namespace EdiFabric.Templates.Hipaa5010 { using System; using System.Collections.Generic; using EdiFabric.Core.Annotations.Edi; using EdiFabric.Core.Annotations.Validation; using EdiFabric.Core.Model.Edi; using EdiFabric.Core.Model.Edi.X12; using EdiFabric.Core.Model.Edi.ErrorContexts; /// /// Health Care Claim : Professional /// [Serializable()] [Message("X12", "005010X222A1", "837")] public class TS837P : EdiMessage { /// /// Transaction Set Header /// [Pos(1)] public ST ST { get; set; } /// /// Beginning of Hierarchical Transaction /// [Required] [Pos(2)] public BHT_BeginningofHierarchicalTransaction_7 BHT_BeginningofHierarchicalTransaction { get; set; } [Required] [Pos(3)] public All_NM1_837P_6 AllNM1 { get; set; } /// /// Loop for Billing Provider Hierarchical Level /// [Required] [Pos(4)] public List Loop2000A { get; set; } /// /// Transaction Set Trailer /// [Pos(5)] public SE SE { get; set; } } [Serializable()] [All()] public class All_AMT_837P { /// /// Sales Tax Amount /// [Pos(1)] public AMT_SalesTaxAmount AMT_SalesTaxAmount { get; set; } /// /// Postage Claimed Amount /// [Pos(2)] public AMT_PostageClaimedAmount AMT_PostageClaimedAmount { get; set; } } [Serializable()] [All()] public class All_AMT_837P_2 { /// /// Coordination of Benefits (COB) Payer Paid Amount /// [Pos(1)] public AMT_CoordinationofBenefits AMT_CoordinationofBenefits_COB_PayerPaidAmount { get; set; } /// /// Coordination of Benefits (COB) Total Non-covered Amount /// [Pos(2)] public AMT_CoordinationofBenefits_2 AMT_CoordinationofBenefits_COB_TotalNon_Amount { get; set; } /// /// Remaining Patient Liability /// [Pos(3)] public AMT_RemainingPatientLiability AMT_RemainingPatientLiability { get; set; } } [Serializable()] [All()] public class All_CRC_837P { /// /// Ambulance Certification /// [ListCount(3)] [Pos(1)] public List CRC_AmbulanceCertification { get; set; } /// /// Hospice Employee Indicator /// [Pos(2)] public CRC_HospiceEmployeeIndicator CRC_HospiceEmployeeIndicator { get; set; } /// /// Condition Indicator/Durable Medical Equipment /// [Pos(3)] public CRC_ConditionIndicator CRC_ConditionIndicator_DurableMedicalEquipment { get; set; } } [Serializable()] [All()] public class All_CRC_837P_2 { /// /// Ambulance Certification /// [ListCount(3)] [Pos(1)] public List CRC_AmbulanceCertification { get; set; } /// /// Patient Condition Information: Vision /// [ListCount(3)] [Pos(2)] public List CRC_PatientConditionInformation_Vision { get; set; } /// /// Homebound Indicator /// [Pos(3)] public CRC_HomeboundIndicator CRC_HomeboundIndicator { get; set; } /// /// EPSDT Referral /// [Pos(4)] public CRC_EPSDTReferral CRC_EPSDTReferral { get; set; } } [Serializable()] [All()] public class All_DTP_837P { /// /// Date - Service Date /// [Required] [Pos(1)] public DTP_ClaimLevelServiceDate DTP_Date_ServiceDate { get; set; } /// /// Date - Prescription Date /// [Pos(2)] public DTP_HearingandVisionPrescriptionDate DTP_Date_PrescriptionDate { get; set; } /// /// DATE - Certification Revision/Recertification Date /// [Pos(3)] public DTP_CertificationRevision DTP_DATE_CertificationRevision_RecertificationDate { get; set; } /// /// Date - Begin Therapy Date /// [Pos(4)] public DTP_BeginTherapyDate DTP_Date_BeginTherapyDate { get; set; } /// /// Date - Last Certification Date /// [Pos(5)] public DTP_LastCertificationDate DTP_Date_LastCertificationDate { get; set; } /// /// Date - Last Seen Date /// [Pos(6)] public DTP_LastSeenDate DTP_Date_LastSeenDate { get; set; } /// /// Date - Test Date /// [ListCount(2)] [Pos(7)] public List DTP_Date_TestDate { get; set; } /// /// Date - Shipped Date /// [Pos(8)] public DTP_ShippedDate DTP_Date_ShippedDate { get; set; } /// /// Date - Last X-ray Date /// [Pos(9)] public DTP_LastXrayDate DTP_Date_LastX_Date { get; set; } /// /// Date - Initial Treatment Date /// [Pos(10)] public DTP_InitialTreatmentDate DTP_Date_InitialTreatmentDate { get; set; } } [Serializable()] [All()] public class All_DTP_837P_2 { /// /// Date - Onset of Current Illness or Symptom /// [Pos(1)] public DTP_OnsetofCurrentIllnessorSymptom DTP_Date_OnsetofCurrentIllnessorSymptom { get; set; } /// /// Date - Initial Treatment Date /// [Pos(2)] public DTP_InitialTreatmentDate DTP_Date_InitialTreatmentDate { get; set; } /// /// Date - Last Seen Date /// [Pos(3)] public DTP_LastSeenDate DTP_Date_LastSeenDate { get; set; } /// /// Date - Acute Manifestation /// [Pos(4)] public DTP_AcuteManifestation DTP_Date_AcuteManifestation { get; set; } /// /// Date - Accident /// [Pos(5)] public DTP_AccidentDate_2 DTP_Date_Accident { get; set; } /// /// Date - Last Menstrual Period /// [Pos(6)] public DTP_LastMenstrualPeriod DTP_Date_LastMenstrualPeriod { get; set; } /// /// Date - Last X-ray Date /// [Pos(7)] public DTP_LastXrayDate DTP_Date_LastX_Date { get; set; } /// /// Date - Hearing and Vision Prescription Date /// [Pos(8)] public DTP_HearingandVisionPrescriptionDate DTP_Date_HearingandVisionPrescriptionDate { get; set; } /// /// Date - Disability Dates /// [Pos(9)] public DTP_DisabilityDates DTP_Date_DisabilityDates { get; set; } /// /// Date - Last Worked /// [Pos(10)] public DTP_LastWorked DTP_Date_LastWorked { get; set; } /// /// Date - Authorized Return to Work /// [Pos(11)] public DTP_AuthorizedReturntoWork DTP_Date_AuthorizedReturntoWork { get; set; } /// /// Date - Admission /// [Pos(12)] public DTP_AdmissionDate_4 DTP_Date_Admission { get; set; } /// /// Date - Discharge /// [Pos(13)] public DTP_Discharge DTP_Date_Discharge { get; set; } /// /// Date - Assumed and Relinquished Care Dates /// [ListCount(2)] [Pos(14)] public List DTP_Date_AssumedandRelinquishedCareDates { get; set; } /// /// Property and Casualty Date of First Contact /// [Pos(15)] public DTP_PropertyandCasualtyDateofFirstContact DTP_PropertyandCasualtyDateofFirstContact { get; set; } /// /// Date - Repricer Received Date /// [Pos(16)] public DTP_RepricerReceivedDate DTP_Date_RepricerReceivedDate { get; set; } } [Serializable()] [All()] public class All_HI_837P { /// /// Health Care Diagnosis Code /// [Required] [Pos(1)] public HI_DependentHealthCareDiagnosisCode HI_HealthCareDiagnosisCode { get; set; } /// /// Anesthesia Related Procedure /// [Pos(2)] public HI_AnesthesiaRelatedProcedure HI_AnesthesiaRelatedProcedure { get; set; } /// /// Condition Information /// [ListCount(2)] [Pos(3)] public List HI_ConditionInformation { get; set; } } [Serializable()] [All()] public class All_NM1_837P { /// /// Loop for Billing Provider Name /// [Required] [Pos(1)] public Loop_2010AA_837P Loop2010AA { get; set; } /// /// Loop for Pay-to Address Name /// [Pos(2)] public Loop_2010AB_837P Loop2010AB { get; set; } /// /// Loop for Pay-To Plan Name /// [Pos(3)] public Loop_2010AC_837P Loop2010AC { get; set; } } [Serializable()] [All()] public class All_NM1_837P_2 { /// /// Loop for Subscriber Name /// [Required] [Pos(1)] public Loop_2010BA_837P Loop2010BA { get; set; } /// /// Loop for Payer Name /// [Required] [Pos(2)] public Loop_2010BB_837P Loop2010BB { get; set; } } [Serializable()] [All()] public class All_NM1_837P_3 { /// /// Loop for Referring Provider Name /// [ListCount(2)] [Pos(1)] public List Loop2310A { get; set; } /// /// Loop for Rendering Provider Name /// [Pos(2)] public Loop_2310B_837P Loop2310B { get; set; } /// /// Loop for Service Facility Location Name /// [Pos(3)] public Loop_2310C_837P Loop2310C { get; set; } /// /// Loop for Supervising Provider Name /// [Pos(4)] public Loop_2310D_837P Loop2310D { get; set; } /// /// Loop for Ambulance Pick-up Location /// [Pos(5)] public Loop_2310E_837P Loop2310E { get; set; } /// /// Loop for Ambulance Drop-off Location /// [Pos(6)] public Loop_2310F_837P Loop2310F { get; set; } } [Serializable()] [All()] public class All_NM1_837P_4 { /// /// Loop for Other Subscriber Name /// [Required] [Pos(1)] public Loop_2330A_837P Loop2330A { get; set; } /// /// Loop for Other Payer Name /// [Required] [Pos(2)] public Loop_2330B_837P Loop2330B { get; set; } /// /// Loop for Other Payer Referring Provider /// [ListCount(2)] [Pos(3)] public List Loop2330C { get; set; } /// /// Loop for Other Payer Rendering Provider /// [Pos(4)] public Loop_2330D_837P Loop2330D { get; set; } /// /// Loop for Other Payer Service Facility Location /// [Pos(5)] public Loop_2330E_837P Loop2330E { get; set; } /// /// Loop for Other Payer Supervising Provider /// [Pos(6)] public Loop_2330F_837P Loop2330F { get; set; } /// /// Loop for Other Payer Billing Provider /// [Pos(7)] public Loop_2330G_837P Loop2330G { get; set; } } [Serializable()] [All()] public class All_NM1_837P_5 { /// /// Loop for Rendering Provider Name /// [Pos(1)] public Loop_2420A_837P Loop2420A { get; set; } /// /// Loop for Purchased Service Provider Name /// [Pos(2)] public Loop_2420B_837P Loop2420B { get; set; } /// /// Loop for Service Facility Location /// [Pos(3)] public Loop_2420C_837P Loop2420C { get; set; } /// /// Loop for Supervising Provider Name /// [Pos(4)] public Loop_2420D_837P Loop2420D { get; set; } /// /// Loop for Ordering Provider Name /// [Pos(5)] public Loop_2420E_837P Loop2420E { get; set; } /// /// Loop for Referring Provider Name /// [ListCount(2)] [Pos(6)] public List Loop2420F { get; set; } /// /// Loop for Ambulance Pick-up Location /// [Pos(7)] public Loop_2420G_837P Loop2420G { get; set; } /// /// Loop for Ambulance Drop-off Location /// [Pos(8)] public Loop_2420H_837P Loop2420H { get; set; } } [Serializable()] [All()] public class All_NM1_837P_6 { /// /// Loop for Submitter Name /// [Required] [Pos(1)] public Loop_1000A_837P Loop1000A { get; set; } /// /// Loop for Receiver Name /// [Required] [Pos(2)] public Loop_1000B_837P Loop1000B { get; set; } } [Serializable()] [All()] public class All_NTE_837P { /// /// Line Note /// [Pos(1)] public NTE_LineNote NTE_LineNote { get; set; } /// /// Third Party Organization Notes /// [Pos(2)] public NTE_ThirdPartyOrganizationNotes NTE_ThirdPartyOrganizationNotes { get; set; } } [Serializable()] [All()] public class All_PWK_837P { /// /// Line Supplemental Information /// [ListCount(10)] [Pos(1)] public List PWK_LineSupplementalInformation { get; set; } /// /// Durable Medical Equipment Certificate of Medical Necessity Indicator /// [Pos(2)] public PWK_DurableMedicalEquipmentCertificateofMedicalNecessityIndicator PWK_DurableMedicalEquipmentCertificateofMedicalNecessityIndicator { get; set; } } [Serializable()] [All()] public class All_QTY_837P { /// /// Ambulance Patient Count /// [Pos(1)] public QTY_AmbulancePatientCount QTY_AmbulancePatientCount { get; set; } /// /// Obstetric Anesthesia Additional Units /// [Pos(2)] public QTY_ObstetricAnesthesiaAdditionalUnits QTY_ObstetricAnesthesiaAdditionalUnits { get; set; } } [Serializable()] [All()] public class All_REF_837P { /// /// Other Payer Secondary Identifier /// [ListCount(2)] [Pos(1)] public List REF_OtherPayerSecondaryIdentifier { get; set; } /// /// Other Payer Prior Authorization Number /// [Pos(2)] public REF_OtherPayerPriorAuthorizationNumber REF_OtherPayerPriorAuthorizationNumber { get; set; } /// /// Other Payer Referral Number /// [Pos(3)] public REF_OtherPayerReferralNumber REF_OtherPayerReferralNumber { get; set; } /// /// Other Payer Claim Adjustment Indicator /// [Pos(4)] public REF_OtherPayerClaimAdjustmentIndicator REF_OtherPayerClaimAdjustmentIndicator { get; set; } /// /// Other Payer Claim Control Number /// [Pos(5)] public REF_OtherPayerClaimControlNumber REF_OtherPayerClaimControlNumber { get; set; } } [Serializable()] [All()] public class All_REF_837P_2 { /// /// Repriced Line Item Reference Number /// [Pos(1)] public REF_RepricedLineItemReferenceNumber REF_RepricedLineItemReferenceNumber { get; set; } /// /// Adjusted Repriced Line Item Reference Number /// [Pos(2)] public REF_AdjustedRepricedLineItemReferenceNumber REF_AdjustedRepricedLineItemReferenceNumber { get; set; } /// /// Prior Authorization /// [ListCount(5)] [Pos(3)] public List REF_PriorAuthorization { get; set; } /// /// Line Item Control Number /// [Pos(4)] public REF_LineItemControlNumber REF_LineItemControlNumber { get; set; } /// /// Mammography Certification Number /// [Pos(5)] public REF_MammographyCertificationNumber REF_MammographyCertificationNumber { get; set; } /// /// Clinical Laboratory Improvement Amendment (CLIA) Number /// [Pos(6)] public REF_ClinicalLaboratoryImprovementAmendment REF_ClinicalLaboratoryImprovementAmendment_CLIA_Number { get; set; } /// /// Referring Clinical Laboratory Improvement Amendment (CLIA) Facility Identification /// [Pos(7)] public REF_ReferringClinicalLaboratoryImprovementAmendment REF_ReferringClinicalLaboratoryImprovementAmendment_CLIA_FacilityIdentification { get; set; } /// /// Immunization Batch Number /// [Pos(8)] public REF_ImmunizationBatchNumber REF_ImmunizationBatchNumber { get; set; } /// /// Referral Number /// [ListCount(5)] [Pos(9)] public List REF_ReferralNumber { get; set; } } [Serializable()] [All()] public class All_REF_837P_3 { /// /// Pay-To Plan Secondary Identification /// [Pos(1)] public REF_Pay REF_Pay_ToPlanSecondaryIdentification { get; set; } /// /// Pay-To Plan Tax Identification Number /// [Required] [Pos(2)] public REF_BillingProviderTaxIdentification_2 REF_Pay_ToPlanTaxIdentificationNumber { get; set; } } [Serializable()] [All()] public class All_REF_837P_4 { /// /// Subscriber Secondary Identification /// [Pos(1)] public REF_OtherSubscriberSecondaryIdentification REF_SubscriberSecondaryIdentification { get; set; } /// /// Property and Casualty Claim Number /// [Pos(2)] public REF_PropertyandCasualtyClaimNumber REF_PropertyandCasualtyClaimNumber { get; set; } } [Serializable()] [All()] public class All_REF_837P_5 { /// /// Payer Secondary Identification /// [ListCount(3)] [Pos(1)] public List REF_PayerSecondaryIdentification { get; set; } /// /// Billing Provider Secondary Identification /// [ListCount(2)] [Pos(2)] public List REF_BillingProviderSecondaryIdentification { get; set; } } [Serializable()] [All()] public class All_REF_837P_6 { /// /// Service Authorization Exception Code /// [Pos(1)] public REF_ServiceAuthorizationExceptionCode REF_ServiceAuthorizationExceptionCode { get; set; } /// /// Mandatory Medicare (Section 4081) Crossover Indicator /// [Pos(2)] public REF_MandatoryMedicare REF_MandatoryMedicare_Section4081_CrossoverIndicator { get; set; } /// /// Mammography Certification Number /// [Pos(3)] public REF_MammographyCertificationNumber REF_MammographyCertificationNumber { get; set; } /// /// Referral Number /// [Pos(4)] public REF_OtherPayerReferralNumber REF_ReferralNumber { get; set; } /// /// Prior Authorization /// [Pos(5)] public REF_OtherPayerPriorAuthorizationNumber REF_PriorAuthorization { get; set; } /// /// Payer Claim Control Number /// [Pos(6)] public REF_OtherPayerClaimControlNumber REF_PayerClaimControlNumber { get; set; } /// /// Clinical Laboratory Improvement Amendment (CLIA) Number /// [Pos(7)] public REF_ClinicalLaboratoryImprovementAmendment REF_ClinicalLaboratoryImprovementAmendment_CLIA_Number { get; set; } /// /// Repriced Claim Number /// [Pos(8)] public REF_RepricedClaimNumber REF_RepricedClaimNumber { get; set; } /// /// Adjusted Repriced Claim Number /// [Pos(9)] public REF_AdjustedRepricedClaimNumber REF_AdjustedRepricedClaimNumber { get; set; } /// /// Investigational Device Exemption Number /// [Pos(10)] public REF_InvestigationalDeviceExemptionNumber REF_InvestigationalDeviceExemptionNumber { get; set; } /// /// Claim Identifier For Transmission Intermediaries /// [Pos(11)] public REF_ClaimIdentificationNumberForClearinghousesandOtherTransmissionIntermediaries REF_ClaimIdentifierForTransmissionIntermediaries { get; set; } /// /// Medical Record Number /// [Pos(12)] public REF_MedicalRecordNumber REF_MedicalRecordNumber { get; set; } /// /// Demonstration Project Identifier /// [Pos(13)] public REF_DemonstrationProjectIdentifier REF_DemonstrationProjectIdentifier { get; set; } /// /// Care Plan Oversight /// [Pos(14)] public REF_CarePlanOversight REF_CarePlanOversight { get; set; } } [Serializable()] [All()] public class All_REF_837P_7 { /// /// Property and Casualty Claim Number /// [Pos(1)] public REF_PropertyandCasualtyClaimNumber REF_PropertyandCasualtyClaimNumber { get; set; } /// /// Property and Casualty Patient Identifier /// [Pos(2)] public REF_PropertyandCasualtyPatientIdentifier REF_PropertyandCasualtyPatientIdentifier { get; set; } } [Serializable()] [All()] public class All_REF_837P_8 { /// /// Billing Provider Tax Identification /// [Required] [Pos(1)] public REF_BillingProviderTaxIdentification REF_BillingProviderTaxIdentification { get; set; } /// /// Billing Provider UPIN/License Information /// [ListCount(2)] [Pos(2)] public List REF_BillingProviderUPIN_LicenseInformation { get; set; } } /// /// Loop for Submitter Name /// [Serializable()] [Group(typeof(NM1_InformationReceiverName_4))] public class Loop_1000A_837P { /// /// Submitter Name /// [Required] [Pos(1)] public NM1_InformationReceiverName_4 NM1_SubmitterName { get; set; } /// /// Submitter EDI Contact Information /// [Required] [ListCount(2)] [Pos(2)] public List PER_SubmitterEDIContactInformation { get; set; } } /// /// Loop for Receiver Name /// [Serializable()] [Group(typeof(NM1_ReceiverName))] public class Loop_1000B_837P { /// /// Receiver Name /// [Required] [Pos(1)] public NM1_ReceiverName NM1_ReceiverName { get; set; } } /// /// Loop for Billing Provider Hierarchical Level /// [Serializable()] [Group(typeof(HL_BillingProviderHierarchicalLevel))] public class Loop_2000A_837P { /// /// Billing Provider Hierarchical Level /// [Required] [Pos(1)] public HL_BillingProviderHierarchicalLevel HL_BillingProviderHierarchicalLevel { get; set; } /// /// Billing Provider Specialty Information /// [Pos(2)] public PRV_BillingProviderSpecialtyInformation PRV_BillingProviderSpecialtyInformation { get; set; } /// /// Foreign Currency Information /// [Pos(3)] public CUR_ForeignCurrencyInformation_3 CUR_ForeignCurrencyInformation { get; set; } [Required] [Pos(4)] public All_NM1_837P AllNM1 { get; set; } /// /// Loop for Subscriber Hierarchical Level /// [Required] [Pos(5)] public List Loop2000B { get; set; } } /// /// Loop for Subscriber Hierarchical Level /// [Serializable()] [Group(typeof(HL_SubscriberHierarchicalLevel))] public class Loop_2000B_837P { /// /// Subscriber Hierarchical Level /// [Required] [Pos(1)] public HL_SubscriberHierarchicalLevel HL_SubscriberHierarchicalLevel { get; set; } /// /// Subscriber Information /// [Required] [Pos(2)] public SBR_SubscriberInformation SBR_SubscriberInformation { get; set; } /// /// Patient Information /// [Pos(3)] public PAT_PatientInformation_3 PAT_PatientInformation { get; set; } [Required] [Pos(4)] public All_NM1_837P_2 AllNM1 { get; set; } /// /// Loop for Claim Information /// [ListCount(100)] [Pos(5)] public List Loop2300 { get; set; } /// /// Loop for Patient Hierarchical Level /// [Pos(6)] public List Loop2000C { get; set; } } /// /// Loop for Patient Hierarchical Level /// [Serializable()] [Group(typeof(HL_DependentLevel))] public class Loop_2000C_837P { /// /// Patient Hierarchical Level /// [Required] [Pos(1)] public HL_DependentLevel HL_PatientHierarchicalLevel { get; set; } /// /// Patient Information /// [Required] [Pos(2)] public PAT_PatientInformation PAT_PatientInformation { get; set; } /// /// Loop for Patient Name /// [Required] [Pos(3)] public Loop_2010CA_837P Loop2010CA { get; set; } /// /// Loop for Claim Information /// [Required] [ListCount(100)] [Pos(4)] public List Loop2300 { get; set; } } /// /// Loop for Billing Provider Name /// [Serializable()] [Group(typeof(NM1_BillingProviderName_2))] public class Loop_2010AA_837P { /// /// Billing Provider Name /// [Required] [Pos(1)] public NM1_BillingProviderName_2 NM1_BillingProviderName { get; set; } /// /// Billing Provider Address /// [Required] [Pos(2)] public N3_AdditionalPatientInformationContactAddress N3_BillingProviderAddress { get; set; } /// /// Billing Provider City, State, ZIP Code /// [Required] [Pos(3)] public N4_AdditionalPatientInformationContactCity N4_BillingProviderCity_State_ZIPCode { get; set; } [Required] [Pos(4)] public All_REF_837P_8 AllREF { get; set; } /// /// Billing Provider Contact Information /// [ListCount(2)] [Pos(5)] public List PER_BillingProviderContactInformation { get; set; } } /// /// Loop for Pay-to Address Name /// [Serializable()] [Group(typeof(NM1_Pay))] public class Loop_2010AB_837P { /// /// Pay-to Address Name /// [Required] [Pos(1)] public NM1_Pay NM1_Pay_AddressName { get; set; } /// /// Pay-To Address - ADDRESS /// [Required] [Pos(2)] public N3_AdditionalPatientInformationContactAddress N3_Pay_ToAddress_ADDRESS { get; set; } /// /// Pay-to Address City, State, ZIP Code /// [Required] [Pos(3)] public N4_AdditionalPatientInformationContactCity N4_Pay_AddressCity_State_ZIPCode { get; set; } } /// /// Loop for Pay-To Plan Name /// [Serializable()] [Group(typeof(NM1_Pay_3))] public class Loop_2010AC_837P { /// /// Pay-To Plan Name /// [Required] [Pos(1)] public NM1_Pay_3 NM1_Pay_ToPlanName { get; set; } /// /// Pay-To Plan Address /// [Required] [Pos(2)] public N3_AdditionalPatientInformationContactAddress N3_Pay_ToPlanAddress { get; set; } /// /// Pay-To Plan City, State, ZIP Code /// [Required] [Pos(3)] public N4_AdditionalPatientInformationContactCity N4_Pay_ToPlanCity_State_ZIPCode { get; set; } [Required] [Pos(4)] public All_REF_837P_3 AllREF { get; set; } } /// /// Loop for Subscriber Name /// [Serializable()] [Group(typeof(NM1_SubscriberName_5))] public class Loop_2010BA_837P { /// /// Subscriber Name /// [Required] [Pos(1)] public NM1_SubscriberName_5 NM1_SubscriberName { get; set; } /// /// Subscriber Address /// [Pos(2)] public N3_AdditionalPatientInformationContactAddress N3_SubscriberAddress { get; set; } /// /// Subscriber City, State, ZIP Code /// [Pos(3)] public N4_AdditionalPatientInformationContactCity N4_SubscriberCity_State_ZIPCode { get; set; } /// /// Subscriber Demographic Information /// [Pos(4)] public DMG_PatientDemographicInformation DMG_SubscriberDemographicInformation { get; set; } [Pos(5)] public All_REF_837P_4 AllREF { get; set; } /// /// Property and Casualty Subscriber Contact Information /// [Pos(6)] public PER_PropertyandCasualtyPatientContactInformation PER_PropertyandCasualtySubscriberContactInformation { get; set; } } /// /// Loop for Payer Name /// [Serializable()] [Group(typeof(NM1_OtherPayerName))] public class Loop_2010BB_837P { /// /// Payer Name /// [Required] [Pos(1)] public NM1_OtherPayerName NM1_PayerName { get; set; } /// /// Payer Address /// [Pos(2)] public N3_AdditionalPatientInformationContactAddress N3_PayerAddress { get; set; } /// /// Payer City, State, ZIP Code /// [Pos(3)] public N4_AdditionalPatientInformationContactCity N4_PayerCity_State_ZIPCode { get; set; } [Pos(4)] public All_REF_837P_5 AllREF { get; set; } } /// /// Loop for Patient Name /// [Serializable()] [Group(typeof(NM1_PatientName_3))] public class Loop_2010CA_837P { /// /// Patient Name /// [Required] [Pos(1)] public NM1_PatientName_3 NM1_PatientName { get; set; } /// /// Patient Address /// [Required] [Pos(2)] public N3_AdditionalPatientInformationContactAddress N3_PatientAddress { get; set; } /// /// Patient City, State, ZIP Code /// [Required] [Pos(3)] public N4_AdditionalPatientInformationContactCity N4_PatientCity_State_ZIPCode { get; set; } /// /// Patient Demographic Information /// [Required] [Pos(4)] public DMG_PatientDemographicInformation DMG_PatientDemographicInformation { get; set; } [Pos(5)] public All_REF_837P_7 AllREF { get; set; } /// /// Property and Casualty Patient Contact Information /// [Pos(6)] public PER_PropertyandCasualtyPatientContactInformation PER_PropertyandCasualtyPatientContactInformation { get; set; } } /// /// Loop for Claim Information /// [Serializable()] [Group(typeof(CLM_ClaimInformation_2))] public class Loop_2300_837P { /// /// Claim Information /// [Required] [Pos(1)] public CLM_ClaimInformation_2 CLM_ClaimInformation { get; set; } [Pos(2)] public All_DTP_837P_2 AllDTP { get; set; } /// /// Claim Supplemental Information /// [ListCount(10)] [Pos(3)] public List PWK_ClaimSupplementalInformation { get; set; } /// /// Contract Information /// [Pos(4)] public CN1_ContractInformation_2 CN1_ContractInformation { get; set; } /// /// Patient Amount Paid /// [Pos(5)] public AMT_PatientAmountPaid AMT_PatientAmountPaid { get; set; } [Pos(6)] public All_REF_837P_6 AllREF { get; set; } /// /// File Information /// [ListCount(10)] [Pos(7)] public List K3_FileInformation { get; set; } /// /// Claim Note /// [Pos(8)] public NTE_ClaimNote_2 NTE_ClaimNote { get; set; } /// /// Ambulance Transport Information /// [Pos(9)] public CR1_AmbulanceTransportInformation CR1_AmbulanceTransportInformation { get; set; } /// /// Spinal Manipulation Service Information /// [Pos(10)] public CR2_SpinalManipulationServiceInformation CR2_SpinalManipulationServiceInformation { get; set; } [Pos(11)] public All_CRC_837P_2 AllCRC { get; set; } [Required] [Pos(12)] public All_HI_837P AllHI { get; set; } /// /// Claim Pricing/Repricing Information /// [Pos(13)] public HCP_ClaimPricing HCP_ClaimPricing_RepricingInformation { get; set; } [Pos(14)] public All_NM1_837P_3 AllNM1 { get; set; } /// /// Loop for Other Subscriber Information /// [ListCount(10)] [Pos(15)] public List Loop2320 { get; set; } /// /// Loop for Service Line Number /// [Required] [ListCount(50)] [Pos(16)] public List Loop2400 { get; set; } } /// /// Loop for Claim Information /// [Serializable()] [Group(typeof(CLM_ClaimInformation_2))] public class Loop_2300_837P_2 { /// /// Claim Information /// [Required] [Pos(1)] public CLM_ClaimInformation_2 CLM_ClaimInformation { get; set; } [Pos(2)] public All_DTP_837P_2 AllDTP { get; set; } /// /// Claim Supplemental Information /// [ListCount(10)] [Pos(3)] public List PWK_ClaimSupplementalInformation { get; set; } /// /// Contract Information /// [Pos(4)] public CN1_ContractInformation_2 CN1_ContractInformation { get; set; } /// /// Patient Amount Paid /// [Pos(5)] public AMT_PatientAmountPaid AMT_PatientAmountPaid { get; set; } [Pos(6)] public All_REF_837P_6 AllREF { get; set; } /// /// File Information /// [ListCount(10)] [Pos(7)] public List K3_FileInformation { get; set; } /// /// Claim Note /// [Pos(8)] public NTE_ClaimNote_2 NTE_ClaimNote { get; set; } /// /// Ambulance Transport Information /// [Pos(9)] public CR1_AmbulanceTransportInformation CR1_AmbulanceTransportInformation { get; set; } /// /// Spinal Manipulation Service Information /// [Pos(10)] public CR2_SpinalManipulationServiceInformation CR2_SpinalManipulationServiceInformation { get; set; } [Pos(11)] public All_CRC_837P_2 AllCRC { get; set; } [Required] [Pos(12)] public All_HI_837P AllHI { get; set; } /// /// Claim Pricing/Repricing Information /// [Pos(13)] public HCP_ClaimPricing HCP_ClaimPricing_RepricingInformation { get; set; } [Pos(14)] public All_NM1_837P_3 AllNM1 { get; set; } /// /// Loop for Other Subscriber Information /// [ListCount(10)] [Pos(15)] public List Loop2320 { get; set; } /// /// Loop for Service Line Number /// [Required] [ListCount(50)] [Pos(16)] public List Loop2400 { get; set; } } /// /// Loop for Referring Provider Name /// [Serializable()] [Group(typeof(NM1_ReferringProviderName))] public class Loop_2310A_837P { /// /// Referring Provider Name /// [Required] [Pos(1)] public NM1_ReferringProviderName NM1_ReferringProviderName { get; set; } /// /// Referring Provider Secondary Identification /// [ListCount(3)] [Pos(2)] public List REF_ReferringProviderSecondaryIdentification { get; set; } } /// /// Loop for Rendering Provider Name /// [Serializable()] [Group(typeof(NM1_RenderingProviderName))] public class Loop_2310B_837P { /// /// Rendering Provider Name /// [Required] [Pos(1)] public NM1_RenderingProviderName NM1_RenderingProviderName { get; set; } /// /// Rendering Provider Specialty Information /// [Pos(2)] public PRV_RenderingProviderSpecialtyInformation PRV_RenderingProviderSpecialtyInformation { get; set; } /// /// Rendering Provider Secondary Identification /// [ListCount(4)] [Pos(3)] public List REF_RenderingProviderSecondaryIdentification { get; set; } } /// /// Loop for Service Facility Location Name /// [Serializable()] [Group(typeof(NM1_ServiceFacilityLocation))] public class Loop_2310C_837P { /// /// Service Facility Location Name /// [Required] [Pos(1)] public NM1_ServiceFacilityLocation NM1_ServiceFacilityLocationName { get; set; } /// /// Service Facility Location Address /// [Required] [Pos(2)] public N3_AdditionalPatientInformationContactAddress N3_ServiceFacilityLocationAddress { get; set; } /// /// Service Facility Location City, State, ZIP Code /// [Required] [Pos(3)] public N4_AdditionalPatientInformationContactCity N4_ServiceFacilityLocationCity_State_ZIPCode { get; set; } /// /// Service Facility Location Secondary Identification /// [ListCount(3)] [Pos(4)] public List REF_ServiceFacilityLocationSecondaryIdentification { get; set; } /// /// Service Facility Contact Information /// [Pos(5)] public PER_PropertyandCasualtyPatientContactInformation PER_ServiceFacilityContactInformation { get; set; } } /// /// Loop for Supervising Provider Name /// [Serializable()] [Group(typeof(NM1_SupervisingProviderName))] public class Loop_2310D_837P { /// /// Supervising Provider Name /// [Required] [Pos(1)] public NM1_SupervisingProviderName NM1_SupervisingProviderName { get; set; } /// /// Supervising Provider Secondary Identification /// [ListCount(4)] [Pos(2)] public List REF_SupervisingProviderSecondaryIdentification { get; set; } } /// /// Loop for Ambulance Pick-up Location /// [Serializable()] [Group(typeof(NM1_AmbulancePick))] public class Loop_2310E_837P { /// /// Ambulance Pick-up Location /// [Required] [Pos(1)] public NM1_AmbulancePick NM1_AmbulancePick_Location { get; set; } /// /// Ambulance Pick-up Location Address /// [Required] [Pos(2)] public N3_AdditionalPatientInformationContactAddress N3_AmbulancePick_LocationAddress { get; set; } /// /// Ambulance Pick-up Location City, State, Zip Code /// [Required] [Pos(3)] public N4_AdditionalPatientInformationContactCity N4_AmbulancePick_LocationCity_State_ZipCode { get; set; } } /// /// Loop for Ambulance Drop-off Location /// [Serializable()] [Group(typeof(NM1_AmbulanceDrop))] public class Loop_2310F_837P { /// /// Ambulance Drop-off Location /// [Required] [Pos(1)] public NM1_AmbulanceDrop NM1_AmbulanceDrop_Location { get; set; } /// /// Ambulance Drop-off Location Address /// [Required] [Pos(2)] public N3_AdditionalPatientInformationContactAddress N3_AmbulanceDrop_LocationAddress { get; set; } /// /// Ambulance Drop-off Location City, State, Zip Code /// [Required] [Pos(3)] public N4_AdditionalPatientInformationContactCity N4_AmbulanceDrop_LocationCity_State_ZipCode { get; set; } } /// /// Loop for Other Subscriber Information /// [Serializable()] [Group(typeof(SBR_OtherSubscriberInformation))] public class Loop_2320_837P { /// /// Other Subscriber Information /// [Required] [Pos(1)] public SBR_OtherSubscriberInformation SBR_OtherSubscriberInformation { get; set; } /// /// Claim Level Adjustments /// [ListCount(5)] [Pos(2)] public List CAS_ClaimLevelAdjustments { get; set; } [Pos(3)] public All_AMT_837P_2 AllAMT { get; set; } /// /// Other Insurance Coverage Information /// [Required] [Pos(4)] public OI_OtherInsuranceCoverageInformation_2 OI_OtherInsuranceCoverageInformation { get; set; } /// /// Outpatient Adjudication Information /// [Pos(5)] public MOA_OutpatientAdjudicationInformation MOA_OutpatientAdjudicationInformation { get; set; } [Required] [Pos(6)] public All_NM1_837P_4 AllNM1 { get; set; } } /// /// Loop for Other Subscriber Name /// [Serializable()] [Group(typeof(NM1_OtherSubscriberName))] public class Loop_2330A_837P { /// /// Other Subscriber Name /// [Required] [Pos(1)] public NM1_OtherSubscriberName NM1_OtherSubscriberName { get; set; } /// /// Other Subscriber Address /// [Pos(2)] public N3_AdditionalPatientInformationContactAddress N3_OtherSubscriberAddress { get; set; } /// /// Other Subscriber City, State, ZIP Code /// [Pos(3)] public N4_AdditionalPatientInformationContactCity N4_OtherSubscriberCity_State_ZIPCode { get; set; } /// /// Other Subscriber Secondary Identification /// [Pos(4)] public REF_OtherSubscriberSecondaryIdentification REF_OtherSubscriberSecondaryIdentification { get; set; } } /// /// Loop for Other Payer Name /// [Serializable()] [Group(typeof(NM1_OtherPayerName))] public class Loop_2330B_837P { /// /// Other Payer Name /// [Required] [Pos(1)] public NM1_OtherPayerName NM1_OtherPayerName { get; set; } /// /// Other Payer Address /// [Pos(2)] public N3_AdditionalPatientInformationContactAddress N3_OtherPayerAddress { get; set; } /// /// Other Payer City, State, ZIP Code /// [Pos(3)] public N4_AdditionalPatientInformationContactCity N4_OtherPayerCity_State_ZIPCode { get; set; } /// /// Claim Check or Remittance Date /// [Pos(4)] public DTP_ClaimCheckOrRemittanceDate DTP_ClaimCheckorRemittanceDate { get; set; } [Pos(5)] public All_REF_837P AllREF { get; set; } } /// /// Loop for Other Payer Referring Provider /// [Serializable()] [Group(typeof(NM1_OtherPayerReferringProvider))] public class Loop_2330C_837P { /// /// Other Payer Referring Provider /// [Required] [Pos(1)] public NM1_OtherPayerReferringProvider NM1_OtherPayerReferringProvider { get; set; } /// /// Other Payer Referring Provider Secondary Identification /// [Required] [ListCount(3)] [Pos(2)] public List REF_OtherPayerReferringProviderSecondaryIdentification { get; set; } } /// /// Loop for Other Payer Rendering Provider /// [Serializable()] [Group(typeof(NM1_OtherPayerRenderingProvider_2))] public class Loop_2330D_837P { /// /// Other Payer Rendering Provider /// [Required] [Pos(1)] public NM1_OtherPayerRenderingProvider_2 NM1_OtherPayerRenderingProvider { get; set; } /// /// Other Payer Rendering Provider Secondary Identification /// [Required] [ListCount(3)] [Pos(2)] public List REF_OtherPayerRenderingProviderSecondaryIdentification { get; set; } } /// /// Loop for Other Payer Service Facility Location /// [Serializable()] [Group(typeof(NM1_OtherPayerServiceFacilityLocation))] public class Loop_2330E_837P { /// /// Other Payer Service Facility Location /// [Required] [Pos(1)] public NM1_OtherPayerServiceFacilityLocation NM1_OtherPayerServiceFacilityLocation { get; set; } /// /// Other Payer Service Facility Location Secondary Identification /// [Required] [ListCount(3)] [Pos(2)] public List REF_OtherPayerServiceFacilityLocationSecondaryIdentification { get; set; } } /// /// Loop for Other Payer Supervising Provider /// [Serializable()] [Group(typeof(NM1_OtherPayerSupervisingProvider))] public class Loop_2330F_837P { /// /// Other Payer Supervising Provider /// [Required] [Pos(1)] public NM1_OtherPayerSupervisingProvider NM1_OtherPayerSupervisingProvider { get; set; } /// /// Other Payer Supervising Provider Secondary Identification /// [Required] [ListCount(3)] [Pos(2)] public List REF_OtherPayerSupervisingProviderSecondaryIdentification { get; set; } } /// /// Loop for Other Payer Billing Provider /// [Serializable()] [Group(typeof(NM1_OtherPayerBillingProvider))] public class Loop_2330G_837P { /// /// Other Payer Billing Provider /// [Required] [Pos(1)] public NM1_OtherPayerBillingProvider NM1_OtherPayerBillingProvider { get; set; } /// /// Other Payer Billing Provider Secondary Identification /// [Required] [ListCount(2)] [Pos(2)] public List REF_OtherPayerBillingProviderSecondaryIdentification { get; set; } } /// /// Loop for Service Line Number /// [Serializable()] [Group(typeof(LX_HeaderNumber))] public class Loop_2400_837P { /// /// Service Line Number /// [Required] [Pos(1)] public LX_HeaderNumber LX_ServiceLineNumber { get; set; } /// /// Professional Service /// [Required] [Pos(2)] public SV1_ProfessionalService SV1_ProfessionalService { get; set; } /// /// Durable Medical Equipment Service /// [Pos(3)] public SV5_DurableMedicalEquipmentService SV5_DurableMedicalEquipmentService { get; set; } [Pos(4)] public All_PWK_837P AllPWK { get; set; } /// /// Ambulance Transport Information /// [Pos(5)] public CR1_AmbulanceTransportInformation CR1_AmbulanceTransportInformation { get; set; } /// /// Durable Medical Equipment Certification /// [Pos(6)] public CR3_DurableMedicalEquipmentCertification CR3_DurableMedicalEquipmentCertification { get; set; } [Pos(7)] public All_CRC_837P AllCRC { get; set; } [Required] [Pos(8)] public All_DTP_837P AllDTP { get; set; } [Pos(9)] public All_QTY_837P AllQTY { get; set; } /// /// Test Result /// [ListCount(5)] [Pos(10)] public List MEA_TestResult { get; set; } /// /// Contract Information /// [Pos(11)] public CN1_ContractInformation_2 CN1_ContractInformation { get; set; } [Pos(12)] public All_REF_837P_2 AllREF { get; set; } [Pos(13)] public All_AMT_837P AllAMT { get; set; } /// /// File Information /// [ListCount(10)] [Pos(14)] public List K3_FileInformation { get; set; } [Pos(15)] public All_NTE_837P AllNTE { get; set; } /// /// Purchased Service Information /// [Pos(16)] public PS1_PurchasedServiceInformation PS1_PurchasedServiceInformation { get; set; } /// /// Line Pricing/Repricing Information /// [Pos(17)] public HCP_LinePricing_3 HCP_LinePricing_RepricingInformation { get; set; } /// /// Loop for Drug Identification /// [Pos(18)] public Loop_2410_837P Loop2410 { get; set; } [Pos(19)] public All_NM1_837P_5 AllNM1 { get; set; } /// /// Loop for Line Adjudication Information /// [ListCount(15)] [Pos(20)] public List Loop2430 { get; set; } /// /// Loop for Form Identification Code /// [Pos(21)] public List Loop2440 { get; set; } } /// /// Loop for Drug Identification /// [Serializable()] [Group(typeof(LIN_DrugIdentification_2))] public class Loop_2410_837P { /// /// Drug Identification /// [Required] [Pos(1)] public LIN_DrugIdentification_2 LIN_DrugIdentification { get; set; } /// /// Drug Quantity /// [Required] [Pos(2)] public CTP_DrugQuantity CTP_DrugQuantity { get; set; } /// /// Prescription or Compound Drug Association Number /// [Pos(3)] public REF_PrescriptionorCompoundDrugAssociationNumber REF_PrescriptionorCompoundDrugAssociationNumber { get; set; } } /// /// Loop for Rendering Provider Name /// [Serializable()] [Group(typeof(NM1_RenderingProviderName))] public class Loop_2420A_837P { /// /// Rendering Provider Name /// [Required] [Pos(1)] public NM1_RenderingProviderName NM1_RenderingProviderName { get; set; } /// /// Rendering Provider Specialty Information /// [Pos(2)] public PRV_RenderingProviderSpecialtyInformation PRV_RenderingProviderSpecialtyInformation { get; set; } /// /// Rendering Provider Secondary Identification /// [ListCount(20)] [Pos(3)] public List REF_RenderingProviderSecondaryIdentification { get; set; } } /// /// Loop for Purchased Service Provider Name /// [Serializable()] [Group(typeof(NM1_PurchasedServiceProviderName))] public class Loop_2420B_837P { /// /// Purchased Service Provider Name /// [Required] [Pos(1)] public NM1_PurchasedServiceProviderName NM1_PurchasedServiceProviderName { get; set; } /// /// Purchased Service Provider Secondary Identification /// [ListCount(20)] [Pos(2)] public List REF_PurchasedServiceProviderSecondaryIdentification { get; set; } } /// /// Loop for Service Facility Location /// [Serializable()] [Group(typeof(NM1_ServiceFacilityLocation))] public class Loop_2420C_837P { /// /// Service Facility Location /// [Required] [Pos(1)] public NM1_ServiceFacilityLocation NM1_ServiceFacilityLocation { get; set; } /// /// Service Facility Location Address /// [Required] [Pos(2)] public N3_AdditionalPatientInformationContactAddress N3_ServiceFacilityLocationAddress { get; set; } /// /// Service Facility Location City, State, ZIP Code /// [Required] [Pos(3)] public N4_AdditionalPatientInformationContactCity N4_ServiceFacilityLocationCity_State_ZIPCode { get; set; } /// /// Service Facility Location Secondary Identification /// [ListCount(3)] [Pos(4)] public List REF_ServiceFacilityLocationSecondaryIdentification { get; set; } } /// /// Loop for Supervising Provider Name /// [Serializable()] [Group(typeof(NM1_SupervisingProviderName))] public class Loop_2420D_837P { /// /// Supervising Provider Name /// [Required] [Pos(1)] public NM1_SupervisingProviderName NM1_SupervisingProviderName { get; set; } /// /// Supervising Provider Secondary Identification /// [ListCount(20)] [Pos(2)] public List REF_SupervisingProviderSecondaryIdentification { get; set; } } /// /// Loop for Ordering Provider Name /// [Serializable()] [Group(typeof(NM1_OrderingProviderName))] public class Loop_2420E_837P { /// /// Ordering Provider Name /// [Required] [Pos(1)] public NM1_OrderingProviderName NM1_OrderingProviderName { get; set; } /// /// Ordering Provider Address /// [Pos(2)] public N3_AdditionalPatientInformationContactAddress N3_OrderingProviderAddress { get; set; } /// /// Ordering Provider City, State, ZIP Code /// [Pos(3)] public N4_AdditionalPatientInformationContactCity N4_OrderingProviderCity_State_ZIPCode { get; set; } /// /// Ordering Provider Secondary Identification /// [ListCount(20)] [Pos(4)] public List REF_OrderingProviderSecondaryIdentification { get; set; } /// /// Ordering Provider Contact Information /// [Pos(5)] public PER_BillingProviderContactInformation PER_OrderingProviderContactInformation { get; set; } } /// /// Loop for Referring Provider Name /// [Serializable()] [Group(typeof(NM1_ReferringProviderName))] public class Loop_2420F_837P { /// /// Referring Provider Name /// [Required] [Pos(1)] public NM1_ReferringProviderName NM1_ReferringProviderName { get; set; } /// /// Referring Provider Secondary Identification /// [ListCount(20)] [Pos(2)] public List REF_ReferringProviderSecondaryIdentification { get; set; } } /// /// Loop for Ambulance Pick-up Location /// [Serializable()] [Group(typeof(NM1_AmbulancePick))] public class Loop_2420G_837P { /// /// Ambulance Pick-up Location /// [Required] [Pos(1)] public NM1_AmbulancePick NM1_AmbulancePick_Location { get; set; } /// /// Ambulance Pick-up Location Address /// [Required] [Pos(2)] public N3_AdditionalPatientInformationContactAddress N3_AmbulancePick_LocationAddress { get; set; } /// /// Ambulance Pick-up Location City, State, Zip Code /// [Required] [Pos(3)] public N4_AdditionalPatientInformationContactCity N4_AmbulancePick_LocationCity_State_ZipCode { get; set; } } /// /// Loop for Ambulance Drop-off Location /// [Serializable()] [Group(typeof(NM1_AmbulanceDrop))] public class Loop_2420H_837P { /// /// Ambulance Drop-off Location /// [Required] [Pos(1)] public NM1_AmbulanceDrop NM1_AmbulanceDrop_Location { get; set; } /// /// Ambulance Drop-off Location Address /// [Required] [Pos(2)] public N3_AdditionalPatientInformationContactAddress N3_AmbulanceDrop_LocationAddress { get; set; } /// /// Ambulance Drop-off Location City, State, Zip Code /// [Required] [Pos(3)] public N4_AdditionalPatientInformationContactCity N4_AmbulanceDrop_LocationCity_State_ZipCode { get; set; } } /// /// Loop for Line Adjudication Information /// [Serializable()] [Group(typeof(SVD_LineAdjudicationInformation))] public class Loop_2430_837P { /// /// Line Adjudication Information /// [Required] [Pos(1)] public SVD_LineAdjudicationInformation SVD_LineAdjudicationInformation { get; set; } /// /// Line Adjustment /// [ListCount(5)] [Pos(2)] public List CAS_LineAdjustment { get; set; } /// /// Line Check or Remittance Date /// [Required] [Pos(3)] public DTP_ClaimCheckOrRemittanceDate DTP_LineCheckorRemittanceDate { get; set; } /// /// Remaining Patient Liability /// [Pos(4)] public AMT_RemainingPatientLiability AMT_RemainingPatientLiability { get; set; } } /// /// Loop for Form Identification Code /// [Serializable()] [Group(typeof(LQ_FormIdentificationCode))] public class Loop_2440_837P { /// /// Form Identification Code /// [Required] [Pos(1)] public LQ_FormIdentificationCode LQ_FormIdentificationCode { get; set; } /// /// Supporting Documentation /// [Required] [ListCount(99)] [Pos(2)] public List FRM_SupportingDocumentation { get; set; } } }