routinely change. If blank or not specified, populate with MC076 -- Billing Provider Number. 2/1/2016 Text 2 Code US for United States MC093 Service Facility Location Country Code MC094 Billing Provider 2/1/2016 Text 2 Code US for United States Country Code MC101 Subscriber Last 1/1/2010 Text 60 The subscriber last name Name MC102 Subscriber First 1/1/2010 Text 35 The subscriber first name Name MC103 Subscriber 1/1/2010 Text 25 The subscriber middle name or Middle Name initial MC104 Member Last 1/1/2010 Text 60 The member last name Name Member First 1/1/2010 Text 35 The member name Name MC106 Member Middle 1/1/2010 Text 25 The member middle name or Name initial MC107 Attending 2/1/2016 Text 30 Payer assigned attending Provider provider number. This number Number should be the identifier used by the payer for internal
routinely change. If blank or not specified, populate with MC076 -- Billing Provider Number. MC093 Service Facility Location Country Code 2/1/2016 Text 2 Code US for United States MC094 Billing Provider Country Code 2/1/2016 Text 2 Code US for United States MC101 Subscriber Last Name 1/1/2010 Text 60 The subscriber last name MC102 Subscriber First Name 1/1/2010 Text 35 The subscriber first name MC103 Subscriber Middle Name 1/1/2010 Text 25 The subscriber middle name or initial MC104 Member Last Name 1/1/2010 Text 60 The member last name Member First Name 1/1/2010 Text 35 The member name MC106 Member Middle Name 1/1/2010 Text 25 The member middle name or initial MC107 Attending Provider Number 2/1/2016 Text 30 Payer assigned attending provider number. This number should be the identifier used by the payer for internal
Chapter%20243_Proposed%20Rule_V3_110116.docx