Segment: SV1

Loop: 2400  Segment: SV1

Element: SV101-1 (Professional Service Product/Service ID Qualifier)

Hard coded to 'HC'.

Element: SV101-2 (Professional Service Product/Service ID)

Element: SV101-2 (Professional Service Product/Service ID)

Edit Charge->Code

Element: SV101-3 (Professional Service Procedure Modifier)

Element: SV101-3 (Professional Service Procedure Modifier)

Edit Charge->Modifiers

Element: SV101-4 (Professional Service Procedure Modifier 2)

Element: SV101-4 (Professional Service Procedure Modifier 2)

Edit Charge->Modifiers

Element: SV101-5 (Professional Service Procedure Modifier 3)

Element: SV101-5 (Professional Service Procedure Modifier 3)

Edit Charge->Modifiers

Element: SV101-6 (Professional Service Procedure Modifier 4)

Element: SV101-6 (Professional Service Procedure Modifier 4)

Edit Charge->Modifiers

Element: SV101-7 (Professional Service Procedure Description)

Element: SV101-7 (Professional Service Procedure Description)

Edit Charge->Description

Element: SV102 (Professional Service Line Item Charge Amount)

Element: SV102 (Professional Service Line Item Charge Amount)

Edit Charge->Charge

Element: SV103 (Professional Service Unit or Basis for Measurement Code)

Element: SV103 (Professional Service Unit or Basis for Measurement Code)

Edit Charge->Units ('MJ' or 'UN')

Element: SV104 (Professional Service Quantity)

Element: SV104 (Professional Service Quantity)

Edit Charge->Unit number

Element: SV105 (Professional Service Facility Code Value)

Element: SV105 (Professional Service Facility Code Value)

Edit Charge->Facility

Element: SV107-1 (Professional Service Diagnosis Code Pointer)

Element: SV107-1 (Professional Service Diagnosis Code Pointer)

Edit Charge->Diagnosis Codes

Element: SV107-2 (Professional Service Diagnosis Code Pointer 2)

Element: SV107-2 (Professional Service Diagnosis Code Pointer 2)

Edit Charge->Diagnosis Codes

Element: SV107-3 (Professional Service Diagnosis Code Pointer 3)

Element: SV107-3 (Professional Service Diagnosis Code Pointer 3)

Edit Charge->Diagnosis Codes

Element: SV107-4 (Professional Service Diagnosis Code Pointer 4)

Element: SV107-4 (Professional Service Diagnosis Code Pointer 4)

Edit Charge->Diagnosis Codes

Element: SV109 (Professional Service Emergency Indicator)

Element: SV109 (Professional Service Emergency Indicator)

Edit Charge->Emergency

Element: SV111 (Professional Service EPSDT Indicator)

Element: SV111 (Professional Service EPSDT Indicator)

Edit Charge->EPSDT

Element: SV112 (Professional Service Family Planning Indicator)

Element: SV112 (Professional Service Family Planning Indicator)

Edit Charge->Family Plan

Element: SV115 (Professional Service Copay Status Code)

Element: SV115 (Professional Service Copay Status Code)

Edit Charge->Misc Details->(Scroll down) Co-Pay Exempt