Created by ProtoGen r1.2 (c) 1994, 1995, 1996 by Gunther Schadow. All rights reserved
MESSAGES SEGMENTS TABLES COMPOSITES
HL7 SEGMENTS

HL7 SEGMENTS

CHAPTER 2 CNT - CONTROL/QUERY

SEGMENT ADD - ADDENDUM

SEQNAMETYPETABLER/OREPLENITEM#
1ADDENDUM CONTINUATION POINTERST6553666

SEGMENT BHS - BATCH HEADER

SEQNAMETYPETABLER/OREPLENITEM#
3BATCH SENDING APPLICATIONST1583
4BATCH SENDING FACILITYST2084
5BATCH RECEIVING APPLICATIONST1585
6BATCH RECEIVING FACILITYST2086
7BATCH CREATION DATE/TIMETS2687
8BATCH SECURITYST4088
9BATCH NAME/ID/TYPEST2089
10BATCH COMMENTST8090
11BATCH CONTROL IDST2091
12REFERENCE BATCH CONTROL IDST2092

SEGMENT BTS - BATCH TRAILER

SEQNAMETYPETABLER/OREPLENITEM#
1BATCH MESSAGE COUNTST1093
2BATCH COMMENTST8096
3BATCH TOTALSCMy10095

SEGMENT DSC - CONTINUATION POINTER

SEQNAMETYPETABLER/OREPLENITEM#
1CONTINUATION POINTERST18060

SEGMENT DSP - DISPLAY DATA

SEQNAMETYPETABLER/OREPLENITEM#
1SET ID - DISPLAY DATASI461
2DISPLAY LEVELSI462
3DATA LINETXr30063
4LOGICAL BREAK POINTST264
5RESULT IDTX2065

SEGMENT ERR - ERROR

SEQNAMETYPETABLER/OREPLENITEM#
1ERROR CODE AND LOCATIONZE60ry8024

SEGMENT FHS - FILE HEADER

SEQNAMETYPETABLER/OREPLENITEM#
3FILE SENDING APPLICATIONST1569
4FILE SENDING FACILITYST2070
5FILE RECEIVING APPLICATIONST1571
6FILE RECEIVING FACILITYST2072
7FILE CREATION DATE/TIMETS2673
8FILE SECURITYST4074
9FILE NAME/IDST2075
10FILE HEADER COMMENTST8076
11FILE CONTROL IDST2077
12REFERENCE FILE CONTROL IDST2078

SEGMENT FTS - FILE TRAILER

SEQNAMETYPETABLER/OREPLENITEM#
1FILE BATCH COUNTNM1079
2FILE TRAILER COMMENTST8080

SEGMENT MSA - MESSAGE ACKNOWLEDGEMENT

SEQNAMETYPETABLER/OREPLENITEM#
1ACKNOWLEDGEMENT CODEID8r218
2MESSAGE CONTROL IDSTr2010
3TEXT MESSAGEST8020
4EXPECTED SEQUENCE NUMBERNM1521
5DELAYED ACKNOWLEDGEMENT TYPEID102122
6ERROR CONDITIONCE10023

SEGMENT MSH - MESSAGE HEADER

SEQNAMETYPETABLER/OREPLENITEM#
3SENDING APPLICATIONST153
4SENDING FACILITYST204
5RECEIVING APPLICATIONST305
6RECEIVING FACILITYST306
7DATE/TIME OF MESSAGETS267
8SECURITYST408
9MESSAGE TYPEZM9995r79
10MESSAGE CONTROL IDSTr2010
11PROCESSING IDID103r111
12VERSION IDID104r812
13SEQUENCE NUMBERNM1513
14CONTINUATION POINTERST18014
15ACCEPT ACKNOWLEDGEMENT TYPEID155215
16APPLICATION ACKNOWLEDGEMENT TYPEID155216
17COUNTRY CODEID217

SEGMENT NTE - NOTES AND COMMENTS

SEQNAMETYPETABLER/OREPLENITEM#
1SET ID - NOTES AND COMMENTSSI496
2SOURCE OF COMMENTID105897
3COMMENTFTy6553698

SEGMENT QRD - QUERY DEFINITION

SEQNAMETYPETABLER/OREPLENITEM#
1QUERY DATE/TIMETSr2625
2QUERY FORMAT CODEID106r126
3QUERY PRIORITYID91r127
4QUERY IDSTr1028
5DEFERRED RESPONSE TYPEID107129
6DEFERRED RESPONSE DATE/TIMETS2630
7QUANTITY LIMITED REQUESTCQ126r1031
8WHO SUBJECT FILTERSTry2032
9WHAT SUBJECT FILTERID48ry333
10WHAT DEPARTMENT DATA CODESTry2034
11WHAT DATA CODE VALUE QUAL.STy2035
12QUERY RESULTS LEVELID108136

SEGMENT QRF - QUERY FILTER

SEQNAMETYPETABLER/OREPLENITEM#
1WHERE SUBJECT FILTERSTry2037
2WHEN DATA START DATE/TIMETS2638
3WHEN DATA END DATE/TIMETS2639
4WHAT USER QUALIFIERSTy2040
5OTHER QRY SUBJECT FILTERSTy2041
6WHICH DATE/TIME QUALIFIERID156y1242
7WHICH DATE/TIME STATUS QUALIFIERID157y1243
8DATE/TIME SELECTION QUALIFIERID158y1244

SEGMENT URD - RESULTS/UPDATE DEFINITION

SEQNAMETYPETABLER/OREPLENITEM#
1R/U DATE/TIMETS2645
2REPORT PRIORITYID109146
3R/U WHO SUBJECT DEFINITIONSTry2047
4R/U WHAT SUBJECT DEFINITIONID48y348
5R/U WHAT DEPARTMENT CODESTy2049
6R/U DISPLAY/PRINT LOCATIONSSTy2050
7R/U RESULTS LEVELID108151

SEGMENT URS - UNSOLICITED SELECTION

SEQNAMETYPETABLER/OREPLENITEM#
1R/U WHERE SUBJECT DEFINITIONSTry2052
2R/U WHEN DATA START DATE/TIMETS2653
3R/U WHEN DATA END DATE/TIMETS2654
4R/U WHAT USER QUALIFIERSTy2055
5R/U OTHER RESULTS SUBJECT DEFINITIONSTy2056
6R/U WHICH DATE/TIME QUALIFIERID156y1257
7R/U WHICH DATE/TIME STATUS QUALIFIERID157y1258
8R/U DATE/TIME SELECTION QUALIFIERID158y1259

CHAPTER 3 ADT - REG/ADT

SEGMENT AL1 - PATIENT ALLERGY INFORMATION

SEQNAMETYPETABLER/OREPLENITEM#
1SET ID - ALLERGYSIr4203
2ALLERGY TYPEID1272204
3ALLERGY CODE/MNEMONIC/DESCRIPTIONCEr60205
4ALLERGY SEVERITYID1282206
5ALLERGY REACTIONST15207
6IDENTIFICATION DATEDT8208

SEGMENT EVN - EVENT TYPE

SEQNAMETYPETABLER/OREPLENITEM#
1EVENT TYPE CODEID9996r399
2DATE/TIME OF EVENTTSr26100
3DATE/TIME PLANNED EVENTTS26101
4EVENT REASON CODEID623102
5OPERATOR IDID1885103

SEGMENT MRG - MERGE PATIENT INFORMATION

SEQNAMETYPETABLER/OREPLENITEM#
1PRIOR PATIENT ID - INTERNALCKr20211
2PRIOR ALTERNATE PATIENT IDST16212
3PRIOR PATIENT ACCOUNT NUMBERCK20213
4PRIOR PATIENT ID - EXTERNALCK16214

SEGMENT NK1 - NEXT OF KIN

SEQNAMETYPETABLER/OREPLENITEM#
1SET ID - NEXT OF KINSIr4190
2NAMEPN48191
3RELATIONSHIPCE6360192
4ADDRESSAD106193
5PHONE NUMBERTNy/340194
6BUSINESS PHONE NUMBERTN40195
7CONTACT ROLECE13160196
8START DATEDT8197
9END DATEDT8198
10NEXT OF KIN JOB TITLEST60199
11NEXT OF KIN JOB CODE/CLASSCM20200
12NEXT OF KIN EMPLOYEE NUMBERST20201
13ORGANIZATION NAMEST60202

SEGMENT NPU - BED STATUS UPDATE

SEQNAMETYPETABLER/OREPLENITEM#
1BED LOCATIONZL79r12209
2BED STATUSID1161170

SEGMENT PID - PATIENT IDENTIFICATION

SEQNAMETYPETABLER/OREPLENITEM#
1SET ID - PATIENT IDSI4104
2PATIENT ID (EXTERNAL ID)CK16105
3PATIENT ID (INTERNAL ID)CKry20106
4ALTERNATE PATIENT IDST12107
5PATIENT NAMEPNr48108
6MOTHER'S MAIDEN NAMEST30109
7DATE OF BIRTHTS26110
8SEXID11111
9PATIENT ALIASPNy48112
10RACEID51113
11PATIENT ADDRESSADy/3106114
12COUNTY CODEID4115
13PHONE NUMBER - HOMETNy/340116
14PHONE NUMBER - BUSINESSTNy/340117
15LANGUAGE - PATIENTST25118
16MARITAL STATUSID21119
17RELIGIONID63120
18PATIENT ACCOUNT NUMBERCK20121
19SSN NUMBER - PATIENTST16122
20DRIVER'S LIC NUM - PATIENTCM25123
21MOTHER'S IDENTIFIERCK20124
22ETHNIC GROUPID1891125
23BIRTH PLACEST25126
24MULTIPLE BIRTH INDICATORID2127
25BIRTH ORDERNM2128
26CITIZENSHIPID171y3129
27VETERANS MILITARY STATUSCE17260130

SEGMENT PV1 - PATIENT VISIT

SEQNAMETYPETABLER/OREPLENITEM#
1SET ID - PATIENT VISITSI4131
2PATIENT CLASSID4r1132
3ASSIGNED PATIENT LOCATIONZL12133
4ADMISSION TYPEID72134
5PREADMIT NUMBERST20135
6PRIOR PATIENT LOCATIONZL12136
7ATTENDING DOCTORCN1060137
8REFERRING DOCTORCN1060138
9CONSULTING DOCTORCN10y60139
10HOSPITAL SERVICEID693140
11TEMPORARY LOCATIONZL7912141
12PREADMIT TEST INDICATORID872142
13READMISSION INDICATORID922143
14ADMIT SOURCEID233144
15AMBULATORY STATUSID9y2145
16VIP INDICATORID992146
17ADMITTING DOCTORCN1060147
18PATIENT TYPEID182148
19VISIT NUMBERCK15149
20FINANCIAL CLASSCM64y/450150
21CHARGE PRICE INDICATORID322151
22COURTESY CODEID452152
23CREDIT RATINGID462153
24CONTRACT CODEID44y2154
25CONTRACT EFFECTIVE DATEDTy8155
26CONTRACT AMOUNTNMy12156
27CONTRACT PERIODNMy3157
28INTEREST CODEID732158
29TRANSFER TO BAD DEBT CODEID1101159
30TRANSFER TO BAD DEBT DATEDT8160
31BAD DEBT AGENCY CODEID2110161
32BAD DEBT TRANSFER AMOUNTNM12162
33BAD DEBT RECOVERY AMOUNTNM12163
34DELETE ACCOUNT INDICATORID1111164
35DELETE ACCOUNT DATEDT8165
36DISCHARGE DISPOSITIONID1123166
37DISCHARGED TO LOCATIONCK11325167
38DIET TYPEID1142168
39SERVICING FACILITYID1152169
40BED STATUSID1161170
41ACCOUNT STATUSID1172171
42PENDING LOCATIONZL12172
43PRIOR TEMPORARY LOCATIONZL12173
44ADMIT DATE/TIMETS26174
45DISCHARGE DATE/TIMETS26175
46CURRENT PATIENT BALANCENM12176
47TOTAL CHARGESNM12177
48TOTAL ADJUSTMENTSNM12178
49TOTAL PAYMENTSNM12179
50ALTERNATE VISIT IDCM20180

SEGMENT PV2 - PATIENT VISIT - ADDITIONAL INFORMATION

SEQNAMETYPETABLER/OREPLENITEM#
1PRIOR PENDING LOCATIONZL12181
2ACCOMMODATION CODECE12960182
3ADMIT REASONCE490160183
4TRANSFER REASONCE60184
5PATIENT VALUABLESSTy25185
6PATIENT VALUABLES LOCATIONST25186
7VISIT USER CODEID1302187
8EXPECTED ADMIT DATEDT8188
9EXPECTED DISCHARGE DATEDT8189

CHAPTER 4 ORD - ORDER ENTRY

SEGMENT BLG - BILLING

SEQNAMETYPETABLER/OREPLENITEM#
1WHEN TO CHARGECM10015234
2CHARGE TYPEID12250235
3ACCOUNT IDCM100236

SEGMENT OBR - OBSERVATION REQUEST

SEQNAMETYPETABLER/OREPLENITEM#
1SET ID OBSERVATION REQUESTSI4237
2PLACER ORDER NUMBERCMc75216
3FILLER ORDER NUMBERCMc75217
4UNIVERSAL SERVICE IDCEr200238
5PRIORITY - NOT USED IN 2.2ID2239
6REQUESTED DATE/TIME - NOT USEDTS26240
7OBSERVATION DATE/TIMETSc26241
8OBSERVATION END DATE/TIMETSc26242
9COLLECTION VOLUMECQc20243
10COLLECTOR IDENTIFIERCNy60244
11SPECIMEN ACTION CODEID651245
12DANGER CODECE60246
13RELEVANT CLINICAL INFO.ST300247
14SPECIMEN RECEIVED DATE/TIMETSc26248
15SPECIMEN SOURCECM70300249
16ORDERING PROVIDERCN80226
17ORDER CALLBACK PHONE NUMBERTNy/240250
18PLACER FIELD 1ST60251
19PLACER FIELD 2ST60252
20FILLER FIELD 1ST60253
21FILLER FIELD 2ST60254
22RESULTS RPT/STATUS CHNG - DATE/TIMETSc26255
23CHARGE TO PRACTICECM40256
24DIAGNOSTIC SERV SECT IDID7410257
25RESULT STATUSID123c1258
26PARENT RESULTCM200259
27QUANTITY/TIMINGTQy200221
28RESULT COPIES TOCNy/5150260
29PARENT NUMBERCM150261
30TRANSPORTATION MODEID12420262
31REASON FOR STUDYCEy300263
32PRINCIPAL RESULT INTERPRETERCM60264
33ASSISTANT RESULT INTERPRETERCMy60265
34TECHNICIANCMy60266
35TRANSCRIPTIONISTCMy60267
36SCHEDULED DATE/TIMETS26268

SEGMENT ODS - DIETARY ORDERS, SUPPLEMENTS, AND PREFERENCES

SEQNAMETYPETABLER/OREPLENITEM#
1TYPEID159r1269
2SERVICE PERIODCEy1060270
3DIET, SUPPLEMENT, OR PREFERENCE CODECEry/2060271
4TEXT INSTRUCTIONSTy/280272

SEGMENT ODT - DIET TRAY INSTRUCTIONS

SEQNAMETYPETABLER/OREPLENITEM#
1TRAY TYPECE160r5273
2SERVICE PERIODCEy1060270
3TEXT INSTRUCTIONSST80272

SEGMENT ORC - COMMON ORDER

SEQNAMETYPETABLER/OREPLENITEM#
1ORDER CONTROLID119r2215
2PLACER ORDER NUMBERCMc75216
3FILLER ORDER NUMBERCMc75217
4PLACER GROUP NUMBERCM75218
5ORDER STATUSID382219
6RESPONSE FLAGID1211220
7QUANTITY/TIMINGTQ200221
8PARENTCM200222
9DATE/TIME OF TRANSACTIONTS26223
10ENTERED BYCN80224
11VERIFIED BYCN80225
12ORDERING PROVIDERCN80226
13ENTERER'S LOCATIONCM80227
14CALL BACK PHONE NUMBERTNy/240228
15ORDER EFFECTIVE DATE/TIMETS26229
16ORDER CONTROL CODE REASONCE200230
17ENTERING ORGANIZATIONCE60231
18ENTERING DEVICECE60232
19ACTION BYCN80233

SEGMENT RQ1 - REQUISITION DETAIL-1

SEQNAMETYPETABLER/OREPLENITEM#
1ANTICIPATED PRICEST10285
2MANUFACTURER IDCE60286
3MANUFACTURER'S CATALOGST16287
4VENDOR IDCE60288
5VENDOR CATALOGST16289
6TAXABLEID1361290
7SUBSTITUTE ALLOWEDID1361291

SEGMENT RQD - REQUISITION DETAIL

SEQNAMETYPETABLER/OREPLENITEM#
1REQUISITION LINE NUMBERSI4275
2ITEM CODE - INTERNALCE60276
3ITEM CODE - EXTERNALCE60277
4HOSPITAL ITEM CODECE60278
5REQUISITION QUANTITYNM6279
6REQUISITION UNIT OFCE60280
7DEPT. COST CENTERID30281
8ITEM NATURAL ACCOUNT CODEID30282
9DELIVER TO IDCE60283
10DATE NEEDEDDT8284

SEGMENT RXA - PHARMACY ADMINISTRATION

SEQNAMETYPETABLER/OREPLENITEM#
1GIVE SUB-ID COUNTERNMr4342
2ADMINISTRATION SUB-ID COUNTERNMr4344
3DATE/TIME START OF ADMINISTRATIONTSr26345
4DATE/TIME END OF ADMINISTRATIONTSr26346
5ADMINISTERED CODECEr100347
6ADMINISTERED AMOUNTNMr20348
7ADMINISTERED UNITSCEc60349
8ADMINISTERED DOSAGE FORMCE60350
9ADMINISTRATION NOTESSTc200351
10ADMINISTERING PROVIDERCN200352
11ADMINISTERED-AT LOCATIONIDc12353
12ADMINISTERED PER (TIME UNIT)STc20354

SEGMENT RXC - PHARMACY COMPONENT ORDER

SEQNAMETYPETABLER/OREPLENITEM#
1RX COMPONENT TYPEID166r1313
2COMPONENT CODECEr100314
3COMPONENT AMOUNTNMr20315
4COMPONENT UNITSCEr20316

SEGMENT RXD - PHARMACY DISPENSE

SEQNAMETYPETABLER/OREPLENITEM#
1DISPENSE SUB-ID COUNTERNMr4334
2DISPENSE/GIVE CODECEr100335
3DATE/TIME DISPENSEDTS26336
4ACTUAL DISPENSE AMOUNTNMr20337
5ACTUAL DISPENSE UNITSCEc60338
6ACTUAL DOSAGE FORMCE60339
7PRESCRIPTION NUMBERNMc20325
8NUMBER OF REFILLS REMAININGNMc20326
9DISPENSE NOTESCEcy200340
10DISPENSING PROVIDERCN200341
11SUBSTITUTION STATUSID1671322
12TOTAL DAILY DOSENM10329
13DISPENSE-TO LOCATIONIDc12299
14NEEDS HUMAN REVIEWID1307
15PHARMACY SPECIAL DISPENSING INSTRUCTIONSCEy200330

SEGMENT RXE - PHARMACY ENCODED ORDER

SEQNAMETYPETABLER/OREPLENITEM#
1QUANTITY/TIMINGTQr200221
2GIVE CODECEr100317
3GIVE AMOUNT - MINIMUMNMr20318
4GIVE AMOUNT - MAXIMUMNM20319
5GIVE UNITSCEr60320
6GIVE DOSAGE FORMCE60321
7PROVIDER'S ADMINISTRATION INSTRUCTIONSCEy200298
8DELIVER-TO LOCATIONCMc12299
9SUBSTITUTION STATUSID1671322
10DISPENSE AMOUNTNMc20323
11DISPENSE UNITSCEc60324
12NUMBER OF REFILLSNM3304
13ORDERING PROVIDER'S DEA NUMBERCNc60305
14PHARMACIST VERIFIER IDCNc60306
15PRESCRIPTION NUMBERSTr20325
16NUMBER OF REFILLS REMAININGNMc20326
17NUMBER OF REFILLS/DOSES DISPENSEDNMc20327
18D/T OF MOST RECENT REFILL OR DOSE DISPENSEDTSc26328
19TOTAL DAILY DOSECQc10329
20NEEDS HUMAN REVIEWID1307
21PHARMACY SPECIAL DISPENSING INSTRUCTIONSST200330
22GIVE PER (TIME UNIT)STc20331
23GIVE RATE AMOUNTST6332
24GIVE RATE UNITSCE60333

SEGMENT RXG - PHARMACY GIVE

SEQNAMETYPETABLER/OREPLENITEM#
1GIVE SUB-ID COUNTERNMr4342
2DISPENSE SUB-IDNM4334
3QUANTITY/TIMINGTQr200221
4GIVE CODECEr100317
5GIVE AMOUNT - MINIMUMNMr20318
6GIVE AMOUNT - MAXIMUMNM20319
7GIVE UNITSCEr60320
8GIVE DOSAGE FORMCE60321
9ADMINISTRATION NOTESCEcy200351
10SUBSTITUTION STATUSID16720322
11DISPENSE-TO LOCATIONID12299
12NEEDS HUMAN REVIEWID1307
13PHARMACY SPECIAL ADMINISTRATION INSTRUCTIONSCEy200343
14GIVE PER (TIME UNIT)STc20331
15GIVE RATE AMOUNTST6332
16GIVE RATE UNITSCE60333

SEGMENT RXO - PHARMACY PRESCRIPTION ORDER

SEQNAMETYPETABLER/OREPLENITEM#
1REQUESTED GIVE CODECEr100292
2REQUESTED GIVE AMOUNT - MINIMUMNMr20293
3REQUESTED GIVE AMOUNT - MAXIMUMNM20294
4REQUESTED GIVE UNITSCEr60295
5REQUESTED DOSAGE FORMCE60296
6PROVIDER'S PHARMACY INSTRUCTIONSCEy200297
7PROVIDER'S ADMINISTRATION INSTRUCTIONSCEy200298
8DELIVER-TO LOCATIONCMc12299
9ALLOW SUBSTITUTIONSID1611300
10REQUESTED DISPENSE CODECEc100301
11REQUESTED DISPENSE AMOUNTNMc20302
12REQUESTED DISPENSE UNITSCEc60303
13NUMBER OF REFILLSNM3304
14ORDERING PROVIDER'S DEA NUMBERCNc60305
15PHARMACIST VERIFIER IDCNc60306
16NEEDS HUMAN REVIEWID1307
17REQUESTED GIVE PER (TIME UNIT)STc20308

SEGMENT RXR - PHARMACY ROUTE

SEQNAMETYPETABLER/OREPLENITEM#
1ROUTECE162r60309
2SITECE16360310
3ADMINISTRATION DEVICECE16460311
4ADMINISTRATION METHODCE060312

CHAPTER 6 BLN - FINANCE

SEGMENT ACC - ACCIDENT

SEQNAMETYPETABLER/OREPLENITEM#
1ACCIDENT DATE/TIMETS26527
2ACCIDENT CODEID502528
3ACCIDENT LOCATIONST25529

SEGMENT DG1 - DIAGNOSIS

SEQNAMETYPETABLER/OREPLENITEM#
1SET ID DIAGNOSISSIr4375
2DIAGNOSIS CODING METHODID53r2376
3DIAGNOSIS CODEID518377
4DIAGNOSIS DESCRIPTIONST40378
5DIAGNOSIS DATE/TIMETS26379
6DIAGNOSIS/DRG TYPEID52r2380
7MAJOR DIAGNOSTIC CATEGORYCE11860381
8DIAGNOSTIC RELATED GROUPID554382
9DRG APPROVAL INDICATORID2383
10DRG GROUPER REVIEW CODEID562384
11OUTLIER TYPECE8360385
12OUTLIER DAYSNM3386
13OUTLIER COSTNM12387
14GROUPER VERSION AND TYPEST4388
15DIAGNOSIS/DRG PRIORITYNM49212389
16DIAGNOSING CLINICIANCN60390

SEGMENT FT1 - FINANCIAL TRANSACTION

SEQNAMETYPETABLER/OREPLENITEM#
1SET ID FINANCIAL TRANSACTIONSI4355
2TRANSACTION IDST12356
3TRANSACTION BATCH IDST10357
4TRANSACTION DATEDTr8358
5TRANSACTION POSTING DATEDT8359
6TRANSACTION TYPEID17r8360
7TRANSACTION CODEID132r20361
8TRANSACTION DESCRIPTIONST40362
9TRANSACTION DESCRIPTION ALTERNATEST40363
10TRANSACTION QUANTITYNM4364
11TRANSACTION AMOUNT EXTENDEDNM12365
12TRANSACTION AMOUNT UNITNM12366
13DEPARTMENT CODECE4960367
14INSURANCE PLAN IDID728368
15INSURANCE AMOUNTCM12369
16ASSIGNED PATIENT LOCATIONCM7912133
17FEE SCHEDULEID241370
18PATIENT TYPEID182148
19DIAGNOSIS CODECE51y8371
20PERFORMED BY CODECN8460372
21ORDERED BY CODECN60373
22UNIT COSTNM12374
23FILLER ORDER NUMBERCM75217

SEGMENT GT1 - GUARANTOR

SEQNAMETYPETABLER/OREPLENITEM#
1SET ID GUARANTORSIr4405
2GUARANTOR NUMBERCK20406
3GUARANTOR NAMEPNr48407
4GUARANTOR SPOUSE NAMEPN48408
5GUARANTOR ADDRESSAD106409
6GUARANTOR PH NUM HOMETNy/340410
7GUARANTOR PH NUM BUSINESSTNy/340411
8GUARANTOR DATE OF BIRTHDT8412
9GUARANTOR SEXID11413
10GUARANTOR TYPEID682414
11GUARANTOR RELATIONSHIPID632415
12GUARANTOR SSNST11416
13GUARANTOR DATE BEGINDT8417
14GUARANTOR DATE ENDDT8418
15GUARANTOR PRIORITYNM2419
16GUARANTOR EMPLOYER NAMEST45420
17GUARANTOR EMPLOYER ADDRESSAD106421
18GUARANTOR EMPLOY PHONE NUMBERTNy/340422
19GUARANTOR EMPLOYEE ID NUMST20423
20GUARANTOR EMPLOYMENT STATUSID662424
21GUARANTOR ORGANIZATIONST60425

SEGMENT IN1 - INSURANCE

SEQNAMETYPETABLER/OREPLENITEM#
1SET ID INSURANCESIr4426
2INSURANCE PLAN IDID72r8368
3INSURANCE COMPANY IDSTr6428
4INSURANCE COMPANY NAMEST45429
5INSURANCE COMPANY ADDRESSAD106430
6INSURANCE CO. CONTACT PERSPN48431
7INSURANCE CO PHONE NUMBERTNy/340432
8GROUP NUMBERST12433
9GROUP NAMEST35434
10INSURED'S GROUP EMP IDST12435
11INSURED'S GROUP EMP NAMEST45436
12PLAN EFFECTIVE DATEDT8437
13PLAN EXPIRATION DATEDT8438
14AUTHORIZATION INFORMATIONCM55439
15PLAN TYPEID862440
16NAME OF INSUREDPN48441
17INSURED'S RELATIONSHIP TO PATIENTID632442
18INSURED'S DATE OF BIRTHDT8443
19INSURED'S ADDRESSAD106444
20ASSIGNMENT OF BENEFITSID1352445
21COORDINATION OF BENEFITSID1732446
22COORD OF BEN. PRIORITYST2447
23NOTICE OF ADMISSION CODEID1362448
24NOTICE OF ADMISSION DATEDT8449
25RPT OF ELIGIBILITY CODEID1362450
26RPT OF ELIGIBILITY DATEDT8451
27RELEASE INFORMATION CODEID932452
28PRE ADMIT CERT (PAC)ST15453
29VERIFICATION DATE/TIMETS26454
30VERIFICATION BYCN60455
31TYPE OF AGREEMENT CODEID982456
32BILLING STATUSID222457
33LIFETIME RESERVE DAYSNM4458
34DELAY BEFORE L. R. DAYNM4459
35COMPANY PLAN CODEID428460
36POLICY NUMBERST15461
37POLICY DEDUCTIBLENM12462
38POLICY LIMIT AMOUNTNM12463
39POLICY LIMIT DAYSNM4464
40ROOM RATE SEMI PRIVATENM12465
41ROOM RATE PRIVATENM12466
42INSURED'S EMPLOYMENT STATUSCE6660467
43INSURED'S SEXID11468
44INSURED'S EMPLOYER ADDRESSAD106469
45VERIFICATION STATUSST2470
46PRIOR INSURANCE PLAN IDID728471

SEGMENT IN2 - INSURANCE ADDITIONAL INFO

SEQNAMETYPETABLER/OREPLENITEM#
1INSURED'S EMPLOYEE IDST15472
2INSURED'S SOCIAL SECURITY NUMBERNM9473
3INSURED'S EMPLOYER NAMECN60474
4EMPLOYER INFORMATION DATAID1391475
5MAIL CLAIM PARTYID1371476
6MEDICARE HEALTH INS CARD NUMBERNM15477
7MEDICAID CASE NAMEPN48478
8MEDICAID CASE NUMBERNM15479
9CHAMPUS SPONSOR NAMEPN48480
10CHAMPUS ID NUMBERNM20481
11DEPENDENT OF CHAMPUS RECIPIENTID1482
12CHAMPUS ORGANIZATIONST25483
13CHAMPUS STATIONST25484
14CHAMPUS SERVICEID14014485
15CHAMPUS RANK/GRADEID1412486
16CHAMPUS STATUSID1423487
17CHAMPUS RETIRE DATEDT8488
18CHAMPUS NON-AVAIL CERT ON FILEID1361489
19BABY COVERAGEID1361490
20COMBINE BABY BILLID1361491
21BLOOD DEDUCTIBLENM1531
22SPECIAL COVERAGE APPROVAL NAMEPN48493
23SPECIAL COVERAGE APPROVAL TITLEST30494
24NON-COVERED INSURANCE CODEID143y8495
25PAYOR IDST6496
26PAYOR SUBSCRIBER IDST6497
27ELIGIBILITY SOURCEID1441498
30DAILY DEDUCTIBLECM25501

SEGMENT IN3 - INSURANCE ADDITIONAL INFO - CERTIFICATION

SEQNAMETYPETABLER/OREPLENITEM#
1SET ID - INSURANCE CERTIFICATIONSIr4502
2CERTIFICATION NUMBERST25503
3CERTIFIED BYCN60504
4CERTIFICATION REQUIREDID1361505
5PENALTYID1481506
6CERTIFICATION DATE/TIMETS26507
7CERTIFICATION MODIFY DATE/TIMETS26508
8OPERATORCN60509
9CERTIFICATION BEGIN DATEDT8510
10CERTIFICATION END DATEDT8511
11DAYSCM1493512
12NON-CONCUR CODE/DESCRIPTIONCE60513
13NON-CONCUR EFF DATE/TIMETS26514
14PHYSICIAN REVIEWERCN60515
15CERTIFICATION CONTACTST48516
16CERTIFICATION CONTACT PHONE NUMBERTNy/340517
17APPEAL REASONCE60518
18CERTIFICATION AGENCYCE60519
19CERTIFICATION AGENCY PHONE NUMBERTNy/340520
20PRE-CERTIFICATION REQ/WINDOWCM150y10521
21CASE MANAGERST48522
22SECOND OPINION DATEDT8523
23SECOND OPINION STATUSID1511524
24SECOND OPINION DOCUMENTATION RECEIVEDID1521525
25SECOND OPINION PRACTITIONERCN60526

SEGMENT PR1 - PROCEDURES

SEQNAMETYPETABLER/OREPLENITEM#
1SET ID PROCEDURESIr4391
2PROCEDURE CODING METHODID89ry2392
3PROCEDURE CODEID88ry10393
4PROCEDURE DESCRIPTIONSTy40394
5PROCEDURE DATE/TIMETSr26395
6PROCEDURE TYPEID90r2396
7PROCEDURE MINUTESNM4397
8ANESTHESIOLOGISTCN1060398
9ANESTHESIA CODEID192399
10ANESTHESIA MINUTESNM4400
11SURGEONCN1060401
12PROCEDURE PRACTITIONERCM10y60402
13CONSENT CODEID592403
14PROCEDURE PRIORITYNM2404

SEGMENT UB1 - UB82 DATA

SEQNAMETYPETABLER/OREPLENITEM#
1SET ID UB82SI4530
2BLOOD DEDUCTIBLE (43)NM1361492
3BLOOD FURN PINTS OF (40)NM2532
4BLOOD REPLACED PINTS (41)NM2533
5BLOOD NOT RPLCD PINTS(42)NM2534
6CO INSURANCE DAYS (25)NM2535
7CONDITION CODE (35-39)ID43y/52536
8COVERED DAYS (23)NM3537
9NON COVERED DAYS (24)NM3538
10VALUE AMOUNT & CODE (46-49)ID153y/812539
11NUMBER OF GRACE DAYS (90)NM2540
12SPEC PROG INDICATOR (44)ID2541
13PSRO/UR APPROVAL IND (87)ID1542
14PSRO/UR APRVD STAY FM (88)DT8543
15PSRO/UR APRVD STAY TO (89)DT8544
16OCCURRENCE (28 32)CMy/520545
17OCCURRENCE SPAN (33)ID2546
18OCCUR SPAN START DATE(33)DT8547
19OCCUR SPAN END DATE (33)DT8548
20UB 82 LOCATOR 2ST30549
21UB 82 LOCATOR 9ST7550
22UB 82 LOCATOR 27ST8551
23UB 82 LOCATOR 45ST17552

SEGMENT UB2 - UB92 DATA

SEQNAMETYPETABLER/OREPLENITEM#
1SET ID UB92SI4553
2CO-INSURANCE DAYS (9)ST3554
3CONDITION CODE (24-30)ID43y/72555
4COVERED DAYS (7)ST3556
5NON-COVERED DAYS (8)ST4557
6VALUE AMOUNT & CODE (39-41)CMy1211558
7OCCURRENCE CODE & DATE (32-35)CMy/811559
8OCCURRENCE SPAN CODE/DATES (36)CMy/228560
9UB92 LOCATOR 2 (STATE)STy/229561
10UB92 LOCATOR 11 (STATE)STy/212562
11UB92 LOCATOR 31 (NATIONAL)ST5563
12DOCUMENT CONTROL NUMBER (37)STy/323564
13UB92 LOCATOR 49 (NATIONAL)STy234565
14UB92 LOCATOR 56 (STATE)STy/514566
15UB92 LOCATOR 57 (NATIONAL)ST27567
16UB92 LOCATOR 78 (STATE)STy/22568

CHAPTER 7 ANR - ANCILLARY RPT

SEGMENT OBX - OBSERVATION

SEQNAMETYPETABLER/OREPLENITEM#
1SET ID - OBSERVATIONAL SIMPLESI4569
2VALUE TYPEID9998r2570
3OBSERVATION IDENTIFIERCEr80571
4OBSERVATION SUB-IDSTc20572
5OBSERVATION VALUEIDc573
6UNITSCE60574
7REFERENCES RANGEST60575
8ABNORMAL FLAGSID78y/510576
9PROBABILITYNM5577
10NATURE OF ABNORMAL TESTID805578
11OBSERV RESULT STATUSID85r2579
12DATE LAST OBS NORMAL VALUESTS26580
13USER DEFINED ACCESS CHECKSST20581
14DATE/TIME OF THE OBSERVATIONTS26582
15PRODUCER'S IDCE60583
16RESPONSIBLE OBSERVERCN60584

SEGMENT OM1 - GENERAL - FIELDS THAT APPLY TO MOST OBSERVATIONS

SEQNAMETYPETABLER/OREPLENITEM#
1SEGMENT TYPE IDSTr3585
2SEQUENCE NUMBERNMr4586
3PRODUCER'S TEST/OBSERVATION IDCEr200587
4PERMITTED DATA TYPESID9998y12588
5SPECIMEN REQUIREDID136r1589
6PRODUCER IDCEr200590
7OBSERVATION DESCRIPTIONCE200591
8OTHER TEST/OBSERVATION IDS FOR THE OBSERVATIONCE200592
9OTHER NAMESSTry200593
10PREFERRED REPORT NAME FOR THE OBSERVATIONST30594
11PREFERRED SHORT NAME OR MNEMONIC FOR OBSERVATIONST8595
12PREFERRED LONG NAME FOR THE OBSERVATIONST200596
13ORDERABILITYID1361597
14IDENTITY OF INSTRUMENT USED TO PERFROM THIS STUDYCEy60598
15CODED REPRESENTATION OF METHODCEy200599
16PORTABLEID1361600
17OBSERVATION PRODUCING DEPARTMENT/SECTIONIDy1601
18TELEPHONE NUMBER OF SECTIONTN40602
19NATURE OF TEST/OBSERVATIONID174r1603
20REPORT SUBHEADERCE200604
21REPORT DISPLAY ORDERST20605
22DATE/TIME STAMP FOR ANY CHANGE IN DEF ATTRI FOR OBSTSr26606
23EFFECTIVE DATE/TIME OF CHANGETN26607
24TYPICAL TURN-AROUND TIMENM20608
25PROCESSING TIMENM20609
26PROCESSING PRIORITYID168y40610
27REPORTING PRIORITYID1765611
28OUTSIDE SITE(S) WHERE OBSERVATION MAY BE PERFORMEDCEy200612
29ADDRESS OF OUTSIDE SITE(S)AD1000613
30PHONE NUMBER OF OUTSIDE SITETN400614
31CONFIDENTIALITY CODEID1771615
32OBSERVATIONS REQUIRED TO INTERPRET THE OBSCE200616
33INTERPRETATION OF OBSERVATIONSTX65536617
34CONTRAINDICATIONS TO OBSERVATIONSCE65536618
35REFLEX TESTS/OBSERVATIONSCEy200619
36RULES THAT TRIGGER REFLEX TESTINGST80620
37FIXED CANNED MESSAGECE65536621
38PATIENT PREPARATIONTX200622
39PROCEDURE MEDICATIONCE200623
40FACTORS THAT MAY EFFECT THE OBSERVATIONTX200624
41TEST/OBSERVATION PERFORMANCE SCHEDULESTy60625
42DESCRIPTION OF TEST METHODSTX65536626

SEGMENT OM2 - NUMERIC OBSERVATION

SEQNAMETYPETABLER/OREPLENITEM#
1SEGMENT TYPE IDST3585
2SEQUENCE NUMBERNM4586
3UNITS OF MEASURECE60627
4RANGE OF DECIMAL PRECISIONNMy10628
5CORRESPONDING SI UNITS OF MEASURECE60629
6SI CONVERSION FACTORTX20630
7REFERENCE (NORMAL) RANGE - ORDINAL & CONTINUOUS OBSCM200631
8CRITICAL RANGE FOR ORDINAL & CONTINUOUS OBSCM200632
9ABSOLUTE RANGE FOR ORDINAL AND CONTINUOUS OBSCM200633
10DELTA CHECK CRITERIACMy200634
11MINIMUM MEANINGFUL INCREMENTSNM20635

SEGMENT OM3 - CATEGORICAL TEST/OBSERVATION

SEQNAMETYPETABLER/OREPLENITEM#
1SEGMENT TYPE IDST3585
2SEQUENCE NUMBERNM4586
3PREFERRED CODING SYSTEMID5636
4VALID CODED ANSWERSCE60637
5NORMAL TEST CODES FOR CATEGORICAL OBSCEy200638
6ABNORMAL TEST CODES FOR CATEGORICAL OBSCE200639
7CRITICAL TEST CODES FOR CATEGORICAL OBSCE200640
8DATA TYPEID2641

SEGMENT OM4 - OBSERVATIONS THAT REQUIRE SPECIMENS

SEQNAMETYPETABLER/OREPLENITEM#
1SEGMENT TYPE IDST3585
2SEQUENCE NUMBERNM4586
3DERIVED SPECIMENID17060642
4CONTAINER DESCRIPTIONTX60643
5CONTAINER VOLUMENM20644
7SPECIMENCE60646
8ADDITIVECE60647
9PREPARATIONTX10000648
10SPECIAL HANDLING REQUIREMENTSTX10000649
11NORMAL COLLECTION VOLUMECQ20650
12MINIMUM COLLECTION VOLUMECQ20651
13SPECIMEN REQUIREMENTSTX10000652
14SPECIMEN PRIORITIESID27y60653
15SPECIMEN RETENTION TIMECQ20634

SEGMENT OM5 - OBSERVATION BATTERIES

SEQNAMETYPETABLER/OREPLENITEM#
1SEGMENT TYPE IDST3585
2SEQUENCE NUMBERNM4586
3TEST/OBSERVATIONS INCLUDED W/AN ORDERED TEST BATTERYCEy200655
4OBSERVATION ID SUFFIXESST200656

SEGMENT OM6 - OBSERVATIONS THAT ARE CALCULATED FROM OTHER OBSERVATIONS

SEQNAMETYPETABLER/OREPLENITEM#
1SEGMENT TYPE IDST3585
2SEQUENCE NUMBERNM4586
3DERIVATION RULETX657

CHAPTER 8 MFI - MASTER FILES

SEGMENT MFA - MASTER FILE ACKNOWLEDGEMENT

SEQNAMETYPETABLER/OREPLENITEM#
1RECORD-LEVEL EVENT CODEID180r3664
2MFN CONTROL IDSTc20665
3EVENT COMPLETION DATE/TIMETSc26668
4ERROR RETURN CODE &/OR TEXTCE181r60669
5PRIMARY KEY VALUECE60667

SEGMENT MFE - MASTER FILE ENTRY

SEQNAMETYPETABLER/OREPLENITEM#
1RECORD-LEVEL EVENT CODEID180r3664
2MFN CONTROL IDSTc20665
3EFFECTIVE DATE/TIMETS26662
4PRIMARY KEY VALUECEry60667

SEGMENT MFI - MASTER FILE IDENTIFICATION

SEQNAMETYPETABLER/OREPLENITEM#
1MASTER FILE IDENTIFIERCE175r60658
2MASTER FILE APPLICATION IDENTIFIERID1766
3FILE-LEVEL EVENT CODEID178r3660
4ENTERED DATE/TIMETS26661
5EFFECTIVE DATE/TIMETS26662
6RESPONSE LEVEL CODEID179r2663

SEGMENT PRA - PRACTITIONER DETAIL

SEQNAMETYPETABLER/OREPLENITEM#
1PRA - PRIMARY KEY VALUESTr200
2PRACTITIONER GROUPCEy600
3PRACTITIONER CATEGORYIDy30
4PROVIDER BILLINGID1688
5SPECIALTYSTy100689
6PRACTITIONER ID NUMBERSSTy100690
7PRIVILEGESSTy20691

SEGMENT STF - STAFF IDENTIFICATION

SEQNAMETYPETABLER/OREPLENITEM#
1STF - PRIMARY KEY VALUECEr60671
2STAFF ID CODECEy60672
3STAFF NAMEPN48673
4STAFF TYPEID182y2674
5SEXID11111
6DATE OF BIRTHTS26110
7ACTIVE/INACTIVEID1831675
8DEPARTMENTCE184y200676
9SERVICECEy200677
10PHONETNy40678
11OFFICE/HOME ADDRESSADy/2106679
12ACTIVATION DATECMy19680
13INACTIVATION DATECMy19681
14BACKUP PERSON IDCEy60682
15E-MAIL ADDRESSSTy40683
16PREFERRED PHONEID1684

CHAPTER C NMT - NETWORK MGMT.

SEGMENT NCK - SYSTEM CLOCK

SEQNAMETYPETABLER/OREPLENITEM#
1SYSTEM DATE/TIMETSr26742

SEGMENT NSC - STATUS CHANGE

SEQNAMETYPETABLER/OREPLENITEM#
1NETWORK CHANGE TYPEIDr4758
2CURRENT CPUST30759
3CURRENT FILESERVERST30760
4CURRENT APPLICATIONST30761
5CURRENT FACILITYST30762
6NEW CPUST30763
7NEW FILESERVERST30764
8NEW APPLICATIONST30765
9NEW FACILITYST30766

SEGMENT NST - STATISTICS

SEQNAMETYPETABLER/OREPLENITEM#
1STATISTICS AVAILABLEIDr1743
2SOURCE IDENTIFIERST30744
3SOURCE TYPEID3745
4STATISTICS STARTTS26746
5STATISTICS ENDTS26747
6RECEIVE CHARACTER COUNTNM10748
7SEND CHARACTER COUNTNM10749
8MESSAGES RECEIVEDNM10750
9MESSAGES SENTNM10751
10CHECKSUM ERRORS RECEIVEDNM10752
11LENGTH ERRORS RECEIVEDNM10753
12OTHER ERRORS RECEIVEDNM10754
13CONNECT TIMEOUTSNM10755
14RECEIVE TIMEOUTSNM10756
15NETWORK ERRORSNM10757


MESSAGES SEGMENTS TABLES COMPOSITES
Created by ProtoGen r1.2 (c) 1994, 1995, 1996 by Gunther Schadow. All rights reserved