1 ST REQ NO_RPT /* 1 Field Separator */ 4 ST REQ NO_RPT /* 2 Encoding Characters */ 15 ST OPT NO_RPT /* 3 Sending Application */ 20 ST OPT NO_RPT /* 4 Sending Facility */ 15 ST OPT NO_RPT /* 5 Receiving Application */ 30 ST OPT NO_RPT /* 6 Receiving Facility */ 19 TS OPT NO_RPT /* 7 Date/Time of Message */ 40 ST OPT NO_RPT /* 8 Security */ 7 ID REQ NO_RPT /* 9 Message Type */ 20 ST REQ NO_RPT /* 10 Message Control ID */ 1 ID REQ NO_RPT /* 11 Processing ID */ 8 NM REQ NO_RPT /* 12 Version ID */ 15 NM OPT NO_RPT /* 13 Sequence Number */ 180 ST OPT NO_RPT /* 14 Continuation Pointer */ MSH 2 ID, REQ NO_RPT /* 1 Acknowledgement Code */ 20 ST REQ NO_RPT /* 2 Message Control ID */ 80 ST OPT NO_RPT /* 3 Text Message */ 15 NM OPT NO_RPT /* 4 Expected Sequence Number */ 1 ID OPT NO_RPT /* 5 Delayed Ack Type */ MSA 3 ID REQ NO_RPT /* 1 Event Type Code */ 19 TS REQ NO_RPT /* 2 Date/Time of Event */ 19 TS OPT NO_RPT /* 3 Date/Time Planned Event */ 3 ID OPT NO_RPT /* 4 Event Reason Code */ EVN 16 CK REQ NO_RPT /* 1 Prior Patient ID - Int */ 16 CK OPT NO_RPT /* 2 Prior Alt Patient ID */ 20 ST OPT NO_RPT /* 3 Prior Patient Account # */ MRG 12 ID REQ NO_RPT /* 1 Bed location */ 1 ID OPT NO_RPT /* 2 Bed Status */ NPU 4 SI OPT NO_RPT /* 1 Set ID - Patient ID */ 16 CK OPT NO_RPT /* 2 Patient ID (External ID) */ 16 CK REQ NO_RPT /* 3 Patient ID (Internal ID) */ 12 ST OPT NO_RPT /* 4 Alternate Patient ID */ 48 PN REQ NO_RPT /* 5 Patient's Name */ 30 ST OPT NO_RPT /* 6 Mother's Maiden Name */ 8 DT OPT NO_RPT /* 7 Date of Birth */ 1 ID OPT NO_RPT /* 8 Sex */ 48 PN OPT NO_MAX /* 9 Patient Alias */ 1 ID OPT NO_RPT /* 10 Ethnic Group */ 106 AD OPT NO_RPT /* 11 Patient Address */ 4 ID OPT NO_RPT /* 12 County Code */ 40 TN OPT NO_RPT /* 13 Phone Number - Home */ 40 TN OPT NO_RPT /* 14 Phone Number - Business */ 25 ST OPT NO_RPT /* 15 Language - Patient */ 1 ID OPT NO_RPT /* 16 Marital Status */ 3 ID OPT NO_RPT /* 17 Religion */ 20 CK OPT NO_RPT /* 18 Patient Account Number */ 16 ST OPT NO_RPT /* 19 SSN Number - Patient */ 25 CM OPT NO_RPT /* 20 Drivers License - Patient */ PID 4 SI OPT NO_RPT /* 1 Set Id */ 1 ID REQ NO_RPT /* 2 Patient Class */ 12 ID REQ NO_RPT /* 3 Assigned Patient Location */ 2 ID OPT NO_RPT /* 4 Admission Type */ 20 ST OPT NO_RPT /* 5 Pre-Admit Number */ 12 ID OPT NO_RPT /* 6 Prior Patient Location */ 60 CN OPT NO_RPT /* 7 Attending Doctor */ 60 CN OPT NO_RPT /* 8 Refering Doctor */ 60 CN OPT NO_MAX /* 9 Consulting Doctor */ 3 ID OPT NO_RPT /* 10 Hospital Service */ 12 ID OPT NO_RPT /* 11 Temporary Location */ 2 ID OPT NO_RPT /* 12 Pre-Admit Test Indicator */ 2 ID OPT NO_RPT /* 13 Re-Admission Indicator */ 3 ID OPT NO_RPT /* 14 Admit Source */ 2 ID OPT NO_RPT /* 15 Ambulatory Status */ 2 ID OPT NO_RPT /* 16 VIP Indicators */ 60 CN OPT NO_RPT /* 17 Admitting Doctor */ 2 ID OPT NO_RPT /* 18 Patient Type */ 4 NM OPT NO_RPT /* 19 Visit Number */ 11 ID OPT NO_RPT /* 20 Financial Class */ 2 ID OPT NO_RPT /* 21 Charge Price Indicator */ 2 ID OPT NO_RPT /* 22 Courtesy Code */ 2 ID OPT NO_RPT /* 23 Credit Rating */ 2 ID OPT NO_MAX /* 24 Contract Code */ 8 DT OPT NO_MAX /* 25 Contract Effective Date */ 12 NM OPT NO_MAX /* 26 Contract Amount */ 3 NM OPT NO_MAX /* 27 Contract Period */ 2 ID OPT NO_RPT /* 28 Interest Code */ 1 ID OPT NO_RPT /* 29 Transfer to Bad Debt Code */ 8 DT OPT NO_RPT /* 30 Transfer to Bad Debt Date */ 10 ST OPT NO_RPT /* 31 Bad Debt Agency Code */ 12 NM OPT NO_RPT /* 32 Bad Debt Transfer Amount */ 12 NM OPT NO_RPT /* 33 Bad Debt Recovery Amount */ 1 ID OPT NO_RPT /* 34 Delete Account Indicator */ 8 DT OPT NO_RPT /* 35 Delete Account Date */ 2 ID OPT NO_RPT /* 36 Discharge Disposition */ 2 ID OPT NO_RPT /* 37 Discharged to Location */ 2 ID OPT NO_RPT /* 38 Diet Type */ 2 ID OPT NO_RPT /* 39 Servicing Facility */ 1 ID OPT NO_RPT /* 40 Bed Status */ 2 ID OPT NO_RPT /* 41 Account Status */ 12 ID OPT NO_RPT /* 42 Pending Location */ 12 ID OPT NO_RPT /* 43 Prior Temporary Location */ 19 TS OPT NO_RPT /* 44 Admit Date/Time */ 19 TS OPT NO_RPT /* 45 Discharge Date/Time */ 12 NM OPT NO_RPT /* 46 Current Patient Balance */ 12 NM OPT NO_RPT /* 47 Total Charges */ 12 NM OPT NO_RPT /* 48 Total Adjustments */ 12 NM OPT NO_RPT /* 49 Total Payments */ PV1 4 SI OPT NO_RPT /* 1 Set Id */ 75 CM OPT NO_RPT /* 2 Placer Orders # */ 75 CM OPT NO_RPT /* 3 Fillers Order # */ 200 CE REQ NO_RPT /* 4 Universal Service ID */ 2 ST OPT NO_RPT /* 5 Priority */ 19 TS OPT NO_RPT /* 6 Requested Date/Time */ 19 TS REQ NO_RPT /* 7 Observation Date/Time */ 19 TS REQ NO_RPT /* 8 Observation End Date/Time */ 20 CQ REQ NO_RPT /* 9 Collection Volume */ 60 CN OPT NO_MAX /* 10 Collector Identifier */ 1 ST OPT NO_RPT /* 11 Specimen Action Code */ 60 CM OPT NO_RPT /* 12 Danger Code */ 300 ST OPT NO_RPT /* 13 Relevant Clinical Info. */ 19 TS REQ NO_RPT /* 14 Specimen Rcvd Date/Time */ 300 CM OPT NO_RPT /* 15 Specimen Source */ 60 CN OPT NO_MAX /* 16 Ordering Provider */ 40 TN OPT 2 /* 17 Order Call Back Phone Num */ 60 ST OPT NO_RPT /* 18 Placers Field #1 */ 60 ST OPT NO_RPT /* 19 Placers Field #2 */ 60 ST OPT NO_RPT /* 20 Fillers Field #1 */ 60 ST OPT NO_RPT /* 21 Fillers Field #2 */ 19 TS REQ NO_RPT /* 22 Results Rpt/Status Chg-dt */ 40 CM OPT NO_RPT /* 23 Charge to Practice */ 10 ID OPT NO_RPT /* 24 Diagnostic Serv Sect Id */ 1 ID OPT NO_RPT /* 25 Result Status */ 200 CE OPT NO_RPT /* 26 Linked Results */ 200 CM OPT NO_MAX /* 27 Quantity/Timing */ 80 CN OPT 5 /* 28 Result Copies to */ 150 CM OPT NO_RPT /* 29 Parent Accession # */ 20 ID OPT NO_RPT /* 30 Transportation Mode */ 300 CE OPT NO_MAX /* 31 Reason for Study */ 60 CN OPT NO_RPT /* 32 Prin Result Interpreter */ 60 CN OPT NO_RPT /* 33 Asst Result Interpreter */ 60 CN OPT NO_RPT /* 34 Technician */ 60 CN OPT NO_RPT /* 35 Transcriptionist */ 19 TS OPT NO_RPT /* 36 Scheduled Date/Time */ OBR 4 SI OPT NO_RPT /* 1 Set Id */ 2 ID OPT NO_RPT /* 2 Value Type */ 80 CE REQ NO_RPT /* 3 Observation Identifier */ 20 ST OPT NO_RPT /* 4 Observation Sub-Id */ 65535 ST REQ NO_RPT /* 5 Observation Results */ 20 ST OPT NO_RPT /* 6 Units */ 60 ST OPT NO_RPT /* 7 Reference Range */ 10 ST OPT 5 /* 8 Abnormal Flags */ 5 NM OPT NO_RPT /* 9 Probability */ 5 ID OPT NO_RPT /* 10 Nature of Abnormal Test */ 2 ID OPT NO_RPT /* 11 Observ Result Status */ 19 TS OPT NO_RPT /* 12 Date Last Normal Value */ OBX 4 SI REQ NO_RPT /* 1 Set ID - Diagnosis */ 2 ID REQ NO_RPT /* 2 Diagnosis Coding Method */ 8 ID OPT NO_RPT /* 3 Diagnosis Code */ 40 ST OPT NO_RPT /* 4 Diagnosis Description */ 19 TS OPT NO_RPT /* 5 Diagnosis Date/Time */ 2 ID REQ NO_RPT /* 6 Diagnosis/DRG Type */ 4 ST OPT NO_RPT /* 7 Major Diagnostic Category */ 4 ID OPT NO_RPT /* 8 Diagnostic Related Group */ 2 ID OPT NO_RPT /* 9 DRG Approval Indicator */ 2 ID OPT NO_RPT /* 10 DRG Grouper Review Code */ 2 ID OPT NO_RPT /* 11 Outlier Type */ 3 NM OPT NO_RPT /* 12 Outlier Days */ 12 NM OPT NO_RPT /* 13 Outlier Cost */ 4 ST OPT NO_RPT /* 14 Grouper Version and Type */ DG1 4 SI OPT NO_RPT /* 1 Set ID - Financial Trans */ 12 ST OPT NO_RPT /* 2 Transaction ID */ 5 ST OPT NO_RPT /* 3 Transaction Batch ID */ 8 DT REQ NO_RPT /* 4 Transaction Date */ 8 DT OPT NO_RPT /* 5 Transaction Posting Date */ 8 ID REQ NO_RPT /* 6 Transaction Type */ 20 ID REQ NO_RPT /* 7 Transaction Code */ 40 ST OPT NO_RPT /* 8 Transaction Description */ 40 ST OPT NO_RPT /* 9 Transaction Desc. - Alt */ 4 NM OPT NO_RPT /* 10 Transaction Quantity */ 12 NM OPT NO_RPT /* 11 Transaction Amount - Ext. */ 12 NM OPT NO_RPT /* 12 Transaction Amount - Unit */ 16 ST OPT NO_RPT /* 13 Department Code */ 8 ID OPT NO_RPT /* 14 Insurance Plan ID */ 12 NM OPT NO_RPT /* 15 Insurance Amount */ 12 ST OPT NO_RPT /* 16 Patient Location */ 1 ID OPT NO_RPT /* 17 Fee Schedule */ 2 ID OPT NO_RPT /* 18 Patient Type */ 8 ID OPT NO_RPT /* 19 Diagnosis Code */ 60 CN OPT NO_RPT /* 20 Performed by Code */ 60 CN OPT NO_RPT /* 21 Ordered by Code */ 12 NM OPT NO_RPT /* 22 Unit Cost */ FT1 4 SI REQ NO_RPT /* 1 Set ID - Guarantor */ 20 ID OPT NO_RPT /* 2 Guarantor Number */ 48 PN REQ NO_RPT /* 3 Guarantor Name */ 48 PN OPT NO_RPT /* 4 Guarantor Spouse Name */ 106 AD OPT NO_RPT /* 5 Guarantor Address */ 40 TN OPT NO_RPT /* 6 Guarantor Phone - Home */ 40 TN OPT NO_RPT /* 7 Guarantor Phone - Bus. */ 8 DT OPT NO_RPT /* 8 Guarantor Date of Birth */ 1 ID OPT NO_RPT /* 9 Guarantor Sex */ 2 ID OPT NO_RPT /* 10 Guarantor Type */ 2 ID OPT NO_RPT /* 11 Guarantor Relationship */ 11 ST OPT NO_RPT /* 12 Guarantor SSN */ 8 DT OPT NO_RPT /* 13 Guarantor Date - Begin */ 8 DT OPT NO_RPT /* 14 Guarantor Date - End */ 2 NM OPT NO_RPT /* 15 Guarantor Priority */ 45 ST OPT NO_RPT /* 16 Guarantor Employer Name */ 106 AD OPT NO_RPT /* 17 Guarantor Employer Addr */ 40 TN OPT NO_RPT /* 18 Guarantor Employer Phone */ 20 ST OPT NO_RPT /* 19 Guarantor Employee ID # */ 2 ID OPT NO_RPT /* 20 Guarantor Employmt Status */ GT1 4 SI REQ NO_RPT /* 1 Set ID - Insurance */ 8 ID REQ NO_RPT /* 2 Insurance Plan ID */ 6 ST REQ NO_RPT /* 3 Insurance Company ID */ 45 ST OPT NO_RPT /* 4 Insurance Company Name */ 106 AD OPT NO_RPT /* 5 Insurance Company Address */ 48 PN OPT NO_RPT /* 6 Insurance Co Contact Pers */ 40 TN OPT NO_RPT /* 7 Insurance Co Phone Number */ 12 ST OPT NO_RPT /* 8 Group Number */ 35 ST OPT NO_RPT /* 9 Group Name */ 12 ST OPT NO_RPT /* 10 Insured's Group Emp. ID */ 45 ST OPT NO_RPT /* 11 Insured's Group Emp. Name */ 8 DT OPT NO_RPT /* 12 Plan Effective Date */ 8 DT OPT NO_RPT /* 13 Plan Expiration Date */ 55 ST OPT NO_RPT /* 14 Authorization Information */ 2 ID OPT NO_RPT /* 15 Plan Type */ 48 PN OPT NO_RPT /* 16 Name of Insured */ 2 ID OPT NO_RPT /* 17 Insured's Relation to Pat */ 8 DT OPT NO_RPT /* 18 Insured's Date of Birth */ 106 AD OPT NO_RPT /* 19 Insured's Address */ 2 ID OPT NO_RPT /* 20 Assignment of Benefits */ 2 ID OPT NO_RPT /* 21 Coordination of Benefits */ 2 ST OPT NO_RPT /* 22 Coord. of Ben. Priority */ 2 ID OPT NO_RPT /* 23 Notice of Admission Code */ 8 DT OPT NO_RPT /* 24 Notice of Admission Date */ 2 ID OPT NO_RPT /* 25 Rpt of Eligibility Code */ 8 DT OPT NO_RPT /* 26 Rpt of Eligibility Date */ 2 ID OPT NO_RPT /* 27 Release Information Code */ 15 ST OPT NO_RPT /* 28 Pre-Admit Cert. (PAC) */ 8 DT OPT NO_RPT /* 29 Verification Date */ 60 CM OPT NO_RPT /* 30 Verification By */ 2 ID OPT NO_RPT /* 31 Type of Agreement Code */ 2 ID OPT NO_RPT /* 32 Billing Status */ 4 NM OPT NO_RPT /* 33 Lifetime Reserve Days */ 4 NM OPT NO_RPT /* 34 Delay Before L. R. Day */ 8 ST OPT NO_RPT /* 35 Company Plan Code */ 15 ST OPT NO_RPT /* 36 Policy Number */ 12 NM OPT NO_RPT /* 37 Policy Deductible */ 12 NM OPT NO_RPT /* 38 Policy Limit - Amount */ 4 NM OPT NO_RPT /* 39 Policy Limit - Days */ 12 NM OPT NO_RPT /* 40 Room Rate - Semi-Private */ 12 NM OPT NO_RPT /* 41 Room Rate - Private */ 1 ID OPT NO_RPT /* 42 Insured's Employ Status */ 1 ID OPT NO_RPT /* 43 Insured's Sex */ 106 AD OPT NO_RPT /* 44 Insured's Employer Addr */ IN1 4 SI REQ NO_RPT /* 1 Set ID - Next of Kin */ 48 PN OPT NO_RPT /* 2 Next of Kin Name */ 15 ST OPT NO_RPT /* 3 Next of Kin Relationship */ 106 AD OPT NO_RPT /* 4 Next of Kin Address */ 40 TN OPT NO_MAX /* 5 Next of Kin Phone Number */ NK1 4 SI REQ NO_MAX /* 1 Set ID - Procedure */ 2 ID REQ NO_MAX /* 2 Procedure Coding Method */ 10 ID REQ NO_MAX /* 3 Procedure Code */ 40 ST OPT NO_MAX /* 4 Procedure Description */ 19 TS REQ NO_RPT /* 5 Procedure Date/Time */ 2 ID REQ NO_RPT /* 6 Procedure Type */ 4 NM OPT NO_RPT /* 7 Procedure Minutes */ 60 CN OPT NO_RPT /* 8 Anesthesiologist */ 2 ID OPT NO_RPT /* 9 Anesthesia Code */ 4 NM OPT NO_RPT /* 10 Anesthesia Minutes */ 60 CN OPT NO_RPT /* 11 Surgeon */ 60 CN OPT NO_RPT /* 12 Resident Code */ 2 ID OPT NO_RPT /* 13 Consent Code */ PR1 19 TS OPT NO_RPT /* 1 Accident date/time */ 2 ID OPT NO_RPT /* 2 Accident code */ 25 ST OPT NO_RPT /* 3 Accident Location */ ACC 4 SI OPT NO_RPT /* 1 Set ID - UB82 */ 1 ST OPT NO_RPT /* 2 Blood Deductible */ 2 ST OPT NO_RPT /* 3 Blood Furn.-Pints of (40) */ 2 ST OPT NO_RPT /* 4 Blook Replaced-Pints (41) */ 2 ST OPT NO_RPT /* 5 Blood Not Rplcd-Pints(42) */ 2 ST OPT NO_RPT /* 6 Co-Insurance Days (25) */ 2 ID OPT 5 /* 7 Condition Code */ 3 ST OPT NO_RPT /* 8 Covered Days (23) */ 3 ST OPT NO_RPT /* 9 Non-Covered Days (24) */ 12 CM OPT 8 /* 10 Value Amount & Code */ 2 ST OPT NO_RPT /* 11 Number of Grace Days (90) */ 2 ID OPT NO_RPT /* 12 Spec. Prog. Indicator(44) */ 1 ID OPT NO_RPT /* 13 PSRO/UR Approvl Ind. (87) */ 8 DT OPT NO_RPT /* 14 PSRO/UR Aprvd Stay-Fm(88) */ 8 DT OPT NO_RPT /* 15 PSRO/UR Aprvd Stay-To(89) */ 20 ID OPT 5 /* 16 Occurrence (28-32) */ 2 ID OPT NO_RPT /* 17 Occurrence Span (33) */ 8 DT OPT NO_RPT /* 18 Occur Span Start Date(33) */ 8 DT OPT NO_RPT /* 19 Occur Span End Date (33) */ 30 ST OPT NO_RPT /* 20 UB-82 Locator 2 */ 7 ST OPT NO_RPT /* 21 UB-82 Locator 9 */ 8 ST OPT NO_RPT /* 22 UB-82 Locator 27 */ 17 ST OPT NO_RPT /* 23 UB-82 Locator 45 */ UB1 60 ST OPT NO_RPT /* */ ADD 1 ST REQ NO_RPT /* 1 Batch Field Separator */ 3 ST REQ NO_RPT /* 2 Batch Encoding Characters */ 15 ST OPT NO_RPT /* 3 Batch Sending Application */ 20 ST OPT NO_RPT /* 4 Batch Sending Facility */ 15 ST OPT NO_RPT /* 5 Batch Rcving Application */ 20 ST OPT NO_RPT /* 6 Batch Receiving Facility */ 19 TS OPT NO_RPT /* 7 Batch Creation Date/Time */ 40 ST OPT NO_RPT /* 8 Batch Security */ 20 ST OPT NO_RPT /* 9 Batch Name/ID/Type */ 80 ST OPT NO_RPT /* 10 Batch Comment */ 20 ST OPT NO_RPT /* 11 Batch Control ID */ 20 ST OPT NO_RPT /* 12 Reference Batch Cntrl ID */ BHS 10 ST OPT NO_RPT /* 1 Batch Message Count */ 80 ST OPT NO_RPT /* 2 Batch Comment */ 100 CM OPT NO_RPT /* 3 Batch Totals */ BTS 80 ID REQ NO_MAX /* 1 Error Code and Location */ ERR 1 ST REQ NO_RPT /* 1 File Field Separators */ 4 ST REQ NO_RPT /* 2 File Encoding Characters */ 15 ST OPT NO_RPT /* 3 File Sending Application */ 20 ST OPT NO_RPT /* 4 File Sending Facility */ 15 ST OPT NO_RPT /* 5 File Rcving Application */ 20 ST OPT NO_RPT /* 6 File Receiving Facility */ 19 TS OPT NO_RPT /* 7 File Creation Date/Time */ 40 ST OPT NO_RPT /* 8 File Security */ 20 ST OPT NO_RPT /* 9 File Name/ID/Type */ 80 ST OPT NO_RPT /* 10 File Comment */ 20 ST OPT NO_RPT /* 11 File Control ID */ 20 ST OPT NO_RPT /* 12 Reference File Cntrl ID */ FHS 10 ST OPT NO_RPT /* 1 File Batch Count */ 80 CM OPT NO_RPT /* 2 File Trailer Comment */ FTS 4 SI OPT NO_RPT /* 1 Set ID */ 8 ID OPT NO_RPT /* 2 Source of Comment */ 120 TX REQ NO_MAX /* 3 Comment */ NTE 15 CM OPT NO_RPT /* 1 When to Charge */ 50 CM OPT NO_RPT /* 2 Value Type */ 100 CM OPT NO_RPT /* 3 Observation Identifier */ BLG 2 ST REQ NO_RPT /* 1 Order Control */ 75 CM OPT NO_RPT /* 2 Placer Order # */ 75 CM OPT NO_RPT /* 3 Filler Order # */ 75 CM OPT NO_RPT /* 4 Placer Order # */ 2 ST OPT NO_RPT /* 5 Order Status */ 200 ST OPT NO_RPT /* 6 Response Flag */ 200 CM OPT NO_RPT /* 7 Timing/Quantity */ 19 CM OPT NO_RPT /* 8 Parent */ 80 TS OPT NO_RPT /* 9 Date/Time of Transaction */ 80 CN OPT NO_RPT /* 10 Enterted BY */ 80 CN OPT NO_RPT /* 11 Verified By */ 80 CN OPT NO_RPT /* 12 Ordering Provider */ 80 CM OPT NO_RPT /* 13 Enterer's Location */ 40 TN OPT 2 /* 14 Call Back Phone Number */ ORC 200 CE OPT NO_RPT /* 1 Order Item Id */ 1 ID OPT NO_RPT /* 2 Substitute Allowed */ 80 CN OPT NO_MAX /* 3 Results Copied To */ 2 ID OPT NO_RPT /* 4 Stock Location */ ORO 0 UN OPT NO_RPT /* 1 Unused */ 0 UN OPT NO_RPT /* 2 Unused */ 8 ST OPT NO_RPT /* 3 Route */ 20 ST OPT NO_RPT /* 4 Site Administered */ 10 CQ OPT NO_RPT /* 5 IV Solution Rate */ 14 CQ OPT NO_RPT /* 6 Drug Strength */ 10 NM OPT NO_RPT /* 7 Final Concentration */ 10 NM OPT NO_RPT /* 8 Final Volume in Ml. */ 10 CM OPT NO_RPT /* 9 Drug Dose */ 1 ID OPT NO_RPT /* 10 Drug Role */ 3 NM OPT NO_RPT /* 11 Prescription Sequence Num */ 4 CQ OPT NO_RPT /* 12 Quantity Dispensed */ 0 UN OPT NO_RPT /* 13 Unused */ 5 CE OPT NO_RPT /* 14 Drug ID */ 5 ID OPT 5 /* 15 Component Drug IDs */ 2 ID OPT NO_RPT /* 16 Prescription Type */ 1 ID OPT NO_RPT /* 17 Substitution Status */ 2 ID OPT NO_RPT /* 18 Rx Order Status */ 3 NM OPT NO_RPT /* 19 Number of Refills */ 0 UN OPT NO_RPT /* 20 Unused */ 3 NM OPT NO_RPT /* 21 Refills Remaining */ 5 ID OPT NO_RPT /* 22 DEA Class */ 10 NM OPT NO_RPT /* 23 Ordering Md's DEA Number */ 0 UN OPT NO_RPT /* 24 Unused */ 19 TS OPT NO_RPT /* 25 Last Refill Date/Time */ 20 ST OPT NO_RPT /* 26 RX Number */ 5 ID OPT NO_RPT /* 27 PRN Status */ 80 TX OPT 5 /* 28 Pharmacy Instructions */ 80 TX OPT 5 /* 29 Patient Instruction */ 500 TX OPT NO_MAX /* 30 Instructions (SIG) */ RX1 60 TYPE_ST OPT NO_RPT /* 1 Continuation Pointer */ DSC 4 TYPE_SI OPT NO_RPT /* 1 Set ID - Display Data */ 4 TYPE_SI OPT NO_RPT /* 2 Display Level */ 300 TYPE_TX REQ NO_RPT /* 3 Data Line */ 2 TYPE_ST OPT NO_RPT /* 4 Logical Break Point */ 20 TYPE_TX OPT NO_RPT /* 5 Result ID */ DSP 19 TYPE_TS REQ NO_RPT /* 1 Query Date/Time */ 1 TYPE_ID REQ NO_RPT /* 2 Query Format Code */ 1 TYPE_ID REQ NO_RPT /* 3 Query Priority */ 10 TYPE_ST REQ NO_RPT /* 4 Query ID */ 1 TYPE_ID OPT NO_RPT /* 5 Deferred Response Type */ 19 TYPE_TS OPT NO_RPT /* 6 Def. Resp. Date/Time */ 5 TYPE_CQ REQ NO_RPT /* 7 Quantity Limited Request */ 20 TYPE_ST REQ NO_MAX /* 8 Who Subject Filter */ 3 TYPE_ID REQ NO_MAX /* 9 What Subject Filter */ 20 TYPE_ST REQ NO_MAX /* 10 What Dept. Data Code */ 20 TYPE_ST OPT NO_MAX /* 11 What data Cd. Value Qua. */ 1 TYPE_ID OPT NO_RPT /* 12 Query Results Level */ QRD 20 TYPE_ST REQ NO_MAX /* 1 Where Subject Filter */ 19 TYPE_TS OPT NO_RPT /* 2 When Data Start Date/Time */ 19 TYPE_TS OPT NO_RPT /* 3 When Data End Date/Time */ 20 TYPE_ST OPT NO_MAX /* 4 What User Qualifier */ 20 TYPE_ST OPT NO_MAX /* 5 Other Qry Subject Filter */ QRF 19 TYPE_SI OPT NO_RPT /* 1 R/U Date/Time */ 1 TYPE_CK OPT NO_RPT /* 2 Report Priority */ 20 TYPE_CK REQ NO_MAX /* 3 R/U Who Subject Defnition */ 3 TYPE_ST OPT NO_MAX /* 4 R/U What Subject Defntion */ 20 TYPE_PN OPT NO_MAX /* 5 R/U What Department Code */ 20 TYPE_ST OPT NO_MAX /* 6 R/U Display/Print Locs */ 1 TYPE_DT OPT NO_RPT /* 7 R/U Results Level */ URD 20 TYPE_ST REQ NO_MAX /* 1 R/U Where Subject Def. */ 19 TYPE_TS OPT NO_RPT /* 2 R/U When Start Dte/Tme */ 19 TYPE_TS OPT NO_RPT /* 3 R/U When End Dte/Tme */ 20 TYPE_ST OPT NO_MAX /* 4 R/U What User Qualifier */ 20 TYPE_ST OPT NO_MAX /* 5 R/U Oth Results Def. */ URS