>
                        <code>MA96</code>
                        <code>MA97</code>
                        <code>MA98</code>
                        <code>MA99</code>
                        <code>MA100</code>
                        <code>MA101</code>
                        <code>MA102</code>
                        <code>MA103</code>
                        <code>MA104</code>
                        <code>MA105</code>
                        <code>MA106</code>
                        <code>MA107</code>
                        <code>MA108</code>
                        <code>MA109</code>
                        <code>MA110</code>
                        <code>MA111</code>
                        <code>MA112</code>
                        <code>MA113</code>
                        <code>MA114</code>
                        <code>MA115</code>
                        <code>MA116</code>
                        <code>MA117</code>
                        <code>MA118</code>
                        <code>MA119</code>
                        <code>MA120</code>
                        <code>MA121</code>
                        <code>MA122</code>
                        <code>MA123</code>
                        <code>MA124</code>
                        <code>MA125</code>
                        <code>MA126</code>
                        <code>MA127</code>
                        <code>MA128</code>
                        <code>MA129</code>
                        <code>MA130</code>
                        <code>MA131</code>
                        <code>MA132</code>
                        <code>MA133</code>
                        <code>MA134</code>
                        <code>N1</code>
                        <code>N2</code>
                        <code>N3</code>
                        <code>N4</code>
                        <code>N5</code>
                        <code>N6</code>
                        <code>N7</code>
                        <code>N8</code>
                        <code>N9</code>
                        <code>N10</code>
                        <code>N11</code>
                        <code>N12</code>
                        <code>N13</code>
                        <code>N14</code>
                        <code>N15</code>
                        <code>N16</code>
                        <code>N17</code>
                        <code>N18</code>
                        <code>N19</code>
                        <code>N20</code>
                        <code>N21</code>
                        <code>N22</code>
                        <code>N23</code>
                        <code>N24</code>
                        <code>N25</code>
                        <code>N26</code>
                        <code>N27</code>
                        <code>N28</code>
                        <code>N29</code>
                        <code>N30</code>
                        <code>N31</code>
                        <code>N32</code>
                        <code>N33</code>
                        <code>N34</code>
                        <code>N35</code>
                        <code>N36</code>
                        <code>N37</code>
                        <code>N38</code>
                        <code>N39</code>
                        <code>N40</code>
                        <code>N41</code>
                        <code>N42</code>
                        <code>N43</code>
                        <code>N44</code>
                        <code>N45</code>
                        <code>N46</code>
                        <code>N47</code>
                        <code>N48</code>
                        <code>N49</code>
                        <code>N50</code>
                        <code>N51</code>
                        <code>N52</code>
                        <code>N53</code>
                        <code>N54</code>
                        <code>N55</code>
                        <code>N56</code>
                        <code>N57</code>
                        <code>N58</code>
                        <code>N59</code>
                        <code>N60</code>
                        <code>N61</code>
                        <code>N62</code>
                        <code>N63</code>
                        <code>N64</code>
                        <code>N65</code>
                        <code>N66</code>
                        <code>N67</code>
                        <code>N68</code>
                        <code>N69</code>
                        <code>N70</code>
                        <code>N71</code>
                        <code>N72</code>
                        <code>N73</code>
                        <code>N74</code>
                        <code>N75</code>
                        <code>N76</code>
                        <code>N77</code>
                        <code>N78</code>
                        <code>N79</code>
                        <code>N80</code>
                        <code>N81</code>
                        <code>N82</code>
                        <code>N83</code>
                        <code>N84</code>
                        <code>N85</code>
                        <code>N86</code>
                        <code>N87</code>
                        <code>N88</code>
                        <code>N89</code>
                        <code>N90</code>
                        <code>N91</code>
                        <code>N92</code>
                        <code>N93</code>
                        <code>N94</code>
                        <code>N95</code>
                        <code>N96</code>
                        <code>N97</code>
                        <code>N98</code>
                        <code>N99</code>
                        <code>N100</code>
                        <code>N101</code>
                        <code>N102</code>
                        <code>N103</code>
                        <code>N104</code>
                        <code>N105</code>
                        <code>N106</code>
                        <code>N107</code>
                        <code>N108</code>
                        <code>N109</code>
                        <code>N110</code>
                        <code>N111</code>
                        <code>N112</code>
                        <code>N113</code>
                        <code>N114</code>
                        <code>N115</code>
                        <code>N116</code>
                        <code>N117</code>
                        <code>N118</code>
                        <code>N119</code>
                        <code>N120</code>
                        <code>N121</code>
                        <code>N122</code>
                        <code>N123</code>
                        <code>N124</code>
                        <code>N125</code>
                        <code>N126</code>
                        <code>N127</code>
                        <code>N128</code>
                        <code>N129</code>
                        <code>N130</code>
                        <code>N131</code>
                        <code>N132</code>
                        <code>N133</code>
                        <code>N134</code>
                        <code>N135</code>
                        <code>N136</code>
                        <code>N137</code>
                        <code>N138</code>
                        <code>N139</code>
                        <code>N140</code>
                        <code>N141</code>
                        <code>N142</code>
                        <code>N143</code>
                        <code>N144</code>
                        <code>N145</code>
                        <code>N146</code>
                        <code>N147</code>
                        <code>N148</code>
                        <code>N149</code>
                        <code>N150</code>
                        <code>N151</code>
                        <code>N152</code>
                        <code>N153</code>
                        <code>N154</code>
                        <code>N155</code>
                        <code>N156 </code>
                      </valid_codes>
                    </element>
                    <element xid="MIA22">
                      <data_ele>127</data_ele>
                      <name>Remark Code</name>
                      <usage>S</usage>
                      <seq>22</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                      <valid_codes>
                        <code>M1</code>
                        <code>M2</code>
                        <code>M3</code>
                        <code>M4</code>
                        <code>M5</code>
                        <code>M6</code>
                        <code>M7</code>
                        <code>M8</code>
                        <code>M9</code>
                        <code>M10</code>
                        <code>M11</code>
                        <code>M12</code>
                        <code>M13</code>
                        <code>M14</code>
                        <code>M15</code>
                        <code>M16</code>
                        <code>M17</code>
                        <code>M18</code>
                        <code>M19</code>
                        <code>M20</code>
                        <code>M21</code>
                        <code>M22</code>
                        <code>M23</code>
                        <code>M24</code>
                        <code>M25</code>
                        <code>M26</code>
                        <code>M27</code>
                        <code>M28</code>
                        <code>M29</code>
                        <code>M30</code>
                        <code>M31</code>
                        <code>M32</code>
                        <code>M33</code>
                        <code>M34</code>
                        <code>M35</code>
                        <code>M36</code>
                        <code>M37</code>
                        <code>M38</code>
                        <code>M39</code>
                        <code>M40</code>
                        <code>M41</code>
                        <code>M42</code>
                        <code>M43</code>
                        <code>M44</code>
                        <code>M45</code>
                        <code>M46</code>
                        <code>M47</code>
                        <code>M48</code>
                        <code>M49</code>
                        <code>M50</code>
                        <code>M51</code>
                        <code>M52</code>
                        <code>M53</code>
                        <code>M54</code>
                        <code>M55</code>
                        <code>M56</code>
                        <code>M57</code>
                        <code>M58</code>
                        <code>M59</code>
                        <code>M60</code>
                        <code>M61</code>
                        <code>M62</code>
                        <code>M63</code>
                        <code>M64</code>
                        <code>M65</code>
                        <code>M66</code>
                        <code>M67</code>
                        <code>M68</code>
                        <code>M69</code>
                        <code>M70</code>
                        <code>M71</code>
                        <code>M72</code>
                        <code>M73</code>
                        <code>M74</code>
                        <code>M75</code>
                        <code>M76</code>
                        <code>M77</code>
                        <code>M78</code>
                        <code>M79</code>
                        <code>M80</code>
                        <code>M81</code>
                        <code>M82</code>
                        <code>M83</code>
                        <code>M84</code>
                        <code>M85</code>
                        <code>M86</code>
                        <code>M87</code>
                        <code>M88</code>
                        <code>M89</code>
                        <code>M90</code>
                        <code>M91</code>
                        <code>M92</code>
                        <code>M93</code>
                        <code>M94</code>
                        <code>M95</code>
                        <code>M96</code>
                        <code>M97</code>
                        <code>M98</code>
                        <code>M99</code>
                        <code>M100</code>
                        <code>M101</code>
                        <code>M102</code>
                        <code>M103</code>
                        <code>M104</code>
                        <code>M105</code>
                        <code>M106</code>
                        <code>M107</code>
                        <code>M108</code>
                        <code>M109</code>
                        <code>M110</code>
                        <code>M111</code>
                        <code>M112</code>
                        <code>M113</code>
                        <code>M114</code>
                        <code>M115</code>
                        <code>M116</code>
                        <code>M117</code>
                        <code>M118</code>
                        <code>M119</code>
                        <code>M120</code>
                        <code>M121</code>
                        <code>M122</code>
                        <code>M123</code>
                        <code>M124</code>
                        <code>M125</code>
                        <code>M126</code>
                        <code>M127</code>
                        <code>M128</code>
                        <code>M129</code>
                        <code>M130</code>
                        <code>M131</code>
                        <code>M132</code>
                        <code>M133</code>
                        <code>M134</code>
                        <code>M135</code>
                        <code>M136</code>
                        <code>M137</code>
                        <code>M138</code>
                        <code>M139</code>
                        <code>M140</code>
                        <code>M141</code>
                        <code>M142</code>
                        <code>M143</code>
                        <code>M144</code>
                        <code>MA01</code>
                        <code>MA02</code>
                        <code>MA03</code>
                        <code>MA04</code>
                        <code>MA05</code>
                        <code>MA06</code>
                        <code>MA07</code>
                        <code>MA08</code>
                        <code>MA09</code>
                        <code>MA10</code>
                        <code>MA11</code>
                        <code>MA12</code>
                        <code>MA13</code>
                        <code>MA14</code>
                        <code>MA15</code>
                        <code>MA16</code>
                        <code>MA17</code>
                        <code>MA18</code>
                        <code>MA19</code>
                        <code>MA20</code>
                        <code>MA21</code>
                        <code>MA22</code>
                        <code>MA23</code>
                        <code>MA24</code>
                        <code>MA25</code>
                        <code>MA26</code>
                        <code>MA27</code>
                        <code>MA28</code>
                        <code>MA29</code>
                        <code>MA30</code>
                        <code>MA31</code>
                        <code>MA32</code>
                        <code>MA33</code>
                        <code>MA34</code>
                        <code>MA35</code>
                        <code>MA36</code>
                        <code>MA37</code>
                        <code>MA38</code>
                        <code>MA39</code>
                        <code>MA40</code>
                        <code>MA41</code>
                        <code>MA42</code>
                        <code>MA43</code>
                        <code>MA44</code>
                        <code>MA45</code>
                        <code>MA46</code>
                        <code>MA47</code>
                        <code>MA48</code>
                        <code>MA49</code>
                        <code>MA50</code>
                        <code>MA51</code>
                        <code>MA52</code>
                        <code>MA53</code>
                        <code>MA54</code>
                        <code>MA55</code>
                        <code>MA56</code>
                        <code>MA57</code>
                        <code>MA58</code>
                        <code>MA59</code>
                        <code>MA60</code>
                        <code>MA61</code>
                        <code>MA62</code>
                        <code>MA63</code>
                        <code>MA64</code>
                        <code>MA65</code>
                        <code>MA66</code>
                        <code>MA67</code>
                        <code>MA68</code>
                        <code>MA69</code>
                        <code>MA70</code>
                        <code>MA71</code>
                        <code>MA72</code>
                        <code>MA73</code>
                        <code>MA74</code>
                        <code>MA75</code>
                        <code>MA76</code>
                        <code>MA77</code>
                        <code>MA78</code>
                        <code>MA79</code>
                        <code>MA80</code>
                        <code>MA81</code>
                        <code>MA82</code>
                        <code>MA83</code>
                        <code>MA84</code>
                        <code>MA85</code>
                        <code>MA86</code>
                        <code>MA87</code>
                        <code>MA88</code>
                        <code>MA89</code>
                        <code>MA90</code>
                        <code>MA91</code>
                        <code>MA92</code>
                        <code>MA93</code>
                        <code>MA94</code>
                        <code>MA95</code>
                        <code>MA96</code>
                        <code>MA97</code>
                        <code>MA98</code>
                        <code>MA99</code>
                        <code>MA100</code>
                        <code>MA101</code>
                        <code>MA102</code>
                        <code>MA103</code>
                        <code>MA104</code>
                        <code>MA105</code>
                        <code>MA106</code>
                        <code>MA107</code>
                        <code>MA108</code>
                        <code>MA109</code>
                        <code>MA110</code>
                        <code>MA111</code>
                        <code>MA112</code>
                        <code>MA113</code>
                        <code>MA114</code>
                        <code>MA115</code>
                        <code>MA116</code>
                        <code>MA117</code>
                        <code>MA118</code>
                        <code>MA119</code>
                        <code>MA120</code>
                        <code>MA121</code>
                        <code>MA122</code>
                        <code>MA123</code>
                        <code>MA124</code>
                        <code>MA125</code>
                        <code>MA126</code>
                        <code>MA127</code>
                        <code>MA128</code>
                        <code>MA129</code>
                        <code>MA130</code>
                        <code>MA131</code>
                        <code>MA132</code>
                        <code>MA133</code>
                        <code>MA134</code>
                        <code>N1</code>
                        <code>N2</code>
                        <code>N3</code>
                        <code>N4</code>
                        <code>N5</code>
                        <code>N6</code>
                        <code>N7</code>
                        <code>N8</code>
                        <code>N9</code>
                        <code>N10</code>
                        <code>N11</code>
                        <code>N12</code>
                        <code>N13</code>
                        <code>N14</code>
                        <code>N15</code>
                        <code>N16</code>
                        <code>N17</code>
                        <code>N18</code>
                        <code>N19</code>
                        <code>N20</code>
                        <code>N21</code>
                        <code>N22</code>
                        <code>N23</code>
                        <code>N24</code>
                        <code>N25</code>
                        <code>N26</code>
                        <code>N27</code>
                        <code>N28</code>
                        <code>N29</code>
                        <code>N30</code>
                        <code>N31</code>
                        <code>N32</code>
                        <code>N33</code>
                        <code>N34</code>
                        <code>N35</code>
                        <code>N36</code>
                        <code>N37</code>
                        <code>N38</code>
                        <code>N39</code>
                        <code>N40</code>
                        <code>N41</code>
                        <code>N42</code>
                        <code>N43</code>
                        <code>N44</code>
                        <code>N45</code>
                        <code>N46</code>
                        <code>N47</code>
                        <code>N48</code>
                        <code>N49</code>
                        <code>N50</code>
                        <code>N51</code>
                        <code>N52</code>
                        <code>N53</code>
                        <code>N54</code>
                        <code>N55</code>
                        <code>N56</code>
                        <code>N57</code>
                        <code>N58</code>
                        <code>N59</code>
                        <code>N60</code>
                        <code>N61</code>
                        <code>N62</code>
                        <code>N63</code>
                        <code>N64</code>
                        <code>N65</code>
                        <code>N66</code>
                        <code>N67</code>
                        <code>N68</code>
                        <code>N69</code>
                        <code>N70</code>
                        <code>N71</code>
                        <code>N72</code>
                        <code>N73</code>
                        <code>N74</code>
                        <code>N75</code>
                        <code>N76</code>
                        <code>N77</code>
                        <code>N78</code>
                        <code>N79</code>
                        <code>N80</code>
                        <code>N81</code>
                        <code>N82</code>
                        <code>N83</code>
                        <code>N84</code>
                        <code>N85</code>
                        <code>N86</code>
                        <code>N87</code>
                        <code>N88</code>
                        <code>N89</code>
                        <code>N90</code>
                        <code>N91</code>
                        <code>N92</code>
                        <code>N93</code>
                        <code>N94</code>
                        <code>N95</code>
                        <code>N96</code>
                        <code>N97</code>
                        <code>N98</code>
                        <code>N99</code>
                        <code>N100</code>
                        <code>N101</code>
                        <code>N102</code>
                        <code>N103</code>
                        <code>N104</code>
                        <code>N105</code>
                        <code>N106</code>
                        <code>N107</code>
                        <code>N108</code>
                        <code>N109</code>
                        <code>N110</code>
                        <code>N111</code>
                        <code>N112</code>
                        <code>N113</code>
                        <code>N114</code>
                        <code>N115</code>
                        <code>N116</code>
                        <code>N117</code>
                        <code>N118</code>
                        <code>N119</code>
                        <code>N120</code>
                        <code>N121</code>
                        <code>N122</code>
                        <code>N123</code>
                        <code>N124</code>
                        <code>N125</code>
                        <code>N126</code>
                        <code>N127</code>
                        <code>N128</code>
                        <code>N129</code>
                        <code>N130</code>
                        <code>N131</code>
                        <code>N132</code>
                        <code>N133</code>
                        <code>N134</code>
                        <code>N135</code>
                        <code>N136</code>
                        <code>N137</code>
                        <code>N138</code>
                        <code>N139</code>
                        <code>N140</code>
                        <code>N141</code>
                        <code>N142</code>
                        <code>N143</code>
                        <code>N144</code>
                        <code>N145</code>
                        <code>N146</code>
                        <code>N147</code>
                        <code>N148</code>
                        <code>N149</code>
                        <code>N150</code>
                        <code>N151</code>
                        <code>N152</code>
                        <code>N153</code>
                        <code>N154</code>
                        <code>N155</code>
                        <code>N156 </code>
                      </valid_codes>
                    </element>
                    <element xid="MIA23">
                      <data_ele>127</data_ele>
                      <name>Remark Code</name>
                      <usage>S</usage>
                      <seq>23</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                      <valid_codes>
                        <code>M1</code>
                        <code>M2</code>
                        <code>M3</code>
                        <code>M4</code>
                        <code>M5</code>
                        <code>M6</code>
                        <code>M7</code>
                        <code>M8</code>
                        <code>M9</code>
                        <code>M10</code>
                        <code>M11</code>
                        <code>M12</code>
                        <code>M13</code>
                        <code>M14</code>
                        <code>M15</code>
                        <code>M16</code>
                        <code>M17</code>
                        <code>M18</code>
                        <code>M19</code>
                        <code>M20</code>
                        <code>M21</code>
                        <code>M22</code>
                        <code>M23</code>
                        <code>M24</code>
                        <code>M25</code>
                        <code>M26</code>
                        <code>M27</code>
                        <code>M28</code>
                        <code>M29</code>
                        <code>M30</code>
                        <code>M31</code>
                        <code>M32</code>
                        <code>M33</code>
                        <code>M34</code>
                        <code>M35</code>
                        <code>M36</code>
                        <code>M37</code>
                        <code>M38</code>
                        <code>M39</code>
                        <code>M40</code>
                        <code>M41</code>
                        <code>M42</code>
                        <code>M43</code>
                        <code>M44</code>
                        <code>M45</code>
                        <code>M46</code>
                        <code>M47</code>
                        <code>M48</code>
                        <code>M49</code>
                        <code>M50</code>
                        <code>M51</code>
                        <code>M52</code>
                        <code>M53</code>
                        <code>M54</code>
                        <code>M55</code>
                        <code>M56</code>
                        <code>M57</code>
                        <code>M58</code>
                        <code>M59</code>
                        <code>M60</code>
                        <code>M61</code>
                        <code>M62</code>
                        <code>M63</code>
                        <code>M64</code>
                        <code>M65</code>
                        <code>M66</code>
                        <code>M67</code>
                        <code>M68</code>
                        <code>M69</code>
                        <code>M70</code>
                        <code>M71</code>
                        <code>M72</code>
                        <code>M73</code>
                        <code>M74</code>
                        <code>M75</code>
                        <code>M76</code>
                        <code>M77</code>
                        <code>M78</code>
                        <code>M79</code>
                        <code>M80</code>
                        <code>M81</code>
                        <code>M82</code>
                        <code>M83</code>
                        <code>M84</code>
                        <code>M85</code>
                        <code>M86</code>
                        <code>M87</code>
                        <code>M88</code>
                        <code>M89</code>
                        <code>M90</code>
                        <code>M91</code>
                        <code>M92</code>
                        <code>M93</code>
                        <code>M94</code>
                        <code>M95</code>
                        <code>M96</code>
                        <code>M97</code>
                        <code>M98</code>
                        <code>M99</code>
                        <code>M100</code>
                        <code>M101</code>
                        <code>M102</code>
                        <code>M103</code>
                        <code>M104</code>
                        <code>M105</code>
                        <code>M106</code>
                        <code>M107</code>
                        <code>M108</code>
                        <code>M109</code>
                        <code>M110</code>
                        <code>M111</code>
                        <code>M112</code>
                        <code>M113</code>
                        <code>M114</code>
                        <code>M115</code>
                        <code>M116</code>
                        <code>M117</code>
                        <code>M118</code>
                        <code>M119</code>
                        <code>M120</code>
                        <code>M121</code>
                        <code>M122</code>
                        <code>M123</code>
                        <code>M124</code>
                        <code>M125</code>
                        <code>M126</code>
                        <code>M127</code>
                        <code>M128</code>
                        <code>M129</code>
                        <code>M130</code>
                        <code>M131</code>
                        <code>M132</code>
                        <code>M133</code>
                        <code>M134</code>
                        <code>M135</code>
                        <code>M136</code>
                        <code>M137</code>
                        <code>M138</code>
                        <code>M139</code>
                        <code>M140</code>
                        <code>M141</code>
                        <code>M142</code>
                        <code>M143</code>
                        <code>M144</code>
                        <code>MA01</code>
                        <code>MA02</code>
                        <code>MA03</code>
                        <code>MA04</code>
                        <code>MA05</code>
                        <code>MA06</code>
                        <code>MA07</code>
                        <code>MA08</code>
                        <code>MA09</code>
                        <code>MA10</code>
                        <code>MA11</code>
                        <code>MA12</code>
                        <code>MA13</code>
                        <code>MA14</code>
                        <code>MA15</code>
                        <code>MA16</code>
                        <code>MA17</code>
                        <code>MA18</code>
                        <code>MA19</code>
                        <code>MA20</code>
                        <code>MA21</code>
                        <code>MA22</code>
                        <code>MA23</code>
                        <code>MA24</code>
                        <code>MA25</code>
                        <code>MA26</code>
                        <code>MA27</code>
                        <code>MA28</code>
                        <code>MA29</code>
                        <code>MA30</code>
                        <code>MA31</code>
                        <code>MA32</code>
                        <code>MA33</code>
                        <code>MA34</code>
                        <code>MA35</code>
                        <code>MA36</code>
                        <code>MA37</code>
                        <code>MA38</code>
                        <code>MA39</code>
                        <code>MA40</code>
                        <code>MA41</code>
                        <code>MA42</code>
                        <code>MA43</code>
                        <code>MA44</code>
                        <code>MA45</code>
                        <code>MA46</code>
                        <code>MA47</code>
                        <code>MA48</code>
                        <code>MA49</code>
                        <code>MA50</code>
                        <code>MA51</code>
                        <code>MA52</code>
                        <code>MA53</code>
                        <code>MA54</code>
                        <code>MA55</code>
                        <code>MA56</code>
                        <code>MA57</code>
                        <code>MA58</code>
                        <code>MA59</code>
                        <code>MA60</code>
                        <code>MA61</code>
                        <code>MA62</code>
                        <code>MA63</code>
                        <code>MA64</code>
                        <code>MA65</code>
                        <code>MA66</code>
                        <code>MA67</code>
                        <code>MA68</code>
                        <code>MA69</code>
                        <code>MA70</code>
                        <code>MA71</code>
                        <code>MA72</code>
                        <code>MA73</code>
                        <code>MA74</code>
                        <code>MA75</code>
                        <code>MA76</code>
                        <code>MA77</code>
                        <code>MA78</code>
                        <code>MA79</code>
                        <code>MA80</code>
                        <code>MA81</code>
                        <code>MA82</code>
                        <code>MA83</code>
                        <code>MA84</code>
                        <code>MA85</code>
                        <code>MA86</code>
                        <code>MA87</code>
                        <code>MA88</code>
                        <code>MA89</code>
                        <code>MA90</code>
                        <code>MA91</code>
                        <code>MA92</code>
                        <code>MA93</code>
                        <code>MA94</code>
                        <code>MA95</code>
                        <code>MA96</code>
                        <code>MA97</code>
                        <code>MA98</code>
                        <code>MA99</code>
                        <code>MA100</code>
                        <code>MA101</code>
                        <code>MA102</code>
                        <code>MA103</code>
                        <code>MA104</code>
                        <code>MA105</code>
                        <code>MA106</code>
                        <code>MA107</code>
                        <code>MA108</code>
                        <code>MA109</code>
                        <code>MA110</code>
                        <code>MA111</code>
                        <code>MA112</code>
                        <code>MA113</code>
                        <code>MA114</code>
                        <code>MA115</code>
                        <code>MA116</code>
                        <code>MA117</code>
                        <code>MA118</code>
                        <code>MA119</code>
                        <code>MA120</code>
                        <code>MA121</code>
                        <code>MA122</code>
                        <code>MA123</code>
                        <code>MA124</code>
                        <code>MA125</code>
                        <code>MA126</code>
                        <code>MA127</code>
                        <code>MA128</code>
                        <code>MA129</code>
                        <code>MA130</code>
                        <code>MA131</code>
                        <code>MA132</code>
                        <code>MA133</code>
                        <code>MA134</code>
                        <code>N1</code>
                        <code>N2</code>
                        <code>N3</code>
                        <code>N4</code>
                        <code>N5</code>
                        <code>N6</code>
                        <code>N7</code>
                        <code>N8</code>
                        <code>N9</code>
                        <code>N10</code>
                        <code>N11</code>
                        <code>N12</code>
                        <code>N13</code>
                        <code>N14</code>
                        <code>N15</code>
                        <code>N16</code>
                        <code>N17</code>
                        <code>N18</code>
                        <code>N19</code>
                        <code>N20</code>
                        <code>N21</code>
                        <code>N22</code>
                        <code>N23</code>
                        <code>N24</code>
                        <code>N25</code>
                        <code>N26</code>
                        <code>N27</code>
                        <code>N28</code>
                        <code>N29</code>
                        <code>N30</code>
                        <code>N31</code>
                        <code>N32</code>
                        <code>N33</code>
                        <code>N34</code>
                        <code>N35</code>
                        <code>N36</code>
                        <code>N37</code>
                        <code>N38</code>
                        <code>N39</code>
                        <code>N40</code>
                        <code>N41</code>
                        <code>N42</code>
                        <code>N43</code>
                        <code>N44</code>
                        <code>N45</code>
                        <code>N46</code>
                        <code>N47</code>
                        <code>N48</code>
                        <code>N49</code>
                        <code>N50</code>
                        <code>N51</code>
                        <code>N52</code>
                        <code>N53</code>
                        <code>N54</code>
                        <code>N55</code>
                        <code>N56</code>
                        <code>N57</code>
                        <code>N58</code>
                        <code>N59</code>
                        <code>N60</code>
                        <code>N61</code>
                        <code>N62</code>
                        <code>N63</code>
                        <code>N64</code>
                        <code>N65</code>
                        <code>N66</code>
                        <code>N67</code>
                        <code>N68</code>
                        <code>N69</code>
                        <code>N70</code>
                        <code>N71</code>
                        <code>N72</code>
                        <code>N73</code>
                        <code>N74</code>
                        <code>N75</code>
                        <code>N76</code>
                        <code>N77</code>
                        <code>N78</code>
                        <code>N79</code>
                        <code>N80</code>
                        <code>N81</code>
                        <code>N82</code>
                        <code>N83</code>
                        <code>N84</code>
                        <code>N85</code>
                        <code>N86</code>
                        <code>N87</code>
                        <code>N88</code>
                        <code>N89</code>
                        <code>N90</code>
                        <code>N91</code>
                        <code>N92</code>
                        <code>N93</code>
                        <code>N94</code>
                        <code>N95</code>
                        <code>N96</code>
                        <code>N97</code>
                        <code>N98</code>
                        <code>N99</code>
                        <code>N100</code>
                        <code>N101</code>
                        <code>N102</code>
                        <code>N103</code>
                        <code>N104</code>
                        <code>N105</code>
                        <code>N106</code>
                        <code>N107</code>
                        <code>N108</code>
                        <code>N109</code>
                        <code>N110</code>
                        <code>N111</code>
                        <code>N112</code>
                        <code>N113</code>
                        <code>N114</code>
                        <code>N115</code>
                        <code>N116</code>
                        <code>N117</code>
                        <code>N118</code>
                        <code>N119</code>
                        <code>N120</code>
                        <code>N121</code>
                        <code>N122</code>
                        <code>N123</code>
                        <code>N124</code>
                        <code>N125</code>
                        <code>N126</code>
                        <code>N127</code>
                        <code>N128</code>
                        <code>N129</code>
                        <code>N130</code>
                        <code>N131</code>
                        <code>N132</code>
                        <code>N133</code>
                        <code>N134</code>
                        <code>N135</code>
                        <code>N136</code>
                        <code>N137</code>
                        <code>N138</code>
                        <code>N139</code>
                        <code>N140</code>
                        <code>N141</code>
                        <code>N142</code>
                        <code>N143</code>
                        <code>N144</code>
                        <code>N145</code>
                        <code>N146</code>
                        <code>N147</code>
                        <code>N148</code>
                        <code>N149</code>
                        <code>N150</code>
                        <code>N151</code>
                        <code>N152</code>
                        <code>N153</code>
                        <code>N154</code>
                        <code>N155</code>
                        <code>N156 </code>
                      </valid_codes>
                    </element>
                    <element xid="MIA24">
                      <data_ele>782</data_ele>
                      <name>PPS-Capital Exception Amount</name>
                      <usage>S</usage>
                      <seq>24</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                  </segment>
<!--End of MIA segment-->
                  <segment xid="MOA">
                    <name>Medicare Outpatient Adjudication Information</name>
                    <usage>S</usage>
                    <pos>320</pos>
                    <max_use>1</max_use>
                    <element xid="MOA01">
                      <data_ele>954</data_ele>
                      <name>Reimbursement Rate</name>
                      <usage>S</usage>
                      <seq>01</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>10</max_len>
                    </element>
                    <element xid="MOA02">
                      <data_ele>782</data_ele>
                      <name>Claim HCPCS Payable Amount</name>
                      <usage>S</usage>
                      <seq>02</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="MOA03">
                      <data_ele>127</data_ele>
                      <name>Remark Code</name>
                      <usage>S</usage>
                      <seq>03</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                      <valid_codes>
                        <code>M1</code>
                        <code>M2</code>
                        <code>M3</code>
                        <code>M4</code>
                        <code>M5</code>
                        <code>M6</code>
                        <code>M7</code>
                        <code>M8</code>
                        <code>M9</code>
                        <code>M10</code>
                        <code>M11</code>
                        <code>M12</code>
                        <code>M13</code>
                        <code>M14</code>
                        <code>M15</code>
                        <code>M16</code>
                        <code>M17</code>
                        <code>M18</code>
                        <code>M19</code>
                        <code>M20</code>
                        <code>M21</code>
                        <code>M22</code>
                        <code>M23</code>
                        <code>M24</code>
                        <code>M25</code>
                        <code>M26</code>
                        <code>M27</code>
                        <code>M28</code>
                        <code>M29</code>
                        <code>M30</code>
                        <code>M31</code>
                        <code>M32</code>
                        <code>M33</code>
                        <code>M34</code>
                        <code>M35</code>
                        <code>M36</code>
                        <code>M37</code>
                        <code>M38</code>
                        <code>M39</code>
                        <code>M40</code>
                        <code>M41</code>
                        <code>M42</code>
                        <code>M43</code>
                        <code>M44</code>
                        <code>M45</code>
                        <code>M46</code>
                        <code>M47</code>
                        <code>M48</code>
                        <code>M49</code>
                        <code>M50</code>
                        <code>M51</code>
                        <code>M52</code>
                        <code>M53</code>
                        <code>M54</code>
                        <code>M55</code>
                        <code>M56</code>
                        <code>M57</code>
                        <code>M58</code>
                        <code>M59</code>
                        <code>M60</code>
                        <code>M61</code>
                        <code>M62</code>
                        <code>M63</code>
                        <code>M64</code>
                        <code>M65</code>
                        <code>M66</code>
                        <code>M67</code>
                        <code>M68</code>
                        <code>M69</code>
                        <code>M70</code>
                        <code>M71</code>
                        <code>M72</code>
                        <code>M73</code>
                        <code>M74</code>
                        <code>M75</code>
                        <code>M76</code>
                        <code>M77</code>
                        <code>M78</code>
                        <code>M79</code>
                        <code>M80</code>
                        <code>M81</code>
                        <code>M82</code>
                        <code>M83</code>
                        <code>M84</code>
                        <code>M85</code>
                        <code>M86</code>
                        <code>M87</code>
                        <code>M88</code>
                        <code>M89</code>
                        <code>M90</code>
                        <code>M91</code>
                        <code>M92</code>
                        <code>M93</code>
                        <code>M94</code>
                        <code>M95</code>
                        <code>M96</code>
                        <code>M97</code>
                        <code>M98</code>
                        <code>M99</code>
                        <code>M100</code>
                        <code>M101</code>
                        <code>M102</code>
                        <code>M103</code>
                        <code>M104</code>
                        <code>M105</code>
                        <code>M106</code>
                        <code>M107</code>
                        <code>M108</code>
                        <code>M109</code>
                        <code>M110</code>
                        <code>M111</code>
                        <code>M112</code>
                        <code>M113</code>
                        <code>M114</code>
                        <code>M115</code>
                        <code>M116</code>
                        <code>M117</code>
                        <code>M118</code>
                        <code>M119</code>
                        <code>M120</code>
                        <code>M121</code>
                        <code>M122</code>
                        <code>M123</code>
                        <code>M124</code>
                        <code>M125</code>
                        <code>M126</code>
                        <code>M127</code>
                        <code>M128</code>
                        <code>M129</code>
                        <code>M130</code>
                        <code>M131</code>
                        <code>M132</code>
                        <code>M133</code>
                        <code>M134</code>
                        <code>M135</code>
                        <code>M136</code>
                        <code>M137</code>
                        <code>M138</code>
                        <code>M139</code>
                        <code>M140</code>
                        <code>M141</code>
                        <code>M142</code>
                        <code>M143</code>
                        <code>M144</code>
                        <code>MA01</code>
                        <code>MA02</code>
                        <code>MA03</code>
                        <code>MA04</code>
                        <code>MA05</code>
                        <code>MA06</code>
                        <code>MA07</code>
                        <code>MA08</code>
                        <code>MA09</code>
                        <code>MA10</code>
                        <code>MA11</code>
                        <code>MA12</code>
                        <code>MA13</code>
                        <code>MA14</code>
                        <code>MA15</code>
                        <code>MA16</code>
                        <code>MA17</code>
                        <code>MA18</code>
                        <code>MA19</code>
                        <code>MA20</code>
                        <code>MA21</code>
                        <code>MA22</code>
                        <code>MA23</code>
                        <code>MA24</code>
                        <code>MA25</code>
                        <code>MA26</code>
                        <code>MA27</code>
                        <code>MA28</code>
                        <code>MA29</code>
                        <code>MA30</code>
                        <code>MA31</code>
                        <code>MA32</code>
                        <code>MA33</code>
                        <code>MA34</code>
                        <code>MA35</code>
                        <code>MA36</code>
                        <code>MA37</code>
                        <code>MA38</code>
                        <code>MA39</code>
                        <code>MA40</code>
                        <code>MA41</code>
                        <code>MA42</code>
                        <code>MA43</code>
                        <code>MA44</code>
                        <code>MA45</code>
                        <code>MA46</code>
                        <code>MA47</code>
                        <code>MA48</code>
                        <code>MA49</code>
                        <code>MA50</code>
                        <code>MA51</code>
                        <code>MA52</code>
                        <code>MA53</code>
                        <code>MA54</code>
                        <code>MA55</code>
                        <code>MA56</code>
                        <code>MA57</code>
                        <code>MA58</code>
                        <code>MA59</code>
                        <code>MA60</code>
                        <code>MA61</code>
                        <code>MA62</code>
                        <code>MA63</code>
                        <code>MA64</code>
                        <code>MA65</code>
                        <code>MA66</code>
                        <code>MA67</code>
                        <code>MA68</code>
                        <code>MA69</code>
                        <code>MA70</code>
                        <code>MA71</code>
                        <code>MA72</code>
                        <code>MA73</code>
                        <code>MA74</code>
                        <code>MA75</code>
                        <code>MA76</code>
                        <code>MA77</code>
                        <code>MA78</code>
                        <code>MA79</code>
                        <code>MA80</code>
                        <code>MA81</code>
                        <code>MA82</code>
                        <code>MA83</code>
                        <code>MA84</code>
                        <code>MA85</code>
                        <code>MA86</code>
                        <code>MA87</code>
                        <code>MA88</code>
                        <code>MA89</code>
                        <code>MA90</code>
                        <code>MA91</code>
                        <code>MA92</code>
                        <code>MA93</code>
                        <code>MA94</code>
                        <code>MA95</code>
                        <code>MA96</code>
                        <code>MA97</code>
                        <code>MA98</code>
                        <code>MA99</code>
                        <code>MA100</code>
                        <code>MA101</code>
                        <code>MA102</code>
                        <code>MA103</code>
                        <code>MA104</code>
                        <code>MA105</code>
                        <code>MA106</code>
                        <code>MA107</code>
                        <code>MA108</code>
                        <code>MA109</code>
                        <code>MA110</code>
                        <code>MA111</code>
                        <code>MA112</code>
                        <code>MA113</code>
                        <code>MA114</code>
                        <code>MA115</code>
                        <code>MA116</code>
                        <code>MA117</code>
                        <code>MA118</code>
                        <code>MA119</code>
                        <code>MA120</code>
                        <code>MA121</code>
                        <code>MA122</code>
                        <code>MA123</code>
                        <code>MA124</code>
                        <code>MA125</code>
                        <code>MA126</code>
                        <code>MA127</code>
                        <code>MA128</code>
                        <code>MA129</code>
                        <code>MA130</code>
                        <code>MA131</code>
                        <code>MA132</code>
                        <code>MA133</code>
                        <code>MA134</code>
                        <code>N1</code>
                        <code>N2</code>
                        <code>N3</code>
                        <code>N4</code>
                        <code>N5</code>
                        <code>N6</code>
                        <code>N7</code>
                        <code>N8</code>
                        <code>N9</code>
                        <code>N10</code>
                        <code>N11</code>
                        <code>N12</code>
                        <code>N13</code>
                        <code>N14</code>
                        <code>N15</code>
                        <code>N16</code>
                        <code>N17</code>
                        <code>N18</code>
                        <code>N19</code>
                        <code>N20</code>
                        <code>N21</code>
                        <code>N22</code>
                        <code>N23</code>
                        <code>N24</code>
                        <code>N25</code>
                        <code>N26</code>
                        <code>N27</code>
                        <code>N28</code>
                        <code>N29</code>
                        <code>N30</code>
                        <code>N31</code>
                        <code>N32</code>
                        <code>N33</code>
                        <code>N34</code>
                        <code>N35</code>
                        <code>N36</code>
                        <code>N37</code>
                        <code>N38</code>
                        <code>N39</code>
                        <code>N40</code>
                        <code>N41</code>
                        <code>N42</code>
                        <code>N43</code>
                        <code>N44</code>
                        <code>N45</code>
                        <code>N46</code>
                        <code>N47</code>
                        <code>N48</code>
                        <code>N49</code>
                        <code>N50</code>
                        <code>N51</code>
                        <code>N52</code>
                        <code>N53</code>
                        <code>N54</code>
                        <code>N55</code>
                        <code>N56</code>
                        <code>N57</code>
                        <code>N58</code>
                        <code>N59</code>
                        <code>N60</code>
                        <code>N61</code>
                        <code>N62</code>
                        <code>N63</code>
                        <code>N64</code>
                        <code>N65</code>
                        <code>N66</code>
                        <code>N67</code>
                        <code>N68</code>
                        <code>N69</code>
                        <code>N70</code>
                        <code>N71</code>
                        <code>N72</code>
                        <code>N73</code>
                        <code>N74</code>
                        <code>N75</code>
                        <code>N76</code>
                        <code>N77</code>
                        <code>N78</code>
                        <code>N79</code>
                        <code>N80</code>
                        <code>N81</code>
                        <code>N82</code>
                        <code>N83</code>
                        <code>N84</code>
                        <code>N85</code>
                        <code>N86</code>
                        <code>N87</code>
                        <code>N88</code>
                        <code>N89</code>
                        <code>N90</code>
                        <code>N91</code>
                        <code>N92</code>
                        <code>N93</code>
                        <code>N94</code>
                        <code>N95</code>
                        <code>N96</code>
                        <code>N97</code>
                        <code>N98</code>
                        <code>N99</code>
                        <code>N100</code>
                        <code>N101</code>
                        <code>N102</code>
                        <code>N103</code>
                        <code>N104</code>
                        <code>N105</code>
                        <code>N106</code>
                        <code>N107</code>
                        <code>N108</code>
                        <code>N109</code>
                        <code>N110</code>
                        <code>N111</code>
                        <code>N112</code>
                        <code>N113</code>
                        <code>N114</code>
                        <code>N115</code>
                        <code>N116</code>
                        <code>N117</code>
                        <code>N118</code>
                        <code>N119</code>
                        <code>N120</code>
                        <code>N121</code>
                        <code>N122</code>
                        <code>N123</code>
                        <code>N124</code>
                        <code>N125</code>
                        <code>N126</code>
                        <code>N127</code>
                        <code>N128</code>
                        <code>N129</code>
                        <code>N130</code>
                        <code>N131</code>
                        <code>N132</code>
                        <code>N133</code>
                        <code>N134</code>
                        <code>N135</code>
                        <code>N136</code>
                        <code>N137</code>
                        <code>N138</code>
                        <code>N139</code>
                        <code>N140</code>
                        <code>N141</code>
                        <code>N142</code>
                        <code>N143</code>
                        <code>N144</code>
                        <code>N145</code>
                        <code>N146</code>
                        <code>N147</code>
                        <code>N148</code>
                        <code>N149</code>
                        <code>N150</code>
                        <code>N151</code>
                        <code>N152</code>
                        <code>N153</code>
                        <code>N154</code>
                        <code>N155</code>
                        <code>N156 </code>
                      </valid_codes>
                    </element>
                    <element xid="MOA04">
                      <data_ele>127</data_ele>
                      <name>Remark Code</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                      <valid_codes>
                        <code>M1</code>
                        <code>M2</code>
                        <code>M3</code>
                        <code>M4</code>
                        <code>M5</code>
                        <code>M6</code>
                        <code>M7</code>
                        <code>M8</code>
                        <code>M9</code>
                        <code>M10</code>
                        <code>M11</code>
                        <code>M12</code>
                        <code>M13</code>
                        <code>M14</code>
                        <code>M15</code>
                        <code>M16</code>
                        <code>M17</code>
                        <code>M18</code>
                        <code>M19</code>
                        <code>M20</code>
                        <code>M21</code>
                        <code>M22</code>
                        <code>M23</code>
                        <code>M24</code>
                        <code>M25</code>
                        <code>M26</code>
                        <code>M27</code>
                        <code>M28</code>
                        <code>M29</code>
                        <code>M30</code>
                        <code>M31</code>
                        <code>M32</code>
                        <code>M33</code>
                        <code>M34</code>
                        <code>M35</code>
                        <code>M36</code>
                        <code>M37</code>
                        <code>M38</code>
                        <code>M39</code>
                        <code>M40</code>
                        <code>M41</code>
                        <code>M42</code>
                        <code>M43</code>
                        <code>M44</code>
                        <code>M45</code>
                        <code>M46</code>
                        <code>M47</code>
                        <code>M48</code>
                        <code>M49</code>
                        <code>M50</code>
                        <code>M51</code>
                        <code>M52</code>
                        <code>M53</code>
                        <code>M54</code>
                        <code>M55</code>
                        <code>M56</code>
                        <code>M57</code>
                        <code>M58</code>
                        <code>M59</code>
                        <code>M60</code>
                        <code>M61</code>
                        <code>M62</code>
                        <code>M63</code>
                        <code>M64</code>
                        <code>M65</code>
                        <code>M66</code>
                        <code>M67</code>
                        <code>M68</code>
                        <code>M69</code>
                        <code>M70</code>
                        <code>M71</code>
                        <code>M72</code>
                        <code>M73</code>
                        <code>M74</code>
                        <code>M75</code>
                        <code>M76</code>
                        <code>M77</code>
                        <code>M78</code>
                        <code>M79</code>
                        <code>M80</code>
                        <code>M81</code>
                        <code>M82</code>
                        <code>M83</code>
                        <code>M84</code>
                        <code>M85</code>
                        <code>M86</code>
                        <code>M87</code>
                        <code>M88</code>
                        <code>M89</code>
                        <code>M90</code>
                        <code>M91</code>
                        <code>M92</code>
                        <code>M93</code>
                        <code>M94</code>
                        <code>M95</code>
                        <code>M96</code>
                        <code>M97</code>
                        <code>M98</code>
                        <code>M99</code>
                        <code>M100</code>
                        <code>M101</code>
                        <code>M102</code>
                        <code>M103</code>
                        <code>M104</code>
                        <code>M105</code>
                        <code>M106</code>
                        <code>M107</code>
                        <code>M108</code>
                        <code>M109</code>
                        <code>M110</code>
                        <code>M111</code>
                        <code>M112</code>
                        <code>M113</code>
                        <code>M114</code>
                        <code>M115</code>
                        <code>M116</code>
                        <code>M117</code>
                        <code>M118</code>
                        <code>M119</code>
                        <code>M120</code>
                        <code>M121</code>
                        <code>M122</code>
                        <code>M123</code>
                        <code>M124</code>
                        <code>M125</code>
                        <code>M126</code>
                        <code>M127</code>
                        <code>M128</code>
                        <code>M129</code>
                        <code>M130</code>
                        <code>M131</code>
                        <code>M132</code>
                        <code>M133</code>
                        <code>M134</code>
                        <code>M135</code>
                        <code>M136</code>
                        <code>M137</code>
                        <code>M138</code>
                        <code>M139</code>
                        <code>M140</code>
                        <code>M141</code>
                        <code>M142</code>
                        <code>M143</code>
                        <code>M144</code>
                        <code>MA01</code>
                        <code>MA02</code>
                        <code>MA03</code>
                        <code>MA04</code>
                        <code>MA05</code>
                        <code>MA06</code>
                        <code>MA07</code>
                        <code>MA08</code>
                        <code>MA09</code>
                        <code>MA10</code>
                        <code>MA11</code>
                        <code>MA12</code>
                        <code>MA13</code>
                        <code>MA14</code>
                        <code>MA15</code>
                        <code>MA16</code>
                        <code>MA17</code>
                        <code>MA18</code>
                        <code>MA19</code>
                        <code>MA20</code>
                        <code>MA21</code>
                        <code>MA22</code>
                        <code>MA23</code>
                        <code>MA24</code>
                        <code>MA25</code>
                        <code>MA26</code>
                        <code>MA27</code>
                        <code>MA28</code>
                        <code>MA29</code>
                        <code>MA30</code>
                        <code>MA31</code>
                        <code>MA32</code>
                        <code>MA33</code>
                        <code>MA34</code>
                        <code>MA35</code>
                        <code>MA36</code>
                        <code>MA37</code>
                        <code>MA38</code>
                        <code>MA39</code>
                        <code>MA40</code>
                        <code>MA41</code>
                        <code>MA42</code>
                        <code>MA43</code>
                        <code>MA44</code>
                        <code>MA45</code>
                        <code>MA46</code>
                        <code>MA47</code>
                        <code>MA48</code>
                        <code>MA49</code>
                        <code>MA50</code>
                        <code>MA51</code>
                        <code>MA52</code>
                        <code>MA53</code>
                        <code>MA54</code>
                        <code>MA55</code>
                        <code>MA56</code>
                        <code>MA57</code>
                        <code>MA58</code>
                        <code>MA59</code>
                        <code>MA60</code>
                        <code>MA61</code>
                        <code>MA62</code>
                        <code>MA63</code>
                        <code>MA64</code>
                        <code>MA65</code>
                        <code>MA66</code>
                        <code>MA67</code>
                        <code>MA68</code>
                        <code>MA69</code>
                        <code>MA70</code>
                        <code>MA71</code>
                        <code>MA72</code>
                        <code>MA73</code>
                        <code>MA74</code>
                        <code>MA75</code>
                        <code>MA76</code>
                        <code>MA77</code>
                        <code>MA78</code>
                        <code>MA79</code>
                        <code>MA80</code>
                        <code>MA81</code>
                        <code>MA82</code>
                        <code>MA83</code>
                        <code>MA84</code>
                        <code>MA85</code>
                        <code>MA86</code>
                        <code>MA87</code>
                        <code>MA88</code>
                        <code>MA89</code>
                        <code>MA90</code>
                        <code>MA91</code>
                        <code>MA92</code>
                        <code>MA93</code>
                        <code>MA94</code>
                        <code>MA95</code>
                        <code>MA96</code>
                        <code>MA97</code>
                        <code>MA98</code>
                        <code>MA99</code>
                        <code>MA100</code>
                        <code>MA101</code>
                        <code>MA102</code>
                        <code>MA103</code>
                        <code>MA104</code>
                        <code>MA105</code>
                        <code>MA106</code>
                        <code>MA107</code>
                        <code>MA108</code>
                        <code>MA109</code>
                        <code>MA110</code>
                        <code>MA111</code>
                        <code>MA112</code>
                        <code>MA113</code>
                        <code>MA114</code>
                        <code>MA115</code>
                        <code>MA116</code>
                        <code>MA117</code>
                        <code>MA118</code>
                        <code>MA119</code>
                        <code>MA120</code>
                        <code>MA121</code>
                        <code>MA122</code>
                        <code>MA123</code>
                        <code>MA124</code>
                        <code>MA125</code>
                        <code>MA126</code>
                        <code>MA127</code>
                        <code>MA128</code>
                        <code>MA129</code>
                        <code>MA130</code>
                        <code>MA131</code>
                        <code>MA132</code>
                        <code>MA133</code>
                        <code>MA134</code>
                        <code>N1</code>
                        <code>N2</code>
                        <code>N3</code>
                        <code>N4</code>
                        <code>N5</code>
                        <code>N6</code>
                        <code>N7</code>
                        <code>N8</code>
                        <code>N9</code>
                        <code>N10</code>
                        <code>N11</code>
                        <code>N12</code>
                        <code>N13</code>
                        <code>N14</code>
                        <code>N15</code>
                        <code>N16</code>
                        <code>N17</code>
                        <code>N18</code>
                        <code>N19</code>
                        <code>N20</code>
                        <code>N21</code>
                        <code>N22</code>
                        <code>N23</code>
                        <code>N24</code>
                        <code>N25</code>
                        <code>N26</code>
                        <code>N27</code>
                        <code>N28</code>
                        <code>N29</code>
                        <code>N30</code>
                        <code>N31</code>
                        <code>N32</code>
                        <code>N33</code>
                        <code>N34</code>
                        <code>N35</code>
                        <code>N36</code>
                        <code>N37</code>
                        <code>N38</code>
                        <code>N39</code>
                        <code>N40</code>
                        <code>N41</code>
                        <code>N42</code>
                        <code>N43</code>
                        <code>N44</code>
                        <code>N45</code>
                        <code>N46</code>
                        <code>N47</code>
                        <code>N48</code>
                        <code>N49</code>
                        <code>N50</code>
                        <code>N51</code>
                        <code>N52</code>
                        <code>N53</code>
                        <code>N54</code>
                        <code>N55</code>
                        <code>N56</code>
                        <code>N57</code>
                        <code>N58</code>
                        <code>N59</code>
                        <code>N60</code>
                        <code>N61</code>
                        <code>N62</code>
                        <code>N63</code>
                        <code>N64</code>
                        <code>N65</code>
                        <code>N66</code>
                        <code>N67</code>
                        <code>N68</code>
                        <code>N69</code>
                        <code>N70</code>
                        <code>N71</code>
                        <code>N72</code>
                        <code>N73</code>
                        <code>N74</code>
                        <code>N75</code>
                        <code>N76</code>
                        <code>N77</code>
                        <code>N78</code>
                        <code>N79</code>
                        <code>N80</code>
                        <code>N81</code>
                        <code>N82</code>
                        <code>N83</code>
                        <code>N84</code>
                        <code>N85</code>
                        <code>N86</code>
                        <code>N87</code>
                        <code>N88</code>
                        <code>N89</code>
                        <code>N90</code>
                        <code>N91</code>
                        <code>N92</code>
                        <code>N93</code>
                        <code>N94</code>
                        <code>N95</code>
                        <code>N96</code>
                        <code>N97</code>
                        <code>N98</code>
                        <code>N99</code>
                        <code>N100</code>
                        <code>N101</code>
                        <code>N102</code>
                        <code>N103</code>
                        <code>N104</code>
                        <code>N105</code>
                        <code>N106</code>
                        <code>N107</code>
                        <code>N108</code>
                        <code>N109</code>
                        <code>N110</code>
                        <code>N111</code>
                        <code>N112</code>
                        <code>N113</code>
                        <code>N114</code>
                        <code>N115</code>
                        <code>N116</code>
                        <code>N117</code>
                        <code>N118</code>
                        <code>N119</code>
                        <code>N120</code>
                        <code>N121</code>
                        <code>N122</code>
                        <code>N123</code>
                        <code>N124</code>
                        <code>N125</code>
                        <code>N126</code>
                        <code>N127</code>
                        <code>N128</code>
                        <code>N129</code>
                        <code>N130</code>
                        <code>N131</code>
                        <code>N132</code>
                        <code>N133</code>
                        <code>N134</code>
                        <code>N135</code>
                        <code>N136</code>
                        <code>N137</code>
                        <code>N138</code>
                        <code>N139</code>
                        <code>N140</code>
                        <code>N141</code>
                        <code>N142</code>
                        <code>N143</code>
                        <code>N144</code>
                        <code>N145</code>
                        <code>N146</code>
                        <code>N147</code>
                        <code>N148</code>
                        <code>N149</code>
                        <code>N150</code>
                        <code>N151</code>
                        <code>N152</code>
                        <code>N153</code>
                        <code>N154</code>
                        <code>N155</code>
                        <code>N156 </code>
                      </valid_codes>
                    </element>
                    <element xid="MOA05">
                      <data_ele>127</data_ele>
                      <name>Remark Code</name>
                      <usage>S</usage>
                      <seq>05</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                      <valid_codes>
                        <code>M1</code>
                        <code>M2</code>
                        <code>M3</code>
                        <code>M4</code>
                        <code>M5</code>
                        <code>M6</code>
                        <code>M7</code>
                        <code>M8</code>
                        <code>M9</code>
                        <code>M10</code>
                        <code>M11</code>
                        <code>M12</code>
                        <code>M13</code>
                        <code>M14</code>
                        <code>M15</code>
                        <code>M16</code>
                        <code>M17</code>
                        <code>M18</code>
                        <code>M19</code>
                        <code>M20</code>
                        <code>M21</code>
                        <code>M22</code>
                        <code>M23</code>
                        <code>M24</code>
                        <code>M25</code>
                        <code>M26</code>
                        <code>M27</code>
                        <code>M28</code>
                        <code>M29</code>
                        <code>M30</code>
                        <code>M31</code>
                        <code>M32</code>
                        <code>M33</code>
                        <code>M34</code>
                        <code>M35</code>
                        <code>M36</code>
                        <code>M37</code>
                        <code>M38</code>
                        <code>M39</code>
                        <code>M40</code>
                        <code>M41</code>
                        <code>M42</code>
                        <code>M43</code>
                        <code>M44</code>
                        <code>M45</code>
                        <code>M46</code>
                        <code>M47</code>
                        <code>M48</code>
                        <code>M49</code>
                        <code>M50</code>
                        <code>M51</code>
                        <code>M52</code>
                        <code>M53</code>
                        <code>M54</code>
                        <code>M55</code>
                        <code>M56</code>
                        <code>M57</code>
                        <code>M58</code>
                        <code>M59</code>
                        <code>M60</code>
                        <code>M61</code>
                        <code>M62</code>
                        <code>M63</code>
                        <code>M64</code>
                        <code>M65</code>
                        <code>M66</code>
                        <code>M67</code>
                        <code>M68</code>
                        <code>M69</code>
                        <code>M70</code>
                        <code>M71</code>
                        <code>M72</code>
                        <code>M73</code>
                        <code>M74</code>
                        <code>M75</code>
                        <code>M76</code>
                        <code>M77</code>
                        <code>M78</code>
                        <code>M79</code>
                        <code>M80</code>
                        <code>M81</code>
                        <code>M82</code>
                        <code>M83</code>
                        <code>M84</code>
                        <code>M85</code>
                        <code>M86</code>
                        <code>M87</code>
                        <code>M88</code>
                        <code>M89</code>
                        <code>M90</code>
                        <code>M91</code>
                        <code>M92</code>
                        <code>M93</code>
                        <code>M94</code>
                        <code>M95</code>
                        <code>M96</code>
                        <code>M97</code>
                        <code>M98</code>
                        <code>M99</code>
                        <code>M100</code>
                        <code>M101</code>
                        <code>M102</code>
                        <code>M103</code>
                        <code>M104</code>
                        <code>M105</code>
                        <code>M106</code>
                        <code>M107</code>
                        <code>M108</code>
                        <code>M109</code>
                        <code>M110</code>
                        <code>M111</code>
                        <code>M112</code>
                        <code>M113</code>
                        <code>M114</code>
                        <code>M115</code>
                        <code>M116</code>
                        <code>M117</code>
                        <code>M118</code>
                        <code>M119</code>
                        <code>M120</code>
                        <code>M121</code>
                        <code>M122</code>
                        <code>M123</code>
                        <code>M124</code>
                        <code>M125</code>
                        <code>M126</code>
                        <code>M127</code>
                        <code>M128</code>
                        <code>M129</code>
                        <code>M130</code>
                        <code>M131</code>
                        <code>M132</code>
                        <code>M133</code>
                        <code>M134</code>
                        <code>M135</code>
                        <code>M136</code>
                        <code>M137</code>
                        <code>M138</code>
                        <code>M139</code>
                        <code>M140</code>
                        <code>M141</code>
                        <code>M142</code>
                        <code>M143</code>
                        <code>M144</code>
                        <code>MA01</code>
                        <code>MA02</code>
                        <code>MA03</code>
                        <code>MA04</code>
                        <code>MA05</code>
                        <code>MA06</code>
                        <code>MA07</code>
                        <code>MA08</code>
                        <code>MA09</code>
                        <code>MA10</code>
                        <code>MA11</code>
                        <code>MA12</code>
                        <code>MA13</code>
                        <code>MA14</code>
                        <code>MA15</code>
                        <code>MA16</code>
                        <code>MA17</code>
                        <code>MA18</code>
                        <code>MA19</code>
                        <code>MA20</code>
                        <code>MA21</code>
                        <code>MA22</code>
                        <code>MA23</code>
                        <code>MA24</code>
                        <code>MA25</code>
                        <code>MA26</code>
                        <code>MA27</code>
                        <code>MA28</code>
                        <code>MA29</code>
                        <code>MA30</code>
                        <code>MA31</code>
                        <code>MA32</code>
                        <code>MA33</code>
                        <code>MA34</code>
                        <code>MA35</code>
                        <code>MA36</code>
                        <code>MA37</code>
                        <code>MA38</code>
                        <code>MA39</code>
                        <code>MA40</code>
                        <code>MA41</code>
                        <code>MA42</code>
                        <code>MA43</code>
                        <code>MA44</code>
                        <code>MA45</code>
                        <code>MA46</code>
                        <code>MA47</code>
                        <code>MA48</code>
                        <code>MA49</code>
                        <code>MA50</code>
                        <code>MA51</code>
                        <code>MA52</code>
                        <code>MA53</code>
                        <code>MA54</code>
                        <code>MA55</code>
                        <code>MA56</code>
                        <code>MA57</code>
                        <code>MA58</code>
                        <code>MA59</code>
                        <code>MA60</code>
                        <code>MA61</code>
                        <code>MA62</code>
                        <code>MA63</code>
                        <code>MA64</code>
                        <code>MA65</code>
                        <code>MA66</code>
                        <code>MA67</code>
                        <code>MA68</code>
                        <code>MA69</code>
                        <code>MA70</code>
                        <code>MA71</code>
                        <code>MA72</code>
                        <code>MA73</code>
                        <code>MA74</code>
                        <code>MA75</code>
                        <code>MA76</code>
                        <code>MA77</code>
                        <code>MA78</code>
                        <code>MA79</code>
                        <code>MA80</code>
                        <code>MA81</code>
                        <code>MA82</code>
                        <code>MA83</code>
                        <code>MA84</code>
                        <code>MA85</code>
                        <code>MA86</code>
                        <code>MA87</code>
                        <code>MA88</code>
                        <code>MA89</code>
                        <code>MA90</code>
                        <code>MA91</code>
                        <code>MA92</code>
                        <code>MA93</code>
                        <code>MA94</code>
                        <code>MA95</code>
                        <code>MA96</code>
                        <code>MA97</code>
                        <code>MA98</code>
                        <code>MA99</code>
                        <code>MA100</code>
                        <code>MA101</code>
                        <code>MA102</code>
                        <code>MA103</code>
                        <code>MA104</code>
                        <code>MA105</code>
                        <code>MA106</code>
                        <code>MA107</code>
                        <code>MA108</code>
                        <code>MA109</code>
                        <code>MA110</code>
                        <code>MA111</code>
                        <code>MA112</code>
                        <code>MA113</code>
                        <code>MA114</code>
                        <code>MA115</code>
                        <code>MA116</code>
                        <code>MA117</code>
                        <code>MA118</code>
                        <code>MA119</code>
                        <code>MA120</code>
                        <code>MA121</code>
                        <code>MA122</code>
                        <code>MA123</code>
                        <code>MA124</code>
                        <code>MA125</code>
                        <code>MA126</code>
                        <code>MA127</code>
                        <code>MA128</code>
                        <code>MA129</code>
                        <code>MA130</code>
                        <code>MA131</code>
                        <code>MA132</code>
                        <code>MA133</code>
                        <code>MA134</code>
                        <code>N1</code>
                        <code>N2</code>
                        <code>N3</code>
                        <code>N4</code>
                        <code>N5</code>
                        <code>N6</code>
                        <code>N7</code>
                        <code>N8</code>
                        <code>N9</code>
                        <code>N10</code>
                        <code>N11</code>
                        <code>N12</code>
                        <code>N13</code>
                        <code>N14</code>
                        <code>N15</code>
                        <code>N16</code>
                        <code>N17</code>
                        <code>N18</code>
                        <code>N19</code>
                        <code>N20</code>
                        <code>N21</code>
                        <code>N22</code>
                        <code>N23</code>
                        <code>N24</code>
                        <code>N25</code>
                        <code>N26</code>
                        <code>N27</code>
                        <code>N28</code>
                        <code>N29</code>
                        <code>N30</code>
                        <code>N31</code>
                        <code>N32</code>
                        <code>N33</code>
                        <code>N34</code>
                        <code>N35</code>
                        <code>N36</code>
                        <code>N37</code>
                        <code>N38</code>
                        <code>N39</code>
                        <code>N40</code>
                        <code>N41</code>
                        <code>N42</code>
                        <code>N43</code>
                        <code>N44</code>
                        <code>N45</code>
                        <code>N46</code>
                        <code>N47</code>
                        <code>N48</code>
                        <code>N49</code>
                        <code>N50</code>
                        <code>N51</code>
                        <code>N52</code>
                        <code>N53</code>
                        <code>N54</code>
                        <code>N55</code>
                        <code>N56</code>
                        <code>N57</code>
                        <code>N58</code>
                        <code>N59</code>
                        <code>N60</code>
                        <code>N61</code>
                        <code>N62</code>
                        <code>N63</code>
                        <code>N64</code>
                        <code>N65</code>
                        <code>N66</code>
                        <code>N67</code>
                        <code>N68</code>
                        <code>N69</code>
                        <code>N70</code>
                        <code>N71</code>
                        <code>N72</code>
                        <code>N73</code>
                        <code>N74</code>
                        <code>N75</code>
                        <code>N76</code>
                        <code>N77</code>
                        <code>N78</code>
                        <code>N79</code>
                        <code>N80</code>
                        <code>N81</code>
                        <code>N82</code>
                        <code>N83</code>
                        <code>N84</code>
                        <code>N85</code>
                        <code>N86</code>
                        <code>N87</code>
                        <code>N88</code>
                        <code>N89</code>
                        <code>N90</code>
                        <code>N91</code>
                        <code>N92</code>
                        <code>N93</code>
                        <code>N94</code>
                        <code>N95</code>
                        <code>N96</code>
                        <code>N97</code>
                        <code>N98</code>
                        <code>N99</code>
                        <code>N100</code>
                        <code>N101</code>
                        <code>N102</code>
                        <code>N103</code>
                        <code>N104</code>
                        <code>N105</code>
                        <code>N106</code>
                        <code>N107</code>
                        <code>N108</code>
                        <code>N109</code>
                        <code>N110</code>
                        <code>N111</code>
                        <code>N112</code>
                        <code>N113</code>
                        <code>N114</code>
                        <code>N115</code>
                        <code>N116</code>
                        <code>N117</code>
                        <code>N118</code>
                        <code>N119</code>
                        <code>N120</code>
                        <code>N121</code>
                        <code>N122</code>
                        <code>N123</code>
                        <code>N124</code>
                        <code>N125</code>
                        <code>N126</code>
                        <code>N127</code>
                        <code>N128</code>
                        <code>N129</code>
                        <code>N130</code>
                        <code>N131</code>
                        <code>N132</code>
                        <code>N133</code>
                        <code>N134</code>
                        <code>N135</code>
                        <code>N136</code>
                        <code>N137</code>
                        <code>N138</code>
                        <code>N139</code>
                        <code>N140</code>
                        <code>N141</code>
                        <code>N142</code>
                        <code>N143</code>
                        <code>N144</code>
                        <code>N145</code>
                        <code>N146</code>
                        <code>N147</code>
                        <code>N148</code>
                        <code>N149</code>
                        <code>N150</code>
                        <code>N151</code>
                        <code>N152</code>
                        <code>N153</code>
                        <code>N154</code>
                        <code>N155</code>
                        <code>N156 </code>
                      </valid_codes>
                    </element>
                    <element xid="MOA06">
                      <data_ele>127</data_ele>
                      <name>Remark Code</name>
                      <usage>S</usage>
                      <seq>06</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                      <valid_codes>
                        <code>M1</code>
                        <code>M2</code>
                        <code>M3</code>
                        <code>M4</code>
                        <code>M5</code>
                        <code>M6</code>
                        <code>M7</code>
                        <code>M8</code>
                        <code>M9</code>
                        <code>M10</code>
                        <code>M11</code>
                        <code>M12</code>
                        <code>M13</code>
                        <code>M14</code>
                        <code>M15</code>
                        <code>M16</code>
                        <code>M17</code>
                        <code>M18</code>
                        <code>M19</code>
                        <code>M20</code>
                        <code>M21</code>
                        <code>M22</code>
                        <code>M23</code>
                        <code>M24</code>
                        <code>M25</code>
                        <code>M26</code>
                        <code>M27</code>
                        <code>M28</code>
                        <code>M29</code>
                        <code>M30</code>
                        <code>M31</code>
                        <code>M32</code>
                        <code>M33</code>
                        <code>M34</code>
                        <code>M35</code>
                        <code>M36</code>
                        <code>M37</code>
                        <code>M38</code>
                        <code>M39</code>
                        <code>M40</code>
                        <code>M41</code>
                        <code>M42</code>
                        <code>M43</code>
                        <code>M44</code>
                        <code>M45</code>
                        <code>M46</code>
                        <code>M47</code>
                        <code>M48</code>
                        <code>M49</code>
                        <code>M50</code>
                        <code>M51</code>
                        <code>M52</code>
                        <code>M53</code>
                        <code>M54</code>
                        <code>M55</code>
                        <code>M56</code>
                        <code>M57</code>
                        <code>M58</code>
                        <code>M59</code>
                        <code>M60</code>
                        <code>M61</code>
                        <code>M62</code>
                        <code>M63</code>
                        <code>M64</code>
                        <code>M65</code>
                        <code>M66</code>
                        <code>M67</code>
                        <code>M68</code>
                        <code>M69</code>
                        <code>M70</code>
                        <code>M71</code>
                        <code>M72</code>
                        <code>M73</code>
                        <code>M74</code>
                        <code>M75</code>
                        <code>M76</code>
                        <code>M77</code>
                        <code>M78</code>
                        <code>M79</code>
                        <code>M80</code>
                        <code>M81</code>
                        <code>M82</code>
                        <code>M83</code>
                        <code>M84</code>
                        <code>M85</code>
                        <code>M86</code>
                        <code>M87</code>
                        <code>M88</code>
                        <code>M89</code>
                        <code>M90</code>
                        <code>M91</code>
                        <code>M92</code>
                        <code>M93</code>
                        <code>M94</code>
                        <code>M95</code>
                        <code>M96</code>
                        <code>M97</code>
                        <code>M98</code>
                        <code>M99</code>
                        <code>M100</code>
                        <code>M101</code>
                        <code>M102</code>
                        <code>M103</code>
                        <code>M104</code>
                        <code>M105</code>
                        <code>M106</code>
                        <code>M107</code>
                        <code>M108</code>
                        <code>M109</code>
                        <code>M110</code>
                        <code>M111</code>
                        <code>M112</code>
                        <code>M113</code>
                        <code>M114</code>
                        <code>M115</code>
                        <code>M116</code>
                        <code>M117</code>
                        <code>M118</code>
                        <code>M119</code>
                        <code>M120</code>
                        <code>M121</code>
                        <code>M122</code>
                        <code>M123</code>
                        <code>M124</code>
                        <code>M125</code>
                        <code>M126</code>
                        <code>M127</code>
                        <code>M128</code>
                        <code>M129</code>
                        <code>M130</code>
                        <code>M131</code>
                        <code>M132</code>
                        <code>M133</code>
                        <code>M134</code>
                        <code>M135</code>
                        <code>M136</code>
                        <code>M137</code>
                        <code>M138</code>
                        <code>M139</code>
                        <code>M140</code>
                        <code>M141</code>
                        <code>M142</code>
                        <code>M143</code>
                        <code>M144</code>
                        <code>MA01</code>
                        <code>MA02</code>
                        <code>MA03</code>
                        <code>MA04</code>
                        <code>MA05</code>
                        <code>MA06</code>
                        <code>MA07</code>
                        <code>MA08</code>
                        <code>MA09</code>
                        <code>MA10</code>
                        <code>MA11</code>
                        <code>MA12</code>
                        <code>MA13</code>
                        <code>MA14</code>
                        <code>MA15</code>
                        <code>MA16</code>
                        <code>MA17</code>
                        <code>MA18</code>
                        <code>MA19</code>
                        <code>MA20</code>
                        <code>MA21</code>
                        <code>MA22</code>
                        <code>MA23</code>
                        <code>MA24</code>
                        <code>MA25</code>
                        <code>MA26</code>
                        <code>MA27</code>
                        <code>MA28</code>
                        <code>MA29</code>
                        <code>MA30</code>
                        <code>MA31</code>
                        <code>MA32</code>
                        <code>MA33</code>
                        <code>MA34</code>
                        <code>MA35</code>
                        <code>MA36</code>
                        <code>MA37</code>
                        <code>MA38</code>
                        <code>MA39</code>
                        <code>MA40</code>
                        <code>MA41</code>
                        <code>MA42</code>
                        <code>MA43</code>
                        <code>MA44</code>
                        <code>MA45</code>
                        <code>MA46</code>
                        <code>MA47</code>
                        <code>MA48</code>
                        <code>MA49</code>
                        <code>MA50</code>
                        <code>MA51</code>
                        <code>MA52</code>
                        <code>MA53</code>
                        <code>MA54</code>
                        <code>MA55</code>
                        <code>MA56</code>
                        <code>MA57</code>
                        <code>MA58</code>
                        <code>MA59</code>
                        <code>MA60</code>
                        <code>MA61</code>
                        <code>MA62</code>
                        <code>MA63</code>
                        <code>MA64</code>
                        <code>MA65</code>
                        <code>MA66</code>
                        <code>MA67</code>
                        <code>MA68</code>
                        <code>MA69</code>
                        <code>MA70</code>
                        <code>MA71</code>
                        <code>MA72</code>
                        <code>MA73</code>
                        <code>MA74</code>
                        <code>MA75</code>
                        <code>MA76</code>
                        <code>MA77</code>
                        <code>MA78</code>
                        <code>MA79</code>
                        <code>MA80</code>
                        <code>MA81</code>
                        <code>MA82</code>
                        <code>MA83</code>
                        <code>MA84</code>
                        <code>MA85</code>
                        <code>MA86</code>
                        <code>MA87</code>
                        <code>MA88</code>
                        <code>MA89</code>
                        <code>MA90</code>
                        <code>MA91</code>
                        <code>MA92</code>
                        <code>MA93</code>
                        <code>MA94</code>
                        <code>MA95</code>
                        <code>MA96</code>
                        <code>MA97</code>
                        <code>MA98</code>
                        <code>MA99</code>
                        <code>MA100</code>
                        <code>MA101</code>
                        <code>MA102</code>
                        <code>MA103</code>
                        <code>MA104</code>
                        <code>MA105</code>
                        <code>MA106</code>
                        <code>MA107</code>
                        <code>MA108</code>
                        <code>MA109</code>
                        <code>MA110</code>
                        <code>MA111</code>
                        <code>MA112</code>
                        <code>MA113</code>
                        <code>MA114</code>
                        <code>MA115</code>
                        <code>MA116</code>
                        <code>MA117</code>
                        <code>MA118</code>
                        <code>MA119</code>
                        <code>MA120</code>
                        <code>MA121</code>
                        <code>MA122</code>
                        <code>MA123</code>
                        <code>MA124</code>
                        <code>MA125</code>
                        <code>MA126</code>
                        <code>MA127</code>
                        <code>MA128</code>
                        <code>MA129</code>
                        <code>MA130</code>
                        <code>MA131</code>
                        <code>MA132</code>
                        <code>MA133</code>
                        <code>MA134</code>
                        <code>N1</code>
                        <code>N2</code>
                        <code>N3</code>
                        <code>N4</code>
                        <code>N5</code>
                        <code>N6</code>
                        <code>N7</code>
                        <code>N8</code>
                        <code>N9</code>
                        <code>N10</code>
                        <code>N11</code>
                        <code>N12</code>
                        <code>N13</code>
                        <code>N14</code>
                        <code>N15</code>
                        <code>N16</code>
                        <code>N17</code>
                        <code>N18</code>
                        <code>N19</code>
                        <code>N20</code>
                        <code>N21</code>
                        <code>N22</code>
                        <code>N23</code>
                        <code>N24</code>
                        <code>N25</code>
                        <code>N26</code>
                        <code>N27</code>
                        <code>N28</code>
                        <code>N29</code>
                        <code>N30</code>
                        <code>N31</code>
                        <code>N32</code>
                        <code>N33</code>
                        <code>N34</code>
                        <code>N35</code>
                        <code>N36</code>
                        <code>N37</code>
                        <code>N38</code>
                        <code>N39</code>
                        <code>N40</code>
                        <code>N41</code>
                        <code>N42</code>
                        <code>N43</code>
                        <code>N44</code>
                        <code>N45</code>
                        <code>N46</code>
                        <code>N47</code>
                        <code>N48</code>
                        <code>N49</code>
                        <code>N50</code>
                        <code>N51</code>
                        <code>N52</code>
                        <code>N53</code>
                        <code>N54</code>
                        <code>N55</code>
                        <code>N56</code>
                        <code>N57</code>
                        <code>N58</code>
                        <code>N59</code>
                        <code>N60</code>
                        <code>N61</code>
                        <code>N62</code>
                        <code>N63</code>
                        <code>N64</code>
                        <code>N65</code>
                        <code>N66</code>
                        <code>N67</code>
                        <code>N68</code>
                        <code>N69</code>
                        <code>N70</code>
                        <code>N71</code>
                        <code>N72</code>
                        <code>N73</code>
                        <code>N74</code>
                        <code>N75</code>
                        <code>N76</code>
                        <code>N77</code>
                        <code>N78</code>
                        <code>N79</code>
                        <code>N80</code>
                        <code>N81</code>
                        <code>N82</code>
                        <code>N83</code>
                        <code>N84</code>
                        <code>N85</code>
                        <code>N86</code>
                        <code>N87</code>
                        <code>N88</code>
                        <code>N89</code>
                        <code>N90</code>
                        <code>N91</code>
                        <code>N92</code>
                        <code>N93</code>
                        <code>N94</code>
                        <code>N95</code>
                        <code>N96</code>
                        <code>N97</code>
                        <code>N98</code>
                        <code>N99</code>
                        <code>N100</code>
                        <code>N101</code>
                        <code>N102</code>
                        <code>N103</code>
                        <code>N104</code>
                        <code>N105</code>
                        <code>N106</code>
                        <code>N107</code>
                        <code>N108</code>
                        <code>N109</code>
                        <code>N110</code>
                        <code>N111</code>
                        <code>N112</code>
                        <code>N113</code>
                        <code>N114</code>
                        <code>N115</code>
                        <code>N116</code>
                        <code>N117</code>
                        <code>N118</code>
                        <code>N119</code>
                        <code>N120</code>
                        <code>N121</code>
                        <code>N122</code>
                        <code>N123</code>
                        <code>N124</code>
                        <code>N125</code>
                        <code>N126</code>
                        <code>N127</code>
                        <code>N128</code>
                        <code>N129</code>
                        <code>N130</code>
                        <code>N131</code>
                        <code>N132</code>
                        <code>N133</code>
                        <code>N134</code>
                        <code>N135</code>
                        <code>N136</code>
                        <code>N137</code>
                        <code>N138</code>
                        <code>N139</code>
                        <code>N140</code>
                        <code>N141</code>
                        <code>N142</code>
                        <code>N143</code>
                        <code>N144</code>
                        <code>N145</code>
                        <code>N146</code>
                        <code>N147</code>
                        <code>N148</code>
                        <code>N149</code>
                        <code>N150</code>
                        <code>N151</code>
                        <code>N152</code>
                        <code>N153</code>
                        <code>N154</code>
                        <code>N155</code>
                        <code>N156 </code>
                      </valid_codes>
                    </element>
                    <element xid="MOA07">
                      <data_ele>127</data_ele>
                      <name>Remark Code</name>
                      <usage>S</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                      <valid_codes>
                        <code>M1</code>
                        <code>M2</code>
                        <code>M3</code>
                        <code>M4</code>
                        <code>M5</code>
                        <code>M6</code>
                        <code>M7</code>
                        <code>M8</code>
                        <code>M9</code>
                        <code>M10</code>
                        <code>M11</code>
                        <code>M12</code>
                        <code>M13</code>
                        <code>M14</code>
                        <code>M15</code>
                        <code>M16</code>
                        <code>M17</code>
                        <code>M18</code>
                        <code>M19</code>
                        <code>M20</code>
                        <code>M21</code>
                        <code>M22</code>
                        <code>M23</code>
                        <code>M24</code>
                        <code>M25</code>
                        <code>M26</code>
                        <code>M27</code>
                        <code>M28</code>
                        <code>M29</code>
                        <code>M30</code>
                        <code>M31</code>
                        <code>M32</code>
                        <code>M33</code>
                        <code>M34</code>
                        <code>M35</code>
                        <code>M36</code>
                        <code>M37</code>
                        <code>M38</code>
                        <code>M39</code>
                        <code>M40</code>
                        <code>M41</code>
                        <code>M42</code>
                        <code>M43</code>
                        <code>M44</code>
                        <code>M45</code>
                        <code>M46</code>
                        <code>M47</code>
                        <code>M48</code>
                        <code>M49</code>
                        <code>M50</code>
                        <code>M51</code>
                        <code>M52</code>
                        <code>M53</code>
                        <code>M54</code>
                        <code>M55</code>
                        <code>M56</code>
                        <code>M57</code>
                        <code>M58</code>
                        <code>M59</code>
                        <code>M60</code>
                        <code>M61</code>
                        <code>M62</code>
                        <code>M63</code>
                        <code>M64</code>
                        <code>M65</code>
                        <code>M66</code>
                        <code>M67</code>
                        <code>M68</code>
                        <code>M69</code>
                        <code>M70</code>
                        <code>M71</code>
                        <code>M72</code>
                        <code>M73</code>
                        <code>M74</code>
                        <code>M75</code>
                        <code>M76</code>
                        <code>M77</code>
                        <code>M78</code>
                        <code>M79</code>
                        <code>M80</code>
                        <code>M81</code>
                        <code>M82</code>
                        <code>M83</code>
                        <code>M84</code>
                        <code>M85</code>
                        <code>M86</code>
                        <code>M87</code>
                        <code>M88</code>
                        <code>M89</code>
                        <code>M90</code>
                        <code>M91</code>
                        <code>M92</code>
                        <code>M93</code>
                        <code>M94</code>
                        <code>M95</code>
                        <code>M96</code>
                        <code>M97</code>
                        <code>M98</code>
                        <code>M99</code>
                        <code>M100</code>
                        <code>M101</code>
                        <code>M102</code>
                        <code>M103</code>
                        <code>M104</code>
                        <code>M105</code>
                        <code>M106</code>
                        <code>M107</code>
                        <code>M108</code>
                        <code>M109</code>
                        <code>M110</code>
                        <code>M111</code>
                        <code>M112</code>
                        <code>M113</code>
                        <code>M114</code>
                        <code>M115</code>
                        <code>M116</code>
                        <code>M117</code>
                        <code>M118</code>
                        <code>M119</code>
                        <code>M120</code>
                        <code>M121</code>
                        <code>M122</code>
                        <code>M123</code>
                        <code>M124</code>
                        <code>M125</code>
                        <code>M126</code>
                        <code>M127</code>
                        <code>M128</code>
                        <code>M129</code>
                        <code>M130</code>
                        <code>M131</code>
                        <code>M132</code>
                        <code>M133</code>
                        <code>M134</code>
                        <code>M135</code>
                        <code>M136</code>
                        <code>M137</code>
                        <code>M138</code>
                        <code>M139</code>
                        <code>M140</code>
                        <code>M141</code>
                        <code>M142</code>
                        <code>M143</code>
                        <code>M144</code>
                        <code>MA01</code>
                        <code>MA02</code>
                        <code>MA03</code>
                        <code>MA04</code>
                        <code>MA05</code>
                        <code>MA06</code>
                        <code>MA07</code>
                        <code>MA08</code>
                        <code>MA09</code>
                        <code>MA10</code>
                        <code>MA11</code>
                        <code>MA12</code>
                        <code>MA13</code>
                        <code>MA14</code>
                        <code>MA15</code>
                        <code>MA16</code>
                        <code>MA17</code>
                        <code>MA18</code>
                        <code>MA19</code>
                        <code>MA20</code>
                        <code>MA21</code>
                        <code>MA22</code>
                        <code>MA23</code>
                        <code>MA24</code>
                        <code>MA25</code>
                        <code>MA26</code>
                        <code>MA27</code>
                        <code>MA28</code>
                        <code>MA29</code>
                        <code>MA30</code>
                        <code>MA31</code>
                        <code>MA32</code>
                        <code>MA33</code>
                        <code>MA34</code>
                        <code>MA35</code>
                        <code>MA36</code>
                        <code>MA37</code>
                        <code>MA38</code>
                        <code>MA39</code>
                        <code>MA40</code>
                        <code>MA41</code>
                        <code>MA42</code>
                        <code>MA43</code>
                        <code>MA44</code>
                        <code>MA45</code>
                        <code>MA46</code>
                        <code>MA47</code>
                        <code>MA48</code>
                        <code>MA49</code>
                        <code>MA50</code>
                        <code>MA51</code>
                        <code>MA52</code>
                        <code>MA53</code>
                        <code>MA54</code>
                        <code>MA55</code>
                        <code>MA56</code>
                        <code>MA57</code>
                        <code>MA58</code>
                        <code>MA59</code>
                        <code>MA60</code>
                        <code>MA61</code>
                        <code>MA62</code>
                        <code>MA63</code>
                        <code>MA64</code>
                        <code>MA65</code>
                        <code>MA66</code>
                        <code>MA67</code>
                        <code>MA68</code>
                        <code>MA69</code>
                        <code>MA70</code>
                        <code>MA71</code>
                        <code>MA72</code>
                        <code>MA73</code>
                        <code>MA74</code>
                        <code>MA75</code>
                        <code>MA76</code>
                        <code>MA77</code>
                        <code>MA78</code>
                        <code>MA79</code>
                        <code>MA80</code>
                        <code>MA81</code>
                        <code>MA82</code>
                        <code>MA83</code>
                        <code>MA84</code>
                        <code>MA85</code>
                        <code>MA86</code>
                        <code>MA87</code>
                        <code>MA88</code>
                        <code>MA89</code>
                        <code>MA90</code>
                        <code>MA91</code>
                        <code>MA92</code>
                        <code>MA93</code>
                        <code>MA94</code>
                        <code>MA95</code>
                        <code>MA96</code>
                        <code>MA97</code>
                        <code>MA98</code>
                        <code>MA99</code>
                        <code>MA100</code>
                        <code>MA101</code>
                        <code>MA102</code>
                        <code>MA103</code>
                        <code>MA104</code>
                        <code>MA105</code>
                        <code>MA106</code>
                        <code>MA107</code>
                        <code>MA108</code>
                        <code>MA109</code>
                        <code>MA110</code>
                        <code>MA111</code>
                        <code>MA112</code>
                        <code>MA113</code>
                        <code>MA114</code>
                        <code>MA115</code>
                        <code>MA116</code>
                        <code>MA117</code>
                        <code>MA118</code>
                        <code>MA119</code>
                        <code>MA120</code>
                        <code>MA121</code>
                        <code>MA122</code>
                        <code>MA123</code>
                        <code>MA124</code>
                        <code>MA125</code>
                        <code>MA126</code>
                        <code>MA127</code>
                        <code>MA128</code>
                        <code>MA129</code>
                        <code>MA130</code>
                        <code>MA131</code>
                        <code>MA132</code>
                        <code>MA133</code>
                        <code>MA134</code>
                        <code>N1</code>
                        <code>N2</code>
                        <code>N3</code>
                        <code>N4</code>
                        <code>N5</code>
                        <code>N6</code>
                        <code>N7</code>
                        <code>N8</code>
                        <code>N9</code>
                        <code>N10</code>
                        <code>N11</code>
                        <code>N12</code>
                        <code>N13</code>
                        <code>N14</code>
                        <code>N15</code>
                        <code>N16</code>
                        <code>N17</code>
                        <code>N18</code>
                        <code>N19</code>
                        <code>N20</code>
                        <code>N21</code>
                        <code>N22</code>
                        <code>N23</code>
                        <code>N24</code>
                        <code>N25</code>
                        <code>N26</code>
                        <code>N27</code>
                        <code>N28</code>
                        <code>N29</code>
                        <code>N30</code>
                        <code>N31</code>
                        <code>N32</code>
                        <code>N33</code>
                        <code>N34</code>
                        <code>N35</code>
                        <code>N36</code>
                        <code>N37</code>
                        <code>N38</code>
                        <code>N39</code>
                        <code>N40</code>
                        <code>N41</code>
                        <code>N42</code>
                        <code>N43</code>
                        <code>N44</code>
                        <code>N45</code>
                        <code>N46</code>
                        <code>N47</code>
                        <code>N48</code>
                        <code>N49</code>
                        <code>N50</code>
                        <code>N51</code>
                        <code>N52</code>
                        <code>N53</code>
                        <code>N54</code>
                        <code>N55</code>
                        <code>N56</code>
                        <code>N57</code>
                        <code>N58</code>
                        <code>N59</code>
                        <code>N60</code>
                        <code>N61</code>
                        <code>N62</code>
                        <code>N63</code>
                        <code>N64</code>
                        <code>N65</code>
                        <code>N66</code>
                        <code>N67</code>
                        <code>N68</code>
                        <code>N69</code>
                        <code>N70</code>
                        <code>N71</code>
                        <code>N72</code>
                        <code>N73</code>
                        <code>N74</code>
                        <code>N75</code>
                        <code>N76</code>
                        <code>N77</code>
                        <code>N78</code>
                        <code>N79</code>
                        <code>N80</code>
                        <code>N81</code>
                        <code>N82</code>
                        <code>N83</code>
                        <code>N84</code>
                        <code>N85</code>
                        <code>N86</code>
                        <code>N87</code>
                        <code>N88</code>
                        <code>N89</code>
                        <code>N90</code>
                        <code>N91</code>
                        <code>N92</code>
                        <code>N93</code>
                        <code>N94</code>
                        <code>N95</code>
                        <code>N96</code>
                        <code>N97</code>
                        <code>N98</code>
                        <code>N99</code>
                        <code>N100</code>
                        <code>N101</code>
                        <code>N102</code>
                        <code>N103</code>
                        <code>N104</code>
                        <code>N105</code>
                        <code>N106</code>
                        <code>N107</code>
                        <code>N108</code>
                        <code>N109</code>
                        <code>N110</code>
                        <code>N111</code>
                        <code>N112</code>
                        <code>N113</code>
                        <code>N114</code>
                        <code>N115</code>
                        <code>N116</code>
                        <code>N117</code>
                        <code>N118</code>
                        <code>N119</code>
                        <code>N120</code>
                        <code>N121</code>
                        <code>N122</code>
                        <code>N123</code>
                        <code>N124</code>
                        <code>N125</code>
                        <code>N126</code>
                        <code>N127</code>
                        <code>N128</code>
                        <code>N129</code>
                        <code>N130</code>
                        <code>N131</code>
                        <code>N132</code>
                        <code>N133</code>
                        <code>N134</code>
                        <code>N135</code>
                        <code>N136</code>
                        <code>N137</code>
                        <code>N138</code>
                        <code>N139</code>
                        <code>N140</code>
                        <code>N141</code>
                        <code>N142</code>
                        <code>N143</code>
                        <code>N144</code>
                        <code>N145</code>
                        <code>N146</code>
                        <code>N147</code>
                        <code>N148</code>
                        <code>N149</code>
                        <code>N150</code>
                        <code>N151</code>
                        <code>N152</code>
                        <code>N153</code>
                        <code>N154</code>
                        <code>N155</code>
                        <code>N156 </code>
                      </valid_codes>
                    </element>
                    <element xid="MOA08">
                      <data_ele>782</data_ele>
                      <name>Claim ESRD Payment Amount</name>
                      <usage>S</usage>
                      <seq>08</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="MOA09">
                      <data_ele>782</data_ele>
                      <name>Nonpayable Professional Component Amount</name>
                      <usage>S</usage>
                      <seq>09</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                  </segment>
<!--End of MOA segment-->
                  <loop xid="2330A">
                    <name>Other Subscriber Name</name>
                    <usage>R</usage>
                    <pos>325</pos>
                    <repeat>1</repeat>
                    <segment xid="NM1">
                      <name>Other Subscriber Name</name>
                      <usage>R</usage>
                      <pos>325</pos>
                      <max_use>1</max_use>
                      <element xid="NM101">
                        <data_ele>98</data_ele>
                        <name>Entity Identifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>IL</code>
                        </valid_codes>
                      </element>
                      <element xid="NM102">
                        <data_ele>1065</data_ele>
                        <name>Entity Type Qualifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                        <valid_codes>
                          <code>1</code>
                          <code>2</code>
                        </valid_codes>
                      </element>
                      <element xid="NM103">
                        <data_ele>1035</data_ele>
                        <name>Other Insured Last Name</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="NM104">
                        <data_ele>1036</data_ele>
                        <name>Other Insured First Name</name>
                        <usage>S</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>25</max_len>
                      </element>
                      <element xid="NM105">
                        <data_ele>1037</data_ele>
                        <name>Other Insured Middle Name</name>
                        <usage>S</usage>
                        <seq>05</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>25</max_len>
                      </element>
                      <element xid="NM106">
                        <data_ele>1038</data_ele>
                        <name>fix</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="NM107">
                        <data_ele>1039</data_ele>
                        <name>Other Insured Name Suffix</name>
                        <usage>S</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="NM108">
                        <data_ele>66</data_ele>
                        <name>Identification Code Qualifier</name>
                        <usage>R</usage>
                        <seq>08</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>MI</code>
                          <code>ZZ</code>
                        </valid_codes>
                      </element>
                      <element xid="NM109">
                        <data_ele>67</data_ele>
                        <name>Other Insured Identifier</name>
                        <usage>R</usage>
                        <seq>09</seq>
                        <data_type>AN</data_type>
                        <min_len>2</min_len>
                        <max_len>80</max_len>
                      </element>
                      <element xid="NM110">
                        <data_ele>706</data_ele>
                        <name>Entity Relationship Code</name>
                        <usage>N</usage>
                        <seq>10</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="NM111">
                        <data_ele>98</data_ele>
                        <name>Entity Identifier Code</name>
                        <usage>N</usage>
                        <seq>11</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                    </segment>
<!--End of NM1 segment-->
                    <segment xid="N3">
                      <name>Other Subscriber Address</name>
                      <usage>S</usage>
                      <pos>332</pos>
                      <max_use>1</max_use>
                      <element xid="N301">
                        <data_ele>166</data_ele>
                        <name>Other Insured Address Line</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>55</max_len>
                      </element>
                      <element xid="N302">
                        <data_ele>166</data_ele>
                        <name>Other Insured Address Line</name>
                        <usage>S</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>55</max_len>
                      </element>
                    </segment>
<!--End of N3 segment-->
                    <segment xid="N4">
                      <name>Other Subscriber City/State/ZIP Code</name>
                      <usage>S</usage>
                      <pos>340</pos>
                      <max_use>1</max_use>
                      <element xid="N401">
                        <data_ele>19</data_ele>
                        <name>Other Insured City Name</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>AN</data_type>
                        <min_len>2</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="N402">
                        <data_ele>156</data_ele>
                        <name>Other Insured State Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                        <valid_codes external="states"/>
                      </element>
                      <element xid="N403">
                        <data_ele>116</data_ele>
                        <name>Other Insured Postal Zone or Zip Code</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>3</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="N404">
                        <data_ele>26</data_ele>
                        <name>Subscriber Country Code</name>
                        <usage>S</usage>
                        <seq>04</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes external="country"/>
                      </element>
                      <element xid="N405">
                        <data_ele>309</data_ele>
                        <name>Location Qualifier</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="N406">
                        <data_ele>310</data_ele>
                        <name>Location Identifier</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </segment>
<!--End of N4 segment-->
                    <segment xid="REF">
                      <name>Other Subscriber Secondary Information</name>
                      <usage>S</usage>
                      <pos>355</pos>
                      <max_use>3</max_use>
                      <element xid="REF01">
                        <data_ele>128</data_ele>
                        <name>Reference Identification Qualifier</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>1W</code>
                          <code>23</code>
                          <code>IG</code>
                          <code>SY</code>
                        </valid_codes>
                      </element>
                      <element xid="REF02">
                        <data_ele>127</data_ele>
                        <name>Other Insured Additional Identifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="REF03">
                        <data_ele>352</data_ele>
                        <name>Description</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>80</max_len>
                      </element>
                      <composite>
                        <data_ele>C040</data_ele>
                        <name>Reference Identifier</name>
                        <usage>N</usage>
                        <seq>04</seq>
                      </composite>
                    </segment>
<!--End of REF segment-->
                  </loop>
<!--End of 2330A loop-->
                  <loop xid="2330B">
                    <name>Other Payer Name</name>
                    <usage>R</usage>
                    <pos>325</pos>
                    <repeat>1</repeat>
                    <segment xid="NM1">
                      <name>Other Payer Name</name>
                      <usage>R</usage>
                      <pos>325</pos>
                      <max_use>1</max_use>
                      <element xid="NM101">
                        <data_ele>98</data_ele>
                        <name>Entity Identifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>PR</code>
                        </valid_codes>
                      </element>
                      <element xid="NM102">
                        <data_ele>1065</data_ele>
                        <name>Entity Type Qualifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                        <valid_codes>
                          <code>2</code>
                        </valid_codes>
                      </element>
                      <element xid="NM103">
                        <data_ele>1035</data_ele>
                        <name>Other Payer Last or Organization Name</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="NM104">
                        <data_ele>1036</data_ele>
                        <name>Name First</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>25</max_len>
                      </element>
                      <element xid="NM105">
                        <data_ele>1037</data_ele>
                        <name>Name Middle</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>25</max_len>
                      </element>
                      <element xid="NM106">
                        <data_ele>1038</data_ele>
                        <name>Name Prefix</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="NM107">
                        <data_ele>1039</data_ele>
                        <name>Name Suffix</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="NM108">
                        <data_ele>66</data_ele>
                        <name>Identification Code Qualifier</name>
                        <usage>R</usage>
                        <seq>08</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>PI</code>
                          <code>XV</code>
                        </valid_codes>
                      </element>
                      <element xid="NM109">
                        <data_ele>67</data_ele>
                        <name>Other Payer Primary Identifier</name>
                        <usage>R</usage>
                        <seq>09</seq>
                        <data_type>AN</data_type>
                        <min_len>2</min_len>
                        <max_len>80</max_len>
                      </element>
                      <element xid="NM110">
                        <data_ele>706</data_ele>
                        <name>Entity Relationship Code</name>
                        <usage>N</usage>
                        <seq>10</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="NM111">
                        <data_ele>98</data_ele>
                        <name>Entity Identifier Code</name>
                        <usage>N</usage>
                        <seq>11</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                    </segment>
<!--End of NM1 segment-->
                    <segment xid="N3">
                      <name>Other Payer Address</name>
                      <usage>S</usage>
                      <pos>332</pos>
                      <max_use>1</max_use>
                      <element xid="N301">
                        <data_ele>166</data_ele>
                        <name>Other Payer Address Line</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>55</max_len>
                      </element>
                      <element xid="N302">
                        <data_ele>166</data_ele>
                        <name>Other Payer Address Line</name>
                        <usage>S</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>55</max_len>
                      </element>
                    </segment>
<!--End of N3 segment-->
                    <segment xid="N4">
                      <name>Other Payer City/State/ZIP Code</name>
                      <usage>S</usage>
                      <pos>340</pos>
                      <max_use>1</max_use>
                      <element xid="N401">
                        <data_ele>19</data_ele>
                        <name>Other Payer City Name</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>AN</data_type>
                        <min_len>2</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="N402">
                        <data_ele>156</data_ele>
                        <name>Other Payer State Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                        <valid_codes external="states"/>
                      </element>
                      <element xid="N403">
                        <data_ele>116</data_ele>
                        <name>Other Payer Postal Zone or Zip Code</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>3</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="N404">
                        <data_ele>26</data_ele>
                        <name>Payer Country Code</name>
                        <usage>S</usage>
                        <seq>04</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes external="country"/>
                      </element>
                      <element xid="N405">
                        <data_ele>309</data_ele>
                        <name>Location Qualifier</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="N406">
                        <data_ele>310</data_ele>
                        <name>Location Identifier</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </segment>
<!--End of N4 segment-->
                    <segment xid="DTP">
                      <name>Claim Adjudication Date</name>
                      <usage>S</usage>
                      <pos>350</pos>
                      <max_use>1</max_use>
                      <element xid="DTP01">
                        <data_ele>374</data_ele>
                        <name>Date Time Qualifier</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>3</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>573</code>
                        </valid_codes>
                      </element>
                      <element xid="DTP02">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>D8</code>
                        </valid_codes>
                      </element>
                      <element xid="DTP03">
                        <data_ele>1251</data_ele>
                        <name>Adjudication or Payment Date</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                    </segment>
<!--End of DTP segment-->
                    <segment xid="REF">
                      <name>Other Payer Secondary Identification and Reference Number</name>
                      <usage>S</usage>
                      <pos>355</pos>
                      <max_use>2</max_use>
                      <element xid="REF01">
                        <data_ele>128</data_ele>
                        <name>Reference Identification Qualifier</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>2U</code>
                          <code>F8</code>
                          <code>FY</code>
                          <code>NF</code>
                          <code>TJ</code>
                        </valid_codes>
                      </element>
                      <element xid="REF02">
                        <data_ele>127</data_ele>
                        <name>Other Payer Secondary Identifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="REF03">
                        <data_ele>352</data_ele>
                        <name>Description</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>80</max_len>
                      </element>
                      <composite>
                        <data_ele>C040</data_ele>
                        <name>Reference Identifier</name>
                        <usage>N</usage>
                        <seq>04</seq>
                      </composite>
                    </segment>
<!--End of REF segment-->
                    <segment xid="REF">
                      <name>Other Payer Prior Authorization or Referral Number</name>
                      <usage>S</usage>
                      <pos>355</pos>
                      <max_use>1</max_use>
                      <element xid="REF01">
                        <data_ele>128</data_ele>
                        <name>Reference Identification Qualifier</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>9F</code>
                          <code>G1</code>
                        </valid_codes>
                      </element>
                      <element xid="REF02">
                        <data_ele>127</data_ele>
                        <name>Other Payer Prior Authorization or Referral Number</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="REF03">
                        <data_ele>352</data_ele>
                        <name>Description</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>80</max_len>
                      </element>
                      <composite>
                        <data_ele>C040</data_ele>
                        <name>Reference Identifier</name>
                        <usage>N</usage>
                        <seq>04</seq>
                      </composite>
                    </segment>
<!--End of REF segment-->
                  </loop>
<!--End of 2330B loop-->
                  <loop xid="2330C">
                    <name>Other Payer Patient Information</name>
                    <usage>S</usage>
                    <pos>325</pos>
                    <repeat>1</repeat>
                    <segment xid="NM1">
                      <name>Other Payer Patient Information</name>
                      <usage>R</usage>
                      <pos>325</pos>
                      <max_use>1</max_use>
                      <element xid="NM101">
                        <data_ele>98</data_ele>
                        <name>Entity Identifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>QC</code>
                        </valid_codes>
                      </element>
                      <element xid="NM102">
                        <data_ele>1065</data_ele>
                        <name>Entity Type Qualifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                        <valid_codes>
                          <code>1</code>
                        </valid_codes>
                      </element>
                      <element xid="NM103">
                        <data_ele>1035</data_ele>
                        <name>Name Last or Organization Name</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="NM104">
                        <data_ele>1036</data_ele>
                        <name>Name First</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>25</max_len>
                      </element>
                      <element xid="NM105">
                        <data_ele>1037</data_ele>
                        <name>Name Middle</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>25</max_len>
                      </element>
                      <element xid="NM106">
                        <data_ele>1038</data_ele>
                        <name>Name Prefix</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="NM107">
                        <data_ele>1039</data_ele>
                        <name>Name Suffix</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="NM108">
                        <data_ele>66</data_ele>
                        <name>Identification Code Qualifier</name>
                        <usage>R</usage>
                        <seq>08</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>EI</code>
                          <code>MI</code>
                        </valid_codes>
                      </element>
                      <element xid="NM109">
                        <data_ele>67</data_ele>
                        <name>Other Payer Patient Primary Identifier</name>
                        <usage>R</usage>
                        <seq>09</seq>
                        <data_type>AN</data_type>
                        <min_len>2</min_len>
                        <max_len>80</max_len>
                      </element>
                      <element xid="NM110">
                        <data_ele>706</data_ele>
                        <name>Entity Relationship Code</name>
                        <usage>N</usage>
                        <seq>10</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="NM111">
                        <data_ele>98</data_ele>
                        <name>Entity Identifier Code</name>
                        <usage>N</usage>
                        <seq>11</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                    </segment>
<!--End of NM1 segment-->
                    <segment xid="REF">
                      <name>Other Payer identification Number</name>
                      <usage>S</usage>
                      <pos>355</pos>
                      <max_use>3</max_use>
                      <element xid="REF01">
                        <data_ele>128</data_ele>
                        <name>Reference Identification Qualifier</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>1W</code>
                          <code>IG</code>
                          <code>SY</code>
                        </valid_codes>
                      </element>
                      <element xid="REF02">
                        <data_ele>127</data_ele>
                        <name>Other Payer Patient Secondary Identifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="REF03">
                        <data_ele>352</data_ele>
                        <name>Description</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>80</max_len>
                      </element>
                      <composite>
                        <data_ele>C040</data_ele>
                        <name>Reference Identifier</name>
                        <usage>N</usage>
                        <seq>04</seq>
                      </composite>
                    </segment>
<!--End of REF segment-->
                  </loop>
<!--End of 2330C loop-->
                  <loop xid="2330D">
                    <name>Other Payer Attending Provider</name>
                    <usage>S</usage>
                    <pos>325</pos>
                    <repeat>1</repeat>
                    <segment xid="NM1">
                      <name>Other Payer Attending Provider</name>
                      <usage>R</usage>
                      <pos>325</pos>
                      <max_use>1</max_use>
                      <element xid="NM101">
                        <data_ele>98</data_ele>
                        <name>Entity Identifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>71</code>
                        </valid_codes>
                      </element>
                      <element xid="NM102">
                        <data_ele>1065</data_ele>
                        <name>Entity Type Qualifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                        <valid_codes>
                          <code>1</code>
                          <code>2</code>
                        </valid_codes>
                      </element>
                      <element xid="NM103">
                        <data_ele>1035</data_ele>
                        <name>Name Last or Organization Name</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="NM104">
                        <data_ele>1036</data_ele>
                        <name>Name First</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>25</max_len>
                      </element>
                      <element xid="NM105">
                        <data_ele>1037</data_ele>
                        <name>Name Middle</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>25</max_len>
                      </element>
                      <element xid="NM106">
                        <data_ele>1038</data_ele>
                        <name>Name Prefix</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="NM107">
                        <data_ele>1039</data_ele>
                        <name>Name Suffix</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="NM108">
                        <data_ele>66</data_ele>
                        <name>Identification Code Qualifier</name>
                        <usage>N</usage>
                        <seq>08</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="NM109">
                        <data_ele>67</data_ele>
                        <name>Identification Code</name>
                        <usage>N</usage>
                        <seq>09</seq>
                        <data_type>AN</data_type>
                        <min_len>2</min_len>
                        <max_len>80</max_len>
                      </element>
                      <element xid="NM110">
                        <data_ele>706</data_ele>
                        <name>Entity Relationship Code</name>
                        <usage>N</usage>
                        <seq>10</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="NM111">
                        <data_ele>98</data_ele>
                        <name>Entity Identifier Code</name>
                        <usage>N</usage>
                        <seq>11</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                    </segment>
<!--End of NM1 segment-->
                    <segment xid="REF">
                      <name>Other Payer Attending Provider Identification</name>
                      <usage>R</usage>
                      <pos>355</pos>
                      <max_use>3</max_use>
                      <element xid="REF01">
                        <data_ele>128</data_ele>
                        <name>Reference Identification Qualifier</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>1A</code>
                          <code>1B</code>
                          <code>1C</code>
                          <code>1D</code>
                          <code>1G</code>
                          <code>1H</code>
                          <code>EI</code>
                          <code>G2</code>
                          <code>LU</code>
                          <code>N5</code>
                        </valid_codes>
                      </element>
                      <element xid="REF02">
                        <data_ele>127</data_ele>
                        <name>Other Payer Attending Provider Identifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="REF03">
                        <data_ele>352</data_ele>
                        <name>Description</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>80</max_len>
                      </element>
                      <composite>
                        <data_ele>C040</data_ele>
                        <name>Reference Identifier</name>
                        <usage>N</usage>
                        <seq>04</seq>
                      </composite>
                    </segment>
<!--End of REF segment-->
                  </loop>
<!--End of 2330D loop-->
                  <loop xid="2330E">
                    <name>Other Payer Operating Provider</name>
                    <usage>S</usage>
                    <pos>325</pos>
                    <repeat>1</repeat>
                    <segment xid="NM1">
                      <name>Other Payer Operating Provider</name>
                      <usage>R</usage>
                      <pos>325</pos>
                      <max_use>1</max_use>
                      <element xid="NM101">
                        <data_ele>98</data_ele>
                        <name>Entity Identifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>72</code>
                        </valid_codes>
                      </element>
                      <element xid="NM102">
                        <data_ele>1065</data_ele>
                        <name>Entity Type Qualifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                        <valid_codes>
                          <code>1</code>
                        </valid_codes>
                      </element>
                      <element xid="NM103">
                        <data_ele>1035</data_ele>
                        <name>Name Last or Organization Name</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="NM104">
                        <data_ele>1036</data_ele>
                        <name>Name First</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>25</max_len>
                      </element>
                      <element xid="NM105">
                        <data_ele>1037</data_ele>
                        <name>Name Middle</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>25</max_len>
                      </element>
                      <element xid="NM106">
                        <data_ele>1038</data_ele>
                        <name>Name Prefix</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="NM107">
                        <data_ele>1039</data_ele>
                        <name>Name Suffix</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="NM108">
                        <data_ele>66</data_ele>
                        <name>Identification Code Qualifier</name>
                        <usage>N</usage>
                        <seq>08</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="NM109">
                        <data_ele>67</data_ele>
                        <name>Identification Code</name>
                        <usage>N</usage>
                        <seq>09</seq>
                        <data_type>AN</data_type>
                        <min_len>2</min_len>
                        <max_len>80</max_len>
                      </element>
                      <element xid="NM110">
                        <data_ele>706</data_ele>
                        <name>Entity Relationship Code</name>
                        <usage>N</usage>
                        <seq>10</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="NM111">
                        <data_ele>98</data_ele>
                        <name>Entity Identifier Code</name>
                        <usage>N</usage>
                        <seq>11</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                    </segment>
<!--End of NM1 segment-->
                    <segment xid="REF">
                      <name>Other Payer Operating Provider Identification</name>
                      <usage>R</usage>
                      <pos>355</pos>
                      <max_use>3</max_use>
                      <element xid="REF01">
                        <data_ele>128</data_ele>
                        <name>Reference Identification Qualifier</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>1A</code>
                          <code>1B</code>
                          <code>1C</code>
                          <code>1D</code>
                          <code>1G</code>
                          <code>1H</code>
                          <code>EI</code>
                          <code>G2</code>
                          <code>LU</code>
                          <code>N5</code>
                        </valid_codes>
                      </element>
                      <element xid="REF02">
                        <data_ele>127</data_ele>
                        <name>Other Payer Operating Provider Identifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="REF03">
                        <data_ele>352</data_ele>
                        <name>Description</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>80</max_len>
                      </element>
                      <composite>
                        <data_ele>C040</data_ele>
                        <name>Reference Identifier</name>
                        <usage>N</usage>
                        <seq>04</seq>
                      </composite>
                    </segment>
<!--End of REF segment-->
                  </loop>
<!--End of 2330E loop-->
                  <loop xid="2330F">
                    <name>Other Payer Other Provider</name>
                    <usage>S</usage>
                    <pos>325</pos>
                    <repeat>1</repeat>
                    <segment xid="NM1">
                      <name>Other Payer Other Provider</name>
                      <usage>R</usage>
                      <pos>325</pos>
                      <max_use>1</max_use>
                      <element xid="NM101">
                        <data_ele>98</data_ele>
                        <name>Entity Identifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>73</code>
                        </valid_codes>
                      </element>
                      <element xid="NM102">
                        <data_ele>1065</data_ele>
                        <name>Entity Type Qualifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                        <valid_codes>
                          <code>1</code>
                          <code>2</code>
                        </valid_codes>
                      </element>
                      <element xid="NM103">
                        <data_ele>1035</data_ele>
                        <name>Name Last or Organization Name</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="NM104">
                        <data_ele>1036</data_ele>
                        <name>Name First</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>25</max_len>
                      </element>
                      <element xid="NM105">
                        <data_ele>1037</data_ele>
                        <name>Name Middle</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>25</max_len>
                      </element>
                      <element xid="NM106">
                        <data_ele>1038</data_ele>
                        <name>Name Prefix</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="NM107">
                        <data_ele>1039</data_ele>
                        <name>Name Suffix</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="NM108">
                        <data_ele>66</data_ele>
                        <name>Identification Code Qualifier</name>
                        <usage>N</usage>
                        <seq>08</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="NM109">
                        <data_ele>67</data_ele>
                        <name>Identification Code</name>
                        <usage>N</usage>
                        <seq>09</seq>
                        <data_type>AN</data_type>
                        <min_len>2</min_len>
                        <max_len>80</max_len>
                      </element>
                      <element xid="NM110">
                        <data_ele>706</data_ele>
                        <name>Entity Relationship Code</name>
                        <usage>N</usage>
                        <seq>10</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="NM111">
                        <data_ele>98</data_ele>
                        <name>fier Code</name>
                        <usage>N</usage>
                        <seq>11</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                    </segment>
<!--End of NM1 segment-->
                    <segment xid="REF">
                      <name>Other Payer Other Provider Identification</name>
                      <usage>R</usage>
                      <pos>355</pos>
                      <max_use>3</max_use>
                      <element xid="REF01">
                        <data_ele>128</data_ele>
                        <name>Reference Identification Qualifier</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>1A</code>
                          <code>1B</code>
                          <code>1C</code>
                          <code>1D</code>
                          <code>1G</code>
                          <code>1H</code>
                          <code>EI</code>
                          <code>G2</code>
                          <code>LU</code>
                          <code>N5</code>
                          <code>SY</code>
                        </valid_codes>
                      </element>
                      <element xid="REF02">
                        <data_ele>127</data_ele>
                        <name>Other Payer Other Provider Identifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="REF03">
                        <data_ele>352</data_ele>
                        <name>on</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>80</max_len>
                      </element>
                      <composite>
                        <data_ele>C040</data_ele>
                        <name>Reference Identifier</name>
                        <usage>N</usage>
                        <seq>04</seq>
                      </composite>
                    </segment>
<!--End of REF segment-->
                  </loop>
<!--End of 2330F loop-->
                  <loop xid="2330H">
                    <name>Other Payer Service Facility Provider</name>
                    <usage>S</usage>
                    <pos>325</pos>
                    <repeat>1</repeat>
                    <segment xid="NM1">
                      <name>Other Payer Service Facility Provider</name>
                      <usage>R</usage>
                      <pos>325</pos>
                      <max_use>1</max_use>
                      <element xid="NM101">
                        <data_ele>98</data_ele>
                        <name>Entity Identifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>FA</code>
                        </valid_codes>
                      </element>
                      <element xid="NM102">
                        <data_ele>1065</data_ele>
                        <name>Entity Type Qualifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                        <valid_codes>
                          <code>2</code>
                        </valid_codes>
                      </element>
                      <element xid="NM103">
                        <data_ele>1035</data_ele>
                        <name>Name Last or Organization Name</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="NM104">
                        <data_ele>1036</data_ele>
                        <name>Name First</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>25</max_len>
                      </element>
                      <element xid="NM105">
                        <data_ele>1037</data_ele>
                        <name>Name Middle</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>25</max_len>
                      </element>
                      <element xid="NM106">
                        <data_ele>1038</data_ele>
                        <name>Name Prefix</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="NM107">
                        <data_ele>1039</data_ele>
                        <name>Name Suffix</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="NM108">
                        <data_ele>66</data_ele>
                        <name>ode Qualifier</name>
                        <usage>N</usage>
                        <seq>08</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="NM109">
                        <data_ele>67</data_ele>
                        <name>Identification Code</name>
                        <usage>N</usage>
                        <seq>09</seq>
                        <data_type>AN</data_type>
                        <min_len>2</min_len>
                        <max_len>80</max_len>
                      </element>
                      <element xid="NM110">
                        <data_ele>706</data_ele>
                        <name>Entity Relationship Code</name>
                        <usage>N</usage>
                        <seq>10</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="NM111">
                        <data_ele>98</data_ele>
                        <name>Entity Identifier Code</name>
                        <usage>N</usage>
                        <seq>11</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                    </segment>
<!--End of NM1 segment-->
                    <segment xid="REF">
                      <name>Other Payer Service Facility Provider Identification</name>
                      <usage>R</usage>
                      <pos>355</pos>
                      <max_use>3</max_use>
                      <element xid="REF01">
                        <data_ele>128</data_ele>
                        <name>Reference Identification Qualifier</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>1B</code>
                          <code>1C</code>
                          <code>1D</code>
                          <code>EI</code>
                          <code>G2</code>
                          <code>LU</code>
                          <code>N5</code>
                        </valid_codes>
                      </element>
                      <element xid="REF02">
                        <data_ele>127</data_ele>
                        <name>Other Payer Service Facility Provider Identifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="REF03">
                        <data_ele>352</data_ele>
                        <name>Description</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>80</max_len>
                      </element>
                      <composite>
                        <data_ele>C040</data_ele>
                        <name>Reference Identifier</name>
                        <usage>N</usage>
                        <seq>04</seq>
                      </composite>
                    </segment>
<!--End of REF segment-->
                  </loop>
<!--End of 2330H loop-->
                </loop>
<!--End of 2320 loop-->
                <loop xid="2400">
                  <name>Service Line Number</name>
                  <usage>R</usage>
                  <pos>365</pos>
                  <repeat>999</repeat>
                  <segment xid="LX">
                    <name>Service Line Number</name>
                    <usage>R</usage>
                    <pos>365</pos>
                    <max_use>1</max_use>
                    <element xid="LX01">
                      <data_ele>554</data_ele>
                      <name>Assigned Number</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>N0</data_type>
                      <min_len>1</min_len>
                      <max_len>6</max_len>
                    </element>
                  </segment>
<!--End of LX segment-->
                  <segment xid="SV2">
                    <name>Institutional Service Line</name>
                    <usage>R</usage>
                    <pos>375</pos>
                    <max_use>1</max_use>
                    <element xid="SV201">
                      <data_ele>234</data_ele>
                      <name>Service Line Revenue Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>48</max_len>
                    </element>
                    <composite>
                      <data_ele>C003</data_ele>
                      <name>Service Line Procedure Code</name>
                      <usage>S</usage>
                      <seq>02</seq>
                      <element xid="SV202-01">
                        <data_ele>235</data_ele>
                        <name>Product or Service ID Qualifier</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>HC</code>
                          <code>IV</code>
                          <code>N4</code>
                          <code>ZZ</code>
                        </valid_codes>
                      </element>
                      <element xid="SV202-02">
                        <data_ele>234</data_ele>
                        <name>Procedure Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>48</max_len>
                      </element>
                      <element xid="SV202-03">
                        <data_ele>1339</data_ele>
                        <name>HCPCS Modifier 1</name>
                        <usage>S</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="SV202-04">
                        <data_ele>1339</data_ele>
                        <name>HCPCS Modifier 2</name>
                        <usage>S</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="SV202-05">
                        <data_ele>1339</data_ele>
                        <name>HCPCS Modifier 3</name>
                        <usage>S</usage>
                        <seq>05</seq>
                        <data_type>AN</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="SV202-06">
                        <data_ele>1339</data_ele>
                        <name>HCPCS Modifier 4</name>
                        <usage>S</usage>
                        <seq>06</seq>
                        <data_type>AN</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="SV202-07">
                        <data_ele>352</data_ele>
                        <name>Description</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>80</max_len>
                      </element>
                    </composite>
                    <element xid="SV203">
                      <data_ele>782</data_ele>
                      <name>Line Item Charge Amount</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="SV204">
                      <data_ele>355</data_ele>
                      <name>Unit or Basis for Measurement Code</name>
                      <usage>R</usage>
                      <seq>04</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>DA</code>
                        <code>F2</code>
                        <code>UN</code>
                      </valid_codes>
                    </element>
                    <element xid="SV205">
                      <data_ele>380</data_ele>
                      <name>Service Unit Count</name>
                      <usage>R</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="SV206">
                      <data_ele>1371</data_ele>
                      <name>Service Line Rate</name>
                      <usage>S</usage>
                      <seq>06</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>10</max_len>
                    </element>
                    <element xid="SV207">
                      <data_ele>782</data_ele>
                      <name>Line Item Denied Charge or Non-Covered Charge Amount</name>
                      <usage>S</usage>
                      <seq>07</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="SV208">
                      <data_ele>1073</data_ele>
                      <name>Yes/No Condition or Response Code</name>
                      <usage>N</usage>
                      <seq>08</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                    <element xid="SV209">
                      <data_ele>1345</data_ele>
                      <name>Status Code</name>
                      <usage>N</usage>
                      <seq>09</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                    <element xid="SV210">
                      <data_ele>1337</data_ele>
                      <name>Level of Care Code</name>
                      <usage>N</usage>
                      <seq>10</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                  </segment>
<!--End of SV2 segment-->
                  <segment xid="PWK">
                    <name>Line Supplemental Information</name>
                    <usage>S</usage>
                    <pos>420</pos>
                    <max_use>5</max_use>
                    <element xid="PWK01">
                      <data_ele>755</data_ele>
                      <name>Attachment Report Type Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>AS</code>
                        <code>B2</code>
                        <code>B3</code>
                        <code>B4</code>
                        <code>CT</code>
                        <code>DA</code>
                        <code>DG</code>
                        <code>DS</code>
                        <code>EB</code>
                        <code>MT</code>
                        <code>NN</code>
                        <code>OB</code>
                        <code>OZ</code>
                        <code>PN</code>
                        <code>PO</code>
                        <code>PZ</code>
                        <code>RB</code>
                        <code>RR</code>
                        <code>RT</code>
                      </valid_codes>
                    </element>
                    <element xid="PWK02">
                      <data_ele>756</data_ele>
                      <name>Attachment Transmission Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>AA</code>
                        <code>AB</code>
                        <code>AD</code>
                        <code>AF</code>
                        <code>AG</code>
                        <code>BM</code>
                        <code>EL</code>
                        <code>EM</code>
                        <code>FX</code>
                      </valid_codes>
                    </element>
                    <element xid="PWK03">
                      <data_ele>757</data_ele>
                      <name>Report Copies Needed</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>N0</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                    </element>
                    <element xid="PWK04">
                      <data_ele>98</data_ele>
                      <name>Entity Identifier Code</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="PWK05">
                      <data_ele>66</data_ele>
                      <name>Identification Code Qualifier</name>
                      <usage>S</usage>
                      <seq>05</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>AC</code>
                      </valid_codes>
                    </element>
                    <element xid="PWK06">
                      <data_ele>67</data_ele>
                      <name>Attachment Control Number</name>
                      <usage>S</usage>
                      <seq>06</seq>
                      <data_type>AN</data_type>
                      <min_len>2</min_len>
                      <max_len>80</max_len>
                    </element>
                    <element xid="PWK07">
                      <data_ele>352</data_ele>
                      <name>Description</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>80</max_len>
                    </element>
                    <composite>
                      <data_ele>C002</data_ele>
                      <name>Actions Indicated</name>
                      <usage>N</usage>
                      <seq>08</seq>
                    </composite>
                    <element xid="PWK09">
                      <data_ele>1525</data_ele>
                      <name>Request Category Code</name>
                      <usage>N</usage>
                      <seq>09</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                    </element>
                  </segment>
<!--End of PWK segment-->
                  <segment xid="DTP">
                    <name>Service Line Date</name>
                    <usage>S</usage>
                    <pos>455</pos>
                    <max_use>1</max_use>
                    <element xid="DTP01">
                      <data_ele>374</data_ele>
                      <name>Date Time Qualifier</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>3</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>472</code>
                      </valid_codes>
                    </element>
                    <element xid="DTP02">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>D8</code>
                        <code>RD8</code>
                      </valid_codes>
                    </element>
                    <element xid="DTP03">
                      <data_ele>1251</data_ele>
                      <name>Service Date</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                  </segment>
<!--End of DTP segment-->
                  <segment xid="DTP">
                    <name>Assessment Date</name>
                    <usage>S</usage>
                    <pos>455</pos>
                    <max_use>1</max_use>
                    <element xid="DTP01">
                      <data_ele>374</data_ele>
                      <name>Date Time Qualifier</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>3</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>866</code>
                      </valid_codes>
                    </element>
                    <element xid="DTP02">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>D8</code>
                      </valid_codes>
                    </element>
                    <element xid="DTP03">
                      <data_ele>1251</data_ele>
                      <name>Assessment Date</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                  </segment>
<!--End of DTP segment-->
                  <segment xid="AMT">
                    <name>Service Tax Amount</name>
                    <usage>S</usage>
                    <pos>475</pos>
                    <max_use>1</max_use>
                    <element xid="AMT01">
                      <data_ele>522</data_ele>
                      <name>Amount Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>GT</code>
                      </valid_codes>
                    </element>
                    <element xid="AMT02">
                      <data_ele>782</data_ele>
                      <name>Service Tax Amount</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="AMT03">
                      <data_ele>478</data_ele>
                      <name>Credit/Debit Flag Code</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                  </segment>
<!--End of AMT segment-->
                  <segment xid="AMT">
                    <name>Facility Tax Amount</name>
                    <usage>S</usage>
                    <pos>475</pos>
                    <max_use>1</max_use>
                    <element xid="AMT01">
                      <data_ele>522</data_ele>
                      <name>Amount Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>N8</code>
                      </valid_codes>
                    </element>
                    <element xid="AMT02">
                      <data_ele>782</data_ele>
                      <name>Facility Tax Amount</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="AMT03">
                      <data_ele>478</data_ele>
                      <name>Credit/Debit Flag Code</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                  </segment>
<!--End of AMT segment-->
                  <segment xid="HCP">
                    <name>Line Pricing/Repricing Information</name>
                    <usage>S</usage>
                    <pos>492</pos>
                    <syntax>R0113</syntax>
                    <syntax>P0910</syntax>
                    <syntax>P1112</syntax>
                    <max_use>1</max_use>
                    <element xid="HCP01">
                      <data_ele>1473</data_ele>
                      <name>Pricing Methodology</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>00</code>
                        <code>01</code>
                        <code>02</code>
                        <code>03</code>
                        <code>04</code>
                        <code>05</code>
                        <code>06</code>
                        <code>07</code>
                        <code>08</code>
                        <code>09</code>
                        <code>10</code>
                        <code>11</code>
                        <code>12</code>
                        <code>13</code>
                        <code>14</code>
                      </valid_codes>
                    </element>
                    <element xid="HCP02">
                      <data_ele>782</data_ele>
                      <name>Repriced Allowed Amount</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HCP03">
                      <data_ele>782</data_ele>
                      <name>Repriced Saving Amount</name>
                      <usage>S</usage>
                      <seq>03</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HCP04">
                      <data_ele>127</data_ele>
                      <name>Repriced Organizational Identifier</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HCP05">
                      <data_ele>118</data_ele>
                      <name>Repricing Per Diem or Flat Rate Amount</name>
                      <usage>S</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>9</max_len>
                    </element>
                    <element xid="HCP06">
                      <data_ele>127</data_ele>
                      <name>Repriced Approved Ambulatory Patient Group Code</name>
                      <usage>S</usage>
                      <seq>06</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HCP07">
                      <data_ele>782</data_ele>
                      <name>Repriced Approved Ambulatory Patient Group Amount</name>
                      <usage>S</usage>
                      <seq>07</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HCP08">
                      <data_ele>234</data_ele>
                      <name>Repriced Approved Revenue Code</name>
                      <usage>S</usage>
                      <seq>08</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>48</max_len>
                    </element>
                    <element xid="HCP09">
                      <data_ele>235</data_ele>
                      <name>Product/ Service ID Qualifier</name>
                      <usage>S</usage>
                      <seq>09</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>HC</code>
                      </valid_codes>
                    </element>
                    <element xid="HCP10">
                      <data_ele>234</data_ele>
                      <name>Procedure Code</name>
                      <usage>S</usage>
                      <seq>10</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>48</max_len>
                    </element>
                    <element xid="HCP11">
                      <data_ele>355</data_ele>
                      <name>Unit or Basis for Measurement Code</name>
                      <usage>S</usage>
                      <seq>11</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>DA</code>
                        <code>UN</code>
                      </valid_codes>
                    </element>
                    <element xid="HCP12">
                      <data_ele>380</data_ele>
                      <name>Repricing Approved Service Unit Count</name>
                      <usage>S</usage>
                      <seq>12</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HCP13">
                      <data_ele>901</data_ele>
                      <name>Reject Reason Code</name>
                      <usage>S</usage>
                      <seq>13</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>T1</code>
                        <code>T2</code>
                        <code>T3</code>
                        <code>T4</code>
                        <code>T5</code>
                        <code>T6</code>
                      </valid_codes>
                    </element>
                    <element xid="HCP14">
                      <data_ele>1526</data_ele>
                      <name>Policy Compliance Code</name>
                      <usage>S</usage>
                      <seq>14</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>1</code>
                        <code>2</code>
                        <code>3</code>
                        <code>4</code>
                        <code>5</code>
                      </valid_codes>
                    </element>
                    <element xid="HCP15">
                      <data_ele>1527</data_ele>
                      <name>Exception Code</name>
                      <usage>S</usage>
                      <seq>15</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>1</code>
                        <code>2</code>
                        <code>3</code>
                        <code>4</code>
                        <code>5</code>
                        <code>6</code>
                      </valid_codes>
                    </element>
                  </segment>
<!--End of HCP segment-->
                  <loop xid="2410">
                    <name>Drug Identification</name>
                    <usage>S</usage>
                    <pos>494</pos>
                    <repeat>25</repeat>
                    <segment xid="LIN">
                      <name>Drug Identification</name>
                      <usage>S</usage>
                      <pos>494</pos>
                      <max_use>1</max_use>
                      <syntax>P0405</syntax>
                      <syntax>P0607</syntax>
                      <syntax>P0809</syntax>
                      <syntax>P1011</syntax>
                      <syntax>P1213</syntax>
                      <syntax>P1415</syntax>
                      <syntax>P1617</syntax>
                      <syntax>P1819</syntax>
                      <syntax>P2021</syntax>
                      <syntax>P2223</syntax>
                      <syntax>P2425</syntax>
                      <syntax>P2627</syntax>
                      <syntax>P2829</syntax>
                      <syntax>P3031</syntax>
                      <element xid="LIN01">
                        <data_ele>350</data_ele>
                        <name>Assigned Identification</name>
                        <usage>N</usage>
                        <seq>01</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>20</max_len>
                      </element>
                      <element xid="LIN02">
                        <data_ele>235</data_ele>
                        <name>Product/Service ID Qualifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>N4</code>
                        </valid_codes>
                      </element>
                      <element xid="LIN03">
                        <data_ele>234</data_ele>
                        <name>Product/Service ID</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>48</max_len>
                      </element>
                      <element xid="LIN04">
                        <data_ele>235</data_ele>
                        <name>Product/Service ID Qualifier</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>N4</code>
                        </valid_codes>
                      </element>
                      <element xid="LIN05">
                        <data_ele>234</data_ele>
                        <name>Product/Service ID</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>48</max_len>
                      </element>
                      <element xid="LIN06">
                        <data_ele>235</data_ele>
                        <name>Product/Service ID Qualifier</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>N4</code>
                        </valid_codes>
                      </element>
                      <element xid="LIN07">
                        <data_ele>234</data_ele>
                        <name>Product/Service ID</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>48</max_len>
                      </element>
                      <element xid="LIN08">
                        <data_ele>235</data_ele>
                        <name>Product/Service ID Qualifier</name>
                        <usage>N</usage>
                        <seq>08</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>N4</code>
                        </valid_codes>
                      </element>
                      <element xid="LIN09">
                        <data_ele>234</data_ele>
                        <name>Product/Service ID</name>
                        <usage>N</usage>
                        <seq>09</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>48</max_len>
                      </element>
                      <element xid="LIN10">
                        <data_ele>235</data_ele>
                        <name>Product/Service ID Qualifier</name>
                        <usage>N</usage>
                        <seq>10</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>N4</code>
                        </valid_codes>
                      </element>
                      <element xid="LIN11">
                        <data_ele>234</data_ele>
                        <name>Product/Service ID</name>
                        <usage>N</usage>
                        <seq>11</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>48</max_len>
                      </element>
                      <element xid="LIN12">
                        <data_ele>235</data_ele>
                        <name>Product/Service ID Qualifier</name>
                        <usage>N</usage>
                        <seq>12</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>N4</code>
                        </valid_codes>
                      </element>
                      <element xid="LIN13">
                        <data_ele>234</data_ele>
                        <name>Product/Service ID</name>
                        <usage>N</usage>
                        <seq>13</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>48</max_len>
                      </element>
                      <element xid="LIN14">
                        <data_ele>235</data_ele>
                        <name>Product/Service ID Qualifier</name>
                        <usage>N</usage>
                        <seq>14</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>N4</code>
                        </valid_codes>
                      </element>
                      <element xid="LIN15">
                        <data_ele>234</data_ele>
                        <name>Product/Service ID</name>
                        <usage>N</usage>
                        <seq>15</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>48</max_len>
                      </element>
                      <element xid="LIN16">
                        <data_ele>235</data_ele>
                        <name>Product/Service ID Qualifier</name>
                        <usage>N</usage>
                        <seq>16</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>N4</code>
                        </valid_codes>
                      </element>
                      <element xid="LIN17">
                        <data_ele>234</data_ele>
                        <name>Product/Service ID</name>
                        <usage>N</usage>
                        <seq>17</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>48</max_len>
                      </element>
                      <element xid="LIN18">
                        <data_ele>235</data_ele>
                        <name>Product/Service ID Qualifier</name>
                        <usage>N</usage>
                        <seq>18</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>N4</code>
                        </valid_codes>
                      </element>
                      <element xid="LIN19">
                        <data_ele>234</data_ele>
                        <name>Product/Service ID</name>
                        <usage>N</usage>
                        <seq>19</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>48</max_len>
                      </element>
                      <element xid="LIN20">
                        <data_ele>235</data_ele>
                        <name>Product/Service ID Qualifier</name>
                        <usage>N</usage>
                        <seq>20</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>N4</code>
                        </valid_codes>
                      </element>
                      <element xid="LIN21">
                        <data_ele>234</data_ele>
                        <name>Product/Service ID</name>
                        <usage>N</usage>
                        <seq>21</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>48</max_len>
                      </element>
                      <element xid="LIN22">
                        <data_ele>235</data_ele>
                        <name>Product/Service ID Qualifier</name>
                        <usage>N</usage>
                        <seq>22</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>N4</code>
                        </valid_codes>
                      </element>
                      <element xid="LIN23">
                        <data_ele>234</data_ele>
                        <name>Product/Service ID</name>
                        <usage>N</usage>
                        <seq>23</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>48</max_len>
                      </element>
                      <element xid="LIN24">
                        <data_ele>235</data_ele>
                        <name>Product/Service ID Qualifier</name>
                        <usage>N</usage>
                        <seq>24</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>N4</code>
                        </valid_codes>
                      </element>
                      <element xid="LIN25">
                        <data_ele>234</data_ele>
                        <name>Product/Service ID</name>
                        <usage>N</usage>
                        <seq>25</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>48</max_len>
                      </element>
                      <element xid="LIN26">
                        <data_ele>235</data_ele>
                        <name>Product/Service ID Qualifier</name>
                        <usage>N</usage>
                        <seq>26</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>N4</code>
                        </valid_codes>
                      </element>
                      <element xid="LIN27">
                        <data_ele>234</data_ele>
                        <name>Product/Service ID</name>
                        <usage>N</usage>
                        <seq>27</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>48</max_len>
                      </element>
                      <element xid="LIN28">
                        <data_ele>235</data_ele>
                        <name>Product/Service ID Qualifier</name>
                        <usage>N</usage>
                        <seq>28</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>N4</code>
                        </valid_codes>
                      </element>
                      <element xid="LIN29">
                        <data_ele>234</data_ele>
                        <name>Product/Service ID</name>
                        <usage>N</usage>
                        <seq>29</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>48</max_len>
                      </element>
                      <element xid="LIN30">
                        <data_ele>235</data_ele>
                        <name>Product/Service ID Qualifier</name>
                        <usage>N</usage>
                        <seq>30</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>N4</code>
                        </valid_codes>
                      </element>
                      <element xid="LIN31">
                        <data_ele>234</data_ele>
                        <name>Product/Service ID</name>
                        <usage>N</usage>
                        <seq>31</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>48</max_len>
                      </element>
                    </segment>
<!--End of LIN segment-->
                    <segment xid="CTP">
                      <name>Drug Pricing</name>
                      <usage>S</usage>
                      <pos>495</pos>
                      <max_use>1</max_use>
                      <syntax>P0405</syntax>
                      <syntax>C0607</syntax>
                      <syntax>C0902</syntax>
                      <syntax>C1002</syntax>
                      <syntax>C1103</syntax>
                      <element xid="CTP01">
                        <data_ele>687</data_ele>
                        <name>Class of Trade Code</name>
                        <usage>N</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="CTP02">
                        <data_ele>236</data_ele>
                        <name>Price Identifier Code</name>
                        <usage>N</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>3</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="CTP03">
                        <data_ele>212</data_ele>
                        <name>Unit Price</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>17</max_len>
                      </element>
                      <element xid="CTP04">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>R</usage>
                        <seq>04</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <composite>
                        <data_ele>C001</data_ele>
                        <name>Composite Unit of Measure</name>
                        <usage>R</usage>
                        <seq>05</seq>
                        <element xid="CTP05-01">
                          <data_ele>355</data_ele>
                          <name>Unit or Basis for Measurement Code</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                          <valid_codes>
                            <code>F2</code>
                            <code>GR</code>
                            <code>ML</code>
                            <code>UN</code>
                          </valid_codes>
                        </element>
                        <element xid="CTP05-02">
                          <data_ele>1018</data_ele>
                          <name>Exponent</name>
                          <usage>N</usage>
                          <seq>02</seq>
                          <data_type>R</data_type>
                          <min_len>1</min_len>
                          <max_len>15</max_len>
                        </element>
                        <element xid="CTP05-03">
                          <data_ele>649</data_ele>
                          <name>Multiplier</name>
                          <usage>N</usage>
                          <seq>03</seq>
                          <data_type>R</data_type>
                          <min_len>1</min_len>
                          <max_len>10</max_len>
                        </element>
                        <element xid="CTP05-04">
                          <data_ele>355</data_ele>
                          <name>Unit or Basis for Measurement Code</name>
                          <usage>N</usage>
                          <seq>04</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                        </element>
                        <element xid="CTP05-05">
                          <data_ele>1018</data_ele>
                          <name>Exponent</name>
                          <usage>N</usage>
                          <seq>05</seq>
                          <data_type>R</data_type>
                          <min_len>1</min_len>
                          <max_len>15</max_len>
                        </element>
                        <element xid="CTP05-06">
                          <data_ele>649</data_ele>
                          <name>Multiplier</name>
                          <usage>N</usage>
                          <seq>06</seq>
                          <data_type>R</data_type>
                          <min_len>1</min_len>
                          <max_len>10</max_len>
                        </element>
                        <element xid="CTP05-07">
                          <data_ele>355</data_ele>
                          <name>Unit or Basis for Measurement Code</name>
                          <usage>N</usage>
                          <seq>07</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                        </element>
                        <element xid="CTP05-08">
                          <data_ele>1018</data_ele>
                          <name>Exponent</name>
                          <usage>N</usage>
                          <seq>08</seq>
                          <data_type>R</data_type>
                          <min_len>1</min_len>
                          <max_len>15</max_len>
                        </element>
                        <element xid="CTP05-09">
                          <data_ele>649</data_ele>
                          <name>Multiplier</name>
                          <usage>N</usage>
                          <seq>09</seq>
                          <data_type>R</data_type>
                          <min_len>1</min_len>
                          <max_len>10</max_len>
                        </element>
                        <element xid="CTP05-10">
                          <data_ele>355</data_ele>
                          <name>Unit or Basis for Measurement Code</name>
                          <usage>N</usage>
                          <seq>10</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                        </element>
                        <element xid="CTP05-11">
                          <data_ele>1018</data_ele>
                          <name>Exponent</name>
                          <usage>N</usage>
                          <seq>11</seq>
                          <data_type>R</data_type>
                          <min_len>1</min_len>
                          <max_len>15</max_len>
                        </element>
                        <element xid="CTP05-12">
                          <data_ele>649</data_ele>
                          <name>Multiplier</name>
                          <usage>N</usage>
                          <seq>12</seq>
                          <data_type>R</data_type>
                          <min_len>1</min_len>
                          <max_len>10</max_len>
                        </element>
                        <element xid="CTP05-13">
                          <data_ele>355</data_ele>
                          <name>Unit or Basis for Measurement Code</name>
                          <usage>N</usage>
                          <seq>13</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                        </element>
                        <element xid="CTP05-14">
                          <data_ele>1018</data_ele>
                          <name>Exponent</name>
                          <usage>N</usage>
                          <seq>14</seq>
                          <data_type>R</data_type>
                          <min_len>1</min_len>
                          <max_len>15</max_len>
                        </element>
                        <element xid="CTP05-15">
                          <data_ele>649</data_ele>
                          <name>Multiplier</name>
                          <usage>N</usage>
                          <seq>15</seq>
                          <data_type>R</data_type>
                          <min_len>1</min_len>
                          <max_len>10</max_len>
                        </element>
                      </composite>
                      <element xid="CTP06">
                        <data_ele>648</data_ele>
                        <name>Price Multiplier Qualifier</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>ID</data_type>
                        <min_len>3</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="CTP07">
                        <data_ele>649</data_ele>
                        <name>Multiplier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="CTP08">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>08</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="CTP09">
                        <data_ele>639</data_ele>
                        <name>Basis of Unit Price Code</name>
                        <usage>N</usage>
                        <seq>09</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="CTP10">
                        <data_ele>499</data_ele>
                        <name>Condition Value</name>
                        <usage>N</usage>
                        <seq>10</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="CTP11">
                        <data_ele>289</data_ele>
                        <name>Multiple Price Quantity</name>
                        <usage>N</usage>
                        <seq>11</seq>
                        <data_type>N0</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                      </element>
                    </segment>
<!--End of CTP segment-->
                    <segment xid="REF">
                      <name>Prescription Number</name>
                      <pos>496</pos>
                      <max_use>1</max_use>
                      <element xid="REF01">
                        <data_ele>128</data_ele>
                        <name>Reference Identification Qualifier</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>XZ</code>
                        </valid_codes>
                      </element>
                      <element xid="REF02">
                        <data_ele>127</data_ele>
                        <name>Reference Identification</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="REF03">
                        <data_ele>352</data_ele>
                        <name>Description</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>80</max_len>
                      </element>
                      <composite>
                        <data_ele>C040</data_ele>
                        <name>Reference Identifier</name>
                        <usage>N</usage>
                        <seq>04</seq>
                      </composite>
                    </segment>
<!--End of REF segment-->
                  </loop>
<!--End of 2410 loop-->
                  <loop xid="2420A">
                    <name>Attending Physician Name</name>
                    <usage>S</usage>
                    <pos>500</pos>
                    <repeat>1</repeat>
                    <segment xid="NM1">
                      <name>Attending Physician Name</name>
                      <usage>R</usage>
                      <pos>500</pos>
                      <max_use>1</max_use>
                      <element xid="NM101">
                        <data_ele>98</data_ele>
                        <name>Entity Identifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>71</code>
                        </valid_codes>
                      </element>
                      <element xid="NM102">
                        <data_ele>1065</data_ele>
                        <name>Entity Type Qualifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                        <valid_codes>
                          <code>1</code>
                          <code>2</code>
                        </valid_codes>
                      </element>
                      <element xid="NM103">
                        <data_ele>1035</data_ele>
                        <name>Attending Physician Last Name</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="NM104">
                        <data_ele>1036</data_ele>
                        <name>Attending Physician First Name</name>
                        <usage>S</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>25</max_len>
                      </element>
                      <element xid="NM105">
                        <data_ele>1037</data_ele>
                        <name>Attending Physician Middle Name</name>
                        <usage>S</usage>
                        <seq>05</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>25</max_len>
                      </element>
                      <element xid="NM106">
                        <data_ele>1038</data_ele>
                        <name>Name Prefix</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="NM107">
                        <data_ele>1039</data_ele>
                        <name>Attending Physician Name Suffix</name>
                        <usage>S</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="NM108">
                        <data_ele>66</data_ele>
                        <name>Identification Code Qualifier</name>
                        <usage>R</usage>
                        <seq>08</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>24</code>
                          <code>34</code>
                          <code>XX</code>
                        </valid_codes>
                      </element>
                      <element xid="NM109">
                        <data_ele>67</data_ele>
                        <name>Attending Physician Primary Identifier</name>
                        <usage>R</usage>
                        <seq>09</seq>
                        <data_type>AN</data_type>
                        <min_len>2</min_len>
                        <max_len>80</max_len>
                      </element>
                      <element xid="NM110">
                        <data_ele>706</data_ele>
                        <name>Entity Relationship Code</name>
                        <usage>N</usage>
                        <seq>10</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="NM111">
                        <data_ele>98</data_ele>
                        <name>Entity Identifier Code</name>
                        <usage>N</usage>
                        <seq>11</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                    </segment>
<!--End of NM1 segment-->
                    <segment xid="PRV">
                      <name>Attending Physician Specialty Information</name>
                      <usage>S</usage>
                      <pos>255</pos>
                      <max_use>1</max_use>
                      <element xid="PRV01">
                        <data_ele>1221</data_ele>
                        <name>Provider Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>AT</code>
                        </valid_codes>
                      </element>
                      <element xid="PRV02">
                        <data_ele>128</data_ele>
                        <name>Reference Identification Qualifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>ZZ</code>
                        </valid_codes>
                      </element>
                      <element xid="PRV03">
                        <data_ele>127</data_ele>
                        <name>Provider Taxonomy Code</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
<!--<valid_codes external="prov_taxonomy"/>-->
                      </element>
                      <element xid="PRV04">
                        <data_ele>156</data_ele>
                        <name>State or Province Code</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                      </element>
                      <composite>
                        <data_ele>C035</data_ele>
                        <name>Provider Specialty Information</name>
                        <usage>N</usage>
                        <seq>05</seq>
                      </composite>
                      <element xid="PRV06">
                        <data_ele>1223</data_ele>
                        <name>Provider Organization Code</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>ID</data_type>
                        <min_len>3</min_len>
                        <max_len>3</max_len>
                      </element>
                    </segment>
<!--End of PRV segment-->
                    <segment xid="REF">
                      <name>Attending Physician Secondary Identification</name>
                      <usage>S</usage>
                      <pos>525</pos>
                      <max_use>1</max_use>
                      <element xid="REF01">
                        <data_ele>128</data_ele>
                        <name>Reference Identification Qualifier</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>0B</code>
                          <code>1A</code>
                          <code>1B</code>
                          <code>1C</code>
                          <code>1D</code>
                          <code>1G</code>
                          <code>1H</code>
                          <code>EI</code>
                          <code>G2</code>
                          <code>LU</code>
                          <code>N5</code>
                          <code>SY</code>
                          <code>X5</code>
                        </valid_codes>
                      </element>
                      <element xid="REF02">
                        <data_ele>127</data_ele>
                        <name>Attending Physician Secondary Identifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="REF03">
                        <data_ele>352</data_ele>
                        <name>Description</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>80</max_len>
                      </element>
                      <composite>
                        <data_ele>C040</data_ele>
                        <name>Reference Identifier</name>
                        <usage>N</usage>
                        <seq>04</seq>
                      </composite>
                    </segment>
<!--End of REF segment-->
                  </loop>
<!--End of 2420A loop-->
                  <loop xid="2420B">
                    <name>Operating Physician Name</name>
                    <usage>S</usage>
                    <pos>500</pos>
                    <repeat>1</repeat>
                    <segment xid="NM1">
                      <name>Operating Physician Name</name>
                      <usage>R</usage>
                      <pos>500</pos>
                      <max_use>1</max_use>
                      <element xid="NM101">
                        <data_ele>98</data_ele>
                        <name>Entity Identifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>72</code>
                        </valid_codes>
                      </element>
                      <element xid="NM102">
                        <data_ele>1065</data_ele>
                        <name>Entity Type Qualifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                        <valid_codes>
                          <code>1</code>
                        </valid_codes>
                      </element>
                      <element xid="NM103">
                        <data_ele>1035</data_ele>
                        <name>Operating Physician Last Name</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="NM104">
                        <data_ele>1036</data_ele>
                        <name>Operating Physician First Name</name>
                        <usage>R</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>25</max_len>
                      </element>
                      <element xid="NM105">
                        <data_ele>1037</data_ele>
                        <name>Operating Physician Middle Name</name>
                        <usage>S</usage>
                        <seq>05</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>25</max_len>
                      </element>
                      <element xid="NM106">
                        <data_ele>1038</data_ele>
                        <name>Name Prefix</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="NM107">
                        <data_ele>1039</data_ele>
                        <name>Operating Physician Name Suffix</name>
                        <usage>S</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="NM108">
                        <data_ele>66</data_ele>
                        <name>Identification Code Qualifier</name>
                        <usage>R</usage>
                        <seq>08</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>24</code>
                          <code>34</code>
                          <code>XX</code>
                        </valid_codes>
                      </element>
                      <element xid="NM109">
                        <data_ele>67</data_ele>
                        <name>Operating Physician Primary Identifier</name>
                        <usage>R</usage>
                        <seq>09</seq>
                        <data_type>AN</data_type>
                        <min_len>2</min_len>
                        <max_len>80</max_len>
                      </element>
                      <element xid="NM110">
                        <data_ele>706</data_ele>
                        <name>Entity Relationship Code</name>
                        <usage>N</usage>
                        <seq>10</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="NM111">
                        <data_ele>98</data_ele>
                        <name>Entity Identifier Code</name>
                        <usage>N</usage>
                        <seq>11</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                    </segment>
<!--End of NM1 segment-->
                    <segment xid="PRV">
                      <name>Operating Physician Specialty Information</name>
                      <usage>S</usage>
                      <pos>255</pos>
                      <max_use>1</max_use>
                      <element xid="PRV01">
                        <data_ele>1221</data_ele>
                        <name>Provider Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>OP</code>
                        </valid_codes>
                      </element>
                      <element xid="PRV02">
                        <data_ele>128</data_ele>
                        <name>Reference Identification Qualifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>ZZ</code>
                        </valid_codes>
                      </element>
                      <element xid="PRV03">
                        <data_ele>127</data_ele>
                        <name>Provider Taxonomy Code</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
<!--<valid_codes external="prov_taxonomy"/>-->
                      </element>
                      <element xid="PRV04">
                        <data_ele>156</data_ele>
                        <name>State or Province Code</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                      </element>
                      <composite>
                        <data_ele>C035</data_ele>
                        <name>Provider Specialty Information</name>
                        <usage>N</usage>
                        <seq>05</seq>
                      </composite>
                      <element xid="PRV06">
                        <data_ele>1223</data_ele>
                        <name>Provider Organization Code</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>ID</data_type>
                        <min_len>3</min_len>
                        <max_len>3</max_len>
                      </element>
                    </segment>
<!--End of PRV segment-->
                    <segment xid="REF">
                      <name>Operating Physician Secondary Identification</name>
                      <usage>S</usage>
                      <pos>525</pos>
                      <max_use>1</max_use>
                      <element xid="REF01">
                        <data_ele>128</data_ele>
                        <name>Reference Identification Qualifier</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>0B</code>
                          <code>1A</code>
                          <code>1B</code>
                          <code>1C</code>
                          <code>1D</code>
                          <code>1G</code>
                          <code>1H</code>
                          <code>EI</code>
                          <code>G2</code>
                          <code>LU</code>
                          <code>N5</code>
                          <code>SY</code>
                          <code>X5</code>
                        </valid_codes>
                      </element>
                      <element xid="REF02">
                        <data_ele>127</data_ele>
                        <name>Operating Physician Secondary Identifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="REF03">
                        <data_ele>352</data_ele>
                        <name>Description</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>80</max_len>
                      </element>
                      <composite>
                        <data_ele>C040</data_ele>
                        <name>Reference Identifier</name>
                        <usage>N</usage>
                        <seq>04</seq>
                      </composite>
                    </segment>
<!--End of REF segment-->
                  </loop>
<!--End of 2420B loop-->
                  <loop xid="2420C">
                    <name>Other Provider Name</name>
                    <usage>S</usage>
                    <pos>500</pos>
                    <repeat>1</repeat>
                    <segment xid="NM1">
                      <name>Other Provider Name</name>
                      <usage>R</usage>
                      <pos>500</pos>
                      <max_use>1</max_use>
                      <element xid="NM101">
                        <data_ele>98</data_ele>
                        <name>Entity Identifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>73</code>
                        </valid_codes>
                      </element>
                      <element xid="NM102">
                        <data_ele>1065</data_ele>
                        <name>Entity Type Qualifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                        <valid_codes>
                          <code>1</code>
                          <code>2</code>
                        </valid_codes>
                      </element>
                      <element xid="NM103">
                        <data_ele>1035</data_ele>
                        <name>Other Physician Last Name</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="NM104">
                        <data_ele>1036</data_ele>
                        <name>Other Physician First Name</name>
                        <usage>S</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>25</max_len>
                      </element>
                      <element xid="NM105">
                        <data_ele>1037</data_ele>
                        <name>Other Provider Middle Name</name>
                        <usage>S</usage>
                        <seq>05</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>25</max_len>
                      </element>
                      <element xid="NM106">
                        <data_ele>1038</data_ele>
                        <name>Name Prefix</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="NM107">
                        <data_ele>1039</data_ele>
                        <name>Other Provider Name Suffix</name>
                        <usage>S</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="NM108">
                        <data_ele>66</data_ele>
                        <name>Identification Code Qualifier</name>
                        <usage>R</usage>
                        <seq>08</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>24</code>
                          <code>34</code>
                          <code>XX</code>
                        </valid_codes>
                      </element>
                      <element xid="NM109">
                        <data_ele>67</data_ele>
                        <name>Other Provider Identifier</name>
                        <usage>R</usage>
                        <seq>09</seq>
                        <data_type>AN</data_type>
                        <min_len>2</min_len>
                        <max_len>80</max_len>
                      </element>
                      <element xid="NM110">
                        <data_ele>706</data_ele>
                        <name>Entity Relationship Code</name>
                        <usage>N</usage>
                        <seq>10</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="NM111">
                        <data_ele>98</data_ele>
                        <name>Entity Identifier Code</name>
                        <usage>N</usage>
                        <seq>11</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                    </segment>
<!--End of NM1 segment-->
                    <segment xid="PRV">
                      <name>Other Provider Specialty Information</name>
                      <usage>S</usage>
                      <pos>255</pos>
                      <max_use>1</max_use>
                      <element xid="PRV01">
                        <data_ele>1221</data_ele>
                        <name>Provider Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>OT</code>
                          <code>PE</code>
                        </valid_codes>
                      </element>
                      <element xid="PRV02">
                        <data_ele>128</data_ele>
                        <name>Reference Identification Qualifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>ZZ</code>
                        </valid_codes>
                      </element>
                      <element xid="PRV03">
                        <data_ele>127</data_ele>
                        <name>Provider Taxonomy Code</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
<!--<valid_codes external="prov_taxonomy"/>-->
                      </element>
                      <element xid="PRV04">
                        <data_ele>156</data_ele>
                        <name>State or Province Code</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                      </element>
                      <composite>
                        <data_ele>C035</data_ele>
                        <name>Provider Specialty Information</name>
                        <usage>N</usage>
                        <seq>05</seq>
                      </composite>
                      <element xid="PRV06">
                        <data_ele>1223</data_ele>
                        <name>Provider Organization Code</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>ID</data_type>
                        <min_len>3</min_len>
                        <max_len>3</max_len>
                      </element>
                    </segment>
<!--End of PRV segment-->
                    <segment xid="REF">
                      <name>Other Provider Secondary Identification</name>
                      <usage>S</usage>
                      <pos>525</pos>
                      <max_use>1</max_use>
                      <element xid="REF01">
                        <data_ele>128</data_ele>
                        <name>Reference Identification Qualifier</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>0B</code>
                          <code>1A</code>
                          <code>1B</code>
                          <code>1C</code>
                          <code>1D</code>
                          <code>1G</code>
                          <code>1H</code>
                          <code>EI</code>
                          <code>G2</code>
                          <code>LU</code>
                          <code>N5</code>
                          <code>SY</code>
                          <code>X5</code>
                        </valid_codes>
                      </element>
                      <element xid="REF02">
                        <data_ele>127</data_ele>
                        <name>Other Provider Secondary Identifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="REF03">
                        <data_ele>352</data_ele>
                        <name>Description</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>80</max_len>
                      </element>
                      <composite>
                        <data_ele>C040</data_ele>
                        <name>Reference Identifier</name>
                        <usage>N</usage>
                        <seq>04</seq>
                      </composite>
                    </segment>
<!--End of REF segment-->
                  </loop>
<!--End of 2420C loop-->
                  <loop xid="2430">
                    <name>Service Line Adjudication Information</name>
                    <usage>S</usage>
                    <pos>540</pos>
                    <repeat>25</repeat>
                    <segment xid="SVD">
                      <name>Service Line Adjudication Information</name>
                      <usage>R</usage>
                      <pos>540</pos>
                      <max_use>1</max_use>
                      <element xid="SVD01">
                        <data_ele>67</data_ele>
                        <name>Payer Identifier</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>AN</data_type>
                        <min_len>2</min_len>
                        <max_len>80</max_len>
                      </element>
                      <element xid="SVD02">
                        <data_ele>782</data_ele>
                        <name>Service Line Paid Amount</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <composite>
                        <data_ele>C003</data_ele>
                        <name>Composite Medical Procedure Identifier</name>
                        <usage>S</usage>
                        <seq>03</seq>
                        <element xid="SVD03-01">
                          <data_ele>235</data_ele>
                          <name>Product or Service ID Qualifier</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                          <valid_codes>
                            <code>HC</code>
                            <code>IV</code>
                            <code>ZZ</code>
                          </valid_codes>
                        </element>
                        <element xid="SVD03-02">
                          <data_ele>234</data_ele>
                          <name>Procedure Code</name>
                          <usage>R</usage>
                          <seq>02</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>48</max_len>
                        </element>
                        <element xid="SVD03-03">
                          <data_ele>1339</data_ele>
                          <name>Procedure Modifier</name>
                          <usage>S</usage>
                          <seq>03</seq>
                          <data_type>AN</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                        </element>
                        <element xid="SVD03-04">
                          <data_ele>1339</data_ele>
                          <name>Procedure Modifier</name>
                          <usage>S</usage>
                          <seq>04</seq>
                          <data_type>AN</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                        </element>
                        <element xid="SVD03-05">
                          <data_ele>1339</data_ele>
                          <name>Procedure Modifier</name>
                          <usage>S</usage>
                          <seq>05</seq>
                          <data_type>AN</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                        </element>
                        <element xid="SVD03-06">
                          <data_ele>1339</data_ele>
                          <name>Procedure Modifier</name>
                          <usage>S</usage>
                          <seq>06</seq>
                          <data_type>AN</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                        </element>
                        <element xid="SVD03-07">
                          <data_ele>352</data_ele>
                          <name>Procedure Code Description</name>
                          <usage>S</usage>
                          <seq>07</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>80</max_len>
                        </element>
                      </composite>
                      <element xid="SVD04">
                        <data_ele>234</data_ele>
                        <name>Service Line Revenue Code</name>
                        <usage>R</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>48</max_len>
                      </element>
                      <element xid="SVD05">
                        <data_ele>380</data_ele>
                        <name>Adjustment Quantity</name>
                        <usage>R</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="SVD06">
                        <data_ele>554</data_ele>
                        <name>Bundled or Unbundled Line Number</name>
                        <usage>S</usage>
                        <seq>06</seq>
                        <data_type>N0</data_type>
                        <min_len>1</min_len>
                        <max_len>6</max_len>
                      </element>
                    </segment>
<!--End of SVD segment-->
                    <segment xid="CAS">
                      <name>Service Line Adjustment</name>
                      <usage>S</usage>
                      <pos>545</pos>
                      <max_use>99</max_use>
                      <element xid="CAS01">
                        <data_ele>1033</data_ele>
                        <name>Claim Adjustment Group Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>CO</code>
                          <code>CR</code>
                          <code>OA</code>
                          <code>PI</code>
                          <code>PR</code>
                        </valid_codes>
                      </element>
                      <element xid="CAS02">
                        <data_ele>1034</data_ele>
                        <name>Adjustment Reason Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>5</max_len>
                        <valid_codes>
                          <code>1</code>
                          <code>2</code>
                          <code>3</code>
                          <code>4</code>
                          <code>5</code>
                          <code>6</code>
                          <code>7</code>
                          <code>8</code>
                          <code>9</code>
                          <code>10</code>
                          <code>11</code>
                          <code>12</code>
                          <code>13</code>
                          <code>14</code>
                          <code>15</code>
                          <code>16</code>
                          <code>17</code>
                          <code>18</code>
                          <code>19</code>
                          <code>20</code>
                          <code>21</code>
                          <code>22</code>
                          <code>23</code>
                          <code>24</code>
                          <code>25</code>
                          <code>26</code>
                          <code>27</code>
                          <code>28</code>
                          <code>29</code>
                          <code>30</code>
                          <code>31</code>
                          <code>32</code>
                          <code>33</code>
                          <code>34</code>
                          <code>35</code>
                          <code>36</code>
                          <code>37</code>
                          <code>38</code>
                          <code>39</code>
                          <code>40</code>
                          <code>41</code>
                          <code>42</code>
                          <code>43</code>
                          <code>44</code>
                          <code>45</code>
                          <code>46</code>
                          <code>47</code>
                          <code>48</code>
                          <code>49</code>
                          <code>50</code>
                          <code>51</code>
                          <code>52</code>
                          <code>53</code>
                          <code>54</code>
                          <code>55</code>
                          <code>56</code>
                          <code>57</code>
                          <code>58</code>
                          <code>59</code>
                          <code>60</code>
                          <code>61</code>
                          <code>62</code>
                          <code>63</code>
                          <code>64</code>
                          <code>65</code>
                          <code>66</code>
                          <code>67</code>
                          <code>68</code>
                          <code>69</code>
                          <code>70</code>
                          <code>71</code>
                          <code>72</code>
                          <code>73</code>
                          <code>74</code>
                          <code>75</code>
                          <code>76</code>
                          <code>77</code>
                          <code>78</code>
                          <code>79</code>
                          <code>80</code>
                          <code>81</code>
                          <code>82</code>
                          <code>83</code>
                          <code>84</code>
                          <code>85</code>
                          <code>86</code>
                          <code>87</code>
                          <code>88</code>
                          <code>89</code>
                          <code>90</code>
                          <code>91</code>
                          <code>92</code>
                          <code>93</code>
                          <code>94</code>
                          <code>95</code>
                          <code>96</code>
                          <code>97</code>
                          <code>98</code>
                          <code>99</code>
                          <code>100</code>
                          <code>101</code>
                          <code>102</code>
                          <code>103</code>
                          <code>104</code>
                          <code>105</code>
                          <code>106</code>
                          <code>107</code>
                          <code>108</code>
                          <code>109</code>
                          <code>110</code>
                          <code>111</code>
                          <code>112</code>
                          <code>113</code>
                          <code>114</code>
                          <code>115</code>
                          <code>116</code>
                          <code>117</code>
                          <code>118</code>
                          <code>119</code>
                          <code>120</code>
                          <code>121</code>
                          <code>122</code>
                          <code>123</code>
                          <code>124</code>
                          <code>125</code>
                          <code>126</code>
                          <code>127</code>
                          <code>128</code>
                          <code>129</code>
                          <code>130</code>
                          <code>131</code>
                          <code>132</code>
                          <code>133</code>
                          <code>134</code>
                          <code>135</code>
                          <code>136</code>
                          <code>137</code>
                          <code>138</code>
                          <code>139</code>
                          <code>140</code>
                          <code>141</code>
                          <code>142</code>
                          <code>143</code>
                          <code>144</code>
                          <code>145</code>
                          <code>146</code>
                          <code>147</code>
                          <code>148</code>
                          <code>149</code>
                          <code>150</code>
                          <code>151</code>
                          <code>152</code>
                          <code>153</code>
                          <code>154</code>
                          <code>A0</code>
                          <code>A1</code>
                          <code>A2</code>
                          <code>A3</code>
                          <code>A4</code>
                          <code>A5</code>
                          <code>A6</code>
                          <code>A7</code>
                          <code>A8</code>
                          <code>B1</code>
                          <code>B2</code>
                          <code>B3</code>
                          <code>B4</code>
                          <code>B5</code>
                          <code>B6</code>
                          <code>B7</code>
                          <code>B8</code>
                          <code>B9</code>
                          <code>B10</code>
                          <code>B11</code>
                          <code>B12</code>
                          <code>B13</code>
                          <code>B14</code>
                          <code>B15</code>
                          <code>B16</code>
                          <code>B17</code>
                          <code>B18</code>
                          <code>B19</code>
                          <code>B20</code>
                          <code>B21</code>
                          <code>B22</code>
                          <code>B23</code>
                          <code>D1</code>
                          <code>D2</code>
                          <code>D3</code>
                          <code>D4</code>
                          <code>D5</code>
                          <code>D6</code>
                          <code>D7</code>
                          <code>D8</code>
                          <code>D9</code>
                          <code>D10</code>
                          <code>D11</code>
                          <code>D12</code>
                          <code>D13</code>
                          <code>D14</code>
                          <code>D15</code>
                          <code>W1</code>
                        </valid_codes>
                      </element>
                      <element xid="CAS03">
                        <data_ele>782</data_ele>
                        <name>Adjustment Amount</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="CAS04">
                        <data_ele>380</data_ele>
                        <name>Adjustment Quantity</name>
                        <usage>S</usage>
                        <seq>04</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="CAS05">
                        <data_ele>1034</data_ele>
                        <name>Adjustment Reason Code</name>
                        <usage>S</usage>
                        <seq>05</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>5</max_len>
                        <valid_codes>
                          <code>1</code>
                          <code>2</code>
                          <code>3</code>
                          <code>4</code>
                          <code>5</code>
                          <code>6</code>
                          <code>7</code>
                          <code>8</code>
                          <code>9</code>
                          <code>10</code>
                          <code>11</code>
                          <code>12</code>
                          <code>13</code>
                          <code>14</code>
                          <code>15</code>
                          <code>16</code>
                          <code>17</code>
                          <code>18</code>
                          <code>19</code>
                          <code>20</code>
                          <code>21</code>
                          <code>22</code>
                          <code>23</code>
                          <code>24</code>
                          <code>25</code>
                          <code>26</code>
                          <code>27</code>
                          <code>28</code>
                          <code>29</code>
                          <code>30</code>
                          <code>31</code>
                          <code>32</code>
                          <code>33</code>
                          <code>34</code>
                          <code>35</code>
                          <code>36</code>
                          <code>37</code>
                          <code>38</code>
                          <code>39</code>
                          <code>40</code>
                          <code>41</code>
                          <code>42</code>
                          <code>43</code>
                          <code>44</code>
                          <code>45</code>
                          <code>46</code>
                          <code>47</code>
                          <code>48</code>
                          <code>49</code>
                          <code>50</code>
                          <code>51</code>
                          <code>52</code>
                          <code>53</code>
                          <code>54</code>
                          <code>55</code>
                          <code>56</code>
                          <code>57</code>
                          <code>58</code>
                          <code>59</code>
                          <code>60</code>
                          <code>61</code>
                          <code>62</code>
                          <code>63</code>
                          <code>64</code>
                          <code>65</code>
                          <code>66</code>
                          <code>67</code>
                          <code>68</code>
                          <code>69</code>
                          <code>70</code>
                          <code>71</code>
                          <code>72</code>
                          <code>73</code>
                          <code>74</code>
                          <code>75</code>
                          <code>76</code>
                          <code>77</code>
                          <code>78</code>
                          <code>79</code>
                          <code>80</code>
                          <code>81</code>
                          <code>82</code>
                          <code>83</code>
                          <code>84</code>
                          <code>85</code>
                          <code>86</code>
                          <code>87</code>
                          <code>88</code>
                          <code>89</code>
                          <code>90</code>
                          <code>91</code>
                          <code>92</code>
                          <code>93</code>
                          <code>94</code>
                          <code>95</code>
                          <code>96</code>
                          <code>97</code>
                          <code>98</code>
                          <code>99</code>
                          <code>100</code>
                          <code>101</code>
                          <code>102</code>
                          <code>103</code>
                          <code>104</code>
                          <code>105</code>
                          <code>106</code>
                          <code>107</code>
                          <code>108</code>
                          <code>109</code>
                          <code>110</code>
                          <code>111</code>
                          <code>112</code>
                          <code>113</code>
                          <code>114</code>
                          <code>115</code>
                          <code>116</code>
                          <code>117</code>
                          <code>118</code>
                          <code>119</code>
                          <code>120</code>
                          <code>121</code>
                          <code>122</code>
                          <code>123</code>
                          <code>124</code>
                          <code>125</code>
                          <code>126</code>
                          <code>127</code>
                          <code>128</code>
                          <code>129</code>
                          <code>130</code>
                          <code>131</code>
                          <code>132</code>
                          <code>133</code>
                          <code>134</code>
                          <code>135</code>
                          <code>136</code>
                          <code>137</code>
                          <code>138</code>
                          <code>139</code>
                          <code>140</code>
                          <code>141</code>
                          <code>142</code>
                          <code>143</code>
                          <code>144</code>
                          <code>145</code>
                          <code>146</code>
                          <code>147</code>
                          <code>148</code>
                          <code>149</code>
                          <code>150</code>
                          <code>151</code>
                          <code>152</code>
                          <code>153</code>
                          <code>154</code>
                          <code>A0</code>
                          <code>A1</code>
                          <code>A2</code>
                          <code>A3</code>
                          <code>A4</code>
                          <code>A5</code>
                          <code>A6</code>
                          <code>A7</code>
                          <code>A8</code>
                          <code>B1</code>
                          <code>B2</code>
                          <code>B3</code>
                          <code>B4</code>
                          <code>B5</code>
                          <code>B6</code>
                          <code>B7</code>
                          <code>B8</code>
                          <code>B9</code>
                          <code>B10</code>
                          <code>B11</code>
                          <code>B12</code>
                          <code>B13</code>
                          <code>B14</code>
                          <code>B15</code>
                          <code>B16</code>
                          <code>B17</code>
                          <code>B18</code>
                          <code>B19</code>
                          <code>B20</code>
                          <code>B21</code>
                          <code>B22</code>
                          <code>B23</code>
                          <code>D1</code>
                          <code>D2</code>
                          <code>D3</code>
                          <code>D4</code>
                          <code>D5</code>
                          <code>D6</code>
                          <code>D7</code>
                          <code>D8</code>
                          <code>D9</code>
                          <code>D10</code>
                          <code>D11</code>
                          <code>D12</code>
                          <code>D13</code>
                          <code>D14</code>
                          <code>D15</code>
                          <code>W1</code>
                        </valid_codes>
                      </element>
                      <element xid="CAS06">
                        <data_ele>782</data_ele>
                        <name>Adjustment Amount</name>
                        <usage>S</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="CAS07">
                        <data_ele>380</data_ele>
                        <name>Adjustment Quantity</name>
                        <usage>S</usage>
                        <seq>07</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="CAS08">
                        <data_ele>1034</data_ele>
                        <name>Adjustment Reason Code</name>
                        <usage>S</usage>
                        <seq>08</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>5</max_len>
                        <valid_codes>
                          <code>1</code>
                          <code>2</code>
                          <code>3</code>
                          <code>4</code>
                          <code>5</code>
                          <code>6</code>
                          <code>7</code>
                          <code>8</code>
                          <code>9</code>
                          <code>10</code>
                          <code>11</code>
                          <code>12</code>
                          <code>13</code>
                          <code>14</code>
                          <code>15</code>
                          <code>16</code>
                          <code>17</code>
                          <code>18</code>
                          <code>19</code>
                          <code>20</code>
                          <code>21</code>
                          <code>22</code>
                          <code>23</code>
                          <code>24</code>
                          <code>25</code>
                          <code>26</code>
                          <code>27</code>
                          <code>28</code>
                          <code>29</code>
                          <code>30</code>
                          <code>31</code>
                          <code>32</code>
                          <code>33</code>
                          <code>34</code>
                          <code>35</code>
                          <code>36</code>
                          <code>37</code>
                          <code>38</code>
                          <code>39</code>
                          <code>40</code>
                          <code>41</code>
                          <code>42</code>
                          <code>43</code>
                          <code>44</code>
                          <code>45</code>
                          <code>46</code>
                          <code>47</code>
                          <code>48</code>
                          <code>49</code>
                          <code>50</code>
                          <code>51</code>
                          <code>52</code>
                          <code>53</code>
                          <code>54</code>
                          <code>55</code>
                          <code>56</code>
                          <code>57</code>
                          <code>58</code>
                          <code>59</code>
                          <code>60</code>
                          <code>61</code>
                          <code>62</code>
                          <code>63</code>
                          <code>64</code>
                          <code>65</code>
                          <code>66</code>
                          <code>67</code>
                          <code>68</code>
                          <code>69</code>
                          <code>70</code>
                          <code>71</code>
                          <code>72</code>
                          <code>73</code>
                          <code>74</code>
                          <code>75</code>
                          <code>76</code>
                          <code>77</code>
                          <code>78</code>
                          <code>79</code>
                          <code>80</code>
                          <code>81</code>
                          <code>82</code>
                          <code>83</code>
                          <code>84</code>
                          <code>85</code>
                          <code>86</code>
                          <code>87</code>
                          <code>88</code>
                          <code>89</code>
                          <code>90</code>
                          <code>91</code>
                          <code>92</code>
                          <code>93</code>
                          <code>94</code>
                          <code>95</code>
                          <code>96</code>
                          <code>97</code>
                          <code>98</code>
                          <code>99</code>
                          <code>100</code>
                          <code>101</code>
                          <code>102</code>
                          <code>103</code>
                          <code>104</code>
                          <code>105</code>
                          <code>106</code>
                          <code>107</code>
                          <code>108</code>
                          <code>109</code>
                          <code>110</code>
                          <code>111</code>
                          <code>112</code>
                          <code>113</code>
                          <code>114</code>
                          <code>115</code>
                          <code>116</code>
                          <code>117</code>
                          <code>118</code>
                          <code>119</code>
                          <code>120</code>
                          <code>121</code>
                          <code>122</code>
                          <code>123</code>
                          <code>124</code>
                          <code>125</code>
                          <code>126</code>
                          <code>127</code>
                          <code>128</code>
                          <code>129</code>
                          <code>130</code>
                          <code>131</code>
                          <code>132</code>
                          <code>133</code>
                          <code>134</code>
                          <code>135</code>
                          <code>136</code>
                          <code>137</code>
                          <code>138</code>
                          <code>139</code>
                          <code>140</code>
                          <code>141</code>
                          <code>142</code>
                          <code>143</code>
                          <code>144</code>
                          <code>145</code>
                          <code>146</code>
                          <code>147</code>
                          <code>148</code>
                          <code>149</code>
                          <code>150</code>
                          <code>151</code>
                          <code>152</code>
                          <code>153</code>
                          <code>154</code>
                          <code>A0</code>
                          <code>A1</code>
                          <code>A2</code>
                          <code>A3</code>
                          <code>A4</code>
                          <code>A5</code>
                          <code>A6</code>
                          <code>A7</code>
                          <code>A8</code>
                          <code>B1</code>
                          <code>B2</code>
                          <code>B3</code>
                          <code>B4</code>
                          <code>B5</code>
                          <code>B6</code>
                          <code>B7</code>
                          <code>B8</code>
                          <code>B9</code>
                          <code>B10</code>
                          <code>B11</code>
                          <code>B12</code>
                          <code>B13</code>
                          <code>B14</code>
                          <code>B15</code>
                          <code>B16</code>
                          <code>B17</code>
                          <code>B18</code>
                          <code>B19</code>
                          <code>B20</code>
                          <code>B21</code>
                          <code>B22</code>
                          <code>B23</code>
                          <code>D1</code>
                          <code>D2</code>
                          <code>D3</code>
                          <code>D4</code>
                          <code>D5</code>
                          <code>D6</code>
                          <code>D7</code>
                          <code>D8</code>
                          <code>D9</code>
                          <code>D10</code>
                          <code>D11</code>
                          <code>D12</code>
                          <code>D13</code>
                          <code>D14</code>
                          <code>D15</code>
                          <code>W1</code>
                        </valid_codes>
                      </element>
                      <element xid="CAS09">
                        <data_ele>782</data_ele>
                        <name>Adjustment Amount</name>
                        <usage>S</usage>
                        <seq>09</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="CAS10">
                        <data_ele>380</data_ele>
                        <name>Adjustment Quantity</name>
                        <usage>S</usage>
                        <seq>10</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="CAS11">
                        <data_ele>1034</data_ele>
                        <name>Adjustment Reason Code</name>
                        <usage>S</usage>
                        <seq>11</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>5</max_len>
                        <valid_codes>
                          <code>1</code>
                          <code>2</code>
                          <code>3</code>
                          <code>4</code>
                          <code>5</code>
                          <code>6</code>
                          <code>7</code>
                          <code>8</code>
                          <code>9</code>
                          <code>10</code>
                          <code>11</code>
                          <code>12</code>
                          <code>13</code>
                          <code>14</code>
                          <code>15</code>
                          <code>16</code>
                          <code>17</code>
                          <code>18</code>
                          <code>19</code>
                          <code>20</code>
                          <code>21</code>
                          <code>22</code>
                          <code>23</code>
                          <code>24</code>
                          <code>25</code>
                          <code>26</code>
                          <code>27</code>
                          <code>28</code>
                          <code>29</code>
                          <code>30</code>
                          <code>31</code>
                          <code>32</code>
                          <code>33</code>
                          <code>34</code>
                          <code>35</code>
                          <code>36</code>
                          <code>37</code>
                          <code>38</code>
                          <code>39</code>
                          <code>40</code>
                          <code>41</code>
                          <code>42</code>
                          <code>43</code>
                          <code>44</code>
                          <code>45</code>
                          <code>46</code>
                          <code>47</code>
                          <code>48</code>
                          <code>49</code>
                          <code>50</code>
                          <code>51</code>
                          <code>52</code>
                          <code>53</code>
                          <code>54</code>
                          <code>55</code>
                          <code>56</code>
                          <code>57</code>
                          <code>58</code>
                          <code>59</code>
                          <code>60</code>
                          <code>61</code>
                          <code>62</code>
                          <code>63</code>
                          <code>64</code>
                          <code>65</code>
                          <code>66</code>
                          <code>67</code>
                          <code>68</code>
                          <code>69</code>
                          <code>70</code>
                          <code>71</code>
                          <code>72</code>
                          <code>73</code>
                          <code>74</code>
                          <code>75</code>
                          <code>76</code>
                          <code>77</code>
                          <code>78</code>
                          <code>79</code>
                          <code>80</code>
                          <code>81</code>
                          <code>82</code>
                          <code>83</code>
                          <code>84</code>
                          <code>85</code>
                          <code>86</code>
                          <code>87</code>
                          <code>88</code>
                          <code>89</code>
                          <code>90</code>
                          <code>91</code>
                          <code>92</code>
                          <code>93</code>
                          <code>94</code>
                          <code>95</code>
                          <code>96</code>
                          <code>97</code>
                          <code>98</code>
                          <code>99</code>
                          <code>100</code>
                          <code>101</code>
                          <code>102</code>
                          <code>103</code>
                          <code>104</code>
                          <code>105</code>
                          <code>106</code>
                          <code>107</code>
                          <code>108</code>
                          <code>109</code>
                          <code>110</code>
                          <code>111</code>
                          <code>112</code>
                          <code>113</code>
                          <code>114</code>
                          <code>115</code>
                          <code>116</code>
                          <code>117</code>
                          <code>118</code>
                          <code>119</code>
                          <code>120</code>
                          <code>121</code>
                          <code>122</code>
                          <code>123</code>
                          <code>124</code>
                          <code>125</code>
                          <code>126</code>
                          <code>127</code>
                          <code>128</code>
                          <code>129</code>
                          <code>130</code>
                          <code>131</code>
                          <code>132</code>
                          <code>133</code>
                          <code>134</code>
                          <code>135</code>
                          <code>136</code>
                          <code>137</code>
                          <code>138</code>
                          <code>139</code>
                          <code>140</code>
                          <code>141</code>
                          <code>142</code>
                          <code>143</code>
                          <code>144</code>
                          <code>145</code>
                          <code>146</code>
                          <code>147</code>
                          <code>148</code>
                          <code>149</code>
                          <code>150</code>
                          <code>151</code>
                          <code>152</code>
                          <code>153</code>
                          <code>154</code>
                          <code>A0</code>
                          <code>A1</code>
                          <code>A2</code>
                          <code>A3</code>
                          <code>A4</code>
                          <code>A5</code>
                          <code>A6</code>
                          <code>A7</code>
                          <code>A8</code>
                          <code>B1</code>
                          <code>B2</code>
                          <code>B3</code>
                          <code>B4</code>
                          <code>B5</code>
                          <code>B6</code>
                          <code>B7</code>
                          <code>B8</code>
                          <code>B9</code>
                          <code>B10</code>
                          <code>B11</code>
                          <code>B12</code>
                          <code>B13</code>
                          <code>B14</code>
                          <code>B15</code>
                          <code>B16</code>
                          <code>B17</code>
                          <code>B18</code>
                          <code>B19</code>
                          <code>B20</code>
                          <code>B21</code>
                          <code>B22</code>
                          <code>B23</code>
                          <code>D1</code>
                          <code>D2</code>
                          <code>D3</code>
                          <code>D4</code>
                          <code>D5</code>
                          <code>D6</code>
                          <code>D7</code>
                          <code>D8</code>
                          <code>D9</code>
                          <code>D10</code>
                          <code>D11</code>
                          <code>D12</code>
                          <code>D13</code>
                          <code>D14</code>
                          <code>D15</code>
                          <code>W1</code>
                        </valid_codes>
                      </element>
                      <element xid="CAS12">
                        <data_ele>782</data_ele>
                        <name>Adjustment Amount</name>
                        <usage>S</usage>
                        <seq>12</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="CAS13">
                        <data_ele>380</data_ele>
                        <name>Adjustment Quantity</name>
                        <usage>S</usage>
                        <seq>13</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="CAS14">
                        <data_ele>1034</data_ele>
                        <name>Adjustment Reason Code</name>
                        <usage>S</usage>
                        <seq>14</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>5</max_len>
                        <valid_codes>
                          <code>1</code>
                          <code>2</code>
                          <code>3</code>
                          <code>4</code>
                          <code>5</code>
                          <code>6</code>
                          <code>7</code>
                          <code>8</code>
                          <code>9</code>
                          <code>10</code>
                          <code>11</code>
                          <code>12</code>
                          <code>13</code>
                          <code>14</code>
                          <code>15</code>
                          <code>16</code>
                          <code>17</code>
                          <code>18</code>
                          <code>19</code>
                          <code>20</code>
                          <code>21</code>
                          <code>22</code>
                          <code>23</code>
                          <code>24</code>
                          <code>25</code>
                          <code>26</code>
                          <code>27</code>
                          <code>28</code>
                          <code>29</code>
                          <code>30</code>
                          <code>31</code>
                          <code>32</code>
                          <code>33</code>
                          <code>34</code>
                          <code>35</code>
                          <code>36</code>
                          <code>37</code>
                          <code>38</code>
                          <code>39</code>
                          <code>40</code>
                          <code>41</code>
                          <code>42</code>
                          <code>43</code>
                          <code>44</code>
                          <code>45</code>
                          <code>46</code>
                          <code>47</code>
                          <code>48</code>
                          <code>49</code>
                          <code>50</code>
                          <code>51</code>
                          <code>52</code>
                          <code>53</code>
                          <code>54</code>
                          <code>55</code>
                          <code>56</code>
                          <code>57</code>
                          <code>58</code>
                          <code>59</code>
                          <code>60</code>
                          <code>61</code>
                          <code>62</code>
                          <code>63</code>
                          <code>64</code>
                          <code>65</code>
                          <code>66</code>
                          <code>67</code>
                          <code>68</code>
                          <code>69</code>
                          <code>70</code>
                          <code>71</code>
                          <code>72</code>
                          <code>73</code>
                          <code>74</code>
                          <code>75</code>
                          <code>76</code>
                          <code>77</code>
                          <code>78</code>
                          <code>79</code>
                          <code>80</code>
                          <code>81</code>
                          <code>82</code>
                          <code>83</code>
                          <code>84</code>
                          <code>85</code>
                          <code>86</code>
                          <code>87</code>
                          <code>88</code>
                          <code>89</code>
                          <code>90</code>
                          <code>91</code>
                          <code>92</code>
                          <code>93</code>
                          <code>94</code>
                          <code>95</code>
                          <code>96</code>
                          <code>97</code>
                          <code>98</code>
                          <code>99</code>
                          <code>100</code>
                          <code>101</code>
                          <code>102</code>
                          <code>103</code>
                          <code>104</code>
                          <code>105</code>
                          <code>106</code>
                          <code>107</code>
                          <code>108</code>
                          <code>109</code>
                          <code>110</code>
                          <code>111</code>
                          <code>112</code>
                          <code>113</code>
                          <code>114</code>
                          <code>115</code>
                          <code>116</code>
                          <code>117</code>
                          <code>118</code>
                          <code>119</code>
                          <code>120</code>
                          <code>121</code>
                          <code>122</code>
                          <code>123</code>
                          <code>124</code>
                          <code>125</code>
                          <code>126</code>
                          <code>127</code>
                          <code>128</code>
                          <code>129</code>
                          <code>130</code>
                          <code>131</code>
                          <code>132</code>
                          <code>133</code>
                          <code>134</code>
                          <code>135</code>
                          <code>136</code>
                          <code>137</code>
                          <code>138</code>
                          <code>139</code>
                          <code>140</code>
                          <code>141</code>
                          <code>142</code>
                          <code>143</code>
                          <code>144</code>
                          <code>145</code>
                          <code>146</code>
                          <code>147</code>
                          <code>148</code>
                          <code>149</code>
                          <code>150</code>
                          <code>151</code>
                          <code>152</code>
                          <code>153</code>
                          <code>154</code>
                          <code>A0</code>
                          <code>A1</code>
                          <code>A2</code>
                          <code>A3</code>
                          <code>A4</code>
                          <code>A5</code>
                          <code>A6</code>
                          <code>A7</code>
                          <code>A8</code>
                          <code>B1</code>
                          <code>B2</code>
                          <code>B3</code>
                          <code>B4</code>
                          <code>B5</code>
                          <code>B6</code>
                          <code>B7</code>
                          <code>B8</code>
                          <code>B9</code>
                          <code>B10</code>
                          <code>B11</code>
                          <code>B12</code>
                          <code>B13</code>
                          <code>B14</code>
                          <code>B15</code>
                          <code>B16</code>
                          <code>B17</code>
                          <code>B18</code>
                          <code>B19</code>
                          <code>B20</code>
                          <code>B21</code>
                          <code>B22</code>
                          <code>B23</code>
                          <code>D1</code>
                          <code>D2</code>
                          <code>D3</code>
                          <code>D4</code>
                          <code>D5</code>
                          <code>D6</code>
                          <code>D7</code>
                          <code>D8</code>
                          <code>D9</code>
                          <code>D10</code>
                          <code>D11</code>
                          <code>D12</code>
                          <code>D13</code>
                          <code>D14</code>
                          <code>D15</code>
                          <code>W1</code>
                        </valid_codes>
                      </element>
                      <element xid="CAS15">
                        <data_ele>782</data_ele>
                        <name>Adjustment Amount</name>
                        <usage>S</usage>
                        <seq>15</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="CAS16">
                        <data_ele>380</data_ele>
                        <name>Adjustment Quantity</name>
                        <usage>S</usage>
                        <seq>16</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="CAS17">
                        <data_ele>1034</data_ele>
                        <name>Adjustment Reason Code</name>
                        <usage>S</usage>
                        <seq>17</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>5</max_len>
                        <valid_codes>
                          <code>1</code>
                          <code>2</code>
                          <code>3</code>
                          <code>4</code>
                          <code>5</code>
                          <code>6</code>
                          <code>7</code>
                          <code>8</code>
                          <code>9</code>
                          <code>10</code>
                          <code>11</code>
                          <code>12</code>
                          <code>13</code>
                          <code>14</code>
                          <code>15</code>
                          <code>16</code>
                          <code>17</code>
                          <code>18</code>
                          <code>19</code>
                          <code>20</code>
                          <code>21</code>
                          <code>22</code>
                          <code>23</code>
                          <code>24</code>
                          <code>25</code>
                          <code>26</code>
                          <code>27</code>
                          <code>28</code>
                          <code>29</code>
                          <code>30</code>
                          <code>31</code>
                          <code>32</code>
                          <code>33</code>
                          <code>34</code>
                          <code>35</code>
                          <code>36</code>
                          <code>37</code>
                          <code>38</code>
                          <code>39</code>
                          <code>40</code>
                          <code>41</code>
                          <code>42</code>
                          <code>43</code>
                          <code>44</code>
                          <code>45</code>
                          <code>46</code>
                          <code>47</code>
                          <code>48</code>
                          <code>49</code>
                          <code>50</code>
                          <code>51</code>
                          <code>52</code>
                          <code>53</code>
                          <code>54</code>
                          <code>55</code>
                          <code>56</code>
                          <code>57</code>
                          <code>58</code>
                          <code>59</code>
                          <code>60</code>
                          <code>61</code>
                          <code>62</code>
                          <code>63</code>
                          <code>64</code>
                          <code>65</code>
                          <code>66</code>
                          <code>67</code>
                          <code>68</code>
                          <code>69</code>
                          <code>70</code>
                          <code>71</code>
                          <code>72</code>
                          <code>73</code>
                          <code>74</code>
                          <code>75</code>
                          <code>76</code>
                          <code>77</code>
                          <code>78</code>
                          <code>79</code>
                          <code>80</code>
                          <code>81</code>
                          <code>82</code>
                          <code>83</code>
                          <code>84</code>
                          <code>85</code>
                          <code>86</code>
                          <code>87</code>
                          <code>88</code>
                          <code>89</code>
                          <code>90</code>
                          <code>91</code>
                          <code>92</code>
                          <code>93</code>
                          <code>94</code>
                          <code>95</code>
                          <code>96</code>
                          <code>97</code>
                          <code>98</code>
                          <code>99</code>
                          <code>100</code>
                          <code>101</code>
                          <code>102</code>
                          <code>103</code>
                          <code>104</code>
                          <code>105</code>
                          <code>106</code>
                          <code>107</code>
                          <code>108</code>
                          <code>109</code>
                          <code>110</code>
                          <code>111</code>
                          <code>112</code>
                          <code>113</code>
                          <code>114</code>
                          <code>115</code>
                          <code>116</code>
                          <code>117</code>
                          <code>118</code>
                          <code>119</code>
                          <code>120</code>
                          <code>121</code>
                          <code>122</code>
                          <code>123</code>
                          <code>124</code>
                          <code>125</code>
                          <code>126</code>
                          <code>127</code>
                          <code>128</code>
                          <code>129</code>
                          <code>130</code>
                          <code>131</code>
                          <code>132</code>
                          <code>133</code>
                          <code>134</code>
                          <code>135</code>
                          <code>136</code>
                          <code>137</code>
                          <code>138</code>
                          <code>139</code>
                          <code>140</code>
                          <code>141</code>
                          <code>142</code>
                          <code>143</code>
                          <code>144</code>
                          <code>145</code>
                          <code>146</code>
                          <code>147</code>
                          <code>148</code>
                          <code>149</code>
                          <code>150</code>
                          <code>151</code>
                          <code>152</code>
                          <code>153</code>
                          <code>154</code>
                          <code>A0</code>
                          <code>A1</code>
                          <code>A2</code>
                          <code>A3</code>
                          <code>A4</code>
                          <code>A5</code>
                          <code>A6</code>
                          <code>A7</code>
                          <code>A8</code>
                          <code>B1</code>
                          <code>B2</code>
                          <code>B3</code>
                          <code>B4</code>
                          <code>B5</code>
                          <code>B6</code>
                          <code>B7</code>
                          <code>B8</code>
                          <code>B9</code>
                          <code>B10</code>
                          <code>B11</code>
                          <code>B12</code>
                          <code>B13</code>
                          <code>B14</code>
                          <code>B15</code>
                          <code>B16</code>
                          <code>B17</code>
                          <code>B18</code>
                          <code>B19</code>
                          <code>B20</code>
                          <code>B21</code>
                          <code>B22</code>
                          <code>B23</code>
                          <code>D1</code>
                          <code>D2</code>
                          <code>D3</code>
                          <code>D4</code>
                          <code>D5</code>
                          <code>D6</code>
                          <code>D7</code>
                          <code>D8</code>
                          <code>D9</code>
                          <code>D10</code>
                          <code>D11</code>
                          <code>D12</code>
                          <code>D13</code>
                          <code>D14</code>
                          <code>D15</code>
                          <code>W1</code>
                        </valid_codes>
                      </element>
                      <element xid="CAS18">
                        <data_ele>782</data_ele>
                        <name>Adjustment Amount</name>
                        <usage>S</usage>
                        <seq>18</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="CAS19">
                        <data_ele>380</data_ele>
                        <name>Adjustment Quantity</name>
                        <usage>S</usage>
                        <seq>19</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                    </segment>
<!--End of CAS segment-->
                    <segment xid="DTP">
                      <name>Service Adjudication Date</name>
                      <usage>S</usage>
                      <pos>550</pos>
                      <max_use>1</max_use>
                      <element xid="DTP01">
                        <data_ele>374</data_ele>
                        <name>Date Time Qualifier</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>3</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>573</code>
                        </valid_codes>
                      </element>
                      <element xid="DTP02">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>D8</code>
                        </valid_codes>
                      </element>
                      <element xid="DTP03">
                        <data_ele>1251</data_ele>
                        <name>Service Adjudication or Payment Date</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                    </segment>
<!--End of DTP segment-->
                  </loop>
<!--End of 2430 loop-->
                </loop>
<!--End of 2400 loop-->
              </loop>
<!--End of 2300 loop-->
              <loop xid="2000C">
                <name>Patient Hierarchical Level</name>
                <usage>S</usage>
                <pos>160</pos>
                <repeat>&gt;1</repeat>
                <segment xid="HL">
                  <name>Patient Hierarchical Level</name>
                  <usage>R</usage>
                  <pos>001</pos>
                  <max_use>1</max_use>
                  <element xid="HL01">
                    <data_ele>628</data_ele>
                    <name>Hierarchical ID Number</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>12</max_len>
                  </element>
                  <element xid="HL02">
                    <data_ele>734</data_ele>
                    <name>Hierarchical Parent ID Number</name>
                    <usage>R</usage>
                    <seq>02</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>12</max_len>
                  </element>
                  <element xid="HL03">
                    <data_ele>735</data_ele>
                    <name>Hierarchical Level Code</name>
                    <usage>R</usage>
                    <seq>03</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>23</code>
                    </valid_codes>
                  </element>
                  <element xid="HL04">
                    <data_ele>736</data_ele>
                    <name>Hierarchical Child Code</name>
                    <usage>R</usage>
                    <seq>04</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                    <valid_codes>
                      <code>0</code>
                    </valid_codes>
                  </element>
                </segment>
<!--End of HL segment-->
                <segment xid="PAT">
                  <name>Patient Information</name>
                  <usage>R</usage>
                  <pos>007</pos>
                  <max_use>1</max_use>
                  <element xid="PAT01">
                    <data_ele>1069</data_ele>
                    <name>Patients Relationship to Insured</name>
                    <usage>R</usage>
                    <seq>01</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code>01</code>
                      <code>04</code>
                      <code>05</code>
                      <code>07</code>
                      <code>10</code>
                      <code>15</code>
                      <code>17</code>
                      <code>19</code>
                      <code>20</code>
                      <code>21</code>
                      <code>22</code>
                      <code>23</code>
                      <code>24</code>
                      <code>29</code>
                      <code>32</code>
                      <code>33</code>
                      <code>36</code>
                      <code>39</code>
                      <code>40</code>
                      <code>41</code>
                      <code>43</code>
                      <code>53</code>
                      <code>G8</code>
                    </valid_codes>
                  </element>
                  <element xid="PAT02">
                    <data_ele>1384</data_ele>
                    <name>Patient Location Code</name>
                    <usage>N</usage>
                    <seq>02</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                  </element>
                  <element xid="PAT03">
                    <data_ele>584</data_ele>
                    <name>Employment Status Code</name>
                    <usage>N</usage>
                    <seq>03</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                  </element>
                  <element xid="PAT04">
                    <data_ele>1220</data_ele>
                    <name>Student Status Code</name>
                    <usage>N</usage>
                    <seq>04</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                  </element>
                  <element xid="PAT05">
                    <data_ele>1250</data_ele>
                    <name>Date Time Period Format Qualifier</name>
                    <usage>N</usage>
                    <seq>05</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>3</max_len>
                  </element>
                  <element xid="PAT06">
                    <data_ele>1251</data_ele>
                    <name>Date Time Period</name>
                    <usage>N</usage>
                    <seq>06</seq>
                    <data_type>AN</data_type>
                    <min_len>1</min_len>
                    <max_len>35</max_len>
                  </element>
                  <element xid="PAT07">
                    <data_ele>355</data_ele>
                    <name>Unit or Basis for Measurement Code</name>
                    <usage>N</usage>
                    <seq>07</seq>
                    <data_type>ID</data_type>
                    <min_len>2</min_len>
                    <max_len>2</max_len>
                    <valid_codes>
                      <code/>
                    </valid_codes>
                  </element>
                  <element xid="PAT08">
                    <data_ele>81</data_ele>
                    <name>Patient Weight</name>
                    <usage>N</usage>
                    <seq>08</seq>
                    <data_type>R</data_type>
                    <min_len>1</min_len>
                    <max_len>10</max_len>
                  </element>
                  <element xid="PAT09">
                    <data_ele>1073</data_ele>
                    <name>Pregnancy Indicator</name>
                    <usage>N</usage>
                    <seq>09</seq>
                    <data_type>ID</data_type>
                    <min_len>1</min_len>
                    <max_len>1</max_len>
                    <valid_codes>
                      <code/>
                    </valid_codes>
                  </element>
                </segment>
<!--End of PAT segment-->
                <loop xid="2010CA">
                  <name>Patient Name</name>
                  <usage>R</usage>
                  <pos>015</pos>
                  <repeat>1</repeat>
                  <segment xid="NM1">
                    <name>Patient Name</name>
                    <usage>R</usage>
                    <pos>015</pos>
                    <max_use>1</max_use>
                    <element xid="NM101">
                      <data_ele>98</data_ele>
                      <name>Entity Identifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>QC</code>
                      </valid_codes>
                    </element>
                    <element xid="NM102">
                      <data_ele>1065</data_ele>
                      <name>Entity Type Qualifier</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                      <valid_codes>
                        <code>1</code>
                      </valid_codes>
                    </element>
                    <element xid="NM103">
                      <data_ele>1035</data_ele>
                      <name>Patient Last Name</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="NM104">
                      <data_ele>1036</data_ele>
                      <name>Patient First Name</name>
                      <usage>R</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>25</max_len>
                    </element>
                    <element xid="NM105">
                      <data_ele>1037</data_ele>
                      <name>Patient Middle Name</name>
                      <usage>S</usage>
                      <seq>05</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>25</max_len>
                    </element>
                    <element xid="NM106">
                      <data_ele>1038</data_ele>
                      <name>Name Prefix</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>10</max_len>
                    </element>
                    <element xid="NM107">
                      <data_ele>1039</data_ele>
                      <name>Patient Name Suffix</name>
                      <usage>S</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>10</max_len>
                    </element>
                    <element xid="NM108">
                      <data_ele>66</data_ele>
                      <name>Identification Code Qualifier</name>
                      <usage>S</usage>
                      <seq>08</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>MI</code>
                        <code>ZZ</code>
                      </valid_codes>
                    </element>
                    <element xid="NM109">
                      <data_ele>67</data_ele>
                      <name>Patient Primary Identifier</name>
                      <usage>S</usage>
                      <seq>09</seq>
                      <data_type>AN</data_type>
                      <min_len>2</min_len>
                      <max_len>80</max_len>
                    </element>
                    <element xid="NM110">
                      <data_ele>706</data_ele>
                      <name>Entity Relationship Code</name>
                      <usage>N</usage>
                      <seq>10</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                    </element>
                    <element xid="NM111">
                      <data_ele>98</data_ele>
                      <name>Entity Identifier Code</name>
                      <usage>N</usage>
                      <seq>11</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                  </segment>
<!--End of NM1 segment-->
                  <segment xid="N3">
                    <name>Patient Address</name>
                    <usage>R</usage>
                    <pos>025</pos>
                    <max_use>1</max_use>
                    <element xid="N301">
                      <data_ele>166</data_ele>
                      <name>Patient Address Line</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>55</max_len>
                    </element>
                    <element xid="N302">
                      <data_ele>166</data_ele>
                      <name>Patient Address Line</name>
                      <usage>S</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>55</max_len>
                    </element>
                  </segment>
<!--End of N3 segment-->
                  <segment xid="N4">
                    <name>Patient City/State/ZIP Code</name>
                    <usage>R</usage>
                    <pos>030</pos>
                    <max_use>1</max_use>
                    <element xid="N401">
                      <data_ele>19</data_ele>
                      <name>Patient City Name</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>AN</data_type>
                      <min_len>2</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="N402">
                      <data_ele>156</data_ele>
                      <name>Patient State Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes external="states"/>
                    </element>
                    <element xid="N403">
                      <data_ele>116</data_ele>
                      <name>Patient Postal Zone or ZIP Code</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>3</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="N404">
                      <data_ele>26</data_ele>
                      <name>Country Code</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes external="country"/>
                    </element>
                    <element xid="N405">
                      <data_ele>309</data_ele>
                      <name>Location Qualifier</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                    </element>
                    <element xid="N406">
                      <data_ele>310</data_ele>
                      <name>Location Identifier</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </segment>
<!--End of N4 segment-->
                  <segment xid="DMG">
                    <name>Patient Demographic Information</name>
                    <usage>R</usage>
                    <pos>032</pos>
                    <max_use>1</max_use>
                    <element xid="DMG01">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>D8</code>
                      </valid_codes>
                    </element>
                    <element xid="DMG02">
                      <data_ele>1251</data_ele>
                      <name>Patient Birth Date</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="DMG03">
                      <data_ele>1068</data_ele>
                      <name>Patient Gender Code</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                      <valid_codes>
                        <code>F</code>
                        <code>M</code>
                        <code>U</code>
                      </valid_codes>
                    </element>
                    <element xid="DMG04">
                      <data_ele>1067</data_ele>
                      <name>Marital Status Code</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                    <element xid="DMG05">
                      <data_ele>1109</data_ele>
                      <name>Race or Ethnicity Code</name>
                      <usage>N</usage>
                      <seq>05</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                    <element xid="DMG06">
                      <data_ele>1066</data_ele>
                      <name>Citizenship Status Code</name>
                      <usage>N</usage>
                      <seq>06</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                    </element>
                    <element xid="DMG07">
                      <data_ele>26</data_ele>
                      <name>Country Code</name>
                      <usage>N</usage>
                      <seq>07</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes external="country"/>
                    </element>
                    <element xid="DMG08">
                      <data_ele>659</data_ele>
                      <name>Basis of Verification Code</name>
                      <usage>N</usage>
                      <seq>08</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                    </element>
                    <element xid="DMG09">
                      <data_ele>380</data_ele>
                      <name>Quantity</name>
                      <usage>N</usage>
                      <seq>09</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                  </segment>
<!--End of DMG segment-->
                  <segment xid="REF">
                    <name>Patient Secondary Identification Number</name>
                    <usage>S</usage>
                    <pos>035</pos>
                    <max_use>5</max_use>
                    <element xid="REF01">
                      <data_ele>128</data_ele>
                      <name>Reference Identification Qualifier</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>1W</code>
                        <code>23</code>
                        <code>IG</code>
                        <code>SY</code>
                      </valid_codes>
                    </element>
                    <element xid="REF02">
                      <data_ele>127</data_ele>
                      <name>Patient Secondary Identifier</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="REF03">
                      <data_ele>352</data_ele>
                      <name>Description</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>80</max_len>
                    </element>
                    <composite>
                      <data_ele>C040</data_ele>
                      <name>Reference Identifier</name>
                      <usage>N</usage>
                      <seq>04</seq>
                    </composite>
                  </segment>
<!--End of REF segment-->
                  <segment xid="REF">
                    <name>Property and Casualty Claim Number</name>
                    <usage>S</usage>
                    <pos>035</pos>
                    <max_use>1</max_use>
                    <element xid="REF01">
                      <data_ele>128</data_ele>
                      <name>Reference Identification Qualifier</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>Y4</code>
                      </valid_codes>
                    </element>
                    <element xid="REF02">
                      <data_ele>127</data_ele>
                      <name>Property Casualty Claim Number</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="REF03">
                      <data_ele>352</data_ele>
                      <name>Description</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>80</max_len>
                    </element>
                    <composite>
                      <data_ele>C040</data_ele>
                      <name>Reference Identifier</name>
                      <usage>N</usage>
                      <seq>04</seq>
                    </composite>
                  </segment>
<!--End of REF segment-->
                </loop>
<!--End of 2010CA loop-->
                <loop xid="2300">
                  <name>Claim Information</name>
                  <usage>R</usage>
                  <pos>130</pos>
                  <repeat>100</repeat>
                  <segment xid="CLM">
                    <name>Claim Information</name>
                    <usage>R</usage>
                    <pos>130</pos>
                    <max_use>1</max_use>
                    <element xid="CLM01">
                      <data_ele>1028</data_ele>
                      <name>Patient Account Number</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>38</max_len>
                    </element>
                    <element xid="CLM02">
                      <data_ele>782</data_ele>
                      <name>Total Claim Charge Amount</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="CLM03">
                      <data_ele>1032</data_ele>
                      <name>Claim Filing Indicator Code</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                    </element>
                    <element xid="CLM04">
                      <data_ele>1343</data_ele>
                      <name>Non-Institutional Claim Type Code</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                    </element>
                    <composite>
                      <data_ele>C023</data_ele>
                      <name>Type of Bill</name>
                      <usage>R</usage>
                      <seq>05</seq>
                      <element xid="CLM05-01">
                        <data_ele>1331</data_ele>
                        <name>Facility Type Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code/>
                        </valid_codes>
                      </element>
                      <element xid="CLM05-02">
                        <data_ele>1332</data_ele>
                        <name>Facility Code Qualifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>A</code>
                        </valid_codes>
                      </element>
                      <element xid="CLM05-03">
                        <data_ele>1325</data_ele>
                        <name>Claim Frequency Code</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                        <valid_codes>
                          <code>0</code>
                          <code>1</code>
                          <code>2</code>
                          <code>3</code>
                          <code>4</code>
                          <code>5</code>
                          <code>6</code>
                          <code>7</code>
                          <code>8</code>
                          <code>9</code>
                          <code>A</code>
                          <code>B</code>
                          <code>C</code>
                          <code>D</code>
                          <code>E</code>
                          <code>F</code>
                          <code>G</code>
                          <code>H</code>
                          <code>I</code>
                          <code>J</code>
                          <code>K</code>
                          <code>L</code>
                          <code>M</code>
                          <code>N</code>
                          <code>O</code>
                          <code>X</code>
                          <code>Y</code>
                          <code>Z </code>
                        </valid_codes>
                      </element>
                    </composite>
                    <element xid="CLM06">
                      <data_ele>1073</data_ele>
                      <name>Provider or Supplier Signature Indicator</name>
                      <usage>R</usage>
                      <seq>06</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                      <valid_codes>
                        <code>N</code>
                        <code>Y</code>
                      </valid_codes>
                    </element>
                    <element xid="CLM07">
                      <data_ele>1359</data_ele>
                      <name>Medicare Assignment Code</name>
                      <usage>S</usage>
                      <seq>07</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                      <valid_codes>
                        <code>A</code>
                        <code>C</code>
                      </valid_codes>
                    </element>
                    <element xid="CLM08">
                      <data_ele>1073</data_ele>
                      <name>Benefits Assignment Certification Indicator</name>
                      <usage>R</usage>
                      <seq>08</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                      <valid_codes>
                        <code>N</code>
                        <code>Y</code>
                      </valid_codes>
                    </element>
                    <element xid="CLM09">
                      <data_ele>1363</data_ele>
                      <name>Release of Information Code</name>
                      <usage>R</usage>
                      <seq>09</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                      <valid_codes>
                        <code>A</code>
                        <code>I</code>
                        <code>M</code>
                        <code>N</code>
                        <code>O</code>
                        <code>Y</code>
                      </valid_codes>
                    </element>
                    <element xid="CLM10">
                      <data_ele>1351</data_ele>
                      <name>Patient Signature Source Code</name>
                      <usage>N</usage>
                      <seq>10</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                    <composite>
                      <data_ele>C024</data_ele>
                      <name>Property and Casualty Related Causes Codes</name>
                      <usage>N</usage>
                      <seq>11</seq>
                    </composite>
                    <element xid="CLM12">
                      <data_ele>1366</data_ele>
                      <name>Special Program Indicator</name>
                      <usage>N</usage>
                      <seq>12</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>01</code>
                        <code>02</code>
                        <code>03</code>
                        <code>05</code>
                        <code>07</code>
                        <code>08</code>
                        <code>09</code>
                      </valid_codes>
                    </element>
                    <element xid="CLM13">
                      <data_ele>1073</data_ele>
                      <name>Yes/No Condition or Response Code</name>
                      <usage>N</usage>
                      <seq>13</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                    <element xid="CLM14">
                      <data_ele>1338</data_ele>
                      <name>Level of Service Code</name>
                      <usage>N</usage>
                      <seq>14</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="CLM15">
                      <data_ele>1073</data_ele>
                      <name>Yes/No Condition or Response Code</name>
                      <usage>N</usage>
                      <seq>15</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                    <element xid="CLM16">
                      <data_ele>1360</data_ele>
                      <name>Provider Agreement Code</name>
                      <usage>N</usage>
                      <seq>16</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                    <element xid="CLM07">
                      <data_ele>1029</data_ele>
                      <name>Claim Status Code</name>
                      <usage>N</usage>
                      <seq>7</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                    </element>
                    <element xid="CLM18">
                      <data_ele>1073</data_ele>
                      <name>Explanation of Benefits Indicator</name>
                      <usage>R</usage>
                      <seq>18</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                      <valid_codes>
                        <code>N</code>
                        <code>Y</code>
                      </valid_codes>
                    </element>
                    <element xid="CLM19">
                      <data_ele>1383</data_ele>
                      <name>Claim Submission Reason Code</name>
                      <usage>N</usage>
                      <seq>19</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                    </element>
                    <element xid="CLM20">
                      <data_ele>1514</data_ele>
                      <name>Delay Reason Code</name>
                      <usage>S</usage>
                      <seq>20</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>1</code>
                        <code>2</code>
                        <code>3</code>
                        <code>4</code>
                        <code>5</code>
                        <code>6</code>
                        <code>7</code>
                        <code>8</code>
                        <code>9</code>
                        <code>10</code>
                        <code>11</code>
                      </valid_codes>
                    </element>
                  </segment>
<!--End of CLM segment-->
                  <segment xid="DTP">
                    <name>Discharge Hour</name>
                    <usage>S</usage>
                    <pos>135</pos>
                    <max_use>1</max_use>
                    <element xid="DTP01">
                      <data_ele>374</data_ele>
                      <name>Date Time Qualifier</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>3</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>096</code>
                      </valid_codes>
                    </element>
                    <element xid="DTP02">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>TM</code>
                      </valid_codes>
                    </element>
                    <element xid="DTP03">
                      <data_ele>1251</data_ele>
                      <name>Discharge Hour</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                  </segment>
<!--End of DTP segment-->
                  <segment xid="DTP">
                    <name>Statement Dates</name>
                    <usage>R</usage>
                    <pos>135</pos>
                    <max_use>1</max_use>
                    <element xid="DTP01">
                      <data_ele>374</data_ele>
                      <name>Date Time Qualifier</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>3</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>434</code>
                      </valid_codes>
                    </element>
                    <element xid="DTP02">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>D8</code>
                        <code>RD8</code>
                      </valid_codes>
                    </element>
                    <element xid="DTP03">
                      <data_ele>1251</data_ele>
                      <name>Statement From or To Date</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                  </segment>
<!--End of DTP segment-->
                  <segment xid="DTP">
                    <name>Admission Date/Hour</name>
                    <usage>S</usage>
                    <pos>135</pos>
                    <max_use>1</max_use>
                    <element xid="DTP01">
                      <data_ele>374</data_ele>
                      <name>Date Time Qualifier</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>3</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>435</code>
                      </valid_codes>
                    </element>
                    <element xid="DTP02">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>DT</code>
                      </valid_codes>
                    </element>
                    <element xid="DTP03">
                      <data_ele>1251</data_ele>
                      <name>Admission Date and Hour</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                  </segment>
<!--End of DTP segment-->
                  <segment xid="CL1">
                    <name>Institutional Claim Code</name>
                    <usage>S</usage>
                    <pos>140</pos>
                    <max_use>1</max_use>
                    <element xid="CL101">
                      <data_ele>1315</data_ele>
                      <name>Admission Type Code</name>
                      <usage>S</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                    <element xid="CL102">
                      <data_ele>1314</data_ele>
                      <name>Admission Source Code</name>
                      <usage>S</usage>
                      <seq>02</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                    <element xid="CL103">
                      <data_ele>1352</data_ele>
                      <name>Patient Status Code</name>
                      <usage>S</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                    </element>
                    <element xid="CL104">
                      <data_ele>1345</data_ele>
                      <name>Nursing Home Residential Status Code</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                  </segment>
<!--End of CL1 segment-->
                  <segment xid="PWK">
                    <name>Claim Supplemental Information</name>
                    <usage>S</usage>
                    <pos>155</pos>
                    <max_use>10</max_use>
                    <element xid="PWK01">
                      <data_ele>755</data_ele>
                      <name>Attachment Report Type Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>AS</code>
                        <code>B2</code>
                        <code>B3</code>
                        <code>B4</code>
                        <code>CT</code>
                        <code>DA</code>
                        <code>DG</code>
                        <code>DS</code>
                        <code>EB</code>
                        <code>MT</code>
                        <code>NN</code>
                        <code>OB</code>
                        <code>OZ</code>
                        <code>PN</code>
                        <code>PO</code>
                        <code>PZ</code>
                        <code>RB</code>
                        <code>RR</code>
                        <code>RT</code>
                      </valid_codes>
                    </element>
                    <element xid="PWK02">
                      <data_ele>756</data_ele>
                      <name>Attachment Transmission Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>AA</code>
                        <code>BM</code>
                        <code>EL</code>
                        <code>EM</code>
                        <code>FX</code>
                      </valid_codes>
                    </element>
                    <element xid="PWK03">
                      <data_ele>757</data_ele>
                      <name>Report Copies Needed</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>N0</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                    </element>
                    <element xid="PWK04">
                      <data_ele>98</data_ele>
                      <name>Entity Identifier Code</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                    </element>
                    <element xid="PWK05">
                      <data_ele>66</data_ele>
                      <name>Identification Code Qualifier</name>
                      <usage>S</usage>
                      <seq>05</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>AC</code>
                      </valid_codes>
                    </element>
                    <element xid="PWK06">
                      <data_ele>67</data_ele>
                      <name>Attachment Control Number</name>
                      <usage>S</usage>
                      <seq>06</seq>
                      <data_type>AN</data_type>
                      <min_len>2</min_len>
                      <max_len>80</max_len>
                    </element>
                    <element xid="PWK07">
                      <data_ele>352</data_ele>
                      <name>Attachment Description</name>
                      <usage>S</usage>
                      <seq>07</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>80</max_len>
                    </element>
                    <composite>
                      <data_ele>C002</data_ele>
                      <name>Actions Indicated</name>
                      <usage>N</usage>
                      <seq>08</seq>
                    </composite>
                    <element xid="PWK09">
                      <data_ele>1525</data_ele>
                      <name>Request Category Code</name>
                      <usage>N</usage>
                      <seq>09</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                    </element>
                  </segment>
<!--End of PWK segment-->
                  <segment xid="CN1">
                    <name>Contract Information</name>
                    <usage>S</usage>
                    <pos>160</pos>
                    <max_use>1</max_use>
                    <element xid="CN101">
                      <data_ele>1166</data_ele>
                      <name>Contract Type Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>01</code>
                        <code>02</code>
                        <code>03</code>
                        <code>04</code>
                        <code>05</code>
                        <code>06</code>
                        <code>09</code>
                      </valid_codes>
                    </element>
                    <element xid="CN102">
                      <data_ele>782</data_ele>
                      <name>Contract Amount</name>
                      <usage>S</usage>
                      <seq>02</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="CN103">
                      <data_ele>332</data_ele>
                      <name>Contract Percentage</name>
                      <usage>S</usage>
                      <seq>03</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>6</max_len>
                    </element>
                    <element xid="CN104">
                      <data_ele>127</data_ele>
                      <name>Contract Code</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="CN105">
                      <data_ele>338</data_ele>
                      <name>Terms Discount Percentage</name>
                      <usage>S</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>6</max_len>
                    </element>
                    <element xid="CN106">
                      <data_ele>799</data_ele>
                      <name>Contract Version Identifier</name>
                      <usage>S</usage>
                      <seq>06</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </segment>
<!--End of CN1 segment-->
                  <segment xid="AMT">
                    <name>Payer Estimated Amount Due</name>
                    <usage>S</usage>
                    <pos>175</pos>
                    <max_use>1</max_use>
                    <element xid="AMT01">
                      <data_ele>522</data_ele>
                      <name>Amount Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>C5</code>
                      </valid_codes>
                    </element>
                    <element xid="AMT02">
                      <data_ele>782</data_ele>
                      <name>Estimated Claim Due Amount</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="AMT03">
                      <data_ele>478</data_ele>
                      <name>Credit/Debit Flag Code</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                  </segment>
<!--End of AMT segment-->
                  <segment xid="AMT">
                    <name>Patient Estimated Amount Due</name>
                    <usage>S</usage>
                    <pos>175</pos>
                    <max_use>1</max_use>
                    <element xid="AMT01">
                      <data_ele>522</data_ele>
                      <name>Amount Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>F3</code>
                      </valid_codes>
                    </element>
                    <element xid="AMT02">
                      <data_ele>782</data_ele>
                      <name>Patient Responsibility Amount</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="AMT03">
                      <data_ele>478</data_ele>
                      <name>Credit/Debit Flag Code</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                  </segment>
<!--End of AMT segment-->
                  <segment xid="AMT">
                    <name>Patient Paid Amount</name>
                    <usage>S</usage>
                    <pos>175</pos>
                    <max_use>1</max_use>
                    <element xid="AMT01">
                      <data_ele>522</data_ele>
                      <name>Amount Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>F5</code>
                      </valid_codes>
                    </element>
                    <element xid="AMT02">
                      <data_ele>782</data_ele>
                      <name>Patient Amount Paid</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="AMT03">
                      <data_ele>478</data_ele>
                      <name>Credit/Debit Flag Code</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                  </segment>
<!--End of AMT segment-->
                  <segment xid="AMT">
                    <name>Credit/Debit Card Maximum Amount</name>
                    <usage>S</usage>
                    <pos>175</pos>
                    <max_use>1</max_use>
                    <element xid="AMT01">
                      <data_ele>522</data_ele>
                      <name>Amount Qualifier Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>MA</code>
                      </valid_codes>
                    </element>
                    <element xid="AMT02">
                      <data_ele>782</data_ele>
                      <name>Credit or Debit Card Maximum Amount</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="AMT03">
                      <data_ele>478</data_ele>
                      <name>Credit/Debit Flag Code</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                    </element>
                  </segment>
<!--End of AMT segment-->
                  <segment xid="REF">
                    <name>Adjusted Repriced Claim Number</name>
                    <usage>S</usage>
                    <pos>180</pos>
                    <max_use>1</max_use>
                    <element xid="REF01">
                      <data_ele>128</data_ele>
                      <name>Reference Identification Qualifier</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>9C</code>
                      </valid_codes>
                    </element>
                    <element xid="REF02">
                      <data_ele>127</data_ele>
                      <name>Adjusted Repriced Claim Reference Number</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="REF03">
                      <data_ele>352</data_ele>
                      <name>Description</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>80</max_len>
                    </element>
                    <composite>
                      <data_ele>C040</data_ele>
                      <name>Reference Identifier</name>
                      <usage>N</usage>
                      <seq>04</seq>
                    </composite>
                  </segment>
<!--End of REF segment-->
                  <segment xid="REF">
                    <name>Repriced Claim Number</name>
                    <usage>S</usage>
                    <pos>180</pos>
                    <max_use>1</max_use>
                    <element xid="REF01">
                      <data_ele>128</data_ele>
                      <name>Reference Identification Qualifier</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>9A</code>
                      </valid_codes>
                    </element>
                    <element xid="REF02">
                      <data_ele>127</data_ele>
                      <name>Repriced Claim Reference Number</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="REF03">
                      <data_ele>352</data_ele>
                      <name>Description</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>80</max_len>
                    </element>
                    <composite>
                      <data_ele>C040</data_ele>
                      <name>Reference Identifier</name>
                      <usage>N</usage>
                      <seq>04</seq>
                    </composite>
                  </segment>
<!--End of REF segment-->
                  <segment xid="REF">
                    <name>Claim Identification Number For Clearinghouses and Other Transmission Intermediaries</name>
                    <usage>S</usage>
                    <pos>180</pos>
                    <max_use>1</max_use>
                    <element xid="REF01">
                      <data_ele>128</data_ele>
                      <name>Reference Identification Qualifier</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>D9</code>
                      </valid_codes>
                    </element>
                    <element xid="REF02">
                      <data_ele>127</data_ele>
                      <name>Value Added Network Trace Number</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="REF03">
                      <data_ele>352</data_ele>
                      <name>Description</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>80</max_len>
                    </element>
                    <composite>
                      <data_ele>C040</data_ele>
                      <name>Reference Identifier</name>
                      <usage>N</usage>
                      <seq>04</seq>
                    </composite>
                  </segment>
<!--End of REF segment-->
                  <segment xid="REF">
                    <name>Document Identification Code</name>
                    <usage>S</usage>
                    <pos>180</pos>
                    <max_use>2</max_use>
                    <element xid="REF01">
                      <data_ele>128</data_ele>
                      <name>Reference Identification Qualifier</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>DD</code>
                      </valid_codes>
                    </element>
                    <element xid="REF02">
                      <data_ele>127</data_ele>
                      <name>Document Control Identifier</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="REF03">
                      <data_ele>352</data_ele>
                      <name>Description</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>80</max_len>
                    </element>
                    <composite>
                      <data_ele>C040</data_ele>
                      <name>Reference Identifier</name>
                      <usage>N</usage>
                      <seq>04</seq>
                    </composite>
                  </segment>
<!--End of REF segment-->
                  <segment xid="REF">
                    <name>Original Reference Number (ICN/DCN)</name>
                    <usage>S</usage>
                    <pos>180</pos>
                    <max_use>1</max_use>
                    <element xid="REF01">
                      <data_ele>128</data_ele>
                      <name>Reference Identification Qualifier</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>F8</code>
                      </valid_codes>
                    </element>
                    <element xid="REF02">
                      <data_ele>127</data_ele>
                      <name>Claim Original Reference Number</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="REF03">
                      <data_ele>352</data_ele>
                      <name>Description</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>80</max_len>
                    </element>
                    <composite>
                      <data_ele>C040</data_ele>
                      <name>Reference Identifier</name>
                      <usage>N</usage>
                      <seq>04</seq>
                    </composite>
                  </segment>
<!--End of REF segment-->
                  <segment xid="REF">
                    <name>Investigational Device Exemption Number</name>
                    <usage>S</usage>
                    <pos>180</pos>
                    <max_use>1</max_use>
                    <element xid="REF01">
                      <data_ele>128</data_ele>
                      <name>Reference Identification Qualifier</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>LX</code>
                      </valid_codes>
                    </element>
                    <element xid="REF02">
                      <data_ele>127</data_ele>
                      <name>Investigational Device Exemption Identifier</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="REF03">
                      <data_ele>352</data_ele>
                      <name>Description</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>80</max_len>
                    </element>
                    <composite>
                      <data_ele>C040</data_ele>
                      <name>Reference Identifier</name>
                      <usage>N</usage>
                      <seq>04</seq>
                    </composite>
                  </segment>
<!--End of REF segment-->
                  <segment xid="REF">
                    <name>Service Authorization Exception Code</name>
                    <usage>S</usage>
                    <pos>180</pos>
                    <max_use>1</max_use>
                    <element xid="REF01">
                      <data_ele>128</data_ele>
                      <name>Reference Identification Qualifier</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>4N</code>
                      </valid_codes>
                    </element>
                    <element xid="REF02">
                      <data_ele>127</data_ele>
                      <name>Service Authorization Exception Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                      <valid_codes>
                        <code>1</code>
                        <code>2</code>
                        <code>3</code>
                        <code>4</code>
                        <code>5</code>
                        <code>6</code>
                        <code>7</code>
                      </valid_codes>
                    </element>
                    <element xid="REF03">
                      <data_ele>352</data_ele>
                      <name>Description</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>80</max_len>
                    </element>
                    <composite>
                      <data_ele>C040</data_ele>
                      <name>Reference Identifier</name>
                      <usage>N</usage>
                      <seq>04</seq>
                    </composite>
                  </segment>
<!--End of REF segment-->
                  <segment xid="REF">
                    <name>Peer Review Organization (PRO) Approval Number</name>
                    <usage>S</usage>
                    <pos>180</pos>
                    <max_use>1</max_use>
                    <element xid="REF01">
                      <data_ele>128</data_ele>
                      <name>Reference Identification Qualifier</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>G4</code>
                      </valid_codes>
                    </element>
                    <element xid="REF02">
                      <data_ele>127</data_ele>
                      <name>Peer Review Authorization Number</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="REF03">
                      <data_ele>352</data_ele>
                      <name>Description</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>80</max_len>
                    </element>
                    <composite>
                      <data_ele>C040</data_ele>
                      <name>Reference Identifier</name>
                      <usage>N</usage>
                      <seq>04</seq>
                    </composite>
                  </segment>
<!--End of REF segment-->
                  <segment xid="REF">
                    <name>Prior Authorization or Referral Number</name>
                    <usage>S</usage>
                    <pos>180</pos>
                    <max_use>2</max_use>
                    <element xid="REF01">
                      <data_ele>128</data_ele>
                      <name>Reference Identification Qualifier</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>9F</code>
                        <code>G1</code>
                      </valid_codes>
                    </element>
                    <element xid="REF02">
                      <data_ele>127</data_ele>
                      <name>Prior Authorization Number</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="REF03">
                      <data_ele>352</data_ele>
                      <name>Description</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>80</max_len>
                    </element>
                    <composite>
                      <data_ele>C040</data_ele>
                      <name>Reference Identifier</name>
                      <usage>N</usage>
                      <seq>04</seq>
                    </composite>
                  </segment>
<!--End of REF segment-->
                  <segment xid="REF">
                    <name>Medical Record Number</name>
                    <usage>S</usage>
                    <pos>180</pos>
                    <max_use>1</max_use>
                    <element xid="REF01">
                      <data_ele>128</data_ele>
                      <name>Reference Identification Qualifier</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>EA</code>
                      </valid_codes>
                    </element>
                    <element xid="REF02">
                      <data_ele>127</data_ele>
                      <name>Medical Record Number</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="REF03">
                      <data_ele>352</data_ele>
                      <name>Description</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>80</max_len>
                    </element>
                    <composite>
                      <data_ele>C040</data_ele>
                      <name>Reference Identifier</name>
                      <usage>N</usage>
                      <seq>04</seq>
                    </composite>
                  </segment>
<!--End of REF segment-->
                  <segment xid="REF">
                    <name>Demonstration Project Identifier</name>
                    <usage>S</usage>
                    <pos>180</pos>
                    <max_use>1</max_use>
                    <element xid="REF01">
                      <data_ele>128</data_ele>
                      <name>Reference Identification Qualifier</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>P4</code>
                      </valid_codes>
                    </element>
                    <element xid="REF02">
                      <data_ele>127</data_ele>
                      <name>Demonstration Project Identifier</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="REF03">
                      <data_ele>352</data_ele>
                      <name>Description</name>
                      <usage>N</usage>
                      <seq>03</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>80</max_len>
                    </element>
                    <composite>
                      <data_ele>C040</data_ele>
                      <name>Reference Identifier</name>
                      <usage>N</usage>
                      <seq>04</seq>
                    </composite>
                  </segment>
<!--End of REF segment-->
                  <segment xid="K3">
                    <name>File Information</name>
                    <usage>S</usage>
                    <pos>185</pos>
                    <max_use>10</max_use>
                    <element xid="K301">
                      <data_ele>449</data_ele>
                      <name>Fixed Format Information</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>80</max_len>
                    </element>
                    <element xid="K302">
                      <data_ele>1333</data_ele>
                      <name>Record Format Code</name>
                      <usage>N</usage>
                      <seq>02</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                    </element>
                    <composite>
                      <data_ele>C001</data_ele>
                      <name>Composite Unit of Measure</name>
                      <usage>N</usage>
                      <seq>03</seq>
                    </composite>
                  </segment>
<!--End of K3 segment-->
                  <segment xid="NTE">
                    <name>Claim Note</name>
                    <usage>S</usage>
                    <pos>190</pos>
                    <max_use>10</max_use>
                    <element xid="NTE01">
                      <data_ele>363</data_ele>
                      <name>Note Reference Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>3</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>ALG</code>
                        <code>DCP</code>
                        <code>DGN</code>
                        <code>DME</code>
                        <code>MED</code>
                        <code>NTR</code>
                        <code>ODT</code>
                        <code>RHB</code>
                        <code>RLH</code>
                        <code>RNH</code>
                        <code>SET</code>
                        <code>SFM</code>
                        <code>SPT</code>
                        <code>UPI</code>
                      </valid_codes>
                    </element>
                    <element xid="NTE02">
                      <data_ele>352</data_ele>
                      <name>Claim Note Text</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>80</max_len>
                    </element>
                  </segment>
<!--End of NTE segment-->
                  <segment xid="NTE">
                    <name>Billing Note</name>
                    <usage>S</usage>
                    <pos>190</pos>
                    <max_use>1</max_use>
                    <element xid="NTE01">
                      <data_ele>363</data_ele>
                      <name>Note Reference Code</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>3</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>ADD</code>
                      </valid_codes>
                    </element>
                    <element xid="NTE02">
                      <data_ele>352</data_ele>
                      <name>Billing Note Text</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>80</max_len>
                    </element>
                  </segment>
<!--End of NTE segment-->
                  <segment xid="CR6">
                    <name>Home Health Care Information</name>
                    <usage>S</usage>
                    <pos>216</pos>
                    <max_use>1</max_use>
                    <element xid="CR601">
                      <data_ele>923</data_ele>
                      <name>Prognosis Indicator</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                      <valid_codes>
                        <code>1</code>
                        <code>2</code>
                        <code>3</code>
                        <code>4</code>
                        <code>5</code>
                        <code>6</code>
                        <code>7</code>
                        <code>8</code>
                      </valid_codes>
                    </element>
                    <element xid="CR602">
                      <data_ele>373</data_ele>
                      <name>Service From Date</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>DT</data_type>
                      <min_len>8</min_len>
                      <max_len>8</max_len>
                      <valid_codes>
                        <code/>
                      </valid_codes>
                    </element>
                    <element xid="CR603">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>S</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>RD8</code>
                      </valid_codes>
                    </element>
                    <element xid="CR604">
                      <data_ele>1251</data_ele>
                      <name>Home Health Certification Period</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="CR605">
                      <data_ele>373</data_ele>
                      <name>Diagnosis Date</name>
                      <usage>R</usage>
                      <seq>05</seq>
                      <data_type>DT</data_type>
                      <min_len>8</min_len>
                      <max_len>8</max_len>
                      <valid_codes>
                        <code/>
                      </valid_codes>
                    </element>
                    <element xid="CR606">
                      <data_ele>1073</data_ele>
                      <name>Skilled Nursing Facility Indicator</name>
                      <usage>R</usage>
                      <seq>06</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                      <valid_codes>
                        <code>N</code>
                        <code>U</code>
                        <code>Y</code>
                      </valid_codes>
                    </element>
                    <element xid="CR607">
                      <data_ele>1073</data_ele>
                      <name>Medicare Coverage Indicator</name>
                      <usage>R</usage>
                      <seq>07</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                      <valid_codes>
                        <code>N</code>
                        <code>Y</code>
                      </valid_codes>
                    </element>
                    <element xid="CR608">
                      <data_ele>1322</data_ele>
                      <name>Certification Type Indicator</name>
                      <usage>R</usage>
                      <seq>08</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                      <valid_codes>
                        <code>I</code>
                        <code>R</code>
                        <code>S</code>
                      </valid_codes>
                    </element>
                    <element xid="CR609">
                      <data_ele>373</data_ele>
                      <name>Surgery Date</name>
                      <usage>S</usage>
                      <seq>09</seq>
                      <data_type>DT</data_type>
                      <min_len>8</min_len>
                      <max_len>8</max_len>
                      <valid_codes>
                        <code/>
                      </valid_codes>
                    </element>
                    <element xid="CR610">
                      <data_ele>235</data_ele>
                      <name>Product or Service ID Qualifier</name>
                      <usage>S</usage>
                      <seq>10</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>HC</code>
                        <code>ID</code>
                      </valid_codes>
                    </element>
                    <element xid="CR611">
                      <data_ele>1137</data_ele>
                      <name>Surgical Procedure Code</name>
                      <usage>S</usage>
                      <seq>11</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="CR612">
                      <data_ele>373</data_ele>
                      <name>Physician Order Date</name>
                      <usage>S</usage>
                      <seq>12</seq>
                      <data_type>DT</data_type>
                      <min_len>8</min_len>
                      <max_len>8</max_len>
                      <valid_codes>
                        <code/>
                      </valid_codes>
                    </element>
                    <element xid="CR613">
                      <data_ele>373</data_ele>
                      <name>Last Visit Date</name>
                      <usage>S</usage>
                      <seq>13</seq>
                      <data_type>DT</data_type>
                      <min_len>8</min_len>
                      <max_len>8</max_len>
                      <valid_codes>
                        <code/>
                      </valid_codes>
                    </element>
                    <element xid="CR614">
                      <data_ele>373</data_ele>
                      <name>Physician Contact Date</name>
                      <usage>S</usage>
                      <seq>14</seq>
                      <data_type>DT</data_type>
                      <min_len>8</min_len>
                      <max_len>8</max_len>
                      <valid_codes>
                        <code/>
                      </valid_codes>
                    </element>
                    <element xid="CR615">
                      <data_ele>1250</data_ele>
                      <name>Date Time Period Format Qualifier</name>
                      <usage>S</usage>
                      <seq>15</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>3</max_len>
                      <valid_codes>
                        <code>RD8</code>
                      </valid_codes>
                    </element>
                    <element xid="CR616">
                      <data_ele>1251</data_ele>
                      <name>Last Admission Period</name>
                      <usage>S</usage>
                      <seq>16</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>35</max_len>
                    </element>
                    <element xid="CR617">
                      <data_ele>1384</data_ele>
                      <name>Patient Discharge Facility Type Code</name>
                      <usage>R</usage>
                      <seq>17</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                      <valid_codes>
                        <code>A</code>
                        <code>B</code>
                        <code>C</code>
                        <code>D</code>
                        <code>E</code>
                        <code>F</code>
                        <code>G</code>
                        <code>H</code>
                        <code>L</code>
                        <code>M</code>
                        <code>O</code>
                        <code>R</code>
                        <code>S</code>
                        <code>T</code>
                      </valid_codes>
                    </element>
                    <element xid="CR618">
                      <data_ele>373</data_ele>
                      <name>Diagnosis Date</name>
                      <usage>S</usage>
                      <seq>18</seq>
                      <data_type>DT</data_type>
                      <min_len>8</min_len>
                      <max_len>8</max_len>
                      <valid_codes>
                        <code/>
                      </valid_codes>
                    </element>
                    <element xid="CR619">
                      <data_ele>373</data_ele>
                      <name>Diagnosis Date</name>
                      <usage>S</usage>
                      <seq>19</seq>
                      <data_type>DT</data_type>
                      <min_len>8</min_len>
                      <max_len>8</max_len>
                      <valid_codes>
                        <code/>
                      </valid_codes>
                    </element>
                    <element xid="CR620">
                      <data_ele>373</data_ele>
                      <name>Diagnosis Date</name>
                      <usage>S</usage>
                      <seq>20</seq>
                      <data_type>DT</data_type>
                      <min_len>8</min_len>
                      <max_len>8</max_len>
                      <valid_codes>
                        <code/>
                      </valid_codes>
                    </element>
                    <element xid="CR621">
                      <data_ele>373</data_ele>
                      <name>Diagnosis Date</name>
                      <usage>S</usage>
                      <seq>21</seq>
                      <data_type>DT</data_type>
                      <min_len>8</min_len>
                      <max_len>8</max_len>
                      <valid_codes>
                        <code/>
                      </valid_codes>
                    </element>
                  </segment>
<!--End of CR6 segment-->
                  <segment xid="CRC">
                    <name>Home Health Functional Limitations</name>
                    <usage>S</usage>
                    <pos>220</pos>
                    <max_use>3</max_use>
                    <element xid="CRC01">
                      <data_ele>1136</data_ele>
                      <name>Code Category</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>75</code>
                      </valid_codes>
                    </element>
                    <element xid="CRC02">
                      <data_ele>1073</data_ele>
                      <name>Certification Condition Indicator</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                      <valid_codes>
                        <code>N</code>
                        <code>Y</code>
                      </valid_codes>
                    </element>
                    <element xid="CRC03">
                      <data_ele>1321</data_ele>
                      <name>Functional Limitation Code</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>AA</code>
                        <code>AL</code>
                        <code>BL</code>
                        <code>CO</code>
                        <code>DY</code>
                        <code>EL</code>
                        <code>HL</code>
                        <code>LB</code>
                        <code>OL</code>
                        <code>PA</code>
                        <code>SL</code>
                      </valid_codes>
                    </element>
                    <element xid="CRC04">
                      <data_ele>1321</data_ele>
                      <name>Functional Limitation Code</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>AA</code>
                        <code>AL</code>
                        <code>BL</code>
                        <code>CO</code>
                        <code>DY</code>
                        <code>EL</code>
                        <code>HL</code>
                        <code>LB</code>
                        <code>OL</code>
                        <code>PA</code>
                        <code>SL</code>
                      </valid_codes>
                    </element>
                    <element xid="CRC05">
                      <data_ele>1321</data_ele>
                      <name>Functional Limitation Code</name>
                      <usage>S</usage>
                      <seq>05</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>AA</code>
                        <code>AL</code>
                        <code>BL</code>
                        <code>CO</code>
                        <code>DY</code>
                        <code>EL</code>
                        <code>HL</code>
                        <code>LB</code>
                        <code>OL</code>
                        <code>PA</code>
                        <code>SL</code>
                      </valid_codes>
                    </element>
                    <element xid="CRC06">
                      <data_ele>1321</data_ele>
                      <name>Functional Limitation Code</name>
                      <usage>S</usage>
                      <seq>06</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>AA</code>
                        <code>AL</code>
                        <code>BL</code>
                        <code>CO</code>
                        <code>DY</code>
                        <code>EL</code>
                        <code>HL</code>
                        <code>LB</code>
                        <code>OL</code>
                        <code>PA</code>
                        <code>SL</code>
                      </valid_codes>
                    </element>
                    <element xid="CRC07">
                      <data_ele>1321</data_ele>
                      <name>Functional Limitation Code</name>
                      <usage>S</usage>
                      <seq>07</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>AA</code>
                        <code>AL</code>
                        <code>BL</code>
                        <code>CO</code>
                        <code>DY</code>
                        <code>EL</code>
                        <code>HL</code>
                        <code>LB</code>
                        <code>OL</code>
                        <code>PA</code>
                        <code>SL</code>
                      </valid_codes>
                    </element>
                  </segment>
<!--End of CRC segment-->
                  <segment xid="CRC">
                    <name>Home Health Activities Permitted</name>
                    <usage>S</usage>
                    <pos>220</pos>
                    <max_use>3</max_use>
                    <element xid="CRC01">
                      <data_ele>1136</data_ele>
                      <name>Certification Condition Indicator</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>76</code>
                      </valid_codes>
                    </element>
                    <element xid="CRC02">
                      <data_ele>1073</data_ele>
                      <name> Functional Limitation Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                      <valid_codes>
                        <code>N</code>
                        <code>Y</code>
                      </valid_codes>
                    </element>
                    <element xid="CRC03">
                      <data_ele>1321</data_ele>
                      <name>Activities Permitted Code</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>BR</code>
                        <code>CA</code>
                        <code>CB</code>
                        <code>CR</code>
                        <code>EP</code>
                        <code>IH</code>
                        <code>NR</code>
                        <code>PW</code>
                        <code>TR</code>
                        <code>UT</code>
                        <code>WA</code>
                        <code>WR</code>
                      </valid_codes>
                    </element>
                    <element xid="CRC04">
                      <data_ele>1321</data_ele>
                      <name>Activities Permitted Code</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>BR</code>
                        <code>CA</code>
                        <code>CB</code>
                        <code>CR</code>
                        <code>EP</code>
                        <code>IH</code>
                        <code>NR</code>
                        <code>PW</code>
                        <code>TR</code>
                        <code>UT</code>
                        <code>WA</code>
                        <code>WR</code>
                      </valid_codes>
                    </element>
                    <element xid="CRC05">
                      <data_ele>1321</data_ele>
                      <name>Activities Permitted Code</name>
                      <usage>S</usage>
                      <seq>05</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>BR</code>
                        <code>CA</code>
                        <code>CB</code>
                        <code>CR</code>
                        <code>EP</code>
                        <code>IH</code>
                        <code>NR</code>
                        <code>PW</code>
                        <code>TR</code>
                        <code>UT</code>
                        <code>WA</code>
                        <code>WR</code>
                      </valid_codes>
                    </element>
                    <element xid="CRC06">
                      <data_ele>1321</data_ele>
                      <name>Activities Permitted Code</name>
                      <usage>S</usage>
                      <seq>06</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>BR</code>
                        <code>CA</code>
                        <code>CB</code>
                        <code>CR</code>
                        <code>EP</code>
                        <code>IH</code>
                        <code>NR</code>
                        <code>PW</code>
                        <code>TR</code>
                        <code>UT</code>
                        <code>WA</code>
                        <code>WR</code>
                      </valid_codes>
                    </element>
                    <element xid="CRC07">
                      <data_ele>1321</data_ele>
                      <name>Activities Permitted Code</name>
                      <usage>S</usage>
                      <seq>07</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>BR</code>
                        <code>CA</code>
                        <code>CB</code>
                        <code>CR</code>
                        <code>EP</code>
                        <code>IH</code>
                        <code>NR</code>
                        <code>PW</code>
                        <code>TR</code>
                        <code>UT</code>
                        <code>WA</code>
                        <code>WR</code>
                      </valid_codes>
                    </element>
                  </segment>
<!--End of CRC segment-->
                  <segment xid="CRC">
                    <name>Home Health Mental Status</name>
                    <usage>S</usage>
                    <pos>220</pos>
                    <max_use>2</max_use>
                    <element xid="CRC01">
                      <data_ele>1136</data_ele>
                      <name>Certification Condition Indicator</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>77</code>
                      </valid_codes>
                    </element>
                    <element xid="CRC02">
                      <data_ele>1073</data_ele>
                      <name>Functional Limitation Code</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>1</max_len>
                      <valid_codes>
                        <code>N</code>
                        <code>Y</code>
                      </valid_codes>
                    </element>
                    <element xid="CRC03">
                      <data_ele>1321</data_ele>
                      <name>Mental Status Code</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>AG</code>
                        <code>CM</code>
                        <code>DI</code>
                        <code>DP</code>
                        <code>FO</code>
                        <code>LE</code>
                        <code>MC</code>
                        <code>OT</code>
                      </valid_codes>
                    </element>
                    <element xid="CRC04">
                      <data_ele>1321</data_ele>
                      <name>Mental Status Code</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>AG</code>
                        <code>CM</code>
                        <code>DI</code>
                        <code>DP</code>
                        <code>FO</code>
                        <code>LE</code>
                        <code>MC</code>
                        <code>OT</code>
                      </valid_codes>
                    </element>
                    <element xid="CRC05">
                      <data_ele>1321</data_ele>
                      <name>Mental Status Code</name>
                      <usage>S</usage>
                      <seq>05</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>AG</code>
                        <code>CM</code>
                        <code>DI</code>
                        <code>DP</code>
                        <code>FO</code>
                        <code>LE</code>
                        <code>MC</code>
                        <code>OT</code>
                      </valid_codes>
                    </element>
                    <element xid="CRC06">
                      <data_ele>1321</data_ele>
                      <name>Mental Status Code</name>
                      <usage>S</usage>
                      <seq>06</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>AG</code>
                        <code>CM</code>
                        <code>DI</code>
                        <code>DP</code>
                        <code>FO</code>
                        <code>LE</code>
                        <code>MC</code>
                        <code>OT</code>
                      </valid_codes>
                    </element>
                    <element xid="CRC07">
                      <data_ele>1321</data_ele>
                      <name>Mental Status Code</name>
                      <usage>S</usage>
                      <seq>07</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>AG</code>
                        <code>CM</code>
                        <code>DI</code>
                        <code>DP</code>
                        <code>FO</code>
                        <code>LE</code>
                        <code>MC</code>
                        <code>OT</code>
                      </valid_codes>
                    </element>
                  </segment>
<!--End of CRC segment-->
                  <segment xid="HI">
                    <name>Principal, Admitting, E-Code and Patient Reason for Visit Diagnosis Information</name>
                    <usage>S</usage>
                    <pos>231</pos>
                    <max_use>1</max_use>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <element xid="HI01-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BK</code>
                        </valid_codes>
                      </element>
                      <element xid="HI01-02">
                        <data_ele>1271</data_ele>
                        <name>Industry Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI01-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI01-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI01-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI01-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI01-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>02</seq>
                      <element xid="HI02-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BJ</code>
                          <code>ZZ</code>
                        </valid_codes>
                      </element>
                      <element xid="HI02-02">
                        <data_ele>1271</data_ele>
                        <name>Industry Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI02-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI02-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI02-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI02-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI02-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>03</seq>
                      <element xid="HI03-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BN</code>
                        </valid_codes>
                      </element>
                      <element xid="HI03-02">
                        <data_ele>1271</data_ele>
                        <name>Industry Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI03-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI03-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI03-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI03-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI03-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>N</usage>
                      <seq>04</seq>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>N</usage>
                      <seq>05</seq>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>N</usage>
                      <seq>06</seq>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>N</usage>
                      <seq>07</seq>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>N</usage>
                      <seq>08</seq>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>N</usage>
                      <seq>09</seq>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>N</usage>
                      <seq>10</seq>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>N</usage>
                      <seq>11</seq>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>N</usage>
                      <seq>12</seq>
                    </composite>
                  </segment>
<!--End of HI segment-->
                  <segment xid="HI">
                    <name>Diagnosis Related Group (DRG) Information</name>
                    <usage>S</usage>
                    <pos>231</pos>
                    <max_use>1</max_use>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <element xid="HI01-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>DR</code>
                        </valid_codes>
                      </element>
                      <element xid="HI01-02">
                        <data_ele>1271</data_ele>
                        <name>Diagnosis Related Group (DRG) Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI01-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI01-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI01-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI01-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI01-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>N</usage>
                      <seq>02</seq>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>N</usage>
                      <seq>03</seq>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>N</usage>
                      <seq>04</seq>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>N</usage>
                      <seq>05</seq>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>N</usage>
                      <seq>06</seq>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>N</usage>
                      <seq>07</seq>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>N</usage>
                      <seq>08</seq>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>N</usage>
                      <seq>09</seq>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>N</usage>
                      <seq>10</seq>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>N</usage>
                      <seq>11</seq>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>N</usage>
                      <seq>12</seq>
                    </composite>
                  </segment>
<!--End of HI segment-->
                  <segment xid="HI">
                    <name>Other Diagnosis Information</name>
                    <usage>S</usage>
                    <pos>231</pos>
                    <max_use>2</max_use>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <element xid="HI01-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BF</code>
                        </valid_codes>
                      </element>
                      <element xid="HI01-02">
                        <data_ele>1271</data_ele>
                        <name>Other Diagnosis</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI01-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI01-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI01-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI01-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI01-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>02</seq>
                      <element xid="HI02-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BF</code>
                        </valid_codes>
                      </element>
                      <element xid="HI02-02">
                        <data_ele>1271</data_ele>
                        <name>Other Diagnosis</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI02-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI02-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI02-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI02-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI02-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>03</seq>
                      <element xid="HI03-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BF</code>
                        </valid_codes>
                      </element>
                      <element xid="HI03-02">
                        <data_ele>1271</data_ele>
                        <name>Other Diagnosis</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI03-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI03-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI03-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI03-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI03-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <element xid="HI04-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BF</code>
                        </valid_codes>
                      </element>
                      <element xid="HI04-02">
                        <data_ele>1271</data_ele>
                        <name>Other Diagnosis</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI04-03">
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                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI04-04">
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                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI04-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI04-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI04-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>05</seq>
                      <element xid="HI05-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BF</code>
                        </valid_codes>
                      </element>
                      <element xid="HI05-02">
                        <data_ele>1271</data_ele>
                        <name>Other Diagnosis</name>
                        <usage>R</usage>
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                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI05-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI05-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI05-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI05-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI05-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>06</seq>
                      <element xid="HI06-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BF</code>
                        </valid_codes>
                      </element>
                      <element xid="HI06-02">
                        <data_ele>1271</data_ele>
                        <name>Other Diagnosis</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI06-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI06-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI06-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI06-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI06-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>07</seq>
                      <element xid="HI07-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BF</code>
                        </valid_codes>
                      </element>
                      <element xid="HI07-02">
                        <data_ele>1271</data_ele>
                        <name>Other Diagnosis</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI07-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI07-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI07-05">
                        <data_ele>782</data_ele>
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                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI07-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI07-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>08</seq>
                      <element xid="HI08-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BF</code>
                        </valid_codes>
                      </element>
                      <element xid="HI08-02">
                        <data_ele>1271</data_ele>
                        <name>Other Diagnosis</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI08-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI08-04">
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                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI08-05">
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                        <usage>N</usage>
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                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI08-06">
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                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI08-07">
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                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
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                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>09</seq>
                      <element xid="HI09-01">
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                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
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                        <max_len>3</max_len>
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                        </valid_codes>
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                        <name>Other Diagnosis</name>
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                        <data_type>AN</data_type>
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                        <max_len>30</max_len>
                      </element>
                      <element xid="HI09-03">
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                        <data_type>ID</data_type>
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                        <max_len>3</max_len>
                      </element>
                      <element xid="HI09-04">
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                        <usage>N</usage>
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                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI09-05">
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                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI09-06">
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                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI09-07">
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                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
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                    <composite>
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                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>10</seq>
                      <element xid="HI10-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
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                        </valid_codes>
                      </element>
                      <element xid="HI10-02">
                        <data_ele>1271</data_ele>
                        <name>Other Diagnosis</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI10-03">
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                        <usage>N</usage>
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                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI10-04">
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                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI10-05">
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                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI10-06">
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                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI10-07">
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                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>11</seq>
                      <element xid="HI11-01">
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                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
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                        <name>Other Diagnosis</name>
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                        <data_type>AN</data_type>
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                        <max_len>30</max_len>
                      </element>
                      <element xid="HI11-03">
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                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI11-04">
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                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI11-05">
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                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI11-06">
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                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI11-07">
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                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>12</seq>
                      <element xid="HI12-01">
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                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
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                        </valid_codes>
                      </element>
                      <element xid="HI12-02">
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                        <name>Other Diagnosis</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI12-03">
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                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI12-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI12-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI12-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI12-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                  </segment>
<!--End of HI segment-->
                  <segment xid="HI">
                    <name>Principal Procedure Information</name>
                    <usage>S</usage>
                    <pos>231</pos>
                    <max_use>1</max_use>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <element xid="HI01-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BP</code>
                          <code>BR</code>
                        </valid_codes>
                      </element>
                      <element xid="HI01-02">
                        <data_ele>1271</data_ele>
                        <name>Principal Procedure Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI01-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>S</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>D8</code>
                        </valid_codes>
                      </element>
                      <element xid="HI01-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>S</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI01-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI01-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI01-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>N</usage>
                      <seq>02</seq>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>N</usage>
                      <seq>03</seq>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>N</usage>
                      <seq>04</seq>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>N</usage>
                      <seq>05</seq>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>N</usage>
                      <seq>06</seq>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>N</usage>
                      <seq>07</seq>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>N</usage>
                      <seq>08</seq>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>N</usage>
                      <seq>09</seq>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>N</usage>
                      <seq>10</seq>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>N</usage>
                      <seq>11</seq>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>N</usage>
                      <seq>12</seq>
                    </composite>
                  </segment>
<!--End of HI segment-->
                  <segment xid="HI">
                    <name>Other Procedure Information</name>
                    <usage>S</usage>
                    <pos>231</pos>
                    <max_use>2</max_use>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <element xid="HI01-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BO</code>
                          <code>BQ</code>
                        </valid_codes>
                      </element>
                      <element xid="HI01-02">
                        <data_ele>1271</data_ele>
                        <name>Procedure Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI01-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>S</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>D8</code>
                        </valid_codes>
                      </element>
                      <element xid="HI01-04">
                        <data_ele>1251</data_ele>
                        <name>Procedure Date</name>
                        <usage>S</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI01-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI01-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI01-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>02</seq>
                      <element xid="HI02-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BO</code>
                          <code>BQ</code>
                        </valid_codes>
                      </element>
                      <element xid="HI02-02">
                        <data_ele>1271</data_ele>
                        <name>Procedure Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI02-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>S</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>D8</code>
                        </valid_codes>
                      </element>
                      <element xid="HI02-04">
                        <data_ele>1251</data_ele>
                        <name>Procedure Date</name>
                        <usage>S</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI02-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI02-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI02-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>03</seq>
                      <element xid="HI03-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BO</code>
                          <code>BQ</code>
                        </valid_codes>
                      </element>
                      <element xid="HI03-02">
                        <data_ele>1271</data_ele>
                        <name>Procedure Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI03-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>S</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>D8</code>
                        </valid_codes>
                      </element>
                      <element xid="HI03-04">
                        <data_ele>1251</data_ele>
                        <name>Procedure Date</name>
                        <usage>S</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI03-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI03-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI03-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <element xid="HI04-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BO</code>
                          <code>BQ</code>
                        </valid_codes>
                      </element>
                      <element xid="HI04-02">
                        <data_ele>1271</data_ele>
                        <name>Procedure Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI04-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>S</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>D8</code>
                        </valid_codes>
                      </element>
                      <element xid="HI04-04">
                        <data_ele>1251</data_ele>
                        <name>Procedure Date</name>
                        <usage>S</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI04-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI04-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI04-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>05</seq>
                      <element xid="HI05-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BO</code>
                          <code>BQ</code>
                        </valid_codes>
                      </element>
                      <element xid="HI05-02">
                        <data_ele>1271</data_ele>
                        <name>Procedure Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI05-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>S</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>D8</code>
                        </valid_codes>
                      </element>
                      <element xid="HI05-04">
                        <data_ele>1251</data_ele>
                        <name>Procedure Date</name>
                        <usage>S</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI05-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI05-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI05-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>06</seq>
                      <element xid="HI06-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BO</code>
                          <code>BQ</code>
                        </valid_codes>
                      </element>
                      <element xid="HI06-02">
                        <data_ele>1271</data_ele>
                        <name>Procedure Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI06-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>S</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>D8</code>
                        </valid_codes>
                      </element>
                      <element xid="HI06-04">
                        <data_ele>1251</data_ele>
                        <name>Procedure Date</name>
                        <usage>S</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI06-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI06-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI06-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>07</seq>
                      <element xid="HI07-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BO</code>
                          <code>BQ</code>
                        </valid_codes>
                      </element>
                      <element xid="HI07-02">
                        <data_ele>1271</data_ele>
                        <name>Procedure Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI07-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>S</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>D8</code>
                        </valid_codes>
                      </element>
                      <element xid="HI07-04">
                        <data_ele>1251</data_ele>
                        <name>Procedure Date</name>
                        <usage>S</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI07-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI07-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI07-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>08</seq>
                      <element xid="HI08-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BO</code>
                          <code>BQ</code>
                        </valid_codes>
                      </element>
                      <element xid="HI08-02">
                        <data_ele>1271</data_ele>
                        <name>Procedure Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI08-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>S</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>D8</code>
                        </valid_codes>
                      </element>
                      <element xid="HI08-04">
                        <data_ele>1251</data_ele>
                        <name>Procedure Date</name>
                        <usage>S</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI08-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI08-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI08-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>09</seq>
                      <element xid="HI09-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BO</code>
                          <code>BQ</code>
                        </valid_codes>
                      </element>
                      <element xid="HI09-02">
                        <data_ele>1271</data_ele>
                        <name>Procedure Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI09-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>S</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>D8</code>
                        </valid_codes>
                      </element>
                      <element xid="HI09-04">
                        <data_ele>1251</data_ele>
                        <name>Procedure Date</name>
                        <usage>S</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI09-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI09-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI09-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>10</seq>
                      <element xid="HI10-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BO</code>
                          <code>BQ</code>
                        </valid_codes>
                      </element>
                      <element xid="HI10-02">
                        <data_ele>1271</data_ele>
                        <name>Procedure Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI10-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>S</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>D8</code>
                        </valid_codes>
                      </element>
                      <element xid="HI10-04">
                        <data_ele>1251</data_ele>
                        <name>Procedure Date</name>
                        <usage>S</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI10-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI10-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI10-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>11</seq>
                      <element xid="HI11-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BO</code>
                          <code>BQ</code>
                        </valid_codes>
                      </element>
                      <element xid="HI11-02">
                        <data_ele>1271</data_ele>
                        <name>Procedure Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI11-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>S</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>D8</code>
                        </valid_codes>
                      </element>
                      <element xid="HI11-04">
                        <data_ele>1251</data_ele>
                        <name>Procedure Date</name>
                        <usage>S</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI11-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI11-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI11-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>12</seq>
                      <element xid="HI12-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BO</code>
                          <code>BQ</code>
                        </valid_codes>
                      </element>
                      <element xid="HI12-02">
                        <data_ele>1271</data_ele>
                        <name>Procedure Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI12-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>S</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>D8</code>
                        </valid_codes>
                      </element>
                      <element xid="HI12-04">
                        <data_ele>1251</data_ele>
                        <name>Procedure Date</name>
                        <usage>S</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI12-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI12-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI12-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                  </segment>
<!--End of HI segment-->
                  <segment xid="HI">
                    <name>Occurrence Span Information</name>
                    <usage>S</usage>
                    <pos>231</pos>
                    <max_use>2</max_use>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <element xid="HI01-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BI</code>
                        </valid_codes>
                      </element>
                      <element xid="HI01-02">
                        <data_ele>1271</data_ele>
                        <name>Occurrence Span Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI01-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>RD8</code>
                        </valid_codes>
                      </element>
                      <element xid="HI01-04">
                        <data_ele>1251</data_ele>
                        <name>Occurrence or Occurrence Span Code Associated Date</name>
                        <usage>R</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI01-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI01-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI01-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>02</seq>
                      <element xid="HI02-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BI</code>
                        </valid_codes>
                      </element>
                      <element xid="HI02-02">
                        <data_ele>1271</data_ele>
                        <name>Occurrence Span Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI02-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>RD8</code>
                        </valid_codes>
                      </element>
                      <element xid="HI02-04">
                        <data_ele>1251</data_ele>
                        <name>Occurrence or Occurrence Span Code Associated Date</name>
                        <usage>R</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI02-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI02-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI02-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>03</seq>
                      <element xid="HI03-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BI</code>
                        </valid_codes>
                      </element>
                      <element xid="HI03-02">
                        <data_ele>1271</data_ele>
                        <name>Occurrence Span Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI03-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>RD8</code>
                        </valid_codes>
                      </element>
                      <element xid="HI03-04">
                        <data_ele>1251</data_ele>
                        <name>Occurrence or Occurrence Span Code Associated Date</name>
                        <usage>R</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI03-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI03-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI03-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <element xid="HI04-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BI</code>
                        </valid_codes>
                      </element>
                      <element xid="HI04-02">
                        <data_ele>1271</data_ele>
                        <name>Occurrence Span Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI04-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>RD8</code>
                        </valid_codes>
                      </element>
                      <element xid="HI04-04">
                        <data_ele>1251</data_ele>
                        <name>Occurrence or Occurrence Span Code Associated Date</name>
                        <usage>R</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI04-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI04-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI04-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>05</seq>
                      <element xid="HI05-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BI</code>
                        </valid_codes>
                      </element>
                      <element xid="HI05-02">
                        <data_ele>1271</data_ele>
                        <name>Occurrence Span Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI05-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>RD8</code>
                        </valid_codes>
                      </element>
                      <element xid="HI05-04">
                        <data_ele>1251</data_ele>
                        <name>Occurrence or Occurrence Span Code Associated Date</name>
                        <usage>R</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI05-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI05-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI05-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>06</seq>
                      <element xid="HI06-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BI</code>
                        </valid_codes>
                      </element>
                      <element xid="HI06-02">
                        <data_ele>1271</data_ele>
                        <name>Occurrence Span Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI06-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>RD8</code>
                        </valid_codes>
                      </element>
                      <element xid="HI06-04">
                        <data_ele>1251</data_ele>
                        <name>Occurrence or Occurrence Span Code Associated Date</name>
                        <usage>R</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI06-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI06-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI06-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>07</seq>
                      <element xid="HI07-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BI</code>
                        </valid_codes>
                      </element>
                      <element xid="HI07-02">
                        <data_ele>1271</data_ele>
                        <name>Occurrence Span Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI07-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>RD8</code>
                        </valid_codes>
                      </element>
                      <element xid="HI07-04">
                        <data_ele>1251</data_ele>
                        <name>Occurrence or Occurrence Span Code Associated Date</name>
                        <usage>R</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI07-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI07-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI07-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>08</seq>
                      <element xid="HI08-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BI</code>
                        </valid_codes>
                      </element>
                      <element xid="HI08-02">
                        <data_ele>1271</data_ele>
                        <name>Occurrence Span Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI08-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>RD8</code>
                        </valid_codes>
                      </element>
                      <element xid="HI08-04">
                        <data_ele>1251</data_ele>
                        <name>Occurrence or Occurrence Span Code Associated Date</name>
                        <usage>R</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI08-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI08-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI08-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>09</seq>
                      <element xid="HI09-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BI</code>
                        </valid_codes>
                      </element>
                      <element xid="HI09-02">
                        <data_ele>1271</data_ele>
                        <name>Occurrence Span Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI09-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>RD8</code>
                        </valid_codes>
                      </element>
                      <element xid="HI09-04">
                        <data_ele>1251</data_ele>
                        <name>Occurrence or Occurrence Span Code Associated Date</name>
                        <usage>R</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI09-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI09-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI09-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>10</seq>
                      <element xid="HI10-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BI</code>
                        </valid_codes>
                      </element>
                      <element xid="HI10-02">
                        <data_ele>1271</data_ele>
                        <name>Occurrence Span Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI10-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>RD8</code>
                        </valid_codes>
                      </element>
                      <element xid="HI10-04">
                        <data_ele>1251</data_ele>
                        <name>Occurrence or Occurrence Span Code Associated Date</name>
                        <usage>R</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI10-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI10-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI10-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>11</seq>
                      <element xid="HI11-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BI</code>
                        </valid_codes>
                      </element>
                      <element xid="HI11-02">
                        <data_ele>1271</data_ele>
                        <name>Occurrence Span Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI11-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>RD8</code>
                        </valid_codes>
                      </element>
                      <element xid="HI11-04">
                        <data_ele>1251</data_ele>
                        <name>Occurrence or Occurrence Span Code Associated Date</name>
                        <usage>R</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI11-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI11-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI11-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>12</seq>
                      <element xid="HI12-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BI</code>
                        </valid_codes>
                      </element>
                      <element xid="HI12-02">
                        <data_ele>1271</data_ele>
                        <name>Occurrence Span Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI12-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>RD8</code>
                        </valid_codes>
                      </element>
                      <element xid="HI12-04">
                        <data_ele>1251</data_ele>
                        <name>Occurrence or Occurrence Span Code Associated Date</name>
                        <usage>R</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI12-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI12-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI12-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                  </segment>
<!--End of HI segment-->
                  <segment xid="HI">
                    <name>Occurrence Information</name>
                    <usage>S</usage>
                    <pos>231</pos>
                    <max_use>2</max_use>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <element xid="HI01-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BH</code>
                        </valid_codes>
                      </element>
                      <element xid="HI01-02">
                        <data_ele>1271</data_ele>
                        <name>Occurrence Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI01-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>D8</code>
                        </valid_codes>
                      </element>
                      <element xid="HI01-04">
                        <data_ele>1251</data_ele>
                        <name>Occurrence or Occurrence Span Code Associated Date</name>
                        <usage>R</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI01-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI01-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI01-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>02</seq>
                      <element xid="HI02-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BH</code>
                        </valid_codes>
                      </element>
                      <element xid="HI02-02">
                        <data_ele>1271</data_ele>
                        <name>Occurrence Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI02-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>D8</code>
                        </valid_codes>
                      </element>
                      <element xid="HI02-04">
                        <data_ele>1251</data_ele>
                        <name>Occurrence or Occurrence Span Code Associated Date</name>
                        <usage>R</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI02-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI02-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI02-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>03</seq>
                      <element xid="HI03-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BH</code>
                        </valid_codes>
                      </element>
                      <element xid="HI03-02">
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                        </valid_codes>
                      </element>
                      <element xid="HI12-04">
                        <data_ele>1251</data_ele>
                        <name>Occurrence or Occurrence Span Code Associated Date</name>
                        <usage>R</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI12-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI12-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI12-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                  </segment>
<!--End of HI segment-->
                  <segment xid="HI">
                    <name>Value Information</name>
                    <usage>S</usage>
                    <pos>231</pos>
                    <max_use>2</max_use>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <element xid="HI01-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BE</code>
                        </valid_codes>
                      </element>
                      <element xid="HI01-02">
                        <data_ele>1271</data_ele>
                        <name>Value Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI01-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI01-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI01-05">
                        <data_ele>782</data_ele>
                        <name>Value Code Associated Amount</name>
                        <usage>R</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI01-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI01-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>02</seq>
                      <element xid="HI02-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BE</code>
                        </valid_codes>
                      </element>
                      <element xid="HI02-02">
                        <data_ele>1271</data_ele>
                        <name>Value Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI02-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI02-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI02-05">
                        <data_ele>782</data_ele>
                        <name>Value Code Associated Amount</name>
                        <usage>R</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI02-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI02-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>03</seq>
                      <element xid="HI03-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BE</code>
                        </valid_codes>
                      </element>
                      <element xid="HI03-02">
                        <data_ele>1271</data_ele>
                        <name>Value Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI03-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI03-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI03-05">
                        <data_ele>782</data_ele>
                        <name>Value Code Associated Amount</name>
                        <usage>R</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI03-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI03-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <element xid="HI04-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BE</code>
                        </valid_codes>
                      </element>
                      <element xid="HI04-02">
                        <data_ele>1271</data_ele>
                        <name>Value Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI04-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI04-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI04-05">
                        <data_ele>782</data_ele>
                        <name>Value Code Associated Amount</name>
                        <usage>R</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI04-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI04-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>05</seq>
                      <element xid="HI05-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BE</code>
                        </valid_codes>
                      </element>
                      <element xid="HI05-02">
                        <data_ele>1271</data_ele>
                        <name>Value Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI05-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI05-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI05-05">
                        <data_ele>782</data_ele>
                        <name>Value Code Associated Amount</name>
                        <usage>R</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI05-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI05-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>06</seq>
                      <element xid="HI06-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BE</code>
                        </valid_codes>
                      </element>
                      <element xid="HI06-02">
                        <data_ele>1271</data_ele>
                        <name>Value Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI06-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI06-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI06-05">
                        <data_ele>782</data_ele>
                        <name>Value Code Associated Amount</name>
                        <usage>R</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI06-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI06-07">
                        <data_ele>799</data_ele>
                        <name>n Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>07</seq>
                      <element xid="HI07-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BE</code>
                        </valid_codes>
                      </element>
                      <element xid="HI07-02">
                        <data_ele>1271</data_ele>
                        <name>Value Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI07-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI07-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI07-05">
                        <data_ele>782</data_ele>
                        <name>Value Code Associated Amount</name>
                        <usage>R</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI07-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI07-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>08</seq>
                      <element xid="HI08-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BE</code>
                        </valid_codes>
                      </element>
                      <element xid="HI08-02">
                        <data_ele>1271</data_ele>
                        <name>Value Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI08-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI08-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI08-05">
                        <data_ele>782</data_ele>
                        <name>Value Code Associated Amount</name>
                        <usage>R</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI08-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI08-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>09</seq>
                      <element xid="HI09-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BE</code>
                        </valid_codes>
                      </element>
                      <element xid="HI09-02">
                        <data_ele>1271</data_ele>
                        <name>Value Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI09-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI09-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI09-05">
                        <data_ele>782</data_ele>
                        <name>Value Code Associated Amount</name>
                        <usage>R</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI09-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI09-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>10</seq>
                      <element xid="HI10-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BE</code>
                        </valid_codes>
                      </element>
                      <element xid="HI10-02">
                        <data_ele>1271</data_ele>
                        <name>Value Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI10-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI10-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI10-05">
                        <data_ele>782</data_ele>
                        <name>Value Code Associated Amount</name>
                        <usage>R</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI10-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI10-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>11</seq>
                      <element xid="HI11-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BE</code>
                        </valid_codes>
                      </element>
                      <element xid="HI11-02">
                        <data_ele>1271</data_ele>
                        <name>Value Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI11-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI11-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI11-05">
                        <data_ele>782</data_ele>
                        <name>Value Code Associated Amount</name>
                        <usage>R</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI11-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI11-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>12</seq>
                      <element xid="HI12-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BE</code>
                        </valid_codes>
                      </element>
                      <element xid="HI12-02">
                        <data_ele>1271</data_ele>
                        <name>Value Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI12-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI12-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI12-05">
                        <data_ele>782</data_ele>
                        <name>Value Code Associated Amount</name>
                        <usage>R</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI12-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI12-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                  </segment>
<!--End of HI segment-->
                  <segment xid="HI">
                    <name>Condition Information</name>
                    <usage>S</usage>
                    <pos>231</pos>
                    <max_use>2</max_use>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <element xid="HI01-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BG</code>
                        </valid_codes>
                      </element>
                      <element xid="HI01-02">
                        <data_ele>1271</data_ele>
                        <name>Condition Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                        <valid_codes>
                          <code>24</code>
                          <code>25</code>
                          <code>26</code>
                          <code>27</code>
                          <code>28</code>
                          <code>29</code>
                          <code>30</code>
                        </valid_codes>
                      </element>
                      <element xid="HI01-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI01-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI01-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI01-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI01-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>02</seq>
                      <element xid="HI02-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BG</code>
                        </valid_codes>
                      </element>
                      <element xid="HI02-02">
                        <data_ele>1271</data_ele>
                        <name>Condition Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                        <valid_codes>
                          <code>24</code>
                          <code>25</code>
                          <code>26</code>
                          <code>27</code>
                          <code>28</code>
                          <code>29</code>
                          <code>30</code>
                        </valid_codes>
                      </element>
                      <element xid="HI02-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI02-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI02-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI02-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI02-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>03</seq>
                      <element xid="HI03-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BG</code>
                        </valid_codes>
                      </element>
                      <element xid="HI03-02">
                        <data_ele>1271</data_ele>
                        <name>Condition Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                        <valid_codes>
                          <code>24</code>
                          <code>25</code>
                          <code>26</code>
                          <code>27</code>
                          <code>28</code>
                          <code>29</code>
                          <code>30</code>
                        </valid_codes>
                      </element>
                      <element xid="HI03-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI03-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI03-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI03-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI03-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <element xid="HI04-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BG</code>
                        </valid_codes>
                      </element>
                      <element xid="HI04-02">
                        <data_ele>1271</data_ele>
                        <name>Condition Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                        <valid_codes>
                          <code>24</code>
                          <code>25</code>
                          <code>26</code>
                          <code>27</code>
                          <code>28</code>
                          <code>29</code>
                          <code>30</code>
                        </valid_codes>
                      </element>
                      <element xid="HI04-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI04-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI04-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI04-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI04-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>05</seq>
                      <element xid="HI05-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BG</code>
                        </valid_codes>
                      </element>
                      <element xid="HI05-02">
                        <data_ele>1271</data_ele>
                        <name>Condition Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                        <valid_codes>
                          <code>24</code>
                          <code>25</code>
                          <code>26</code>
                          <code>27</code>
                          <code>28</code>
                          <code>29</code>
                          <code>30</code>
                        </valid_codes>
                      </element>
                      <element xid="HI05-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI05-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI05-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI05-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI05-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>06</seq>
                      <element xid="HI06-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BG</code>
                        </valid_codes>
                      </element>
                      <element xid="HI06-02">
                        <data_ele>1271</data_ele>
                        <name>Condition Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                        <valid_codes>
                          <code>24</code>
                          <code>25</code>
                          <code>26</code>
                          <code>27</code>
                          <code>28</code>
                          <code>29</code>
                          <code>30</code>
                        </valid_codes>
                      </element>
                      <element xid="HI06-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI06-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI06-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI06-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI06-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>07</seq>
                      <element xid="HI07-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BG</code>
                        </valid_codes>
                      </element>
                      <element xid="HI07-02">
                        <data_ele>1271</data_ele>
                        <name>Condition Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                        <valid_codes>
                          <code>24</code>
                          <code>25</code>
                          <code>26</code>
                          <code>27</code>
                          <code>28</code>
                          <code>29</code>
                          <code>30</code>
                        </valid_codes>
                      </element>
                      <element xid="HI07-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI07-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI07-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI07-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI07-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>08</seq>
                      <element xid="HI08-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BG</code>
                        </valid_codes>
                      </element>
                      <element xid="HI08-02">
                        <data_ele>1271</data_ele>
                        <name>Condition Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                        <valid_codes>
                          <code>24</code>
                          <code>25</code>
                          <code>26</code>
                          <code>27</code>
                          <code>28</code>
                          <code>29</code>
                          <code>30</code>
                        </valid_codes>
                      </element>
                      <element xid="HI08-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI08-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI08-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI08-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI08-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>09</seq>
                      <element xid="HI09-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BG</code>
                        </valid_codes>
                      </element>
                      <element xid="HI09-02">
                        <data_ele>1271</data_ele>
                        <name>Condition Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                        <valid_codes>
                          <code>24</code>
                          <code>25</code>
                          <code>26</code>
                          <code>27</code>
                          <code>28</code>
                          <code>29</code>
                          <code>30</code>
                        </valid_codes>
                      </element>
                      <element xid="HI09-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI09-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI09-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI09-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI09-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>10</seq>
                      <element xid="HI10-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BG</code>
                        </valid_codes>
                      </element>
                      <element xid="HI10-02">
                        <data_ele>1271</data_ele>
                        <name>Condition Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                        <valid_codes>
                          <code>24</code>
                          <code>25</code>
                          <code>26</code>
                          <code>27</code>
                          <code>28</code>
                          <code>29</code>
                          <code>30</code>
                        </valid_codes>
                      </element>
                      <element xid="HI10-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI10-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI10-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI10-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI10-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>11</seq>
                      <element xid="HI11-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BG</code>
                        </valid_codes>
                      </element>
                      <element xid="HI11-02">
                        <data_ele>1271</data_ele>
                        <name>Condition Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                        <valid_codes>
                          <code>24</code>
                          <code>25</code>
                          <code>26</code>
                          <code>27</code>
                          <code>28</code>
                          <code>29</code>
                          <code>30</code>
                        </valid_codes>
                      </element>
                      <element xid="HI11-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI11-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI11-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI11-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI11-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>12</seq>
                      <element xid="HI12-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>BG</code>
                        </valid_codes>
                      </element>
                      <element xid="HI12-02">
                        <data_ele>1271</data_ele>
                        <name>Condition Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                        <valid_codes>
                          <code>24</code>
                          <code>25</code>
                          <code>26</code>
                          <code>27</code>
                          <code>28</code>
                          <code>29</code>
                          <code>30</code>
                        </valid_codes>
                      </element>
                      <element xid="HI12-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI12-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI12-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI12-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI12-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                  </segment>
<!--End of HI segment-->
                  <segment xid="HI">
                    <name>Treatment Code Information</name>
                    <usage>S</usage>
                    <pos>231</pos>
                    <max_use>2</max_use>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <element xid="HI01-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>TC</code>
                        </valid_codes>
                      </element>
                      <element xid="HI01-02">
                        <data_ele>1271</data_ele>
                        <name>Treatment Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI01-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI01-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI01-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI01-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI01-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>02</seq>
                      <element xid="HI02-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>TC</code>
                        </valid_codes>
                      </element>
                      <element xid="HI02-02">
                        <data_ele>1271</data_ele>
                        <name>Treatment Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI02-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI02-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI02-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI02-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI02-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>03</seq>
                      <element xid="HI03-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>TC</code>
                        </valid_codes>
                      </element>
                      <element xid="HI03-02">
                        <data_ele>1271</data_ele>
                        <name>Treatment Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI03-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI03-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI03-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI03-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI03-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <element xid="HI04-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>TC</code>
                        </valid_codes>
                      </element>
                      <element xid="HI04-02">
                        <data_ele>1271</data_ele>
                        <name>Treatment Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI04-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI04-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI04-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI04-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI04-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>05</seq>
                      <element xid="HI05-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>TC</code>
                        </valid_codes>
                      </element>
                      <element xid="HI05-02">
                        <data_ele>1271</data_ele>
                        <name>Treatment Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI05-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI05-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI05-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI05-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI05-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>06</seq>
                      <element xid="HI06-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>TC</code>
                        </valid_codes>
                      </element>
                      <element xid="HI06-02">
                        <data_ele>1271</data_ele>
                        <name>Treatment Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI06-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI06-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI06-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI06-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI06-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>07</seq>
                      <element xid="HI07-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>TC</code>
                        </valid_codes>
                      </element>
                      <element xid="HI07-02">
                        <data_ele>1271</data_ele>
                        <name>Treatment Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI07-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI07-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI07-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI07-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI07-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>08</seq>
                      <element xid="HI08-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>TC</code>
                        </valid_codes>
                      </element>
                      <element xid="HI08-02">
                        <data_ele>1271</data_ele>
                        <name>Treatment Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI08-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI08-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI08-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI08-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI08-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>09</seq>
                      <element xid="HI09-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>TC</code>
                        </valid_codes>
                      </element>
                      <element xid="HI09-02">
                        <data_ele>1271</data_ele>
                        <name>Treatment Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI09-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI09-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI09-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI09-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI09-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>10</seq>
                      <element xid="HI10-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>TC</code>
                        </valid_codes>
                      </element>
                      <element xid="HI10-02">
                        <data_ele>1271</data_ele>
                        <name>Treatment Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI10-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI10-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI10-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI10-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI10-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>11</seq>
                      <element xid="HI11-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>TC</code>
                        </valid_codes>
                      </element>
                      <element xid="HI11-02">
                        <data_ele>1271</data_ele>
                        <name>Treatment Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI11-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI11-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI11-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI11-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI11-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                    <composite>
                      <data_ele>C022</data_ele>
                      <name>Health Care Code Information</name>
                      <usage>S</usage>
                      <seq>12</seq>
                      <element xid="HI12-01">
                        <data_ele>1270</data_ele>
                        <name>Code List Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>TC</code>
                        </valid_codes>
                      </element>
                      <element xid="HI12-02">
                        <data_ele>1271</data_ele>
                        <name>Treatment Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HI12-03">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HI12-04">
                        <data_ele>1251</data_ele>
                        <name>Date Time Period</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="HI12-05">
                        <data_ele>782</data_ele>
                        <name>Monetary Amount</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HI12-06">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HI12-07">
                        <data_ele>799</data_ele>
                        <name>Version Identifier</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </composite>
                  </segment>
<!--End of HI segment-->
                  <segment xid="QTY">
                    <name>Claim Quantity</name>
                    <usage>S</usage>
                    <pos>240</pos>
                    <max_use>4</max_use>
                    <element xid="QTY01">
                      <data_ele>673</data_ele>
                      <name>Quantity Qualifier</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>CA</code>
                        <code>CD</code>
                        <code>LA</code>
                        <code>NA</code>
                      </valid_codes>
                    </element>
                    <element xid="QTY02">
                      <data_ele>380</data_ele>
                      <name>Claim Days Count</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <composite>
                      <data_ele>C001</data_ele>
                      <name>Composite Unit of Measure</name>
                      <usage>R</usage>
                      <seq>03</seq>
                      <element xid="QTY03-01">
                        <data_ele>355</data_ele>
                        <name>Unit or Basis for Measurement Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>DA</code>
                        </valid_codes>
                      </element>
                      <element xid="QTY03-02">
                        <data_ele>1018</data_ele>
                        <name>Exponent</name>
                        <usage>N</usage>
                        <seq>02</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="QTY03-03">
                        <data_ele>649</data_ele>
                        <name>Multiplier</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="QTY03-04">
                        <data_ele>355</data_ele>
                        <name>Unit or Basis for Measurement Code</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="QTY03-05">
                        <data_ele>1018</data_ele>
                        <name>Exponent</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="QTY03-06">
                        <data_ele>649</data_ele>
                        <name>Multiplier</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="QTY03-07">
                        <data_ele>355</data_ele>
                        <name>Unit or Basis for Measurement Code</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="QTY03-08">
                        <data_ele>1018</data_ele>
                        <name>Exponent</name>
                        <usage>N</usage>
                        <seq>08</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="QTY03-09">
                        <data_ele>649</data_ele>
                        <name>Multiplier</name>
                        <usage>N</usage>
                        <seq>09</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="QTY03-10">
                        <data_ele>355</data_ele>
                        <name>Unit or Basis for Measurement Code</name>
                        <usage>N</usage>
                        <seq>10</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="QTY03-11">
                        <data_ele>1018</data_ele>
                        <name>Exponent</name>
                        <usage>N</usage>
                        <seq>11</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="QTY03-12">
                        <data_ele>649</data_ele>
                        <name>Multiplier</name>
                        <usage>N</usage>
                        <seq>12</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="QTY03-13">
                        <data_ele>355</data_ele>
                        <name>Unit or Basis for Measurement Code</name>
                        <usage>N</usage>
                        <seq>13</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="QTY03-14">
                        <data_ele>1018</data_ele>
                        <name>Exponent</name>
                        <usage>N</usage>
                        <seq>14</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="QTY03-15">
                        <data_ele>649</data_ele>
                        <name>Multiplier</name>
                        <usage>N</usage>
                        <seq>15</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                    </composite>
                    <element xid="QTY04">
                      <data_ele>61</data_ele>
                      <name>Free-Form Message</name>
                      <usage>N</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                  </segment>
<!--End of QTY segment-->
                  <segment xid="HCP">
                    <name>Claim Pricing/Repricing Information</name>
                    <usage>S</usage>
                    <pos>241</pos>
                    <max_use>1</max_use>
                    <element xid="HCP01">
                      <data_ele>1473</data_ele>
                      <name>Pricing Methodology</name>
                      <usage>R</usage>
                      <seq>01</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>00</code>
                        <code>01</code>
                        <code>02</code>
                        <code>03</code>
                        <code>04</code>
                        <code>05</code>
                        <code>06</code>
                        <code>07</code>
                        <code>08</code>
                        <code>09</code>
                        <code>10</code>
                        <code>11</code>
                        <code>12</code>
                        <code>13</code>
                        <code>14</code>
                      </valid_codes>
                    </element>
                    <element xid="HCP02">
                      <data_ele>782</data_ele>
                      <name>Repriced Allowed Amount</name>
                      <usage>R</usage>
                      <seq>02</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HCP03">
                      <data_ele>782</data_ele>
                      <name>Repriced Saving Amount</name>
                      <usage>S</usage>
                      <seq>03</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HCP04">
                      <data_ele>127</data_ele>
                      <name>Repricing Organization Identifier</name>
                      <usage>S</usage>
                      <seq>04</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HCP05">
                      <data_ele>118</data_ele>
                      <name>Repricing Per Diem or Flat Rate Amount</name>
                      <usage>S</usage>
                      <seq>05</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>9</max_len>
                    </element>
                    <element xid="HCP06">
                      <data_ele>127</data_ele>
                      <name>Repriced Approved DRG Code</name>
                      <usage>S</usage>
                      <seq>06</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>30</max_len>
                    </element>
                    <element xid="HCP07">
                      <data_ele>782</data_ele>
                      <name>Repriced Approved Amount</name>
                      <usage>S</usage>
                      <seq>07</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>18</max_len>
                    </element>
                    <element xid="HCP08">
                      <data_ele>234</data_ele>
                      <name>Repriced Approved Revenue Code</name>
                      <usage>S</usage>
                      <seq>08</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>48</max_len>
                    </element>
                    <element xid="HCP09">
                      <data_ele>235</data_ele>
                      <name>Product or Service ID Qualifier</name>
                      <usage>S</usage>
                      <seq>09</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>HC</code>
                      </valid_codes>
                    </element>
                    <element xid="HCP10">
                      <data_ele>234</data_ele>
                      <name>Repriced Approved HCPCS Code</name>
                      <usage>S</usage>
                      <seq>10</seq>
                      <data_type>AN</data_type>
                      <min_len>1</min_len>
                      <max_len>48</max_len>
                    </element>
                    <element xid="HCP11">
                      <data_ele>355</data_ele>
                      <name>Unit or Basis for Measurement Code</name>
                      <usage>S</usage>
                      <seq>11</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>DA</code>
                        <code>UN</code>
                      </valid_codes>
                    </element>
                    <element xid="HCP12">
                      <data_ele>380</data_ele>
                      <name>Repriced Approved Service Unit Count</name>
                      <usage>S</usage>
                      <seq>12</seq>
                      <data_type>R</data_type>
                      <min_len>1</min_len>
                      <max_len>15</max_len>
                    </element>
                    <element xid="HCP13">
                      <data_ele>901</data_ele>
                      <name>Rejection Message</name>
                      <usage>S</usage>
                      <seq>13</seq>
                      <data_type>ID</data_type>
                      <min_len>2</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>T1</code>
                        <code>T2</code>
                        <code>T3</code>
                        <code>T4</code>
                        <code>T5</code>
                        <code>T6</code>
                      </valid_codes>
                    </element>
                    <element xid="HCP14">
                      <data_ele>1526</data_ele>
                      <name>Policy Compliance Code</name>
                      <usage>S</usage>
                      <seq>14</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>1</code>
                        <code>2</code>
                        <code>3</code>
                        <code>4</code>
                        <code>5</code>
                      </valid_codes>
                    </element>
                    <element xid="HCP15">
                      <data_ele>1527</data_ele>
                      <name>Exception Reason Code</name>
                      <usage>S</usage>
                      <seq>15</seq>
                      <data_type>ID</data_type>
                      <min_len>1</min_len>
                      <max_len>2</max_len>
                      <valid_codes>
                        <code>1</code>
                        <code>2</code>
                        <code>3</code>
                        <code>4</code>
                        <code>5</code>
                        <code>6</code>
                      </valid_codes>
                    </element>
                  </segment>
<!--End of HCP segment-->
                  <loop xid="2305">
                    <name>Home Health Care Plan Information</name>
                    <usage>S</usage>
                    <pos>242</pos>
                    <repeat>6</repeat>
                    <segment xid="CR7">
                      <name>Home Health Care Plan Information</name>
                      <usage>R</usage>
                      <pos>242</pos>
                      <max_use>1</max_use>
                      <element xid="CR701">
                        <data_ele>921</data_ele>
                        <name>Discipline Type Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>AI</code>
                          <code>MS</code>
                          <code>OT</code>
                          <code>PT</code>
                          <code>SN</code>
                          <code>ST</code>
                        </valid_codes>
                      </element>
                      <element xid="CR702">
                        <data_ele>1470</data_ele>
                        <name>Visits Prior to Recertification Date Count</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>N0</data_type>
                        <min_len>1</min_len>
                        <max_len>9</max_len>
                      </element>
                      <element xid="CR703">
                        <data_ele>1470</data_ele>
                        <name>Total Visits Projected This Certification Count</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>N0</data_type>
                        <min_len>1</min_len>
                        <max_len>9</max_len>
                      </element>
                    </segment>
<!--End of CR7 segment-->
                    <segment xid="HSD">
                      <name>Health Care Services Delivery</name>
                      <usage>S</usage>
                      <pos>243</pos>
                      <max_use>12</max_use>
                      <element xid="HSD01">
                        <data_ele>673</data_ele>
                        <name>Visits</name>
                        <usage>S</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>VS</code>
                        </valid_codes>
                      </element>
                      <element xid="HSD02">
                        <data_ele>380</data_ele>
                        <name>Number of Visits</name>
                        <usage>S</usage>
                        <seq>02</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HSD03">
                        <data_ele>355</data_ele>
                        <name>Frequency Period</name>
                        <usage>S</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>DA</code>
                          <code>MO</code>
                          <code>Q1</code>
                          <code>WK</code>
                        </valid_codes>
                      </element>
                      <element xid="HSD04">
                        <data_ele>1167</data_ele>
                        <name>Frequency Count</name>
                        <usage>S</usage>
                        <seq>04</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>6</max_len>
                      </element>
                      <element xid="HSD05">
                        <data_ele>615</data_ele>
                        <name>Duration of Visits Units</name>
                        <usage>S</usage>
                        <seq>05</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>7</code>
                          <code>35</code>
                        </valid_codes>
                      </element>
                      <element xid="HSD06">
                        <data_ele>616</data_ele>
                        <name>Duration of Visits, Number of Units</name>
                        <usage>S</usage>
                        <seq>06</seq>
                        <data_type>N0</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="HSD07">
                        <data_ele>678</data_ele>
                        <name>Ship, Delivery or Calendar Pattern Code</name>
                        <usage>S</usage>
                        <seq>07</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>1</code>
                          <code>2</code>
                          <code>3</code>
                          <code>4</code>
                          <code>5</code>
                          <code>6</code>
                          <code>7</code>
                          <code>8</code>
                          <code>9</code>
                          <code>A</code>
                          <code>B</code>
                          <code>C</code>
                          <code>D</code>
                          <code>E</code>
                          <code>F</code>
                          <code>G</code>
                          <code>H</code>
                          <code>J</code>
                          <code>K</code>
                          <code>L</code>
                          <code>N</code>
                          <code>O</code>
                          <code>S</code>
                          <code>SA</code>
                          <code>SB</code>
                          <code>SC</code>
                          <code>SD</code>
                          <code>SG</code>
                          <code>SL</code>
                          <code>SP</code>
                          <code>SX</code>
                          <code>SY</code>
                          <code>SZ</code>
                          <code>W</code>
                        </valid_codes>
                      </element>
                      <element xid="HSD08">
                        <data_ele>679</data_ele>
                        <name>Delivery Pattern Time Code</name>
                        <usage>S</usage>
                        <seq>08</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                        <valid_codes>
                          <code>D</code>
                          <code>E</code>
                          <code>F</code>
                        </valid_codes>
                      </element>
                    </segment>
<!--End of HSD segment-->
                  </loop>
<!--End of 2305 loop-->
                  <loop xid="2310A">
                    <name>Attending Physician Name</name>
                    <usage>S</usage>
                    <pos>250</pos>
                    <repeat>1</repeat>
                    <segment xid="NM1">
                      <name>Attending Physician Name</name>
                      <usage>R</usage>
                      <pos>250</pos>
                      <max_use>1</max_use>
                      <element xid="NM101">
                        <data_ele>98</data_ele>
                        <name>Entity Identifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>71</code>
                        </valid_codes>
                      </element>
                      <element xid="NM102">
                        <data_ele>1065</data_ele>
                        <name>Entity Type Qualifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                        <valid_codes>
                          <code>1</code>
                          <code>2</code>
                        </valid_codes>
                      </element>
                      <element xid="NM103">
                        <data_ele>1035</data_ele>
                        <name>Attending Physician Last Name</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="NM104">
                        <data_ele>1036</data_ele>
                        <name>Attending Physician First Name</name>
                        <usage>S</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>25</max_len>
                      </element>
                      <element xid="NM105">
                        <data_ele>1037</data_ele>
                        <name>Attending Physician Middle Name</name>
                        <usage>S</usage>
                        <seq>05</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>25</max_len>
                      </element>
                      <element xid="NM106">
                        <data_ele>1038</data_ele>
                        <name>Name Prefix</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="NM107">
                        <data_ele>1039</data_ele>
                        <name>Attending Physician Name Suffix</name>
                        <usage>S</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="NM108">
                        <data_ele>66</data_ele>
                        <name>Identification Code Qualifier</name>
                        <usage>R</usage>
                        <seq>08</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>24</code>
                          <code>34</code>
                          <code>XX</code>
                        </valid_codes>
                      </element>
                      <element xid="NM109">
                        <data_ele>67</data_ele>
                        <name>Attending Physician Primary Identifier</name>
                        <usage>R</usage>
                        <seq>09</seq>
                        <data_type>AN</data_type>
                        <min_len>2</min_len>
                        <max_len>80</max_len>
                      </element>
                      <element xid="NM110">
                        <data_ele>706</data_ele>
                        <name>Entity Relationship Code</name>
                        <usage>N</usage>
                        <seq>10</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="NM111">
                        <data_ele>98</data_ele>
                        <name>Entity Identifier Code</name>
                        <usage>N</usage>
                        <seq>11</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                    </segment>
<!--End of NM1 segment-->
                    <segment xid="PRV">
                      <name>Attending Physician Specialty Information</name>
                      <usage>S</usage>
                      <pos>255</pos>
                      <max_use>1</max_use>
                      <element xid="PRV01">
                        <data_ele>1221</data_ele>
                        <name>Provider Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>AT</code>
                          <code>SU</code>
                        </valid_codes>
                      </element>
                      <element xid="PRV02">
                        <data_ele>128</data_ele>
                        <name>Reference Identification Qualifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>ZZ</code>
                        </valid_codes>
                      </element>
                      <element xid="PRV03">
                        <data_ele>127</data_ele>
                        <name>Provider Taxonomy Code</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
<!--<valid_codes external="prov_taxonomy"/>-->
                      </element>
                      <element xid="PRV04">
                        <data_ele>156</data_ele>
                        <name>State or Province Code</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                        <valid_codes external="states"/>
                      </element>
                      <composite>
                        <data_ele>C035</data_ele>
                        <name>Provider Specialty Information</name>
                        <usage>N</usage>
                        <seq>05</seq>
                      </composite>
                      <element xid="PRV06">
                        <data_ele>1223</data_ele>
                        <name>Provider Organization Code</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>ID</data_type>
                        <min_len>3</min_len>
                        <max_len>3</max_len>
                      </element>
                    </segment>
<!--End of PRV segment-->
                    <segment xid="REF">
                      <name>Attending Physician Secondary Identification</name>
                      <usage>S</usage>
                      <pos>271</pos>
                      <max_use>5</max_use>
                      <element xid="REF01">
                        <data_ele>128</data_ele>
                        <name>Reference Identification Qualifier</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>0B</code>
                          <code>1A</code>
                          <code>1B</code>
                          <code>1C</code>
                          <code>1D</code>
                          <code>1G</code>
                          <code>1H</code>
                          <code>EI</code>
                          <code>G2</code>
                          <code>LU</code>
                          <code>N5</code>
                          <code>SY</code>
                          <code>X5</code>
                        </valid_codes>
                      </element>
                      <element xid="REF02">
                        <data_ele>127</data_ele>
                        <name>Attending Physician Secondary Identifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="REF03">
                        <data_ele>352</data_ele>
                        <name>Description</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>80</max_len>
                      </element>
                      <composite>
                        <data_ele>C040</data_ele>
                        <name>Reference Identifier</name>
                        <usage>N</usage>
                        <seq>04</seq>
                      </composite>
                    </segment>
<!--End of REF segment-->
                  </loop>
<!--End of 2310A loop-->
                  <loop xid="2310B">
                    <name>Operating Physician Name</name>
                    <usage>S</usage>
                    <pos>250</pos>
                    <repeat>1</repeat>
                    <segment xid="NM1">
                      <name>Operating Physician Name</name>
                      <usage>R</usage>
                      <pos>250</pos>
                      <max_use>1</max_use>
                      <element xid="NM101">
                        <data_ele>98</data_ele>
                        <name>Entity Identifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>72</code>
                        </valid_codes>
                      </element>
                      <element xid="NM102">
                        <data_ele>1065</data_ele>
                        <name>Entity Type Qualifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                        <valid_codes>
                          <code>1</code>
                        </valid_codes>
                      </element>
                      <element xid="NM103">
                        <data_ele>1035</data_ele>
                        <name>Operating Physician Last Name</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="NM104">
                        <data_ele>1036</data_ele>
                        <name>Operating Physician First Name</name>
                        <usage>R</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>25</max_len>
                      </element>
                      <element xid="NM105">
                        <data_ele>1037</data_ele>
                        <name>Operating Physician Middle Name</name>
                        <usage>S</usage>
                        <seq>05</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>25</max_len>
                      </element>
                      <element xid="NM106">
                        <data_ele>1038</data_ele>
                        <name>Name Prefix</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="NM107">
                        <data_ele>1039</data_ele>
                        <name>Operating Physician Name Suffix</name>
                        <usage>S</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="NM108">
                        <data_ele>66</data_ele>
                        <name>Identification Code Qualifier</name>
                        <usage>R</usage>
                        <seq>08</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>24</code>
                          <code>34</code>
                          <code>XX</code>
                        </valid_codes>
                      </element>
                      <element xid="NM109">
                        <data_ele>67</data_ele>
                        <name>Operating Physician Primary Identifier</name>
                        <usage>R</usage>
                        <seq>09</seq>
                        <data_type>AN</data_type>
                        <min_len>2</min_len>
                        <max_len>80</max_len>
                      </element>
                      <element xid="NM110">
                        <data_ele>706</data_ele>
                        <name>Entity Relationship Code</name>
                        <usage>N</usage>
                        <seq>10</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="NM111">
                        <data_ele>98</data_ele>
                        <name>Entity Identifier Code</name>
                        <usage>N</usage>
                        <seq>11</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                    </segment>
<!--End of NM1 segment-->
                    <segment xid="PRV">
                      <name>Operating Physician Specialty Information</name>
                      <usage>S</usage>
                      <pos>255</pos>
                      <max_use>1</max_use>
                      <element xid="PRV01">
                        <data_ele>1221</data_ele>
                        <name>Provider Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>OP</code>
                        </valid_codes>
                      </element>
                      <element xid="PRV02">
                        <data_ele>128</data_ele>
                        <name>Reference Identification Qualifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>ZZ</code>
                        </valid_codes>
                      </element>
                      <element xid="PRV03">
                        <data_ele>127</data_ele>
                        <name>Provider Taxonomy Code</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
<!--<valid_codes external="prov_taxonomy"/>-->
                      </element>
                      <element xid="PRV04">
                        <data_ele>156</data_ele>
                        <name>State or Province Code</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                      </element>
                      <composite>
                        <data_ele>C035</data_ele>
                        <name>Provider Specialty Information</name>
                        <usage>N</usage>
                        <seq>05</seq>
                      </composite>
                      <element xid="PRV06">
                        <data_ele>1223</data_ele>
                        <name>Provider Organization Code</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>ID</data_type>
                        <min_len>3</min_len>
                        <max_len>3</max_len>
                      </element>
                    </segment>
<!--End of PRV segment-->
                    <segment xid="REF">
                      <name>Operating Physician Secondary Identification</name>
                      <usage>S</usage>
                      <pos>271</pos>
                      <max_use>5</max_use>
                      <element xid="REF01">
                        <data_ele>128</data_ele>
                        <name>Reference Identification Qualifier</name>
                        <usage>R</usage>
                        <seq>1</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>0B</code>
                          <code>1A</code>
                          <code>1B</code>
                          <code>1C</code>
                          <code>1D</code>
                          <code>1G</code>
                          <code>1H</code>
                          <code>EI</code>
                          <code>G2</code>
                          <code>LU</code>
                          <code>N5</code>
                          <code>SY</code>
                          <code>X5</code>
                        </valid_codes>
                      </element>
                      <element xid="REF02">
                        <data_ele>127</data_ele>
                        <name>Operating Physician Secondary Identifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="REF03">
                        <data_ele>352</data_ele>
                        <name>Description</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>80</max_len>
                      </element>
                      <composite>
                        <data_ele>C040</data_ele>
                        <name>Reference Identifier</name>
                        <usage>N</usage>
                        <seq>04</seq>
                      </composite>
                    </segment>
<!--End of REF segment-->
                  </loop>
<!--End of 2310B loop-->
                  <loop xid="2310C">
                    <name>Other Provider Name</name>
                    <usage>S</usage>
                    <pos>250</pos>
                    <repeat>1</repeat>
                    <segment xid="NM1">
                      <name>Other Provider Name</name>
                      <usage>R</usage>
                      <pos>250</pos>
                      <max_use>1</max_use>
                      <element xid="NM101">
                        <data_ele>98</data_ele>
                        <name>Entity Identifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>73</code>
                        </valid_codes>
                      </element>
                      <element xid="NM102">
                        <data_ele>1065</data_ele>
                        <name>Entity Type Qualifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                        <valid_codes>
                          <code>1</code>
                          <code>2</code>
                        </valid_codes>
                      </element>
                      <element xid="NM103">
                        <data_ele>1035</data_ele>
                        <name>Other Physician Last Name</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="NM104">
                        <data_ele>1036</data_ele>
                        <name>Other Physician First Name</name>
                        <usage>S</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>25</max_len>
                      </element>
                      <element xid="NM105">
                        <data_ele>1037</data_ele>
                        <name>Other Provider Middle Name</name>
                        <usage>S</usage>
                        <seq>05</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>25</max_len>
                      </element>
                      <element xid="NM106">
                        <data_ele>1038</data_ele>
                        <name>Name Prefix</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="NM107">
                        <data_ele>1039</data_ele>
                        <name>Other Provider Name Suffix</name>
                        <usage>S</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="NM108">
                        <data_ele>66</data_ele>
                        <name>Identification Code Qualifier</name>
                        <usage>R</usage>
                        <seq>08</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>24</code>
                          <code>34</code>
                          <code>XX</code>
                        </valid_codes>
                      </element>
                      <element xid="NM109">
                        <data_ele>67</data_ele>
                        <name>Other Physician Identifier</name>
                        <usage>R</usage>
                        <seq>09</seq>
                        <data_type>AN</data_type>
                        <min_len>2</min_len>
                        <max_len>80</max_len>
                      </element>
                      <element xid="NM110">
                        <data_ele>706</data_ele>
                        <name>Entity Relationship Code</name>
                        <usage>N</usage>
                        <seq>10</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="NM111">
                        <data_ele>98</data_ele>
                        <name>Entity Identifier Code</name>
                        <usage>N</usage>
                        <seq>11</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                    </segment>
<!--End of NM1 segment-->
                    <segment xid="PRV">
                      <name>Other Provider Specialty Information</name>
                      <usage>S</usage>
                      <pos>255</pos>
                      <max_use>1</max_use>
                      <element xid="PRV01">
                        <data_ele>1221</data_ele>
                        <name>Provider Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>OT</code>
                          <code>PE</code>
                        </valid_codes>
                      </element>
                      <element xid="PRV02">
                        <data_ele>128</data_ele>
                        <name>Reference Identification Qualifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>ZZ</code>
                        </valid_codes>
                      </element>
                      <element xid="PRV03">
                        <data_ele>127</data_ele>
                        <name>Provider Taxonomy Code</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
<!--<valid_codes external="prov_taxonomy"/>-->
                      </element>
                      <element xid="PRV04">
                        <data_ele>156</data_ele>
                        <name>State or Province Code</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                      </element>
                      <composite>
                        <data_ele>C035</data_ele>
                        <name>Provider Specialty Information</name>
                        <usage>N</usage>
                        <seq>05</seq>
                      </composite>
                      <element xid="PRV06">
                        <data_ele>1223</data_ele>
                        <name>Provider Organization Code</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>ID</data_type>
                        <min_len>3</min_len>
                        <max_len>3</max_len>
                      </element>
                    </segment>
<!--End of PRV segment-->
                    <segment xid="REF">
                      <name>Other Provider Secondary Identification</name>
                      <usage>S</usage>
                      <pos>271</pos>
                      <max_use>5</max_use>
                      <element xid="REF01">
                        <data_ele>128</data_ele>
                        <name>Reference Identification Qualifier</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>0B</code>
                          <code>1A</code>
                          <code>1B</code>
                          <code>1C</code>
                          <code>1D</code>
                          <code>1G</code>
                          <code>1H</code>
                          <code>EI</code>
                          <code>G2</code>
                          <code>LU</code>
                          <code>N5</code>
                          <code>SY</code>
                          <code>X5</code>
                        </valid_codes>
                      </element>
                      <element xid="REF02">
                        <data_ele>127</data_ele>
                        <name>Other Provider Secondary Identifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="REF03">
                        <data_ele>352</data_ele>
                        <name>Description</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>80</max_len>
                      </element>
                      <composite>
                        <data_ele>C040</data_ele>
                        <name>Reference Identifier</name>
                        <usage>N</usage>
                        <seq>04</seq>
                      </composite>
                    </segment>
<!--End of REF segment-->
                  </loop>
<!--End of 2310C loop-->
                  <loop xid="2310E">
                    <name>Service Facility Name</name>
                    <usage>S</usage>
                    <pos>250</pos>
                    <repeat>1</repeat>
                    <segment xid="NM1">
                      <name>Service Facility Name</name>
                      <usage>R</usage>
                      <pos>250</pos>
                      <max_use>1</max_use>
                      <element xid="NM101">
                        <data_ele>98</data_ele>
                        <name>Entity Identifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>FA</code>
                        </valid_codes>
                      </element>
                      <element xid="NM102">
                        <data_ele>1065</data_ele>
                        <name>Entity Type Qualifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                        <valid_codes>
                          <code>2</code>
                        </valid_codes>
                      </element>
                      <element xid="NM103">
                        <data_ele>1035</data_ele>
                        <name>Laboratory or Facility Name</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="NM104">
                        <data_ele>1036</data_ele>
                        <name>Name First</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>25</max_len>
                      </element>
                      <element xid="NM105">
                        <data_ele>1037</data_ele>
                        <name>Name Middle</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>25</max_len>
                      </element>
                      <element xid="NM106">
                        <data_ele>1038</data_ele>
                        <name>Name Prefix</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="NM107">
                        <data_ele>1039</data_ele>
                        <name>Name Suffix</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="NM108">
                        <data_ele>66</data_ele>
                        <name>Identification Code Qualifier</name>
                        <usage>S</usage>
                        <seq>08</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>24</code>
                          <code>34</code>
                          <code>XX</code>
                        </valid_codes>
                      </element>
                      <element xid="NM109">
                        <data_ele>67</data_ele>
                        <name>Laboratory or Facility Primary Identifier</name>
                        <usage>S</usage>
                        <seq>09</seq>
                        <data_type>AN</data_type>
                        <min_len>2</min_len>
                        <max_len>80</max_len>
                      </element>
                      <element xid="NM110">
                        <data_ele>706</data_ele>
                        <name>Entity Relationship Code</name>
                        <usage>N</usage>
                        <seq>10</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="NM111">
                        <data_ele>98</data_ele>
                        <name>Entity Identifier Code</name>
                        <usage>N</usage>
                        <seq>11</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                    </segment>
<!--End of NM1 segment-->
                    <segment xid="PRV">
                      <name>Service Facility Specialty Information</name>
                      <usage>S</usage>
                      <pos>255</pos>
                      <max_use>1</max_use>
                      <element xid="PRV01">
                        <data_ele>1221</data_ele>
                        <name>Provider Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>RP</code>
                        </valid_codes>
                      </element>
                      <element xid="PRV02">
                        <data_ele>128</data_ele>
                        <name>Reference Identification Qualifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>ZZ</code>
                        </valid_codes>
                      </element>
                      <element xid="PRV03">
                        <data_ele>127</data_ele>
                        <name>Provider Taxonomy Code</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
<!--<valid_codes external="prov_taxonomy"/>-->
                      </element>
                      <element xid="PRV04">
                        <data_ele>156</data_ele>
                        <name>State or Province Code</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                      </element>
                      <composite>
                        <data_ele>C035</data_ele>
                        <name>Provider Specialty Information</name>
                        <usage>N</usage>
                        <seq>05</seq>
                      </composite>
                      <element xid="PRV06">
                        <data_ele>1223</data_ele>
                        <name>Provider Organization Code</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>ID</data_type>
                        <min_len>3</min_len>
                        <max_len>3</max_len>
                      </element>
                    </segment>
<!--End of PRV segment-->
                    <segment xid="N3">
                      <name>Service Facility Address</name>
                      <usage>R</usage>
                      <pos>265</pos>
                      <max_use>1</max_use>
                      <element xid="N301">
                        <data_ele>166</data_ele>
                        <name>Laboratory or Facility Address Line</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>55</max_len>
                      </element>
                      <element xid="N302">
                        <data_ele>166</data_ele>
                        <name>Laboratory or Facility Address Line</name>
                        <usage>S</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>55</max_len>
                      </element>
                    </segment>
<!--End of N3 segment-->
                    <segment xid="N4">
                      <name>Service Facility City/State/Zip Code</name>
                      <usage>R</usage>
                      <pos>270</pos>
                      <max_use>1</max_use>
                      <element xid="N401">
                        <data_ele>19</data_ele>
                        <name>Laboratory or Facility City Name</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>AN</data_type>
                        <min_len>2</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="N402">
                        <data_ele>156</data_ele>
                        <name>Laboratory or Facility State or Province Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                        <valid_codes external="states"/>
                      </element>
                      <element xid="N403">
                        <data_ele>116</data_ele>
                        <name>Laboratory or Facility Postal Zone or Zip Code</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>3</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="N404">
                        <data_ele>26</data_ele>
                        <name>Laboratory/Facility Country Code</name>
                        <usage>S</usage>
                        <seq>04</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes external="country"/>
                      </element>
                      <element xid="N405">
                        <data_ele>309</data_ele>
                        <name>Location Qualifier</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="N406">
                        <data_ele>310</data_ele>
                        <name>Location Identifier</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                    </segment>
<!--End of N4 segment-->
                    <segment xid="REF">
                      <name>Service Facility Secondary Identification</name>
                      <usage>S</usage>
                      <pos>271</pos>
                      <max_use>5</max_use>
                      <element xid="REF01">
                        <data_ele>128</data_ele>
                        <name>Reference Identification Qualifier</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>0B</code>
                          <code>1A</code>
                          <code>1B</code>
                          <code>1C</code>
                          <code>1D</code>
                          <code>1G</code>
                          <code>1H</code>
                          <code>1J</code>
                          <code>EI</code>
                          <code>FH</code>
                          <code>G2</code>
                          <code>G5</code>
                          <code>LU</code>
                          <code>N5</code>
                          <code>X5</code>
                        </valid_codes>
                      </element>
                      <element xid="REF02">
                        <data_ele>127</data_ele>
                        <name>Laboratory or Facility Secondary Identifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="REF03">
                        <data_ele>352</data_ele>
                        <name>Description</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>80</max_len>
                      </element>
                      <composite>
                        <data_ele>C040</data_ele>
                        <name>Reference Identifier</name>
                        <usage>N</usage>
                        <seq>04</seq>
                      </composite>
                    </segment>
<!--End of REF segment-->
                  </loop>
<!--End of 2310E loop-->
                  <loop xid="2320">
                    <name>Other Subscriber Information</name>
                    <usage>S</usage>
                    <pos>290</pos>
                    <repeat>10</repeat>
                    <segment xid="SBR">
                      <name>Other Subscriber Information</name>
                      <usage>R</usage>
                      <pos>290</pos>
                      <max_use>1</max_use>
                      <element xid="SBR01">
                        <data_ele>1138</data_ele>
                        <name>Payer Responsibility Sequence Number Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                        <valid_codes>
                          <code>P</code>
                          <code>S</code>
                          <code>T</code>
                        </valid_codes>
                      </element>
                      <element xid="SBR02">
                        <data_ele>1069</data_ele>
                        <name>Individual Relationship Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>01</code>
                          <code>04</code>
                          <code>05</code>
                          <code>07</code>
                          <code>10</code>
                          <code>15</code>
                          <code>17</code>
                          <code>18</code>
                          <code>19</code>
                          <code>20</code>
                          <code>21</code>
                          <code>22</code>
                          <code>23</code>
                          <code>24</code>
                          <code>29</code>
                          <code>32</code>
                          <code>33</code>
                          <code>36</code>
                          <code>39</code>
                          <code>40</code>
                          <code>41</code>
                          <code>43</code>
                          <code>53</code>
                          <code>G8</code>
                        </valid_codes>
                      </element>
                      <element xid="SBR03">
                        <data_ele>127</data_ele>
                        <name>Insured Group or Policy Number</name>
                        <usage>S</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="SBR04">
                        <data_ele>93</data_ele>
                        <name>Other Insured Group Name</name>
                        <usage>S</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>60</max_len>
                      </element>
                      <element xid="SBR05">
                        <data_ele>1336</data_ele>
                        <name>Insurance Type Code</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="SBR06">
                        <data_ele>1143</data_ele>
                        <name>Coordination of Benefits Code</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                      </element>
                      <element xid="SBR07">
                        <data_ele>1073</data_ele>
                        <name>Condition or Response Code</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                      </element>
                      <element xid="SBR08">
                        <data_ele>584</data_ele>
                        <name>Employment Status Code</name>
                        <usage>N</usage>
                        <seq>08</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="SBR09">
                        <data_ele>1032</data_ele>
                        <name>Claim Filing Indicator Code</name>
                        <usage>S</usage>
                        <seq>09</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>09</code>
                          <code>10</code>
                          <code>11</code>
                          <code>12</code>
                          <code>13</code>
                          <code>14</code>
                          <code>15</code>
                          <code>16</code>
                          <code>AM</code>
                          <code>BL</code>
                          <code>CH</code>
                          <code>CI</code>
                          <code>DS</code>
                          <code>HM</code>
                          <code>LI</code>
                          <code>LM</code>
                          <code>MA</code>
                          <code>MB</code>
                          <code>MC</code>
                          <code>OF</code>
                          <code>TV</code>
                          <code>VA</code>
                          <code>WC</code>
                          <code>ZZ</code>
                        </valid_codes>
                      </element>
                    </segment>
<!--End of SBR segment-->
                    <segment xid="CAS">
                      <name>Claim Level Adjustment</name>
                      <usage>S</usage>
                      <pos>295</pos>
                      <max_use>5</max_use>
                      <element xid="CAS01">
                        <data_ele>1033</data_ele>
                        <name>Claim Adjustment Group Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>CO</code>
                          <code>CR</code>
                          <code>OA</code>
                          <code>PI</code>
                          <code>PR</code>
                        </valid_codes>
                      </element>
                      <element xid="CAS02">
                        <data_ele>1034</data_ele>
                        <name>Adjustment Reason Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>5</max_len>
                        <valid_codes>
                          <code>1</code>
                          <code>2</code>
                          <code>3</code>
                          <code>4</code>
                          <code>5</code>
                          <code>6</code>
                          <code>7</code>
                          <code>8</code>
                          <code>9</code>
                          <code>10</code>
                          <code>11</code>
                          <code>12</code>
                          <code>13</code>
                          <code>14</code>
                          <code>15</code>
                          <code>16</code>
                          <code>17</code>
                          <code>18</code>
                          <code>19</code>
                          <code>20</code>
                          <code>21</code>
                          <code>22</code>
                          <code>23</code>
                          <code>24</code>
                          <code>25</code>
                          <code>26</code>
                          <code>27</code>
                          <code>28</code>
                          <code>29</code>
                          <code>30</code>
                          <code>31</code>
                          <code>32</code>
                          <code>33</code>
                          <code>34</code>
                          <code>35</code>
                          <code>36</code>
                          <code>37</code>
                          <code>38</code>
                          <code>39</code>
                          <code>40</code>
                          <code>41</code>
                          <code>42</code>
                          <code>43</code>
                          <code>44</code>
                          <code>45</code>
                          <code>46</code>
                          <code>47</code>
                          <code>48</code>
                          <code>49</code>
                          <code>50</code>
                          <code>51</code>
                          <code>52</code>
                          <code>53</code>
                          <code>54</code>
                          <code>55</code>
                          <code>56</code>
                          <code>57</code>
                          <code>58</code>
                          <code>59</code>
                          <code>60</code>
                          <code>61</code>
                          <code>62</code>
                          <code>63</code>
                          <code>64</code>
                          <code>65</code>
                          <code>66</code>
                          <code>67</code>
                          <code>68</code>
                          <code>69</code>
                          <code>70</code>
                          <code>71</code>
                          <code>72</code>
                          <code>73</code>
                          <code>74</code>
                          <code>75</code>
                          <code>76</code>
                          <code>77</code>
                          <code>78</code>
                          <code>79</code>
                          <code>80</code>
                          <code>81</code>
                          <code>82</code>
                          <code>83</code>
                          <code>84</code>
                          <code>85</code>
                          <code>86</code>
                          <code>87</code>
                          <code>88</code>
                          <code>89</code>
                          <code>90</code>
                          <code>91</code>
                          <code>92</code>
                          <code>93</code>
                          <code>94</code>
                          <code>95</code>
                          <code>96</code>
                          <code>97</code>
                          <code>98</code>
                          <code>99</code>
                          <code>100</code>
                          <code>101</code>
                          <code>102</code>
                          <code>103</code>
                          <code>104</code>
                          <code>105</code>
                          <code>106</code>
                          <code>107</code>
                          <code>108</code>
                          <code>109</code>
                          <code>110</code>
                          <code>111</code>
                          <code>112</code>
                          <code>113</code>
                          <code>114</code>
                          <code>115</code>
                          <code>116</code>
                          <code>117</code>
                          <code>118</code>
                          <code>119</code>
                          <code>120</code>
                          <code>121</code>
                          <code>122</code>
                          <code>123</code>
                          <code>124</code>
                          <code>125</code>
                          <code>126</code>
                          <code>127</code>
                          <code>128</code>
                          <code>129</code>
                          <code>130</code>
                          <code>131</code>
                          <code>132</code>
                          <code>133</code>
                          <code>134</code>
                          <code>135</code>
                          <code>136</code>
                          <code>137</code>
                          <code>138</code>
                          <code>139</code>
                          <code>140</code>
                          <code>141</code>
                          <code>142</code>
                          <code>143</code>
                          <code>144</code>
                          <code>145</code>
                          <code>146</code>
                          <code>147</code>
                          <code>148</code>
                          <code>149</code>
                          <code>150</code>
                          <code>151</code>
                          <code>152</code>
                          <code>153</code>
                          <code>154</code>
                          <code>A0</code>
                          <code>A1</code>
                          <code>A2</code>
                          <code>A3</code>
                          <code>A4</code>
                          <code>A5</code>
                          <code>A6</code>
                          <code>A7</code>
                          <code>A8</code>
                          <code>B1</code>
                          <code>B2</code>
                          <code>B3</code>
                          <code>B4</code>
                          <code>B5</code>
                          <code>B6</code>
                          <code>B7</code>
                          <code>B8</code>
                          <code>B9</code>
                          <code>B10</code>
                          <code>B11</code>
                          <code>B12</code>
                          <code>B13</code>
                          <code>B14</code>
                          <code>B15</code>
                          <code>B16</code>
                          <code>B17</code>
                          <code>B18</code>
                          <code>B19</code>
                          <code>B20</code>
                          <code>B21</code>
                          <code>B22</code>
                          <code>B23</code>
                          <code>D1</code>
                          <code>D2</code>
                          <code>D3</code>
                          <code>D4</code>
                          <code>D5</code>
                          <code>D6</code>
                          <code>D7</code>
                          <code>D8</code>
                          <code>D9</code>
                          <code>D10</code>
                          <code>D11</code>
                          <code>D12</code>
                          <code>D13</code>
                          <code>D14</code>
                          <code>D15</code>
                          <code>W1</code>
                        </valid_codes>
                      </element>
                      <element xid="CAS03">
                        <data_ele>782</data_ele>
                        <name>Adjustment Amount</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="CAS04">
                        <data_ele>380</data_ele>
                        <name>Adjustment Quantity</name>
                        <usage>S</usage>
                        <seq>04</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="CAS05">
                        <data_ele>1034</data_ele>
                        <name>Adjustment Reason Code</name>
                        <usage>S</usage>
                        <seq>05</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>5</max_len>
                        <valid_codes>
                          <code>1</code>
                          <code>2</code>
                          <code>3</code>
                          <code>4</code>
                          <code>5</code>
                          <code>6</code>
                          <code>7</code>
                          <code>8</code>
                          <code>9</code>
                          <code>10</code>
                          <code>11</code>
                          <code>12</code>
                          <code>13</code>
                          <code>14</code>
                          <code>15</code>
                          <code>16</code>
                          <code>17</code>
                          <code>18</code>
                          <code>19</code>
                          <code>20</code>
                          <code>21</code>
                          <code>22</code>
                          <code>23</code>
                          <code>24</code>
                          <code>25</code>
                          <code>26</code>
                          <code>27</code>
                          <code>28</code>
                          <code>29</code>
                          <code>30</code>
                          <code>31</code>
                          <code>32</code>
                          <code>33</code>
                          <code>34</code>
                          <code>35</code>
                          <code>36</code>
                          <code>37</code>
                          <code>38</code>
                          <code>39</code>
                          <code>40</code>
                          <code>41</code>
                          <code>42</code>
                          <code>43</code>
                          <code>44</code>
                          <code>45</code>
                          <code>46</code>
                          <code>47</code>
                          <code>48</code>
                          <code>49</code>
                          <code>50</code>
                          <code>51</code>
                          <code>52</code>
                          <code>53</code>
                          <code>54</code>
                          <code>55</code>
                          <code>56</code>
                          <code>57</code>
                          <code>58</code>
                          <code>59</code>
                          <code>60</code>
                          <code>61</code>
                          <code>62</code>
                          <code>63</code>
                          <code>64</code>
                          <code>65</code>
                          <code>66</code>
                          <code>67</code>
                          <code>68</code>
                          <code>69</code>
                          <code>70</code>
                          <code>71</code>
                          <code>72</code>
                          <code>73</code>
                          <code>74</code>
                          <code>75</code>
                          <code>76</code>
                          <code>77</code>
                          <code>78</code>
                          <code>79</code>
                          <code>80</code>
                          <code>81</code>
                          <code>82</code>
                          <code>83</code>
                          <code>84</code>
                          <code>85</code>
                          <code>86</code>
                          <code>87</code>
                          <code>88</code>
                          <code>89</code>
                          <code>90</code>
                          <code>91</code>
                          <code>92</code>
                          <code>93</code>
                          <code>94</code>
                          <code>95</code>
                          <code>96</code>
                          <code>97</code>
                          <code>98</code>
                          <code>99</code>
                          <code>100</code>
                          <code>101</code>
                          <code>102</code>
                          <code>103</code>
                          <code>104</code>
                          <code>105</code>
                          <code>106</code>
                          <code>107</code>
                          <code>108</code>
                          <code>109</code>
                          <code>110</code>
                          <code>111</code>
                          <code>112</code>
                          <code>113</code>
                          <code>114</code>
                          <code>115</code>
                          <code>116</code>
                          <code>117</code>
                          <code>118</code>
                          <code>119</code>
                          <code>120</code>
                          <code>121</code>
                          <code>122</code>
                          <code>123</code>
                          <code>124</code>
                          <code>125</code>
                          <code>126</code>
                          <code>127</code>
                          <code>128</code>
                          <code>129</code>
                          <code>130</code>
                          <code>131</code>
                          <code>132</code>
                          <code>133</code>
                          <code>134</code>
                          <code>135</code>
                          <code>136</code>
                          <code>137</code>
                          <code>138</code>
                          <code>139</code>
                          <code>140</code>
                          <code>141</code>
                          <code>142</code>
                          <code>143</code>
                          <code>144</code>
                          <code>145</code>
                          <code>146</code>
                          <code>147</code>
                          <code>148</code>
                          <code>149</code>
                          <code>150</code>
                          <code>151</code>
                          <code>152</code>
                          <code>153</code>
                          <code>154</code>
                          <code>A0</code>
                          <code>A1</code>
                          <code>A2</code>
                          <code>A3</code>
                          <code>A4</code>
                          <code>A5</code>
                          <code>A6</code>
                          <code>A7</code>
                          <code>A8</code>
                          <code>B1</code>
                          <code>B2</code>
                          <code>B3</code>
                          <code>B4</code>
                          <code>B5</code>
                          <code>B6</code>
                          <code>B7</code>
                          <code>B8</code>
                          <code>B9</code>
                          <code>B10</code>
                          <code>B11</code>
                          <code>B12</code>
                          <code>B13</code>
                          <code>B14</code>
                          <code>B15</code>
                          <code>B16</code>
                          <code>B17</code>
                          <code>B18</code>
                          <code>B19</code>
                          <code>B20</code>
                          <code>B21</code>
                          <code>B22</code>
                          <code>B23</code>
                          <code>D1</code>
                          <code>D2</code>
                          <code>D3</code>
                          <code>D4</code>
                          <code>D5</code>
                          <code>D6</code>
                          <code>D7</code>
                          <code>D8</code>
                          <code>D9</code>
                          <code>D10</code>
                          <code>D11</code>
                          <code>D12</code>
                          <code>D13</code>
                          <code>D14</code>
                          <code>D15</code>
                          <code>W1</code>
                        </valid_codes>
                      </element>
                      <element xid="CAS06">
                        <data_ele>782</data_ele>
                        <name>Adjustment Amount</name>
                        <usage>S</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="CAS07">
                        <data_ele>380</data_ele>
                        <name>Adjustment Quantity</name>
                        <usage>S</usage>
                        <seq>07</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="CAS08">
                        <data_ele>1034</data_ele>
                        <name>Adjustment Reason Code</name>
                        <usage>S</usage>
                        <seq>08</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>5</max_len>
                        <valid_codes>
                          <code>1</code>
                          <code>2</code>
                          <code>3</code>
                          <code>4</code>
                          <code>5</code>
                          <code>6</code>
                          <code>7</code>
                          <code>8</code>
                          <code>9</code>
                          <code>10</code>
                          <code>11</code>
                          <code>12</code>
                          <code>13</code>
                          <code>14</code>
                          <code>15</code>
                          <code>16</code>
                          <code>17</code>
                          <code>18</code>
                          <code>19</code>
                          <code>20</code>
                          <code>21</code>
                          <code>22</code>
                          <code>23</code>
                          <code>24</code>
                          <code>25</code>
                          <code>26</code>
                          <code>27</code>
                          <code>28</code>
                          <code>29</code>
                          <code>30</code>
                          <code>31</code>
                          <code>32</code>
                          <code>33</code>
                          <code>34</code>
                          <code>35</code>
                          <code>36</code>
                          <code>37</code>
                          <code>38</code>
                          <code>39</code>
                          <code>40</code>
                          <code>41</code>
                          <code>42</code>
                          <code>43</code>
                          <code>44</code>
                          <code>45</code>
                          <code>46</code>
                          <code>47</code>
                          <code>48</code>
                          <code>49</code>
                          <code>50</code>
                          <code>51</code>
                          <code>52</code>
                          <code>53</code>
                          <code>54</code>
                          <code>55</code>
                          <code>56</code>
                          <code>57</code>
                          <code>58</code>
                          <code>59</code>
                          <code>60</code>
                          <code>61</code>
                          <code>62</code>
                          <code>63</code>
                          <code>64</code>
                          <code>65</code>
                          <code>66</code>
                          <code>67</code>
                          <code>68</code>
                          <code>69</code>
                          <code>70</code>
                          <code>71</code>
                          <code>72</code>
                          <code>73</code>
                          <code>74</code>
                          <code>75</code>
                          <code>76</code>
                          <code>77</code>
                          <code>78</code>
                          <code>79</code>
                          <code>80</code>
                          <code>81</code>
                          <code>82</code>
                          <code>83</code>
                          <code>84</code>
                          <code>85</code>
                          <code>86</code>
                          <code>87</code>
                          <code>88</code>
                          <code>89</code>
                          <code>90</code>
                          <code>91</code>
                          <code>92</code>
                          <code>93</code>
                          <code>94</code>
                          <code>95</code>
                          <code>96</code>
                          <code>97</code>
                          <code>98</code>
                          <code>99</code>
                          <code>100</code>
                          <code>101</code>
                          <code>102</code>
                          <code>103</code>
                          <code>104</code>
                          <code>105</code>
                          <code>106</code>
                          <code>107</code>
                          <code>108</code>
                          <code>109</code>
                          <code>110</code>
                          <code>111</code>
                          <code>112</code>
                          <code>113</code>
                          <code>114</code>
                          <code>115</code>
                          <code>116</code>
                          <code>117</code>
                          <code>118</code>
                          <code>119</code>
                          <code>120</code>
                          <code>121</code>
                          <code>122</code>
                          <code>123</code>
                          <code>124</code>
                          <code>125</code>
                          <code>126</code>
                          <code>127</code>
                          <code>128</code>
                          <code>129</code>
                          <code>130</code>
                          <code>131</code>
                          <code>132</code>
                          <code>133</code>
                          <code>134</code>
                          <code>135</code>
                          <code>136</code>
                          <code>137</code>
                          <code>138</code>
                          <code>139</code>
                          <code>140</code>
                          <code>141</code>
                          <code>142</code>
                          <code>143</code>
                          <code>144</code>
                          <code>145</code>
                          <code>146</code>
                          <code>147</code>
                          <code>148</code>
                          <code>149</code>
                          <code>150</code>
                          <code>151</code>
                          <code>152</code>
                          <code>153</code>
                          <code>154</code>
                          <code>A0</code>
                          <code>A1</code>
                          <code>A2</code>
                          <code>A3</code>
                          <code>A4</code>
                          <code>A5</code>
                          <code>A6</code>
                          <code>A7</code>
                          <code>A8</code>
                          <code>B1</code>
                          <code>B2</code>
                          <code>B3</code>
                          <code>B4</code>
                          <code>B5</code>
                          <code>B6</code>
                          <code>B7</code>
                          <code>B8</code>
                          <code>B9</code>
                          <code>B10</code>
                          <code>B11</code>
                          <code>B12</code>
                          <code>B13</code>
                          <code>B14</code>
                          <code>B15</code>
                          <code>B16</code>
                          <code>B17</code>
                          <code>B18</code>
                          <code>B19</code>
                          <code>B20</code>
                          <code>B21</code>
                          <code>B22</code>
                          <code>B23</code>
                          <code>D1</code>
                          <code>D2</code>
                          <code>D3</code>
                          <code>D4</code>
                          <code>D5</code>
                          <code>D6</code>
                          <code>D7</code>
                          <code>D8</code>
                          <code>D9</code>
                          <code>D10</code>
                          <code>D11</code>
                          <code>D12</code>
                          <code>D13</code>
                          <code>D14</code>
                          <code>D15</code>
                          <code>W1</code>
                        </valid_codes>
                      </element>
                      <element xid="CAS09">
                        <data_ele>782</data_ele>
                        <name>Adjustment Amount</name>
                        <usage>S</usage>
                        <seq>09</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="CAS10">
                        <data_ele>380</data_ele>
                        <name>Adjustment Quantity</name>
                        <usage>S</usage>
                        <seq>10</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="CAS11">
                        <data_ele>1034</data_ele>
                        <name>Adjustment Reason Code</name>
                        <usage>S</usage>
                        <seq>11</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>5</max_len>
                        <valid_codes>
                          <code>1</code>
                          <code>2</code>
                          <code>3</code>
                          <code>4</code>
                          <code>5</code>
                          <code>6</code>
                          <code>7</code>
                          <code>8</code>
                          <code>9</code>
                          <code>10</code>
                          <code>11</code>
                          <code>12</code>
                          <code>13</code>
                          <code>14</code>
                          <code>15</code>
                          <code>16</code>
                          <code>17</code>
                          <code>18</code>
                          <code>19</code>
                          <code>20</code>
                          <code>21</code>
                          <code>22</code>
                          <code>23</code>
                          <code>24</code>
                          <code>25</code>
                          <code>26</code>
                          <code>27</code>
                          <code>28</code>
                          <code>29</code>
                          <code>30</code>
                          <code>31</code>
                          <code>32</code>
                          <code>33</code>
                          <code>34</code>
                          <code>35</code>
                          <code>36</code>
                          <code>37</code>
                          <code>38</code>
                          <code>39</code>
                          <code>40</code>
                          <code>41</code>
                          <code>42</code>
                          <code>43</code>
                          <code>44</code>
                          <code>45</code>
                          <code>46</code>
                          <code>47</code>
                          <code>48</code>
                          <code>49</code>
                          <code>50</code>
                          <code>51</code>
                          <code>52</code>
                          <code>53</code>
                          <code>54</code>
                          <code>55</code>
                          <code>56</code>
                          <code>57</code>
                          <code>58</code>
                          <code>59</code>
                          <code>60</code>
                          <code>61</code>
                          <code>62</code>
                          <code>63</code>
                          <code>64</code>
                          <code>65</code>
                          <code>66</code>
                          <code>67</code>
                          <code>68</code>
                          <code>69</code>
                          <code>70</code>
                          <code>71</code>
                          <code>72</code>
                          <code>73</code>
                          <code>74</code>
                          <code>75</code>
                          <code>76</code>
                          <code>77</code>
                          <code>78</code>
                          <code>79</code>
                          <code>80</code>
                          <code>81</code>
                          <code>82</code>
                          <code>83</code>
                          <code>84</code>
                          <code>85</code>
                          <code>86</code>
                          <code>87</code>
                          <code>88</code>
                          <code>89</code>
                          <code>90</code>
                          <code>91</code>
                          <code>92</code>
                          <code>93</code>
                          <code>94</code>
                          <code>95</code>
                          <code>96</code>
                          <code>97</code>
                          <code>98</code>
                          <code>99</code>
                          <code>100</code>
                          <code>101</code>
                          <code>102</code>
                          <code>103</code>
                          <code>104</code>
                          <code>105</code>
                          <code>106</code>
                          <code>107</code>
                          <code>108</code>
                          <code>109</code>
                          <code>110</code>
                          <code>111</code>
                          <code>112</code>
                          <code>113</code>
                          <code>114</code>
                          <code>115</code>
                          <code>116</code>
                          <code>117</code>
                          <code>118</code>
                          <code>119</code>
                          <code>120</code>
                          <code>121</code>
                          <code>122</code>
                          <code>123</code>
                          <code>124</code>
                          <code>125</code>
                          <code>126</code>
                          <code>127</code>
                          <code>128</code>
                          <code>129</code>
                          <code>130</code>
                          <code>131</code>
                          <code>132</code>
                          <code>133</code>
                          <code>134</code>
                          <code>135</code>
                          <code>136</code>
                          <code>137</code>
                          <code>138</code>
                          <code>139</code>
                          <code>140</code>
                          <code>141</code>
                          <code>142</code>
                          <code>143</code>
                          <code>144</code>
                          <code>145</code>
                          <code>146</code>
                          <code>147</code>
                          <code>148</code>
                          <code>149</code>
                          <code>150</code>
                          <code>151</code>
                          <code>152</code>
                          <code>153</code>
                          <code>154</code>
                          <code>A0</code>
                          <code>A1</code>
                          <code>A2</code>
                          <code>A3</code>
                          <code>A4</code>
                          <code>A5</code>
                          <code>A6</code>
                          <code>A7</code>
                          <code>A8</code>
                          <code>B1</code>
                          <code>B2</code>
                          <code>B3</code>
                          <code>B4</code>
                          <code>B5</code>
                          <code>B6</code>
                          <code>B7</code>
                          <code>B8</code>
                          <code>B9</code>
                          <code>B10</code>
                          <code>B11</code>
                          <code>B12</code>
                          <code>B13</code>
                          <code>B14</code>
                          <code>B15</code>
                          <code>B16</code>
                          <code>B17</code>
                          <code>B18</code>
                          <code>B19</code>
                          <code>B20</code>
                          <code>B21</code>
                          <code>B22</code>
                          <code>B23</code>
                          <code>D1</code>
                          <code>D2</code>
                          <code>D3</code>
                          <code>D4</code>
                          <code>D5</code>
                          <code>D6</code>
                          <code>D7</code>
                          <code>D8</code>
                          <code>D9</code>
                          <code>D10</code>
                          <code>D11</code>
                          <code>D12</code>
                          <code>D13</code>
                          <code>D14</code>
                          <code>D15</code>
                          <code>W1</code>
                        </valid_codes>
                      </element>
                      <element xid="CAS12">
                        <data_ele>782</data_ele>
                        <name>Adjustment Amount</name>
                        <usage>S</usage>
                        <seq>12</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="CAS13">
                        <data_ele>380</data_ele>
                        <name>Adjustment Quantity</name>
                        <usage>S</usage>
                        <seq>13</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="CAS14">
                        <data_ele>1034</data_ele>
                        <name>Adjustment Reason Code</name>
                        <usage>S</usage>
                        <seq>14</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>5</max_len>
                        <valid_codes>
                          <code>1</code>
                          <code>2</code>
                          <code>3</code>
                          <code>4</code>
                          <code>5</code>
                          <code>6</code>
                          <code>7</code>
                          <code>8</code>
                          <code>9</code>
                          <code>10</code>
                          <code>11</code>
                          <code>12</code>
                          <code>13</code>
                          <code>14</code>
                          <code>15</code>
                          <code>16</code>
                          <code>17</code>
                          <code>18</code>
                          <code>19</code>
                          <code>20</code>
                          <code>21</code>
                          <code>22</code>
                          <code>23</code>
                          <code>24</code>
                          <code>25</code>
                          <code>26</code>
                          <code>27</code>
                          <code>28</code>
                          <code>29</code>
                          <code>30</code>
                          <code>31</code>
                          <code>32</code>
                          <code>33</code>
                          <code>34</code>
                          <code>35</code>
                          <code>36</code>
                          <code>37</code>
                          <code>38</code>
                          <code>39</code>
                          <code>40</code>
                          <code>41</code>
                          <code>42</code>
                          <code>43</code>
                          <code>44</code>
                          <code>45</code>
                          <code>46</code>
                          <code>47</code>
                          <code>48</code>
                          <code>49</code>
                          <code>50</code>
                          <code>51</code>
                          <code>52</code>
                          <code>53</code>
                          <code>54</code>
                          <code>55</code>
                          <code>56</code>
                          <code>57</code>
                          <code>58</code>
                          <code>59</code>
                          <code>60</code>
                          <code>61</code>
                          <code>62</code>
                          <code>63</code>
                          <code>64</code>
                          <code>65</code>
                          <code>66</code>
                          <code>67</code>
                          <code>68</code>
                          <code>69</code>
                          <code>70</code>
                          <code>71</code>
                          <code>72</code>
                          <code>73</code>
                          <code>74</code>
                          <code>75</code>
                          <code>76</code>
                          <code>77</code>
                          <code>78</code>
                          <code>79</code>
                          <code>80</code>
                          <code>81</code>
                          <code>82</code>
                          <code>83</code>
                          <code>84</code>
                          <code>85</code>
                          <code>86</code>
                          <code>87</code>
                          <code>88</code>
                          <code>89</code>
                          <code>90</code>
                          <code>91</code>
                          <code>92</code>
                          <code>93</code>
                          <code>94</code>
                          <code>95</code>
                          <code>96</code>
                          <code>97</code>
                          <code>98</code>
                          <code>99</code>
                          <code>100</code>
                          <code>101</code>
                          <code>102</code>
                          <code>103</code>
                          <code>104</code>
                          <code>105</code>
                          <code>106</code>
                          <code>107</code>
                          <code>108</code>
                          <code>109</code>
                          <code>110</code>
                          <code>111</code>
                          <code>112</code>
                          <code>113</code>
                          <code>114</code>
                          <code>115</code>
                          <code>116</code>
                          <code>117</code>
                          <code>118</code>
                          <code>119</code>
                          <code>120</code>
                          <code>121</code>
                          <code>122</code>
                          <code>123</code>
                          <code>124</code>
                          <code>125</code>
                          <code>126</code>
                          <code>127</code>
                          <code>128</code>
                          <code>129</code>
                          <code>130</code>
                          <code>131</code>
                          <code>132</code>
                          <code>133</code>
                          <code>134</code>
                          <code>135</code>
                          <code>136</code>
                          <code>137</code>
                          <code>138</code>
                          <code>139</code>
                          <code>140</code>
                          <code>141</code>
                          <code>142</code>
                          <code>143</code>
                          <code>144</code>
                          <code>145</code>
                          <code>146</code>
                          <code>147</code>
                          <code>148</code>
                          <code>149</code>
                          <code>150</code>
                          <code>151</code>
                          <code>152</code>
                          <code>153</code>
                          <code>154</code>
                          <code>A0</code>
                          <code>A1</code>
                          <code>A2</code>
                          <code>A3</code>
                          <code>A4</code>
                          <code>A5</code>
                          <code>A6</code>
                          <code>A7</code>
                          <code>A8</code>
                          <code>B1</code>
                          <code>B2</code>
                          <code>B3</code>
                          <code>B4</code>
                          <code>B5</code>
                          <code>B6</code>
                          <code>B7</code>
                          <code>B8</code>
                          <code>B9</code>
                          <code>B10</code>
                          <code>B11</code>
                          <code>B12</code>
                          <code>B13</code>
                          <code>B14</code>
                          <code>B15</code>
                          <code>B16</code>
                          <code>B17</code>
                          <code>B18</code>
                          <code>B19</code>
                          <code>B20</code>
                          <code>B21</code>
                          <code>B22</code>
                          <code>B23</code>
                          <code>D1</code>
                          <code>D2</code>
                          <code>D3</code>
                          <code>D4</code>
                          <code>D5</code>
                          <code>D6</code>
                          <code>D7</code>
                          <code>D8</code>
                          <code>D9</code>
                          <code>D10</code>
                          <code>D11</code>
                          <code>D12</code>
                          <code>D13</code>
                          <code>D14</code>
                          <code>D15</code>
                          <code>W1</code>
                        </valid_codes>
                      </element>
                      <element xid="CAS15">
                        <data_ele>782</data_ele>
                        <name>Adjustment Amount</name>
                        <usage>S</usage>
                        <seq>15</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="CAS16">
                        <data_ele>380</data_ele>
                        <name>Adjustment Quantity</name>
                        <usage>S</usage>
                        <seq>16</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="CAS17">
                        <data_ele>1034</data_ele>
                        <name>Adjustment Reason Code</name>
                        <usage>S</usage>
                        <seq>17</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>5</max_len>
                        <valid_codes>
                          <code>1</code>
                          <code>2</code>
                          <code>3</code>
                          <code>4</code>
                          <code>5</code>
                          <code>6</code>
                          <code>7</code>
                          <code>8</code>
                          <code>9</code>
                          <code>10</code>
                          <code>11</code>
                          <code>12</code>
                          <code>13</code>
                          <code>14</code>
                          <code>15</code>
                          <code>16</code>
                          <code>17</code>
                          <code>18</code>
                          <code>19</code>
                          <code>20</code>
                          <code>21</code>
                          <code>22</code>
                          <code>23</code>
                          <code>24</code>
                          <code>25</code>
                          <code>26</code>
                          <code>27</code>
                          <code>28</code>
                          <code>29</code>
                          <code>30</code>
                          <code>31</code>
                          <code>32</code>
                          <code>33</code>
                          <code>34</code>
                          <code>35</code>
                          <code>36</code>
                          <code>37</code>
                          <code>38</code>
                          <code>39</code>
                          <code>40</code>
                          <code>41</code>
                          <code>42</code>
                          <code>43</code>
                          <code>44</code>
                          <code>45</code>
                          <code>46</code>
                          <code>47</code>
                          <code>48</code>
                          <code>49</code>
                          <code>50</code>
                          <code>51</code>
                          <code>52</code>
                          <code>53</code>
                          <code>54</code>
                          <code>55</code>
                          <code>56</code>
                          <code>57</code>
                          <code>58</code>
                          <code>59</code>
                          <code>60</code>
                          <code>61</code>
                          <code>62</code>
                          <code>63</code>
                          <code>64</code>
                          <code>65</code>
                          <code>66</code>
                          <code>67</code>
                          <code>68</code>
                          <code>69</code>
                          <code>70</code>
                          <code>71</code>
                          <code>72</code>
                          <code>73</code>
                          <code>74</code>
                          <code>75</code>
                          <code>76</code>
                          <code>77</code>
                          <code>78</code>
                          <code>79</code>
                          <code>80</code>
                          <code>81</code>
                          <code>82</code>
                          <code>83</code>
                          <code>84</code>
                          <code>85</code>
                          <code>86</code>
                          <code>87</code>
                          <code>88</code>
                          <code>89</code>
                          <code>90</code>
                          <code>91</code>
                          <code>92</code>
                          <code>93</code>
                          <code>94</code>
                          <code>95</code>
                          <code>96</code>
                          <code>97</code>
                          <code>98</code>
                          <code>99</code>
                          <code>100</code>
                          <code>101</code>
                          <code>102</code>
                          <code>103</code>
                          <code>104</code>
                          <code>105</code>
                          <code>106</code>
                          <code>107</code>
                          <code>108</code>
                          <code>109</code>
                          <code>110</code>
                          <code>111</code>
                          <code>112</code>
                          <code>113</code>
                          <code>114</code>
                          <code>115</code>
                          <code>116</code>
                          <code>117</code>
                          <code>118</code>
                          <code>119</code>
                          <code>120</code>
                          <code>121</code>
                          <code>122</code>
                          <code>123</code>
                          <code>124</code>
                          <code>125</code>
                          <code>126</code>
                          <code>127</code>
                          <code>128</code>
                          <code>129</code>
                          <code>130</code>
                          <code>131</code>
                          <code>132</code>
                          <code>133</code>
                          <code>134</code>
                          <code>135</code>
                          <code>136</code>
                          <code>137</code>
                          <code>138</code>
                          <code>139</code>
                          <code>140</code>
                          <code>141</code>
                          <code>142</code>
                          <code>143</code>
                          <code>144</code>
                          <code>145</code>
                          <code>146</code>
                          <code>147</code>
                          <code>148</code>
                          <code>149</code>
                          <code>150</code>
                          <code>151</code>
                          <code>152</code>
                          <code>153</code>
                          <code>154</code>
                          <code>A0</code>
                          <code>A1</code>
                          <code>A2</code>
                          <code>A3</code>
                          <code>A4</code>
                          <code>A5</code>
                          <code>A6</code>
                          <code>A7</code>
                          <code>A8</code>
                          <code>B1</code>
                          <code>B2</code>
                          <code>B3</code>
                          <code>B4</code>
                          <code>B5</code>
                          <code>B6</code>
                          <code>B7</code>
                          <code>B8</code>
                          <code>B9</code>
                          <code>B10</code>
                          <code>B11</code>
                          <code>B12</code>
                          <code>B13</code>
                          <code>B14</code>
                          <code>B15</code>
                          <code>B16</code>
                          <code>B17</code>
                          <code>B18</code>
                          <code>B19</code>
                          <code>B20</code>
                          <code>B21</code>
                          <code>B22</code>
                          <code>B23</code>
                          <code>D1</code>
                          <code>D2</code>
                          <code>D3</code>
                          <code>D4</code>
                          <code>D5</code>
                          <code>D6</code>
                          <code>D7</code>
                          <code>D8</code>
                          <code>D9</code>
                          <code>D10</code>
                          <code>D11</code>
                          <code>D12</code>
                          <code>D13</code>
                          <code>D14</code>
                          <code>D15</code>
                          <code>W1</code>
                        </valid_codes>
                      </element>
                      <element xid="CAS18">
                        <data_ele>782</data_ele>
                        <name>Adjustment Amount</name>
                        <usage>S</usage>
                        <seq>18</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="CAS19">
                        <data_ele>380</data_ele>
                        <name>Adjustment Quantity</name>
                        <usage>S</usage>
                        <seq>19</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                    </segment>
<!--End of CAS segment-->
                    <segment xid="AMT">
                      <name>Payer Prior Payment</name>
                      <usage>S</usage>
                      <pos>300</pos>
                      <max_use>1</max_use>
                      <element xid="AMT01">
                        <data_ele>522</data_ele>
                        <name>Amount Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>C4</code>
                        </valid_codes>
                      </element>
                      <element xid="AMT02">
                        <data_ele>782</data_ele>
                        <name>Other Payer Patient Paid Amount</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="AMT03">
                        <data_ele>478</data_ele>
                        <name>Credit/Debit Flag Code</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                      </element>
                    </segment>
<!--End of AMT segment-->
                    <segment xid="AMT">
                      <name>Coordination of Benefits (COB) Total Allowed Amount</name>
                      <usage>S</usage>
                      <pos>300</pos>
                      <max_use>1</max_use>
                      <element xid="AMT01">
                        <data_ele>522</data_ele>
                        <name>Amount Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>B6</code>
                        </valid_codes>
                      </element>
                      <element xid="AMT02">
                        <data_ele>782</data_ele>
                        <name>Allowed Amount</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="AMT03">
                        <data_ele>478</data_ele>
                        <name>Credit/Debit Flag Code</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                      </element>
                    </segment>
<!--End of AMT segment-->
                    <segment xid="AMT">
                      <name>Coordination of Benefits (COB) Total Submitted Charges</name>
                      <usage>S</usage>
                      <pos>300</pos>
                      <max_use>1</max_use>
                      <element xid="AMT01">
                        <data_ele>522</data_ele>
                        <name>Amount Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>T3</code>
                        </valid_codes>
                      </element>
                      <element xid="AMT02">
                        <data_ele>782</data_ele>
                        <name>Coordination of Benefits Total Submitted Charge Amount</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="AMT03">
                        <data_ele>478</data_ele>
                        <name>Credit/Debit Flag Code</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                      </element>
                    </segment>
<!--End of AMT segment-->
                    <segment xid="AMT">
                      <name>Diagnostic Related Group (DRG) Outlier Amount</name>
                      <usage>S</usage>
                      <pos>300</pos>
                      <max_use>1</max_use>
                      <element xid="AMT01">
                        <data_ele>522</data_ele>
                        <name>Amount Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>ZZ</code>
                        </valid_codes>
                      </element>
                      <element xid="AMT02">
                        <data_ele>782</data_ele>
                        <name>Claim DRG Outlier Amount</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="AMT03">
                        <data_ele>478</data_ele>
                        <name>Credit/Debit Flag Code</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                      </element>
                    </segment>
<!--End of AMT segment-->
                    <segment xid="AMT">
                      <name>Coordination of Benefits (COB) Total Medicare Paid Amount</name>
                      <usage>S</usage>
                      <pos>300</pos>
                      <max_use>1</max_use>
                      <element xid="AMT01">
                        <data_ele>522</data_ele>
                        <name>Amount Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>N1</code>
                        </valid_codes>
                      </element>
                      <element xid="AMT02">
                        <data_ele>782</data_ele>
                        <name>Total Medicare Paid Amount</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="AMT03">
                        <data_ele>478</data_ele>
                        <name>Credit/Debit Flag Code</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                      </element>
                    </segment>
<!--End of AMT segment-->
                    <segment xid="AMT">
                      <name>Medicare Paid Amount - 100%</name>
                      <usage>S</usage>
                      <pos>300</pos>
                      <max_use>1</max_use>
                      <element xid="AMT01">
                        <data_ele>522</data_ele>
                        <name>Amount Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>KF</code>
                        </valid_codes>
                      </element>
                      <element xid="AMT02">
                        <data_ele>782</data_ele>
                        <name>Medicare Paid at 100% Amount</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="AMT03">
                        <data_ele>478</data_ele>
                        <name>Credit/Debit Flag Code</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                      </element>
                    </segment>
<!--End of AMT segment-->
                    <segment xid="AMT">
                      <name>Medicare Paid Amount - 80%</name>
                      <usage>S</usage>
                      <pos>300</pos>
                      <max_use>1</max_use>
                      <element xid="AMT01">
                        <data_ele>522</data_ele>
                        <name>Amount Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>PG</code>
                        </valid_codes>
                      </element>
                      <element xid="AMT02">
                        <data_ele>782</data_ele>
                        <name>Medicare Paid at 80% Amount</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="AMT03">
                        <data_ele>478</data_ele>
                        <name>Credit/Debit Flag Code</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                      </element>
                    </segment>
<!--End of AMT segment-->
                    <segment xid="AMT">
                      <name>Coordination of Benefits (COB) Medicare A Trust Fund Paid Amount</name>
                      <usage>S</usage>
                      <pos>300</pos>
                      <max_use>1</max_use>
                      <element xid="AMT01">
                        <data_ele>522</data_ele>
                        <name>Amount Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>AA</code>
                        </valid_codes>
                      </element>
                      <element xid="AMT02">
                        <data_ele>782</data_ele>
                        <name>Paid From Part A Medicare Trust Fund Amount</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="AMT03">
                        <data_ele>478</data_ele>
                        <name>Credit/Debit Flag Code</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                      </element>
                    </segment>
<!--End of AMT segment-->
                    <segment xid="AMT">
                      <name>Coordination of Benefits (COB) Medicare B Trust Fund Paid Amount</name>
                      <usage>S</usage>
                      <pos>300</pos>
                      <max_use>1</max_use>
                      <element xid="AMT01">
                        <data_ele>522</data_ele>
                        <name>Amount Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>B1</code>
                        </valid_codes>
                      </element>
                      <element xid="AMT02">
                        <data_ele>782</data_ele>
                        <name>Paid From Part B Medicare Trust Fund Amount</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="AMT03">
                        <data_ele>478</data_ele>
                        <name>Credit/Debit Flag Code</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                      </element>
                    </segment>
<!--End of AMT segment-->
                    <segment xid="AMT">
                      <name>Coordination of Benefits (COB) Total Non-Covered Amount</name>
                      <usage>S</usage>
                      <pos>300</pos>
                      <max_use>1</max_use>
                      <element xid="AMT01">
                        <data_ele>522</data_ele>
                        <name>Amount Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>A8</code>
                        </valid_codes>
                      </element>
                      <element xid="AMT02">
                        <data_ele>782</data_ele>
                        <name>Non-Covered Charge Amount</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="AMT03">
                        <data_ele>478</data_ele>
                        <name>Credit/Debit Flag Code</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                      </element>
                    </segment>
<!--End of AMT segment-->
                    <segment xid="AMT">
                      <name>Coordination of Benefits (COB) Total Denied Amount</name>
                      <usage>S</usage>
                      <pos>300</pos>
                      <max_use>1</max_use>
                      <element xid="AMT01">
                        <data_ele>522</data_ele>
                        <name>Amount Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>YT</code>
                        </valid_codes>
                      </element>
                      <element xid="AMT02">
                        <data_ele>782</data_ele>
                        <name>Claim Total Denied Charge Amount</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="AMT03">
                        <data_ele>478</data_ele>
                        <name>Credit/Debit Flag Code</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                      </element>
                    </segment>
<!--End of AMT segment-->
                    <segment xid="DMG">
                      <name>Other Subscriber Demographic Information</name>
                      <usage>S</usage>
                      <pos>305</pos>
                      <max_use>1</max_use>
                      <element xid="DMG01">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>D8</code>
                        </valid_codes>
                      </element>
                      <element xid="DMG02">
                        <data_ele>1251</data_ele>
                        <name>Other Insured Birth Date</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                      <element xid="DMG03">
                        <data_ele>1068</data_ele>
                        <name>Other Insured Gender Code</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                        <valid_codes>
                          <code>F</code>
                          <code>M</code>
                          <code>U</code>
                        </valid_codes>
                      </element>
                      <element xid="DMG04">
                        <data_ele>1067</data_ele>
                        <name>Marital Status Code</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                      </element>
                      <element xid="DMG05">
                        <data_ele>1109</data_ele>
                        <name>nicity Code</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                      </element>
                      <element xid="DMG06">
                        <data_ele>1066</data_ele>
                        <name>Citizenship Status Code</name>
                        <usage>N</usage>
                        <seq>06</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="DMG07">
                        <data_ele>26</data_ele>
                        <name>Country Code</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes external="country"/>
                      </element>
                      <element xid="DMG08">
                        <data_ele>659</data_ele>
                        <name>Basis of Verification Code</name>
                        <usage>N</usage>
                        <seq>08</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="DMG09">
                        <data_ele>380</data_ele>
                        <name>Quantity</name>
                        <usage>N</usage>
                        <seq>09</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                    </segment>
<!--End of DMG segment-->
                    <segment xid="OI">
                      <name>Other Insurance Coverage Information</name>
                      <usage>R</usage>
                      <pos>310</pos>
                      <max_use>1</max_use>
                      <element xid="OI01">
                        <data_ele>1032</data_ele>
                        <name>Claim Filing Indicator Code</name>
                        <usage>N</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="OI02">
                        <data_ele>1383</data_ele>
                        <name>Claim Submission Reason Code</name>
                        <usage>N</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="OI03">
                        <data_ele>1073</data_ele>
                        <name>Benefits Assignment Certification Indicator</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                        <valid_codes>
                          <code>N</code>
                          <code>Y</code>
                        </valid_codes>
                      </element>
                      <element xid="OI04">
                        <data_ele>1351</data_ele>
                        <name>Patient Signature Source Code</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                      </element>
                      <element xid="OI05">
                        <data_ele>1360</data_ele>
                        <name>Provider Agreement Code</name>
                        <usage>N</usage>
                        <seq>05</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                      </element>
                      <element xid="OI06">
                        <data_ele>1363</data_ele>
                        <name>Release of Information Code</name>
                        <usage>R</usage>
                        <seq>06</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                        <valid_codes>
                          <code>A</code>
                          <code>I</code>
                          <code>M</code>
                          <code>N</code>
                          <code>O</code>
                          <code>Y</code>
                        </valid_codes>
                      </element>
                    </segment>
<!--End of OI segment-->
                    <segment xid="MIA">
                      <name>Medicare Inpatient Adjudication Information</name>
                      <usage>S</usage>
                      <pos>315</pos>
                      <max_use>1</max_use>
                      <element xid="MIA01">
                        <data_ele>380</data_ele>
                        <name>Covered Days or Visits Count</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="MIA02">
                        <data_ele>380</data_ele>
                        <name>Lifetime Reserve Days Count</name>
                        <usage>S</usage>
                        <seq>02</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="MIA03">
                        <data_ele>380</data_ele>
                        <name>Lifetime Psychiatric Days Count</name>
                        <usage>S</usage>
                        <seq>03</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="MIA04">
                        <data_ele>782</data_ele>
                        <name>Claim DRG Amount</name>
                        <usage>S</usage>
                        <seq>04</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="MIA05">
                        <data_ele>127</data_ele>
                        <name>Remark Code</name>
                        <usage>S</usage>
                        <seq>05</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                        <valid_codes>
                          <code>M1</code>
                          <code>M2</code>
                          <code>M3</code>
                          <code>M4</code>
                          <code>M5</code>
                          <code>M6</code>
                          <code>M7</code>
                          <code>M8</code>
                          <code>M9</code>
                          <code>M10</code>
                          <code>M11</code>
                          <code>M12</code>
                          <code>M13</code>
                          <code>M14</code>
                          <code>M15</code>
                          <code>M16</code>
                          <code>M17</code>
                          <code>M18</code>
                          <code>M19</code>
                          <code>M20</code>
                          <code>M21</code>
                          <code>M22</code>
                          <code>M23</code>
                          <code>M24</code>
                          <code>M25</code>
                          <code>M26</code>
                          <code>M27</code>
                          <code>M28</code>
                          <code>M29</code>
                          <code>M30</code>
                          <code>M31</code>
                          <code>M32</code>
                          <code>M33</code>
                          <code>M34</code>
                          <code>M35</code>
                          <code>M36</code>
                          <code>M37</code>
                          <code>M38</code>
                          <code>M39</code>
                          <code>M40</code>
                          <code>M41</code>
                          <code>M42</code>
                          <code>M43</code>
                          <code>M44</code>
                          <code>M45</code>
                          <code>M46</code>
                          <code>M47</code>
                          <code>M48</code>
                          <code>M49</code>
                          <code>M50</code>
                          <code>M51</code>
                          <code>M52</code>
                          <code>M53</code>
                          <code>M54</code>
                          <code>M55</code>
                          <code>M56</code>
                          <code>M57</code>
                          <code>M58</code>
                          <code>M59</code>
                          <code>M60</code>
                          <code>M61</code>
                          <code>M62</code>
                          <code>M63</code>
                          <code>M64</code>
                          <code>M65</code>
                          <code>M66</code>
                          <code>M67</code>
                          <code>M68</code>
                          <code>M69</code>
                          <code>M70</code>
                          <code>M71</code>
                          <code>M72</code>
                          <code>M73</code>
                          <code>M74</code>
                          <code>M75</code>
                          <code>M76</code>
                          <code>M77</code>
                          <code>M78</code>
                          <code>M79</code>
                          <code>M80</code>
                          <code>M81</code>
                          <code>M82</code>
                          <code>M83</code>
                          <code>M84</code>
                          <code>M85</code>
                          <code>M86</code>
                          <code>M87</code>
                          <code>M88</code>
                          <code>M89</code>
                          <code>M90</code>
                          <code>M91</code>
                          <code>M92</code>
                          <code>M93</code>
                          <code>M94</code>
                          <code>M95</code>
                          <code>M96</code>
                          <code>M97</code>
                          <code>M98</code>
                          <code>M99</code>
                          <code>M100</code>
                          <code>M101</code>
                          <code>M102</code>
                          <code>M103</code>
                          <code>M104</code>
                          <code>M105</code>
                          <code>M106</code>
                          <code>M107</code>
                          <code>M108</code>
                          <code>M109</code>
                          <code>M110</code>
                          <code>M111</code>
                          <code>M112</code>
                          <code>M113</code>
                          <code>M114</code>
                          <code>M115</code>
                          <code>M116</code>
                          <code>M117</code>
                          <code>M118</code>
                          <code>M119</code>
                          <code>M120</code>
                          <code>M121</code>
                          <code>M122</code>
                          <code>M123</code>
                          <code>M124</code>
                          <code>M125</code>
                          <code>M126</code>
                          <code>M127</code>
                          <code>M128</code>
                          <code>M129</code>
                          <code>M130</code>
                          <code>M131</code>
                          <code>M132</code>
                          <code>M133</code>
                          <code>M134</code>
                          <code>M135</code>
                          <code>M136</code>
                          <code>M137</code>
                          <code>M138</code>
                          <code>M139</code>
                          <code>M140</code>
                          <code>M141</code>
                          <code>M142</code>
                          <code>M143</code>
                          <code>M144</code>
                          <code>MA01</code>
                          <code>MA02</code>
                          <code>MA03</code>
                          <code>MA04</code>
                          <code>MA05</code>
                          <code>MA06</code>
                          <code>MA07</code>
                          <code>MA08</code>
                          <code>MA09</code>
                          <code>MA10</code>
                          <code>MA11</code>
                          <code>MA12</code>
                          <code>MA13</code>
                          <code>MA14</code>
                          <code>MA15</code>
                          <code>MA16</code>
                          <code>MA17</code>
                          <code>MA18</code>
                          <code>MA19</code>
                          <code>MA20</code>
                          <code>MA21</code>
                          <code>MA22</code>
                          <code>MA23</code>
                          <code>MA24</code>
                          <code>MA25</code>
                          <code>MA26</code>
                          <code>MA27</code>
                          <code>MA28</code>
                          <code>MA29</code>
                          <code>MA30</code>
                          <code>MA31</code>
                          <code>MA32</code>
                          <code>MA33</code>
                          <code>MA34</code>
                          <code>MA35</code>
                          <code>MA36</code>
                          <code>MA37</code>
                          <code>MA38</code>
                          <code>MA39</code>
                          <code>MA40</code>
                          <code>MA41</code>
                          <code>MA42</code>
                          <code>MA43</code>
                          <code>MA44</code>
                          <code>MA45</code>
                          <code>MA46</code>
                          <code>MA47</code>
                          <code>MA48</code>
                          <code>MA49</code>
                          <code>MA50</code>
                          <code>MA51</code>
                          <code>MA52</code>
                          <code>MA53</code>
                          <code>MA54</code>
                          <code>MA55</code>
                          <code>MA56</code>
                          <code>MA57</code>
                          <code>MA58</code>
                          <code>MA59</code>
                          <code>MA60</code>
                          <code>MA61</code>
                          <code>MA62</code>
                          <code>MA63</code>
                          <code>MA64</code>
                          <code>MA65</code>
                          <code>MA66</code>
                          <code>MA67</code>
                          <code>MA68</code>
                          <code>MA69</code>
                          <code>MA70</code>
                          <code>MA71</code>
                          <code>MA72</code>
                          <code>MA73</code>
                          <code>MA74</code>
                          <code>MA75</code>
                          <code>MA76</code>
                          <code>MA77</code>
                          <code>MA78</code>
                          <code>MA79</code>
                          <code>MA80</code>
                          <code>MA81</code>
                          <code>MA82</code>
                          <code>MA83</code>
                          <code>MA84</code>
                          <code>MA85</code>
                          <code>MA86</code>
                          <code>MA87</code>
                          <code>MA88</code>
                          <code>MA89</code>
                          <code>MA90</code>
                          <code>MA91</code>
                          <code>MA92</code>
                          <code>MA93</code>
                          <code>MA94</code>
                          <code>MA95</code>
                          <code>MA96</code>
                          <code>MA97</code>
                          <code>MA98</code>
                          <code>MA99</code>
                          <code>MA100</code>
                          <code>MA101</code>
                          <code>MA102</code>
                          <code>MA103</code>
                          <code>MA104</code>
                          <code>MA105</code>
                          <code>MA106</code>
                          <code>MA107</code>
                          <code>MA108</code>
                          <code>MA109</code>
                          <code>MA110</code>
                          <code>MA111</code>
                          <code>MA112</code>
                          <code>MA113</code>
                          <code>MA114</code>
                          <code>MA115</code>
                          <code>MA116</code>
                          <code>MA117</code>
                          <code>MA118</code>
                          <code>MA119</code>
                          <code>MA120</code>
                          <code>MA121</code>
                          <code>MA122</code>
                          <code>MA123</code>
                          <code>MA124</code>
                          <code>MA125</code>
                          <code>MA126</code>
                          <code>MA127</code>
                          <code>MA128</code>
                          <code>MA129</code>
                          <code>MA130</code>
                          <code>MA131</code>
                          <code>MA132</code>
                          <code>MA133</code>
                          <code>MA134</code>
                          <code>N1</code>
                          <code>N2</code>
                          <code>N3</code>
                          <code>N4</code>
                          <code>N5</code>
                          <code>N6</code>
                          <code>N7</code>
                          <code>N8</code>
                          <code>N9</code>
                          <code>N10</code>
                          <code>N11</code>
                          <code>N12</code>
                          <code>N13</code>
                          <code>N14</code>
                          <code>N15</code>
                          <code>N16</code>
                          <code>N17</code>
                          <code>N18</code>
                          <code>N19</code>
                          <code>N20</code>
                          <code>N21</code>
                          <code>N22</code>
                          <code>N23</code>
                          <code>N24</code>
                          <code>N25</code>
                          <code>N26</code>
                          <code>N27</code>
                          <code>N28</code>
                          <code>N29</code>
                          <code>N30</code>
                          <code>N31</code>
                          <code>N32</code>
                          <code>N33</code>
                          <code>N34</code>
                          <code>N35</code>
                          <code>N36</code>
                          <code>N37</code>
                          <code>N38</code>
                          <code>N39</code>
                          <code>N40</code>
                          <code>N41</code>
                          <code>N42</code>
                          <code>N43</code>
                          <code>N44</code>
                          <code>N45</code>
                          <code>N46</code>
                          <code>N47</code>
                          <code>N48</code>
                          <code>N49</code>
                          <code>N50</code>
                          <code>N51</code>
                          <code>N52</code>
                          <code>N53</code>
                          <code>N54</code>
                          <code>N55</code>
                          <code>N56</code>
                          <code>N57</code>
                          <code>N58</code>
                          <code>N59</code>
                          <code>N60</code>
                          <code>N61</code>
                          <code>N62</code>
                          <code>N63</code>
                          <code>N64</code>
                          <code>N65</code>
                          <code>N66</code>
                          <code>N67</code>
                          <code>N68</code>
                          <code>N69</code>
                          <code>N70</code>
                          <code>N71</code>
                          <code>N72</code>
                          <code>N73</code>
                          <code>N74</code>
                          <code>N75</code>
                          <code>N76</code>
                          <code>N77</code>
                          <code>N78</code>
                          <code>N79</code>
                          <code>N80</code>
                          <code>N81</code>
                          <code>N82</code>
                          <code>N83</code>
                          <code>N84</code>
                          <code>N85</code>
                          <code>N86</code>
                          <code>N87</code>
                          <code>N88</code>
                          <code>N89</code>
                          <code>N90</code>
                          <code>N91</code>
                          <code>N92</code>
                          <code>N93</code>
                          <code>N94</code>
                          <code>N95</code>
                          <code>N96</code>
                          <code>N97</code>
                          <code>N98</code>
                          <code>N99</code>
                          <code>N100</code>
                          <code>N101</code>
                          <code>N102</code>
                          <code>N103</code>
                          <code>N104</code>
                          <code>N105</code>
                          <code>N106</code>
                          <code>N107</code>
                          <code>N108</code>
                          <code>N109</code>
                          <code>N110</code>
                          <code>N111</code>
                          <code>N112</code>
                          <code>N113</code>
                          <code>N114</code>
                          <code>N115</code>
                          <code>N116</code>
                          <code>N117</code>
                          <code>N118</code>
                          <code>N119</code>
                          <code>N120</code>
                          <code>N121</code>
                          <code>N122</code>
                          <code>N123</code>
                          <code>N124</code>
                          <code>N125</code>
                          <code>N126</code>
                          <code>N127</code>
                          <code>N128</code>
                          <code>N129</code>
                          <code>N130</code>
                          <code>N131</code>
                          <code>N132</code>
                          <code>N133</code>
                          <code>N134</code>
                          <code>N135</code>
                          <code>N136</code>
                          <code>N137</code>
                          <code>N138</code>
                          <code>N139</code>
                          <code>N140</code>
                          <code>N141</code>
                          <code>N142</code>
                          <code>N143</code>
                          <code>N144</code>
                          <code>N145</code>
                          <code>N146</code>
                          <code>N147</code>
                          <code>N148</code>
                          <code>N149</code>
                          <code>N150</code>
                          <code>N151</code>
                          <code>N152</code>
                          <code>N153</code>
                          <code>N154</code>
                          <code>N155</code>
                          <code>N156 </code>
                        </valid_codes>
                      </element>
                      <element xid="MIA06">
                        <data_ele>782</data_ele>
                        <name>Claim Disproportionate Share Amount</name>
                        <usage>S</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="MIA07">
                        <data_ele>782</data_ele>
                        <name>Claim MSP Pass-through Amount</name>
                        <usage>S</usage>
                        <seq>07</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="MIA08">
                        <data_ele>782</data_ele>
                        <name>Claim PPS Capital Amount</name>
                        <usage>S</usage>
                        <seq>08</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="MIA09">
                        <data_ele>782</data_ele>
                        <name>PPS-Capital FSP DRG Amount</name>
                        <usage>S</usage>
                        <seq>09</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="MIA10">
                        <data_ele>782</data_ele>
                        <name>PPS-Capital HSP DRG Amount</name>
                        <usage>S</usage>
                        <seq>10</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="MIA11">
                        <data_ele>782</data_ele>
                        <name>PPS-Capital DSH DRG Amount</name>
                        <usage>S</usage>
                        <seq>11</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="MIA12">
                        <data_ele>782</data_ele>
                        <name>Old Capital Amount</name>
                        <usage>S</usage>
                        <seq>12</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="MIA13">
                        <data_ele>782</data_ele>
                        <name>PPS-Capital IME Amount</name>
                        <usage>S</usage>
                        <seq>13</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="MIA14">
                        <data_ele>782</data_ele>
                        <name>PPS-Operating Hospital Specific DRG Amount</name>
                        <usage>S</usage>
                        <seq>14</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="MIA15">
                        <data_ele>380</data_ele>
                        <name>Cost Report Day Count</name>
                        <usage>S</usage>
                        <seq>15</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="MIA16">
                        <data_ele>782</data_ele>
                        <name>PPS-Operating Federal Specific DRG Amount</name>
                        <usage>S</usage>
                        <seq>16</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="MIA17">
                        <data_ele>782</data_ele>
                        <name>Claim PPS Capital Outlier Amount</name>
                        <usage>S</usage>
                        <seq>17</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="MIA18">
                        <data_ele>782</data_ele>
                        <name>Claim Indirect Teaching Amount</name>
                        <usage>S</usage>
                        <seq>18</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="MIA19">
                        <data_ele>782</data_ele>
                        <name>Nonpayable Professional Component Amount</name>
                        <usage>S</usage>
                        <seq>19</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="MIA20">
                        <data_ele>127</data_ele>
                        <name>Remark Code</name>
                        <usage>S</usage>
                        <seq>20</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                        <valid_codes>
                          <code>M1</code>
                          <code>M2</code>
                          <code>M3</code>
                          <code>M4</code>
                          <code>M5</code>
                          <code>M6</code>
                          <code>M7</code>
                          <code>M8</code>
                          <code>M9</code>
                          <code>M10</code>
                          <code>M11</code>
                          <code>M12</code>
                          <code>M13</code>
                          <code>M14</code>
                          <code>M15</code>
                          <code>M16</code>
                          <code>M17</code>
                          <code>M18</code>
                          <code>M19</code>
                          <code>M20</code>
                          <code>M21</code>
                          <code>M22</code>
                          <code>M23</code>
                          <code>M24</code>
                          <code>M25</code>
                          <code>M26</code>
                          <code>M27</code>
                          <code>M28</code>
                          <code>M29</code>
                          <code>M30</code>
                          <code>M31</code>
                          <code>M32</code>
                          <code>M33</code>
                          <code>M34</code>
                          <code>M35</code>
                          <code>M36</code>
                          <code>M37</code>
                          <code>M38</code>
                          <code>M39</code>
                          <code>M40</code>
                          <code>M41</code>
                          <code>M42</code>
                          <code>M43</code>
                          <code>M44</code>
                          <code>M45</code>
                          <code>M46</code>
                          <code>M47</code>
                          <code>M48</code>
                          <code>M49</code>
                          <code>M50</code>
                          <code>M51</code>
                          <code>M52</code>
                          <code>M53</code>
                          <code>M54</code>
                          <code>M55</code>
                          <code>M56</code>
                          <code>M57</code>
                          <code>M58</code>
                          <code>M59</code>
                          <code>M60</code>
                          <code>M61</code>
                          <code>M62</code>
                          <code>M63</code>
                          <code>M64</code>
                          <code>M65</code>
                          <code>M66</code>
                          <code>M67</code>
                          <code>M68</code>
                          <code>M69</code>
                          <code>M70</code>
                          <code>M71</code>
                          <code>M72</code>
                          <code>M73</code>
                          <code>M74</code>
                          <code>M75</code>
                          <code>M76</code>
                          <code>M77</code>
                          <code>M78</code>
                          <code>M79</code>
                          <code>M80</code>
                          <code>M81</code>
                          <code>M82</code>
                          <code>M83</code>
                          <code>M84</code>
                          <code>M85</code>
                          <code>M86</code>
                          <code>M87</code>
                          <code>M88</code>
                          <code>M89</code>
                          <code>M90</code>
                          <code>M91</code>
                          <code>M92</code>
                          <code>M93</code>
                          <code>M94</code>
                          <code>M95</code>
                          <code>M96</code>
                          <code>M97</code>
                          <code>M98</code>
                          <code>M99</code>
                          <code>M100</code>
                          <code>M101</code>
                          <code>M102</code>
                          <code>M103</code>
                          <code>M104</code>
                          <code>M105</code>
                          <code>M106</code>
                          <code>M107</code>
                          <code>M108</code>
                          <code>M109</code>
                          <code>M110</code>
                          <code>M111</code>
                          <code>M112</code>
                          <code>M113</code>
                          <code>M114</code>
                          <code>M115</code>
                          <code>M116</code>
                          <code>M117</code>
                          <code>M118</code>
                          <code>M119</code>
                          <code>M120</code>
                          <code>M121</code>
                          <code>M122</code>
                          <code>M123</code>
                          <code>M124</code>
                          <code>M125</code>
                          <code>M126</code>
                          <code>M127</code>
                          <code>M128</code>
                          <code>M129</code>
                          <code>M130</code>
                          <code>M131</code>
                          <code>M132</code>
                          <code>M133</code>
                          <code>M134</code>
                          <code>M135</code>
                          <code>M136</code>
                          <code>M137</code>
                          <code>M138</code>
                          <code>M139</code>
                          <code>M140</code>
                          <code>M141</code>
                          <code>M142</code>
                          <code>M143</code>
                          <code>M144</code>
                          <code>MA01</code>
                          <code>MA02</code>
                          <code>MA03</code>
                          <code>MA04</code>
                          <code>MA05</code>
                          <code>MA06</code>
                          <code>MA07</code>
                          <code>MA08</code>
                          <code>MA09</code>
                          <code>MA10</code>
                          <code>MA11</code>
                          <code>MA12</code>
                          <code>MA13</code>
                          <code>MA14</code>
                          <code>MA15</code>
                          <code>MA16</code>
                          <code>MA17</code>
                          <code>MA18</code>
                          <code>MA19</code>
                          <code>MA20</code>
                          <code>MA21</code>
                          <code>MA22</code>
                          <code>MA23</code>
                          <code>MA24</code>
                          <code>MA25</code>
                          <code>MA26</code>
                          <code>MA27</code>
                          <code>MA28</code>
                          <code>MA29</code>
                          <code>MA30</code>
                          <code>MA31</code>
                          <code>MA32</code>
                          <code>MA33</code>
                          <code>MA34</code>
                          <code>MA35</code>
                          <code>MA36</code>
                          <code>MA37</code>
                          <code>MA38</code>
                          <code>MA39</code>
                          <code>MA40</code>
                          <code>MA41</code>
                          <code>MA42</code>
                          <code>MA43</code>
                          <code>MA44</code>
                          <code>MA45</code>
                          <code>MA46</code>
                          <code>MA47</code>
                          <code>MA48</code>
                          <code>MA49</code>
                          <code>MA50</code>
                          <code>MA51</code>
                          <code>MA52</code>
                          <code>MA53</code>
                          <code>MA54</code>
                          <code>MA55</code>
                          <code>MA56</code>
                          <code>MA57</code>
                          <code>MA58</code>
                          <code>MA59</code>
                          <code>MA60</code>
                          <code>MA61</code>
                          <code>MA62</code>
                          <code>MA63</code>
                          <code>MA64</code>
                          <code>MA65</code>
                          <code>MA66</code>
                          <code>MA67</code>
                          <code>MA68</code>
                          <code>MA69</code>
                          <code>MA70</code>
                          <code>MA71</code>
                          <code>MA72</code>
                          <code>MA73</code>
                          <code>MA74</code>
                          <code>MA75</code>
                          <code>MA76</code>
                          <code>MA77</code>
                          <code>MA78</code>
                          <code>MA79</code>
                          <code>MA80</code>
                          <code>MA81</code>
                          <code>MA82</code>
                          <code>MA83</code>
                          <code>MA84</code>
                          <code>MA85</code>
                          <code>MA86</code>
                          <code>MA87</code>
                          <code>MA88</code>
                          <code>MA89</code>
                          <code>MA90</code>
                          <code>MA91</code>
                          <code>MA92</code>
                          <code>MA93</code>
                          <code>MA94</code>
                          <code>MA95</code>
                          <code>MA96</code>
                          <code>MA97</code>
                          <code>MA98</code>
                          <code>MA99</code>
                          <code>MA100</code>
                          <code>MA101</code>
                          <code>MA102</code>
                          <code>MA103</code>
                          <code>MA104</code>
                          <code>MA105</code>
                          <code>MA106</code>
                          <code>MA107</code>
                          <code>MA108</code>
                          <code>MA109</code>
                          <code>MA110</code>
                          <code>MA111</code>
                          <code>MA112</code>
                          <code>MA113</code>
                          <code>MA114</code>
                          <code>MA115</code>
                          <code>MA116</code>
                          <code>MA117</code>
                          <code>MA118</code>
                          <code>MA119</code>
                          <code>MA120</code>
                          <code>MA121</code>
                          <code>MA122</code>
                          <code>MA123</code>
                          <code>MA124</code>
                          <code>MA125</code>
                          <code>MA126</code>
                          <code>MA127</code>
                          <code>MA128</code>
                          <code>MA129</code>
                          <code>MA130</code>
                          <code>MA131</code>
                          <code>MA132</code>
                          <code>MA133</code>
                          <code>MA134</code>
                          <code>N1</code>
                          <code>N2</code>
                          <code>N3</code>
                          <code>N4</code>
                          <code>N5</code>
                          <code>N6</code>
                          <code>N7</code>
                          <code>N8</code>
                          <code>N9</code>
                          <code>N10</code>
                          <code>N11</code>
                          <code>N12</code>
                          <code>N13</code>
                          <code>N14</code>
                          <code>N15</code>
                          <code>N16</code>
                          <code>N17</code>
                          <code>N18</code>
                          <code>N19</code>
                          <code>N20</code>
                          <code>N21</code>
                          <code>N22</code>
                          <code>N23</code>
                          <code>N24</code>
                          <code>N25</code>
                          <code>N26</code>
                          <code>N27</code>
                          <code>N28</code>
                          <code>N29</code>
                          <code>N30</code>
                          <code>N31</code>
                          <code>N32</code>
                          <code>N33</code>
                          <code>N34</code>
                          <code>N35</code>
                          <code>N36</code>
                          <code>N37</code>
                          <code>N38</code>
                          <code>N39</code>
                          <code>N40</code>
                          <code>N41</code>
                          <code>N42</code>
                          <code>N43</code>
                          <code>N44</code>
                          <code>N45</code>
                          <code>N46</code>
                          <code>N47</code>
                          <code>N48</code>
                          <code>N49</code>
                          <code>N50</code>
                          <code>N51</code>
                          <code>N52</code>
                          <code>N53</code>
                          <code>N54</code>
                          <code>N55</code>
                          <code>N56</code>
                          <code>N57</code>
                          <code>N58</code>
                          <code>N59</code>
                          <code>N60</code>
                          <code>N61</code>
                          <code>N62</code>
                          <code>N63</code>
                          <code>N64</code>
                          <code>N65</code>
                          <code>N66</code>
                          <code>N67</code>
                          <code>N68</code>
                          <code>N69</code>
                          <code>N70</code>
                          <code>N71</code>
                          <code>N72</code>
                          <code>N73</code>
                          <code>N74</code>
                          <code>N75</code>
                          <code>N76</code>
                          <code>N77</code>
                          <code>N78</code>
                          <code>N79</code>
                          <code>N80</code>
                          <code>N81</code>
                          <code>N82</code>
                          <code>N83</code>
                          <code>N84</code>
                          <code>N85</code>
                          <code>N86</code>
                          <code>N87</code>
                          <code>N88</code>
                          <code>N89</code>
                          <code>N90</code>
                          <code>N91</code>
                          <code>N92</code>
                          <code>N93</code>
                          <code>N94</code>
                          <code>N95</code>
                          <code>N96</code>
                          <code>N97</code>
                          <code>N98</code>
                          <code>N99</code>
                          <code>N100</code>
                          <code>N101</code>
                          <code>N102</code>
                          <code>N103</code>
                          <code>N104</code>
                          <code>N105</code>
                          <code>N106</code>
                          <code>N107</code>
                          <code>N108</code>
                          <code>N109</code>
                          <code>N110</code>
                          <code>N111</code>
                          <code>N112</code>
                          <code>N113</code>
                          <code>N114</code>
                          <code>N115</code>
                          <code>N116</code>
                          <code>N117</code>
                          <code>N118</code>
                          <code>N119</code>
                          <code>N120</code>
                          <code>N121</code>
                          <code>N122</code>
                          <code>N123</code>
                          <code>N124</code>
                          <code>N125</code>
                          <code>N126</code>
                          <code>N127</code>
                          <code>N128</code>
                          <code>N129</code>
                          <code>N130</code>
                          <code>N131</code>
                          <code>N132</code>
                          <code>N133</code>
                          <code>N134</code>
                          <code>N135</code>
                          <code>N136</code>
                          <code>N137</code>
                          <code>N138</code>
                          <code>N139</code>
                          <code>N140</code>
                          <code>N141</code>
                          <code>N142</code>
                          <code>N143</code>
                          <code>N144</code>
                          <code>N145</code>
                          <code>N146</code>
                          <code>N147</code>
                          <code>N148</code>
                          <code>N149</code>
                          <code>N150</code>
                          <code>N151</code>
                          <code>N152</code>
                          <code>N153</code>
                          <code>N154</code>
                          <code>N155</code>
                          <code>N156 </code>
                        </valid_codes>
                      </element>
                      <element xid="MIA21">
                        <data_ele>127</data_ele>
                        <name>Remark Code</name>
                        <usage>S</usage>
                        <seq>21</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                        <valid_codes>
                          <code>M1</code>
                          <code>M2</code>
                          <code>M3</code>
                          <code>M4</code>
                          <code>M5</code>
                          <code>M6</code>
                          <code>M7</code>
                          <code>M8</code>
                          <code>M9</code>
                          <code>M10</code>
                          <code>M11</code>
                          <code>M12</code>
                          <code>M13</code>
                          <code>M14</code>
                          <code>M15</code>
                          <code>M16</code>
                          <code>M17</code>
                          <code>M18</code>
                          <code>M19</code>
                          <code>M20</code>
                          <code>M21</code>
                          <code>M22</code>
                          <code>M23</code>
                          <code>M24</code>
                          <code>M25</code>
                          <code>M26</code>
                          <code>M27</code>
                          <code>M28</code>
                          <code>M29</code>
                          <code>M30</code>
                          <code>M31</code>
                          <code>M32</code>
                          <code>M33</code>
                          <code>M34</code>
                          <code>M35</code>
                          <code>M36</code>
                          <code>M37</code>
                          <code>M38</code>
                          <code>M39</code>
                          <code>M40</code>
                          <code>M41</code>
                          <code>M42</code>
                          <code>M43</code>
                          <code>M44</code>
                          <code>M45</code>
                          <code>M46</code>
                          <code>M47</code>
                          <code>M48</code>
                          <code>M49</code>
                          <code>M50</code>
                          <code>M51</code>
                          <code>M52</code>
                          <code>M53</code>
                          <code>M54</code>
                          <code>M55</code>
                          <code>M56</code>
                          <code>M57</code>
                          <code>M58</code>
                          <code>M59</code>
                          <code>M60</code>
                          <code>M61</code>
                          <code>M62</code>
                          <code>M63</code>
                          <code>M64</code>
                          <code>M65</code>
                          <code>M66</code>
                          <code>M67</code>
                          <code>M68</code>
                          <code>M69</code>
                          <code>M70</code>
                          <code>M71</code>
                          <code>M72</code>
                          <code>M73</code>
                          <code>M74</code>
                          <code>M75</code>
                          <code>M76</code>
                          <code>M77</code>
                          <code>M78</code>
                          <code>M79</code>
                          <code>M80</code>
                          <code>M81</code>
                          <code>M82</code>
                          <code>M83</code>
                          <code>M84</code>
                          <code>M85</code>
                          <code>M86</code>
                          <code>M87</code>
                          <code>M88</code>
                          <code>M89</code>
                          <code>M90</code>
                          <code>M91</code>
                          <code>M92</code>
                          <code>M93</code>
                          <code>M94</code>
                          <code>M95</code>
                          <code>M96</code>
                          <code>M97</code>
                          <code>M98</code>
                          <code>M99</code>
                          <code>M100</code>
                          <code>M101</code>
                          <code>M102</code>
                          <code>M103</code>
                          <code>M104</code>
                          <code>M105</code>
                          <code>M106</code>
                          <code>M107</code>
                          <code>M108</code>
                          <code>M109</code>
                          <code>M110</code>
                          <code>M111</code>
                          <code>M112</code>
                          <code>M113</code>
                          <code>M114</code>
                          <code>M115</code>
                          <code>M116</code>
                          <code>M117</code>
                          <code>M118</code>
                          <code>M119</code>
                          <code>M120</code>
                          <code>M121</code>
                          <code>M122</code>
                          <code>M123</code>
                          <code>M124</code>
                          <code>M125</code>
                          <code>M126</code>
                          <code>M127</code>
                          <code>M128</code>
                          <code>M129</code>
                          <code>M130</code>
                          <code>M131</code>
                          <code>M132</code>
                          <code>M133</code>
                          <code>M134</code>
                          <code>M135</code>
                          <code>M136</code>
                          <code>M137</code>
                          <code>M138</code>
                          <code>M139</code>
                          <code>M140</code>
                          <code>M141</code>
                          <code>M142</code>
                          <code>M143</code>
                          <code>M144</code>
                          <code>MA01</code>
                          <code>MA02</code>
                          <code>MA03</code>
                          <code>MA04</code>
                          <code>MA05</code>
                          <code>MA06</code>
                          <code>MA07</code>
                          <code>MA08</code>
                          <code>MA09</code>
                          <code>MA10</code>
                          <code>MA11</code>
                          <code>MA12</code>
                          <code>MA13</code>
                          <code>MA14</code>
                          <code>MA15</code>
                          <code>MA16</code>
                          <code>MA17</code>
                          <code>MA18</code>
                          <code>MA19</code>
                          <code>MA20</code>
                          <code>MA21</code>
                          <code>MA22</code>
                          <code>MA23</code>
                          <code>MA24</code>
                          <code>MA25</code>
                          <code>MA26</code>
                          <code>MA27</code>
                          <code>MA28</code>
                          <code>MA29</code>
                          <code>MA30</code>
                          <code>MA31</code>
                          <code>MA32</code>
                          <code>MA33</code>
                          <code>MA34</code>
                          <code>MA35</code>
                          <code>MA36</code>
                          <code>MA37</code>
                          <code>MA38</code>
                          <code>MA39</code>
                          <code>MA40</code>
                          <code>MA41</code>
                          <code>MA42</code>
                          <code>MA43</code>
                          <code>MA44</code>
                          <code>MA45</code>
                          <code>MA46</code>
                          <code>MA47</code>
                          <code>MA48</code>
                          <code>MA49</code>
                          <code>MA50</code>
                          <code>MA51</code>
                          <code>MA52</code>
                          <code>MA53</code>
                          <code>MA54</code>
                          <code>MA55</code>
                          <code>MA56</code>
                          <code>MA57</code>
                          <code>MA58</code>
                          <code>MA59</code>
                          <code>MA60</code>
                          <code>MA61</code>
                          <code>MA62</code>
                          <code>MA63</code>
                          <code>MA64</code>
                          <code>MA65</code>
                          <code>MA66</code>
                          <code>MA67</code>
                          <code>MA68</code>
                          <code>MA69</code>
                          <code>MA70</code>
                          <code>MA71</code>
                          <code>MA72</code>
                          <code>MA73</code>
                          <code>MA74</code>
                          <code>MA75</code>
                          <code>MA76</code>
                          <code>MA77</code>
                          <code>MA78</code>
                          <code>MA79</code>
                          <code>MA80</code>
                          <code>MA81</code>
                          <code>MA82</code>
                          <code>MA83</code>
                          <code>MA84</code>
                          <code>MA85</code>
                          <code>MA86</code>
                          <code>MA87</code>
                          <code>MA88</code>
                          <code>MA89</code>
                          <code>MA90</code>
                          <code>MA91</code>
                          <code>MA92</code>
                          <code>MA93</code>
                          <code>MA94</code>
                          <code>MA95</code>
                          <code>MA96</code>
                          <code>MA97</code>
                          <code>MA98</code>
                          <code>MA99</code>
                          <code>MA100</code>
                          <code>MA101</code>
                          <code>MA102</code>
                          <code>MA103</code>
                          <code>MA104</code>
                          <code>MA105</code>
                          <code>MA106</code>
                          <code>MA107</code>
                          <code>MA108</code>
                          <code>MA109</code>
                          <code>MA110</code>
                          <code>MA111</code>
                          <code>MA112</code>
                          <code>MA113</code>
                          <code>MA114</code>
                          <code>MA115</code>
                          <code>MA116</code>
                          <code>MA117</code>
                          <code>MA118</code>
                          <code>MA119</code>
                          <code>MA120</code>
                          <code>MA121</code>
                          <code>MA122</code>
                          <code>MA123</code>
                          <code>MA124</code>
                          <code>MA125</code>
                          <code>MA126</code>
                          <code>MA127</code>
                          <code>MA128</code>
                          <code>MA129</code>
                          <code>MA130</code>
                          <code>MA131</code>
                          <code>MA132</code>
                          <code>MA133</code>
                          <code>MA134</code>
                          <code>N1</code>
                          <code>N2</code>
                          <code>N3</code>
                          <code>N4</code>
                          <code>N5</code>
                          <code>N6</code>
                          <code>N7</code>
                          <code>N8</code>
                          <code>N9</code>
                          <code>N10</code>
                          <code>N11</code>
                          <code>N12</code>
                          <code>N13</code>
                          <code>N14</code>
                          <code>N15</code>
                          <code>N16</code>
                          <code>N17</code>
                          <code>N18</code>
                          <code>N19</code>
                          <code>N20</code>
                          <code>N21</code>
                          <code>N22</code>
                          <code>N23</code>
                          <code>N24</code>
                          <code>N25</code>
                          <code>N26</code>
                          <code>N27</code>
                          <code>N28</code>
                          <code>N29</code>
                          <code>N30</code>
                          <code>N31</code>
                          <code>N32</code>
                          <code>N33</code>
                          <code>N34</code>
                          <code>N35</code>
                          <code>N36</code>
                          <code>N37</code>
                          <code>N38</code>
                          <code>N39</code>
                          <code>N40</code>
                          <code>N41</code>
                          <code>N42</code>
                          <code>N43</code>
                          <code>N44</code>
                          <code>N45</code>
                          <code>N46</code>
                          <code>N47</code>
                          <code>N48</code>
                          <code>N49</code>
                          <code>N50</code>
                          <code>N51</code>
                          <code>N52</code>
                          <code>N53</code>
                          <code>N54</code>
                          <code>N55</code>
                          <code>N56</code>
                          <code>N57</code>
                          <code>N58</code>
                          <code>N59</code>
                          <code>N60</code>
                          <code>N61</code>
                          <code>N62</code>
                          <code>N63</code>
                          <code>N64</code>
                          <code>N65</code>
                          <code>N66</code>
                          <code>N67</code>
                          <code>N68</code>
                          <code>N69</code>
                          <code>N70</code>
                          <code>N71</code>
                          <code>N72</code>
                          <code>N73</code>
                          <code>N74</code>
                          <code>N75</code>
                          <code>N76</code>
                          <code>N77</code>
                          <code>N78</code>
                          <code>N79</code>
                          <code>N80</code>
                          <code>N81</code>
                          <code>N82</code>
                          <code>N83</code>
                          <code>N84</code>
                          <code>N85</code>
                          <code>N86</code>
                          <code>N87</code>
                          <code>N88</code>
                          <code>N89</code>
                          <code>N90</code>
                          <code>N91</code>
                          <code>N92</code>
                          <code>N93</code>
                          <code>N94</code>
                          <code>N95</code>
                          <code>N96</code>
                          <code>N97</code>
                          <code>N98</code>
                          <code>N99</code>
                          <code>N100</code>
                          <code>N101</code>
                          <code>N102</code>
                          <code>N103</code>
                          <code>N104</code>
                          <code>N105</code>
                          <code>N106</code>
                          <code>N107</code>
                          <code>N108</code>
                          <code>N109</code>
                          <code>N110</code>
                          <code>N111</code>
                          <code>N112</code>
                          <code>N113</code>
                          <code>N114</code>
                          <code>N115</code>
                          <code>N116</code>
                          <code>N117</code>
                          <code>N118</code>
                          <code>N119</code>
                          <code>N120</code>
                          <code>N121</code>
                          <code>N122</code>
                          <code>N123</code>
                          <code>N124</code>
                          <code>N125</code>
                          <code>N126</code>
                          <code>N127</code>
                          <code>N128</code>
                          <code>N129</code>
                          <code>N130</code>
                          <code>N131</code>
                          <code>N132</code>
                          <code>N133</code>
                          <code>N134</code>
                          <code>N135</code>
                          <code>N136</code>
                          <code>N137</code>
                          <code>N138</code>
                          <code>N139</code>
                          <code>N140</code>
                          <code>N141</code>
                          <code>N142</code>
                          <code>N143</code>
                          <code>N144</code>
                          <code>N145</code>
                          <code>N146</code>
                          <code>N147</code>
                          <code>N148</code>
                          <code>N149</code>
                          <code>N150</code>
                          <code>N151</code>
                          <code>N152</code>
                          <code>N153</code>
                          <code>N154</code>
                          <code>N155</code>
                          <code>N156 </code>
                        </valid_codes>
                      </element>
                      <element xid="MIA22">
                        <data_ele>127</data_ele>
                        <name>Remark Code</name>
                        <usage>S</usage>
                        <seq>22</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                        <valid_codes>
                          <code>M1</code>
                          <code>M2</code>
                          <code>M3</code>
                          <code>M4</code>
                          <code>M5</code>
                          <code>M6</code>
                          <code>M7</code>
                          <code>M8</code>
                          <code>M9</code>
                          <code>M10</code>
                          <code>M11</code>
                          <code>M12</code>
                          <code>M13</code>
                          <code>M14</code>
                          <code>M15</code>
                          <code>M16</code>
                          <code>M17</code>
                          <code>M18</code>
                          <code>M19</code>
                          <code>M20</code>
                          <code>M21</code>
                          <code>M22</code>
                          <code>M23</code>
                          <code>M24</code>
                          <code>M25</code>
                          <code>M26</code>
                          <code>M27</code>
                          <code>M28</code>
                          <code>M29</code>
                          <code>M30</code>
                          <code>M31</code>
                          <code>M32</code>
                          <code>M33</code>
                          <code>M34</code>
                          <code>M35</code>
                          <code>M36</code>
                          <code>M37</code>
                          <code>M38</code>
                          <code>M39</code>
                          <code>M40</code>
                          <code>M41</code>
                          <code>M42</code>
                          <code>M43</code>
                          <code>M44</code>
                          <code>M45</code>
                          <code>M46</code>
                          <code>M47</code>
                          <code>M48</code>
                          <code>M49</code>
                          <code>M50</code>
                          <code>M51</code>
                          <code>M52</code>
                          <code>M53</code>
                          <code>M54</code>
                          <code>M55</code>
                          <code>M56</code>
                          <code>M57</code>
                          <code>M58</code>
                          <code>M59</code>
                          <code>M60</code>
                          <code>M61</code>
                          <code>M62</code>
                          <code>M63</code>
                          <code>M64</code>
                          <code>M65</code>
                          <code>M66</code>
                          <code>M67</code>
                          <code>M68</code>
                          <code>M69</code>
                          <code>M70</code>
                          <code>M71</code>
                          <code>M72</code>
                          <code>M73</code>
                          <code>M74</code>
                          <code>M75</code>
                          <code>M76</code>
                          <code>M77</code>
                          <code>M78</code>
                          <code>M79</code>
                          <code>M80</code>
                          <code>M81</code>
                          <code>M82</code>
                          <code>M83</code>
                          <code>M84</code>
                          <code>M85</code>
                          <code>M86</code>
                          <code>M87</code>
                          <code>M88</code>
                          <code>M89</code>
                          <code>M90</code>
                          <code>M91</code>
                          <code>M92</code>
                          <code>M93</code>
                          <code>M94</code>
                          <code>M95</code>
                          <code>M96</code>
                          <code>M97</code>
                          <code>M98</code>
                          <code>M99</code>
                          <code>M100</code>
                          <code>M101</code>
                          <code>M102</code>
                          <code>M103</code>
                          <code>M104</code>
                          <code>M105</code>
                          <code>M106</code>
                          <code>M107</code>
                          <code>M108</code>
                          <code>M109</code>
                          <code>M110</code>
                          <code>M111</code>
                          <code>M112</code>
                          <code>M113</code>
                          <code>M114</code>
                          <code>M115</code>
                          <code>M116</code>
                          <code>M117</code>
                          <code>M118</code>
                          <code>M119</code>
                          <code>M120</code>
                          <code>M121</code>
                          <code>M122</code>
                          <code>M123</code>
                          <code>M124</code>
                          <code>M125</code>
                          <code>M126</code>
                          <code>M127</code>
                          <code>M128</code>
                          <code>M129</code>
                          <code>M130</code>
                          <code>M131</code>
                          <code>M132</code>
                          <code>M133</code>
                          <code>M134</code>
                          <code>M135</code>
                          <code>M136</code>
                          <code>M137</code>
                          <code>M138</code>
                          <code>M139</code>
                          <code>M140</code>
                          <code>M141</code>
                          <code>M142</code>
                          <code>M143</code>
                          <code>M144</code>
                          <code>MA01</code>
                          <code>MA02</code>
                          <code>MA03</code>
                          <code>MA04</code>
                          <code>MA05</code>
                          <code>MA06</code>
                          <code>MA07</code>
                          <code>MA08</code>
                          <code>MA09</code>
                          <code>MA10</code>
                          <code>MA11</code>
                          <code>MA12</code>
                          <code>MA13</code>
                          <code>MA14</code>
                          <code>MA15</code>
                          <code>MA16</code>
                          <code>MA17</code>
                          <code>MA18</code>
                          <code>MA19</code>
                          <code>MA20</code>
                          <code>MA21</code>
                          <code>MA22</code>
                          <code>MA23</code>
                          <code>MA24</code>
                          <code>MA25</code>
                          <code>MA26</code>
                          <code>MA27</code>
                          <code>MA28</code>
                          <code>MA29</code>
                          <code>MA30</code>
                          <code>MA31</code>
                          <code>MA32</code>
                          <code>MA33</code>
                          <code>MA34</code>
                          <code>MA35</code>
                          <code>MA36</code>
                          <code>MA37</code>
                          <code>MA38</code>
                          <code>MA39</code>
                          <code>MA40</code>
                          <code>MA41</code>
                          <code>MA42</code>
                          <code>MA43</code>
                          <code>MA44</code>
                          <code>MA45</code>
                          <code>MA46</code>
                          <code>MA47</code>
                          <code>MA48</code>
                          <code>MA49</code>
                          <code>MA50</code>
                          <code>MA51</code>
                          <code>MA52</code>
                          <code>MA53</code>
                          <code>MA54</code>
                          <code>MA55</code>
                          <code>MA56</code>
                          <code>MA57</code>
                          <code>MA58</code>
                          <code>MA59</code>
                          <code>MA60</code>
                          <code>MA61</code>
                          <code>MA62</code>
                          <code>MA63</code>
                          <code>MA64</code>
                          <code>MA65</code>
                          <code>MA66</code>
                          <code>MA67</code>
                          <code>MA68</code>
                          <code>MA69</code>
                          <code>MA70</code>
                          <code>MA71</code>
                          <code>MA72</code>
                          <code>MA73</code>
                          <code>MA74</code>
                          <code>MA75</code>
                          <code>MA76</code>
                          <code>MA77</code>
                          <code>MA78</code>
                          <code>MA79</code>
                          <code>MA80</code>
                          <code>MA81</code>
                          <code>MA82</code>
                          <code>MA83</code>
                          <code>MA84</code>
                          <code>MA85</code>
                          <code>MA86</code>
                          <code>MA87</code>
                          <code>MA88</code>
                          <code>MA89</code>
                          <code>MA90</code>
                          <code>MA91</code>
                          <code>MA92</code>
                          <code>MA93</code>
                          <code>MA94</code>
                          <code>MA95</code>
                          <code>MA96</code>
                          <code>MA97</code>
                          <code>MA98</code>
                          <code>MA99</code>
                          <code>MA100</code>
                          <code>MA101</code>
                          <code>MA102</code>
                          <code>MA103</code>
                          <code>MA104</code>
                          <code>MA105</code>
                          <code>MA106</code>
                          <code>MA107</code>
                          <code>MA108</code>
                          <code>MA109</code>
                          <code>MA110</code>
                          <code>MA111</code>
                          <code>MA112</code>
                          <code>MA113</code>
                          <code>MA114</code>
                          <code>MA115</code>
                          <code>MA116</code>
                          <code>MA117</code>
                          <code>MA118</code>
                          <code>MA119</code>
                          <code>MA120</code>
                          <code>MA121</code>
                          <code>MA122</code>
                          <code>MA123</code>
                          <code>MA124</code>
                          <code>MA125</code>
                          <code>MA126</code>
                          <code>MA127</code>
                          <code>MA128</code>
                          <code>MA129</code>
                          <code>MA130</code>
                          <code>MA131</code>
                          <code>MA132</code>
                          <code>MA133</code>
                          <code>MA134</code>
                          <code>N1</code>
                          <code>N2</code>
                          <code>N3</code>
                          <code>N4</code>
                          <code>N5</code>
                          <code>N6</code>
                          <code>N7</code>
                          <code>N8</code>
                          <code>N9</code>
                          <code>N10</code>
                          <code>N11</code>
                          <code>N12</code>
                          <code>N13</code>
                          <code>N14</code>
                          <code>N15</code>
                          <code>N16</code>
                          <code>N17</code>
                          <code>N18</code>
                          <code>N19</code>
                          <code>N20</code>
                          <code>N21</code>
                          <code>N22</code>
                          <code>N23</code>
                          <code>N24</code>
                          <code>N25</code>
                          <code>N26</code>
                          <code>N27</code>
                          <code>N28</code>
                          <code>N29</code>
                          <code>N30</code>
                          <code>N31</code>
                          <code>N32</code>
                          <code>N33</code>
                          <code>N34</code>
                          <code>N35</code>
                          <code>N36</code>
                          <code>N37</code>
                          <code>N38</code>
                          <code>N39</code>
                          <code>N40</code>
                          <code>N41</code>
                          <code>N42</code>
                          <code>N43</code>
                          <code>N44</code>
                          <code>N45</code>
                          <code>N46</code>
                          <code>N47</code>
                          <code>N48</code>
                          <code>N49</code>
                          <code>N50</code>
                          <code>N51</code>
                          <code>N52</code>
                          <code>N53</code>
                          <code>N54</code>
                          <code>N55</code>
                          <code>N56</code>
                          <code>N57</code>
                          <code>N58</code>
                          <code>N59</code>
                          <code>N60</code>
                          <code>N61</code>
                          <code>N62</code>
                          <code>N63</code>
                          <code>N64</code>
                          <code>N65</code>
                          <code>N66</code>
                          <code>N67</code>
                          <code>N68</code>
                          <code>N69</code>
                          <code>N70</code>
                          <code>N71</code>
                          <code>N72</code>
                          <code>N73</code>
                          <code>N74</code>
                          <code>N75</code>
                          <code>N76</code>
                          <code>N77</code>
                          <code>N78</code>
                          <code>N79</code>
                          <code>N80</code>
                          <code>N81</code>
                          <code>N82</code>
                          <code>N83</code>
                          <code>N84</code>
                          <code>N85</code>
                          <code>N86</code>
                          <code>N87</code>
                          <code>N88</code>
                          <code>N89</code>
                          <code>N90</code>
                          <code>N91</code>
                          <code>N92</code>
                          <code>N93</code>
                          <code>N94</code>
                          <code>N95</code>
                          <code>N96</code>
                          <code>N97</code>
                          <code>N98</code>
                          <code>N99</code>
                          <code>N100</code>
                          <code>N101</code>
                          <code>N102</code>
                          <code>N103</code>
                          <code>N104</code>
                          <code>N105</code>
                          <code>N106</code>
                          <code>N107</code>
                          <code>N108</code>
                          <code>N109</code>
                          <code>N110</code>
                          <code>N111</code>
                          <code>N112</code>
                          <code>N113</code>
                          <code>N114</code>
                          <code>N115</code>
                          <code>N116</code>
                          <code>N117</code>
                          <code>N118</code>
                          <code>N119</code>
                          <code>N120</code>
                          <code>N121</code>
                          <code>N122</code>
                          <code>N123</code>
                          <code>N124</code>
                          <code>N125</code>
                          <code>N126</code>
                          <code>N127</code>
                          <code>N128</code>
                          <code>N129</code>
                          <code>N130</code>
                          <code>N131</code>
                          <code>N132</code>
                          <code>N133</code>
                          <code>N134</code>
                          <code>N135</code>
                          <code>N136</code>
                          <code>N137</code>
                          <code>N138</code>
                          <code>N139</code>
                          <code>N140</code>
                          <code>N141</code>
                          <code>N142</code>
                          <code>N143</code>
                          <code>N144</code>
                          <code>N145</code>
                          <code>N146</code>
                          <code>N147</code>
                          <code>N148</code>
                          <code>N149</code>
                          <code>N150</code>
                          <code>N151</code>
                          <code>N152</code>
                          <code>N153</code>
                          <code>N154</code>
                          <code>N155</code>
                          <code>N156 </code>
                        </valid_codes>
                      </element>
                      <element xid="MIA23">
                        <data_ele>127</data_ele>
                        <name>Remark Code</name>
                        <usage>S</usage>
                        <seq>23</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                        <valid_codes>
                          <code>M1</code>
                          <code>M2</code>
                          <code>M3</code>
                          <code>M4</code>
                          <code>M5</code>
                          <code>M6</code>
                          <code>M7</code>
                          <code>M8</code>
                          <code>M9</code>
                          <code>M10</code>
                          <code>M11</code>
                          <code>M12</code>
                          <code>M13</code>
                          <code>M14</code>
                          <code>M15</code>
                          <code>M16</code>
                          <code>M17</code>
                          <code>M18</code>
                          <code>M19</code>
                          <code>M20</code>
                          <code>M21</code>
                          <code>M22</code>
                          <code>M23</code>
                          <code>M24</code>
                          <code>M25</code>
                          <code>M26</code>
                          <code>M27</code>
                          <code>M28</code>
                          <code>M29</code>
                          <code>M30</code>
                          <code>M31</code>
                          <code>M32</code>
                          <code>M33</code>
                          <code>M34</code>
                          <code>M35</code>
                          <code>M36</code>
                          <code>M37</code>
                          <code>M38</code>
                          <code>M39</code>
                          <code>M40</code>
                          <code>M41</code>
                          <code>M42</code>
                          <code>M43</code>
                          <code>M44</code>
                          <code>M45</code>
                          <code>M46</code>
                          <code>M47</code>
                          <code>M48</code>
                          <code>M49</code>
                          <code>M50</code>
                          <code>M51</code>
                          <code>M52</code>
                          <code>M53</code>
                          <code>M54</code>
                          <code>M55</code>
                          <code>M56</code>
                          <code>M57</code>
                          <code>M58</code>
                          <code>M59</code>
                          <code>M60</code>
                          <code>M61</code>
                          <code>M62</code>
                          <code>M63</code>
                          <code>M64</code>
                          <code>M65</code>
                          <code>M66</code>
                          <code>M67</code>
                          <code>M68</code>
                          <code>M69</code>
                          <code>M70</code>
                          <code>M71</code>
                          <code>M72</code>
                          <code>M73</code>
                          <code>M74</code>
                          <code>M75</code>
                          <code>M76</code>
                          <code>M77</code>
                          <code>M78</code>
                          <code>M79</code>
                          <code>M80</code>
                          <code>M81</code>
                          <code>M82</code>
                          <code>M83</code>
                          <code>M84</code>
                          <code>M85</code>
                          <code>M86</code>
                          <code>M87</code>
                          <code>M88</code>
                          <code>M89</code>
                          <code>M90</code>
                          <code>M91</code>
                          <code>M92</code>
                          <code>M93</code>
                          <code>M94</code>
                          <code>M95</code>
                          <code>M96</code>
                          <code>M97</code>
                          <code>M98</code>
                          <code>M99</code>
                          <code>M100</code>
                          <code>M101</code>
                          <code>M102</code>
                          <code>M103</code>
                          <code>M104</code>
                          <code>M105</code>
                          <code>M106</code>
                          <code>M107</code>
                          <code>M108</code>
                          <code>M109</code>
                          <code>M110</code>
                          <code>M111</code>
                          <code>M112</code>
                          <code>M113</code>
                          <code>M114</code>
                          <code>M115</code>
                          <code>M116</code>
                          <code>M117</code>
                          <code>M118</code>
                          <code>M119</code>
                          <code>M120</code>
                          <code>M121</code>
                          <code>M122</code>
                          <code>M123</code>
                          <code>M124</code>
                          <code>M125</code>
                          <code>M126</code>
                          <code>M127</code>
                          <code>M128</code>
                          <code>M129</code>
                          <code>M130</code>
                          <code>M131</code>
                          <code>M132</code>
                          <code>M133</code>
                          <code>M134</code>
                          <code>M135</code>
                          <code>M136</code>
                          <code>M137</code>
                          <code>M138</code>
                          <code>M139</code>
                          <code>M140</code>
                          <code>M141</code>
                          <code>M142</code>
                          <code>M143</code>
                          <code>M144</code>
                          <code>MA01</code>
                          <code>MA02</code>
                          <code>MA03</code>
                          <code>MA04</code>
                          <code>MA05</code>
                          <code>MA06</code>
                          <code>MA07</code>
                          <code>MA08</code>
                          <code>MA09</code>
                          <code>MA10</code>
                          <code>MA11</code>
                          <code>MA12</code>
                          <code>MA13</code>
                          <code>MA14</code>
                          <code>MA15</code>
                          <code>MA16</code>
                          <code>MA17</code>
                          <code>MA18</code>
                          <code>MA19</code>
                          <code>MA20</code>
                          <code>MA21</code>
                          <code>MA22</code>
                          <code>MA23</code>
                          <code>MA24</code>
                          <code>MA25</code>
                          <code>MA26</code>
                          <code>MA27</code>
                          <code>MA28</code>
                          <code>MA29</code>
                          <code>MA30</code>
                          <code>MA31</code>
                          <code>MA32</code>
                          <code>MA33</code>
                          <code>MA34</code>
                          <code>MA35</code>
                          <code>MA36</code>
                          <code>MA37</code>
                          <code>MA38</code>
                          <code>MA39</code>
                          <code>MA40</code>
                          <code>MA41</code>
                          <code>MA42</code>
                          <code>MA43</code>
                          <code>MA44</code>
                          <code>MA45</code>
                          <code>MA46</code>
                          <code>MA47</code>
                          <code>MA48</code>
                          <code>MA49</code>
                          <code>MA50</code>
                          <code>MA51</code>
                          <code>MA52</code>
                          <code>MA53</code>
                          <code>MA54</code>
                          <code>MA55</code>
                          <code>MA56</code>
                          <code>MA57</code>
                          <code>MA58</code>
                          <code>MA59</code>
                          <code>MA60</code>
                          <code>MA61</code>
                          <code>MA62</code>
                          <code>MA63</code>
                          <code>MA64</code>
                          <code>MA65</code>
                          <code>MA66</code>
                          <code>MA67</code>
                          <code>MA68</code>
                          <code>MA69</code>
                          <code>MA70</code>
                          <code>MA71</code>
                          <code>MA72</code>
                          <code>MA73</code>
                          <code>MA74</code>
                          <code>MA75</code>
                          <code>MA76</code>
                          <code>MA77</code>
                          <code>MA78</code>
                          <code>MA79</code>
                          <code>MA80</code>
                          <code>MA81</code>
                          <code>MA82</code>
                          <code>MA83</code>
                          <code>MA84</code>
                          <code>MA85</code>
                          <code>MA86</code>
                          <code>MA87</code>
                          <code>MA88</code>
                          <code>MA89</code>
                          <code>MA90</code>
                          <code>MA91</code>
                          <code>MA92</code>
                          <code>MA93</code>
                          <code>MA94</code>
                          <code>MA95</code>
                          <code>MA96</code>
                          <code>MA97</code>
                          <code>MA98</code>
                          <code>MA99</code>
                          <code>MA100</code>
                          <code>MA101</code>
                          <code>MA102</code>
                          <code>MA103</code>
                          <code>MA104</code>
                          <code>MA105</code>
                          <code>MA106</code>
                          <code>MA107</code>
                          <code>MA108</code>
                          <code>MA109</code>
                          <code>MA110</code>
                          <code>MA111</code>
                          <code>MA112</code>
                          <code>MA113</code>
                          <code>MA114</code>
                          <code>MA115</code>
                          <code>MA116</code>
                          <code>MA117</code>
                          <code>MA118</code>
                          <code>MA119</code>
                          <code>MA120</code>
                          <code>MA121</code>
                          <code>MA122</code>
                          <code>MA123</code>
                          <code>MA124</code>
                          <code>MA125</code>
                          <code>MA126</code>
                          <code>MA127</code>
                          <code>MA128</code>
                          <code>MA129</code>
                          <code>MA130</code>
                          <code>MA131</code>
                          <code>MA132</code>
                          <code>MA133</code>
                          <code>MA134</code>
                          <code>N1</code>
                          <code>N2</code>
                          <code>N3</code>
                          <code>N4</code>
                          <code>N5</code>
                          <code>N6</code>
                          <code>N7</code>
                          <code>N8</code>
                          <code>N9</code>
                          <code>N10</code>
                          <code>N11</code>
                          <code>N12</code>
                          <code>N13</code>
                          <code>N14</code>
                          <code>N15</code>
                          <code>N16</code>
                          <code>N17</code>
                          <code>N18</code>
                          <code>N19</code>
                          <code>N20</code>
                          <code>N21</code>
                          <code>N22</code>
                          <code>N23</code>
                          <code>N24</code>
                          <code>N25</code>
                          <code>N26</code>
                          <code>N27</code>
                          <code>N28</code>
                          <code>N29</code>
                          <code>N30</code>
                          <code>N31</code>
                          <code>N32</code>
                          <code>N33</code>
                          <code>N34</code>
                          <code>N35</code>
                          <code>N36</code>
                          <code>N37</code>
                          <code>N38</code>
                          <code>N39</code>
                          <code>N40</code>
                          <code>N41</code>
                          <code>N42</code>
                          <code>N43</code>
                          <code>N44</code>
                          <code>N45</code>
                          <code>N46</code>
                          <code>N47</code>
                          <code>N48</code>
                          <code>N49</code>
                          <code>N50</code>
                          <code>N51</code>
                          <code>N52</code>
                          <code>N53</code>
                          <code>N54</code>
                          <code>N55</code>
                          <code>N56</code>
                          <code>N57</code>
                          <code>N58</code>
                          <code>N59</code>
                          <code>N60</code>
                          <code>N61</code>
                          <code>N62</code>
                          <code>N63</code>
                          <code>N64</code>
                          <code>N65</code>
                          <code>N66</code>
                          <code>N67</code>
                          <code>N68</code>
                          <code>N69</code>
                          <code>N70</code>
                          <code>N71</code>
                          <code>N72</code>
                          <code>N73</code>
                          <code>N74</code>
                          <code>N75</code>
                          <code>N76</code>
                          <code>N77</code>
                          <code>N78</code>
                          <code>N79</code>
                          <code>N80</code>
                          <code>N81</code>
                          <code>N82</code>
                          <code>N83</code>
                          <code>N84</code>
                          <code>N85</code>
                          <code>N86</code>
                          <code>N87</code>
                          <code>N88</code>
                          <code>N89</code>
                          <code>N90</code>
                          <code>N91</code>
                          <code>N92</code>
                          <code>N93</code>
                          <code>N94</code>
                          <code>N95</code>
                          <code>N96</code>
                          <code>N97</code>
                          <code>N98</code>
                          <code>N99</code>
                          <code>N100</code>
                          <code>N101</code>
                          <code>N102</code>
                          <code>N103</code>
                          <code>N104</code>
                          <code>N105</code>
                          <code>N106</code>
                          <code>N107</code>
                          <code>N108</code>
                          <code>N109</code>
                          <code>N110</code>
                          <code>N111</code>
                          <code>N112</code>
                          <code>N113</code>
                          <code>N114</code>
                          <code>N115</code>
                          <code>N116</code>
                          <code>N117</code>
                          <code>N118</code>
                          <code>N119</code>
                          <code>N120</code>
                          <code>N121</code>
                          <code>N122</code>
                          <code>N123</code>
                          <code>N124</code>
                          <code>N125</code>
                          <code>N126</code>
                          <code>N127</code>
                          <code>N128</code>
                          <code>N129</code>
                          <code>N130</code>
                          <code>N131</code>
                          <code>N132</code>
                          <code>N133</code>
                          <code>N134</code>
                          <code>N135</code>
                          <code>N136</code>
                          <code>N137</code>
                          <code>N138</code>
                          <code>N139</code>
                          <code>N140</code>
                          <code>N141</code>
                          <code>N142</code>
                          <code>N143</code>
                          <code>N144</code>
                          <code>N145</code>
                          <code>N146</code>
                          <code>N147</code>
                          <code>N148</code>
                          <code>N149</code>
                          <code>N150</code>
                          <code>N151</code>
                          <code>N152</code>
                          <code>N153</code>
                          <code>N154</code>
                          <code>N155</code>
                          <code>N156 </code>
                        </valid_codes>
                      </element>
                      <element xid="MIA24">
                        <data_ele>782</data_ele>
                        <name>PPS-Capital Exception Amount</name>
                        <usage>S</usage>
                        <seq>24</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                    </segment>
<!--End of MIA segment-->
                    <segment xid="MOA">
                      <name>Medicare Outpatient Adjudication Information</name>
                      <usage>S</usage>
                      <pos>320</pos>
                      <max_use>1</max_use>
                      <element xid="MOA01">
                        <data_ele>954</data_ele>
                        <name>Reimbursement Rate</name>
                        <usage>S</usage>
                        <seq>01</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="MOA02">
                        <data_ele>782</data_ele>
                        <name>Claim HCPCS Payable Amount</name>
                        <usage>S</usage>
                        <seq>02</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="MOA03">
                        <data_ele>127</data_ele>
                        <name>Remark Code</name>
                        <usage>S</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                        <valid_codes>
                          <code>M1</code>
                          <code>M2</code>
                          <code>M3</code>
                          <code>M4</code>
                          <code>M5</code>
                          <code>M6</code>
                          <code>M7</code>
                          <code>M8</code>
                          <code>M9</code>
                          <code>M10</code>
                          <code>M11</code>
                          <code>M12</code>
                          <code>M13</code>
                          <code>M14</code>
                          <code>M15</code>
                          <code>M16</code>
                          <code>M17</code>
                          <code>M18</code>
                          <code>M19</code>
                          <code>M20</code>
                          <code>M21</code>
                          <code>M22</code>
                          <code>M23</code>
                          <code>M24</code>
                          <code>M25</code>
                          <code>M26</code>
                          <code>M27</code>
                          <code>M28</code>
                          <code>M29</code>
                          <code>M30</code>
                          <code>M31</code>
                          <code>M32</code>
                          <code>M33</code>
                          <code>M34</code>
                          <code>M35</code>
                          <code>M36</code>
                          <code>M37</code>
                          <code>M38</code>
                          <code>M39</code>
                          <code>M40</code>
                          <code>M41</code>
                          <code>M42</code>
                          <code>M43</code>
                          <code>M44</code>
                          <code>M45</code>
                          <code>M46</code>
                          <code>M47</code>
                          <code>M48</code>
                          <code>M49</code>
                          <code>M50</code>
                          <code>M51</code>
                          <code>M52</code>
                          <code>M53</code>
                          <code>M54</code>
                          <code>M55</code>
                          <code>M56</code>
                          <code>M57</code>
                          <code>M58</code>
                          <code>M59</code>
                          <code>M60</code>
                          <code>M61</code>
                          <code>M62</code>
                          <code>M63</code>
                          <code>M64</code>
                          <code>M65</code>
                          <code>M66</code>
                          <code>M67</code>
                          <code>M68</code>
                          <code>M69</code>
                          <code>M70</code>
                          <code>M71</code>
                          <code>M72</code>
                          <code>M73</code>
                          <code>M74</code>
                          <code>M75</code>
                          <code>M76</code>
                          <code>M77</code>
                          <code>M78</code>
                          <code>M79</code>
                          <code>M80</code>
                          <code>M81</code>
                          <code>M82</code>
                          <code>M83</code>
                          <code>M84</code>
                          <code>M85</code>
                          <code>M86</code>
                          <code>M87</code>
                          <code>M88</code>
                          <code>M89</code>
                          <code>M90</code>
                          <code>M91</code>
                          <code>M92</code>
                          <code>M93</code>
                          <code>M94</code>
                          <code>M95</code>
                          <code>M96</code>
                          <code>M97</code>
                          <code>M98</code>
                          <code>M99</code>
                          <code>M100</code>
                          <code>M101</code>
                          <code>M102</code>
                          <code>M103</code>
                          <code>M104</code>
                          <code>M105</code>
                          <code>M106</code>
                          <code>M107</code>
                          <code>M108</code>
                          <code>M109</code>
                          <code>M110</code>
                          <code>M111</code>
                          <code>M112</code>
                          <code>M113</code>
                          <code>M114</code>
                          <code>M115</code>
                          <code>M116</code>
                          <code>M117</code>
                          <code>M118</code>
                          <code>M119</code>
                          <code>M120</code>
                          <code>M121</code>
                          <code>M122</code>
                          <code>M123</code>
                          <code>M124</code>
                          <code>M125</code>
                          <code>M126</code>
                          <code>M127</code>
                          <code>M128</code>
                          <code>M129</code>
                          <code>M130</code>
                          <code>M131</code>
                          <code>M132</code>
                          <code>M133</code>
                          <code>M134</code>
                          <code>M135</code>
                          <code>M136</code>
                          <code>M137</code>
                          <code>M138</code>
                          <code>M139</code>
                          <code>M140</code>
                          <code>M141</code>
                          <code>M142</code>
                          <code>M143</code>
                          <code>M144</code>
                          <code>MA01</code>
                          <code>MA02</code>
                          <code>MA03</code>
                          <code>MA04</code>
                          <code>MA05</code>
                          <code>MA06</code>
                          <code>MA07</code>
                          <code>MA08</code>
                          <code>MA09</code>
                          <code>MA10</code>
                          <code>MA11</code>
                          <code>MA12</code>
                          <code>MA13</code>
                          <code>MA14</code>
                          <code>MA15</code>
                          <code>MA16</code>
                          <code>MA17</code>
                          <code>MA18</code>
                          <code>MA19</code>
                          <code>MA20</code>
                          <code>MA21</code>
                          <code>MA22</code>
                          <code>MA23</code>
                          <code>MA24</code>
                          <code>MA25</code>
                          <code>MA26</code>
                          <code>MA27</code>
                          <code>MA28</code>
                          <code>MA29</code>
                          <code>MA30</code>
                          <code>MA31</code>
                          <code>MA32</code>
                          <code>MA33</code>
                          <code>MA34</code>
                          <code>MA35</code>
                          <code>MA36</code>
                          <code>MA37</code>
                          <code>MA38</code>
                          <code>MA39</code>
                          <code>MA40</code>
                          <code>MA41</code>
                          <code>MA42</code>
                          <code>MA43</code>
                          <code>MA44</code>
                          <code>MA45</code>
                          <code>MA46</code>
                          <code>MA47</code>
                          <code>MA48</code>
                          <code>MA49</code>
                          <code>MA50</code>
                          <code>MA51</code>
                          <code>MA52</code>
                          <code>MA53</code>
                          <code>MA54</code>
                          <code>MA55</code>
                          <code>MA56</code>
                          <code>MA57</code>
                          <code>MA58</code>
                          <code>MA59</code>
                          <code>MA60</code>
                          <code>MA61</code>
                          <code>MA62</code>
                          <code>MA63</code>
                          <code>MA64</code>
                          <code>MA65</code>
                          <code>MA66</code>
                          <code>MA67</code>
                          <code>MA68</code>
                          <code>MA69</code>
                          <code>MA70</code>
                          <code>MA71</code>
                          <code>MA72</code>
                          <code>MA73</code>
                          <code>MA74</code>
                          <code>MA75</code>
                          <code>MA76</code>
                          <code>MA77</code>
                          <code>MA78</code>
                          <code>MA79</code>
                          <code>MA80</code>
                          <code>MA81</code>
                          <code>MA82</code>
                          <code>MA83</code>
                          <code>MA84</code>
                          <code>MA85</code>
                          <code>MA86</code>
                          <code>MA87</code>
                          <code>MA88</code>
                          <code>MA89</code>
                          <code>MA90</code>
                          <code>MA91</code>
                          <code>MA92</code>
                          <code>MA93</code>
                          <code>MA94</code>
                          <code>MA95</code>
                          <code>MA96</code>
                          <code>MA97</code>
                          <code>MA98</code>
                          <code>MA99</code>
                          <code>MA100</code>
                          <code>MA101</code>
                          <code>MA102</code>
                          <code>MA103</code>
                          <code>MA104</code>
                          <code>MA105</code>
                          <code>MA106</code>
                          <code>MA107</code>
                          <code>MA108</code>
                          <code>MA109</code>
                          <code>MA110</code>
                          <code>MA111</code>
                          <code>MA112</code>
                          <code>MA113</code>
                          <code>MA114</code>
                          <code>MA115</code>
                          <code>MA116</code>
                          <code>MA117</code>
                          <code>MA118</code>
                          <code>MA119</code>
                          <code>MA120</code>
                          <code>MA121</code>
                          <code>MA122</code>
                          <code>MA123</code>
                          <code>MA124</code>
                          <code>MA125</code>
                          <code>MA126</code>
                          <code>MA127</code>
                          <code>MA128</code>
                          <code>MA129</code>
                          <code>MA130</code>
                          <code>MA131</code>
                          <code>MA132</code>
                          <code>MA133</code>
                          <code>MA134</code>
                          <code>N1</code>
                          <code>N2</code>
                          <code>N3</code>
                          <code>N4</code>
                          <code>N5</code>
                          <code>N6</code>
                          <code>N7</code>
                          <code>N8</code>
                          <code>N9</code>
                          <code>N10</code>
                          <code>N11</code>
                          <code>N12</code>
                          <code>N13</code>
                          <code>N14</code>
                          <code>N15</code>
                          <code>N16</code>
                          <code>N17</code>
                          <code>N18</code>
                          <code>N19</code>
                          <code>N20</code>
                          <code>N21</code>
                          <code>N22</code>
                          <code>N23</code>
                          <code>N24</code>
                          <code>N25</code>
                          <code>N26</code>
                          <code>N27</code>
                          <code>N28</code>
                          <code>N29</code>
                          <code>N30</code>
                          <code>N31</code>
                          <code>N32</code>
                          <code>N33</code>
                          <code>N34</code>
                          <code>N35</code>
                          <code>N36</code>
                          <code>N37</code>
                          <code>N38</code>
                          <code>N39</code>
                          <code>N40</code>
                          <code>N41</code>
                          <code>N42</code>
                          <code>N43</code>
                          <code>N44</code>
                          <code>N45</code>
                          <code>N46</code>
                          <code>N47</code>
                          <code>N48</code>
                          <code>N49</code>
                          <code>N50</code>
                          <code>N51</code>
                          <code>N52</code>
                          <code>N53</code>
                          <code>N54</code>
                          <code>N55</code>
                          <code>N56</code>
                          <code>N57</code>
                          <code>N58</code>
                          <code>N59</code>
                          <code>N60</code>
                          <code>N61</code>
                          <code>N62</code>
                          <code>N63</code>
                          <code>N64</code>
                          <code>N65</code>
                          <code>N66</code>
                          <code>N67</code>
                          <code>N68</code>
                          <code>N69</code>
                          <code>N70</code>
                          <code>N71</code>
                          <code>N72</code>
                          <code>N73</code>
                          <code>N74</code>
                          <code>N75</code>
                          <code>N76</code>
                          <code>N77</code>
                          <code>N78</code>
                          <code>N79</code>
                          <code>N80</code>
                          <code>N81</code>
                          <code>N82</code>
                          <code>N83</code>
                          <code>N84</code>
                          <code>N85</code>
                          <code>N86</code>
                          <code>N87</code>
                          <code>N88</code>
                          <code>N89</code>
                          <code>N90</code>
                          <code>N91</code>
                          <code>N92</code>
                          <code>N93</code>
                          <code>N94</code>
                          <code>N95</code>
                          <code>N96</code>
                          <code>N97</code>
                          <code>N98</code>
                          <code>N99</code>
                          <code>N100</code>
                          <code>N101</code>
                          <code>N102</code>
                          <code>N103</code>
                          <code>N104</code>
                          <code>N105</code>
                          <code>N106</code>
                          <code>N107</code>
                          <code>N108</code>
                          <code>N109</code>
                          <code>N110</code>
                          <code>N111</code>
                          <code>N112</code>
                          <code>N113</code>
                          <code>N114</code>
                          <code>N115</code>
                          <code>N116</code>
                          <code>N117</code>
                          <code>N118</code>
                          <code>N119</code>
                          <code>N120</code>
                          <code>N121</code>
                          <code>N122</code>
                          <code>N123</code>
                          <code>N124</code>
                          <code>N125</code>
                          <code>N126</code>
                          <code>N127</code>
                          <code>N128</code>
                          <code>N129</code>
                          <code>N130</code>
                          <code>N131</code>
                          <code>N132</code>
                          <code>N133</code>
                          <code>N134</code>
                          <code>N135</code>
                          <code>N136</code>
                          <code>N137</code>
                          <code>N138</code>
                          <code>N139</code>
                          <code>N140</code>
                          <code>N141</code>
                          <code>N142</code>
                          <code>N143</code>
                          <code>N144</code>
                          <code>N145</code>
                          <code>N146</code>
                          <code>N147</code>
                          <code>N148</code>
                          <code>N149</code>
                          <code>N150</code>
                          <code>N151</code>
                          <code>N152</code>
                          <code>N153</code>
                          <code>N154</code>
                          <code>N155</code>
                          <code>N156 </code>
                        </valid_codes>
                      </element>
                      <element xid="MOA04">
                        <data_ele>127</data_ele>
                        <name>Remark Code</name>
                        <usage>S</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                        <valid_codes>
                          <code>M1</code>
                          <code>M2</code>
                          <code>M3</code>
                          <code>M4</code>
                          <code>M5</code>
                          <code>M6</code>
                          <code>M7</code>
                          <code>M8</code>
                          <code>M9</code>
                          <code>M10</code>
                          <code>M11</code>
                          <code>M12</code>
                          <code>M13</code>
                          <code>M14</code>
                          <code>M15</code>
                          <code>M16</code>
                          <code>M17</code>
                          <code>M18</code>
                          <code>M19</code>
                          <code>M20</code>
                          <code>M21</code>
                          <code>M22</code>
                          <code>M23</code>
                          <code>M24</code>
                          <code>M25</code>
                          <code>M26</code>
                          <code>M27</code>
                          <code>M28</code>
                          <code>M29</code>
                          <code>M30</code>
                          <code>M31</code>
                          <code>M32</code>
                          <code>M33</code>
                          <code>M34</code>
                          <code>M35</code>
                          <code>M36</code>
                          <code>M37</code>
                          <code>M38</code>
                          <code>M39</code>
                          <code>M40</code>
                          <code>M41</code>
                          <code>M42</code>
                          <code>M43</code>
                          <code>M44</code>
                          <code>M45</code>
                          <code>M46</code>
                          <code>M47</code>
                          <code>M48</code>
                          <code>M49</code>
                          <code>M50</code>
                          <code>M51</code>
                          <code>M52</code>
                          <code>M53</code>
                          <code>M54</code>
                          <code>M55</code>
                          <code>M56</code>
                          <code>M57</code>
                          <code>M58</code>
                          <code>M59</code>
                          <code>M60</code>
                          <code>M61</code>
                          <code>M62</code>
                          <code>M63</code>
                          <code>M64</code>
                          <code>M65</code>
                          <code>M66</code>
                          <code>M67</code>
                          <code>M68</code>
                          <code>M69</code>
                          <code>M70</code>
                          <code>M71</code>
                          <code>M72</code>
                          <code>M73</code>
                          <code>M74</code>
                          <code>M75</code>
                          <code>M76</code>
                          <code>M77</code>
                          <code>M78</code>
                          <code>M79</code>
                          <code>M80</code>
                          <code>M81</code>
                          <code>M82</code>
                          <code>M83</code>
                          <code>M84</code>
                          <code>M85</code>
                          <code>M86</code>
                          <code>M87</code>
                          <code>M88</code>
                          <code>M89</code>
                          <code>M90</code>
                          <code>M91</code>
                          <code>M92</code>
                          <code>M93</code>
                          <code>M94</code>
                          <code>M95</code>
                          <code>M96</code>
                          <code>M97</code>
                          <code>M98</code>
                          <code>M99</code>
                          <code>M100</code>
                          <code>M101</code>
                          <code>M102</code>
                          <code>M103</code>
                          <code>M104</code>
                          <code>M105</code>
                          <code>M106</code>
                          <code>M107</code>
                          <code>M108</code>
                          <code>M109</code>
                          <code>M110</code>
                          <code>M111</code>
                          <code>M112</code>
                          <code>M113</code>
                          <code>M114</code>
                          <code>M115</code>
                          <code>M116</code>
                          <code>M117</code>
                          <code>M118</code>
                          <code>M119</code>
                          <code>M120</code>
                          <code>M121</code>
                          <code>M122</code>
                          <code>M123</code>
                          <code>M124</code>
                          <code>M125</code>
                          <code>M126</code>
                          <code>M127</code>
                          <code>M128</code>
                          <code>M129</code>
                          <code>M130</code>
                          <code>M131</code>
                          <code>M132</code>
                          <code>M133</code>
                          <code>M134</code>
                          <code>M135</code>
                          <code>M136</code>
                          <code>M137</code>
                          <code>M138</code>
                          <code>M139</code>
                          <code>M140</code>
                          <code>M141</code>
                          <code>M142</code>
                          <code>M143</code>
                          <code>M144</code>
                          <code>MA01</code>
                          <code>MA02</code>
                          <code>MA03</code>
                          <code>MA04</code>
                          <code>MA05</code>
                          <code>MA06</code>
                          <code>MA07</code>
                          <code>MA08</code>
                          <code>MA09</code>
                          <code>MA10</code>
                          <code>MA11</code>
                          <code>MA12</code>
                          <code>MA13</code>
                          <code>MA14</code>
                          <code>MA15</code>
                          <code>MA16</code>
                          <code>MA17</code>
                          <code>MA18</code>
                          <code>MA19</code>
                          <code>MA20</code>
                          <code>MA21</code>
                          <code>MA22</code>
                          <code>MA23</code>
                          <code>MA24</code>
                          <code>MA25</code>
                          <code>MA26</code>
                          <code>MA27</code>
                          <code>MA28</code>
                          <code>MA29</code>
                          <code>MA30</code>
                          <code>MA31</code>
                          <code>MA32</code>
                          <code>MA33</code>
                          <code>MA34</code>
                          <code>MA35</code>
                          <code>MA36</code>
                          <code>MA37</code>
                          <code>MA38</code>
                          <code>MA39</code>
                          <code>MA40</code>
                          <code>MA41</code>
                          <code>MA42</code>
                          <code>MA43</code>
                          <code>MA44</code>
                          <code>MA45</code>
                          <code>MA46</code>
                          <code>MA47</code>
                          <code>MA48</code>
                          <code>MA49</code>
                          <code>MA50</code>
                          <code>MA51</code>
                          <code>MA52</code>
                          <code>MA53</code>
                          <code>MA54</code>
                          <code>MA55</code>
                          <code>MA56</code>
                          <code>MA57</code>
                          <code>MA58</code>
                          <code>MA59</code>
                          <code>MA60</code>
                          <code>MA61</code>
                          <code>MA62</code>
                          <code>MA63</code>
                          <code>MA64</code>
                          <code>MA65</code>
                          <code>MA66</code>
                          <code>MA67</code>
                          <code>MA68</code>
                          <code>MA69</code>
                          <code>MA70</code>
                          <code>MA71</code>
                          <code>MA72</code>
                          <code>MA73</code>
                          <code>MA74</code>
                          <code>MA75</code>
                          <code>MA76</code>
                          <code>MA77</code>
                          <code>MA78</code>
                          <code>MA79</code>
                          <code>MA80</code>
                          <code>MA81</code>
                          <code>MA82</code>
                          <code>MA83</code>
                          <code>MA84</code>
                          <code>MA85</code>
                          <code>MA86</code>
                          <code>MA87</code>
                          <code>MA88</code>
                          <code>MA89</code>
                          <code>MA90</code>
                          <code>MA91</code>
                          <code>MA92</code>
                          <code>MA93</code>
                          <code>MA94</code>
                          <code>MA95</code>
                          <code>MA96</code>
                          <code>MA97</code>
                          <code>MA98</code>
                          <code>MA99</code>
                          <code>MA100</code>
                          <code>MA101</code>
                          <code>MA102</code>
                          <code>MA103</code>
                          <code>MA104</code>
                          <code>MA105</code>
                          <code>MA106</code>
                          <code>MA107</code>
                          <code>MA108</code>
                          <code>MA109</code>
                          <code>MA110</code>
                          <code>MA111</code>
                          <code>MA112</code>
                          <code>MA113</code>
                          <code>MA114</code>
                          <code>MA115</code>
                          <code>MA116</code>
                          <code>MA117</code>
                          <code>MA118</code>
                          <code>MA119</code>
                          <code>MA120</code>
                          <code>MA121</code>
                          <code>MA122</code>
                          <code>MA123</code>
                          <code>MA124</code>
                          <code>MA125</code>
                          <code>MA126</code>
                          <code>MA127</code>
                          <code>MA128</code>
                          <code>MA129</code>
                          <code>MA130</code>
                          <code>MA131</code>
                          <code>MA132</code>
                          <code>MA133</code>
                          <code>MA134</code>
                          <code>N1</code>
                          <code>N2</code>
                          <code>N3</code>
                          <code>N4</code>
                          <code>N5</code>
                          <code>N6</code>
                          <code>N7</code>
                          <code>N8</code>
                          <code>N9</code>
                          <code>N10</code>
                          <code>N11</code>
                          <code>N12</code>
                          <code>N13</code>
                          <code>N14</code>
                          <code>N15</code>
                          <code>N16</code>
                          <code>N17</code>
                          <code>N18</code>
                          <code>N19</code>
                          <code>N20</code>
                          <code>N21</code>
                          <code>N22</code>
                          <code>N23</code>
                          <code>N24</code>
                          <code>N25</code>
                          <code>N26</code>
                          <code>N27</code>
                          <code>N28</code>
                          <code>N29</code>
                          <code>N30</code>
                          <code>N31</code>
                          <code>N32</code>
                          <code>N33</code>
                          <code>N34</code>
                          <code>N35</code>
                          <code>N36</code>
                          <code>N37</code>
                          <code>N38</code>
                          <code>N39</code>
                          <code>N40</code>
                          <code>N41</code>
                          <code>N42</code>
                          <code>N43</code>
                          <code>N44</code>
                          <code>N45</code>
                          <code>N46</code>
                          <code>N47</code>
                          <code>N48</code>
                          <code>N49</code>
                          <code>N50</code>
                          <code>N51</code>
                          <code>N52</code>
                          <code>N53</code>
                          <code>N54</code>
                          <code>N55</code>
                          <code>N56</code>
                          <code>N57</code>
                          <code>N58</code>
                          <code>N59</code>
                          <code>N60</code>
                          <code>N61</code>
                          <code>N62</code>
                          <code>N63</code>
                          <code>N64</code>
                          <code>N65</code>
                          <code>N66</code>
                          <code>N67</code>
                          <code>N68</code>
                          <code>N69</code>
                          <code>N70</code>
                          <code>N71</code>
                          <code>N72</code>
                          <code>N73</code>
                          <code>N74</code>
                          <code>N75</code>
                          <code>N76</code>
                          <code>N77</code>
                          <code>N78</code>
                          <code>N79</code>
                          <code>N80</code>
                          <code>N81</code>
                          <code>N82</code>
                          <code>N83</code>
                          <code>N84</code>
                          <code>N85</code>
                          <code>N86</code>
                          <code>N87</code>
                          <code>N88</code>
                          <code>N89</code>
                          <code>N90</code>
                          <code>N91</code>
                          <code>N92</code>
                          <code>N93</code>
                          <code>N94</code>
                          <code>N95</code>
                          <code>N96</code>
                          <code>N97</code>
                          <code>N98</code>
                          <code>N99</code>
                          <code>N100</code>
                          <code>N101</code>
                          <code>N102</code>
                          <code>N103</code>
                          <code>N104</code>
                          <code>N105</code>
                          <code>N106</code>
                          <code>N107</code>
                          <code>N108</code>
                          <code>N109</code>
                          <code>N110</code>
                          <code>N111</code>
                          <code>N112</code>
                          <code>N113</code>
                          <code>N114</code>
                          <code>N115</code>
                          <code>N116</code>
                          <code>N117</code>
                          <code>N118</code>
                          <code>N119</code>
                          <code>N120</code>
                          <code>N121</code>
                          <code>N122</code>
                          <code>N123</code>
                          <code>N124</code>
                          <code>N125</code>
                          <code>N126</code>
                          <code>N127</code>
                          <code>N128</code>
                          <code>N129</code>
                          <code>N130</code>
                          <code>N131</code>
                          <code>N132</code>
                          <code>N133</code>
                          <code>N134</code>
                          <code>N135</code>
                          <code>N136</code>
                          <code>N137</code>
                          <code>N138</code>
                          <code>N139</code>
                          <code>N140</code>
                          <code>N141</code>
                          <code>N142</code>
                          <code>N143</code>
                          <code>N144</code>
                          <code>N145</code>
                          <code>N146</code>
                          <code>N147</code>
                          <code>N148</code>
                          <code>N149</code>
                          <code>N150</code>
                          <code>N151</code>
                          <code>N152</code>
                          <code>N153</code>
                          <code>N154</code>
                          <code>N155</code>
                          <code>N156 </code>
                        </valid_codes>
                      </element>
                      <element xid="MOA05">
                        <data_ele>127</data_ele>
                        <name>Remark Code</name>
                        <usage>S</usage>
                        <seq>05</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                        <valid_codes>
                          <code>M1</code>
                          <code>M2</code>
                          <code>M3</code>
                          <code>M4</code>
                          <code>M5</code>
                          <code>M6</code>
                          <code>M7</code>
                          <code>M8</code>
                          <code>M9</code>
                          <code>M10</code>
                          <code>M11</code>
                          <code>M12</code>
                          <code>M13</code>
                          <code>M14</code>
                          <code>M15</code>
                          <code>M16</code>
                          <code>M17</code>
                          <code>M18</code>
                          <code>M19</code>
                          <code>M20</code>
                          <code>M21</code>
                          <code>M22</code>
                          <code>M23</code>
                          <code>M24</code>
                          <code>M25</code>
                          <code>M26</code>
                          <code>M27</code>
                          <code>M28</code>
                          <code>M29</code>
                          <code>M30</code>
                          <code>M31</code>
                          <code>M32</code>
                          <code>M33</code>
                          <code>M34</code>
                          <code>M35</code>
                          <code>M36</code>
                          <code>M37</code>
                          <code>M38</code>
                          <code>M39</code>
                          <code>M40</code>
                          <code>M41</code>
                          <code>M42</code>
                          <code>M43</code>
                          <code>M44</code>
                          <code>M45</code>
                          <code>M46</code>
                          <code>M47</code>
                          <code>M48</code>
                          <code>M49</code>
                          <code>M50</code>
                          <code>M51</code>
                          <code>M52</code>
                          <code>M53</code>
                          <code>M54</code>
                          <code>M55</code>
                          <code>M56</code>
                          <code>M57</code>
                          <code>M58</code>
                          <code>M59</code>
                          <code>M60</code>
                          <code>M61</code>
                          <code>M62</code>
                          <code>M63</code>
                          <code>M64</code>
                          <code>M65</code>
                          <code>M66</code>
                          <code>M67</code>
                          <code>M68</code>
                          <code>M69</code>
                          <code>M70</code>
                          <code>M71</code>
                          <code>M72</code>
                          <code>M73</code>
                          <code>M74</code>
                          <code>M75</code>
                          <code>M76</code>
                          <code>M77</code>
                          <code>M78</code>
                          <code>M79</code>
                          <code>M80</code>
                          <code>M81</code>
                          <code>M82</code>
                          <code>M83</code>
                          <code>M84</code>
                          <code>M85</code>
                          <code>M86</code>
                          <code>M87</code>
                          <code>M88</code>
                          <code>M89</code>
                          <code>M90</code>
                          <code>M91</code>
                          <code>M92</code>
                          <code>M93</code>
                          <code>M94</code>
                          <code>M95</code>
                          <code>M96</code>
                          <code>M97</code>
                          <code>M98</code>
                          <code>M99</code>
                          <code>M100</code>
                          <code>M101</code>
                          <code>M102</code>
                          <code>M103</code>
                          <code>M104</code>
                          <code>M105</code>
                          <code>M106</code>
                          <code>M107</code>
                          <code>M108</code>
                          <code>M109</code>
                          <code>M110</code>
                          <code>M111</code>
                          <code>M112</code>
                          <code>M113</code>
                          <code>M114</code>
                          <code>M115</code>
                          <code>M116</code>
                          <code>M117</code>
                          <code>M118</code>
                          <code>M119</code>
                          <code>M120</code>
                          <code>M121</code>
                          <code>M122</code>
                          <code>M123</code>
                          <code>M124</code>
                          <code>M125</code>
                          <code>M126</code>
                          <code>M127</code>
                          <code>M128</code>
                          <code>M129</code>
                          <code>M130</code>
                          <code>M131</code>
                          <code>M132</code>
                          <code>M133</code>
                          <code>M134</code>
                          <code>M135</code>
                          <code>M136</code>
                          <code>M137</code>
                          <code>M138</code>
                          <code>M139</code>
                          <code>M140</code>
                          <code>M141</code>
                          <code>M142</code>
                          <code>M143</code>
                          <code>M144</code>
                          <code>MA01</code>
                          <code>MA02</code>
                          <code>MA03</code>
                          <code>MA04</code>
                          <code>MA05</code>
                          <code>MA06</code>
                          <code>MA07</code>
                          <code>MA08</code>
                          <code>MA09</code>
                          <code>MA10</code>
                          <code>MA11</code>
                          <code>MA12</code>
                          <code>MA13</code>
                          <code>MA14</code>
                          <code>MA15</code>
                          <code>MA16</code>
                          <code>MA17</code>
                          <code>MA18</code>
                          <code>MA19</code>
                          <code>MA20</code>
                          <code>MA21</code>
                          <code>MA22</code>
                          <code>MA23</code>
                          <code>MA24</code>
                          <code>MA25</code>
                          <code>MA26</code>
                          <code>MA27</code>
                          <code>MA28</code>
                          <code>MA29</code>
                          <code>MA30</code>
                          <code>MA31</code>
                          <code>MA32</code>
                          <code>MA33</code>
                          <code>MA34</code>
                          <code>MA35</code>
                          <code>MA36</code>
                          <code>MA37</code>
                          <code>MA38</code>
                          <code>MA39</code>
                          <code>MA40</code>
                          <code>MA41</code>
                          <code>MA42</code>
                          <code>MA43</code>
                          <code>MA44</code>
                          <code>MA45</code>
                          <code>MA46</code>
                          <code>MA47</code>
                          <code>MA48</code>
                          <code>MA49</code>
                          <code>MA50</code>
                          <code>MA51</code>
                          <code>MA52</code>
                          <code>MA53</code>
                          <code>MA54</code>
                          <code>MA55</code>
                          <code>MA56</code>
                          <code>MA57</code>
                          <code>MA58</code>
                          <code>MA59</code>
                          <code>MA60</code>
                          <code>MA61</code>
                          <code>MA62</code>
                          <code>MA63</code>
                          <code>MA64</code>
                          <code>MA65</code>
                          <code>MA66</code>
                          <code>MA67</code>
                          <code>MA68</code>
                          <code>MA69</code>
                          <code>MA70</code>
                          <code>MA71</code>
                          <code>MA72</code>
                          <code>MA73</code>
                          <code>MA74</code>
                          <code>MA75</code>
                          <code>MA76</code>
                          <code>MA77</code>
                          <code>MA78</code>
                          <code>MA79</code>
                          <code>MA80</code>
                          <code>MA81</code>
                          <code>MA82</code>
                          <code>MA83</code>
                          <code>MA84</code>
                          <code>MA85</code>
                          <code>MA86</code>
                          <code>MA87</code>
                          <code>MA88</code>
                          <code>MA89</code>
                          <code>MA90</code>
                          <code>MA91</code>
                          <code>MA92</code>
                          <code>MA93</code>
                          <code>MA94</code>
                          <code>MA95</code>
                          <code>MA96</code>
                          <code>MA97</code>
                          <code>MA98</code>
                          <code>MA99</code>
                          <code>MA100</code>
                          <code>MA101</code>
                          <code>MA102</code>
                          <code>MA103</code>
                          <code>MA104</code>
                          <code>MA105</code>
                          <code>MA106</code>
                          <code>MA107</code>
                          <code>MA108</code>
                          <code>MA109</code>
                          <code>MA110</code>
                          <code>MA111</code>
                          <code>MA112</code>
                          <code>MA113</code>
                          <code>MA114</code>
                          <code>MA115</code>
                          <code>MA116</code>
                          <code>MA117</code>
                          <code>MA118</code>
                          <code>MA119</code>
                          <code>MA120</code>
                          <code>MA121</code>
                          <code>MA122</code>
                          <code>MA123</code>
                          <code>MA124</code>
                          <code>MA125</code>
                          <code>MA126</code>
                          <code>MA127</code>
                          <code>MA128</code>
                          <code>MA129</code>
                          <code>MA130</code>
                          <code>MA131</code>
                          <code>MA132</code>
                          <code>MA133</code>
                          <code>MA134</code>
                          <code>N1</code>
                          <code>N2</code>
                          <code>N3</code>
                          <code>N4</code>
                          <code>N5</code>
                          <code>N6</code>
                          <code>N7</code>
                          <code>N8</code>
                          <code>N9</code>
                          <code>N10</code>
                          <code>N11</code>
                          <code>N12</code>
                          <code>N13</code>
                          <code>N14</code>
                          <code>N15</code>
                          <code>N16</code>
                          <code>N17</code>
                          <code>N18</code>
                          <code>N19</code>
                          <code>N20</code>
                          <code>N21</code>
                          <code>N22</code>
                          <code>N23</code>
                          <code>N24</code>
                          <code>N25</code>
                          <code>N26</code>
                          <code>N27</code>
                          <code>N28</code>
                          <code>N29</code>
                          <code>N30</code>
                          <code>N31</code>
                          <code>N32</code>
                          <code>N33</code>
                          <code>N34</code>
                          <code>N35</code>
                          <code>N36</code>
                          <code>N37</code>
                          <code>N38</code>
                          <code>N39</code>
                          <code>N40</code>
                          <code>N41</code>
                          <code>N42</code>
                          <code>N43</code>
                          <code>N44</code>
                          <code>N45</code>
                          <code>N46</code>
                          <code>N47</code>
                          <code>N48</code>
                          <code>N49</code>
                          <code>N50</code>
                          <code>N51</code>
                          <code>N52</code>
                          <code>N53</code>
                          <code>N54</code>
                          <code>N55</code>
                          <code>N56</code>
                          <code>N57</code>
                          <code>N58</code>
                          <code>N59</code>
                          <code>N60</code>
                          <code>N61</code>
                          <code>N62</code>
                          <code>N63</code>
                          <code>N64</code>
                          <code>N65</code>
                          <code>N66</code>
                          <code>N67</code>
                          <code>N68</code>
                          <code>N69</code>
                          <code>N70</code>
                          <code>N71</code>
                          <code>N72</code>
                          <code>N73</code>
                          <code>N74</code>
                          <code>N75</code>
                          <code>N76</code>
                          <code>N77</code>
                          <code>N78</code>
                          <code>N79</code>
                          <code>N80</code>
                          <code>N81</code>
                          <code>N82</code>
                          <code>N83</code>
                          <code>N84</code>
                          <code>N85</code>
                          <code>N86</code>
                          <code>N87</code>
                          <code>N88</code>
                          <code>N89</code>
                          <code>N90</code>
                          <code>N91</code>
                          <code>N92</code>
                          <code>N93</code>
                          <code>N94</code>
                          <code>N95</code>
                          <code>N96</code>
                          <code>N97</code>
                          <code>N98</code>
                          <code>N99</code>
                          <code>N100</code>
                          <code>N101</code>
                          <code>N102</code>
                          <code>N103</code>
                          <code>N104</code>
                          <code>N105</code>
                          <code>N106</code>
                          <code>N107</code>
                          <code>N108</code>
                          <code>N109</code>
                          <code>N110</code>
                          <code>N111</code>
                          <code>N112</code>
                          <code>N113</code>
                          <code>N114</code>
                          <code>N115</code>
                          <code>N116</code>
                          <code>N117</code>
                          <code>N118</code>
                          <code>N119</code>
                          <code>N120</code>
                          <code>N121</code>
                          <code>N122</code>
                          <code>N123</code>
                          <code>N124</code>
                          <code>N125</code>
                          <code>N126</code>
                          <code>N127</code>
                          <code>N128</code>
                          <code>N129</code>
                          <code>N130</code>
                          <code>N131</code>
                          <code>N132</code>
                          <code>N133</code>
                          <code>N134</code>
                          <code>N135</code>
                          <code>N136</code>
                          <code>N137</code>
                          <code>N138</code>
                          <code>N139</code>
                          <code>N140</code>
                          <code>N141</code>
                          <code>N142</code>
                          <code>N143</code>
                          <code>N144</code>
                          <code>N145</code>
                          <code>N146</code>
                          <code>N147</code>
                          <code>N148</code>
                          <code>N149</code>
                          <code>N150</code>
                          <code>N151</code>
                          <code>N152</code>
                          <code>N153</code>
                          <code>N154</code>
                          <code>N155</code>
                          <code>N156 </code>
                        </valid_codes>
                      </element>
                      <element xid="MOA06">
                        <data_ele>127</data_ele>
                        <name>Remark Code</name>
                        <usage>S</usage>
                        <seq>06</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                        <valid_codes>
                          <code>M1</code>
                          <code>M2</code>
                          <code>M3</code>
                          <code>M4</code>
                          <code>M5</code>
                          <code>M6</code>
                          <code>M7</code>
                          <code>M8</code>
                          <code>M9</code>
                          <code>M10</code>
                          <code>M11</code>
                          <code>M12</code>
                          <code>M13</code>
                          <code>M14</code>
                          <code>M15</code>
                          <code>M16</code>
                          <code>M17</code>
                          <code>M18</code>
                          <code>M19</code>
                          <code>M20</code>
                          <code>M21</code>
                          <code>M22</code>
                          <code>M23</code>
                          <code>M24</code>
                          <code>M25</code>
                          <code>M26</code>
                          <code>M27</code>
                          <code>M28</code>
                          <code>M29</code>
                          <code>M30</code>
                          <code>M31</code>
                          <code>M32</code>
                          <code>M33</code>
                          <code>M34</code>
                          <code>M35</code>
                          <code>M36</code>
                          <code>M37</code>
                          <code>M38</code>
                          <code>M39</code>
                          <code>M40</code>
                          <code>M41</code>
                          <code>M42</code>
                          <code>M43</code>
                          <code>M44</code>
                          <code>M45</code>
                          <code>M46</code>
                          <code>M47</code>
                          <code>M48</code>
                          <code>M49</code>
                          <code>M50</code>
                          <code>M51</code>
                          <code>M52</code>
                          <code>M53</code>
                          <code>M54</code>
                          <code>M55</code>
                          <code>M56</code>
                          <code>M57</code>
                          <code>M58</code>
                          <code>M59</code>
                          <code>M60</code>
                          <code>M61</code>
                          <code>M62</code>
                          <code>M63</code>
                          <code>M64</code>
                          <code>M65</code>
                          <code>M66</code>
                          <code>M67</code>
                          <code>M68</code>
                          <code>M69</code>
                          <code>M70</code>
                          <code>M71</code>
                          <code>M72</code>
                          <code>M73</code>
                          <code>M74</code>
                          <code>M75</code>
                          <code>M76</code>
                          <code>M77</code>
                          <code>M78</code>
                          <code>M79</code>
                          <code>M80</code>
                          <code>M81</code>
                          <code>M82</code>
                          <code>M83</code>
                          <code>M84</code>
                          <code>M85</code>
                          <code>M86</code>
                          <code>M87</code>
                          <code>M88</code>
                          <code>M89</code>
                          <code>M90</code>
                          <code>M91</code>
                          <code>M92</code>
                          <code>M93</code>
                          <code>M94</code>
                          <code>M95</code>
                          <code>M96</code>
                          <code>M97</code>
                          <code>M98</code>
                          <code>M99</code>
                          <code>M100</code>
                          <code>M101</code>
                          <code>M102</code>
                          <code>M103</code>
                          <code>M104</code>
                          <code>M105</code>
                          <code>M106</code>
                          <code>M107</code>
                          <code>M108</code>
                          <code>M109</code>
                          <code>M110</code>
                          <code>M111</code>
                          <code>M112</code>
                          <code>M113</code>
                          <code>M114</code>
                          <code>M115</code>
                          <code>M116</code>
                          <code>M117</code>
                          <code>M118</code>
                          <code>M119</code>
                          <code>M120</code>
                          <code>M121</code>
                          <code>M122</code>
                          <code>M123</code>
                          <code>M124</code>
                          <code>M125</code>
                          <code>M126</code>
                          <code>M127</code>
                          <code>M128</code>
                          <code>M129</code>
                          <code>M130</code>
                          <code>M131</code>
                          <code>M132</code>
                          <code>M133</code>
                          <code>M134</code>
                          <code>M135</code>
                          <code>M136</code>
                          <code>M137</code>
                          <code>M138</code>
                          <code>M139</code>
                          <code>M140</code>
                          <code>M141</code>
                          <code>M142</code>
                          <code>M143</code>
                          <code>M144</code>
                          <code>MA01</code>
                          <code>MA02</code>
                          <code>MA03</code>
                          <code>MA04</code>
                          <code>MA05</code>
                          <code>MA06</code>
                          <code>MA07</code>
                          <code>MA08</code>
                          <code>MA09</code>
                          <code>MA10</code>
                          <code>MA11</code>
                          <code>MA12</code>
                          <code>MA13</code>
                          <code>MA14</code>
                          <code>MA15</code>
                          <code>MA16</code>
                          <code>MA17</code>
                          <code>MA18</code>
                          <code>MA19</code>
                          <code>MA20</code>
                          <code>MA21</code>
                          <code>MA22</code>
                          <code>MA23</code>
                          <code>MA24</code>
                          <code>MA25</code>
                          <code>MA26</code>
                          <code>MA27</code>
                          <code>MA28</code>
                          <code>MA29</code>
                          <code>MA30</code>
                          <code>MA31</code>
                          <code>MA32</code>
                          <code>MA33</code>
                          <code>MA34</code>
                          <code>MA35</code>
                          <code>MA36</code>
                          <code>MA37</code>
                          <code>MA38</code>
                          <code>MA39</code>
                          <code>MA40</code>
                          <code>MA41</code>
                          <code>MA42</code>
                          <code>MA43</code>
                          <code>MA44</code>
                          <code>MA45</code>
                          <code>MA46</code>
                          <code>MA47</code>
                          <code>MA48</code>
                          <code>MA49</code>
                          <code>MA50</code>
                          <code>MA51</code>
                          <code>MA52</code>
                          <code>MA53</code>
                          <code>MA54</code>
                          <code>MA55</code>
                          <code>MA56</code>
                          <code>MA57</code>
                          <code>MA58</code>
                          <code>MA59</code>
                          <code>MA60</code>
                          <code>MA61</code>
                          <code>MA62</code>
                          <code>MA63</code>
                          <code>MA64</code>
                          <code>MA65</code>
                          <code>MA66</code>
                          <code>MA67</code>
                          <code>MA68</code>
                          <code>MA69</code>
                          <code>MA70</code>
                          <code>MA71</code>
                          <code>MA72</code>
                          <code>MA73</code>
                          <code>MA74</code>
                          <code>MA75</code>
                          <code>MA76</code>
                          <code>MA77</code>
                          <code>MA78</code>
                          <code>MA79</code>
                          <code>MA80</code>
                          <code>MA81</code>
                          <code>MA82</code>
                          <code>MA83</code>
                          <code>MA84</code>
                          <code>MA85</code>
                          <code>MA86</code>
                          <code>MA87</code>
                          <code>MA88</code>
                          <code>MA89</code>
                          <code>MA90</code>
                          <code>MA91</code>
                          <code>MA92</code>
                          <code>MA93</code>
                          <code>MA94</code>
                          <code>MA95</code>
                          <code>MA96</code>
                          <code>MA97</code>
                          <code>MA98</code>
                          <code>MA99</code>
                          <code>MA100</code>
                          <code>MA101</code>
                          <code>MA102</code>
                          <code>MA103</code>
                          <code>MA104</code>
                          <code>MA105</code>
                          <code>MA106</code>
                          <code>MA107</code>
                          <code>MA108</code>
                          <code>MA109</code>
                          <code>MA110</code>
                          <code>MA111</code>
                          <code>MA112</code>
                          <code>MA113</code>
                          <code>MA114</code>
                          <code>MA115</code>
                          <code>MA116</code>
                          <code>MA117</code>
                          <code>MA118</code>
                          <code>MA119</code>
                          <code>MA120</code>
                          <code>MA121</code>
                          <code>MA122</code>
                          <code>MA123</code>
                          <code>MA124</code>
                          <code>MA125</code>
                          <code>MA126</code>
                          <code>MA127</code>
                          <code>MA128</code>
                          <code>MA129</code>
                          <code>MA130</code>
                          <code>MA131</code>
                          <code>MA132</code>
                          <code>MA133</code>
                          <code>MA134</code>
                          <code>N1</code>
                          <code>N2</code>
                          <code>N3</code>
                          <code>N4</code>
                          <code>N5</code>
                          <code>N6</code>
                          <code>N7</code>
                          <code>N8</code>
                          <code>N9</code>
                          <code>N10</code>
                          <code>N11</code>
                          <code>N12</code>
                          <code>N13</code>
                          <code>N14</code>
                          <code>N15</code>
                          <code>N16</code>
                          <code>N17</code>
                          <code>N18</code>
                          <code>N19</code>
                          <code>N20</code>
                          <code>N21</code>
                          <code>N22</code>
                          <code>N23</code>
                          <code>N24</code>
                          <code>N25</code>
                          <code>N26</code>
                          <code>N27</code>
                          <code>N28</code>
                          <code>N29</code>
                          <code>N30</code>
                          <code>N31</code>
                          <code>N32</code>
                          <code>N33</code>
                          <code>N34</code>
                          <code>N35</code>
                          <code>N36</code>
                          <code>N37</code>
                          <code>N38</code>
                          <code>N39</code>
                          <code>N40</code>
                          <code>N41</code>
                          <code>N42</code>
                          <code>N43</code>
                          <code>N44</code>
                          <code>N45</code>
                          <code>N46</code>
                          <code>N47</code>
                          <code>N48</code>
                          <code>N49</code>
                          <code>N50</code>
                          <code>N51</code>
                          <code>N52</code>
                          <code>N53</code>
                          <code>N54</code>
                          <code>N55</code>
                          <code>N56</code>
                          <code>N57</code>
                          <code>N58</code>
                          <code>N59</code>
                          <code>N60</code>
                          <code>N61</code>
                          <code>N62</code>
                          <code>N63</code>
                          <code>N64</code>
                          <code>N65</code>
                          <code>N66</code>
                          <code>N67</code>
                          <code>N68</code>
                          <code>N69</code>
                          <code>N70</code>
                          <code>N71</code>
                          <code>N72</code>
                          <code>N73</code>
                          <code>N74</code>
                          <code>N75</code>
                          <code>N76</code>
                          <code>N77</code>
                          <code>N78</code>
                          <code>N79</code>
                          <code>N80</code>
                          <code>N81</code>
                          <code>N82</code>
                          <code>N83</code>
                          <code>N84</code>
                          <code>N85</code>
                          <code>N86</code>
                          <code>N87</code>
                          <code>N88</code>
                          <code>N89</code>
                          <code>N90</code>
                          <code>N91</code>
                          <code>N92</code>
                          <code>N93</code>
                          <code>N94</code>
                          <code>N95</code>
                          <code>N96</code>
                          <code>N97</code>
                          <code>N98</code>
                          <code>N99</code>
                          <code>N100</code>
                          <code>N101</code>
                          <code>N102</code>
                          <code>N103</code>
                          <code>N104</code>
                          <code>N105</code>
                          <code>N106</code>
                          <code>N107</code>
                          <code>N108</code>
                          <code>N109</code>
                          <code>N110</code>
                          <code>N111</code>
                          <code>N112</code>
                          <code>N113</code>
                          <code>N114</code>
                          <code>N115</code>
                          <code>N116</code>
                          <code>N117</code>
                          <code>N118</code>
                          <code>N119</code>
                          <code>N120</code>
                          <code>N121</code>
                          <code>N122</code>
                          <code>N123</code>
                          <code>N124</code>
                          <code>N125</code>
                          <code>N126</code>
                          <code>N127</code>
                          <code>N128</code>
                          <code>N129</code>
                          <code>N130</code>
                          <code>N131</code>
                          <code>N132</code>
                          <code>N133</code>
                          <code>N134</code>
                          <code>N135</code>
                          <code>N136</code>
                          <code>N137</code>
                          <code>N138</code>
                          <code>N139</code>
                          <code>N140</code>
                          <code>N141</code>
                          <code>N142</code>
                          <code>N143</code>
                          <code>N144</code>
                          <code>N145</code>
                          <code>N146</code>
                          <code>N147</code>
                          <code>N148</code>
                          <code>N149</code>
                          <code>N150</code>
                          <code>N151</code>
                          <code>N152</code>
                          <code>N153</code>
                          <code>N154</code>
                          <code>N155</code>
                          <code>N156 </code>
                        </valid_codes>
                      </element>
                      <element xid="MOA07">
                        <data_ele>127</data_ele>
                        <name>Remark Code</name>
                        <usage>S</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                        <valid_codes>
                          <code>M1</code>
                          <code>M2</code>
                          <code>M3</code>
                          <code>M4</code>
                          <code>M5</code>
                          <code>M6</code>
                          <code>M7</code>
                          <code>M8</code>
                          <code>M9</code>
                          <code>M10</code>
                          <code>M11</code>
                          <code>M12</code>
                          <code>M13</code>
                          <code>M14</code>
                          <code>M15</code>
                          <code>M16</code>
                          <code>M17</code>
                          <code>M18</code>
                          <code>M19</code>
                          <code>M20</code>
                          <code>M21</code>
                          <code>M22</code>
                          <code>M23</code>
                          <code>M24</code>
                          <code>M25</code>
                          <code>M26</code>
                          <code>M27</code>
                          <code>M28</code>
                          <code>M29</code>
                          <code>M30</code>
                          <code>M31</code>
                          <code>M32</code>
                          <code>M33</code>
                          <code>M34</code>
                          <code>M35</code>
                          <code>M36</code>
                          <code>M37</code>
                          <code>M38</code>
                          <code>M39</code>
                          <code>M40</code>
                          <code>M41</code>
                          <code>M42</code>
                          <code>M43</code>
                          <code>M44</code>
                          <code>M45</code>
                          <code>M46</code>
                          <code>M47</code>
                          <code>M48</code>
                          <code>M49</code>
                          <code>M50</code>
                          <code>M51</code>
                          <code>M52</code>
                          <code>M53</code>
                          <code>M54</code>
                          <code>M55</code>
                          <code>M56</code>
                          <code>M57</code>
                          <code>M58</code>
                          <code>M59</code>
                          <code>M60</code>
                          <code>M61</code>
                          <code>M62</code>
                          <code>M63</code>
                          <code>M64</code>
                          <code>M65</code>
                          <code>M66</code>
                          <code>M67</code>
                          <code>M68</code>
                          <code>M69</code>
                          <code>M70</code>
                          <code>M71</code>
                          <code>M72</code>
                          <code>M73</code>
                          <code>M74</code>
                          <code>M75</code>
                          <code>M76</code>
                          <code>M77</code>
                          <code>M78</code>
                          <code>M79</code>
                          <code>M80</code>
                          <code>M81</code>
                          <code>M82</code>
                          <code>M83</code>
                          <code>M84</code>
                          <code>M85</code>
                          <code>M86</code>
                          <code>M87</code>
                          <code>M88</code>
                          <code>M89</code>
                          <code>M90</code>
                          <code>M91</code>
                          <code>M92</code>
                          <code>M93</code>
                          <code>M94</code>
                          <code>M95</code>
                          <code>M96</code>
                          <code>M97</code>
                          <code>M98</code>
                          <code>M99</code>
                          <code>M100</code>
                          <code>M101</code>
                          <code>M102</code>
                          <code>M103</code>
                          <code>M104</code>
                          <code>M105</code>
                          <code>M106</code>
                          <code>M107</code>
                          <code>M108</code>
                          <code>M109</code>
                          <code>M110</code>
                          <code>M111</code>
                          <code>M112</code>
                          <code>M113</code>
                          <code>M114</code>
                          <code>M115</code>
                          <code>M116</code>
                          <code>M117</code>
                          <code>M118</code>
                          <code>M119</code>
                          <code>M120</code>
                          <code>M121</code>
                          <code>M122</code>
                          <code>M123</code>
                          <code>M124</code>
                          <code>M125</code>
                          <code>M126</code>
                          <code>M127</code>
                          <code>M128</code>
                          <code>M129</code>
                          <code>M130</code>
                          <code>M131</code>
                          <code>M132</code>
                          <code>M133</code>
                          <code>M134</code>
                          <code>M135</code>
                          <code>M136</code>
                          <code>M137</code>
                          <code>M138</code>
                          <code>M139</code>
                          <code>M140</code>
                          <code>M141</code>
                          <code>M142</code>
                          <code>M143</code>
                          <code>M144</code>
                          <code>MA01</code>
                          <code>MA02</code>
                          <code>MA03</code>
                          <code>MA04</code>
                          <code>MA05</code>
                          <code>MA06</code>
                          <code>MA07</code>
                          <code>MA08</code>
                          <code>MA09</code>
                          <code>MA10</code>
                          <code>MA11</code>
                          <code>MA12</code>
                          <code>MA13</code>
                          <code>MA14</code>
                          <code>MA15</code>
                          <code>MA16</code>
                          <code>MA17</code>
                          <code>MA18</code>
                          <code>MA19</code>
                          <code>MA20</code>
                          <code>MA21</code>
                          <code>MA22</code>
                          <code>MA23</code>
                          <code>MA24</code>
                          <code>MA25</code>
                          <code>MA26</code>
                          <code>MA27</code>
                          <code>MA28</code>
                          <code>MA29</code>
                          <code>MA30</code>
                          <code>MA31</code>
                          <code>MA32</code>
                          <code>MA33</code>
                          <code>MA34</code>
                          <code>MA35</code>
                          <code>MA36</code>
                          <code>MA37</code>
                          <code>MA38</code>
                          <code>MA39</code>
                          <code>MA40</code>
                          <code>MA41</code>
                          <code>MA42</code>
                          <code>MA43</code>
                          <code>MA44</code>
                          <code>MA45</code>
                          <code>MA46</code>
                          <code>MA47</code>
                          <code>MA48</code>
                          <code>MA49</code>
                          <code>MA50</code>
                          <code>MA51</code>
                          <code>MA52</code>
                          <code>MA53</code>
                          <code>MA54</code>
                          <code>MA55</code>
                          <code>MA56</code>
                          <code>MA57</code>
                          <code>MA58</code>
                          <code>MA59</code>
                          <code>MA60</code>
                          <code>MA61</code>
                          <code>MA62</code>
                          <code>MA63</code>
                          <code>MA64</code>
                          <code>MA65</code>
                          <code>MA66</code>
                          <code>MA67</code>
                          <code>MA68</code>
                          <code>MA69</code>
                          <code>MA70</code>
                          <code>MA71</code>
                          <code>MA72</code>
                          <code>MA73</code>
                          <code>MA74</code>
                          <code>MA75</code>
                          <code>MA76</code>
                          <code>MA77</code>
                          <code>MA78</code>
                          <code>MA79</code>
                          <code>MA80</code>
                          <code>MA81</code>
                          <code>MA82</code>
                          <code>MA83</code>
                          <code>MA84</code>
                          <code>MA85</code>
                          <code>MA86</code>
                          <code>MA87</code>
                          <code>MA88</code>
                          <code>MA89</code>
                          <code>MA90</code>
                          <code>MA91</code>
                          <code>MA92</code>
                          <code>MA93</code>
                          <code>MA94</code>
                          <code>MA95</code>
                          <code>MA96</code>
                          <code>MA97</code>
                          <code>MA98</code>
                          <code>MA99</code>
                          <code>MA100</code>
                          <code>MA101</code>
                          <code>MA102</code>
                          <code>MA103</code>
                          <code>MA104</code>
                          <code>MA105</code>
                          <code>MA106</code>
                          <code>MA107</code>
                          <code>MA108</code>
                          <code>MA109</code>
                          <code>MA110</code>
                          <code>MA111</code>
                          <code>MA112</code>
                          <code>MA113</code>
                          <code>MA114</code>
                          <code>MA115</code>
                          <code>MA116</code>
                          <code>MA117</code>
                          <code>MA118</code>
                          <code>MA119</code>
                          <code>MA120</code>
                          <code>MA121</code>
                          <code>MA122</code>
                          <code>MA123</code>
                          <code>MA124</code>
                          <code>MA125</code>
                          <code>MA126</code>
                          <code>MA127</code>
                          <code>MA128</code>
                          <code>MA129</code>
                          <code>MA130</code>
                          <code>MA131</code>
                          <code>MA132</code>
                          <code>MA133</code>
                          <code>MA134</code>
                          <code>N1</code>
                          <code>N2</code>
                          <code>N3</code>
                          <code>N4</code>
                          <code>N5</code>
                          <code>N6</code>
                          <code>N7</code>
                          <code>N8</code>
                          <code>N9</code>
                          <code>N10</code>
                          <code>N11</code>
                          <code>N12</code>
                          <code>N13</code>
                          <code>N14</code>
                          <code>N15</code>
                          <code>N16</code>
                          <code>N17</code>
                          <code>N18</code>
                          <code>N19</code>
                          <code>N20</code>
                          <code>N21</code>
                          <code>N22</code>
                          <code>N23</code>
                          <code>N24</code>
                          <code>N25</code>
                          <code>N26</code>
                          <code>N27</code>
                          <code>N28</code>
                          <code>N29</code>
                          <code>N30</code>
                          <code>N31</code>
                          <code>N32</code>
                          <code>N33</code>
                          <code>N34</code>
                          <code>N35</code>
                          <code>N36</code>
                          <code>N37</code>
                          <code>N38</code>
                          <code>N39</code>
                          <code>N40</code>
                          <code>N41</code>
                          <code>N42</code>
                          <code>N43</code>
                          <code>N44</code>
                          <code>N45</code>
                          <code>N46</code>
                          <code>N47</code>
                          <code>N48</code>
                          <code>N49</code>
                          <code>N50</code>
                          <code>N51</code>
                          <code>N52</code>
                          <code>N53</code>
                          <code>N54</code>
                          <code>N55</code>
                          <code>N56</code>
                          <code>N57</code>
                          <code>N58</code>
                          <code>N59</code>
                          <code>N60</code>
                          <code>N61</code>
                          <code>N62</code>
                          <code>N63</code>
                          <code>N64</code>
                          <code>N65</code>
                          <code>N66</code>
                          <code>N67</code>
                          <code>N68</code>
                          <code>N69</code>
                          <code>N70</code>
                          <code>N71</code>
                          <code>N72</code>
                          <code>N73</code>
                          <code>N74</code>
                          <code>N75</code>
                          <code>N76</code>
                          <code>N77</code>
                          <code>N78</code>
                          <code>N79</code>
                          <code>N80</code>
                          <code>N81</code>
                          <code>N82</code>
                          <code>N83</code>
                          <code>N84</code>
                          <code>N85</code>
                          <code>N86</code>
                          <code>N87</code>
                          <code>N88</code>
                          <code>N89</code>
                          <code>N90</code>
                          <code>N91</code>
                          <code>N92</code>
                          <code>N93</code>
                          <code>N94</code>
                          <code>N95</code>
                          <code>N96</code>
                          <code>N97</code>
                          <code>N98</code>
                          <code>N99</code>
                          <code>N100</code>
                          <code>N101</code>
                          <code>N102</code>
                          <code>N103</code>
                          <code>N104</code>
                          <code>N105</code>
                          <code>N106</code>
                          <code>N107</code>
                          <code>N108</code>
                          <code>N109</code>
                          <code>N110</code>
                          <code>N111</code>
                          <code>N112</code>
                          <code>N113</code>
                          <code>N114</code>
                          <code>N115</code>
                          <code>N116</code>
                          <code>N117</code>
                          <code>N118</code>
                          <code>N119</code>
                          <code>N120</code>
                          <code>N121</code>
                          <code>N122</code>
                          <code>N123</code>
                          <code>N124</code>
                          <code>N125</code>
                          <code>N126</code>
                          <code>N127</code>
                          <code>N128</code>
                          <code>N129</code>
                          <code>N130</code>
                          <code>N131</code>
                          <code>N132</code>
                          <code>N133</code>
                          <code>N134</code>
                          <code>N135</code>
                          <code>N136</code>
                          <code>N137</code>
                          <code>N138</code>
                          <code>N139</code>
                          <code>N140</code>
                          <code>N141</code>
                          <code>N142</code>
                          <code>N143</code>
                          <code>N144</code>
                          <code>N145</code>
                          <code>N146</code>
                          <code>N147</code>
                          <code>N148</code>
                          <code>N149</code>
                          <code>N150</code>
                          <code>N151</code>
                          <code>N152</code>
                          <code>N153</code>
                          <code>N154</code>
                          <code>N155</code>
                          <code>N156 </code>
                        </valid_codes>
                      </element>
                      <element xid="MOA08">
                        <data_ele>782</data_ele>
                        <name>Claim ESRD Payment Amount</name>
                        <usage>S</usage>
                        <seq>08</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="MOA09">
                        <data_ele>782</data_ele>
                        <name>Nonpayable Professional Component Amount</name>
                        <usage>S</usage>
                        <seq>09</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                    </segment>
<!--End of MOA segment-->
                    <loop xid="2330A">
                      <name>Other Subscriber Name</name>
                      <usage>R</usage>
                      <pos>325</pos>
                      <repeat>1</repeat>
                      <segment xid="NM1">
                        <name>Other Subscriber Name</name>
                        <usage>R</usage>
                        <pos>325</pos>
                        <max_use>1</max_use>
                        <element xid="NM101">
                          <data_ele>98</data_ele>
                          <name>Entity Identifier Code</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                          <valid_codes>
                            <code>IL</code>
                          </valid_codes>
                        </element>
                        <element xid="NM102">
                          <data_ele>1065</data_ele>
                          <name>Entity Type Qualifier</name>
                          <usage>R</usage>
                          <seq>02</seq>
                          <data_type>ID</data_type>
                          <min_len>1</min_len>
                          <max_len>1</max_len>
                          <valid_codes>
                            <code>1</code>
                            <code>2</code>
                          </valid_codes>
                        </element>
                        <element xid="NM103">
                          <data_ele>1035</data_ele>
                          <name>Other Insured Last Name</name>
                          <usage>R</usage>
                          <seq>03</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>35</max_len>
                        </element>
                        <element xid="NM104">
                          <data_ele>1036</data_ele>
                          <name>Other Insured First Name</name>
                          <usage>S</usage>
                          <seq>04</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>25</max_len>
                        </element>
                        <element xid="NM105">
                          <data_ele>1037</data_ele>
                          <name>Other Insured Middle Name</name>
                          <usage>S</usage>
                          <seq>05</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>25</max_len>
                        </element>
                        <element xid="NM106">
                          <data_ele>1038</data_ele>
                          <name>fix</name>
                          <usage>N</usage>
                          <seq>06</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>10</max_len>
                        </element>
                        <element xid="NM107">
                          <data_ele>1039</data_ele>
                          <name>Other Insured Name Suffix</name>
                          <usage>S</usage>
                          <seq>07</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>10</max_len>
                        </element>
                        <element xid="NM108">
                          <data_ele>66</data_ele>
                          <name>Identification Code Qualifier</name>
                          <usage>R</usage>
                          <seq>08</seq>
                          <data_type>ID</data_type>
                          <min_len>1</min_len>
                          <max_len>2</max_len>
                          <valid_codes>
                            <code>MI</code>
                            <code>ZZ</code>
                          </valid_codes>
                        </element>
                        <element xid="NM109">
                          <data_ele>67</data_ele>
                          <name>Other Insured Identifier</name>
                          <usage>R</usage>
                          <seq>09</seq>
                          <data_type>AN</data_type>
                          <min_len>2</min_len>
                          <max_len>80</max_len>
                        </element>
                        <element xid="NM110">
                          <data_ele>706</data_ele>
                          <name>Entity Relationship Code</name>
                          <usage>N</usage>
                          <seq>10</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                        </element>
                        <element xid="NM111">
                          <data_ele>98</data_ele>
                          <name>Entity Identifier Code</name>
                          <usage>N</usage>
                          <seq>11</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                        </element>
                      </segment>
<!--End of NM1 segment-->
                      <segment xid="N3">
                        <name>Other Subscriber Address</name>
                        <usage>S</usage>
                        <pos>332</pos>
                        <max_use>1</max_use>
                        <element xid="N301">
                          <data_ele>166</data_ele>
                          <name>Other Insured Address Line</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>55</max_len>
                        </element>
                        <element xid="N302">
                          <data_ele>166</data_ele>
                          <name>Other Insured Address Line</name>
                          <usage>S</usage>
                          <seq>02</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>55</max_len>
                        </element>
                      </segment>
<!--End of N3 segment-->
                      <segment xid="N4">
                        <name>Other Subscriber City/State/ZIP Code</name>
                        <usage>S</usage>
                        <pos>340</pos>
                        <max_use>1</max_use>
                        <element xid="N401">
                          <data_ele>19</data_ele>
                          <name>Other Insured City Name</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>AN</data_type>
                          <min_len>2</min_len>
                          <max_len>30</max_len>
                        </element>
                        <element xid="N402">
                          <data_ele>156</data_ele>
                          <name>Other Insured State Code</name>
                          <usage>R</usage>
                          <seq>02</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                          <valid_codes external="states"/>
                        </element>
                        <element xid="N403">
                          <data_ele>116</data_ele>
                          <name>Other Insured Postal Zone or Zip Code</name>
                          <usage>R</usage>
                          <seq>03</seq>
                          <data_type>ID</data_type>
                          <min_len>3</min_len>
                          <max_len>15</max_len>
                        </element>
                        <element xid="N404">
                          <data_ele>26</data_ele>
                          <name>Subscriber Country Code</name>
                          <usage>S</usage>
                          <seq>04</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                          <valid_codes external="country"/>
                        </element>
                        <element xid="N405">
                          <data_ele>309</data_ele>
                          <name>Location Qualifier</name>
                          <usage>N</usage>
                          <seq>05</seq>
                          <data_type>ID</data_type>
                          <min_len>1</min_len>
                          <max_len>2</max_len>
                        </element>
                        <element xid="N406">
                          <data_ele>310</data_ele>
                          <name>Location Identifier</name>
                          <usage>N</usage>
                          <seq>06</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>30</max_len>
                        </element>
                      </segment>
<!--End of N4 segment-->
                      <segment xid="REF">
                        <name>Other Subscriber Secondary Information</name>
                        <usage>S</usage>
                        <pos>355</pos>
                        <max_use>3</max_use>
                        <element xid="REF01">
                          <data_ele>128</data_ele>
                          <name>Reference Identification Qualifier</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                          <valid_codes>
                            <code>1W</code>
                            <code>23</code>
                            <code>IG</code>
                            <code>SY</code>
                          </valid_codes>
                        </element>
                        <element xid="REF02">
                          <data_ele>127</data_ele>
                          <name>Other Insured Additional Identifier</name>
                          <usage>R</usage>
                          <seq>02</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>30</max_len>
                        </element>
                        <element xid="REF03">
                          <data_ele>352</data_ele>
                          <name>Description</name>
                          <usage>N</usage>
                          <seq>03</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>80</max_len>
                        </element>
                        <composite>
                          <data_ele>C040</data_ele>
                          <name>Reference Identifier</name>
                          <usage>N</usage>
                          <seq>04</seq>
                        </composite>
                      </segment>
<!--End of REF segment-->
                    </loop>
<!--End of 2330A loop-->
                    <loop xid="2330B">
                      <name>Other Payer Name</name>
                      <usage>R</usage>
                      <pos>325</pos>
                      <repeat>1</repeat>
                      <segment xid="NM1">
                        <name>Other Payer Name</name>
                        <usage>R</usage>
                        <pos>325</pos>
                        <max_use>1</max_use>
                        <element xid="NM101">
                          <data_ele>98</data_ele>
                          <name>Entity Identifier Code</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                          <valid_codes>
                            <code>PR</code>
                          </valid_codes>
                        </element>
                        <element xid="NM102">
                          <data_ele>1065</data_ele>
                          <name>Entity Type Qualifier</name>
                          <usage>R</usage>
                          <seq>02</seq>
                          <data_type>ID</data_type>
                          <min_len>1</min_len>
                          <max_len>1</max_len>
                          <valid_codes>
                            <code>2</code>
                          </valid_codes>
                        </element>
                        <element xid="NM103">
                          <data_ele>1035</data_ele>
                          <name>Other Payer Last or Organization Name</name>
                          <usage>R</usage>
                          <seq>03</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>35</max_len>
                        </element>
                        <element xid="NM104">
                          <data_ele>1036</data_ele>
                          <name>Name First</name>
                          <usage>N</usage>
                          <seq>04</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>25</max_len>
                        </element>
                        <element xid="NM105">
                          <data_ele>1037</data_ele>
                          <name>Name Middle</name>
                          <usage>N</usage>
                          <seq>05</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>25</max_len>
                        </element>
                        <element xid="NM106">
                          <data_ele>1038</data_ele>
                          <name>Name Prefix</name>
                          <usage>N</usage>
                          <seq>06</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>10</max_len>
                        </element>
                        <element xid="NM107">
                          <data_ele>1039</data_ele>
                          <name>Name Suffix</name>
                          <usage>N</usage>
                          <seq>07</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>10</max_len>
                        </element>
                        <element xid="NM108">
                          <data_ele>66</data_ele>
                          <name>Identification Code Qualifier</name>
                          <usage>R</usage>
                          <seq>08</seq>
                          <data_type>ID</data_type>
                          <min_len>1</min_len>
                          <max_len>2</max_len>
                          <valid_codes>
                            <code>PI</code>
                            <code>XV</code>
                          </valid_codes>
                        </element>
                        <element xid="NM109">
                          <data_ele>67</data_ele>
                          <name>Other Payer Primary Identifier</name>
                          <usage>R</usage>
                          <seq>09</seq>
                          <data_type>AN</data_type>
                          <min_len>2</min_len>
                          <max_len>80</max_len>
                        </element>
                        <element xid="NM110">
                          <data_ele>706</data_ele>
                          <name>Entity Relationship Code</name>
                          <usage>N</usage>
                          <seq>10</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                        </element>
                        <element xid="NM111">
                          <data_ele>98</data_ele>
                          <name>Entity Identifier Code</name>
                          <usage>N</usage>
                          <seq>11</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                        </element>
                      </segment>
<!--End of NM1 segment-->
                      <segment xid="N3">
                        <name>Other Payer Address</name>
                        <usage>S</usage>
                        <pos>332</pos>
                        <max_use>1</max_use>
                        <element xid="N301">
                          <data_ele>166</data_ele>
                          <name>Other Payer Address Line</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>55</max_len>
                        </element>
                        <element xid="N302">
                          <data_ele>166</data_ele>
                          <name>Other Payer Address Line</name>
                          <usage>S</usage>
                          <seq>02</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>55</max_len>
                        </element>
                      </segment>
<!--End of N3 segment-->
                      <segment xid="N4">
                        <name>Other Payer City/State/ZIP Code</name>
                        <usage>S</usage>
                        <pos>340</pos>
                        <max_use>1</max_use>
                        <element xid="N401">
                          <data_ele>19</data_ele>
                          <name>Other Payer City Name</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>AN</data_type>
                          <min_len>2</min_len>
                          <max_len>30</max_len>
                        </element>
                        <element xid="N402">
                          <data_ele>156</data_ele>
                          <name>Other Payer State Code</name>
                          <usage>R</usage>
                          <seq>02</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                          <valid_codes external="states"/>
                        </element>
                        <element xid="N403">
                          <data_ele>116</data_ele>
                          <name>Other Payer Postal Zone or Zip Code</name>
                          <usage>R</usage>
                          <seq>03</seq>
                          <data_type>ID</data_type>
                          <min_len>3</min_len>
                          <max_len>15</max_len>
                        </element>
                        <element xid="N404">
                          <data_ele>26</data_ele>
                          <name>Payer Country Code</name>
                          <usage>S</usage>
                          <seq>04</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                          <valid_codes external="country"/>
                        </element>
                        <element xid="N405">
                          <data_ele>309</data_ele>
                          <name>Location Qualifier</name>
                          <usage>N</usage>
                          <seq>05</seq>
                          <data_type>ID</data_type>
                          <min_len>1</min_len>
                          <max_len>2</max_len>
                        </element>
                        <element xid="N406">
                          <data_ele>310</data_ele>
                          <name>Location Identifier</name>
                          <usage>N</usage>
                          <seq>06</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>30</max_len>
                        </element>
                      </segment>
<!--End of N4 segment-->
                      <segment xid="DTP">
                        <name>Claim Adjudication Date</name>
                        <usage>S</usage>
                        <pos>350</pos>
                        <max_use>1</max_use>
                        <element xid="DTP01">
                          <data_ele>374</data_ele>
                          <name>Date Time Qualifier</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>ID</data_type>
                          <min_len>3</min_len>
                          <max_len>3</max_len>
                          <valid_codes>
                            <code>573</code>
                          </valid_codes>
                        </element>
                        <element xid="DTP02">
                          <data_ele>1250</data_ele>
                          <name>Date Time Period Format Qualifier</name>
                          <usage>R</usage>
                          <seq>02</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                          <valid_codes>
                            <code>D8</code>
                          </valid_codes>
                        </element>
                        <element xid="DTP03">
                          <data_ele>1251</data_ele>
                          <name>Adjudication or Payment Date</name>
                          <usage>R</usage>
                          <seq>03</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>35</max_len>
                        </element>
                      </segment>
<!--End of DTP segment-->
                      <segment xid="REF">
                        <name>Other Payer Secondary Identification and Reference Number</name>
                        <usage>S</usage>
                        <pos>355</pos>
                        <max_use>2</max_use>
                        <element xid="REF01">
                          <data_ele>128</data_ele>
                          <name>Reference Identification Qualifier</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                          <valid_codes>
                            <code>2U</code>
                            <code>F8</code>
                            <code>FY</code>
                            <code>NF</code>
                            <code>TJ</code>
                          </valid_codes>
                        </element>
                        <element xid="REF02">
                          <data_ele>127</data_ele>
                          <name>Other Payer Secondary Identifier</name>
                          <usage>R</usage>
                          <seq>02</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>30</max_len>
                        </element>
                        <element xid="REF03">
                          <data_ele>352</data_ele>
                          <name>Description</name>
                          <usage>N</usage>
                          <seq>03</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>80</max_len>
                        </element>
                        <composite>
                          <data_ele>C040</data_ele>
                          <name>Reference Identifier</name>
                          <usage>N</usage>
                          <seq>04</seq>
                        </composite>
                      </segment>
<!--End of REF segment-->
                      <segment xid="REF">
                        <name>Other Payer Prior Authorization or Referral Number</name>
                        <usage>S</usage>
                        <pos>355</pos>
                        <max_use>1</max_use>
                        <element xid="REF01">
                          <data_ele>128</data_ele>
                          <name>Reference Identification Qualifier</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                          <valid_codes>
                            <code>9F</code>
                            <code>G1</code>
                          </valid_codes>
                        </element>
                        <element xid="REF02">
                          <data_ele>127</data_ele>
                          <name>Other Payer Prior Authorization or Referral Number</name>
                          <usage>R</usage>
                          <seq>02</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>30</max_len>
                        </element>
                        <element xid="REF03">
                          <data_ele>352</data_ele>
                          <name>Description</name>
                          <usage>N</usage>
                          <seq>03</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>80</max_len>
                        </element>
                        <composite>
                          <data_ele>C040</data_ele>
                          <name>Reference Identifier</name>
                          <usage>N</usage>
                          <seq>04</seq>
                        </composite>
                      </segment>
<!--End of REF segment-->
                    </loop>
<!--End of 2330B loop-->
                    <loop xid="2330C">
                      <name>Other Payer Patient Information</name>
                      <usage>S</usage>
                      <pos>325</pos>
                      <repeat>1</repeat>
                      <segment xid="NM1">
                        <name>Other Payer Patient Information</name>
                        <usage>R</usage>
                        <pos>325</pos>
                        <max_use>1</max_use>
                        <element xid="NM101">
                          <data_ele>98</data_ele>
                          <name>Entity Identifier Code</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                          <valid_codes>
                            <code>QC</code>
                          </valid_codes>
                        </element>
                        <element xid="NM102">
                          <data_ele>1065</data_ele>
                          <name>Entity Type Qualifier</name>
                          <usage>R</usage>
                          <seq>02</seq>
                          <data_type>ID</data_type>
                          <min_len>1</min_len>
                          <max_len>1</max_len>
                          <valid_codes>
                            <code>1</code>
                          </valid_codes>
                        </element>
                        <element xid="NM103">
                          <data_ele>1035</data_ele>
                          <name>Name Last or Organization Name</name>
                          <usage>N</usage>
                          <seq>03</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>35</max_len>
                        </element>
                        <element xid="NM104">
                          <data_ele>1036</data_ele>
                          <name>Name First</name>
                          <usage>N</usage>
                          <seq>04</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>25</max_len>
                        </element>
                        <element xid="NM105">
                          <data_ele>1037</data_ele>
                          <name>Name Middle</name>
                          <usage>N</usage>
                          <seq>05</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>25</max_len>
                        </element>
                        <element xid="NM106">
                          <data_ele>1038</data_ele>
                          <name>Name Prefix</name>
                          <usage>N</usage>
                          <seq>06</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>10</max_len>
                        </element>
                        <element xid="NM107">
                          <data_ele>1039</data_ele>
                          <name>Name Suffix</name>
                          <usage>N</usage>
                          <seq>07</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>10</max_len>
                        </element>
                        <element xid="NM108">
                          <data_ele>66</data_ele>
                          <name>Identification Code Qualifier</name>
                          <usage>R</usage>
                          <seq>08</seq>
                          <data_type>ID</data_type>
                          <min_len>1</min_len>
                          <max_len>2</max_len>
                          <valid_codes>
                            <code>EI</code>
                            <code>MI</code>
                          </valid_codes>
                        </element>
                        <element xid="NM109">
                          <data_ele>67</data_ele>
                          <name>Other Payer Patient Primary Identifier</name>
                          <usage>R</usage>
                          <seq>09</seq>
                          <data_type>AN</data_type>
                          <min_len>2</min_len>
                          <max_len>80</max_len>
                        </element>
                        <element xid="NM110">
                          <data_ele>706</data_ele>
                          <name>Entity Relationship Code</name>
                          <usage>N</usage>
                          <seq>10</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                        </element>
                        <element xid="NM111">
                          <data_ele>98</data_ele>
                          <name>Entity Identifier Code</name>
                          <usage>N</usage>
                          <seq>11</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                        </element>
                      </segment>
<!--End of NM1 segment-->
                      <segment xid="REF">
                        <name>Other Payer identification Number</name>
                        <usage>S</usage>
                        <pos>355</pos>
                        <max_use>3</max_use>
                        <element xid="REF01">
                          <data_ele>128</data_ele>
                          <name>Reference Identification Qualifier</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                          <valid_codes>
                            <code>1W</code>
                            <code>IG</code>
                            <code>SY</code>
                          </valid_codes>
                        </element>
                        <element xid="REF02">
                          <data_ele>127</data_ele>
                          <name>Other Payer Patient Secondary Identifier</name>
                          <usage>R</usage>
                          <seq>02</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>30</max_len>
                        </element>
                        <element xid="REF03">
                          <data_ele>352</data_ele>
                          <name>Description</name>
                          <usage>N</usage>
                          <seq>03</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>80</max_len>
                        </element>
                        <composite>
                          <data_ele>C040</data_ele>
                          <name>Reference Identifier</name>
                          <usage>N</usage>
                          <seq>04</seq>
                        </composite>
                      </segment>
<!--End of REF segment-->
                    </loop>
<!--End of 2330C loop-->
                    <loop xid="2330D">
                      <name>Other Payer Attending Provider</name>
                      <usage>S</usage>
                      <pos>325</pos>
                      <repeat>1</repeat>
                      <segment xid="NM1">
                        <name>Other Payer Attending Provider</name>
                        <usage>R</usage>
                        <pos>325</pos>
                        <max_use>1</max_use>
                        <element xid="NM101">
                          <data_ele>98</data_ele>
                          <name>Entity Identifier Code</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                          <valid_codes>
                            <code>71</code>
                          </valid_codes>
                        </element>
                        <element xid="NM102">
                          <data_ele>1065</data_ele>
                          <name>Entity Type Qualifier</name>
                          <usage>R</usage>
                          <seq>02</seq>
                          <data_type>ID</data_type>
                          <min_len>1</min_len>
                          <max_len>1</max_len>
                          <valid_codes>
                            <code>1</code>
                            <code>2</code>
                          </valid_codes>
                        </element>
                        <element xid="NM103">
                          <data_ele>1035</data_ele>
                          <name>Name Last or Organization Name</name>
                          <usage>N</usage>
                          <seq>03</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>35</max_len>
                        </element>
                        <element xid="NM104">
                          <data_ele>1036</data_ele>
                          <name>Name First</name>
                          <usage>N</usage>
                          <seq>04</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>25</max_len>
                        </element>
                        <element xid="NM105">
                          <data_ele>1037</data_ele>
                          <name>Name Middle</name>
                          <usage>N</usage>
                          <seq>05</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>25</max_len>
                        </element>
                        <element xid="NM106">
                          <data_ele>1038</data_ele>
                          <name>Name Prefix</name>
                          <usage>N</usage>
                          <seq>06</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>10</max_len>
                        </element>
                        <element xid="NM107">
                          <data_ele>1039</data_ele>
                          <name>Name Suffix</name>
                          <usage>N</usage>
                          <seq>07</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>10</max_len>
                        </element>
                        <element xid="NM108">
                          <data_ele>66</data_ele>
                          <name>Identification Code Qualifier</name>
                          <usage>N</usage>
                          <seq>08</seq>
                          <data_type>ID</data_type>
                          <min_len>1</min_len>
                          <max_len>2</max_len>
                        </element>
                        <element xid="NM109">
                          <data_ele>67</data_ele>
                          <name>Identification Code</name>
                          <usage>N</usage>
                          <seq>09</seq>
                          <data_type>AN</data_type>
                          <min_len>2</min_len>
                          <max_len>80</max_len>
                        </element>
                        <element xid="NM110">
                          <data_ele>706</data_ele>
                          <name>Entity Relationship Code</name>
                          <usage>N</usage>
                          <seq>10</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                        </element>
                        <element xid="NM111">
                          <data_ele>98</data_ele>
                          <name>Entity Identifier Code</name>
                          <usage>N</usage>
                          <seq>11</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                        </element>
                      </segment>
<!--End of NM1 segment-->
                      <segment xid="REF">
                        <name>Other Payer Attending Provider Identification</name>
                        <usage>R</usage>
                        <pos>355</pos>
                        <max_use>3</max_use>
                        <element xid="REF01">
                          <data_ele>128</data_ele>
                          <name>Reference Identification Qualifier</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                          <valid_codes>
                            <code>1A</code>
                            <code>1B</code>
                            <code>1C</code>
                            <code>1D</code>
                            <code>1G</code>
                            <code>1H</code>
                            <code>EI</code>
                            <code>G2</code>
                            <code>LU</code>
                            <code>N5</code>
                          </valid_codes>
                        </element>
                        <element xid="REF02">
                          <data_ele>127</data_ele>
                          <name>Other Payer Attending Provider Identifier</name>
                          <usage>R</usage>
                          <seq>02</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>30</max_len>
                        </element>
                        <element xid="REF03">
                          <data_ele>352</data_ele>
                          <name>Description</name>
                          <usage>N</usage>
                          <seq>03</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>80</max_len>
                        </element>
                        <composite>
                          <data_ele>C040</data_ele>
                          <name>Reference Identifier</name>
                          <usage>N</usage>
                          <seq>04</seq>
                        </composite>
                      </segment>
<!--End of REF segment-->
                    </loop>
<!--End of 2330D loop-->
                    <loop xid="2330E">
                      <name>Other Payer Operating Provider</name>
                      <usage>S</usage>
                      <pos>325</pos>
                      <repeat>1</repeat>
                      <segment xid="NM1">
                        <name>Other Payer Operating Provider</name>
                        <usage>R</usage>
                        <pos>325</pos>
                        <max_use>1</max_use>
                        <element xid="NM101">
                          <data_ele>98</data_ele>
                          <name>Entity Identifier Code</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                          <valid_codes>
                            <code>72</code>
                          </valid_codes>
                        </element>
                        <element xid="NM102">
                          <data_ele>1065</data_ele>
                          <name>Entity Type Qualifier</name>
                          <usage>R</usage>
                          <seq>02</seq>
                          <data_type>ID</data_type>
                          <min_len>1</min_len>
                          <max_len>1</max_len>
                          <valid_codes>
                            <code>1</code>
                          </valid_codes>
                        </element>
                        <element xid="NM103">
                          <data_ele>1035</data_ele>
                          <name>Name Last or Organization Name</name>
                          <usage>N</usage>
                          <seq>03</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>35</max_len>
                        </element>
                        <element xid="NM104">
                          <data_ele>1036</data_ele>
                          <name>Name First</name>
                          <usage>N</usage>
                          <seq>04</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>25</max_len>
                        </element>
                        <element xid="NM105">
                          <data_ele>1037</data_ele>
                          <name>Name Middle</name>
                          <usage>N</usage>
                          <seq>05</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>25</max_len>
                        </element>
                        <element xid="NM106">
                          <data_ele>1038</data_ele>
                          <name>Name Prefix</name>
                          <usage>N</usage>
                          <seq>06</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>10</max_len>
                        </element>
                        <element xid="NM107">
                          <data_ele>1039</data_ele>
                          <name>Name Suffix</name>
                          <usage>N</usage>
                          <seq>07</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>10</max_len>
                        </element>
                        <element xid="NM108">
                          <data_ele>66</data_ele>
                          <name>Identification Code Qualifier</name>
                          <usage>N</usage>
                          <seq>08</seq>
                          <data_type>ID</data_type>
                          <min_len>1</min_len>
                          <max_len>2</max_len>
                        </element>
                        <element xid="NM109">
                          <data_ele>67</data_ele>
                          <name>Identification Code</name>
                          <usage>N</usage>
                          <seq>09</seq>
                          <data_type>AN</data_type>
                          <min_len>2</min_len>
                          <max_len>80</max_len>
                        </element>
                        <element xid="NM110">
                          <data_ele>706</data_ele>
                          <name>Entity Relationship Code</name>
                          <usage>N</usage>
                          <seq>10</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                        </element>
                        <element xid="NM111">
                          <data_ele>98</data_ele>
                          <name>Entity Identifier Code</name>
                          <usage>N</usage>
                          <seq>11</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                        </element>
                      </segment>
<!--End of NM1 segment-->
                      <segment xid="REF">
                        <name>Other Payer Operating Provider Identification</name>
                        <usage>R</usage>
                        <pos>355</pos>
                        <max_use>3</max_use>
                        <element xid="REF01">
                          <data_ele>128</data_ele>
                          <name>Reference Identification Qualifier</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                          <valid_codes>
                            <code>1A</code>
                            <code>1B</code>
                            <code>1C</code>
                            <code>1D</code>
                            <code>1G</code>
                            <code>1H</code>
                            <code>EI</code>
                            <code>G2</code>
                            <code>LU</code>
                            <code>N5</code>
                          </valid_codes>
                        </element>
                        <element xid="REF02">
                          <data_ele>127</data_ele>
                          <name>Other Payer Operating Provider Identifier</name>
                          <usage>R</usage>
                          <seq>02</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>30</max_len>
                        </element>
                        <element xid="REF03">
                          <data_ele>352</data_ele>
                          <name>Description</name>
                          <usage>N</usage>
                          <seq>03</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>80</max_len>
                        </element>
                        <composite>
                          <data_ele>C040</data_ele>
                          <name>Reference Identifier</name>
                          <usage>N</usage>
                          <seq>04</seq>
                        </composite>
                      </segment>
<!--End of REF segment-->
                    </loop>
<!--End of 2330E loop-->
                    <loop xid="2330F">
                      <name>Other Payer Other Provider</name>
                      <usage>S</usage>
                      <pos>325</pos>
                      <repeat>1</repeat>
                      <segment xid="NM1">
                        <name>Other Payer Other Provider</name>
                        <usage>R</usage>
                        <pos>325</pos>
                        <max_use>1</max_use>
                        <element xid="NM101">
                          <data_ele>98</data_ele>
                          <name>Entity Identifier Code</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                          <valid_codes>
                            <code>73</code>
                          </valid_codes>
                        </element>
                        <element xid="NM102">
                          <data_ele>1065</data_ele>
                          <name>Entity Type Qualifier</name>
                          <usage>R</usage>
                          <seq>02</seq>
                          <data_type>ID</data_type>
                          <min_len>1</min_len>
                          <max_len>1</max_len>
                          <valid_codes>
                            <code>1</code>
                            <code>2</code>
                          </valid_codes>
                        </element>
                        <element xid="NM103">
                          <data_ele>1035</data_ele>
                          <name>Name Last or Organization Name</name>
                          <usage>N</usage>
                          <seq>03</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>35</max_len>
                        </element>
                        <element xid="NM104">
                          <data_ele>1036</data_ele>
                          <name>Name First</name>
                          <usage>N</usage>
                          <seq>04</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>25</max_len>
                        </element>
                        <element xid="NM105">
                          <data_ele>1037</data_ele>
                          <name>Name Middle</name>
                          <usage>N</usage>
                          <seq>05</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>25</max_len>
                        </element>
                        <element xid="NM106">
                          <data_ele>1038</data_ele>
                          <name>Name Prefix</name>
                          <usage>N</usage>
                          <seq>06</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>10</max_len>
                        </element>
                        <element xid="NM107">
                          <data_ele>1039</data_ele>
                          <name>Name Suffix</name>
                          <usage>N</usage>
                          <seq>07</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>10</max_len>
                        </element>
                        <element xid="NM108">
                          <data_ele>66</data_ele>
                          <name>Identification Code Qualifier</name>
                          <usage>N</usage>
                          <seq>08</seq>
                          <data_type>ID</data_type>
                          <min_len>1</min_len>
                          <max_len>2</max_len>
                        </element>
                        <element xid="NM109">
                          <data_ele>67</data_ele>
                          <name>Identification Code</name>
                          <usage>N</usage>
                          <seq>09</seq>
                          <data_type>AN</data_type>
                          <min_len>2</min_len>
                          <max_len>80</max_len>
                        </element>
                        <element xid="NM110">
                          <data_ele>706</data_ele>
                          <name>Entity Relationship Code</name>
                          <usage>N</usage>
                          <seq>10</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                        </element>
                        <element xid="NM111">
                          <data_ele>98</data_ele>
                          <name>fier Code</name>
                          <usage>N</usage>
                          <seq>11</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                        </element>
                      </segment>
<!--End of NM1 segment-->
                      <segment xid="REF">
                        <name>Other Payer Other Provider Identification</name>
                        <usage>R</usage>
                        <pos>355</pos>
                        <max_use>3</max_use>
                        <element xid="REF01">
                          <data_ele>128</data_ele>
                          <name>Reference Identification Qualifier</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                          <valid_codes>
                            <code>1A</code>
                            <code>1B</code>
                            <code>1C</code>
                            <code>1D</code>
                            <code>1G</code>
                            <code>1H</code>
                            <code>EI</code>
                            <code>G2</code>
                            <code>LU</code>
                            <code>N5</code>
                            <code>SY</code>
                          </valid_codes>
                        </element>
                        <element xid="REF02">
                          <data_ele>127</data_ele>
                          <name>Other Payer Other Provider Identifier</name>
                          <usage>R</usage>
                          <seq>02</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>30</max_len>
                        </element>
                        <element xid="REF03">
                          <data_ele>352</data_ele>
                          <name>on</name>
                          <usage>N</usage>
                          <seq>03</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>80</max_len>
                        </element>
                        <composite>
                          <data_ele>C040</data_ele>
                          <name>Reference Identifier</name>
                          <usage>N</usage>
                          <seq>04</seq>
                        </composite>
                      </segment>
<!--End of REF segment-->
                    </loop>
<!--End of 2330F loop-->
                    <loop xid="2330H">
                      <name>Other Payer Service Facility Provider</name>
                      <usage>S</usage>
                      <pos>325</pos>
                      <repeat>1</repeat>
                      <segment xid="NM1">
                        <name>Other Payer Service Facility Provider</name>
                        <usage>R</usage>
                        <pos>325</pos>
                        <max_use>1</max_use>
                        <element xid="NM101">
                          <data_ele>98</data_ele>
                          <name>Entity Identifier Code</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                          <valid_codes>
                            <code>FA</code>
                          </valid_codes>
                        </element>
                        <element xid="NM102">
                          <data_ele>1065</data_ele>
                          <name>Entity Type Qualifier</name>
                          <usage>R</usage>
                          <seq>02</seq>
                          <data_type>ID</data_type>
                          <min_len>1</min_len>
                          <max_len>1</max_len>
                          <valid_codes>
                            <code>2</code>
                          </valid_codes>
                        </element>
                        <element xid="NM103">
                          <data_ele>1035</data_ele>
                          <name>Name Last or Organization Name</name>
                          <usage>N</usage>
                          <seq>03</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>35</max_len>
                        </element>
                        <element xid="NM104">
                          <data_ele>1036</data_ele>
                          <name>Name First</name>
                          <usage>N</usage>
                          <seq>04</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>25</max_len>
                        </element>
                        <element xid="NM105">
                          <data_ele>1037</data_ele>
                          <name>Name Middle</name>
                          <usage>N</usage>
                          <seq>05</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>25</max_len>
                        </element>
                        <element xid="NM106">
                          <data_ele>1038</data_ele>
                          <name>Name Prefix</name>
                          <usage>N</usage>
                          <seq>06</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>10</max_len>
                        </element>
                        <element xid="NM107">
                          <data_ele>1039</data_ele>
                          <name>Name Suffix</name>
                          <usage>N</usage>
                          <seq>07</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>10</max_len>
                        </element>
                        <element xid="NM108">
                          <data_ele>66</data_ele>
                          <name>ode Qualifier</name>
                          <usage>N</usage>
                          <seq>08</seq>
                          <data_type>ID</data_type>
                          <min_len>1</min_len>
                          <max_len>2</max_len>
                        </element>
                        <element xid="NM109">
                          <data_ele>67</data_ele>
                          <name>Identification Code</name>
                          <usage>N</usage>
                          <seq>09</seq>
                          <data_type>AN</data_type>
                          <min_len>2</min_len>
                          <max_len>80</max_len>
                        </element>
                        <element xid="NM110">
                          <data_ele>706</data_ele>
                          <name>Entity Relationship Code</name>
                          <usage>N</usage>
                          <seq>10</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                        </element>
                        <element xid="NM111">
                          <data_ele>98</data_ele>
                          <name>Entity Identifier Code</name>
                          <usage>N</usage>
                          <seq>11</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                        </element>
                      </segment>
<!--End of NM1 segment-->
                      <segment xid="REF">
                        <name>Other Payer Service Facility Provider Identification</name>
                        <usage>R</usage>
                        <pos>355</pos>
                        <max_use>3</max_use>
                        <element xid="REF01">
                          <data_ele>128</data_ele>
                          <name>Reference Identification Qualifier</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                          <valid_codes>
                            <code>1B</code>
                            <code>1C</code>
                            <code>1D</code>
                            <code>EI</code>
                            <code>G2</code>
                            <code>LU</code>
                            <code>N5</code>
                          </valid_codes>
                        </element>
                        <element xid="REF02">
                          <data_ele>127</data_ele>
                          <name>Other Payer Service Facility Provider Identifier</name>
                          <usage>R</usage>
                          <seq>02</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>30</max_len>
                        </element>
                        <element xid="REF03">
                          <data_ele>352</data_ele>
                          <name>Description</name>
                          <usage>N</usage>
                          <seq>03</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>80</max_len>
                        </element>
                        <composite>
                          <data_ele>C040</data_ele>
                          <name>Reference Identifier</name>
                          <usage>N</usage>
                          <seq>04</seq>
                        </composite>
                      </segment>
<!--End of REF segment-->
                    </loop>
<!--End of 2330H loop-->
                  </loop>
<!--End of 2320 loop-->
                  <loop xid="2400">
                    <name>Service Line Number</name>
                    <usage>R</usage>
                    <pos>365</pos>
                    <repeat>999</repeat>
                    <segment xid="LX">
                      <name>Service Line Number</name>
                      <usage>R</usage>
                      <pos>365</pos>
                      <max_use>1</max_use>
                      <element xid="LX01">
                        <data_ele>554</data_ele>
                        <name>Assigned Number</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>N0</data_type>
                        <min_len>1</min_len>
                        <max_len>6</max_len>
                      </element>
                    </segment>
<!--End of LX segment-->
                    <segment xid="SV2">
                      <name>Institutional Service Line</name>
                      <usage>R</usage>
                      <pos>375</pos>
                      <max_use>1</max_use>
                      <element xid="SV201">
                        <data_ele>234</data_ele>
                        <name>Service Line Revenue Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>48</max_len>
                      </element>
                      <composite>
                        <data_ele>C003</data_ele>
                        <name>Service Line Procedure Code</name>
                        <usage>S</usage>
                        <seq>02</seq>
                        <element xid="SV202-01">
                          <data_ele>235</data_ele>
                          <name>Product or Service ID Qualifier</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                          <valid_codes>
                            <code>HC</code>
                            <code>IV</code>
                            <code>N4</code>
                            <code>ZZ</code>
                          </valid_codes>
                        </element>
                        <element xid="SV202-02">
                          <data_ele>234</data_ele>
                          <name>Procedure Code</name>
                          <usage>R</usage>
                          <seq>02</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>48</max_len>
                        </element>
                        <element xid="SV202-03">
                          <data_ele>1339</data_ele>
                          <name>HCPCS Modifier 1</name>
                          <usage>S</usage>
                          <seq>03</seq>
                          <data_type>AN</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                        </element>
                        <element xid="SV202-04">
                          <data_ele>1339</data_ele>
                          <name>HCPCS Modifier 2</name>
                          <usage>S</usage>
                          <seq>04</seq>
                          <data_type>AN</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                        </element>
                        <element xid="SV202-05">
                          <data_ele>1339</data_ele>
                          <name>HCPCS Modifier 3</name>
                          <usage>S</usage>
                          <seq>05</seq>
                          <data_type>AN</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                        </element>
                        <element xid="SV202-06">
                          <data_ele>1339</data_ele>
                          <name>HCPCS Modifier 4</name>
                          <usage>S</usage>
                          <seq>06</seq>
                          <data_type>AN</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                        </element>
                        <element xid="SV202-07">
                          <data_ele>352</data_ele>
                          <name>Description</name>
                          <usage>N</usage>
                          <seq>07</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>80</max_len>
                        </element>
                      </composite>
                      <element xid="SV203">
                        <data_ele>782</data_ele>
                        <name>Line Item Charge Amount</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="SV204">
                        <data_ele>355</data_ele>
                        <name>Unit or Basis for Measurement Code</name>
                        <usage>R</usage>
                        <seq>04</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>DA</code>
                          <code>F2</code>
                          <code>UN</code>
                        </valid_codes>
                      </element>
                      <element xid="SV205">
                        <data_ele>380</data_ele>
                        <name>Service Unit Count</name>
                        <usage>R</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="SV206">
                        <data_ele>1371</data_ele>
                        <name>Service Line Rate</name>
                        <usage>S</usage>
                        <seq>06</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>10</max_len>
                      </element>
                      <element xid="SV207">
                        <data_ele>782</data_ele>
                        <name>Line Item Denied Charge or Non-Covered Charge Amount</name>
                        <usage>S</usage>
                        <seq>07</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="SV208">
                        <data_ele>1073</data_ele>
                        <name>Yes/No Condition or Response Code</name>
                        <usage>N</usage>
                        <seq>08</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                      </element>
                      <element xid="SV209">
                        <data_ele>1345</data_ele>
                        <name>Status Code</name>
                        <usage>N</usage>
                        <seq>09</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                      </element>
                      <element xid="SV210">
                        <data_ele>1337</data_ele>
                        <name>Level of Care Code</name>
                        <usage>N</usage>
                        <seq>10</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                      </element>
                    </segment>
<!--End of SV2 segment-->
                    <segment xid="PWK">
                      <name>Line Supplemental Information</name>
                      <usage>S</usage>
                      <pos>420</pos>
                      <max_use>5</max_use>
                      <element xid="PWK01">
                        <data_ele>755</data_ele>
                        <name>Attachment Report Type Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>AS</code>
                          <code>B2</code>
                          <code>B3</code>
                          <code>B4</code>
                          <code>CT</code>
                          <code>DA</code>
                          <code>DG</code>
                          <code>DS</code>
                          <code>EB</code>
                          <code>MT</code>
                          <code>NN</code>
                          <code>OB</code>
                          <code>OZ</code>
                          <code>PN</code>
                          <code>PO</code>
                          <code>PZ</code>
                          <code>RB</code>
                          <code>RR</code>
                          <code>RT</code>
                        </valid_codes>
                      </element>
                      <element xid="PWK02">
                        <data_ele>756</data_ele>
                        <name>Attachment Transmission Code</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>AA</code>
                          <code>AB</code>
                          <code>AD</code>
                          <code>AF</code>
                          <code>AG</code>
                          <code>BM</code>
                          <code>EL</code>
                          <code>EM</code>
                          <code>FX</code>
                        </valid_codes>
                      </element>
                      <element xid="PWK03">
                        <data_ele>757</data_ele>
                        <name>Report Copies Needed</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>N0</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                      </element>
                      <element xid="PWK04">
                        <data_ele>98</data_ele>
                        <name>Entity Identifier Code</name>
                        <usage>N</usage>
                        <seq>04</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                      </element>
                      <element xid="PWK05">
                        <data_ele>66</data_ele>
                        <name>Identification Code Qualifier</name>
                        <usage>S</usage>
                        <seq>05</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>AC</code>
                        </valid_codes>
                      </element>
                      <element xid="PWK06">
                        <data_ele>67</data_ele>
                        <name>Attachment Control Number</name>
                        <usage>S</usage>
                        <seq>06</seq>
                        <data_type>AN</data_type>
                        <min_len>2</min_len>
                        <max_len>80</max_len>
                      </element>
                      <element xid="PWK07">
                        <data_ele>352</data_ele>
                        <name>Description</name>
                        <usage>N</usage>
                        <seq>07</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>80</max_len>
                      </element>
                      <composite>
                        <data_ele>C002</data_ele>
                        <name>Actions Indicated</name>
                        <usage>N</usage>
                        <seq>08</seq>
                      </composite>
                      <element xid="PWK09">
                        <data_ele>1525</data_ele>
                        <name>Request Category Code</name>
                        <usage>N</usage>
                        <seq>09</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                      </element>
                    </segment>
<!--End of PWK segment-->
                    <segment xid="DTP">
                      <name>Service Line Date</name>
                      <usage>S</usage>
                      <pos>455</pos>
                      <max_use>1</max_use>
                      <element xid="DTP01">
                        <data_ele>374</data_ele>
                        <name>Date Time Qualifier</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>3</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>472</code>
                        </valid_codes>
                      </element>
                      <element xid="DTP02">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>D8</code>
                          <code>RD8</code>
                        </valid_codes>
                      </element>
                      <element xid="DTP03">
                        <data_ele>1251</data_ele>
                        <name>Service Date</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                    </segment>
<!--End of DTP segment-->
                    <segment xid="DTP">
                      <name>Assessment Date</name>
                      <usage>S</usage>
                      <pos>455</pos>
                      <max_use>1</max_use>
                      <element xid="DTP01">
                        <data_ele>374</data_ele>
                        <name>Date Time Qualifier</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>3</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>866</code>
                        </valid_codes>
                      </element>
                      <element xid="DTP02">
                        <data_ele>1250</data_ele>
                        <name>Date Time Period Format Qualifier</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>D8</code>
                        </valid_codes>
                      </element>
                      <element xid="DTP03">
                        <data_ele>1251</data_ele>
                        <name>Assessment Date</name>
                        <usage>R</usage>
                        <seq>03</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>35</max_len>
                      </element>
                    </segment>
<!--End of DTP segment-->
                    <segment xid="AMT">
                      <name>Service Tax Amount</name>
                      <usage>S</usage>
                      <pos>475</pos>
                      <max_use>1</max_use>
                      <element xid="AMT01">
                        <data_ele>522</data_ele>
                        <name>Amount Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>GT</code>
                        </valid_codes>
                      </element>
                      <element xid="AMT02">
                        <data_ele>782</data_ele>
                        <name>Service Tax Amount</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="AMT03">
                        <data_ele>478</data_ele>
                        <name>Credit/Debit Flag Code</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                      </element>
                    </segment>
<!--End of AMT segment-->
                    <segment xid="AMT">
                      <name>Facility Tax Amount</name>
                      <usage>S</usage>
                      <pos>475</pos>
                      <max_use>1</max_use>
                      <element xid="AMT01">
                        <data_ele>522</data_ele>
                        <name>Amount Qualifier Code</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>3</max_len>
                        <valid_codes>
                          <code>N8</code>
                        </valid_codes>
                      </element>
                      <element xid="AMT02">
                        <data_ele>782</data_ele>
                        <name>Facility Tax Amount</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="AMT03">
                        <data_ele>478</data_ele>
                        <name>Credit/Debit Flag Code</name>
                        <usage>N</usage>
                        <seq>03</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>1</max_len>
                      </element>
                    </segment>
<!--End of AMT segment-->
                    <segment xid="HCP">
                      <name>Line Pricing/Repricing Information</name>
                      <usage>S</usage>
                      <pos>492</pos>
                      <syntax>R0113</syntax>
                      <syntax>P0910</syntax>
                      <syntax>P1112</syntax>
                      <max_use>1</max_use>
                      <element xid="HCP01">
                        <data_ele>1473</data_ele>
                        <name>Pricing Methodology</name>
                        <usage>R</usage>
                        <seq>01</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>00</code>
                          <code>01</code>
                          <code>02</code>
                          <code>03</code>
                          <code>04</code>
                          <code>05</code>
                          <code>06</code>
                          <code>07</code>
                          <code>08</code>
                          <code>09</code>
                          <code>10</code>
                          <code>11</code>
                          <code>12</code>
                          <code>13</code>
                          <code>14</code>
                        </valid_codes>
                      </element>
                      <element xid="HCP02">
                        <data_ele>782</data_ele>
                        <name>Repriced Allowed Amount</name>
                        <usage>R</usage>
                        <seq>02</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HCP03">
                        <data_ele>782</data_ele>
                        <name>Repriced Saving Amount</name>
                        <usage>S</usage>
                        <seq>03</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HCP04">
                        <data_ele>127</data_ele>
                        <name>Repriced Organizational Identifier</name>
                        <usage>S</usage>
                        <seq>04</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HCP05">
                        <data_ele>118</data_ele>
                        <name>Repricing Per Diem or Flat Rate Amount</name>
                        <usage>S</usage>
                        <seq>05</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>9</max_len>
                      </element>
                      <element xid="HCP06">
                        <data_ele>127</data_ele>
                        <name>Repriced Approved Ambulatory Patient Group Code</name>
                        <usage>S</usage>
                        <seq>06</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>30</max_len>
                      </element>
                      <element xid="HCP07">
                        <data_ele>782</data_ele>
                        <name>Repriced Approved Ambulatory Patient Group Amount</name>
                        <usage>S</usage>
                        <seq>07</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>18</max_len>
                      </element>
                      <element xid="HCP08">
                        <data_ele>234</data_ele>
                        <name>Repriced Approved Revenue Code</name>
                        <usage>S</usage>
                        <seq>08</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>48</max_len>
                      </element>
                      <element xid="HCP09">
                        <data_ele>235</data_ele>
                        <name>Product/ Service ID Qualifier</name>
                        <usage>S</usage>
                        <seq>09</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>HC</code>
                        </valid_codes>
                      </element>
                      <element xid="HCP10">
                        <data_ele>234</data_ele>
                        <name>Procedure Code</name>
                        <usage>S</usage>
                        <seq>10</seq>
                        <data_type>AN</data_type>
                        <min_len>1</min_len>
                        <max_len>48</max_len>
                      </element>
                      <element xid="HCP11">
                        <data_ele>355</data_ele>
                        <name>Unit or Basis for Measurement Code</name>
                        <usage>S</usage>
                        <seq>11</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>DA</code>
                          <code>UN</code>
                        </valid_codes>
                      </element>
                      <element xid="HCP12">
                        <data_ele>380</data_ele>
                        <name>Repricing Approved Service Unit Count</name>
                        <usage>S</usage>
                        <seq>12</seq>
                        <data_type>R</data_type>
                        <min_len>1</min_len>
                        <max_len>15</max_len>
                      </element>
                      <element xid="HCP13">
                        <data_ele>901</data_ele>
                        <name>Reject Reason Code</name>
                        <usage>S</usage>
                        <seq>13</seq>
                        <data_type>ID</data_type>
                        <min_len>2</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>T1</code>
                          <code>T2</code>
                          <code>T3</code>
                          <code>T4</code>
                          <code>T5</code>
                          <code>T6</code>
                        </valid_codes>
                      </element>
                      <element xid="HCP14">
                        <data_ele>1526</data_ele>
                        <name>Policy Compliance Code</name>
                        <usage>S</usage>
                        <seq>14</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>1</code>
                          <code>2</code>
                          <code>3</code>
                          <code>4</code>
                          <code>5</code>
                        </valid_codes>
                      </element>
                      <element xid="HCP15">
                        <data_ele>1527</data_ele>
                        <name>Exception Code</name>
                        <usage>S</usage>
                        <seq>15</seq>
                        <data_type>ID</data_type>
                        <min_len>1</min_len>
                        <max_len>2</max_len>
                        <valid_codes>
                          <code>1</code>
                          <code>2</code>
                          <code>3</code>
                          <code>4</code>
                          <code>5</code>
                          <code>6</code>
                        </valid_codes>
                      </element>
                    </segment>
<!--End of HCP segment-->
                    <loop xid="2410">
                      <name>Drug Identification</name>
                      <usage>S</usage>
                      <pos>494</pos>
                      <syntax>P0405</syntax>
                      <syntax>P0607</syntax>
                      <syntax>P0809</syntax>
                      <syntax>P1011</syntax>
                      <syntax>P1213</syntax>
                      <syntax>P1415</syntax>
                      <syntax>P1617</syntax>
                      <syntax>P1819</syntax>
                      <syntax>P2021</syntax>
                      <syntax>P2223</syntax>
                      <syntax>P2425</syntax>
                      <syntax>P2627</syntax>
                      <syntax>P2829</syntax>
                      <syntax>P3031</syntax>
                      <repeat>25</repeat>
                      <segment xid="LIN">
                        <name>Drug Identification</name>
                        <usage>S</usage>
                        <pos>494</pos>
                        <max_use>1</max_use>
                        <element xid="LIN01">
                          <data_ele>350</data_ele>
                          <name>Assigned Identification</name>
                          <usage>N</usage>
                          <seq>01</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>20</max_len>
                        </element>
                        <element xid="LIN02">
                          <data_ele>235</data_ele>
                          <name>Product/Service ID Qualifier</name>
                          <usage>R</usage>
                          <seq>02</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                          <valid_codes>
                            <code>N4</code>
                          </valid_codes>
                        </element>
                        <element xid="LIN03">
                          <data_ele>234</data_ele>
                          <name>Product/Service ID</name>
                          <usage>R</usage>
                          <seq>03</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>48</max_len>
                        </element>
                        <element xid="LIN04">
                          <data_ele>235</data_ele>
                          <name>Product/Service ID Qualifier</name>
                          <usage>N</usage>
                          <seq>04</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                          <valid_codes>
                            <code>N4</code>
                          </valid_codes>
                        </element>
                        <element xid="LIN05">
                          <data_ele>234</data_ele>
                          <name>Product/Service ID</name>
                          <usage>N</usage>
                          <seq>05</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>48</max_len>
                        </element>
                        <element xid="LIN06">
                          <data_ele>235</data_ele>
                          <name>Product/Service ID Qualifier</name>
                          <usage>N</usage>
                          <seq>06</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                          <valid_codes>
                            <code>N4</code>
                          </valid_codes>
                        </element>
                        <element xid="LIN07">
                          <data_ele>234</data_ele>
                          <name>Product/Service ID</name>
                          <usage>N</usage>
                          <seq>07</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>48</max_len>
                        </element>
                        <element xid="LIN08">
                          <data_ele>235</data_ele>
                          <name>Product/Service ID Qualifier</name>
                          <usage>N</usage>
                          <seq>08</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                          <valid_codes>
                            <code>N4</code>
                          </valid_codes>
                        </element>
                        <element xid="LIN09">
                          <data_ele>234</data_ele>
                          <name>Product/Service ID</name>
                          <usage>N</usage>
                          <seq>09</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>48</max_len>
                        </element>
                        <element xid="LIN10">
                          <data_ele>235</data_ele>
                          <name>Product/Service ID Qualifier</name>
                          <usage>N</usage>
                          <seq>10</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                          <valid_codes>
                            <code>N4</code>
                          </valid_codes>
                        </element>
                        <element xid="LIN11">
                          <data_ele>234</data_ele>
                          <name>Product/Service ID</name>
                          <usage>N</usage>
                          <seq>11</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>48</max_len>
                        </element>
                        <element xid="LIN12">
                          <data_ele>235</data_ele>
                          <name>Product/Service ID Qualifier</name>
                          <usage>N</usage>
                          <seq>12</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                          <valid_codes>
                            <code>N4</code>
                          </valid_codes>
                        </element>
                        <element xid="LIN13">
                          <data_ele>234</data_ele>
                          <name>Product/Service ID</name>
                          <usage>N</usage>
                          <seq>13</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>48</max_len>
                        </element>
                        <element xid="LIN14">
                          <data_ele>235</data_ele>
                          <name>Product/Service ID Qualifier</name>
                          <usage>N</usage>
                          <seq>14</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                          <valid_codes>
                            <code>N4</code>
                          </valid_codes>
                        </element>
                        <element xid="LIN15">
                          <data_ele>234</data_ele>
                          <name>Product/Service ID</name>
                          <usage>N</usage>
                          <seq>15</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>48</max_len>
                        </element>
                        <element xid="LIN16">
                          <data_ele>235</data_ele>
                          <name>Product/Service ID Qualifier</name>
                          <usage>N</usage>
                          <seq>16</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                          <valid_codes>
                            <code>N4</code>
                          </valid_codes>
                        </element>
                        <element xid="LIN17">
                          <data_ele>234</data_ele>
                          <name>Product/Service ID</name>
                          <usage>N</usage>
                          <seq>17</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>48</max_len>
                        </element>
                        <element xid="LIN18">
                          <data_ele>235</data_ele>
                          <name>Product/Service ID Qualifier</name>
                          <usage>N</usage>
                          <seq>18</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                          <valid_codes>
                            <code>N4</code>
                          </valid_codes>
                        </element>
                        <element xid="LIN19">
                          <data_ele>234</data_ele>
                          <name>Product/Service ID</name>
                          <usage>N</usage>
                          <seq>19</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>48</max_len>
                        </element>
                        <element xid="LIN20">
                          <data_ele>235</data_ele>
                          <name>Product/Service ID Qualifier</name>
                          <usage>N</usage>
                          <seq>20</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                          <valid_codes>
                            <code>N4</code>
                          </valid_codes>
                        </element>
                        <element xid="LIN21">
                          <data_ele>234</data_ele>
                          <name>Product/Service ID</name>
                          <usage>N</usage>
                          <seq>21</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>48</max_len>
                        </element>
                        <element xid="LIN22">
                          <data_ele>235</data_ele>
                          <name>Product/Service ID Qualifier</name>
                          <usage>N</usage>
                          <seq>22</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                          <valid_codes>
                            <code>N4</code>
                          </valid_codes>
                        </element>
                        <element xid="LIN23">
                          <data_ele>234</data_ele>
                          <name>Product/Service ID</name>
                          <usage>N</usage>
                          <seq>23</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>48</max_len>
                        </element>
                        <element xid="LIN24">
                          <data_ele>235</data_ele>
                          <name>Product/Service ID Qualifier</name>
                          <usage>N</usage>
                          <seq>24</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                          <valid_codes>
                            <code>N4</code>
                          </valid_codes>
                        </element>
                        <element xid="LIN25">
                          <data_ele>234</data_ele>
                          <name>Product/Service ID</name>
                          <usage>N</usage>
                          <seq>25</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>48</max_len>
                        </element>
                        <element xid="LIN26">
                          <data_ele>235</data_ele>
                          <name>Product/Service ID Qualifier</name>
                          <usage>N</usage>
                          <seq>26</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                          <valid_codes>
                            <code>N4</code>
                          </valid_codes>
                        </element>
                        <element xid="LIN27">
                          <data_ele>234</data_ele>
                          <name>Product/Service ID</name>
                          <usage>N</usage>
                          <seq>27</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>48</max_len>
                        </element>
                        <element xid="LIN28">
                          <data_ele>235</data_ele>
                          <name>Product/Service ID Qualifier</name>
                          <usage>N</usage>
                          <seq>28</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                          <valid_codes>
                            <code>N4</code>
                          </valid_codes>
                        </element>
                        <element xid="LIN29">
                          <data_ele>234</data_ele>
                          <name>Product/Service ID</name>
                          <usage>N</usage>
                          <seq>29</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>48</max_len>
                        </element>
                        <element xid="LIN30">
                          <data_ele>235</data_ele>
                          <name>Product/Service ID Qualifier</name>
                          <usage>N</usage>
                          <seq>30</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                          <valid_codes>
                            <code>N4</code>
                          </valid_codes>
                        </element>
                        <element xid="LIN31">
                          <data_ele>234</data_ele>
                          <name>Product/Service ID</name>
                          <usage>N</usage>
                          <seq>31</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>48</max_len>
                        </element>
                      </segment>
<!--End of LIN segment-->
                      <segment xid="CTP">
                        <name>Drug Pricing</name>
                        <pos>495</pos>
                        <max_use>1</max_use>
                        <syntax>P0405</syntax>
                        <syntax>C0607</syntax>
                        <syntax>C0902</syntax>
                        <syntax>C1002</syntax>
                        <syntax>C1103</syntax>
                        <element xid="CTP01">
                          <data_ele>687</data_ele>
                          <name>Class of Trade Code</name>
                          <usage>N</usage>
                          <seq>01</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                        </element>
                        <element xid="CTP02">
                          <data_ele>236</data_ele>
                          <name>Price Identifier Code</name>
                          <usage>N</usage>
                          <seq>02</seq>
                          <data_type>ID</data_type>
                          <min_len>3</min_len>
                          <max_len>3</max_len>
                        </element>
                        <element xid="CTP03">
                          <data_ele>212</data_ele>
                          <name>Unit Price</name>
                          <usage>R</usage>
                          <seq>03</seq>
                          <data_type>R</data_type>
                          <min_len>1</min_len>
                          <max_len>17</max_len>
                        </element>
                        <element xid="CTP04">
                          <data_ele>380</data_ele>
                          <name>Quantity</name>
                          <usage>R</usage>
                          <seq>04</seq>
                          <data_type>R</data_type>
                          <min_len>1</min_len>
                          <max_len>15</max_len>
                        </element>
                        <composite>
                          <data_ele>C001</data_ele>
                          <name>Composite Unit of Measure</name>
                          <usage>R</usage>
                          <seq>05</seq>
                          <element xid="CTP05-01">
                            <data_ele>355</data_ele>
                            <name>Unit or Basis for Measurement Code</name>
                            <usage>R</usage>
                            <seq>01</seq>
                            <data_type>ID</data_type>
                            <min_len>2</min_len>
                            <max_len>2</max_len>
                            <valid_codes>
                              <code>F2</code>
                              <code>GR</code>
                              <code>ML</code>
                              <code>UN</code>
                            </valid_codes>
                          </element>
                          <element xid="CTP05-02">
                            <data_ele>1018</data_ele>
                            <name>Exponent</name>
                            <usage>N</usage>
                            <seq>02</seq>
                            <data_type>R</data_type>
                            <min_len>1</min_len>
                            <max_len>15</max_len>
                          </element>
                          <element xid="CTP05-03">
                            <data_ele>649</data_ele>
                            <name>Multiplier</name>
                            <usage>N</usage>
                            <seq>03</seq>
                            <data_type>R</data_type>
                            <min_len>1</min_len>
                            <max_len>10</max_len>
                          </element>
                          <element xid="CTP05-04">
                            <data_ele>355</data_ele>
                            <name>Unit or Basis for Measurement Code</name>
                            <usage>N</usage>
                            <seq>04</seq>
                            <data_type>ID</data_type>
                            <min_len>2</min_len>
                            <max_len>2</max_len>
                          </element>
                          <element xid="CTP05-05">
                            <data_ele>1018</data_ele>
                            <name>Exponent</name>
                            <usage>N</usage>
                            <seq>05</seq>
                            <data_type>R</data_type>
                            <min_len>1</min_len>
                            <max_len>15</max_len>
                          </element>
                          <element xid="CTP05-06">
                            <data_ele>649</data_ele>
                            <name>Multiplier</name>
                            <usage>N</usage>
                            <seq>06</seq>
                            <data_type>R</data_type>
                            <min_len>1</min_len>
                            <max_len>10</max_len>
                          </element>
                          <element xid="CTP05-07">
                            <data_ele>355</data_ele>
                            <name>Unit or Basis for Measurement Code</name>
                            <usage>N</usage>
                            <seq>07</seq>
                            <data_type>ID</data_type>
                            <min_len>2</min_len>
                            <max_len>2</max_len>
                          </element>
                          <element xid="CTP05-08">
                            <data_ele>1018</data_ele>
                            <name>Exponent</name>
                            <usage>N</usage>
                            <seq>08</seq>
                            <data_type>R</data_type>
                            <min_len>1</min_len>
                            <max_len>15</max_len>
                          </element>
                          <element xid="CTP05-09">
                            <data_ele>649</data_ele>
                            <name>Multiplier</name>
                            <usage>N</usage>
                            <seq>09</seq>
                            <data_type>R</data_type>
                            <min_len>1</min_len>
                            <max_len>10</max_len>
                          </element>
                          <element xid="CTP05-10">
                            <data_ele>355</data_ele>
                            <name>Unit or Basis for Measurement Code</name>
                            <usage>N</usage>
                            <seq>10</seq>
                            <data_type>ID</data_type>
                            <min_len>2</min_len>
                            <max_len>2</max_len>
                          </element>
                          <element xid="CTP05-11">
                            <data_ele>1018</data_ele>
                            <name>Exponent</name>
                            <usage>N</usage>
                            <seq>11</seq>
                            <data_type>R</data_type>
                            <min_len>1</min_len>
                            <max_len>15</max_len>
                          </element>
                          <element xid="CTP05-12">
                            <data_ele>649</data_ele>
                            <name>Multiplier</name>
                            <usage>N</usage>
                            <seq>12</seq>
                            <data_type>R</data_type>
                            <min_len>1</min_len>
                            <max_len>10</max_len>
                          </element>
                          <element xid="CTP05-13">
                            <data_ele>355</data_ele>
                            <name>Unit or Basis for Measurement Code</name>
                            <usage>N</usage>
                            <seq>13</seq>
                            <data_type>ID</data_type>
                            <min_len>2</min_len>
                            <max_len>2</max_len>
                          </element>
                          <element xid="CTP05-14">
                            <data_ele>1018</data_ele>
                            <name>Exponent</name>
                            <usage>N</usage>
                            <seq>14</seq>
                            <data_type>R</data_type>
                            <min_len>1</min_len>
                            <max_len>15</max_len>
                          </element>
                          <element xid="CTP05-15">
                            <data_ele>649</data_ele>
                            <name>Multiplier</name>
                            <usage>N</usage>
                            <seq>15</seq>
                            <data_type>R</data_type>
                            <min_len>1</min_len>
                            <max_len>10</max_len>
                          </element>
                        </composite>
                        <element xid="CTP06">
                          <data_ele>648</data_ele>
                          <name>Price Multiplier Qualifier</name>
                          <usage>N</usage>
                          <seq>06</seq>
                          <data_type>ID</data_type>
                          <min_len>3</min_len>
                          <max_len>3</max_len>
                        </element>
                        <element xid="CTP07">
                          <data_ele>649</data_ele>
                          <name>Multiplier</name>
                          <usage>N</usage>
                          <seq>07</seq>
                          <data_type>R</data_type>
                          <min_len>1</min_len>
                          <max_len>10</max_len>
                        </element>
                        <element xid="CTP08">
                          <data_ele>782</data_ele>
                          <name>Monetary Amount</name>
                          <usage>N</usage>
                          <seq>08</seq>
                          <data_type>R</data_type>
                          <min_len>1</min_len>
                          <max_len>18</max_len>
                        </element>
                        <element xid="CTP09">
                          <data_ele>639</data_ele>
                          <name>Basis of Unit Price Code</name>
                          <usage>N</usage>
                          <seq>09</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                        </element>
                        <element xid="CTP10">
                          <data_ele>499</data_ele>
                          <name>Condition Value</name>
                          <usage>N</usage>
                          <seq>10</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>10</max_len>
                        </element>
                        <element xid="CTP11">
                          <data_ele>289</data_ele>
                          <name>Multiple Price Quantity</name>
                          <usage>N</usage>
                          <seq>11</seq>
                          <data_type>N0</data_type>
                          <min_len>1</min_len>
                          <max_len>2</max_len>
                        </element>
                      </segment>
<!--End of CTP segment-->
<!--End of REF segment-->
                    </loop>
<!--End of 2410 loop-->
                    <loop xid="2420A">
                      <name>Attending Physician Name</name>
                      <usage>S</usage>
                      <pos>500</pos>
                      <repeat>1</repeat>
                      <segment xid="NM1">
                        <name>Attending Physician Name</name>
                        <usage>R</usage>
                        <pos>500</pos>
                        <max_use>1</max_use>
                        <element xid="NM101">
                          <data_ele>98</data_ele>
                          <name>Entity Identifier Code</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                          <valid_codes>
                            <code>71</code>
                          </valid_codes>
                        </element>
                        <element xid="NM102">
                          <data_ele>1065</data_ele>
                          <name>Entity Type Qualifier</name>
                          <usage>R</usage>
                          <seq>02</seq>
                          <data_type>ID</data_type>
                          <min_len>1</min_len>
                          <max_len>1</max_len>
                          <valid_codes>
                            <code>1</code>
                            <code>2</code>
                          </valid_codes>
                        </element>
                        <element xid="NM103">
                          <data_ele>1035</data_ele>
                          <name>Attending Physician Last Name</name>
                          <usage>R</usage>
                          <seq>03</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>35</max_len>
                        </element>
                        <element xid="NM104">
                          <data_ele>1036</data_ele>
                          <name>Attending Physician First Name</name>
                          <usage>S</usage>
                          <seq>04</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>25</max_len>
                        </element>
                        <element xid="NM105">
                          <data_ele>1037</data_ele>
                          <name>Attending Physician Middle Name</name>
                          <usage>S</usage>
                          <seq>05</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>25</max_len>
                        </element>
                        <element xid="NM106">
                          <data_ele>1038</data_ele>
                          <name>Name Prefix</name>
                          <usage>N</usage>
                          <seq>06</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>10</max_len>
                        </element>
                        <element xid="NM107">
                          <data_ele>1039</data_ele>
                          <name>Attending Physician Name Suffix</name>
                          <usage>S</usage>
                          <seq>07</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>10</max_len>
                        </element>
                        <element xid="NM108">
                          <data_ele>66</data_ele>
                          <name>Identification Code Qualifier</name>
                          <usage>R</usage>
                          <seq>08</seq>
                          <data_type>ID</data_type>
                          <min_len>1</min_len>
                          <max_len>2</max_len>
                          <valid_codes>
                            <code>24</code>
                            <code>34</code>
                            <code>XX</code>
                          </valid_codes>
                        </element>
                        <element xid="NM109">
                          <data_ele>67</data_ele>
                          <name>Attending Physician Primary Identifier</name>
                          <usage>R</usage>
                          <seq>09</seq>
                          <data_type>AN</data_type>
                          <min_len>2</min_len>
                          <max_len>80</max_len>
                        </element>
                        <element xid="NM110">
                          <data_ele>706</data_ele>
                          <name>Entity Relationship Code</name>
                          <usage>N</usage>
                          <seq>10</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                        </element>
                        <element xid="NM111">
                          <data_ele>98</data_ele>
                          <name>Entity Identifier Code</name>
                          <usage>N</usage>
                          <seq>11</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                        </element>
                      </segment>
<!--End of NM1 segment-->
                      <segment xid="PRV">
                        <name>Attending Physician Specialty Information</name>
                        <usage>S</usage>
                        <pos>255</pos>
                        <max_use>1</max_use>
                        <element xid="PRV01">
                          <data_ele>1221</data_ele>
                          <name>Provider Code</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>ID</data_type>
                          <min_len>1</min_len>
                          <max_len>3</max_len>
                          <valid_codes>
                            <code>AT</code>
                          </valid_codes>
                        </element>
                        <element xid="PRV02">
                          <data_ele>128</data_ele>
                          <name>Reference Identification Qualifier</name>
                          <usage>R</usage>
                          <seq>02</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                          <valid_codes>
                            <code>ZZ</code>
                          </valid_codes>
                        </element>
                        <element xid="PRV03">
                          <data_ele>127</data_ele>
                          <name>Provider Taxonomy Code</name>
                          <usage>R</usage>
                          <seq>03</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>30</max_len>
<!--<valid_codes external="prov_taxonomy"/>-->
                        </element>
                        <element xid="PRV04">
                          <data_ele>156</data_ele>
                          <name>State or Province Code</name>
                          <usage>N</usage>
                          <seq>04</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                        </element>
                        <composite>
                          <data_ele>C035</data_ele>
                          <name>Provider Specialty Information</name>
                          <usage>N</usage>
                          <seq>05</seq>
                        </composite>
                        <element xid="PRV06">
                          <data_ele>1223</data_ele>
                          <name>Provider Organization Code</name>
                          <usage>N</usage>
                          <seq>06</seq>
                          <data_type>ID</data_type>
                          <min_len>3</min_len>
                          <max_len>3</max_len>
                        </element>
                      </segment>
<!--End of PRV segment-->
                      <segment xid="REF">
                        <name>Attending Physician Secondary Identification</name>
                        <usage>S</usage>
                        <pos>525</pos>
                        <max_use>1</max_use>
                        <element xid="REF01">
                          <data_ele>128</data_ele>
                          <name>Reference Identification Qualifier</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                          <valid_codes>
                            <code>0B</code>
                            <code>1A</code>
                            <code>1B</code>
                            <code>1C</code>
                            <code>1D</code>
                            <code>1G</code>
                            <code>1H</code>
                            <code>EI</code>
                            <code>G2</code>
                            <code>LU</code>
                            <code>N5</code>
                            <code>SY</code>
                            <code>X5</code>
                          </valid_codes>
                        </element>
                        <element xid="REF02">
                          <data_ele>127</data_ele>
                          <name>Attending Physician Secondary Identifier</name>
                          <usage>R</usage>
                          <seq>02</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>30</max_len>
                        </element>
                        <element xid="REF03">
                          <data_ele>352</data_ele>
                          <name>Description</name>
                          <usage>N</usage>
                          <seq>03</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>80</max_len>
                        </element>
                        <composite>
                          <data_ele>C040</data_ele>
                          <name>Reference Identifier</name>
                          <usage>N</usage>
                          <seq>04</seq>
                        </composite>
                      </segment>
<!--End of REF segment-->
                    </loop>
<!--End of 2420A loop-->
                    <loop xid="2420B">
                      <name>Operating Physician Name</name>
                      <usage>S</usage>
                      <pos>500</pos>
                      <repeat>1</repeat>
                      <segment xid="NM1">
                        <name>Operating Physician Name</name>
                        <usage>R</usage>
                        <pos>500</pos>
                        <max_use>1</max_use>
                        <element xid="NM101">
                          <data_ele>98</data_ele>
                          <name>Entity Identifier Code</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                          <valid_codes>
                            <code>72</code>
                          </valid_codes>
                        </element>
                        <element xid="NM102">
                          <data_ele>1065</data_ele>
                          <name>Entity Type Qualifier</name>
                          <usage>R</usage>
                          <seq>02</seq>
                          <data_type>ID</data_type>
                          <min_len>1</min_len>
                          <max_len>1</max_len>
                          <valid_codes>
                            <code>1</code>
                          </valid_codes>
                        </element>
                        <element xid="NM103">
                          <data_ele>1035</data_ele>
                          <name>Operating Physician Last Name</name>
                          <usage>R</usage>
                          <seq>03</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>35</max_len>
                        </element>
                        <element xid="NM104">
                          <data_ele>1036</data_ele>
                          <name>Operating Physician First Name</name>
                          <usage>R</usage>
                          <seq>04</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>25</max_len>
                        </element>
                        <element xid="NM105">
                          <data_ele>1037</data_ele>
                          <name>Operating Physician Middle Name</name>
                          <usage>S</usage>
                          <seq>05</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>25</max_len>
                        </element>
                        <element xid="NM106">
                          <data_ele>1038</data_ele>
                          <name>Name Prefix</name>
                          <usage>N</usage>
                          <seq>06</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>10</max_len>
                        </element>
                        <element xid="NM107">
                          <data_ele>1039</data_ele>
                          <name>Operating Physician Name Suffix</name>
                          <usage>S</usage>
                          <seq>07</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>10</max_len>
                        </element>
                        <element xid="NM108">
                          <data_ele>66</data_ele>
                          <name>Identification Code Qualifier</name>
                          <usage>R</usage>
                          <seq>08</seq>
                          <data_type>ID</data_type>
                          <min_len>1</min_len>
                          <max_len>2</max_len>
                          <valid_codes>
                            <code>24</code>
                            <code>34</code>
                            <code>XX</code>
                          </valid_codes>
                        </element>
                        <element xid="NM109">
                          <data_ele>67</data_ele>
                          <name>Operating Physician Primary Identifier</name>
                          <usage>R</usage>
                          <seq>09</seq>
                          <data_type>AN</data_type>
                          <min_len>2</min_len>
                          <max_len>80</max_len>
                        </element>
                        <element xid="NM110">
                          <data_ele>706</data_ele>
                          <name>Entity Relationship Code</name>
                          <usage>N</usage>
                          <seq>10</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                        </element>
                        <element xid="NM111">
                          <data_ele>98</data_ele>
                          <name>Entity Identifier Code</name>
                          <usage>N</usage>
                          <seq>11</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                        </element>
                      </segment>
<!--End of NM1 segment-->
                      <segment xid="PRV">
                        <name>Operating Physician Specialty Information</name>
                        <usage>S</usage>
                        <pos>255</pos>
                        <max_use>1</max_use>
                        <element xid="PRV01">
                          <data_ele>1221</data_ele>
                          <name>Provider Code</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>ID</data_type>
                          <min_len>1</min_len>
                          <max_len>3</max_len>
                          <valid_codes>
                            <code>OP</code>
                          </valid_codes>
                        </element>
                        <element xid="PRV02">
                          <data_ele>128</data_ele>
                          <name>Reference Identification Qualifier</name>
                          <usage>R</usage>
                          <seq>02</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                          <valid_codes>
                            <code>ZZ</code>
                          </valid_codes>
                        </element>
                        <element xid="PRV03">
                          <data_ele>127</data_ele>
                          <name>Provider Taxonomy Code</name>
                          <usage>R</usage>
                          <seq>03</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>30</max_len>
<!--<valid_codes external="prov_taxonomy"/>-->
                        </element>
                        <element xid="PRV04">
                          <data_ele>156</data_ele>
                          <name>State or Province Code</name>
                          <usage>N</usage>
                          <seq>04</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                        </element>
                        <composite>
                          <data_ele>C035</data_ele>
                          <name>Provider Specialty Information</name>
                          <usage>N</usage>
                          <seq>05</seq>
                        </composite>
                        <element xid="PRV06">
                          <data_ele>1223</data_ele>
                          <name>Provider Organization Code</name>
                          <usage>N</usage>
                          <seq>06</seq>
                          <data_type>ID</data_type>
                          <min_len>3</min_len>
                          <max_len>3</max_len>
                        </element>
                      </segment>
<!--End of PRV segment-->
                      <segment xid="REF">
                        <name>Operating Physician Secondary Identification</name>
                        <usage>S</usage>
                        <pos>525</pos>
                        <max_use>1</max_use>
                        <element xid="REF01">
                          <data_ele>128</data_ele>
                          <name>Reference Identification Qualifier</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                          <valid_codes>
                            <code>0B</code>
                            <code>1A</code>
                            <code>1B</code>
                            <code>1C</code>
                            <code>1D</code>
                            <code>1G</code>
                            <code>1H</code>
                            <code>EI</code>
                            <code>G2</code>
                            <code>LU</code>
                            <code>N5</code>
                            <code>SY</code>
                            <code>X5</code>
                          </valid_codes>
                        </element>
                        <element xid="REF02">
                          <data_ele>127</data_ele>
                          <name>Operating Physician Secondary Identifier</name>
                          <usage>R</usage>
                          <seq>02</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>30</max_len>
                        </element>
                        <element xid="REF03">
                          <data_ele>352</data_ele>
                          <name>Description</name>
                          <usage>N</usage>
                          <seq>03</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>80</max_len>
                        </element>
                        <composite>
                          <data_ele>C040</data_ele>
                          <name>Reference Identifier</name>
                          <usage>N</usage>
                          <seq>04</seq>
                        </composite>
                      </segment>
<!--End of REF segment-->
                    </loop>
<!--End of 2420B loop-->
                    <loop xid="2420C">
                      <name>Other Provider Name</name>
                      <usage>S</usage>
                      <pos>500</pos>
                      <repeat>1</repeat>
                      <segment xid="NM1">
                        <name>Other Provider Name</name>
                        <usage>R</usage>
                        <pos>500</pos>
                        <max_use>1</max_use>
                        <element xid="NM101">
                          <data_ele>98</data_ele>
                          <name>Entity Identifier Code</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                          <valid_codes>
                            <code>73</code>
                          </valid_codes>
                        </element>
                        <element xid="NM102">
                          <data_ele>1065</data_ele>
                          <name>Entity Type Qualifier</name>
                          <usage>R</usage>
                          <seq>02</seq>
                          <data_type>ID</data_type>
                          <min_len>1</min_len>
                          <max_len>1</max_len>
                          <valid_codes>
                            <code>1</code>
                            <code>2</code>
                          </valid_codes>
                        </element>
                        <element xid="NM103">
                          <data_ele>1035</data_ele>
                          <name>Other Physician Last Name</name>
                          <usage>R</usage>
                          <seq>03</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>35</max_len>
                        </element>
                        <element xid="NM104">
                          <data_ele>1036</data_ele>
                          <name>Other Physician First Name</name>
                          <usage>S</usage>
                          <seq>04</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>25</max_len>
                        </element>
                        <element xid="NM105">
                          <data_ele>1037</data_ele>
                          <name>Other Provider Middle Name</name>
                          <usage>S</usage>
                          <seq>05</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>25</max_len>
                        </element>
                        <element xid="NM106">
                          <data_ele>1038</data_ele>
                          <name>Name Prefix</name>
                          <usage>N</usage>
                          <seq>06</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>10</max_len>
                        </element>
                        <element xid="NM107">
                          <data_ele>1039</data_ele>
                          <name>Other Provider Name Suffix</name>
                          <usage>S</usage>
                          <seq>07</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>10</max_len>
                        </element>
                        <element xid="NM108">
                          <data_ele>66</data_ele>
                          <name>Identification Code Qualifier</name>
                          <usage>R</usage>
                          <seq>08</seq>
                          <data_type>ID</data_type>
                          <min_len>1</min_len>
                          <max_len>2</max_len>
                          <valid_codes>
                            <code>24</code>
                            <code>34</code>
                            <code>XX</code>
                          </valid_codes>
                        </element>
                        <element xid="NM109">
                          <data_ele>67</data_ele>
                          <name>Other Provider Identifier</name>
                          <usage>R</usage>
                          <seq>09</seq>
                          <data_type>AN</data_type>
                          <min_len>2</min_len>
                          <max_len>80</max_len>
                        </element>
                        <element xid="NM110">
                          <data_ele>706</data_ele>
                          <name>Entity Relationship Code</name>
                          <usage>N</usage>
                          <seq>10</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                        </element>
                        <element xid="NM111">
                          <data_ele>98</data_ele>
                          <name>Entity Identifier Code</name>
                          <usage>N</usage>
                          <seq>11</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                        </element>
                      </segment>
<!--End of NM1 segment-->
                      <segment xid="PRV">
                        <name>Other Provider Specialty Information</name>
                        <usage>S</usage>
                        <pos>255</pos>
                        <max_use>1</max_use>
                        <element xid="PRV01">
                          <data_ele>1221</data_ele>
                          <name>Provider Code</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>ID</data_type>
                          <min_len>1</min_len>
                          <max_len>3</max_len>
                          <valid_codes>
                            <code>OT</code>
                            <code>PE</code>
                          </valid_codes>
                        </element>
                        <element xid="PRV02">
                          <data_ele>128</data_ele>
                          <name>Reference Identification Qualifier</name>
                          <usage>R</usage>
                          <seq>02</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                          <valid_codes>
                            <code>ZZ</code>
                          </valid_codes>
                        </element>
                        <element xid="PRV03">
                          <data_ele>127</data_ele>
                          <name>Provider Taxonomy Code</name>
                          <usage>R</usage>
                          <seq>03</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>30</max_len>
<!--<valid_codes external="prov_taxonomy"/>-->
                        </element>
                        <element xid="PRV04">
                          <data_ele>156</data_ele>
                          <name>State or Province Code</name>
                          <usage>N</usage>
                          <seq>04</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>2</max_len>
                        </element>
                        <composite>
                          <data_ele>C035</data_ele>
                          <name>Provider Specialty Information</name>
                          <usage>N</usage>
                          <seq>05</seq>
                        </composite>
                        <element xid="PRV06">
                          <data_ele>1223</data_ele>
                          <name>Provider Organization Code</name>
                          <usage>N</usage>
                          <seq>06</seq>
                          <data_type>ID</data_type>
                          <min_len>3</min_len>
                          <max_len>3</max_len>
                        </element>
                      </segment>
<!--End of PRV segment-->
                      <segment xid="REF">
                        <name>Other Provider Secondary Identification</name>
                        <usage>S</usage>
                        <pos>525</pos>
                        <max_use>1</max_use>
                        <element xid="REF01">
                          <data_ele>128</data_ele>
                          <name>Reference Identification Qualifier</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                          <valid_codes>
                            <code>0B</code>
                            <code>1A</code>
                            <code>1B</code>
                            <code>1C</code>
                            <code>1D</code>
                            <code>1G</code>
                            <code>1H</code>
                            <code>EI</code>
                            <code>G2</code>
                            <code>LU</code>
                            <code>N5</code>
                            <code>SY</code>
                            <code>X5</code>
                          </valid_codes>
                        </element>
                        <element xid="REF02">
                          <data_ele>127</data_ele>
                          <name>Other Provider Secondary Identifier</name>
                          <usage>R</usage>
                          <seq>02</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>30</max_len>
                        </element>
                        <element xid="REF03">
                          <data_ele>352</data_ele>
                          <name>Description</name>
                          <usage>N</usage>
                          <seq>03</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>80</max_len>
                        </element>
                        <composite>
                          <data_ele>C040</data_ele>
                          <name>Reference Identifier</name>
                          <usage>N</usage>
                          <seq>04</seq>
                        </composite>
                      </segment>
<!--End of REF segment-->
                    </loop>
<!--End of 2420C loop-->
                    <loop xid="2430">
                      <name>Service Line Adjudication Information</name>
                      <usage>S</usage>
                      <pos>540</pos>
                      <repeat>25</repeat>
                      <segment xid="SVD">
                        <name>Service Line Adjudication Information</name>
                        <usage>R</usage>
                        <pos>540</pos>
                        <max_use>1</max_use>
                        <element xid="SVD01">
                          <data_ele>67</data_ele>
                          <name>Payer Identifier</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>AN</data_type>
                          <min_len>2</min_len>
                          <max_len>80</max_len>
                        </element>
                        <element xid="SVD02">
                          <data_ele>782</data_ele>
                          <name>Service Line Paid Amount</name>
                          <usage>R</usage>
                          <seq>02</seq>
                          <data_type>R</data_type>
                          <min_len>1</min_len>
                          <max_len>18</max_len>
                        </element>
                        <composite>
                          <data_ele>C003</data_ele>
                          <name>Composite Medical Procedure Identifier</name>
                          <usage>S</usage>
                          <seq>03</seq>
                          <element xid="SVD03-01">
                            <data_ele>235</data_ele>
                            <name>Product or Service ID Qualifier</name>
                            <usage>R</usage>
                            <seq>01</seq>
                            <data_type>ID</data_type>
                            <min_len>2</min_len>
                            <max_len>2</max_len>
                            <valid_codes>
                              <code>HC</code>
                              <code>IV</code>
                              <code>ZZ</code>
                            </valid_codes>
                          </element>
                          <element xid="SVD03-02">
                            <data_ele>234</data_ele>
                            <name>Procedure Code</name>
                            <usage>R</usage>
                            <seq>02</seq>
                            <data_type>AN</data_type>
                            <min_len>1</min_len>
                            <max_len>48</max_len>
                          </element>
                          <element xid="SVD03-03">
                            <data_ele>1339</data_ele>
                            <name>Procedure Modifier</name>
                            <usage>S</usage>
                            <seq>03</seq>
                            <data_type>AN</data_type>
                            <min_len>2</min_len>
                            <max_len>2</max_len>
                          </element>
                          <element xid="SVD03-04">
                            <data_ele>1339</data_ele>
                            <name>Procedure Modifier</name>
                            <usage>S</usage>
                            <seq>04</seq>
                            <data_type>AN</data_type>
                            <min_len>2</min_len>
                            <max_len>2</max_len>
                          </element>
                          <element xid="SVD03-05">
                            <data_ele>1339</data_ele>
                            <name>Procedure Modifier</name>
                            <usage>S</usage>
                            <seq>05</seq>
                            <data_type>AN</data_type>
                            <min_len>2</min_len>
                            <max_len>2</max_len>
                          </element>
                          <element xid="SVD03-06">
                            <data_ele>1339</data_ele>
                            <name>Procedure Modifier</name>
                            <usage>S</usage>
                            <seq>06</seq>
                            <data_type>AN</data_type>
                            <min_len>2</min_len>
                            <max_len>2</max_len>
                          </element>
                          <element xid="SVD03-07">
                            <data_ele>352</data_ele>
                            <name>Procedure Code Description</name>
                            <usage>S</usage>
                            <seq>07</seq>
                            <data_type>AN</data_type>
                            <min_len>1</min_len>
                            <max_len>80</max_len>
                          </element>
                        </composite>
                        <element xid="SVD04">
                          <data_ele>234</data_ele>
                          <name>Service Line Revenue Code</name>
                          <usage>R</usage>
                          <seq>04</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>48</max_len>
                        </element>
                        <element xid="SVD05">
                          <data_ele>380</data_ele>
                          <name>Adjustment Quantity</name>
                          <usage>R</usage>
                          <seq>05</seq>
                          <data_type>R</data_type>
                          <min_len>1</min_len>
                          <max_len>15</max_len>
                        </element>
                        <element xid="SVD06">
                          <data_ele>554</data_ele>
                          <name>Bundled or Unbundled Line Number</name>
                          <usage>S</usage>
                          <seq>06</seq>
                          <data_type>N0</data_type>
                          <min_len>1</min_len>
                          <max_len>6</max_len>
                        </element>
                      </segment>
<!--End of SVD segment-->
                      <segment xid="CAS">
                        <name>Service Line Adjustment</name>
                        <usage>S</usage>
                        <pos>545</pos>
                        <max_use>99</max_use>
                        <element xid="CAS01">
                          <data_ele>1033</data_ele>
                          <name>Claim Adjustment Group Code</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>ID</data_type>
                          <min_len>1</min_len>
                          <max_len>2</max_len>
                          <valid_codes>
                            <code>CO</code>
                            <code>CR</code>
                            <code>OA</code>
                            <code>PI</code>
                            <code>PR</code>
                          </valid_codes>
                        </element>
                        <element xid="CAS02">
                          <data_ele>1034</data_ele>
                          <name>Adjustment Reason Code</name>
                          <usage>R</usage>
                          <seq>02</seq>
                          <data_type>ID</data_type>
                          <min_len>1</min_len>
                          <max_len>5</max_len>
                          <valid_codes>
                            <code>1</code>
                            <code>2</code>
                            <code>3</code>
                            <code>4</code>
                            <code>5</code>
                            <code>6</code>
                            <code>7</code>
                            <code>8</code>
                            <code>9</code>
                            <code>10</code>
                            <code>11</code>
                            <code>12</code>
                            <code>13</code>
                            <code>14</code>
                            <code>15</code>
                            <code>16</code>
                            <code>17</code>
                            <code>18</code>
                            <code>19</code>
                            <code>20</code>
                            <code>21</code>
                            <code>22</code>
                            <code>23</code>
                            <code>24</code>
                            <code>25</code>
                            <code>26</code>
                            <code>27</code>
                            <code>28</code>
                            <code>29</code>
                            <code>30</code>
                            <code>31</code>
                            <code>32</code>
                            <code>33</code>
                            <code>34</code>
                            <code>35</code>
                            <code>36</code>
                            <code>37</code>
                            <code>38</code>
                            <code>39</code>
                            <code>40</code>
                            <code>41</code>
                            <code>42</code>
                            <code>43</code>
                            <code>44</code>
                            <code>45</code>
                            <code>46</code>
                            <code>47</code>
                            <code>48</code>
                            <code>49</code>
                            <code>50</code>
                            <code>51</code>
                            <code>52</code>
                            <code>53</code>
                            <code>54</code>
                            <code>55</code>
                            <code>56</code>
                            <code>57</code>
                            <code>58</code>
                            <code>59</code>
                            <code>60</code>
                            <code>61</code>
                            <code>62</code>
                            <code>63</code>
                            <code>64</code>
                            <code>65</code>
                            <code>66</code>
                            <code>67</code>
                            <code>68</code>
                            <code>69</code>
                            <code>70</code>
                            <code>71</code>
                            <code>72</code>
                            <code>73</code>
                            <code>74</code>
                            <code>75</code>
                            <code>76</code>
                            <code>77</code>
                            <code>78</code>
                            <code>79</code>
                            <code>80</code>
                            <code>81</code>
                            <code>82</code>
                            <code>83</code>
                            <code>84</code>
                            <code>85</code>
                            <code>86</code>
                            <code>87</code>
                            <code>88</code>
                            <code>89</code>
                            <code>90</code>
                            <code>91</code>
                            <code>92</code>
                            <code>93</code>
                            <code>94</code>
                            <code>95</code>
                            <code>96</code>
                            <code>97</code>
                            <code>98</code>
                            <code>99</code>
                            <code>100</code>
                            <code>101</code>
                            <code>102</code>
                            <code>103</code>
                            <code>104</code>
                            <code>105</code>
                            <code>106</code>
                            <code>107</code>
                            <code>108</code>
                            <code>109</code>
                            <code>110</code>
                            <code>111</code>
                            <code>112</code>
                            <code>113</code>
                            <code>114</code>
                            <code>115</code>
                            <code>116</code>
                            <code>117</code>
                            <code>118</code>
                            <code>119</code>
                            <code>120</code>
                            <code>121</code>
                            <code>122</code>
                            <code>123</code>
                            <code>124</code>
                            <code>125</code>
                            <code>126</code>
                            <code>127</code>
                            <code>128</code>
                            <code>129</code>
                            <code>130</code>
                            <code>131</code>
                            <code>132</code>
                            <code>133</code>
                            <code>134</code>
                            <code>135</code>
                            <code>136</code>
                            <code>137</code>
                            <code>138</code>
                            <code>139</code>
                            <code>140</code>
                            <code>141</code>
                            <code>142</code>
                            <code>143</code>
                            <code>144</code>
                            <code>145</code>
                            <code>146</code>
                            <code>147</code>
                            <code>148</code>
                            <code>149</code>
                            <code>150</code>
                            <code>151</code>
                            <code>152</code>
                            <code>153</code>
                            <code>154</code>
                            <code>A0</code>
                            <code>A1</code>
                            <code>A2</code>
                            <code>A3</code>
                            <code>A4</code>
                            <code>A5</code>
                            <code>A6</code>
                            <code>A7</code>
                            <code>A8</code>
                            <code>B1</code>
                            <code>B2</code>
                            <code>B3</code>
                            <code>B4</code>
                            <code>B5</code>
                            <code>B6</code>
                            <code>B7</code>
                            <code>B8</code>
                            <code>B9</code>
                            <code>B10</code>
                            <code>B11</code>
                            <code>B12</code>
                            <code>B13</code>
                            <code>B14</code>
                            <code>B15</code>
                            <code>B16</code>
                            <code>B17</code>
                            <code>B18</code>
                            <code>B19</code>
                            <code>B20</code>
                            <code>B21</code>
                            <code>B22</code>
                            <code>B23</code>
                            <code>D1</code>
                            <code>D2</code>
                            <code>D3</code>
                            <code>D4</code>
                            <code>D5</code>
                            <code>D6</code>
                            <code>D7</code>
                            <code>D8</code>
                            <code>D9</code>
                            <code>D10</code>
                            <code>D11</code>
                            <code>D12</code>
                            <code>D13</code>
                            <code>D14</code>
                            <code>D15</code>
                            <code>W1</code>
                          </valid_codes>
                        </element>
                        <element xid="CAS03">
                          <data_ele>782</data_ele>
                          <name>Adjustment Amount</name>
                          <usage>R</usage>
                          <seq>03</seq>
                          <data_type>R</data_type>
                          <min_len>1</min_len>
                          <max_len>18</max_len>
                        </element>
                        <element xid="CAS04">
                          <data_ele>380</data_ele>
                          <name>Adjustment Quantity</name>
                          <usage>S</usage>
                          <seq>04</seq>
                          <data_type>R</data_type>
                          <min_len>1</min_len>
                          <max_len>15</max_len>
                        </element>
                        <element xid="CAS05">
                          <data_ele>1034</data_ele>
                          <name>Adjustment Reason Code</name>
                          <usage>S</usage>
                          <seq>05</seq>
                          <data_type>ID</data_type>
                          <min_len>1</min_len>
                          <max_len>5</max_len>
                          <valid_codes>
                            <code>1</code>
                            <code>2</code>
                            <code>3</code>
                            <code>4</code>
                            <code>5</code>
                            <code>6</code>
                            <code>7</code>
                            <code>8</code>
                            <code>9</code>
                            <code>10</code>
                            <code>11</code>
                            <code>12</code>
                            <code>13</code>
                            <code>14</code>
                            <code>15</code>
                            <code>16</code>
                            <code>17</code>
                            <code>18</code>
                            <code>19</code>
                            <code>20</code>
                            <code>21</code>
                            <code>22</code>
                            <code>23</code>
                            <code>24</code>
                            <code>25</code>
                            <code>26</code>
                            <code>27</code>
                            <code>28</code>
                            <code>29</code>
                            <code>30</code>
                            <code>31</code>
                            <code>32</code>
                            <code>33</code>
                            <code>34</code>
                            <code>35</code>
                            <code>36</code>
                            <code>37</code>
                            <code>38</code>
                            <code>39</code>
                            <code>40</code>
                            <code>41</code>
                            <code>42</code>
                            <code>43</code>
                            <code>44</code>
                            <code>45</code>
                            <code>46</code>
                            <code>47</code>
                            <code>48</code>
                            <code>49</code>
                            <code>50</code>
                            <code>51</code>
                            <code>52</code>
                            <code>53</code>
                            <code>54</code>
                            <code>55</code>
                            <code>56</code>
                            <code>57</code>
                            <code>58</code>
                            <code>59</code>
                            <code>60</code>
                            <code>61</code>
                            <code>62</code>
                            <code>63</code>
                            <code>64</code>
                            <code>65</code>
                            <code>66</code>
                            <code>67</code>
                            <code>68</code>
                            <code>69</code>
                            <code>70</code>
                            <code>71</code>
                            <code>72</code>
                            <code>73</code>
                            <code>74</code>
                            <code>75</code>
                            <code>76</code>
                            <code>77</code>
                            <code>78</code>
                            <code>79</code>
                            <code>80</code>
                            <code>81</code>
                            <code>82</code>
                            <code>83</code>
                            <code>84</code>
                            <code>85</code>
                            <code>86</code>
                            <code>87</code>
                            <code>88</code>
                            <code>89</code>
                            <code>90</code>
                            <code>91</code>
                            <code>92</code>
                            <code>93</code>
                            <code>94</code>
                            <code>95</code>
                            <code>96</code>
                            <code>97</code>
                            <code>98</code>
                            <code>99</code>
                            <code>100</code>
                            <code>101</code>
                            <code>102</code>
                            <code>103</code>
                            <code>104</code>
                            <code>105</code>
                            <code>106</code>
                            <code>107</code>
                            <code>108</code>
                            <code>109</code>
                            <code>110</code>
                            <code>111</code>
                            <code>112</code>
                            <code>113</code>
                            <code>114</code>
                            <code>115</code>
                            <code>116</code>
                            <code>117</code>
                            <code>118</code>
                            <code>119</code>
                            <code>120</code>
                            <code>121</code>
                            <code>122</code>
                            <code>123</code>
                            <code>124</code>
                            <code>125</code>
                            <code>126</code>
                            <code>127</code>
                            <code>128</code>
                            <code>129</code>
                            <code>130</code>
                            <code>131</code>
                            <code>132</code>
                            <code>133</code>
                            <code>134</code>
                            <code>135</code>
                            <code>136</code>
                            <code>137</code>
                            <code>138</code>
                            <code>139</code>
                            <code>140</code>
                            <code>141</code>
                            <code>142</code>
                            <code>143</code>
                            <code>144</code>
                            <code>145</code>
                            <code>146</code>
                            <code>147</code>
                            <code>148</code>
                            <code>149</code>
                            <code>150</code>
                            <code>151</code>
                            <code>152</code>
                            <code>153</code>
                            <code>154</code>
                            <code>A0</code>
                            <code>A1</code>
                            <code>A2</code>
                            <code>A3</code>
                            <code>A4</code>
                            <code>A5</code>
                            <code>A6</code>
                            <code>A7</code>
                            <code>A8</code>
                            <code>B1</code>
                            <code>B2</code>
                            <code>B3</code>
                            <code>B4</code>
                            <code>B5</code>
                            <code>B6</code>
                            <code>B7</code>
                            <code>B8</code>
                            <code>B9</code>
                            <code>B10</code>
                            <code>B11</code>
                            <code>B12</code>
                            <code>B13</code>
                            <code>B14</code>
                            <code>B15</code>
                            <code>B16</code>
                            <code>B17</code>
                            <code>B18</code>
                            <code>B19</code>
                            <code>B20</code>
                            <code>B21</code>
                            <code>B22</code>
                            <code>B23</code>
                            <code>D1</code>
                            <code>D2</code>
                            <code>D3</code>
                            <code>D4</code>
                            <code>D5</code>
                            <code>D6</code>
                            <code>D7</code>
                            <code>D8</code>
                            <code>D9</code>
                            <code>D10</code>
                            <code>D11</code>
                            <code>D12</code>
                            <code>D13</code>
                            <code>D14</code>
                            <code>D15</code>
                            <code>W1</code>
                          </valid_codes>
                        </element>
                        <element xid="CAS06">
                          <data_ele>782</data_ele>
                          <name>Adjustment Amount</name>
                          <usage>S</usage>
                          <seq>06</seq>
                          <data_type>R</data_type>
                          <min_len>1</min_len>
                          <max_len>18</max_len>
                        </element>
                        <element xid="CAS07">
                          <data_ele>380</data_ele>
                          <name>Adjustment Quantity</name>
                          <usage>S</usage>
                          <seq>07</seq>
                          <data_type>R</data_type>
                          <min_len>1</min_len>
                          <max_len>15</max_len>
                        </element>
                        <element xid="CAS08">
                          <data_ele>1034</data_ele>
                          <name>Adjustment Reason Code</name>
                          <usage>S</usage>
                          <seq>08</seq>
                          <data_type>ID</data_type>
                          <min_len>1</min_len>
                          <max_len>5</max_len>
                          <valid_codes>
                            <code>1</code>
                            <code>2</code>
                            <code>3</code>
                            <code>4</code>
                            <code>5</code>
                            <code>6</code>
                            <code>7</code>
                            <code>8</code>
                            <code>9</code>
                            <code>10</code>
                            <code>11</code>
                            <code>12</code>
                            <code>13</code>
                            <code>14</code>
                            <code>15</code>
                            <code>16</code>
                            <code>17</code>
                            <code>18</code>
                            <code>19</code>
                            <code>20</code>
                            <code>21</code>
                            <code>22</code>
                            <code>23</code>
                            <code>24</code>
                            <code>25</code>
                            <code>26</code>
                            <code>27</code>
                            <code>28</code>
                            <code>29</code>
                            <code>30</code>
                            <code>31</code>
                            <code>32</code>
                            <code>33</code>
                            <code>34</code>
                            <code>35</code>
                            <code>36</code>
                            <code>37</code>
                            <code>38</code>
                            <code>39</code>
                            <code>40</code>
                            <code>41</code>
                            <code>42</code>
                            <code>43</code>
                            <code>44</code>
                            <code>45</code>
                            <code>46</code>
                            <code>47</code>
                            <code>48</code>
                            <code>49</code>
                            <code>50</code>
                            <code>51</code>
                            <code>52</code>
                            <code>53</code>
                            <code>54</code>
                            <code>55</code>
                            <code>56</code>
                            <code>57</code>
                            <code>58</code>
                            <code>59</code>
                            <code>60</code>
                            <code>61</code>
                            <code>62</code>
                            <code>63</code>
                            <code>64</code>
                            <code>65</code>
                            <code>66</code>
                            <code>67</code>
                            <code>68</code>
                            <code>69</code>
                            <code>70</code>
                            <code>71</code>
                            <code>72</code>
                            <code>73</code>
                            <code>74</code>
                            <code>75</code>
                            <code>76</code>
                            <code>77</code>
                            <code>78</code>
                            <code>79</code>
                            <code>80</code>
                            <code>81</code>
                            <code>82</code>
                            <code>83</code>
                            <code>84</code>
                            <code>85</code>
                            <code>86</code>
                            <code>87</code>
                            <code>88</code>
                            <code>89</code>
                            <code>90</code>
                            <code>91</code>
                            <code>92</code>
                            <code>93</code>
                            <code>94</code>
                            <code>95</code>
                            <code>96</code>
                            <code>97</code>
                            <code>98</code>
                            <code>99</code>
                            <code>100</code>
                            <code>101</code>
                            <code>102</code>
                            <code>103</code>
                            <code>104</code>
                            <code>105</code>
                            <code>106</code>
                            <code>107</code>
                            <code>108</code>
                            <code>109</code>
                            <code>110</code>
                            <code>111</code>
                            <code>112</code>
                            <code>113</code>
                            <code>114</code>
                            <code>115</code>
                            <code>116</code>
                            <code>117</code>
                            <code>118</code>
                            <code>119</code>
                            <code>120</code>
                            <code>121</code>
                            <code>122</code>
                            <code>123</code>
                            <code>124</code>
                            <code>125</code>
                            <code>126</code>
                            <code>127</code>
                            <code>128</code>
                            <code>129</code>
                            <code>130</code>
                            <code>131</code>
                            <code>132</code>
                            <code>133</code>
                            <code>134</code>
                            <code>135</code>
                            <code>136</code>
                            <code>137</code>
                            <code>138</code>
                            <code>139</code>
                            <code>140</code>
                            <code>141</code>
                            <code>142</code>
                            <code>143</code>
                            <code>144</code>
                            <code>145</code>
                            <code>146</code>
                            <code>147</code>
                            <code>148</code>
                            <code>149</code>
                            <code>150</code>
                            <code>151</code>
                            <code>152</code>
                            <code>153</code>
                            <code>154</code>
                            <code>A0</code>
                            <code>A1</code>
                            <code>A2</code>
                            <code>A3</code>
                            <code>A4</code>
                            <code>A5</code>
                            <code>A6</code>
                            <code>A7</code>
                            <code>A8</code>
                            <code>B1</code>
                            <code>B2</code>
                            <code>B3</code>
                            <code>B4</code>
                            <code>B5</code>
                            <code>B6</code>
                            <code>B7</code>
                            <code>B8</code>
                            <code>B9</code>
                            <code>B10</code>
                            <code>B11</code>
                            <code>B12</code>
                            <code>B13</code>
                            <code>B14</code>
                            <code>B15</code>
                            <code>B16</code>
                            <code>B17</code>
                            <code>B18</code>
                            <code>B19</code>
                            <code>B20</code>
                            <code>B21</code>
                            <code>B22</code>
                            <code>B23</code>
                            <code>D1</code>
                            <code>D2</code>
                            <code>D3</code>
                            <code>D4</code>
                            <code>D5</code>
                            <code>D6</code>
                            <code>D7</code>
                            <code>D8</code>
                            <code>D9</code>
                            <code>D10</code>
                            <code>D11</code>
                            <code>D12</code>
                            <code>D13</code>
                            <code>D14</code>
                            <code>D15</code>
                            <code>W1</code>
                          </valid_codes>
                        </element>
                        <element xid="CAS09">
                          <data_ele>782</data_ele>
                          <name>Adjustment Amount</name>
                          <usage>S</usage>
                          <seq>09</seq>
                          <data_type>R</data_type>
                          <min_len>1</min_len>
                          <max_len>18</max_len>
                        </element>
                        <element xid="CAS10">
                          <data_ele>380</data_ele>
                          <name>Adjustment Quantity</name>
                          <usage>S</usage>
                          <seq>10</seq>
                          <data_type>R</data_type>
                          <min_len>1</min_len>
                          <max_len>15</max_len>
                        </element>
                        <element xid="CAS11">
                          <data_ele>1034</data_ele>
                          <name>Adjustment Reason Code</name>
                          <usage>S</usage>
                          <seq>11</seq>
                          <data_type>ID</data_type>
                          <min_len>1</min_len>
                          <max_len>5</max_len>
                          <valid_codes>
                            <code>1</code>
                            <code>2</code>
                            <code>3</code>
                            <code>4</code>
                            <code>5</code>
                            <code>6</code>
                            <code>7</code>
                            <code>8</code>
                            <code>9</code>
                            <code>10</code>
                            <code>11</code>
                            <code>12</code>
                            <code>13</code>
                            <code>14</code>
                            <code>15</code>
                            <code>16</code>
                            <code>17</code>
                            <code>18</code>
                            <code>19</code>
                            <code>20</code>
                            <code>21</code>
                            <code>22</code>
                            <code>23</code>
                            <code>24</code>
                            <code>25</code>
                            <code>26</code>
                            <code>27</code>
                            <code>28</code>
                            <code>29</code>
                            <code>30</code>
                            <code>31</code>
                            <code>32</code>
                            <code>33</code>
                            <code>34</code>
                            <code>35</code>
                            <code>36</code>
                            <code>37</code>
                            <code>38</code>
                            <code>39</code>
                            <code>40</code>
                            <code>41</code>
                            <code>42</code>
                            <code>43</code>
                            <code>44</code>
                            <code>45</code>
                            <code>46</code>
                            <code>47</code>
                            <code>48</code>
                            <code>49</code>
                            <code>50</code>
                            <code>51</code>
                            <code>52</code>
                            <code>53</code>
                            <code>54</code>
                            <code>55</code>
                            <code>56</code>
                            <code>57</code>
                            <code>58</code>
                            <code>59</code>
                            <code>60</code>
                            <code>61</code>
                            <code>62</code>
                            <code>63</code>
                            <code>64</code>
                            <code>65</code>
                            <code>66</code>
                            <code>67</code>
                            <code>68</code>
                            <code>69</code>
                            <code>70</code>
                            <code>71</code>
                            <code>72</code>
                            <code>73</code>
                            <code>74</code>
                            <code>75</code>
                            <code>76</code>
                            <code>77</code>
                            <code>78</code>
                            <code>79</code>
                            <code>80</code>
                            <code>81</code>
                            <code>82</code>
                            <code>83</code>
                            <code>84</code>
                            <code>85</code>
                            <code>86</code>
                            <code>87</code>
                            <code>88</code>
                            <code>89</code>
                            <code>90</code>
                            <code>91</code>
                            <code>92</code>
                            <code>93</code>
                            <code>94</code>
                            <code>95</code>
                            <code>96</code>
                            <code>97</code>
                            <code>98</code>
                            <code>99</code>
                            <code>100</code>
                            <code>101</code>
                            <code>102</code>
                            <code>103</code>
                            <code>104</code>
                            <code>105</code>
                            <code>106</code>
                            <code>107</code>
                            <code>108</code>
                            <code>109</code>
                            <code>110</code>
                            <code>111</code>
                            <code>112</code>
                            <code>113</code>
                            <code>114</code>
                            <code>115</code>
                            <code>116</code>
                            <code>117</code>
                            <code>118</code>
                            <code>119</code>
                            <code>120</code>
                            <code>121</code>
                            <code>122</code>
                            <code>123</code>
                            <code>124</code>
                            <code>125</code>
                            <code>126</code>
                            <code>127</code>
                            <code>128</code>
                            <code>129</code>
                            <code>130</code>
                            <code>131</code>
                            <code>132</code>
                            <code>133</code>
                            <code>134</code>
                            <code>135</code>
                            <code>136</code>
                            <code>137</code>
                            <code>138</code>
                            <code>139</code>
                            <code>140</code>
                            <code>141</code>
                            <code>142</code>
                            <code>143</code>
                            <code>144</code>
                            <code>145</code>
                            <code>146</code>
                            <code>147</code>
                            <code>148</code>
                            <code>149</code>
                            <code>150</code>
                            <code>151</code>
                            <code>152</code>
                            <code>153</code>
                            <code>154</code>
                            <code>A0</code>
                            <code>A1</code>
                            <code>A2</code>
                            <code>A3</code>
                            <code>A4</code>
                            <code>A5</code>
                            <code>A6</code>
                            <code>A7</code>
                            <code>A8</code>
                            <code>B1</code>
                            <code>B2</code>
                            <code>B3</code>
                            <code>B4</code>
                            <code>B5</code>
                            <code>B6</code>
                            <code>B7</code>
                            <code>B8</code>
                            <code>B9</code>
                            <code>B10</code>
                            <code>B11</code>
                            <code>B12</code>
                            <code>B13</code>
                            <code>B14</code>
                            <code>B15</code>
                            <code>B16</code>
                            <code>B17</code>
                            <code>B18</code>
                            <code>B19</code>
                            <code>B20</code>
                            <code>B21</code>
                            <code>B22</code>
                            <code>B23</code>
                            <code>D1</code>
                            <code>D2</code>
                            <code>D3</code>
                            <code>D4</code>
                            <code>D5</code>
                            <code>D6</code>
                            <code>D7</code>
                            <code>D8</code>
                            <code>D9</code>
                            <code>D10</code>
                            <code>D11</code>
                            <code>D12</code>
                            <code>D13</code>
                            <code>D14</code>
                            <code>D15</code>
                            <code>W1</code>
                          </valid_codes>
                        </element>
                        <element xid="CAS12">
                          <data_ele>782</data_ele>
                          <name>Adjustment Amount</name>
                          <usage>S</usage>
                          <seq>12</seq>
                          <data_type>R</data_type>
                          <min_len>1</min_len>
                          <max_len>18</max_len>
                        </element>
                        <element xid="CAS13">
                          <data_ele>380</data_ele>
                          <name>Adjustment Quantity</name>
                          <usage>S</usage>
                          <seq>13</seq>
                          <data_type>R</data_type>
                          <min_len>1</min_len>
                          <max_len>15</max_len>
                        </element>
                        <element xid="CAS14">
                          <data_ele>1034</data_ele>
                          <name>Adjustment Reason Code</name>
                          <usage>S</usage>
                          <seq>14</seq>
                          <data_type>ID</data_type>
                          <min_len>1</min_len>
                          <max_len>5</max_len>
                          <valid_codes>
                            <code>1</code>
                            <code>2</code>
                            <code>3</code>
                            <code>4</code>
                            <code>5</code>
                            <code>6</code>
                            <code>7</code>
                            <code>8</code>
                            <code>9</code>
                            <code>10</code>
                            <code>11</code>
                            <code>12</code>
                            <code>13</code>
                            <code>14</code>
                            <code>15</code>
                            <code>16</code>
                            <code>17</code>
                            <code>18</code>
                            <code>19</code>
                            <code>20</code>
                            <code>21</code>
                            <code>22</code>
                            <code>23</code>
                            <code>24</code>
                            <code>25</code>
                            <code>26</code>
                            <code>27</code>
                            <code>28</code>
                            <code>29</code>
                            <code>30</code>
                            <code>31</code>
                            <code>32</code>
                            <code>33</code>
                            <code>34</code>
                            <code>35</code>
                            <code>36</code>
                            <code>37</code>
                            <code>38</code>
                            <code>39</code>
                            <code>40</code>
                            <code>41</code>
                            <code>42</code>
                            <code>43</code>
                            <code>44</code>
                            <code>45</code>
                            <code>46</code>
                            <code>47</code>
                            <code>48</code>
                            <code>49</code>
                            <code>50</code>
                            <code>51</code>
                            <code>52</code>
                            <code>53</code>
                            <code>54</code>
                            <code>55</code>
                            <code>56</code>
                            <code>57</code>
                            <code>58</code>
                            <code>59</code>
                            <code>60</code>
                            <code>61</code>
                            <code>62</code>
                            <code>63</code>
                            <code>64</code>
                            <code>65</code>
                            <code>66</code>
                            <code>67</code>
                            <code>68</code>
                            <code>69</code>
                            <code>70</code>
                            <code>71</code>
                            <code>72</code>
                            <code>73</code>
                            <code>74</code>
                            <code>75</code>
                            <code>76</code>
                            <code>77</code>
                            <code>78</code>
                            <code>79</code>
                            <code>80</code>
                            <code>81</code>
                            <code>82</code>
                            <code>83</code>
                            <code>84</code>
                            <code>85</code>
                            <code>86</code>
                            <code>87</code>
                            <code>88</code>
                            <code>89</code>
                            <code>90</code>
                            <code>91</code>
                            <code>92</code>
                            <code>93</code>
                            <code>94</code>
                            <code>95</code>
                            <code>96</code>
                            <code>97</code>
                            <code>98</code>
                            <code>99</code>
                            <code>100</code>
                            <code>101</code>
                            <code>102</code>
                            <code>103</code>
                            <code>104</code>
                            <code>105</code>
                            <code>106</code>
                            <code>107</code>
                            <code>108</code>
                            <code>109</code>
                            <code>110</code>
                            <code>111</code>
                            <code>112</code>
                            <code>113</code>
                            <code>114</code>
                            <code>115</code>
                            <code>116</code>
                            <code>117</code>
                            <code>118</code>
                            <code>119</code>
                            <code>120</code>
                            <code>121</code>
                            <code>122</code>
                            <code>123</code>
                            <code>124</code>
                            <code>125</code>
                            <code>126</code>
                            <code>127</code>
                            <code>128</code>
                            <code>129</code>
                            <code>130</code>
                            <code>131</code>
                            <code>132</code>
                            <code>133</code>
                            <code>134</code>
                            <code>135</code>
                            <code>136</code>
                            <code>137</code>
                            <code>138</code>
                            <code>139</code>
                            <code>140</code>
                            <code>141</code>
                            <code>142</code>
                            <code>143</code>
                            <code>144</code>
                            <code>145</code>
                            <code>146</code>
                            <code>147</code>
                            <code>148</code>
                            <code>149</code>
                            <code>150</code>
                            <code>151</code>
                            <code>152</code>
                            <code>153</code>
                            <code>154</code>
                            <code>A0</code>
                            <code>A1</code>
                            <code>A2</code>
                            <code>A3</code>
                            <code>A4</code>
                            <code>A5</code>
                            <code>A6</code>
                            <code>A7</code>
                            <code>A8</code>
                            <code>B1</code>
                            <code>B2</code>
                            <code>B3</code>
                            <code>B4</code>
                            <code>B5</code>
                            <code>B6</code>
                            <code>B7</code>
                            <code>B8</code>
                            <code>B9</code>
                            <code>B10</code>
                            <code>B11</code>
                            <code>B12</code>
                            <code>B13</code>
                            <code>B14</code>
                            <code>B15</code>
                            <code>B16</code>
                            <code>B17</code>
                            <code>B18</code>
                            <code>B19</code>
                            <code>B20</code>
                            <code>B21</code>
                            <code>B22</code>
                            <code>B23</code>
                            <code>D1</code>
                            <code>D2</code>
                            <code>D3</code>
                            <code>D4</code>
                            <code>D5</code>
                            <code>D6</code>
                            <code>D7</code>
                            <code>D8</code>
                            <code>D9</code>
                            <code>D10</code>
                            <code>D11</code>
                            <code>D12</code>
                            <code>D13</code>
                            <code>D14</code>
                            <code>D15</code>
                            <code>W1</code>
                          </valid_codes>
                        </element>
                        <element xid="CAS15">
                          <data_ele>782</data_ele>
                          <name>Adjustment Amount</name>
                          <usage>S</usage>
                          <seq>15</seq>
                          <data_type>R</data_type>
                          <min_len>1</min_len>
                          <max_len>18</max_len>
                        </element>
                        <element xid="CAS16">
                          <data_ele>380</data_ele>
                          <name>Adjustment Quantity</name>
                          <usage>S</usage>
                          <seq>16</seq>
                          <data_type>R</data_type>
                          <min_len>1</min_len>
                          <max_len>15</max_len>
                        </element>
                        <element xid="CAS17">
                          <data_ele>1034</data_ele>
                          <name>Adjustment Reason Code</name>
                          <usage>S</usage>
                          <seq>17</seq>
                          <data_type>ID</data_type>
                          <min_len>1</min_len>
                          <max_len>5</max_len>
                          <valid_codes>
                            <code>1</code>
                            <code>2</code>
                            <code>3</code>
                            <code>4</code>
                            <code>5</code>
                            <code>6</code>
                            <code>7</code>
                            <code>8</code>
                            <code>9</code>
                            <code>10</code>
                            <code>11</code>
                            <code>12</code>
                            <code>13</code>
                            <code>14</code>
                            <code>15</code>
                            <code>16</code>
                            <code>17</code>
                            <code>18</code>
                            <code>19</code>
                            <code>20</code>
                            <code>21</code>
                            <code>22</code>
                            <code>23</code>
                            <code>24</code>
                            <code>25</code>
                            <code>26</code>
                            <code>27</code>
                            <code>28</code>
                            <code>29</code>
                            <code>30</code>
                            <code>31</code>
                            <code>32</code>
                            <code>33</code>
                            <code>34</code>
                            <code>35</code>
                            <code>36</code>
                            <code>37</code>
                            <code>38</code>
                            <code>39</code>
                            <code>40</code>
                            <code>41</code>
                            <code>42</code>
                            <code>43</code>
                            <code>44</code>
                            <code>45</code>
                            <code>46</code>
                            <code>47</code>
                            <code>48</code>
                            <code>49</code>
                            <code>50</code>
                            <code>51</code>
                            <code>52</code>
                            <code>53</code>
                            <code>54</code>
                            <code>55</code>
                            <code>56</code>
                            <code>57</code>
                            <code>58</code>
                            <code>59</code>
                            <code>60</code>
                            <code>61</code>
                            <code>62</code>
                            <code>63</code>
                            <code>64</code>
                            <code>65</code>
                            <code>66</code>
                            <code>67</code>
                            <code>68</code>
                            <code>69</code>
                            <code>70</code>
                            <code>71</code>
                            <code>72</code>
                            <code>73</code>
                            <code>74</code>
                            <code>75</code>
                            <code>76</code>
                            <code>77</code>
                            <code>78</code>
                            <code>79</code>
                            <code>80</code>
                            <code>81</code>
                            <code>82</code>
                            <code>83</code>
                            <code>84</code>
                            <code>85</code>
                            <code>86</code>
                            <code>87</code>
                            <code>88</code>
                            <code>89</code>
                            <code>90</code>
                            <code>91</code>
                            <code>92</code>
                            <code>93</code>
                            <code>94</code>
                            <code>95</code>
                            <code>96</code>
                            <code>97</code>
                            <code>98</code>
                            <code>99</code>
                            <code>100</code>
                            <code>101</code>
                            <code>102</code>
                            <code>103</code>
                            <code>104</code>
                            <code>105</code>
                            <code>106</code>
                            <code>107</code>
                            <code>108</code>
                            <code>109</code>
                            <code>110</code>
                            <code>111</code>
                            <code>112</code>
                            <code>113</code>
                            <code>114</code>
                            <code>115</code>
                            <code>116</code>
                            <code>117</code>
                            <code>118</code>
                            <code>119</code>
                            <code>120</code>
                            <code>121</code>
                            <code>122</code>
                            <code>123</code>
                            <code>124</code>
                            <code>125</code>
                            <code>126</code>
                            <code>127</code>
                            <code>128</code>
                            <code>129</code>
                            <code>130</code>
                            <code>131</code>
                            <code>132</code>
                            <code>133</code>
                            <code>134</code>
                            <code>135</code>
                            <code>136</code>
                            <code>137</code>
                            <code>138</code>
                            <code>139</code>
                            <code>140</code>
                            <code>141</code>
                            <code>142</code>
                            <code>143</code>
                            <code>144</code>
                            <code>145</code>
                            <code>146</code>
                            <code>147</code>
                            <code>148</code>
                            <code>149</code>
                            <code>150</code>
                            <code>151</code>
                            <code>152</code>
                            <code>153</code>
                            <code>154</code>
                            <code>A0</code>
                            <code>A1</code>
                            <code>A2</code>
                            <code>A3</code>
                            <code>A4</code>
                            <code>A5</code>
                            <code>A6</code>
                            <code>A7</code>
                            <code>A8</code>
                            <code>B1</code>
                            <code>B2</code>
                            <code>B3</code>
                            <code>B4</code>
                            <code>B5</code>
                            <code>B6</code>
                            <code>B7</code>
                            <code>B8</code>
                            <code>B9</code>
                            <code>B10</code>
                            <code>B11</code>
                            <code>B12</code>
                            <code>B13</code>
                            <code>B14</code>
                            <code>B15</code>
                            <code>B16</code>
                            <code>B17</code>
                            <code>B18</code>
                            <code>B19</code>
                            <code>B20</code>
                            <code>B21</code>
                            <code>B22</code>
                            <code>B23</code>
                            <code>D1</code>
                            <code>D2</code>
                            <code>D3</code>
                            <code>D4</code>
                            <code>D5</code>
                            <code>D6</code>
                            <code>D7</code>
                            <code>D8</code>
                            <code>D9</code>
                            <code>D10</code>
                            <code>D11</code>
                            <code>D12</code>
                            <code>D13</code>
                            <code>D14</code>
                            <code>D15</code>
                            <code>W1</code>
                          </valid_codes>
                        </element>
                        <element xid="CAS18">
                          <data_ele>782</data_ele>
                          <name>Adjustment Amount</name>
                          <usage>S</usage>
                          <seq>18</seq>
                          <data_type>R</data_type>
                          <min_len>1</min_len>
                          <max_len>18</max_len>
                        </element>
                        <element xid="CAS19">
                          <data_ele>380</data_ele>
                          <name>Adjustment Quantity</name>
                          <usage>S</usage>
                          <seq>19</seq>
                          <data_type>R</data_type>
                          <min_len>1</min_len>
                          <max_len>15</max_len>
                        </element>
                      </segment>
<!--End of CAS segment-->
                      <segment xid="DTP">
                        <name>Service Adjudication Date</name>
                        <usage>S</usage>
                        <pos>550</pos>
                        <max_use>1</max_use>
                        <element xid="DTP01">
                          <data_ele>374</data_ele>
                          <name>Date Time Qualifier</name>
                          <usage>R</usage>
                          <seq>01</seq>
                          <data_type>ID</data_type>
                          <min_len>3</min_len>
                          <max_len>3</max_len>
                          <valid_codes>
                            <code>573</code>
                          </valid_codes>
                        </element>
                        <element xid="DTP02">
                          <data_ele>1250</data_ele>
                          <name>Date Time Period Format Qualifier</name>
                          <usage>R</usage>
                          <seq>02</seq>
                          <data_type>ID</data_type>
                          <min_len>2</min_len>
                          <max_len>3</max_len>
                          <valid_codes>
                            <code>D8</code>
                          </valid_codes>
                        </element>
                        <element xid="DTP03">
                          <data_ele>1251</data_ele>
                          <name>Service Adjudication or Payment Date</name>
                          <usage>R</usage>
                          <seq>03</seq>
                          <data_type>AN</data_type>
                          <min_len>1</min_len>
                          <max_len>35</max_len>
                        </element>
                      </segment>
<!--End of DTP segment-->
                    </loop>
<!--End of 2430 loop-->
                  </loop>
<!--End of 2400 loop-->
                </loop>
<!--End of 2300 loop-->
              </loop>
<!--End of 2000C loop-->
            </loop>
<!--End of 2000B loop-->
          </loop>
<!--End of 2000A loop-->
        </loop>
<!--End of DETAIL loop-->
        <loop xid="FOOTER" type="wrapper">
          <name>Table 3 - Footer</name>
          <usage>N</usage>
          <pos>030</pos>
          <repeat>1</repeat>
        </loop>
<!--End of FOOTER loop-->
        <segment xid="SE">
          <name>Transaction Set Trailer</name>
          <usage>R</usage>
          <pos>555</pos>
          <max_use>1</max_use>
          <element xid="SE01">
            <data_ele>96</data_ele>
            <name>Transaction Segment Count</name>
            <usage>R</usage>
            <seq>01</seq>
            <data_type>N0</data_type>
            <min_len>1</min_len>
            <max_len>10</max_len>
          </element>
          <element xid="SE02">
            <data_ele>329</data_ele>
            <name>Transaction Set Control Number</name>
            <usage>R</usage>
            <seq>02</seq>
            <data_type>AN</data_type>
            <min_len>4</min_len>
            <max_len>9</max_len>
          </element>
        </segment>
<!--End of SE segment-->
      </loop>
<!--End of ST loop-->
      <segment xid="GE">
        <name>Functional Group Trailer</name>
        <usage>R</usage>
        <pos>030</pos>
        <max_use>1</max_use>
        <element xid="GE01">
          <data_ele>97</data_ele>
          <name>Number of Transaction Sets Included</name>
          <usage>R</usage>
          <seq>01</seq>
          <data_type>N0</data_type>
          <min_len>1</min_len>
          <max_len>6</max_len>
        </element>
        <element xid="GE02">
          <data_ele>28</data_ele>
          <name>Group Control Number</name>
          <usage>R</usage>
          <seq>02</seq>
          <data_type>N0</data_type>
          <min_len>1</min_len>
          <max_len>9</max_len>
        </element>
      </segment>
<!--End of GE segment-->
    </loop>
<!--End of GS loop-->
    <segment xid="TA1">
      <name>Interchange Achnowledgement</name>
      <usage>S</usage>
      <pos>020</pos>
      <element xid="TA101">
        <data_ele>I12</data_ele>
        <name>Interchange Control Number</name>
        <usage>R</usage>
        <seq>01</seq>
        <data_type>N0</data_type>
        <min_len>9</min_len>
        <max_len>9</max_len>
      </element>
      <element xid="TA102">
        <data_ele>I08</data_ele>
        <name>Interchange Date</name>
        <usage>R</usage>
        <seq>02</seq>
        <data_type>DT</data_type>
        <min_len>6</min_len>
        <max_len>6</max_len>
      </element>
      <element xid="TA103">
        <data_ele>I09</data_ele>
        <name>Interchange Time</name>
        <usage>R</usage>
        <seq>03</seq>
        <data_type>TM</data_type>
        <min_len>4</min_len>
        <max_len>4</max_len>
      </element>
      <element xid="TA104">
        <data_ele>I17</data_ele>
        <name>Interchange Achnowledgement Code</name>
        <usage>R</usage>
        <seq>04</seq>
        <data_type>ID</data_type>
        <min_len>1</min_len>
        <max_len>1</max_len>
        <valid_codes>
          <code>A</code>
          <code>E</code>
          <code>R</code>
        </valid_codes>
      </element>
      <element xid="TA105">
        <data_ele>I18</data_ele>
        <name>Interchange Note Code</name>
        <usage>R</usage>
        <seq>05</seq>
        <data_type>ID</data_type>
        <min_len>3</min_len>
        <max_len>3</max_len>
        <valid_codes>
          <code>000</code>
          <code>001</code>
          <code>002</code>
          <code>003</code>
          <code>004</code>
          <code>005</code>
          <code>006</code>
          <code>007</code>
          <code>008</code>
          <code>009</code>
          <code>010</code>
          <code>011</code>
          <code>012</code>
          <code>013</code>
          <code>014</code>
          <code>015</code>
          <code>016</code>
          <code>017</code>
          <code>018</code>
          <code>019</code>
          <code>020</code>
          <code>021</code>
          <code>022</code>
          <code>023</code>
          <code>024</code>
          <code>025</code>
          <code>026</code>
          <code>027</code>
          <code>028</code>
          <code>029</code>
          <code>030</code>
          <code>031</code>
        </valid_codes>
      </element>
    </segment>
<!--End of TA1 segment-->
    <segment xid="IEA">
      <name>Interchange Control Trailer</name>
      <usage>R</usage>
      <pos>030</pos>
      <max_use>1</max_use>
      <element xid="IEA01">
        <data_ele>I16</data_ele>
        <name>Number of Included Functional Groups</name>
        <usage>R</usage>
        <seq>01</seq>
        <data_type>N0</data_type>
        <min_len>1</min_len>
        <max_len>5</max_len>
      </element>
      <element xid="IEA02">
        <data_ele>I12</data_ele>
        <name>Interchange Control Number</name>
        <usage>R</usage>
        <seq>2</seq>
        <data_type>N0</data_type>
        <min_len>9</min_len>
        <max_len>9</max_len>
      </element>
    </segment>
<!--End of IEA segment-->
  </loop>
<!--End of ISA loop-->
</transaction>
