FX3 Product Information

To provide information relevant to a product

Position
Element
Name
Type
Requirement
Min
Max
Repeat
FX3-01
Yes/No Condition or Response Code
Identifier (ID)
Mandatory
1
1
1
Code indicating a Yes or No condition or response
FX301 indicates if the product is included or excluded. A 'Y' indicates that the product is included. An 'N' indicates that the product is excluded.
FX3-02
Product/Service ID Qualifier
Identifier (ID)
Conditional
2
2
1
Code identifying the type/source of the descriptive number used in Product/Service ID (234)
P0203: If either FX3-02 or FX3-03 is present, then the other is required
FX3-03
Product/Service ID
String (AN)
Conditional
1
80
1
Identifying number for a product or service
FX3-04
Product/Service ID Qualifier
Identifier (ID)
Conditional
2
2
1
Code identifying the type/source of the descriptive number used in Product/Service ID (234)
P0405: If either FX3-04 or FX3-05 is present, then the other is required
FX3-05
Product/Service ID
String (AN)
Conditional
1
80
1
Identifying number for a product or service
FX3-06
Product/Service ID Qualifier
Identifier (ID)
Conditional
2
2
1
Code identifying the type/source of the descriptive number used in Product/Service ID (234)
P0607: If either FX3-06 or FX3-07 is present, then the other is required
FX3-07
Product/Service ID
String (AN)
Conditional
1
80
1
Identifying number for a product or service
FX3-08
Assigned Identification
String (AN)
Optional
1
20
1
Alphanumeric characters assigned for differentiation within a transaction set
FX3-09
Description
String (AN)
Optional
1
80
1
A free-form description to clarify the related data elements and their content
FX309 is the product description.
FX3-10
Yes/No Condition or Response Code
Identifier (ID)
Optional
1
1
1
Code indicating a Yes or No condition or response
FX310 indicates if this product is required for the program. A 'Y' indicates that the product is required. An 'N' indicates that the product is not required.
FX3-11
Condition Indicator
Identifier (ID)
Optional
2
3
1
Code indicating a condition
FX311 indicates if product substitution is allowed.

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