*Loops will vary by Payer*

Electronic Location:
Loop 2400
"Service Line Number"

Segments

Medisoft Location for Paper Claims

Box 24h

EPSDT/Family Plan. Unshaded area: Prints a Y if the EPDST check box on the Case window, Medicare - Tricare selected. If EPDST is selected AND the Family Planning is selected, it prints a Y. If EPDST is selected and Family Planning is clear, it prints Y/N. Shaded area: see detail for Box 24A