************************************************** ********* 837P Claim Submission Configuration ************************************************** X12TRANSACTIONTYPE=837P KEYHEADERFIELD=HL,,,20 KEYFIELD=CLM KEYLINEFIELD=SV1 FIELD=SUBID,16,NM1,IL,2,9 FIELD=SUBLNAME,32,NM1,IL,2,3,,SUBID FIELD=SUBFNAME,32,NM1,IL,2,4,,SUBID FIELD=SUBMI,1,NM1,IL,2,5,,SUBID FIELD=PAYERID,16,NM1,PR,2,9 FIELD=PAYERNAME,32,NM1,PR,2,3,,PAYERID FIELD=CLAIMID,20,CLM,,,1 FIELD=CLAIMAMT,20,CLM,,,2 FIELD=PROVSIGNATUREONFILE,4,CLM,,,7 FIELD=PROVACCEPTASSIGNMENTCODE,4,CLM,,,8 FIELD=BENEFITINDICATOR,4,CLM,,,9 FIELD=NOTECODE,4,NTE,,,1 FIELD=NOTEDESC,4,NTE,,,2 FIELD=DX1,7,HI,ABK,2,1,2 FIELD=DX2,7,HI,ABK,2,2,2 FIELD=DX3,7,HI,ABK,2,3,2 FIELD=DX4,7,HI,ABK,2,4,2 FIELD=REFERRINGID,16,NM1,DN,2,9 FIELD=REFERRINGLNAME,32,NM1,DN,2,3 FIELD=REFERRINGFNAME,32,NM1,DN,2,4 FIELD=REFERRINGMNAME,32,NM1,DN,2,5 FIELD=REFERRINGPREFIX,32,NM1,DN,2,6 FIELD=REFERRINGSUFFIX,32,NM1,DN,2,7 FIELD=REFERRINGIDCODE,4,NM1,DN,2,8 FIELD=REFERRINGTYPE,2,NM1,DN,2,1 FIELD=RENDERINGID,16,NM1,82,2,9 FIELD=RENDERINGLNAME,32,NM1,82,2,3 FIELD=RENDERINGFNAME,32,NM1,82,2,4 FIELD=RENDERINGMNAME,32,NM1,82,2,5 FIELD=RENDERINGPREFIX,32,NM1,82,2,6 FIELD=RENDERINGSUFFIX,32,NM1,82,2,7 FIELD=RENDERINGIDCODE,4,NM1,82,2,8 FIELD=RENDERINGTYPE,2,NM1,82,2,1 FIELD=SUPERVISINGID,16,NM1,DQ,2,9 FIELD=SUPERVISINGLNAME,32,NM1,DQ,2,3 FIELD=SUPERVISINGFNAME,32,NM1,DQ,2,4 FIELD=SUPERVISINGMNAME,32,NM1,DQ,2,5 FIELD=SUPERVISINGPREFIX,32,NM1,DQ,2,6 FIELD=SUPERVISINGSUFFIX,32,NM1,DQ,2,7 FIELD=SUPERVISINGIDCODE,4,NM1,DQ,2,8 FIELD=SUPERVISINGTYPE,2,NM1,DQ,2,1 FIELD=SERVICEFACILITYNAME,32,NM1,77,2,3 FIELD=SERVICEFACILIYID,16,NM1,77,2,9 FIELD=PROC1,10,SV1,,,1,2,SUBID,,,1 FIELD=MODA1,3,SV1,,,1,3,SUBID,,,1 FIELD=MODB1,3,SV1,,,1,4,SUBID,,,1 FIELD=MODC1,3,SV1,,,1,5,SUBID,,,1 FIELD=MODD1,3,SV1,,,1,6,SUBID,,,1 FIELD=AMT1,10,SV1,,,2,,SUBID,,,1 FIELD=UNITS1,10,SV1,,,3,,SUBID,,,1 FIELD=QTY1,15,SV1,,,4,,SUBID,,,1 FIELD=FACILITYCODE1,2,SV1,,,5,,SUBID,,,1 FIELD=DCPA1,1,SV1,,,7,1,,,,1 FIELD=DCPB1,1,SV1,,,7,2,,,,1 FIELD=DCPC1,1,SV1,,,7,3,,,,1 FIELD=DCPD1,1,SV1,,,7,4,,,,1 FIELD=DOS1,10,DTP,472,2,3,,,,,1 FIELD=BILLINGPROVIDERID,16,NM1,85,2,9,,,,2 FIELD=BILLINGPROVIDERNAME,32,NM1,85,2,3,,,,2 FIELD=BILLINGPROVIDERADDR1,30,N3,,,1,,BILLINGPROVIDERNAME,,2 FIELD=BILLINGPROVIDERADDR2,30,N3,,,2,,BILLINGPROVIDERNAME,,2 FIELD=BILLINGPROVIDERCITY,30,N4,,,1,,BILLINGPROVIDERNAME,,2 FIELD=BILLINGPROVIDERST,2,N4,,,2,,BILLINGPROVIDERNAME,,2 FIELD=BILLINGPROVIDERZIP,10,N4,,,3,,BILLINGPROVIDERNAME,,2