ANSI X12 837P - 4010 2310E REF - Supervising Provider Secondary Identification

The 2310E REF Subscriber Supervising Provider Identification Segment is required when a secondary number is necessary to identify the provider.

The 4010 specifications for the REF segment can be found below as it pertains to the 2310E loop.

Sample 837P (4010) - 2310E REF - Supervising Provider Secondary Identification

  • Supervising Provider Secondary Identification (2310E)
  • REF*1B*AB123~~

HIPAA Guide - 837P [4010]


RREF01Reference Identification QualifierMID3
0BState License Number
1BBlue Shield Provider Number
1CMedicare Provider Number
1DMedicaid Provider Number
1GProvider UPIN Number
1HCHAMPUS Identification Number
EIEmployer's Identification Number
G2Provider Commercial Number
LULocation Number
N5Provider Plan Network Identification Number
SYSocial Security Number
X5State Industrial Accident Provider Number
RREF02Reference Identification
[Supervising Provider Secondary Identifier]
NREF04Reference IdentifierO

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