623-624 2 Provider Value set is R for PCPs; 1 determined by otherwise LDH and is optional available in PIHP Companion Guide 625 Delimiter 1 Character, use the ^ character value 626-627 2 O Provider If necessary, 2 Value set is determined by LDH and is available in PIHP Companion Guide 628 Delimiter 1 Character, use the ^ character value 629-630 Provider If necessary, 2 O 3 Value set is determined by LDH and is available in PIHP Companion Guide 631 Delimiter 1 Character, use the ^ character value 632-661 PIHP Contract This should 30 Character R Name or represent the Number contract name/number that is established between the PIHP and the Provider 662 Delimiter 1 Character, use the ^ character value 663-670 PIHP Contract Date that the 8 Numeric date R Begin Date contract value in the form between the YYYYMMDD
623-624 Provider 1 Value set is determined by LDH and is available in PIHP Companion Guide 2 R for PCPs; otherwise optional 625 Delimiter 1 Character, use the ^ character value 626-627 Provider 2 If necessary, Value set is determined by LDH and is available in PIHP Companion Guide 2 O 628 Delimiter 1 Character, use the ^ character value 629-630 Provider 3 If necessary, Value set is determined by LDH and is available in PIHP Companion Guide 2 O 631 Delimiter 1 Character, use the ^ character value 632-661 PIHP Contract Name or Number This should represent the contract name/number that is established between the PIHP and the Provider 30 Character R 662 Delimiter 1 Character, use the ^ character value 663-670 PIHP Contract Begin Date Date that the contract between the 8 Numeric date value in the form YYYYMMDD R