PS1 Purchase Service

To specify the information about services that are purchased

Sequence

Element

Name

Type

Requirement

Min

Max

Repeat

01

127

Reference Identification

String (AN)

Mandatory

1

80

1

Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier

PS101 is provider identification number.

02

782

Monetary Amount

Decimal number (R)

Mandatory

1

18

1

Monetary amount

PS102 is cost of the purchased service.

03

156

State or Province Code

Identifier (ID)

Optional

2

2

1

Code specifying the Standard State/Province as defined by appropriate government agency

PS103 is the state where the service is purchased.