PRV Provider Information

To specify the identifying characteristics of a provider

Position
Element
Name
Type
Requirement
Min
Max
Repeat
PRV-01
Provider Code
Identifier (ID)
Mandatory
1
3
-
Code indentifying the type of provider
P0506: If either PRV-05 or PRV-06 is present, then the other is required
PRV-02
Reference Number Qualifier
Identifier (ID)
Mandatory
2
2
-
Code qualifying the Reference Number.
PRV-03
Reference Number
String (AN)
Mandatory
1
30
-
Reference number or identification number as defined for a particular Transaction Set, or as specified by the Reference Number Qualifier.
PRV-04
State or Province Code
Identifier (ID)
Optional
2
2
-
Code (Standard State/Province) as defined by appropriate government agency.
PRV-05
Agency Qualifier Code
Identifier (ID)
Conditional
2
2
-
Code identifying the agency assigning the code values.
PRV05 qualifies PRV06.
PRV-06
Provider Specialty Code
Identifier (ID)
Conditional
3
3
-
Code indicating the primary specialty of the provider, as defined by the receiver
PRV-07
Provider Organization Code
Identifier (ID)
Optional
3
3
-
Code identifying the organizational structure of a provider

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