Legacy Numbers (Secondary Identifiers)

Loop 2310A Referring Provider Secondary Identifier

The list of valid qualifiers for the Referring Provider Secondary Identifier (REF01) contains only:

  • 0B (State License Number)
  • 1G (Provider UPIN Number)
  • G2 (Provider Commercial Number)

Loop 2310B Rendering Provider Secondary Identifier

The list of valid qualifiers for the Rendering Provider Secondary Identifier (Loop ID-2310A | REF01) contains only:

  • 0B (State License Number)
  • 1G (Provider UPIN Number)
  • G2 (Provider Commercial Number)
  • LU (Location Number)

Loop 2310C Service Facility Location Name Secondary Identifier

The list of valid qualifiers for the Service Facility Location Name Secondary Identifier (Loop ID-2310A | EF01) contains only:

  • 0B (State License Number)
  • G2 (Provider Commercial Number)
  • LU (Location Number)

Loop 2310D Supervising Provider Secondary Identifier

The list of valid qualifiers for the Supervising Provider Secondary Identifier (Loop ID-2310A | REF01) contains only:

  • 0B (State License Number)
  • 1G (Provider UPIN Number)
  • G2 (Provider Commercial Number)
  • LU (Location Number)

Loop 2330C Other Payer Referring Provider Secondary Identifier

The list of valid qualifiers for the Other Payer Referring Provider Secondary Identifier (REF01) contains only:

  • 0B (State License Number)
  • 1G (Provider UPIN Number)
  • G2 (Provider Commercial Number)

Loop 2330D Other Payer Rendering Provider Secondary Identifier

The list of valid qualifiers for the Other Payer Rendering Provider Secondary Identifier (REF01) contains only:

  • 0B (State License Number)
  • 1G (Provider UPIN Number)
  • G2 (Provider Commercial Number)
  • LU (Location Number)

Loop 2330E Other Payer Service Facility Location Secondary Identification

The list of valid qualifiers for the Other Payer Service Facility Location Secondary Identification (REF01) contains only:

  • 0B (State License Number)
  • G2 (Provider Commercial Number)
  • LU (Location Number)

Loop 2330F Other Payer Supervising Provider Secondary Identification

The list of valid qualifiers for the Other Payer Supervising Provider Secondary Identification (REF01) contains only:

  • 0B (State License Number)
  • 1G (Provider UPIN Number)
  • G2 (Provider Commercial Number)
  • LU (Location Number)

Loop 2420A Rendering Provider Secondary Identifier

The list of valid qualifiers for the Rendering Provider Secondary Identifier (REF01) contains only:

  • 0B (State License Number)
  • 1G (Provider UPIN Number)
  • G2 (Provider Commercial Number)
  • LU (Location Number)

Loop 2420B Purchased Service Provider Secondary Identifier

The list of valid qualifiers for the Purchased Service Provider Secondary Identifier (REF01) contains only:

  • 0B (State License Number)
  • 1G (Provider UPIN Number)
  • G2 Provider Commercial Number)
  • LU (Location Number)

Loop 2420C Service Facility Secondary Identifier

The list of valid qualifiers for the Service Facility Location Name Provider Secondary Identifier (REF01) contains only:

  • 0B (State License Number)
  • 1G (Provider UPIN Number)
  • G2 (Provider Commercial Number)
  • LU (Location Number)

Loop 2420D Supervising Provider Secondary Identifier

The list of valid qualifiers for the Supervising Provider Secondary Identifier (REF01) contains only:

  • 0B (State License Number)
  • 1G (Provider UPIN Number)
  • G2 (Provider Commercial Number)
  • LU (Location Number)

Loop 2420E Ordering Provider Secondary Identifier

The list of valid qualifiers for the Ordering Provider Secondary Identifier (REF01) contains only:

  • 0B (State License Number)
  • 1G (Provider UPIN Number)
  • G2 (Provider Commercial Number)
  • LU (Location Number)

Loop 2420F Referring Provider Secondary Identifier

The list of valid qualifiers for the Referring Provider Secondary Identifier (REF01) contains only:

  • 0B (State License Number)
  • 1G (Provider UPIN Number)
  • G2 (Provider Commercial Number)
  • LU (Location Number)

The specific values such as 1B (Blue Shield Provider Number), 1D (Medicaid Provider Number) etc. have been removed. In their place, use G2.

All other qualifiers in Medisoft will appear on paper claims, but will not be sent on electronic claims.