To identify a service and any modifications.
| Position | Element | Name | Type | Min/Max | Repeat | |
|---|---|---|---|---|---|---|
| E021-10 | 7135 | Product identifier | Mandatory | Alphanumeric | 1/35 | 1 |
| E021-20 | 1131 | Code list identification code | Opt | Alphanumeric | 1/17 | 1 |
| E021-30 | 9629 | Procedure modification code | Opt | Alphanumeric | 1/3 | 1 |
| E021-40 | 9629 | Procedure modification code | Opt | Alphanumeric | 1/3 | 1 |
| E021-50 | 9629 | Procedure modification code | Opt | Alphanumeric | 1/3 | 1 |
| E021-60 | 9629 | Procedure modification code | Opt | Alphanumeric | 1/3 | 1 |
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