False
False
False
0
0
0
True
Patient table
1
String
String
String
String
String
String
String
String
String
String
DateTime
String
String
Next of kin
1
String
String
String
String
Admit/visit notification
group
table
patient
table
kin
group
Unsolicited transmission of an observation message
group
table
patient
table
kin
DTM DateTime
False
YYYY
MM
DD
HH
mm
SS
.SSSS
+/-ZZZZ
DT Date
False
YYYY
MM
DD
TM Time
False
HH
mm
SS
.SSSS
+/-ZZZZ
Hierarchic Designator
Id
-1
False
False
Composite
IS
UniversalId
-1
False
False
Composite
ST
UniversalIdType
-1
False
False
Composite
ID
String Data
Value
0
False
False
String
String Data
Value
0
False
False
String
String Data
Value
0
False
False
String
Extended Composite ID Number And Name For Persons
Id
-1
False
False
Composite
ST
FamilyName
-1
False
False
Composite
FN
GivenName
-1
False
False
Composite
ST
Initial
-1
False
False
Composite
ST
Suffix
-1
False
False
Composite
ST
Prefix
-1
False
False
Composite
ST
Degree
-1
False
False
Composite
IS
Source Table
-1
False
False
Composite
IS
Assigning Authority
-1
False
False
Composite
HD
Name Type Code
-1
False
False
Composite
ID
Identifier Check Digit
-1
False
False
Composite
ST
Check Digit Scheme
-1
False
False
Composite
ID
Identifier Type Code
-1
False
False
Composite
ID
Assigning Facility
-1
False
False
Composite
HD
Name Representation Code
-1
False
False
Composite
ID
Name Context
-1
False
False
Composite
CE
Name Validity Range
-1
False
False
Composite
DR
Name Assembly Order
-1
False
False
Composite
ID
Effective Date
-1
False
False
Composite
TS
Expiration Date
-1
False
False
Composite
TS
Professional Suffix
-1
False
False
Composite
ST
Assigning Jurisdiction
-1
False
False
Composite
CWE
Assigning Agency Or Department
-1
False
False
Composite
CWE
Coded With Exceptions
Identifier
-1
False
False
Composite
ST
Text
-1
False
False
Composite
ST
Name Of Coding System
-1
False
False
Composite
ID
Alternate Identifier
-1
False
False
Composite
ST
Alternate Text
-1
False
False
Composite
ST
Name Of Alternate Coding System
-1
False
False
Composite
ID
Coding System Version ID
-1
False
False
Composite
ST
Alternate Coding System Version ID
-1
False
False
Composite
ST
Original Text
-1
False
False
Composite
ST
Family Name
Surname
-1
False
False
Composite
ST
Own Surname Prefix
-1
False
False
Composite
ST
Own Surname
-1
False
False
Composite
ST
Surname Prefix From Partner/spouse
-1
False
False
Composite
ST
Surname From Partner/spouse
-1
False
False
Composite
ST
Time Stamp
Time
-1
False
False
Composite
DTM
Degree Of Precision
-1
False
False
Composite
ID
Date/Time
Value
-1
False
False
DateTime
DateTime
Coded Element
Identifier
-1
False
False
Composite
ST
Text
-1
False
False
Composite
ST
Name Of Coding System
-1
False
False
Composite
ID
Alternate Identifier
-1
False
False
Composite
ST
Alternate Text
-1
False
False
Composite
ST
Name Of Alternate Coding System
-1
False
False
Composite
ID
Date/Time Range
Range Start Date/time
-1
False
False
Composite
TS
Range End Date/time
-1
False
False
Composite
TS
Message Type
Code
-1
False
False
Composite
ID
Event
-1
False
False
Composite
ID
MessageStructure
-1
False
False
Composite
ID
Entity Identifier
Entity Identifier
-1
False
False
Composite
ST
Namespace ID
-1
False
False
Composite
IS
Universal ID
-1
False
False
Composite
ST
Universal ID Type
-1
False
False
Composite
ID
Processing Type
Id
-1
False
False
Composite
ID
Mode
-1
False
False
Composite
ID
Version Identifier
Id
-1
False
False
Composite
ID
InternationalCode
-1
False
False
Composite
CE
International Version ID
-1
False
False
Composite
CE
Numeric
Value
0
False
False
Double
Extended Composite Name And Identification Number For Organizations
Organization Name
-1
False
False
Composite
ST
Organization Name Type Code
-1
False
False
Composite
IS
ID Number
-1
False
False
Composite
NM
Check Digit
-1
False
False
Composite
NM
Check Digit Scheme
-1
False
False
Composite
ID
Assigning Authority
-1
False
False
Composite
HD
Identifier Type Code
-1
False
False
Composite
ID
Assigning Facility
-1
False
False
Composite
HD
Name Representation Code
-1
False
False
Composite
ID
Organization Identifier
-1
False
False
Composite
ST
Extended Address
Street
-1
False
False
Composite
SAD
Other
-1
False
False
Composite
ST
City
-1
False
False
Composite
ST
State
-1
False
False
Composite
ST
Zip
-1
False
False
Composite
ST
Country
-1
False
False
Composite
ID
Type
-1
False
False
Composite
ID
Other
-1
False
False
Composite
ST
County
-1
False
False
Composite
IS
Census
-1
False
False
Composite
IS
Address Representation Code
-1
False
False
Composite
ID
Address Validity Range
-1
False
False
Composite
DR
Effective Date
-1
False
False
Composite
TS
Expiration Date
-1
False
False
Composite
TS
Street Address
Steet
-1
False
False
Composite
ST
StreetName
-1
False
False
Composite
ST
DwellingNumber
-1
False
False
Composite
ST
Date
Value
-1
False
False
DateTime
Date
Sequence ID
Value
0
False
False
String
Extended Person Name
Family Name
-1
False
False
Composite
FN
Given Name
-1
False
False
Composite
ST
Second And Further Given Names Or Initials Thereof
-1
False
False
Composite
ST
Suffix (e.g., Jr Or III)
-1
False
False
Composite
ST
Prefix (e.g., Dr)
-1
False
False
Composite
ST
Degree (e.g., Md)
-1
False
False
Composite
IS
Name Type Code
-1
False
False
Composite
ID
Name Representation Code
-1
False
False
Composite
ID
Name Context
-1
False
False
Composite
CE
Name Validity Range
-1
False
False
Composite
DR
Name Assembly Order
-1
False
False
Composite
ID
Effective Date
-1
False
False
Composite
TS
Expiration Date
-1
False
False
Composite
TS
Professional Suffix
-1
False
False
Composite
ST
Job Code/Class
Job Code
-1
False
False
Composite
IS
Job Class
-1
False
False
Composite
IS
Job Description Text
-1
False
False
Composite
TX
Text Data
Value
0
False
False
String
Extended Composite ID With Check Digit
ID Number
-1
False
False
Composite
ST
Check Digit
-1
False
False
Composite
ST
Check Digit Scheme
-1
False
False
Composite
ID
Assigning Authority
-1
False
False
Composite
HD
Identifier Type Code
-1
False
False
Composite
ID
Assigning Facility
-1
False
False
Composite
HD
Effective Date
-1
False
False
Composite
DT
Expiration Date
-1
False
False
Composite
DT
Assigning Jurisdiction
-1
False
False
Composite
CWE
Assigning Agency Or Department
-1
False
False
Composite
CWE
Extended Telecommunication Number
Telephone Number
-1
False
False
Composite
ST
Telecommunication Use Code
-1
False
False
Composite
ID
Telecommunication Equipment Type
-1
False
False
Composite
ID
Email Address
-1
False
False
Composite
ST
Country Code
-1
False
False
Composite
NM
Area/city Code
-1
False
False
Composite
NM
Local Number
-1
False
False
Composite
NM
Extension
-1
False
False
Composite
NM
Any Text
-1
False
False
Composite
ST
Extension Prefix
-1
False
False
Composite
ST
Speed Dial Code
-1
False
False
Composite
ST
Unformatted Telephone Number
-1
False
False
Composite
ST
Driver's License Number
License Number
-1
False
False
Composite
ST
Issuing State, Province, Country
-1
False
False
Composite
IS
Expiration Date
-1
False
False
Composite
DT
Discharge Location And Date
Discharge Location
-1
False
False
Composite
IS
Effective Date
-1
False
False
Composite
TS
Person Location
Point Of Care
-1
False
False
Composite
IS
Room
-1
False
False
Composite
IS
Bed
-1
False
False
Composite
IS
Facility
-1
False
False
Composite
HD
Location Status
-1
False
False
Composite
IS
Person Location Type
-1
False
False
Composite
IS
Building
-1
False
False
Composite
IS
Floor
-1
False
False
Composite
IS
Location Description
-1
False
False
Composite
ST
Comprehensive Location Identifier
-1
False
False
Composite
EI
Assigning Authority For Location
-1
False
False
Composite
HD
Financial Class
Financial Class Code
-1
False
False
Composite
IS
Effective Date
-1
False
False
Composite
TS
Encapsulated Data
Source Application
1027
False
False
Composite
HD
Type of Data
11
True
False
Composite
ID
Data Subtype
32
False
False
Composite
ID
Encoding
6
True
False
Composite
ID
Data
65536
True
False
Composite
TX
Coded with No Exceptions
Identifier
20
True
False
Composite
ST
Text
199
False
False
Composite
ST
Name of Coding System
20
False
False
Composite
ID
Alternate Identifier
20
False
False
Composite
ST
Alternate Text
199
False
False
Composite
ST
Name of Alternate Coding System
20
False
False
Composite
ID
Coding System Version ID
10
False
False
Composite
ST
Alternate Coding System Version ID
10
False
False
Composite
ST
Original Text
199
False
False
Composite
ST
Channel Definition
Id
22
False
False
Composite
WVI
Waveform Source
17
False
False
Composite
WVS
Channel Sensitivity and Units
478
False
False
Composite
CSU
Channel Calibration Parameters
20
False
False
Composite
CCP
Channel Sampling Frequency
6
False
False
Composite
NM
Minimum and Maximum Data Values
33
False
False
Composite
NR
Channel Calibration Parameters
Channel Calibration Sensitivity Correction Factor
6
False
False
Composite
NM
Channel Calibration Baseline
6
False
False
Composite
NM
Channel Calibration Time Skew
6
False
False
Composite
NM
Channel Identifier
Num
4
True
False
Composite
NM
Name
17
False
False
Composite
ST
Channel Sensitivity and Units
Channel Sensitivity
60
True
False
Composite
NM
Unit of Measure Identifier
20
False
False
Composite
ST
Unit of Measure Description
199
False
False
Composite
ST
Unit of Measure Coding System
20
False
False
Composite
ID
Alternate Unit of Measure Identifier
20
False
False
Composite
ST
Alternate Unit of Measure Description
199
False
False
Composite
ST
Alternate Unit of Measure Coding System
20
False
False
Composite
ID
Numeric Range
Low Value
16
False
False
Composite
NM
High Value
16
False
False
Composite
NM
Waveform Source
Source One Name
8
True
False
Composite
ST
Source Two Name
8
False
False
Composite
ST
Composite Price
Price
20
True
False
Composite
MO
Price Type
2
False
False
Composite
ID
From Value
16
False
False
Composite
NM
To Value
16
False
False
Composite
NM
Range Units
705
False
False
Composite
CWE
Range Type
1
False
False
Composite
ID
Money
Quantity
16
False
False
Composite
NM
Denomination
3
False
False
Composite
ID
Authorization Information
Authorization Number
30
False
False
Composite
ST
Date
8
False
False
Composite
DT
Source
199
False
False
Composite
ST
Policy Type and Amount
Policy Type
5
True
False
Composite
IS
Amount Class
9
False
False
Composite
IS
Money or Percentage Quantity
16
False
False
Composite
NM
Money or Percentage
23
True
False
Composite
MOP
Money or Percentage
Money or Percentage Indicator
2
True
False
Composite
ID
Money or Percentage Quantity
16
True
False
Composite
NM
Currency Denomination
3
False
False
Composite
ID
Daily Deductible Information
Delay Days
3
False
False
Composite
NM
Monetary Amount
16
True
False
Composite
MO
Number of Days
4
False
False
Composite
NM
Room Coverage
Room Type
20
True
False
Composite
IS
Amount Type
20
False
False
Composite
IS
Coverage Amount
16
False
False
Composite
NM
Money or Percentage
23
True
False
Composite
MOP
Insurance Certification Definition
Certification Patient Type
11
False
False
Composite
IS
Certification Required
1
True
False
Composite
ID
Date/Time Certification Required
24
False
False
Composite
DTM
Day Type and Number
Day Type
2
True
False
Composite
IS
Number of Days
3
True
False
Composite
NM
Occurrence Code and Date
Occurrence Code
705
True
False
Composite
CNE
Occurrence Date
8
True
False
Composite
DT
UB Value Code and Amount
Value Code
20
True
False
Composite
CNE
Value Amount
20
False
False
Composite
MO
Occurrence Span Code and Date
Occurrence Span Code
705
True
False
Composite
CNE
Occurrence Span Start Date
8
False
False
Composite
DT
Occurrence Span Stop Date
8
False
False
Composite
DT
Formatted Text Data
Value
-1
False
False
String
Timing Quantity
Quantity
267
False
False
Composite
CQ
Interval
206
False
False
Composite
RI
Duration
6
False
False
Composite
ST
Start Date/Time
24
False
False
Composite
DTM
End Date/Time
24
False
False
Composite
DTM
Priority
6
False
False
Composite
ST
Condition
199
False
False
Composite
ST
Text
200
False
False
Composite
TX
Conjunction
1
False
False
Composite
ID
Order Sequencing
110
False
False
Composite
OSD
Occurrence Duration
705
False
False
Composite
CWE
Total Occurrences
4
False
False
Composite
NM
Repeat Interval
Repeat Pattern
6
False
False
Composite
IS
Explicit Time Interval
199
False
False
Composite
ST
Composite Quantity with Units
Quantity
16
False
False
Composite
NM
Units
705
False
False
Composite
CWE
Order Sequence Definition
Sequence/Results Flag
1
True
False
Composite
ID
Placer Order Number: Entity Identifier
15
True
False
Composite
ST
Placer Order Number: Namespace ID
6
False
False
Composite
IS
Filler Order Number: Entity Identifier
15
True
False
Composite
ST
Filler Order Number: Namespace ID
6
False
False
Composite
IS
Sequence Condition Value
12
False
False
Composite
ST
Maximum Number of Repeats
3
False
False
Composite
NM
Placer Order Number: Universal ID
15
True
False
Composite
ST
Placer Order Number: Universal ID Type
6
False
False
Composite
ID
Filler Order Number: Universal ID
15
True
False
Composite
ST
Filler Order Number: Universal ID Type
6
False
False
Composite
ID
Entity Identifier Pair
Placer Assigned Identifier
427
False
False
Composite
EI
Filler Assigned Identifier
427
False
False
Composite
EI
Parent Result Link
Parent Observation Identifier
705
True
False
Composite
CWE
Parent Observation Sub-identifier
20
False
False
Composite
ST
Parent Observation Value Descriptor
250
False
False
Composite
TX
Money and Code
Monetary Amount
20
False
False
Composite
MO
Charge Code
705
False
False
Composite
CWE
Specimen Source
Specimen Source Name or Code
705
False
False
Composite
CWE
Additives
705
False
False
Composite
CWE
Specimen Collection Method
200
False
False
Composite
TX
Body Site
705
False
False
Composite
CWE
Site Modifier
705
False
False
Composite
CWE
Collection Method Modifier Code
705
False
False
Composite
CWE
Specimen Role
705
False
False
Composite
CWE
Name with Date and Location
Name
406
False
False
Composite
CNN
Start Date/time
24
False
False
Composite
DTM
End Date/time
24
False
False
Composite
DTM
Point of Care
20
False
False
Composite
IS
Room
20
False
False
Composite
IS
Bed
20
False
False
Composite
IS
Facility
227
False
False
Composite
HD
Location Status
20
False
False
Composite
IS
Patient Location Type
20
False
False
Composite
IS
Building
20
False
False
Composite
IS
Floor
20
False
False
Composite
IS
Composite ID Number and Name Simplified
ID Number
15
False
False
Composite
ST
Family Name
50
False
False
Composite
ST
Given Name
30
False
False
Composite
ST
Second and Further Given Names or Initials Thereof
30
False
False
Composite
ST
Suffix (e.g., JR or III)
20
False
False
Composite
ST
Prefix (e.g., DR)
20
False
False
Composite
ST
Degree (e.g., MD
5
False
False
Composite
IS
Source Table
4
False
False
Composite
IS
Assigning Authority - Namespace ID
20
False
False
Composite
IS
Assigning Authority - Universal ID
199
False
False
Composite
ST
Assigning Authority - Universal ID Type
6
False
False
Composite
ID
Location with Address Variation 1
Point of Care
20
False
False
Composite
IS
Room
20
False
False
Composite
IS
Bed
20
False
False
Composite
IS
Facility
227
False
False
Composite
HD
Location Status
20
False
False
Composite
IS
Patient Location Type
20
False
False
Composite
IS
Building
20
False
False
Composite
IS
Floor
20
False
False
Composite
IS
Address
415
False
False
Composite
AD
Address
Street Address
120
False
False
Composite
ST
Other Designation
120
False
False
Composite
ST
City
50
False
False
Composite
ST
State or Province
50
False
False
Composite
ST
Zip or Postal Code
12
False
False
Composite
ST
Country
3
False
False
Composite
ID
Address Type
3
False
False
Composite
ID
Other Geographic Designation
50
False
False
Composite
ST
Practitioner License or Other ID Number
ID Number
20
True
False
Composite
ST
Type of ID Number
8
True
False
Composite
IS
State/other Qualifying Information
62
False
False
Composite
ST
Expiration Date
8
False
False
Composite
DT
Charge Code and Date
Invocation Event
1
True
False
Composite
ID
Date/time
24
False
False
Composite
DTM
Time
Value
-1
False
False
DateTime
Time
Repeat Pattern
Repeat Pattern Code
705
True
False
Composite
CWE
Calendar Alignment
2
False
False
Composite
ID
Phase Range Begin Value
10
False
False
Composite
NM
Phase Range End Value
10
False
False
Composite
NM
Period Quantity
10
False
False
Composite
NM
Period Units
10
False
False
Composite
IS
Institution Specified Time
1
False
False
Composite
ID
Event
6
False
False
Composite
ID
Event Offset Quantity
10
False
False
Composite
NM
Event Offset Units
10
False
False
Composite
IS
General Timing Specification
200
False
False
Composite
GTS
General Timing Specification
Value
-1
False
False
String
EVN
Event Type
True
Event Type Code
0
False
0
ID
Recorded Date/time
0
True
0
TS
Date/time Planned Event
0
False
0
TS
Event Reason Code
0
False
0
IS
Operator ID
-1
False
0
XCN
Event Occurred
0
False
0
TS
Event Facility
0
False
0
HD
MSH
Message Header
True
FieldSep
0
True
0
ST
EncodingChars
0
True
0
ST
SendingApplication
0
False
0
HD
SendingFacility
0
False
0
HD
ReceivingApplication
0
False
0
HD
ReceivingFacility
0
False
0
HD
TimeStamp
0
True
0
TS
Security
0
False
0
ST
Type
0
True
0
MSG
MessageControlID
0
True
0
ST
ProcessingId
0
True
0
PT
Version
0
True
0
VID
SequenceNum
0
False
0
NM
Continuation Pointer
0
False
0
ST
Accept Acknowledgment Type
0
False
0
ID
Application Acknowledgment Type
0
False
0
ID
Country Code
0
False
0
ID
CharSet
-1
False
0
ID
Principal Language Of Message
0
False
0
CE
Alternate Character Set Handling Scheme
0
False
0
ID
Message Profile Identifier
-1
False
0
EI
NK1
Next Of Kin / Associated Parties
True
SetId
0
True
0
SI
Name
-1
False
0
XPN
Relationship
0
False
0
CE
Address
-1
False
0
XAD
Phone
-1
False
0
XTN
BusinessPhone
-1
False
0
XTN
ContactRole
0
False
0
CE
Start Date
0
False
0
DT
End Date
0
False
0
DT
Next Of Kin / Associated Parties Job Title
0
False
0
ST
Next Of Kin / Associated Parties Job Code/class
0
False
0
JCC
Next Of Kin / Associated Parties Employee Number
0
False
0
CX
Organization Name - Nk1
-1
False
0
XON
Marital Status
0
False
0
CE
Sex
0
False
0
IS
Dob
0
False
0
TS
Living Dependency
-1
False
0
IS
Ambulatory Status
-1
False
0
IS
Citizenship
-1
False
0
CE
Primary Language
0
False
0
CE
Living Arrangement
0
False
0
IS
Publicity Code
0
False
0
CE
Protection Indicator
0
False
0
ID
Student Indicator
0
False
0
IS
Religion
0
False
0
CE
Mother's Maiden Name
-1
False
0
XPN
Nationality
0
False
0
CE
Ethnic Group
-1
False
0
CE
Contact Reason
-1
False
0
CE
Contact Person's Name
-1
False
0
XPN
Contact Person's Telephone Number
-1
False
0
XTN
Contact Person's Address
-1
False
0
XAD
Next Of Kin/associated Party's Identifiers
-1
False
0
CX
Job Status
0
False
0
IS
Race
-1
False
0
CE
Handicap
0
False
0
IS
Contact Person Social Security Number
0
False
0
ST
Next Of Kin Birth Place
0
False
0
ST
Vip Indicator
0
False
0
IS
PID
Patient Identification
True
SetId
0
False
0
SI
Id
0
False
0
CX
IdList
-1
True
0
CX
AlternateId
-1
False
0
CX
Name
-1
True
0
XPN
MaidenName
-1
False
0
XPN
Dob
0
False
0
TS
Sex
0
False
0
IS
Alias
-1
False
0
XPN
Race
-1
False
0
CE
Address
-1
False
0
XAD
CountyCode
0
False
0
IS
HomePhone
-1
False
0
XTN
BusinessPhone
-1
False
0
XTN
Language
0
False
0
CE
MaritalStatus
0
False
0
CE
Religion
0
False
0
CE
AccountNumber
0
False
0
CX
SSN
0
False
0
ST
DriverLicense
0
False
0
DLN
MotherId
-1
False
0
CX
Ethnicity
-1
False
0
CE
BirthPlace
0
False
0
ST
Multiple Birth Indicator
0
False
0
ID
BirthOrder
0
False
0
NM
Citizenship
-1
False
0
CE
VeteranMilitartyStatus
0
False
0
CE
Nationality
0
False
0
CE
DeathTimestamp
0
False
0
TS
Patient Death Indicator
0
False
0
ID
Identity Unknown Indicator
0
False
0
ID
Identity Reliability Code
-1
False
0
IS
Last Update Date/time
0
False
0
TS
Last Update Facility
0
False
0
HD
Species Code
0
False
0
CE
Breed Code
0
False
0
CE
Strain
0
False
0
ST
Production Class Code
0
False
0
CE
Tribal Citizenship
-1
False
0
CWE
PV1
Patient Visit
True
Set ID - Pv1
0
False
0
SI
Patient Class
0
True
0
IS
Assigned Patient Location
0
False
0
PL
Admission Type
0
False
0
IS
Preadmit Number
0
False
0
CX
Prior Patient Location
0
False
0
PL
Attending Doctor
-1
False
0
XCN
Referring Doctor
-1
False
0
XCN
Consulting Doctor
-1
False
0
XCN
Hospital Service
0
False
0
IS
Temporary Location
0
False
0
PL
Preadmit Test Indicator
0
False
0
IS
Re-admission Indicator
0
False
0
IS
Admit Source
0
False
0
IS
Ambulatory Status
-1
False
0
IS
Vip Indicator
0
False
0
IS
Admitting Doctor
-1
False
0
XCN
Patient Type
0
False
0
IS
Visit Number
0
False
0
CX
Financial Class
-1
False
0
FC
Charge Price Indicator
0
False
0
IS
Courtesy Code
0
False
0
IS
Credit Rating
0
False
0
IS
Contract Code
-1
False
0
IS
Contract Effective Date
-1
False
0
DT
Contract Amount
-1
False
0
NM
Contract Period
-1
False
0
NM
Interest Code
0
False
0
IS
Transfer To Bad Debt Code
0
False
0
IS
Transfer To Bad Debt Date
0
False
0
DT
Bad Debt Agency Code
0
False
0
IS
Bad Debt Transfer Amount
0
False
0
NM
Bad Debt Recovery Amount
0
False
0
NM
Delete Account Indicator
0
False
0
IS
Delete Account Date
0
False
0
DT
Discharge Disposition
0
False
0
IS
Discharged To Location
0
False
0
DLD
Diet Type
0
False
0
CE
Servicing Facility
0
False
0
IS
Bed Status
0
False
0
IS
Account Status
0
False
0
IS
Pending Location
0
False
0
PL
Prior Temporary Location
0
False
0
PL
Admit Date/time
0
False
0
TS
Discharge Date/time
-1
False
0
TS
Current Patient Balance
0
False
0
NM
Total Charges
0
False
0
NM
Total Adjustments
0
False
0
NM
Total Payments
0
False
0
NM
Alternate Visit ID
0
False
0
CX
Visit Indicator
0
False
0
IS
Other Healthcare Provider
-1
False
0
XCN
SFT
Software Segment
True
Software Vendor Organization
0
True
567
XON
Software Certified Version or Release Number
0
True
15
ST
Software Product Name
0
True
20
ST
Software Binary ID
0
True
20
ST
Software Product Information
0
False
1024
TX
Software Install Date
0
False
24
DTM
UAC
User Authentication Credential Segment
True
User Authentication Credential Type Code
0
True
705
CWE
User Authentication Credential
0
True
65536
ED
PD1
Patient Additional Demographic
True
Living Dependency
-1
False
2
IS
Living Arrangement
0
False
2
IS
Patient Primary Facility
-1
False
250
XON
Patient Primary Care Provider Name & ID No.
-1
False
0
XCN
Student Indicator
0
False
2
IS
Handicap
0
False
2
IS
Living Will Code
0
False
2
IS
Organ Donor Code
0
False
2
IS
Separate Bill
0
False
1
ID
Duplicate Patient
-1
False
250
CX
Publicity Code
0
False
705
CWE
Protection Indicator
0
False
0
ID
Protection Indicator Effective Date
0
False
0
DT
Place of Worship
-1
False
250
XON
Advance Directive Code
-1
False
705
CWE
Immunization Registry Status
0
False
1
IS
Immunization Registry Status Effective Date
0
False
8
DT
Publicity Code Effective Date
0
False
8
DT
Military Branch
0
False
5
IS
Military Rank/Grade
0
False
2
IS
Military Status
0
False
3
IS
Advance Directive Last Verified Date
0
False
8
DT
ARV
Access Restriction
True
Set ID
0
False
4
SI
Access Restriction Action Code
0
True
705
CNE
Access Restriction Value
0
True
705
CWE
Access Restriction Reason
-1
False
705
CWE
Special Access Restriction Instructions
-1
False
250
ST
Access Restriction Date Range
0
False
49
DR
ROL
Role
True
Role Instance ID
0
False
60
EI
Action Code
0
True
2
ID
Role-ROL
0
True
250
CWE
Role Person
-1
True
250
XCN
Role Begin Date/Time
0
False
24
DTM
Role End Date/Time
0
False
24
DTM
Role Duration
0
False
250
CWE
Role Action Reason
0
False
250
CWE
Provider Type
-1
False
250
CWE
Organization Unit Type
0
False
250
CWE
Office/Home Address/Birthplace
-1
False
250
XAD
Phone
-1
False
250
XTN
Person's Location
0
False
1230
PL
NK1
Next of Kin / Associated Parties
True
Set ID - NK1
0
True
4
SI
Name
-1
False
250
XPN
Relationship
0
False
705
CWE
Address
-1
False
250
XAD
Phone Number
-1
False
250
XTN
Business Phone Number
-1
False
250
XTN
Contact Role
0
False
705
CWE
Start Date
0
False
8
DT
End Date
0
False
8
DT
Next of Kin / Associated Parties Job Title
0
False
60
ST
Next of Kin / Associated Parties Job Code/Class
0
False
20
JCC
Next of Kin / Associated Parties Employee Number
0
False
250
CX
Organization Name - NK1
-1
False
250
XON
Marital Status
0
False
705
CWE
Administrative Sex
0
False
1
IS
Date/Time of Birth
0
False
24
DTM
Living Dependency
-1
False
2
IS
Ambulatory Status
-1
False
2
IS
Citizenship
-1
False
705
CWE
Primary Language
0
False
705
CWE
Living Arrangement
0
False
2
IS
Publicity Code
0
False
705
CWE
Protection Indicator
0
False
0
ID
Student Indicator
0
False
2
IS
Religion
0
False
705
CWE
Mother's Maiden Name
-1
False
250
XPN
Nationality
0
False
0
CWE
Ethnic Group
-1
False
705
CWE
Contact Reason
-1
False
705
CWE
Contact Person's Name
-1
False
250
XPN
Contact Person's Telephone Number
-1
False
250
XTN
Contact Person's Address
-1
False
250
XAD
Next of Kin/Associated Party's Identifiers
-1
False
250
CX
Job Status
0
False
2
IS
Race
-1
False
705
CWE
Handicap
0
False
2
IS
Contact Person Social Security Number
0
False
16
ST
Next of Kin Birth Place
0
False
250
ST
VIP Indicator
0
False
2
IS
PV2
Patient Visit - Additional Information
True
Prior Pending Location
0
False
80
PL
Accommodation Code
0
False
705
CWE
Admit Reason
0
False
705
CWE
Transfer Reason
0
False
705
CWE
Patient Valuables
-1
False
25
ST
Patient Valuables Location
0
False
25
ST
Visit User Code
-1
False
2
IS
Expected Admit Date/Time
0
False
24
DTM
Expected Discharge Date/Time
0
False
24
DTM
Estimated Length of Inpatient Stay
0
False
3
NM
Actual Length of Inpatient Stay
0
False
3
NM
Visit Description
0
False
50
ST
Referral Source Code
-1
False
250
XCN
Previous Service Date
0
False
8
DT
Employment Illness Related Indicator
0
False
1
ID
Purge Status Code
0
False
1
IS
Purge Status Date
0
False
8
DT
Special Program Code
0
False
2
IS
Retention Indicator
0
False
1
ID
Expected Number of Insurance Plans
0
False
1
NM
Visit Publicity Code
0
False
1
IS
Visit Protection Indicator
0
False
0
ID
Clinic Organization Name
-1
False
250
XON
Patient Status Code
0
False
2
IS
Visit Priority Code
0
False
1
IS
Previous Treatment Date
0
False
8
DT
Expected Discharge Disposition
0
False
2
IS
Signature on File Date
0
False
8
DT
First Similar Illness Date
0
False
8
DT
Patient Charge Adjustment Code
0
False
705
CWE
Recurring Service Code
0
False
2
IS
Billing Media Code
0
False
1
ID
Expected Surgery Date and Time
0
False
24
DTM
Military Partnership Code
0
False
1
ID
Military Non-Availability Code
0
False
1
ID
Newborn Baby Indicator
0
False
1
ID
Baby Detained Indicator
0
False
1
ID
Mode of Arrival Code
0
False
705
CWE
Recreational Drug Use Code
-1
False
705
CWE
Admission Level of Care Code
0
False
705
CWE
Precaution Code
-1
False
705
CWE
Patient Condition Code
0
False
705
CWE
Living Will Code
0
False
2
IS
Organ Donor Code
0
False
2
IS
Advance Directive Code
-1
False
705
CWE
Patient Status Effective Date
0
False
8
DT
Expected LOA Return Date/Time
0
False
24
DTM
Expected Pre-admission Testing Date/Time
0
False
24
DTM
Notify Clergy Code
-1
False
20
IS
Advance Directive Last Verified Date
0
False
8
DT
DB1
Disability
True
Set ID - DB1
0
True
4
SI
Disabled Person Code
0
False
2
IS
Disabled Person Identifier
-1
False
250
CX
Disability Indicator
0
False
1
ID
Disability Start Date
0
False
8
DT
Disability End Date
0
False
8
DT
Disability Return to Work Date
0
False
8
DT
Disability Unable to Work Date
0
False
8
DT
OBX
Observation/Result
True
Set ID - OBX
0
False
4
SI
Value Type
0
False
3
ID
Identifier
0
True
705
CWE
Sub-Id
0
False
20
ST
Value
0
True
581
CD
Units
0
False
705
CWE
References Range
0
False
60
ST
Abnormal Flags
-1
False
5
IS
Probability
0
False
5
NM
Nature of Abnormal Test
-1
False
2
ID
Observation Result Status
0
True
1
ID
Effective Date of Reference Range
0
False
24
DTM
User Defined Access Checks
0
False
20
ST
Date/Time of the Observation
0
False
24
DTM
Producer's ID
0
False
705
CWE
Responsible Observer
-1
False
3220
XCN
Observation Method
-1
False
705
CWE
Equipment Instance Identifier
-1
False
427
EI
Date/Time of the Analysis
0
False
24
DTM
Observation Site
-1
False
705
CWE
Observation Instance Identifier
0
False
427
EI
Mood Code
0
False
705
CNE
Performing Organization Name
0
False
570
XON
Performing Organization Address
0
False
2915
XAD
Performing Organization Medical Director
0
False
3220
XCN
AL1
Patient Allergy Information
True
Set ID - AL1
0
True
4
SI
Allergen Type Code
0
False
705
CWE
Allergen Code/Mnemonic/Description
0
True
705
CWE
Allergy Severity Code
0
False
705
CWE
Allergy Reaction Code
-1
False
15
ST
Identification Date
0
False
0
DT
DG1
Diagnosis
True
Set ID - DG1
0
True
4
SI
Diagnosis Coding Method
0
False
0
ST
Diagnosis Code - DG1
0
True
250
CWE
Diagnosis Description
0
False
0
ST
Diagnosis Date/Time
0
False
24
DTM
Diagnosis Type
0
True
2
IS
Major Diagnostic Category
0
False
1
CNE
Diagnostic Related Group
0
False
250
CNE
DRG Approval Indicator
0
False
1
ID
DRG Grouper Review Code
0
False
2
IS
Outlier Type
0
False
250
CWE
Outlier Days
0
False
3
NM
Outlier Cost
0
False
12
CP
Grouper Version And Type
0
False
0
ST
Diagnosis Priority
0
False
2
ID
Diagnosing Clinician
-1
False
250
XCN
Diagnosis Classification
0
False
3
IS
Confidential Indicator
0
False
1
ID
Attestation Date/Time
0
False
24
DTM
Diagnosis Identifier
0
False
427
EI
Diagnosis Action Code
0
False
1
ID
Parent Diagnosis
0
False
427
EI
DRG CCL Value Code
0
False
705
CWE
DRG Grouping Usage
0
False
20
ID
DRG Diagnosis Determination Status
0
False
20
IS
Present On Admission (POA) Indicator
0
False
1
IS
DRG
Diagnosis Related Group
True
Diagnostic Related Group
0
False
250
CNE
DRG Assigned Date/Time
0
False
24
DTM
DRG Approval Indicator
0
False
1
ID
DRG Grouper Review Code
0
False
2
IS
Outlier Type
0
False
250
CWE
Outlier Days
0
False
3
NM
Outlier Cost
0
False
12
CP
DRG Payor
0
False
1
IS
Outlier Reimbursement
0
False
9
CP
Confidential Indicator
0
False
1
ID
DRG Transfer Type
0
False
21
IS
Name of Coder
0
False
1103
XPN
Grouper Status
0
False
705
CWE
PCCL Value Code
0
False
20
CWE
Effective Weight
0
False
5
NM
Monetary Amount
0
False
20
MO
Status Patient
0
False
20
IS
Grouper Software Name
0
False
100
ST
Grouper Software Version
0
False
100
ST
Status Financial Calculation
0
False
20
IS
Relative Discount/Surcharge
0
False
20
MO
Basic Charge
0
False
20
MO
Total Charge
0
False
20
MO
Discount/Surcharge
0
False
20
MO
Calculated Days
0
False
5
NM
Status Gender
0
False
20
IS
Status Age
0
False
20
IS
Status Length of Stay
0
False
20
IS
Status Same Day Flag
0
False
20
IS
Status Separation Mode
0
False
20
IS
Status Weight at Birth
0
False
20
IS
Status Respiration Minutes
0
False
20
IS
Status Admission
0
False
20
IS
PR1
Procedures
True
Set ID - PR1
0
True
4
SI
Procedure Coding Method
0
False
0
ST
Procedure Code
0
True
705
CNE
Procedure Description
0
False
0
ST
Procedure Date/Time
0
True
24
DTM
Procedure Functional Type
0
False
2
IS
Procedure Minutes
0
False
4
NM
Anesthesiologist
0
False
0
ST
Anesthesia Code
0
False
2
IS
Anesthesia Minutes
0
False
4
NM
Surgeon
0
False
0
ST
Procedure Practitioner
0
False
0
ST
Consent Code
0
False
250
CWE
Procedure Priority
0
False
2
ID
Associated Diagnosis Code
0
False
250
CWE
Procedure Code Modifier
-1
False
705
CNE
Procedure DRG Type
0
False
20
IS
Tissue Type Code
-1
False
250
CWE
Procedure Identifier
0
False
427
EI
Procedure Action Code
0
False
1
ID
DRG Procedure Determination Status
0
False
20
IS
DRG Procedure Relevance
0
False
20
IS
GT1
Guarantor
True
Set ID - GT1
0
True
4
SI
Guarantor Number
-1
False
250
CX
Guarantor Name
-1
True
250
XPN
Guarantor Spouse Name
-1
False
250
XPN
Guarantor Address
-1
False
250
XAD
Guarantor Ph Num - Home
-1
False
250
XTN
Guarantor Ph Num - Business
-1
False
250
XTN
Guarantor Date/Time Of Birth
0
False
24
DTM
Guarantor Administrative Sex
0
False
1
IS
Guarantor Type
0
False
2
IS
Guarantor Relationship
0
False
250
CWE
Guarantor SSN
0
False
11
ST
Guarantor Date - Begin
0
False
8
DT
Guarantor Date - End
0
False
8
DT
Guarantor Priority
0
False
2
NM
Guarantor Employer Name
-1
False
250
XPN
Guarantor Employer Address
-1
False
250
XAD
Guarantor Employer Phone Number
-1
False
250
XTN
Guarantor Employee ID Number
-1
False
250
CX
Guarantor Employment Status
0
False
2
IS
Guarantor Organization Name
-1
False
250
XON
Guarantor Billing Hold Flag
0
False
1
ID
Guarantor Credit Rating Code
0
False
250
CWE
Guarantor Death Date And Time
0
False
24
DTM
Guarantor Death Flag
0
False
1
ID
Guarantor Charge Adjustment Code
0
False
250
CWE
Guarantor Household Annual Income
0
False
10
CP
Guarantor Household Size
0
False
3
NM
Guarantor Employer ID Number
-1
False
250
CX
Guarantor Marital Status Code
0
False
250
CWE
Guarantor Hire Effective Date
0
False
8
DT
Employment Stop Date
0
False
8
DT
Living Dependency
0
False
2
IS
Ambulatory Status
-1
False
2
IS
Citizenship
-1
False
705
CWE
Primary Language
0
False
705
CWE
Living Arrangement
0
False
2
IS
Publicity Code
0
False
705
CWE
Protection Indicator
0
False
0
ID
Student Indicator
0
False
2
IS
Religion
0
False
705
CWE
Mother's Maiden Name
-1
False
250
XPN
Nationality
0
False
0
CWE
Ethnic Group
-1
False
705
CWE
Contact Person's Name
-1
False
250
XPN
Contact Person's Telephone Number
-1
False
250
XTN
Contact Reason
0
False
705
CWE
Contact Relationship
0
False
3
IS
Job Title
0
False
20
ST
Job Code/Class
0
False
20
JCC
Guarantor Employer's Organization Name
-1
False
250
XON
Handicap
0
False
2
IS
Job Status
0
False
2
IS
Guarantor Financial Class
0
False
50
FC
Guarantor Race
-1
False
250
CWE
Guarantor Birth Place
0
False
250
ST
VIP Indicator
0
False
2
IS
IN1
Insurance
True
Set ID - IN1
0
True
4
SI
Insurance Plan ID
0
True
250
CWE
Insurance Company ID
-1
True
250
CX
Insurance Company Name
-1
False
250
XON
Insurance Company Address
-1
False
250
XAD
Insurance Co Contact Person
-1
False
250
XPN
Insurance Co Phone Number
-1
False
250
XTN
Group Number
0
False
12
ST
Group Name
-1
False
250
XON
Insured's Group Emp ID
-1
False
250
CX
Insured's Group Emp Name
-1
False
250
XON
Plan Effective Date
0
False
8
DT
Plan Expiration Date
0
False
8
DT
Authorization Information
0
False
239
AUI
Plan Type
0
False
3
IS
Name Of Insured
-1
False
250
XPN
Insured's Relationship To Patient
0
False
250
CWE
Insured's Date Of Birth
0
False
24
DTM
Insured's Address
-1
False
250
XAD
Assignment Of Benefits
0
False
2
IS
Coordination Of Benefits
0
False
2
IS
Coord Of Ben. Priority
0
False
2
ST
Notice Of Admission Flag
0
False
1
ID
Notice Of Admission Date
0
False
8
DT
Report Of Eligibility Flag
0
False
1
ID
Report Of Eligibility Date
0
False
8
DT
Release Information Code
0
False
2
IS
Pre-Admit Cert (PAC)
0
False
15
ST
Verification Date/Time
0
False
24
DTM
Verification By
-1
False
250
XCN
Type Of Agreement Code
0
False
2
IS
Billing Status
0
False
2
IS
Lifetime Reserve Days
0
False
4
NM
Delay Before L.R. Day
0
False
4
NM
Company Plan Code
0
False
20
IS
Policy Number
0
False
15
ST
Policy Deductible
0
False
12
CP
Policy Limit - Amount
0
False
0
ST
Policy Limit - Days
0
False
4
NM
Room Rate - Semi-Private
0
False
0
ST
Room Rate - Private
0
False
0
ST
Insured's Employment Status
0
False
250
CWE
Insured's Administrative Sex
0
False
1
IS
Insured's Employer's Address
-1
False
250
XAD
Verification Status
0
False
2
ST
Prior Insurance Plan ID
0
False
8
IS
Coverage Type
0
False
3
IS
Handicap
0
False
2
IS
Insured's ID Number
-1
False
250
CX
Signature Code
0
False
1
IS
Signature Code Date
0
False
8
DT
Insured's Birth Place
0
False
250
ST
VIP Indicator
0
False
2
IS
IN2
Insurance Additional Information
True
Insured's Employee ID
-1
False
250
CX
Insured's Social Security Number
0
False
11
ST
Insured's Employer's Name and ID
-1
False
250
XCN
Employer Information Data
0
False
1
IS
Mail Claim Party
-1
False
1
IS
Medicare Health Ins Card Number
0
False
15
ST
Medicaid Case Name
-1
False
250
XPN
Medicaid Case Number
0
False
15
ST
Military Sponsor Name
-1
False
250
XPN
Military ID Number
0
False
20
ST
Dependent Of Military Recipient
0
False
250
CWE
Military Organization
0
False
25
ST
Military Station
0
False
25
ST
Military Service
0
False
14
IS
Military Rank/Grade
0
False
2
IS
Military Status
0
False
3
IS
Military Retire Date
0
False
8
DT
Military Non-Avail Cert On File
0
False
1
ID
Baby Coverage
0
False
1
ID
Combine Baby Bill
0
False
1
ID
Blood Deductible
0
False
1
ST
Special Coverage Approval Name
-1
False
250
XPN
Special Coverage Approval Title
0
False
30
ST
Non-Covered Insurance Code
-1
False
8
IS
Payor ID
-1
False
250
CX
Payor Subscriber ID
-1
False
250
CX
Eligibility Source
0
False
1
IS
Room Coverage Type/Amount
-1
False
82
RMC
Policy Type/Amount
-1
False
56
PTA
Daily Deductible
0
False
25
DDI
Living Dependency
0
False
2
IS
Ambulatory Status
-1
False
2
IS
Citizenship
-1
False
705
CWE
Primary Language
0
False
705
CWE
Living Arrangement
0
False
2
IS
Publicity Code
0
False
705
CWE
Protection Indicator
0
False
0
ID
Student Indicator
0
False
2
IS
Religion
0
False
705
CWE
Mother's Maiden Name
-1
False
250
XPN
Nationality
0
False
0
CWE
Ethnic Group
-1
False
705
CWE
Marital Status
-1
False
705
CWE
Insured's Employment Start Date
0
False
8
DT
Employment Stop Date
0
False
8
DT
Job Title
0
False
20
ST
Job Code/Class
0
False
20
JCC
Job Status
0
False
2
IS
Employer Contact Person Name
-1
False
250
XPN
Employer Contact Person Phone Number
-1
False
250
XTN
Employer Contact Reason
0
False
2
IS
Insured's Contact Person's Name
-1
False
250
XPN
Insured's Contact Person Phone Number
-1
False
250
XTN
Insured's Contact Person Reason
-1
False
2
IS
Relationship to the Patient Start Date
0
False
8
DT
Relationship to the Patient Stop Date
-1
False
8
DT
Insurance Co Contact Reason
0
False
2
IS
Insurance Co Contact Phone Number
-1
False
250
XTN
Policy Scope
0
False
2
IS
Policy Source
0
False
2
IS
Patient Member Number
0
False
250
CX
Guarantor's Relationship to Insured
0
False
250
CWE
Insured's Phone Number - Home
-1
False
250
XTN
Insured's Employer Phone Number
-1
False
250
XTN
Military Handicapped Program
0
False
250
CWE
Suspend Flag
0
False
1
ID
Copay Limit Flag
0
False
1
ID
Stoploss Limit Flag
0
False
1
ID
Insured Organization Name and ID
-1
False
250
XON
Insured Employer Organization Name and ID
-1
False
250
XON
Race
-1
False
705
CWE
Patient's Relationship to Insured
0
False
705
CWE
IN3
Insurance Additional Information, Certification
True
Set ID - IN3
0
True
4
SI
Certification Number
0
False
250
CX
Certified By
-1
False
250
XCN
Certification Required
0
False
1
ID
Penalty
0
False
23
MOP
Certification Date/Time
0
False
24
DTM
Certification Modify Date/Time
0
False
24
DTM
Operator
-1
False
250
XCN
Certification Begin Date
0
False
8
DT
Certification End Date
0
False
8
DT
Days
0
False
6
DTN
Non-Concur Code/Description
0
False
250
CWE
Non-Concur Effective Date/Time
0
False
24
DTM
Physician Reviewer
-1
False
250
XCN
Certification Contact
0
False
48
ST
Certification Contact Phone Number
-1
False
250
XTN
Appeal Reason
0
False
250
CWE
Certification Agency
0
False
250
CWE
Certification Agency Phone Number
-1
False
250
XTN
Pre-Certification Requirement
-1
False
40
ICD
Case Manager
0
False
48
ST
Second Opinion Date
0
False
8
DT
Second Opinion Status
0
False
1
IS
Second Opinion Documentation Received
-1
False
1
IS
Second Opinion Physician
-1
False
250
XCN
ACC
Accident
True
Accident Date/Time
0
False
24
DTM
Accident Code
0
False
250
CWE
Accident Location
0
False
25
ST
Auto Accident State
0
False
0
CWE
Accident Job Related Indicator
0
False
1
ID
Accident Death Indicator
0
False
12
ID
Entered By
0
False
3220
XCN
Accident Description
0
False
25
ST
Brought In By
0
False
80
ST
Police Notified Indicator
0
False
1
ID
Accident Address
0
False
250
XAD
UB1
UB82
True
Set ID - UB1
0
False
4
SI
Blood Deductible
0
False
0
ST
Blood Furnished-Pints
0
False
2
NM
Blood Replaced-Pints
0
False
2
NM
Blood Not Replaced-Pints
0
False
2
NM
Co-Insurance Days
0
False
0
NM
Condition Code
-1
False
0
IS
Covered Days
0
False
0
NM
Non Covered Days
0
False
0
NM
Value Amount & Code
-1
False
0
UVC
Number Of Grace Days
0
False
2
NM
Special Program Indicator
0
False
250
CWE
PSRO/UR Approval Indicator
0
False
250
CWE
PSRO/UR Approved Stay-Fm
0
False
8
DT
PSRO/UR Approved Stay-To
0
False
8
DT
Occurrence
-1
False
0
OCD
Occurrence Span
0
False
0
CWE
Occur Span Start Date
0
False
0
DT
Occur Span End Date
0
False
0
DT
UB-82 Locator 2
0
False
0
ST
UB-82 Locator 9
0
False
0
ST
UB-82 Locator 27
0
False
0
ST
UB-82 Locator 45
0
False
0
ST
UB2
UB92 Data
True
Set ID - UB2
0
False
4
SI
Co-Insurance Days (9)
0
False
3
ST
Condition Code (24-30)
-1
False
2
IS
Covered Days (7)
0
False
3
ST
Non-Covered Days (8)
0
False
4
ST
Value Amount & Code
-1
False
41
UVC
Occurrence Code & Date (32-35)
-1
False
259
OCD
Occurrence Span Code/Dates (36)
-1
False
268
OSP
UB92 Locator 2 (State)
-1
False
29
ST
UB92 Locator 11 (State)
-1
False
12
ST
UB92 Locator 31 (National)
0
False
5
ST
Document Control Number
-1
False
23
ST
UB92 Locator 49 (National)
-1
False
4
ST
UB92 Locator 56 (State)
-1
False
14
ST
UB92 Locator 57 (National)
0
False
27
ST
UB92 Locator 78 (State)
-1
False
2
ST
Special Visit Count
0
False
3
NM
PDA
Patient Death and Autopsy
True
Death Cause Code
-1
False
705
CWE
Death Location
0
False
80
PL
Death Certified Indicator
0
False
1
ID
Death Certificate Signed Date/Time
0
False
24
DTM
Death Certified By
0
False
250
XCN
Autopsy Indicator
0
False
1
ID
Autopsy Start and End Date/Time
0
False
53
DR
Autopsy Performed By
0
False
250
XCN
Coroner Indicator
0
False
1
ID
NTE
Notes and Comments
True
Set ID - NTE
0
False
4
SI
Source of Comment
0
False
8
ID
Comment
-1
False
65536
FT
Comment Type
0
False
250
CWE
Entered By
0
False
3220
XCN
Entered Date/Time
0
False
24
DTM
Effective Start Date
0
False
24
DTM
Expiration Date
0
False
24
DTM
ORC
Common Order
True
Order Control
0
True
2
ID
Placer Order Number
0
False
427
EI
Filler Order Number
0
False
427
EI
Placer Group Number
0
False
22
EI
Order Status
0
False
2
ID
Response Flag
0
False
1
ID
Quantity/Timing
-1
False
0
TQ
Parent
0
False
200
EIP
Date/Time of Transaction
0
False
24
DTM
Entered By
-1
False
3220
XCN
Verified By
-1
False
250
XCN
Ordering Provider
-1
False
3220
XCN
Enterer's Location
0
False
80
PL
Call Back Phone Number
-1
False
250
XTN
Order Effective Date/Time
0
False
24
DTM
Order Control Code Reason
0
False
250
CWE
Entering Organization
0
False
250
CWE
Entering Device
0
False
250
CWE
Action By
-1
False
250
XCN
Advanced Beneficiary Notice Code
0
False
250
CWE
Ordering Facility Name
-1
False
250
XON
Ordering Facility Address
-1
False
250
XAD
Ordering Facility Phone Number
-1
False
250
XTN
Ordering Provider Address
-1
False
250
XAD
Order Status Modifier
0
False
250
CWE
Advanced Beneficiary Notice Override Reason
0
False
60
CWE
Filler's Expected Availability Date/Time
0
False
24
DTM
Confidentiality Code
0
False
250
CWE
Order Type
0
False
250
CWE
Enterer Authorization Mode
0
False
250
CNE
Parent Universal Service Identifier
0
False
250
CWE
OBR
Observation Request
True
Set ID - OBR
0
False
4
SI
Placer Order Number
0
False
427
EI
Filler Order Number
0
False
427
EI
Universal Service Identifier
0
True
705
CWE
Priority
0
False
0
ID
Requested Date/Time
0
False
0
DTM
Observation Date/Time #
0
False
24
DTM
Observation End Date/Time #
0
False
24
DTM
Collection Volume *
0
False
722
CQ
Collector Identifier *
-1
False
3220
XCN
Specimen Action Code *
0
False
1
ID
Danger Code
0
False
705
CWE
Relevant Clinical Information
0
False
300
ST
Specimen Received Date/Time
0
False
24
DTM
Specimen Source
0
False
0
SPS
Ordering Provider
-1
False
3220
XCN
Order Callback Phone Number
-1
False
2743
XTN
Placer Field 1
0
False
199
ST
Placer Field 2
0
False
199
ST
Filler Field 1 +
0
False
199
ST
Filler Field 2 +
0
False
199
ST
Results Rpt/Status Chng - Date/Time +
0
False
24
DTM
Charge to Practice +
0
False
504
MOC
Diagnostic Serv Sect ID
0
False
10
ID
Result Status +
0
False
1
ID
Parent Result +
0
False
977
PRL
Quantity/Timing
-1
False
0
TQ
Result Copies To
-1
False
3220
XCN
Parent
0
False
855
EIP
Transportation Mode
0
False
20
ID
Reason for Study
-1
False
705
CWE
Principal Result Interpreter +
0
False
0
NDL
Assistant Result Interpreter +
-1
False
0
NDL
Technician +
-1
False
0
NDL
Transcriptionist +
-1
False
0
NDL
Scheduled Date/Time +
0
False
24
DTM
Number of Sample Containers *
0
False
16
NM
Transport Logistics of Collected Sample *
-1
False
705
CWE
Collector's Comment *
-1
False
705
CWE
Transport Arrangement Responsibility
0
False
705
CWE
Transport Arranged
0
False
30
ID
Escort Required
0
False
1
ID
Planned Patient Transport Comment
-1
False
705
CWE
Procedure Code
0
False
705
CNE
Procedure Code Modifier
-1
False
705
CNE
Placer Supplemental Service Information
-1
False
705
CWE
Filler Supplemental Service Information
-1
False
705
CWE
Medically Necessary Duplicate Procedure Reason
0
False
705
CWE
Result Handling
0
False
2
IS
Parent Universal Service Identifier
0
False
705
CWE
RQD
Requisition Detail
True
Requisition Line Number
0
False
4
SI
Item Code - Internal
0
False
250
CWE
Item Code - External
0
False
250
CWE
Hospital Item Code
0
False
250
CWE
Requisition Quantity
0
False
6
NM
Requisition Unit of Measure
0
False
250
CWE
Cost Center Account Number
0
False
30
IS
Item Natural Account Code
0
False
30
IS
Deliver To ID
0
False
250
CWE
Date Needed
0
False
8
DT
RQ1
Requisition Detail-1
True
Anticipated Price
0
False
10
ST
Manufacturer Identifier
0
False
705
CWE
Manufacturer's Catalog
0
False
16
ST
Vendor ID
0
False
250
CWE
Vendor Catalog
0
False
16
ST
Taxable
0
False
1
ID
Substitute Allowed
0
False
1
ID
RXO
Pharmacy/Treatment Order
True
Requested Give Code
0
False
250
CWE
Requested Give Amount - Minimum
0
False
20
NM
Requested Give Amount - Maximum
0
False
20
NM
Requested Give Units
0
False
250
CWE
Requested Dosage Form
0
False
250
CWE
Provider's Pharmacy/Treatment Instructions
-1
False
250
CWE
Provider's Administration Instructions
-1
False
250
CWE
Deliver-To Location
0
False
0
LA1
Allow Substitutions
0
False
1
ID
Requested Dispense Code
0
False
250
CWE
Requested Dispense Amount
0
False
20
NM
Requested Dispense Units
0
False
250
CWE
Number Of Refills
0
False
3
NM
Ordering Provider's DEA Number
-1
False
250
XCN
Pharmacist/Treatment Supplier's Verifier ID
-1
False
250
XCN
Needs Human Review
0
False
1
ID
Requested Give Per (Time Unit)
0
False
20
ST
Requested Give Strength
0
False
20
NM
Requested Give Strength Units
0
False
250
CWE
Indication
-1
False
250
CWE
Requested Give Rate Amount
0
False
6
ST
Requested Give Rate Units
0
False
250
CWE
Total Daily Dose
0
False
10
CQ
Supplementary Code
-1
False
250
CWE
Requested Drug Strength Volume
0
False
5
NM
Requested Drug Strength Volume Units
0
False
250
CWE
Pharmacy Order Type
0
False
1
ID
Dispensing Interval
0
False
20
NM
Medication Instance Identifier
0
False
60
EI
Segment Instance Identifier
0
False
60
EI
Mood Code
0
False
2
CNE
Dispensing Pharmacy
0
False
250
CWE
Dispensing Pharmacy Address
0
False
250
XAD
Deliver-to Patient Location
0
False
80
PL
Deliver-to Address
0
False
250
XAD
ODS
Dietary Orders, Supplements, and Preferences
True
Type
0
True
1
ID
Service Period
-1
False
250
CWE
Diet, Supplement, or Preference Code
-1
True
250
CWE
Text Instruction
-1
False
80
ST
ODT
Diet Tray Instructions
True
Tray Type
0
True
250
CWE
Service Period
-1
False
250
CWE
Text Instruction
0
False
80
ST
CTD
Contact Data
True
Contact Role
-1
True
705
CWE
Contact Name
-1
False
250
XPN
Contact Address
-1
False
2915
XAD
Contact Location
0
False
60
PL
Contact Communication Information
-1
False
250
XTN
Preferred Method of Contact
0
False
705
CWE
Contact Identifiers
-1
False
100
PLN
FT1
Financial Transaction
True
Set ID - FT1
0
False
4
SI
Transaction ID
0
False
12
ST
Transaction Batch ID
0
False
10
ST
Transaction Date
0
True
53
DR
Transaction Posting Date
0
False
24
DTM
Transaction Type
0
True
8
IS
Transaction Code
0
True
250
CWE
Transaction Description
0
False
0
ST
Transaction Description - Alt
0
False
0
ST
Transaction Quantity
0
False
6
NM
Transaction Amount - Extended
0
False
12
CP
Transaction amount - unit
0
False
12
CP
Department Code
0
False
250
CWE
Insurance Plan ID
0
False
250
CWE
Insurance Amount
0
False
12
CP
Assigned Patient Location
0
False
80
PL
Fee Schedule
0
False
1
IS
Patient Type
0
False
2
IS
Diagnosis Code - FT1
-1
False
250
CWE
Performed By Code
-1
False
250
XCN
Ordered By Code
-1
False
250
XCN
Unit Cost
0
False
12
CP
Filler Order Number
0
False
427
EI
Entered By Code
-1
False
250
XCN
Procedure Code
0
False
705
CNE
Procedure Code Modifier
-1
False
705
CNE
Advanced Beneficiary Notice Code
0
False
250
CWE
Medically Necessary Duplicate Procedure Reason
0
False
705
CWE
NDC Code
0
False
250
CWE
Payment Reference ID
0
False
250
CX
Transaction Reference Key
-1
False
4
SI
CTI
Clinical Trial Identification
True
Sponsor Study ID
0
True
427
EI
Study Phase Identifier
0
False
705
CWE
Study Scheduled Time Point
0
False
705
CWE
BLG
Billing
True
When to Charge
0
False
40
CCD
Charge Type
0
False
50
ID
Account ID
0
False
100
CX
Charge Type Reason
0
False
60
CWE
TQ1
Timing/Quantity
True
Set ID - TQ1
0
False
4
SI
Quantity
0
False
20
CQ
Repeat Pattern
-1
False
540
RPT
Explicit Time
-1
False
20
TM
Relative Time and Units
-1
False
20
CQ
Service Duration
0
False
20
CQ
Start date/time
0
False
24
DTM
End date/time
0
False
24
DTM
Priority
-1
False
250
CWE
Condition text
0
False
250
TX
Text instruction
0
False
250
TX
Conjunction
0
False
10
ID
Occurrence duration
0
False
20
CQ
Total occurrences
0
False
10
NM
TQ2
Timing/Quantity Relationship
True
Set ID - TQ2
0
False
4
SI
Sequence/Results Flag
0
False
1
ID
Related Placer Number
-1
False
22
EI
Related Filler Number
-1
False
22
EI
Related Placer Group Number
-1
False
22
EI
Sequence Condition Code
0
False
2
ID
Cyclic Entry/Exit Indicator
0
False
1
ID
Sequence Condition Time Interval
0
False
20
CQ
Cyclic Group Maximum Number of Repeats
0
False
10
NM
Special Service Request Relationship
0
False
1
ID
SPM
Specimen
True
Set ID - SPM
0
False
4
SI
Specimen ID
0
False
855
EIP
Specimen Parent IDs
-1
False
855
EIP
Specimen Type
0
True
705
CWE
Specimen Type Modifier
-1
False
705
CWE
Specimen Additives
-1
False
705
CWE
Specimen Collection Method
0
False
705
CWE
Specimen Source Site
0
False
705
CWE
Specimen Source Site Modifier
-1
False
705
CWE
Specimen Collection Site
0
False
705
CWE
Specimen Role
-1
False
705
CWE
Specimen Collection Amount
0
False
20
CQ
Grouped Specimen Count
0
False
6
NM
Specimen Description
-1
False
250
ST
Specimen Handling Code
-1
False
705
CWE
Specimen Risk Code
-1
False
705
CWE
Specimen Collection Date/Time
0
False
49
DR
Specimen Received Date/Time
0
False
24
DTM
Specimen Expiration Date/Time
0
False
24
DTM
Specimen Availability
0
False
1
ID
Specimen Reject Reason
-1
False
705
CWE
Specimen Quality
0
False
705
CWE
Specimen Appropriateness
0
False
705
CWE
Specimen Condition
-1
False
705
CWE
Specimen Current Quantity
0
False
722
CQ
Number of Specimen Containers
0
False
4
NM
Container Type
0
False
705
CWE
Container Condition
0
False
705
CWE
Specimen Child Role
0
False
705
CWE
DSC
Continuation Pointer
True
Continuation Pointer
0
False
180
ST
Continuation Style
0
False
1
ID
CT1
True
2
0
0
0
4
0
0
0
0
0
4
0
1
0
9
0
0
0
12
0
0
0
13
0
0
0
16
0
0
0
15
0
0
0
18
0
19
0
0
0
True
False
False
False
False
False
False
False
False
False
False
False
False
2
0
0
0
1
0
0
0
0
0
1
0
1
0
False
False
False
False
True
False
Message
False
False
False
0
group
MSH
False
False
False
0
segment
1
EVN
False
False
False
0
segment
0
PID
False
False
False
0
segment
3
PD1
True
False
False
0
segment
7
NK1
True
True
False
0
segment
10
PV1
False
False
False
0
segment
4
PV2
True
False
False
0
segment
11
OBX
True
True
False
0
segment
13
AL1
True
True
False
0
segment
14
DG1
True
True
False
0
segment
15
DRG
True
False
False
0
segment
16
PROCEDURE
True
True
False
0
group
PR1
False
False
False
0
segment
17
ROL
True
True
False
0
segment
9
GT1
True
True
False
0
segment
18
INSURANCE
True
True
False
0
group
IN1
False
False
False
0
segment
19
IN2
True
False
False
0
segment
20
IN3
True
True
False
0
segment
21
ROL
True
True
False
0
segment
9
ACC
True
False
False
0
segment
22
UB1
True
False
False
0
segment
23
UB2
True
False
False
0
segment
24
PDA
True
False
False
0
segment
25
MSH
ADT
8
0
0
0
group
-1
0
table
-1
Mapset
table
-1
Mapset
True
False
Message
False
False
False
0
group
MSH
False
False
False
0
segment
1
group
-1
0
True
False
Message
False
False
False
0
group
MSH
False
False
False
0
segment
1
NTE
True
True
False
0
segment
26
PATIENT
True
False
False
0
group
PID
False
False
False
0
segment
3
PD1
True
False
False
0
segment
7
NTE
True
True
False
0
segment
26
PATIENT_VISIT
True
False
False
0
group
PV1
False
False
False
0
segment
4
PV2
True
False
False
0
segment
11
INSURANCE
True
True
False
0
group
IN1
False
False
False
0
segment
19
IN2
True
False
False
0
segment
20
IN3
True
False
False
0
segment
21
GT1
True
False
False
0
segment
18
AL1
True
True
False
0
segment
14
ORDER
False
True
False
0
group
ORC
False
False
False
0
segment
27
ORDER_DETAIL
True
False
False
0
group
OBR
False
False
False
0
segment
28
RQD
False
False
False
0
segment
29
RQ1
False
False
False
0
segment
30
RXO
False
False
False
0
segment
31
ODS
False
False
False
0
segment
32
ODT
False
False
False
0
segment
33
NTE
True
True
False
0
segment
26
CTD
True
False
False
0
segment
34
DG1
True
True
False
0
segment
15
OBSERVATION
True
True
False
0
group
OBX
False
False
False
0
segment
13
NTE
True
True
False
0
segment
26
FT1
True
True
False
0
segment
35
CT1
True
True
False
0
segment
42
BLG
True
False
False
0
segment
37
MSH
ORU
8
0
0
0
group
-1
0
table
-1
Mapset
table
-1
Mapset
0
48
92
69
6
HL7
True
True
32
255
HL7
False
46
STANDARD VER 2
False
True
3
False
2
False
True
MSH
True
2
13
0
0
0
-1
-1
124
126
70
82
3
5
94
0
83
0
4
-1
38
0
84
0
7
-1
True
True