HL7 v2 2.3

Segments and their fields in version 2.3. Open a segment to see its fields, the code tables they use and where each field lands in FHIR.

Version2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

Filter segments

FHIR targets come from the HL7 Version 2 to FHIR guide, which is written against the latest HL7 v2 releases. A field that does not exist in this version has no row.

ACCAccident6 fields

Field	Name	Type	Use	Repeats	Table	Length
`ACC-1`	Accident Date/Time	TS	Optional	Once		26
`ACC-2`	Accident Code	CE	Optional	Once	0050	60
`ACC-3`	Accident Location	ST	Optional	Once		25
`ACC-4`	Auto Accident State	CE	Optional	Once		60
`ACC-5`	Accident Job Related Indicator	ID	Optional	Once	0136	2
`ACC-6`	Accident Death Indicator	ID	Optional	Once	0136	2

Defined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

ADDAddendum1 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`ADD-1`	Addendum Continuation Pointer	ST	Optional	Once		65536

Defined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

AIGAppointment Information - General ResourceAppointment14 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`AIG-1`	Set ID - AIG	SI	Required	Once		4
`AIG-2`	Segment Action Code	ID	Conditional	Once	0206	3
`AIG-3`	Resource ID	CE	Conditional	Once		200	Appointment.participant.actor
`AIG-4`	Resource Type	CE	Required	Once		200	Appointment.participant.type
`AIG-5`	Resource Group	CE	Optional	Repeats		200
`AIG-6`	Resource Quantity	NM	Optional	Once		5
`AIG-7`	Resource Quantity Units	CE	Optional	Once		200
`AIG-8`	Start Date/Time	TS	Conditional	Once		26	Appointment.participant.period.start
`AIG-9`	Start Date/Time Offset	NM	Conditional	Once		20	Appointment.participant.period.start
`AIG-10`	Start Date/Time Offset Units	CE	Conditional	Once		200
`AIG-11`	Duration	NM	Optional	Once		20	Appointment.participant.period.end
`AIG-12`	Duration Units	CE	Optional	Once		200
`AIG-13`	Allow Substitution Code	IS	Conditional	Once	0279	10
`AIG-14`	Filler Status Code	CE	Conditional	Once	0278	200

FHIR map of segment AIGDefined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

AILAppointment Information - LocationAppointment12 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`AIL-1`	Set ID - AIL	SI	Required	Once		4
`AIL-2`	Segment Action Code	ID	Conditional	Once	0206	1
`AIL-3`	Location Resource ID	PL	Conditional	Once		80	Appointment.participant.actor
`AIL-4`	Location Type	CE	Required	Once		200
`AIL-5`	Location Group	CE	Optional	Once		200
`AIL-6`	Start Date/Time	TS	Conditional	Once		26	Appointment.participant.period.start
`AIL-7`	Start Date/Time Offset	NM	Conditional	Once		20	Appointment.participant.period.start
`AIL-8`	Start Date/Time Offset Units	CE	Conditional	Once		200
`AIL-9`	Duration	NM	Optional	Once		20	Appointment.participant.period.end
`AIL-10`	Duration Units	CE	Optional	Once		200
`AIL-11`	Allow Substitution Code	IS	Conditional	Once	0279	10
`AIL-12`	Filler Status Code	CE	Conditional	Once	0278	200

FHIR map of segment AILDefined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

AIPAppointment Information - Personnel ResourceAppointment12 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`AIP-1`	Set ID - AIP	SI	Required	Once		4
`AIP-2`	Segment Action Code	ID	Conditional	Once	0206	3
`AIP-3`	Personnel Resource ID	XCN	Conditional	Once		80	Appointment.participant.actor
`AIP-4`	Resource Role	CE	Required	Once		200	Appointment.participant.type
`AIP-5`	Resource Group	CE	Optional	Once		200
`AIP-6`	Start Date/Time	TS	Conditional	Once		26	Appointment.participant.period.start
`AIP-7`	Start Date/Time Offset	NM	Conditional	Once		20	Appointment.participant.period.start
`AIP-8`	Start Date/Time Offset Units	CE	Conditional	Once		200
`AIP-9`	Duration	NM	Optional	Once		20	Appointment.participant.period.end
`AIP-10`	Duration Units	CE	Optional	Once		200
`AIP-11`	Allow Substitution Code	IS	Conditional	Once	0279	10
`AIP-12`	Filler Status Code	CE	Conditional	Once	0278	200	Appointment.participant.status

FHIR map of segment AIPDefined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

AISAppointment Information - ServiceAppointment, ServiceRequest10 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`AIS-1`	Set ID - AIS	SI	Required	Once		4
`AIS-2`	Segment Action Code	ID	Conditional	Once	0206	3
`AIS-3`	Universal Service Identifier	CE	Required	Once		200	Appointment.serviceType ServiceRequest.identifier
`AIS-4`	Start Date/Time	TS	Conditional	Once		26	Appointment.participant.period.start ServiceRequest.occurrencePeriod.start
`AIS-5`	Start Date/Time Offset	NM	Conditional	Once		20	Appointment.participant.period.start ServiceRequest.occurrencePeriod.start
`AIS-6`	Start Date/Time Offset Units	CE	Conditional	Once		200
`AIS-7`	Duration	NM	Optional	Once		20	Appointment.participant.period.end ServiceRequest.occurrencePeriod.end
`AIS-8`	Duration Units	CE	Optional	Once		200
`AIS-9`	Allow Substitution Code	IS	Conditional	Once	0279	10
`AIS-10`	Filler Status Code	CE	Conditional	Once	0278	200	Appointment.status

FHIR map of segment AISDefined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

AL1Patient Allergy InformationAllergyIntolerance6 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`AL1-1`	Set ID - AL1	SI	Required	Once		4
`AL1-2`	Allergy Type	IS	Optional	Once	0127	2	AllergyIntolerance.category AllergyIntolerance.type+1 more
`AL1-3`	Allergy Code/Mnemonic/ Description	CE	Required	Once		60	AllergyIntolerance.code
`AL1-4`	Allergy Severity	IS	Optional	Once	0128	2	AllergyIntolerance.criticality AllergyIntolerance.reaction.severity+1 more
`AL1-5`	Allergy Reaction	ST	Optional	Once		15	AllergyIntolerance.reaction.manifestation.text
`AL1-6`	Identification Date	DT	Optional	Once		8	AllergyIntolerance.onsetDateTime

FHIR map of segment AL1Defined in versions2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

APRAppointment Preferences5 fields

Field	Name	Type	Use	Repeats	Table	Length
`APR-1`	Time Selection Criteria	SCV	Optional	Repeats	0294	80
`APR-2`	Resource Selection Criteria	SCV	Optional	Repeats		80
`APR-3`	Location Selection Criteria	SCV	Optional	Repeats		80
`APR-4`	Slot Spacing Criteria	NM	Optional	Once		5
`APR-5`	Filler Override Criteria	SCV	Optional	Repeats		80

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

ARQAppointment Request23 fields

Field	Name	Type	Use	Repeats	Table	Length
`ARQ-1`	Placer Appointment ID	EI	Required	Once		75
`ARQ-2`	Filler Appointment ID	EI	Conditional	Once		75
`ARQ-3`	Occurrence Number	NM	Conditional	Once		5
`ARQ-4`	Placer Group Number	EI	Optional	Once		75
`ARQ-5`	Schedule ID	CE	Optional	Once		200
`ARQ-6`	Request Event Reason	CE	Optional	Once		200
`ARQ-7`	Appointment Reason	CE	Optional	Once	0276	200
`ARQ-8`	Appointment Type	CE	Optional	Once	0277	200
`ARQ-9`	Appointment Duration	NM	Optional	Once		20
`ARQ-10`	Appointment Duration Units	CE	Optional	Once		200
`ARQ-11`	Requested Start Date/Time Range	DR	Optional	Repeats		53
`ARQ-12`	Priority	ST	Optional	Once		5
`ARQ-13`	Repeating Interval	RI	Optional	Once		100
`ARQ-14`	Repeating Interval Duration	ST	Optional	Once		5
`ARQ-15`	Placer Contact Person	XCN	Required	Once		48
`ARQ-16`	Placer Contact Phone Number	XTN	Optional	Repeats		40
`ARQ-17`	Placer Contact Address	XAD	Optional	Once		106
`ARQ-18`	Placer Contact Location	PL	Optional	Once		80
`ARQ-19`	Entered By Person	XCN	Required	Once		48
`ARQ-20`	Entered By Phone Number	XTN	Optional	Repeats		40
`ARQ-21`	Entered By Location	PL	Optional	Once		80
`ARQ-22`	Parent Placer Appointment ID	EI	Optional	Once		75
`ARQ-23`	Parent Filler Appointment ID	EI	Optional	Once		75

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

AUTAuthorization Information10 fields

Field	Name	Type	Use	Repeats	Table	Length
`AUT-1`	Authorizing Payor, Plan Code	CE	Optional	Once	0072	200
`AUT-2`	Authorizing Payor, Company ID	CE	Required	Once	0285	200
`AUT-3`	Authorizing Payor, Company Name	ST	Optional	Once		45
`AUT-4`	Authorization Effective Date	TS	Optional	Once		26
`AUT-5`	Authorization Expiration Date	TS	Optional	Once		26
`AUT-6`	Authorization Identifier	EI	Conditional	Once		30
`AUT-7`	Reimbursement Limit	CP	Optional	Once		25
`AUT-8`	Requested Number of Treatments	NM	Optional	Once		2
`AUT-9`	Authorized Number of Treatments	NM	Optional	Once		2
`AUT-10`	Process Date	TS	Optional	Once		26

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

BHSBatch Header Segment12 fields

Field	Name	Type	Use	Repeats	Length
`BHS-1`	Batch Field Separator	ST	Required	Once	1
`BHS-2`	Batch Encoding Characters	ST	Required	Once	3
`BHS-3`	Batch Sending Application	ST	Optional	Once	15
`BHS-4`	Batch Sending Facility	ST	Optional	Once	20
`BHS-5`	Batch Receiving Application	ST	Optional	Once	15
`BHS-6`	Batch Receiving Facility	ST	Optional	Once	20
`BHS-7`	Batch Creation Date/Time	TS	Optional	Once	26
`BHS-8`	Batch Security	ST	Optional	Once	40
`BHS-9`	Batch Name/ID/Type	ST	Optional	Once	20
`BHS-10`	Batch Comment	ST	Optional	Once	80
`BHS-11`	Batch Control ID	ST	Optional	Once	20
`BHS-12`	Reference Batch Control ID	ST	Optional	Once	20

Defined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

BLGBilling3 fields

Field	Name	Type	Use	Repeats	Table	Length
`BLG-1`	When to Charge	CM_CCD	Optional	Once		40
`BLG-2`	Charge Type	ID	Optional	Once	0122	50
`BLG-3`	Account ID	CK	Optional	Once		100

Defined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

BTSBatch Trailer Segment3 fields

Field	Name	Type	Use	Repeats	Length
`BTS-1`	Batch Message Count	ST	Optional	Once	10
`BTS-2`	Batch Comment	ST	Optional	Once	80
`BTS-3`	Batch Totals	NM	Optional	Repeats	100

Defined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

CDMCharge Description Master13 fields

Field	Name	Type	Use	Repeats	Table	Length
`CDM-1`	Primary Key Value	CE	Required	Once	0132	200
`CDM-2`	Charge Code Alias	CE	Optional	Repeats		200
`CDM-3`	Charge Description Short	ST	Required	Once		20
`CDM-4`	Charge Description Long	ST	Optional	Once		250
`CDM-5`	Description Override Indicator	IS	Optional	Once	0268	1
`CDM-6`	Exploding Charges	CE	Optional	Repeats		60
`CDM-7`	Procedure Code	CE	Optional	Repeats		200
`CDM-8`	Active/Inactive Flag	ID	Optional	Once	0183	1
`CDM-9`	Inventory Number	CE	Optional	Repeats		60
`CDM-10`	Resource Load	NM	Optional	Once		12
`CDM-11`	Contract Number	CK	Optional	Repeats		200
`CDM-12`	Contract Organization	XON	Optional	Once		200
`CDM-13`	Room Fee Indicator	ID	Optional	Once	0136	1

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

CM0Clinical Study Master11 fields

Field	Name	Type	Use	Repeats	Length
`CM0-1`	CM0 - Set ID	SI	Optional	Once	4
`CM0-2`	Sponsor Study ID	EI	Required	Once	60
`CM0-3`	Alternate Study ID	CE	Optional	Once	60
`CM0-4`	Title of Study	ST	Required	Once	300
`CM0-5`	Chairman of Study	XCN	Optional	Once	60
`CM0-6`	Last IRB Approval Date	DT	Optional	Once	8
`CM0-7`	Total Accrual to Date	NM	Optional	Once	8
`CM0-8`	Last Accrual Date	DT	Optional	Once	8
`CM0-9`	Contact for Study	XCN	Optional	Once	60
`CM0-10`	Contact's Tel. Number	XTN	Optional	Once	40
`CM0-11`	Contact's Address	XAD	Optional	Once	100

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

CM1Clinical Study Phase Master3 fields

Field	Name	Type	Use	Repeats	Length
`CM1-1`	CM1 - Set ID	SI	Required	Once	4
`CM1-2`	Study Phase Identifier	CE	Required	Once	60
`CM1-3`	Description of Study Phase	ST	Required	Once	300

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

CM2Clinical Study Schedule Master4 fields

Field	Name	Type	Use	Repeats	Length
`CM2-1`	CM2 - Set ID	SI	Optional	Once	4
`CM2-2`	Scheduled Time Point	CE	Required	Once	60
`CM2-3`	Description of Time Point	ST	Optional	Once	300
`CM2-4`	Events Scheduled This Time Point	CE	Required	Once	60

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

CSPClinical Study Phase4 fields

Field	Name	Type	Use	Repeats	Length
`CSP-1`	Study Phase Identifier	CE	Required	Once	60
`CSP-2`	Date/time Study Phase Began	TS	Required	Once	26
`CSP-3`	Date/time Study Phase Ended	TS	Optional	Once	26
`CSP-4`	Study Phase Evaluability	CE	Conditional	Once	60

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

CSRClinical Study Registration16 fields

Field	Name	Type	Use	Repeats	Length
`CSR-1`	Sponsor Study ID	EI	Required	Once	60
`CSR-2`	Alternate Study ID	EI	Optional	Once	60
`CSR-3`	Institution Registering the Patient	CE	Optional	Once	60
`CSR-4`	Sponsor Patient ID	CX	Required	Once	30
`CSR-5`	Alternate Patient ID	CX	Optional	Once	30
`CSR-6`	Date/Time of Patient Study Registration	TS	Required	Once	26
`CSR-7`	Person Performing Study Registration	XCN	Optional	Once	60
`CSR-8`	Study Authorizing Provider	XCN	Required	Once	60
`CSR-9`	Date/time Patient Study Consent Signed	TS	Conditional	Once	26
`CSR-10`	Patient Study Eligibility Status	CE	Conditional	Once	60
`CSR-11`	Study Randomization Date/time	TS	Optional	Once	26
`CSR-12`	Study Randomized Arm	CE	Optional	Once	200
`CSR-13`	Stratum for Study Randomization	CE	Optional	Once	200
`CSR-14`	Patient Evaluability Status	CE	Conditional	Once	60
`CSR-15`	Date/time Ended Study	TS	Conditional	Once	26
`CSR-16`	Reason Ended Study	CE	Conditional	Once	60

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

CSSClinical Study Data Schedule3 fields

Field	Name	Type	Use	Repeats	Length
`CSS-1`	Study Scheduled Time Point	CE	Required	Once	60
`CSS-2`	Study Scheduled Patient Time Point	TS	Optional	Once	26
`CSS-3`	Study Quality Control Codes	CE	Optional	Once	60

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

CTDContact Data7 fields

Field	Name	Type	Use	Repeats	Table	Length
`CTD-1`	Contact Role	CE	Required	Repeats	0131	200
`CTD-2`	Contact Name	XPN	Optional	Repeats		106
`CTD-3`	Contact Address	XAD	Optional	Once		60
`CTD-4`	Contact Location	PL	Optional	Once		60
`CTD-5`	Contact Communication Information	XTN	Optional	Repeats		100
`CTD-6`	Preferred Method of Contact	CE	Optional	Once	0185	200
`CTD-7`	Contact Identifiers	CM_PI	Optional	Repeats		100

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

CTIClinical Trial Identification3 fields

Field	Name	Type	Use	Repeats	Length
`CTI-1`	Sponsor Study ID	EI	Required	Once	60
`CTI-2`	Study Phase Identifier	CE	Conditional	Once	60
`CTI-3`	Study Scheduled Time Point	CE	Optional	Once	60

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

DB1Disability Segment8 fields

Field	Name	Type	Use	Repeats	Table	Length
`DB1-1`	Set ID - DB1	SI	Required	Once		4
`DB1-2`	Disabled person code	IS	Optional	Once	0334	2
`DB1-3`	Disabled person identifier	CX	Optional	Repeats		32
`DB1-4`	Disabled Indicator	ID	Optional	Once	0136	1
`DB1-5`	Disability start date	DT	Optional	Once		8
`DB1-6`	Disability end date	DT	Optional	Once		8
`DB1-7`	Disability return to work date	DT	Optional	Once		8
`DB1-8`	Disability unable to work date	DT	Optional	Once		8

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

DG1DiagnosisCondition, Encounter, EpisodeOfCare19 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`DG1-1`	Set ID - Diagnosis	SI	Required	Once		4
`DG1-2`	Diagnosis Coding Method	ID	Backward	Once	0053	2
`DG1-3`	Diagnosis Code	CE	Optional	Once	0051	60	Condition.code Encounter.diagnosis.condition+1 more
`DG1-4`	Diagnosis Description	ST	Backward	Once		40	Condition.code.text Encounter.diagnosis.condition+1 more
`DG1-5`	Diagnosis Date/Time	TS	Optional	Once		26	Condition.onsetDateTime Encounter.diagnosis.condition+1 more
`DG1-6`	Diagnosis Type	IS	Required	Once	0052	2	Encounter.diagnosis.use EpisodeOfCare.diagnosis.role
`DG1-7`	Major Diagnostic Category	CE	Backward	Once	0118	60
`DG1-8`	Diagnostic Related Group	CE	Backward	Once	0055	60
`DG1-9`	DRG Approval Indicator	ID	Backward	Once	0136	2
`DG1-10`	DRG Grouper Review Code	IS	Backward	Once	0056	2
`DG1-11`	Outlier Type	CE	Backward	Once	0083	60
`DG1-12`	Outlier Days	NM	Backward	Once		3
`DG1-13`	Outlier Cost	CP	Backward	Once		12
`DG1-14`	Grouper Version and Type	ST	Backward	Once		4
`DG1-15`	Diagnosis Priority	NM	Backward	Once		2	Encounter.diagnosis.rank EpisodeOfCare.diagnosis.rank
`DG1-16`	Diagnosing Clinician	XCN	Optional	Repeats		60	Condition.asserter Encounter.diagnosis.condition+1 more
`DG1-17`	Diagnosis Classification	IS	Optional	Once	0228	3
`DG1-18`	Confidential Indicator	ID	Optional	Once	0136	1
`DG1-19`	Attestation Date/Time	TS	Optional	Once		26	Condition.recordedDate Encounter.diagnosis.condition+2 more

FHIR map of segment DG1Defined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

DRGDiagnosis Related Group10 fields

Field	Name	Type	Use	Repeats	Table	Length
`DRG-1`	Diagnostic Related Group	CE	Optional	Once	0055	60
`DRG-2`	DRG Assigned Date/Time	TS	Optional	Once		26
`DRG-3`	DRG Approval Indicator	ID	Optional	Once	0136	2
`DRG-4`	DRG Grouper Review Code	IS	Optional	Once	0056	2
`DRG-5`	Outlier Type	CE	Optional	Once	0083	60
`DRG-6`	Outlier Days	NM	Optional	Once		3
`DRG-7`	Outlier Cost	CP	Optional	Once		12
`DRG-8`	DRG Payor	IS	Optional	Once	0229	1
`DRG-9`	Outlier Reimbursement	CP	Optional	Once		9
`DRG-10`	Confidential Indicator	ID	Optional	Once	0136	1

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

DSCContinuation pointer segment1 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`DSC-1`	Continuation Pointer	ST	Optional	Once		180

Defined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

DSPDisplay data segment5 fields

Field	Name	Type	Use	Repeats	Length
`DSP-1`	Set ID - Display Data	SI	Optional	Once	4
`DSP-2`	Display Level	SI	Optional	Once	4
`DSP-3`	Data Line	TX	Required	Once	300
`DSP-4`	Logical Break Point	ST	Optional	Once	2
`DSP-5`	Result ID	TX	Optional	Once	20

Defined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

EQLEmbedded Query Language4 fields

Field	Name	Type	Use	Repeats	Table	Length
`EQL-1`	Query tag	ST	Optional	Once		32
`EQL-2`	Query/ Response Format Code	ID	Required	Once	0106	1
`EQL-3`	EQL Query Name	CE	Required	Once		60
`EQL-4`	EQL Query Statement	ST	Required	Once		4096

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6

ERQEvent Replay Query Segment3 fields

Field	Name	Type	Use	Repeats	Length
`ERQ-1`	Query tag	ST	Optional	Once	32
`ERQ-2`	Event identifier	CE	Required	Once	60
`ERQ-3`	Input parameter list	QIP	Optional	Repeats	256

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6

ERRError segment1 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`ERR-1`	Error Code and Location	CM_ELD	Required	Repeats		80

Defined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

EVNEvent typeProvenance6 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`EVN-1`	Event Type Code	ID	Backward	Once	0003	3
`EVN-2`	Recorded Date/Time	TS	Required	Once		26	Provenance.recorded
`EVN-3`	Date/Time Planned Event	TS	Optional	Once		26
`EVN-4`	Event Reason Code	IS	Optional	Once	0062	3	Provenance.reason Provenance.reason.extension
`EVN-5`	Operator ID	XCN	Optional	Once	0188	60	Provenance.agent.who
`EVN-6`	Event Occurred	TS	Optional	Once		26	Provenance.occurredDateTime

FHIR map of segment EVNDefined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

FACFacility12 fields

Field	Name	Type	Use	Repeats	Table	Length
`FAC-1`	Facility ID	EI	Required	Once		20
`FAC-2`	Facility Type	ID	Optional	Once	0331	1
`FAC-3`	Facility Address	XAD	Required	Once		200
`FAC-4`	Facility Telecommunication	XTN	Required	Once		44
`FAC-5`	Contact Person	XCN	Optional	Repeats		60
`FAC-6`	Contact Title	ST	Optional	Repeats		60
`FAC-7`	Contact Address	XAD	Optional	Repeats		200
`FAC-8`	Contact Telecommunication	XTN	Optional	Repeats		44
`FAC-9`	Signature Authority	XCN	Required	Once		60
`FAC-10`	Signature Authority Title	ST	Optional	Once		60
`FAC-11`	Signature Authority Address	XAD	Optional	Once		200
`FAC-12`	Signature Authority Telecommunication	XTN	Optional	Once		44

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

FHSFile Header Segment12 fields

Field	Name	Type	Use	Repeats	Length
`FHS-1`	File Field Separator	ST	Required	Once	1
`FHS-2`	File Encoding Characters	ST	Required	Once	4
`FHS-3`	File Sending Application	ST	Optional	Once	15
`FHS-4`	File Sending Facility	ST	Optional	Once	20
`FHS-5`	File Receiving Application	ST	Optional	Once	15
`FHS-6`	File Receiving Facility	ST	Optional	Once	20
`FHS-7`	File Creation Date/Time	TS	Optional	Once	26
`FHS-8`	File Security	ST	Optional	Once	40
`FHS-9`	File Name/ID	ST	Optional	Once	20
`FHS-10`	File Header Comment	ST	Optional	Once	80
`FHS-11`	File Control ID	ST	Optional	Once	20
`FHS-12`	Reference File Control ID	ST	Optional	Once	20

Defined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

FT1Financial transaction25 fields

Field	Name	Type	Use	Repeats	Table	Length
`FT1-1`	Set ID - Financial Transaction	SI	Optional	Once		4
`FT1-2`	Transaction ID	ST	Optional	Once		12
`FT1-3`	Transaction Batch ID	ST	Optional	Once		10
`FT1-4`	Transaction Date	TS	Required	Once		26
`FT1-5`	Transaction Posting Date	TS	Optional	Once		26
`FT1-6`	Transaction Type	IS	Required	Once	0017	8
`FT1-7`	Transaction Code	CE	Required	Once	0132	80
`FT1-8`	Transaction Description	ST	Backward	Once		40
`FT1-9`	Transaction Description - alternate	ST	Backward	Once		40
`FT1-10`	Transaction Quantity	NM	Optional	Once		6
`FT1-11`	Transaction Amount - Extended	CP	Optional	Once		12
`FT1-12`	Transaction Amount - Unit	CP	Optional	Once		12
`FT1-13`	Department Code	CE	Optional	Once	0049	60
`FT1-14`	Insurance Plan ID	CE	Optional	Once	0072	60
`FT1-15`	Insurance Amount	CP	Optional	Once		12
`FT1-16`	Assigned Patient Location	PL	Optional	Once		80
`FT1-17`	Fee Schedule	IS	Optional	Once	0024	1
`FT1-18`	Patient Type	IS	Optional	Once	0018	2
`FT1-19`	Diagnosis Code	CE	Optional	Repeats	0051	60
`FT1-20`	Performed By Code	XCN	Optional	Once	0084	120
`FT1-21`	Ordered By Code	XCN	Optional	Once		120
`FT1-22`	Unit Cost	CP	Optional	Once		12
`FT1-23`	Filler Order Number	EI	Optional	Once		22
`FT1-24`	Entered By Code	XCN	Optional	Once		120
`FT1-25`	Procedure Code	CE	Optional	Once	0088	80

Defined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

FTSFile Trailer Segment2 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`FTS-1`	File Batch Count	NM	Optional	Once		10
`FTS-2`	File Trailer Comment	ST	Optional	Once		80

Defined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

GOLGoal Detail21 fields

Field	Name	Type	Use	Repeats	Table	Length
`GOL-1`	Action Code	ID	Required	Once	0287	2
`GOL-2`	Action Date/Time	TS	Required	Once		26
`GOL-3`	Goal ID	CE	Required	Once		80
`GOL-4`	Goal Instance ID	EI	Required	Once		60
`GOL-5`	Episode of Care ID	EI	Optional	Once		60
`GOL-6`	Goal List Priority	NM	Optional	Once		60
`GOL-7`	Goal Established Date/Time	TS	Optional	Once		26
`GOL-8`	Expected Goal Achievement Date/Time	TS	Optional	Once		26
`GOL-9`	Goal Classification	CE	Optional	Once		80
`GOL-10`	Goal Management Discipline	CE	Optional	Once		80
`GOL-11`	Current Goal Review Status	CE	Optional	Once		80
`GOL-12`	Current Goal Review Date/Time	TS	Optional	Once		26
`GOL-13`	Next Goal Review Date/Time	TS	Optional	Once		26
`GOL-14`	Previous Goal Review Date/Time	TS	Optional	Once		26
`GOL-15`	Goal Review Interval	TQ	Optional	Once		200
`GOL-16`	Goal Evaluation	CE	Optional	Once		80
`GOL-17`	Goal Evaluation Comment	ST	Optional	Repeats		300
`GOL-18`	Goal Life Cycle Status	CE	Optional	Once		80
`GOL-19`	Goal Life Cycle Status Date/Time	TS	Optional	Once		26
`GOL-20`	Goal Target Type	CE	Optional	Repeats		80
`GOL-21`	Goal Target Name	XPN	Optional	Repeats		80

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

GT1Guarantor55 fields

Field	Name	Type	Use	Repeats	Table	Length
`GT1-1`	Set ID - Guarantor	SI	Required	Once		4
`GT1-2`	Guarantor Number	CX	Optional	Repeats		59
`GT1-3`	Guarantor Name	XPN	Required	Repeats		48
`GT1-4`	Guarantor Spouse Name	XPN	Optional	Repeats		48
`GT1-5`	Guarantor Address	XAD	Optional	Repeats		106
`GT1-6`	Guarantor Ph Num- Home	XTN	Optional	Repeats		40
`GT1-7`	Guarantor Ph Num-Business	XTN	Optional	Repeats		40
`GT1-8`	Guarantor Date/Time of Birth	TS	Optional	Once		26
`GT1-9`	Guarantor Sex	IS	Optional	Once	0001	1
`GT1-10`	Guarantor Type	IS	Optional	Once	0068	2
`GT1-11`	Guarantor Relationship	IS	Optional	Once	0063	2
`GT1-12`	Guarantor SSN	ST	Optional	Once		11
`GT1-13`	Guarantor Date - Begin	DT	Optional	Once		8
`GT1-14`	Guarantor Date - End	DT	Optional	Once		8
`GT1-15`	Guarantor Priority	NM	Optional	Once		2
`GT1-16`	Guarantor Employer Name	XPN	Optional	Repeats		130
`GT1-17`	Guarantor Employer Address	XAD	Optional	Repeats		106
`GT1-18`	Guarantor Employ Phone Number	XTN	Optional	Repeats		40
`GT1-19`	Guarantor Employee ID Number	CX	Optional	Repeats		20
`GT1-20`	Guarantor Employment Status	IS	Optional	Once	0066	2
`GT1-21`	Guarantor Organization	XON	Optional	Repeats		130
`GT1-22`	Guarantor Billing Hold Flag	ID	Optional	Once	0136	1
`GT1-23`	Guarantor Credit Rating Code	CE	Optional	Once		80
`GT1-24`	Guarantor Death Date And Time	TS	Optional	Once		26
`GT1-25`	Guarantor Death Flag	ID	Optional	Once	0136	1
`GT1-26`	Guarantor Charge Adjustment Code	CE	Optional	Once	0218	80
`GT1-27`	Guarantor Household Annual Income	CP	Optional	Once		10
`GT1-28`	Guarantor Household Size	NM	Optional	Once		3
`GT1-29`	Guarantor Employer ID Number	CX	Optional	Repeats		20
`GT1-30`	Guarantor Marital Status Code	IS	Optional	Once	0002	1
`GT1-31`	Guarantor Hire Effective Date	DT	Optional	Once		8
`GT1-32`	Employment Stop Date	DT	Optional	Once		8
`GT1-33`	Living Dependency	IS	Optional	Once	0223	2
`GT1-34`	Ambulatory Status Code	IS	Optional	Once	0009	2
`GT1-35`	Citizenship	IS	Optional	Once	0171	4
`GT1-36`	Primary Language	CE	Optional	Once	0296	60
`GT1-37`	Living Arrangement	IS	Optional	Once	0220	2
`GT1-38`	Publicity Indicator	CE	Optional	Once	0215	80
`GT1-39`	Protection Indicator	ID	Optional	Once	0136	1
`GT1-40`	Student Indicator	IS	Optional	Once	0231	2
`GT1-41`	Religion	IS	Optional	Once	0006	3
`GT1-42`	Mother s Maiden Name	XPN	Optional	Once		48
`GT1-43`	Nationality Code	CE	Optional	Once	0212	80
`GT1-44`	Ethnic Group	IS	Optional	Once	0189	3
`GT1-45`	Contact Person's Name	XPN	Optional	Repeats		48
`GT1-46`	Contact Person s Telephone Number	XTN	Optional	Repeats		40
`GT1-47`	Contact Reason	CE	Optional	Once	0222	80
`GT1-48`	Contact Relationship Code	IS	Optional	Once	0063	2
`GT1-49`	Job Title	ST	Optional	Once		20
`GT1-50`	Job Code/Class	JCC	Optional	Once		20
`GT1-51`	Guarantor Employer's Organization Name	XON	Optional	Repeats		130
`GT1-52`	Handicap	IS	Optional	Once	0310	2
`GT1-53`	Job Status	IS	Optional	Once	0311	2
`GT1-54`	Guarantor Financial Class	FC	Optional	Once		50
`GT1-55`	Guarantor Race	IS	Optional	Once	0005	1

Defined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

IN1InsuranceCoverage49 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`IN1-1`	Set ID - Insurance	SI	Required	Once		4
`IN1-2`	Insurance Plan ID	CE	Required	Once	0072	60	Coverage.identifier
`IN1-3`	Insurance Company ID	CX	Required	Repeats		59
`IN1-4`	Insurance Company Name	XON	Optional	Repeats		130	Coverage.payor
`IN1-5`	Insurance Company Address	XAD	Optional	Repeats		106	Coverage.payer
`IN1-6`	Insurance Co. Contact Person	XPN	Optional	Repeats		48
`IN1-7`	Insurance Co Phone Number	XTN	Optional	Repeats		40
`IN1-8`	Group Number	ST	Optional	Once		12
`IN1-9`	Group Name	XON	Optional	Repeats		130
`IN1-10`	Insured's group employer ID	CX	Optional	Repeats		12	Coverage.policyHolder Coverage.extension
`IN1-11`	Insured's Group Emp Name	XON	Optional	Repeats		130	Coverage.policyHolder
`IN1-12`	Plan Effective Date	DT	Optional	Once		8	Coverage.period.start
`IN1-13`	Plan Expiration Date	DT	Optional	Once		8	Coverage.period.end
`IN1-14`	Authorization Information	CM_AUI	Optional	Once		55
`IN1-15`	Plan Type	IS	Optional	Once	0086	3	Coverage.type
`IN1-16`	Name of Insured	XPN	Optional	Repeats		48	Coverage.subscriber
`IN1-17`	Insured's Relationship to Patient	IS	Optional	Once	0063	2	Coverage.relationship
`IN1-18`	Insured's Date of Birth	TS	Optional	Once		26
`IN1-19`	Insured's Address	XAD	Optional	Repeats		106
`IN1-20`	Assignment of Benefits	IS	Optional	Once	0135	2
`IN1-21`	Coordination of Benefits	IS	Optional	Once	0173	2
`IN1-22`	Coord of Ben. Priority	ST	Optional	Once		2
`IN1-23`	Notice of Admission Code	ID	Optional	Once	0136	2
`IN1-24`	Notice of Admission Date	DT	Optional	Once		8
`IN1-25`	Report of Eigibility Code	ID	Optional	Once	0136	2
`IN1-26`	Report of Eligibility Date	DT	Optional	Once		8
`IN1-27`	Release Information Code	IS	Optional	Once	0093	2
`IN1-28`	Pre-Admit Cert	ST	Optional	Once		15
`IN1-29`	Verification Date/Time	TS	Optional	Once		26
`IN1-30`	Verification By	XCN	Optional	Once		60
`IN1-31`	Type of Agreement Code	IS	Optional	Once	0098	2
`IN1-32`	Billing Status	IS	Optional	Once	0022	2
`IN1-33`	Lifetime Reserve Days	NM	Optional	Once		4
`IN1-34`	Delay before lifetime reserve days	NM	Optional	Once		4
`IN1-35`	Company Plan Code	IS	Optional	Once	0042	8
`IN1-36`	Policy Number	ST	Optional	Once		15
`IN1-37`	Policy Deductible	CP	Optional	Once		12
`IN1-38`	Policy Limit - Amount	CP	Backward	Once		12
`IN1-39`	Policy Limit - Days	NM	Optional	Once		4
`IN1-40`	Room Rate - Semi-Private	CP	Backward	Once		12
`IN1-41`	Room Rate - Private	CP	Backward	Once		12
`IN1-42`	Insured's Employment Status	CE	Optional	Once	0066	60
`IN1-43`	Insured's Sex	IS	Optional	Once	0001	1
`IN1-44`	Insured's Employer Address	XAD	Optional	Repeats		106
`IN1-45`	Verification Status	ST	Optional	Once		2
`IN1-46`	Prior Insurance Plan ID	IS	Optional	Once	0072	8
`IN1-47`	Coverage Type	IS	Optional	Once	0309	3
`IN1-48`	Handicap	IS	Optional	Once	0310	2
`IN1-49`	Insured's ID Number	CX	Optional	Repeats		12	Coverage.extension

FHIR map of segment IN1Defined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

IN2Insurance additional info72 fields

Field	Name	Type	Use	Repeats	Table	Length
`IN2-1`	Insured's Employee ID	CX	Optional	Repeats		59
`IN2-2`	Insured's Social Security Number	ST	Optional	Once		11
`IN2-3`	Insured's Employer Name	XCN	Optional	Repeats		130
`IN2-4`	Employer Information Data	IS	Optional	Once	0139	1
`IN2-5`	Mail Claim Party	IS	Optional	Repeats	0137	1
`IN2-6`	Medicare Health Ins Card Number	ST	Optional	Once		15
`IN2-7`	Medicaid Case Name	XPN	Optional	Repeats		48
`IN2-8`	Medicaid Case Number	ST	Optional	Once		15
`IN2-9`	Champus Sponsor Name	XPN	Optional	Repeats		48
`IN2-10`	Champus ID Number	ST	Optional	Once		20
`IN2-11`	Dependent of Champus Recipient	CE	Optional	Once		80
`IN2-12`	Champus Organization	ST	Optional	Once		25
`IN2-13`	Champus Station	ST	Optional	Once		25
`IN2-14`	Champus Service	IS	Optional	Once	0140	14
`IN2-15`	Champus Rank/Grade	IS	Optional	Once	0141	2
`IN2-16`	Champus Status	IS	Optional	Once	0142	3
`IN2-17`	Champus Retire Date	DT	Optional	Once		8
`IN2-18`	Champus Non-Avail Cert on File	ID	Optional	Once	0136	1
`IN2-19`	Baby Coverage	ID	Optional	Once	0136	1
`IN2-20`	Combine Baby Bill	ID	Optional	Once	0136	1
`IN2-21`	Blood Deductible	ST	Optional	Once		1
`IN2-22`	Special Coverage Approval Name	XPN	Optional	Repeats		48
`IN2-23`	Special Coverage Approval Title	ST	Optional	Once		30
`IN2-24`	Non-Covered Insurance Code	IS	Optional	Repeats	0143	8
`IN2-25`	Payor ID	CX	Optional	Repeats		59
`IN2-26`	Payor Subscriber ID	CX	Optional	Repeats		59
`IN2-27`	Eligibility Source	IS	Optional	Once	0144	1
`IN2-28`	Room Coverage Type/Amount	CM_RMC	Optional	Repeats		25
`IN2-29`	Policy Type/Amount	CM_PTA	Optional	Repeats		25
`IN2-30`	Daily Deductible	CM_DDI	Optional	Once		25
`IN2-31`	Living Dependency	IS	Optional	Once	0223	2
`IN2-32`	Ambulatory Status	IS	Optional	Once	0009	2
`IN2-33`	Citizenship	IS	Optional	Once	0171	4
`IN2-34`	Primary Language	CE	Optional	Once	0296	60
`IN2-35`	Living Arrangement	IS	Optional	Once	0220	2
`IN2-36`	Publicity Indicator	CE	Optional	Once	0215	80
`IN2-37`	Protection Indicator	ID	Optional	Once	0136	1
`IN2-38`	Student Indicator	IS	Optional	Once	0231	2
`IN2-39`	Religion	IS	Optional	Once	0006	3
`IN2-40`	Mother s Maiden Name	XPN	Optional	Once		48
`IN2-41`	Nationality Code	CE	Optional	Once	0212	80
`IN2-42`	Ethnic Group	IS	Optional	Once	0189	3
`IN2-43`	Marital Status	IS	Optional	Repeats	0002	1
`IN2-44`	Employment Start Date	DT	Optional	Once		8
`IN2-45`	Employment Stop Date	DT	Optional	Once		8
`IN2-46`	Job Title	ST	Optional	Once		20
`IN2-47`	Job Code/Class	JCC	Optional	Once		20
`IN2-48`	Job Status	IS	Optional	Once	0311	2
`IN2-49`	Employer Contact Person Name	XPN	Optional	Repeats		48
`IN2-50`	Employer Contact Person Phone Number	XTN	Optional	Repeats		40
`IN2-51`	Employer Contact Reason	IS	Optional	Once	0222	2
`IN2-52`	Insured's Contact Person Name	XPN	Optional	Repeats		48
`IN2-53`	Insured s Contact Person Telephone Number	XTN	Optional	Repeats		40
`IN2-54`	Insured s Contact Person Reason	IS	Optional	Repeats	0222	2
`IN2-55`	Relationship To The Patient Start Date	DT	Optional	Once		8
`IN2-56`	Relationship To The Patient Stop Date	DT	Optional	Repeats		8
`IN2-57`	Insurance Company Contact Reason	IS	Optional	Once	0232	2
`IN2-58`	Insurance Company Contact Phone Number	XTN	Optional	Once		40
`IN2-59`	Policy Scope	IS	Optional	Once	0312	2
`IN2-60`	Policy Source	IS	Optional	Once	0313	2
`IN2-61`	Patient Member Number	CX	Optional	Once		60
`IN2-62`	Guarantor's Relationship To Insured	IS	Optional	Once	0063	2
`IN2-63`	Insured's Telephone Number - Home	XTN	Optional	Repeats		40
`IN2-64`	Insured's Employer Telephone Number	XTN	Optional	Repeats		40
`IN2-65`	Military Handicapped Program	CE	Optional	Once		60
`IN2-66`	Suspend Flag	ID	Optional	Once	0136	2
`IN2-67`	Co-pay Limit Flag	ID	Optional	Once	0136	2
`IN2-68`	Stoploss Limit Flag	ID	Optional	Once	0136	2
`IN2-69`	Insured Organization Name And ID	XON	Optional	Repeats		130
`IN2-70`	Insured Employer Organization Name And ID	XON	Optional	Repeats		130
`IN2-71`	Race	IS	Optional	Once	0005	1
`IN2-72`	Patient Relationship to Insured	CE	Optional	Once		60

Defined in versions2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

IN3Insurance additional info - certificationCareTeam25 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`IN3-1`	Set ID - Insurance Certification	SI	Required	Once		4
`IN3-2`	Certification Number	CX	Optional	Once		59
`IN3-3`	Certified By	XCN	Optional	Repeats		60
`IN3-4`	Certification Required	ID	Optional	Once	0136	1
`IN3-5`	Penalty	CM_PEN	Optional	Once		10
`IN3-6`	Certification Date/Time	TS	Optional	Once		26
`IN3-7`	Certification Modify Date/Time	TS	Optional	Once		26
`IN3-8`	Operator	XCN	Optional	Repeats		60
`IN3-9`	Certification Begin Date	DT	Optional	Once		8
`IN3-10`	Certification End Date	DT	Optional	Once		8
`IN3-11`	Days	CM_DTN	Optional	Once		3
`IN3-12`	Non-Concur Code/Description	CE	Optional	Once	0233	60
`IN3-13`	Non-Concur Effective Date/Time	TS	Optional	Once		26
`IN3-14`	Physician Reviewer	XCN	Optional	Repeats		60
`IN3-15`	Certification Contact	ST	Optional	Once		48
`IN3-16`	Certification Contact Phone Number	XTN	Optional	Repeats		40
`IN3-17`	Appeal Reason	CE	Optional	Once		60
`IN3-18`	Certification Agency	CE	Optional	Once		60
`IN3-19`	Certification Agency Phone Number	XTN	Optional	Repeats		40
`IN3-20`	Pre-Certification required/Window	CM_PCF	Optional	Repeats		40
`IN3-21`	Case Manager	ST	Optional	Once		48	CareTeam.participant.role.coding.value CareTeam.participant.role.coding.system+1 more
`IN3-22`	Second Opinion Date	DT	Optional	Once		8
`IN3-23`	Second Opinion Status	IS	Optional	Once	0151	1
`IN3-24`	Second Opinion Documentation Received	IS	Optional	Repeats	0152	1
`IN3-25`	Second Opinion Physician	XCN	Optional	Repeats	0010	60

FHIR map of segment IN3Defined in versions2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

LCCLocation Charge Code4 fields

Field	Name	Type	Use	Repeats	Table	Length
`LCC-1`	Primary Key Value	PL	Required	Once		200
`LCC-2`	Location Department	IS	Required	Once	0264	10
`LCC-3`	Accommodation Type	CE	Optional	Repeats		60
`LCC-4`	Charge Code	CE	Required	Repeats	0132	60

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

LCHLocation Characteristic5 fields

Field	Name	Type	Use	Repeats	Table	Length
`LCH-1`	Primary Key Value	PL	Required	Once		200
`LCH-2`	Segment Action Code	ID	Optional	Once	0206	1
`LCH-3`	Segment Unique Key	EI	Optional	Once		80
`LCH-4`	Location Characteristic ID	CE	Required	Once	0324	80
`LCH-5`	Location Characteristic Value	CE	Required	Once		80

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

LDPLocation Department11 fields

Field	Name	Type	Use	Repeats	Table	Length
`LDP-1`	LDP Primary Key Value	PL	Required	Once		200
`LDP-2`	Location Department	IS	Required	Once	0264	10
`LDP-3`	Location Service	IS	Optional	Repeats	0069	3
`LDP-4`	Speciality Type	CE	Optional	Repeats	0265	60
`LDP-5`	Valid Patient Classes	IS	Optional	Repeats	0004	1
`LDP-6`	Active/Inactive Flag	ID	Optional	Once	0183	1
`LDP-7`	Activation Date	TS	Optional	Once		26
`LDP-8`	Inactivation Date - LDP	TS	Optional	Once		26
`LDP-9`	Inactivated Reason	ST	Optional	Once		80
`LDP-10`	Visiting Hours	VH	Optional	Repeats		80
`LDP-11`	Contact Phone	XTN	Optional	Once		40

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

LOCLocation Identification8 fields

Field	Name	Type	Use	Repeats	Table	Length
`LOC-1`	Primary Key Value	PL	Required	Once		200
`LOC-2`	Location Description	ST	Optional	Once		48
`LOC-3`	Location Type	IS	Required	Repeats	0260	2
`LOC-4`	Organization Name	XON	Optional	Once		90
`LOC-5`	Location Address	XAD	Optional	Once		106
`LOC-6`	Location Phone	XTN	Optional	Repeats		40
`LOC-7`	License Number	CE	Optional	Repeats		60
`LOC-8`	Location Equipment	IS	Optional	Repeats	0261	3

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

LRLLocation Relationship6 fields

Field	Name	Type	Use	Repeats	Table	Length
`LRL-1`	Primary Key Value	PL	Required	Once		200
`LRL-2`	Segment Action Code	ID	Optional	Once	0206	3
`LRL-3`	Segment Unique Key	EI	Optional	Once		80
`LRL-4`	Location Relationship ID	CE	Required	Once	0325	80
`LRL-5`	Organizational Location Relationship Value	XON	Conditional	Once		80
`LRL-6`	Patient Location Relationship Value	PL	Conditional	Once		80

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

MFAMaster file acknowledgement segment5 fields

Field	Name	Type	Use	Repeats	Table	Length
`MFA-1`	Record-Level Event Code	ID	Required	Once	0180	3
`MFA-2`	MFN Control ID	ST	Conditional	Once		20
`MFA-3`	Event Completion Date/Time	TS	Optional	Once		26
`MFA-4`	Error Return Code and/or Text	CE	Required	Once	0181	60
`MFA-5`	Primary Key Value	CE	Required	Repeats		60

Defined in versions2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

MFEMaster file entry segment4 fields

Field	Name	Type	Use	Repeats	Table	Length
`MFE-1`	Record-Level Event Code	ID	Required	Once	0180	3
`MFE-2`	MFN Control ID	ST	Conditional	Once		20
`MFE-3`	Effective Date/Time	TS	Optional	Once		26
`MFE-4`	Primary Key Value	VARIES	Required	Repeats		200

Defined in versions2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

MFIMaster file identification segment6 fields

Field	Name	Type	Use	Repeats	Table	Length
`MFI-1`	Master File Identifier	CE	Required	Once	0175	60
`MFI-2`	Master File Application Identifier	HD	Optional	Once		180
`MFI-3`	File-Level Event Code	ID	Required	Once	0178	3
`MFI-4`	Entered Date/Time	TS	Optional	Once		26
`MFI-5`	Effective Date/Time	TS	Optional	Once		26
`MFI-6`	Response Level Code	ID	Required	Once	0179	2

Defined in versions2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

MRGMerge patient informationAccount7 fields

Field	Name	Type	Use	Repeats	Length	FHIR
`MRG-1`	Prior Patient ID - Internal	CX	Required	Repeats	20
`MRG-2`	Prior Alternate Patient ID	CX	Optional	Repeats	20
`MRG-3`	Prior Patient Account Number	CX	Optional	Once	20	Account.identifier
`MRG-4`	Prior Patient ID - External	CX	Optional	Once	20
`MRG-5`	Prior Visit Number	CX	Optional	Once	20
`MRG-6`	Prior Alternate Visit ID	CX	Optional	Once	20
`MRG-7`	Prior Patient Name	XPN	Optional	Once	48

FHIR map of segment MRGDefined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

MSAMessage acknowledgement segmentMessageHeader6 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`MSA-1`	Acknowledgement code	ID	Required	Once	0008	2	MessageHeader.response.code
`MSA-2`	Message Control ID	ST	Required	Once		20	MessageHeader.response.identifier
`MSA-3`	Text Message	ST	Optional	Once		80
`MSA-4`	Expected Sequence Number	NM	Optional	Once		15
`MSA-5`	Delayed Acknowledgement Type	ID	Backward	Once	0102	1
`MSA-6`	Error Condition	CE	Optional	Once		100

FHIR map of segment MSADefined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

MSHMessage header segmentProvenance, Bundle, Encounter +119 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`MSH-1`	Field Separator	ST	Required	Once		1
`MSH-2`	Encoding Characters	ST	Required	Once		4
`MSH-3`	Sending Application	HD	Optional	Once		180	Provenance.entity.what Provenance.entity.role+2 more
`MSH-4`	Sending Facility	HD	Optional	Once		180	Provenance.agent.who Provenance.agent.type.coding.code+2 more
`MSH-5`	Receiving Application	HD	Optional	Once		180	MessageHeader.destination.target MessageHeader.destination.name+1 more
`MSH-6`	Receiving Facility	HD	Optional	Once		180	MessageHeader.destination.receiver
`MSH-7`	Date / Time of Message	TS	Optional	Once		26	Provenance.recorded Provenance.occurred+1 more
`MSH-8`	Security	ST	Optional	Once		40	MessageHeader.meta.security
`MSH-9`	Message Type	CM_MSG	Required	Once		7	Provenance.activity.coding.display Encounter.status+1 more
`MSH-10`	Message Control ID	ST	Required	Once		20	Bundle.identifier.value Bundle.identifier.system
`MSH-11`	Processing ID	PT	Required	Once		3	MessageHeader.meta
`MSH-12`	Version ID	ID	Required	Once	0104	8
`MSH-13`	Sequence Number	NM	Optional	Once		15
`MSH-14`	Continuation Pointer	ST	Optional	Once		180
`MSH-15`	Accept Acknowledgement Type	ID	Optional	Once	0155	2
`MSH-16`	Application Acknowledgement Type	ID	Optional	Once	0155	2
`MSH-17`	Country Code	ID	Optional	Once	`ISO3166`	2	MessageHeader.sender
`MSH-18`	Character Set	ID	Optional	Once	0211	6
`MSH-19`	Principal Language of Message	CE	Optional	Once		60	MessageHeader.language

FHIR map of segment MSHDefined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

NCKSystem Clock1 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`NCK-1`	System Date/Time	TS	Required	Once		26

Defined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

NK1Next of kinPatient, RelatedPerson37 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`NK1-1`	Set ID - Next of Kin	SI	Required	Once		4
`NK1-2`	NK Name	XPN	Optional	Repeats		48	Patient.contact.name RelatedPerson.name
`NK1-3`	Relationship	CE	Optional	Once	0063	60	Patient.contact.relationship RelatedPerson.relationship
`NK1-4`	Address	XAD	Optional	Repeats		106	Patient.contact.address RelatedPerson.address
`NK1-5`	Phone Number	XTN	Optional	Repeats		40	Patient.contact.telecom RelatedPerson.telecom
`NK1-6`	Business Phone Number	XTN	Optional	Repeats		40	Patient.contact.telecom Patient.contact.telecom.use+2 more
`NK1-7`	Contact Role	CE	Optional	Once	0131	60	Patient.contact.relationship RelatedPerson.relationship
`NK1-8`	Start Date	DT	Optional	Once		8	Patient.contact.period.start RelatedPerson.period.start
`NK1-9`	End Date	DT	Optional	Once		8	Patient.contact.period.end RelatedPerson.period.end
`NK1-10`	Next of Kin/Associated Parties Job Title	ST	Optional	Once		60
`NK1-11`	Next of Kin Job/Associated Parties Code/Class	JCC	Optional	Once		20
`NK1-12`	Next of Kin/Associated Parties Employee Number	CX	Optional	Once		20	RelatedPerson.identifier
`NK1-13`	Organization Name	XON	Optional	Repeats		60	Patient.contact.organization
`NK1-14`	Marital Status	IS	Optional	Once	0002	2
`NK1-15`	Sex	IS	Optional	Once	0001	1	Patient.contact.gender RelatedPerson.gender
`NK1-16`	Date of Birth	TS	Optional	Once		26	RelatedPerson.birthDate
`NK1-17`	Living Dependency	IS	Optional	Repeats	0223	2
`NK1-18`	Ambulatory Status	IS	Optional	Repeats	0009	2
`NK1-19`	Citizenship	IS	Optional	Repeats	0171	4
`NK1-20`	Primary Language	CE	Optional	Once	0296	60	RelatedPerson.communication.language
`NK1-21`	Living Arrangement	IS	Optional	Once	0220	2
`NK1-22`	Publicity Indicator	CE	Optional	Once	0215	1
`NK1-23`	Protection Indicator	ID	Optional	Once	0136	1
`NK1-24`	Student Indicator	IS	Optional	Once	0231	2
`NK1-25`	Religion	IS	Optional	Once	0006	3
`NK1-26`	Mother s Maiden Name	XPN	Optional	Once		48
`NK1-27`	Nationality Code	CE	Optional	Once	0212	80
`NK1-28`	Ethnic Group	IS	Optional	Once	0189	3
`NK1-29`	Contact Reason	CE	Optional	Repeats	0222	80
`NK1-30`	Contact Person's Name	XPN	Optional	Repeats		48	Patient.contact.organization RelatedPerson.name
`NK1-31`	Contact Person s Telephone Number	XTN	Optional	Repeats		40	Patient.contact.organization RelatedPerson.telecom
`NK1-32`	Contact Person s Address	XAD	Optional	Repeats		106	Patient.contact.organization RelatedPerson.address
`NK1-33`	Next of kin/associated party identifiers	CX	Optional	Repeats		32	RelatedPerson.identifier
`NK1-34`	Job Status	IS	Optional	Once	0311	2
`NK1-35`	Race	IS	Optional	Once	0005	1
`NK1-36`	Handicap	IS	Optional	Once	0295	2
`NK1-37`	Contact Person Social Security Number	ST	Optional	Once		16	RelatedPerson.identifier.value RelatedPerson.identifier.system+1 more

FHIR map of segment NK1Defined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

NPUBed status update2 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`NPU-1`	Bed Location	PL	Required	Once		80
`NPU-2`	Bed Status	IS	Optional	Once	0116	1

Defined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

NSCStatus change9 fields

Field	Name	Type	Use	Repeats	Table	Length
`NSC-1`	Network Change Type	IS	Required	Once	0333	4
`NSC-2`	Current CPU	ST	Optional	Once		30
`NSC-3`	Current Fileserver	ST	Optional	Once		30
`NSC-4`	Current Application	ST	Optional	Once		30
`NSC-5`	Current Facility	ST	Optional	Once		30
`NSC-6`	New CPU	ST	Optional	Once		30
`NSC-7`	New Fileserver	ST	Optional	Once		30
`NSC-8`	New Application	ST	Optional	Once		30
`NSC-9`	New Facility	ST	Optional	Once		30

Defined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

NSTStatistics15 fields

Field	Name	Type	Use	Repeats	Table	Length
`NST-1`	Statistics Available	ID	Required	Once	0136	1
`NST-2`	Source Identifier	ST	Optional	Once		30
`NST-3`	Source Type	ID	Optional	Once	0332	3
`NST-4`	Statistics Start	TS	Optional	Once		26
`NST-5`	Statistics End	TS	Optional	Once		26
`NST-6`	Receive Character Count	NM	Optional	Once		10
`NST-7`	Send Character Count	NM	Optional	Once		10
`NST-8`	Messages Received	NM	Optional	Once		10
`NST-9`	Messages Sent	NM	Optional	Once		10
`NST-10`	Checksum Errors Received	NM	Optional	Once		10
`NST-11`	Length Errors Received	NM	Optional	Once		10
`NST-12`	Other Errors Received	NM	Optional	Once		10
`NST-13`	Connect Timeouts	NM	Optional	Once		10
`NST-14`	Receive Timeouts	NM	Optional	Once		10
`NST-15`	Network Errors	NM	Optional	Once		10

Defined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

NTENotes and comments segmentAppointment, DocumentReference, Observation +13 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`NTE-1`	Set ID - Notes and Comments	SI	Optional	Once		4
`NTE-2`	Source of Comment	ID	Optional	Once	0105	8
`NTE-3`	Comment	FT	Optional	Repeats		65536	DocumentReference.content.attachment.data DocumentReference.content.contentType+3 more

FHIR map of segment NTEDefined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

OBRObservation request segmentDiagnosticReport, ServiceRequest, Specimen43 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`OBR-1`	Set ID - Observation Request	SI	Conditional	Once		4
`OBR-2`	Placer Order Number	EI	Conditional	Once		75	DiagnosticReport.identifier DiagnosticReport.identifier.type.coding.code+5 more
`OBR-3`	Filler Order Number	EI	Conditional	Once		75	DiagnosticReport.identifier DiagnosticReport.identifier.type.coding.code+4 more
`OBR-4`	Universal Service Identifier	CE	Required	Once		200	DiagnosticReport.code ServiceRequest.code
`OBR-5`	Priority	ID	Backward	Once		2	ServiceRequest.priority
`OBR-6`	Requested Date/Time	TS	Backward	Once		26	ServiceRequest.occurrenceDateTime
`OBR-7`	Observation Date/Time	TS	Conditional	Once		26	DiagnosticReport.effectiveDateTime DiagnosticReport.effectivePeriod.start+2 more
`OBR-8`	Observation End Date/Time	TS	Optional	Once		26	DiagnosticReport.effectivePeriod.end Specimen.collection.collectedPeriod.end
`OBR-9`	Collection Volume	CQ	Optional	Once		20	Specimen.collection.quantity
`OBR-10`	Collector Identifier	XCN	Optional	Repeats		60	Specimen.collection.collector
`OBR-11`	Specimen Action Code	ID	Optional	Once	0065	1	ServiceRequest.intent
`OBR-12`	Danger Code	CE	Optional	Once		60
`OBR-13`	Relevant Clinical Information	ST	Optional	Once		300	Specimen.collection.fastingStatusCodeableConcept Specimen.collection.fastingStatusDuration+2 more
`OBR-14`	Specimen Received Date/Time	TS	Conditional	Once		26	Specimen.receivedTime
`OBR-15`	Specimen Source	CM_SPS	Optional	Once		300	Specimen.$this
`OBR-16`	Ordering Provider	XCN	Optional	Repeats		80	ServiceRequest.requester
`OBR-17`	Order Callback Phone Number	XTN	Optional	Once		40	ServiceRequest.requester.extension
`OBR-18`	Placer Field 1	ST	Optional	Once		60
`OBR-19`	Placer Field 2	ST	Optional	Once		60
`OBR-20`	Filler Field 1	ST	Optional	Once		60
`OBR-21`	Filler Field 2	ST	Optional	Once		60
`OBR-22`	Results Rpt/Status Chng - Date/Time	TS	Conditional	Once		26	DiagnosticReport.issued
`OBR-23`	Charge To Practice	CM_MOC	Optional	Once		40
`OBR-24`	Diagnostic Service Section ID	ID	Optional	Once	0074	10	DiagnosticReport.category
`OBR-25`	Result Status	ID	Conditional	Once	0123	1	DiagnosticReport.status
`OBR-26`	Parent Result	CM_PRL	Optional	Once		400
`OBR-27`	Quantity/Timing	TQ	Optional	Repeats		200	ServiceRequest.$this
`OBR-28`	Result Copies To	XCN	Optional	Once		150
`OBR-29`	Parent Number	CM_EIP	Optional	Once		150	ServiceRequest.basedOn.identifier ServiceRequest.basedOn.type
`OBR-30`	Transportation Mode	ID	Optional	Once	0124	20
`OBR-31`	Reason For Study	CE	Optional	Repeats		300	ServiceRequest.reasonCode
`OBR-32`	Principal Result Interpreter	CM_NDL	Optional	Once		200	DiagnosticReport.resultsInterpreter
`OBR-33`	Assistant Result Interpreter	CM_NDL	Optional	Repeats		200
`OBR-34`	Technician	CM_NDL	Optional	Repeats		200	DiagnosticReport.performer DiagnosticReport.performer.extension+2 more
`OBR-35`	Transcriptionist	CM_NDL	Optional	Repeats		200	DiagnosticReport.performer DiagnosticReport.performer.extension+2 more
`OBR-36`	Scheduled Date/Time	TS	Optional	Once		26
`OBR-37`	Number Of Sample Containers	NM	Optional	Once		4
`OBR-38`	Transport Logistics Of Collected Sample	CE	Optional	Repeats		60
`OBR-39`	Collector s Comment	CE	Optional	Repeats		200	Specimen.note
`OBR-40`	Transport Arrangement Responsibility	CE	Optional	Once		60
`OBR-41`	Transport Arranged	ID	Optional	Once	0224	30
`OBR-42`	Escort Required	ID	Optional	Once	0225	1
`OBR-43`	Planned Patient Transport Comment	CE	Optional	Repeats		200

FHIR map of segment OBRDefined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

OBXObservation segmentObservation, DocumentReference17 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`OBX-1`	Set ID - OBX	SI	Optional	Once		10
`OBX-2`	Value Type	ID	Conditional	Once	0125	2
`OBX-3`	Observation Identifier	CE	Required	Once		590	Observation.code Observation.component[each].code
`OBX-4`	Observation Sub-ID	ST	Conditional	Once		20	Observation.$this
`OBX-5`	Observation Value	VARIES	Conditional	Repeats		65536	Observation.component[each].valueQuantity Observation.component[each].valueString+23 more
`OBX-6`	Units	CE	Optional	Once		60	Observation.component[each].valueQuantity Observation.component[each].valueRange.low+8 more
`OBX-7`	References Range	ST	Optional	Once		10	Observation.component[each].referenceRange.text Observation.referenceRange.text
`OBX-8`	Abnormal Flags	ID	Optional	Once	0078	5	Observation.interpretation
`OBX-9`	Probability	NM	Optional	Once		5
`OBX-10`	Nature of Abnormal Test	ID	Optional	Repeats	0080	2	Observation.extension.uri Observation.extension
`OBX-11`	Observ Result Status	ID	Required	Once	0085	1	Observation.status Observation.dataAbsentReason.coding.code+4 more
`OBX-12`	Date Last Obs Normal Values	TS	Optional	Once		26
`OBX-13`	User Defined Access Checks	ST	Optional	Once		20
`OBX-14`	Date/Time of the Observation	TS	Optional	Once		26	Observation.effectiveDateTime
`OBX-15`	Producer's ID	CE	Optional	Once		60	Observation.performer
`OBX-16`	Responsible Observer	XCN	Optional	Once		80	Observation.performer)Observation.performer
`OBX-17`	Observation Method	CE	Optional	Repeats		60	Observation.method

FHIR map of segment OBXDefined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

ODSDietary orders, supplements, and preferences4 fields

Field	Name	Type	Use	Repeats	Table	Length
`ODS-1`	Type	ID	Required	Once	0159	1
`ODS-2`	Service Period	CE	Optional	Once		60
`ODS-3`	Diet, Supplement, or Preference Code	CE	Required	Once		60
`ODS-4`	Text Instruction	ST	Optional	Once		80

Defined in versions2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

ODTDiet tray instructions segment3 fields

Field	Name	Type	Use	Repeats	Table	Length
`ODT-1`	Tray Type	CE	Required	Once	0160	60
`ODT-2`	Service Period	CE	Optional	Once		60
`ODT-3`	Text Instruction	ST	Optional	Once		80

Defined in versions2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

OM1General - fields that apply to most observations47 fields

Field	Name	Type	Use	Repeats	Table	Length
`OM1-1`	Sequence Number	NM	Required	Once		4
`OM1-2`	Producer's Test/Observation ID	CE	Required	Once		200
`OM1-3`	Permitted Data Types	ID	Optional	Repeats	0125	12
`OM1-4`	Specimen Required	ID	Required	Once	0136	1
`OM1-5`	Producer ID	CE	Required	Once		200
`OM1-6`	Observation Description	TX	Optional	Once		200
`OM1-7`	Other Test/Observation IDs for the Observation	CE	Optional	Once		200
`OM1-8`	Other Names	ST	Required	Repeats		200
`OM1-9`	Preferred Report Name for the Observation	ST	Optional	Once		30
`OM1-10`	Preferred Short Name or Mnemonic for Observation	ST	Optional	Once		8
`OM1-11`	Preferred Long Name for the Observation	ST	Optional	Once		200
`OM1-12`	Orderability	ID	Optional	Once	0136	1
`OM1-13`	Identity of Instrument Used to Perfrom this Study	CE	Optional	Repeats		60
`OM1-14`	Coded Representation of Method	CE	Optional	Repeats		200
`OM1-15`	Portable	ID	Optional	Once	0136	1
`OM1-16`	Observation Producing Department/Section	CE	Optional	Repeats		1
`OM1-17`	Telephone Number of Section	XTN	Optional	Once		40
`OM1-18`	Nature of Test/Observation	IS	Required	Once	0174	1
`OM1-19`	Report Subheader	CE	Optional	Once		200
`OM1-20`	Report Display Order	ST	Optional	Once		20
`OM1-21`	Date/Time Stamp for any change in Def Attri for Obs	TS	Optional	Once		26
`OM1-22`	Effective Date/Time of Change in Test Proc. that make Results Non-Comparable	TS	Optional	Once		26
`OM1-23`	Typical Turn-Around Time	NM	Optional	Once		20
`OM1-24`	Processing Time	NM	Optional	Once		20
`OM1-25`	Processing Priority	ID	Optional	Repeats	0168	40
`OM1-26`	Reporting Priority	ID	Optional	Once	0169	5
`OM1-27`	Outside Site	CE	Optional	Repeats		200
`OM1-28`	Address of Outside Site	XAD	Optional	Once		1000
`OM1-29`	Phone Number of Outside Site	XTN	Optional	Once		400
`OM1-30`	Confidentiality Code	IS	Optional	Once	0177	1
`OM1-31`	Observations Required to Interpret the Observation	CE	Optional	Once		200
`OM1-32`	Interpretation of Observations	TX	Optional	Once		65536
`OM1-33`	Contraindications to Observations	CE	Optional	Once		65536
`OM1-34`	Reflex Tests/Observations	CE	Optional	Repeats		200
`OM1-35`	Rules that Trigger Reflex Testing	TX	Optional	Once		80
`OM1-36`	Fixed Canned Message	CE	Optional	Once		65536
`OM1-37`	Patient Preparation	TX	Optional	Once		200
`OM1-38`	Procedure Medication	CE	Optional	Once		200
`OM1-39`	Factors that may Effect the Observation	TX	Optional	Once		200
`OM1-40`	Test/Observation Performance Schedule	ST	Optional	Repeats		60
`OM1-41`	Description of Test Methods	TX	Optional	Once		65536
`OM1-42`	Kind of Quantity Observed	CE	Optional	Once	0254	60
`OM1-43`	Point versus Interval	CE	Optional	Once	0255	60
`OM1-44`	Challenge information	TX	Optional	Once		200
`OM1-45`	Relationship modifier	CE	Optional	Once	0258	200
`OM1-46`	Target anatomic site of test	CE	Optional	Once		200
`OM1-47`	Modality of imaging measurement	CE	Optional	Once	0259	200

Defined in versions2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

OM2Numeric observation10 fields

Field	Name	Type	Use	Repeats	Length
`OM2-1`	Sequence Number	NM	Optional	Once	4
`OM2-2`	Units of Measure	CE	Optional	Once	60
`OM2-3`	Range of Decimal Precision	NM	Optional	Repeats	10
`OM2-4`	Corresponding SI Units of Measure	CE	Optional	Once	60
`OM2-5`	SI Conversion Factor	TX	Optional	Once	60
`OM2-6`	Reference	CM_RFR	Optional	Once	200
`OM2-7`	Critical Range for Ordinal & Continuous Obs	CM_RANGE	Optional	Once	200
`OM2-8`	Absolute Range for Ordinal & Continuous Obs	CM_ABS_RANGE	Optional	Once	200
`OM2-9`	Delta Check Criteria	CM_DLT	Optional	Repeats	200
`OM2-10`	Minimum Meaningful Increments	NM	Optional	Once	20

Defined in versions2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

OM3Categorical test/observation7 fields

Field	Name	Type	Use	Repeats	Table	Length
`OM3-1`	Sequence Number	NM	Optional	Once		4
`OM3-2`	Preferred Coding System	CE	Optional	Once		60
`OM3-3`	Valid Coded "Answers"	CE	Optional	Once		60
`OM3-4`	Normal Text/Codes for Categorical Observations	CE	Optional	Repeats		200
`OM3-5`	Abnormal Text/Codes for Categorical Observations	CE	Optional	Once		200
`OM3-6`	Critical Text Codes for Categorical Observations	CE	Optional	Once		200
`OM3-7`	Value Type	ID	Optional	Once	0125	3

Defined in versions2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

OM4Observations that require specimens14 fields

Field	Name	Type	Use	Repeats	Table	Length
`OM4-1`	Sequence Number	NM	Optional	Once		4
`OM4-2`	Derived Specimen	ID	Optional	Once	0170	1
`OM4-3`	Container Description	TX	Optional	Once		60
`OM4-4`	Container Volume	NM	Optional	Once		20
`OM4-5`	Container Units	CE	Optional	Once		60
`OM4-6`	Specimen	CE	Optional	Once		60
`OM4-7`	Additive	CE	Optional	Once		60
`OM4-8`	Preparation	TX	Optional	Once		10240
`OM4-9`	Special Handling Requirements	TX	Optional	Once		10240
`OM4-10`	Normal Collection Volume	CQ	Optional	Once		20
`OM4-11`	Minimum Collection Volume	CQ	Optional	Once		20
`OM4-12`	Specimen Requirements	TX	Optional	Once		10240
`OM4-13`	Specimen Priorities	ID	Optional	Repeats	0027	1
`OM4-14`	Specimen Retention Time	CQ	Optional	Once		20

Defined in versions2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

OM5Observation batteries3 fields

Field	Name	Type	Use	Repeats	Length
`OM5-1`	Sequence Number	NM	Optional	Once	4
`OM5-2`	Test/Observations Included w/an Ordered Test Battery	CE	Optional	Repeats	200
`OM5-3`	Observation ID Suffixes	ST	Optional	Once	200

Defined in versions2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

OM6Observations that are calculated from other observations2 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`OM6-1`	Sequence Number	NM	Optional	Once		4
`OM6-2`	Derivation Rule	TX	Optional	Once		10240

Defined in versions2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

ORCCommon order segmentDiagnosticReport, Immunization, MedicationAdministration +219 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`ORC-1`	Order Control	ID	Required	Once	0119	2	Provenance.activity.coding.code Provenance.activity.coding.system+10 more
`ORC-2`	Placer Order Number	EI	Conditional	Once		22	DiagnosticReport.identifier DiagnosticReport.identifier.type.coding.code+11 more
`ORC-3`	Filler Order Number	EI	Conditional	Once		22	DiagnosticReport.identifier DiagnosticReport.identifier.type.coding.code+10 more
`ORC-4`	Placer Group Number	EI	Optional	Once		22	DiagnosticReport.identifier Immunization.identifier+6 more
`ORC-5`	Order Status	ID	Optional	Once	0038	2	ServiceRequest.status
`ORC-6`	Response Flag	ID	Optional	Once	0121	1
`ORC-7`	Quantity/Timing	TQ	Optional	Once		200	ServiceRequest.$this
`ORC-8`	Parent Order	CM_EIP	Optional	Once		200
`ORC-9`	Date/Time of Transaction	TS	Optional	Once		26	Immunization.recorded Provenance.recorded+4 more
`ORC-10`	Entered By	XCN	Optional	Once		120	Provenance.agent.who Provenance.agent.type.coding.code+1 more
`ORC-11`	Verified By	XCN	Optional	Once		120	Provenance.agent.who Provenance.agent.type.coding.code+1 more
`ORC-12`	Ordering Provider	XCN	Optional	Once		120	Immunization.performer.actor Immunization.performer.function.coding.code+8 more
`ORC-13`	Enterer's Location	PL	Optional	Once		80
`ORC-14`	Call Back Phone Number	XTN	Optional	Once		40	ServiceRequest.extension
`ORC-15`	Order Effective Date/Time	TS	Optional	Once		26
`ORC-16`	Order Control Code Reason	CE	Optional	Once		200	DiagnosticReport.extension ServiceRequest.extension
`ORC-17`	Entering Organization	CE	Optional	Once		60	Provenance.agent.onBehalfOf
`ORC-18`	Entering Device	CE	Optional	Once		60	Provenance.agent.who
`ORC-19`	Action By	XCN	Optional	Once		120	Provenance.agent.type.coding.code Provenance.agent.type.coding.system+1 more

FHIR map of segment ORCDefined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

PCRPossible Causal Relationship23 fields

Field	Name	Type	Use	Repeats	Table	Length
`PCR-1`	Implicated Product	CE	Required	Once		60
`PCR-2`	Generic Product	IS	Optional	Once	0249	1
`PCR-3`	Product Class	CE	Optional	Once		60
`PCR-4`	Total Duration Of Therapy	CQ	Optional	Once		8
`PCR-5`	Product Manufacture Date	TS	Optional	Once		26
`PCR-6`	Product Expiration Date	TS	Optional	Once		26
`PCR-7`	Product Implantation Date	TS	Optional	Once		26
`PCR-8`	Product Explantation Date	TS	Optional	Once		26
`PCR-9`	Single Use Device	IS	Optional	Once	0244	8
`PCR-10`	Indication For Product Use	CE	Optional	Once		60
`PCR-11`	Product Problem	IS	Optional	Once	0245	8
`PCR-12`	Product Serial/Lot Number	ST	Optional	Once		30
`PCR-13`	Product Available For Inspection	IS	Optional	Once	0246	1
`PCR-14`	Product Evaluation Performed	CE	Optional	Once		60
`PCR-15`	Product Evaluation Status	CE	Optional	Once	0247	60
`PCR-16`	Product Evaluation Results	CE	Optional	Once		60
`PCR-17`	Evaluated Product Source	ID	Optional	Once	0248	8
`PCR-18`	Date Product Returned To Manufacturer	TS	Optional	Once		26
`PCR-19`	Device Operator Qualifications	ID	Optional	Once	0242	1
`PCR-20`	Relatedness Assessment	ID	Optional	Once	0250	1
`PCR-21`	Action Taken In Response To The Event	ID	Optional	Once	0251	2
`PCR-22`	Event Causality Observations	ID	Optional	Once	0252	2
`PCR-23`	Indirect Exposure Mechanism	ID	Optional	Once	0253	1

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

PD1Patient DemographicObservation, Patient12 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`PD1-1`	Living Dependency	IS	Optional	Repeats	0223	2
`PD1-2`	Living Arrangement	IS	Optional	Once	0220	2
`PD1-3`	Patient Primary Facility	XON	Optional	Repeats		90	Patient.generalPractitioner
`PD1-4`	Patient Primary Care Provider Name & ID No.	XCN	Optional	Repeats		90	Patient.generalPractitioner
`PD1-5`	Student Indicator	IS	Optional	Once	0231	2
`PD1-6`	Handicap	IS	Optional	Once	0295	2	Patient.extension
`PD1-7`	Living Will	IS	Optional	Once	0315	2	Observation.valueCodeableConcept
`PD1-8`	Organ Donor	IS	Optional	Once	0316	2
`PD1-9`	Separate Bill	ID	Optional	Once	0136	2
`PD1-10`	Duplicate Patient	CX	Optional	Repeats		2
`PD1-11`	Publicity Indicator	CE	Optional	Once	0215	1
`PD1-12`	Protection Indicator	ID	Optional	Once	0136	1

FHIR map of segment PD1Defined in versions2.12.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

PDCProduct Detail Country15 fields

Field	Name	Type	Use	Repeats	Table	Length
`PDC-1`	Manufacturer/Distributor	XON	Required	Once		80
`PDC-2`	Country	CE	Required	Once		60
`PDC-3`	Brand Name	ST	Required	Once		60
`PDC-4`	Device Family Name	ST	Optional	Once		60
`PDC-5`	Generic Name	CE	Optional	Once		60
`PDC-6`	Model Identifier	ST	Optional	Repeats		60
`PDC-7`	Catalogue Identifier	ST	Optional	Once		60
`PDC-8`	Other Identifier	ST	Optional	Repeats		60
`PDC-9`	Product Code	CE	Optional	Once		60
`PDC-10`	Marketing Basis	ID	Optional	Once	0330	4
`PDC-11`	Marketing Approval Identifier	ST	Optional	Once		60
`PDC-12`	Labeled Shelf Life	CQ	Optional	Once		12
`PDC-13`	Expected Shelf Life	CQ	Optional	Once		12
`PDC-14`	Date First Marked	TS	Optional	Once		26
`PDC-15`	Date Last Marked	TS	Optional	Once		26

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

PEOProduct Experience Observation25 fields

Field	Name	Type	Use	Repeats	Table	Length
`PEO-1`	Event Identifiers Used	CE	Optional	Repeats		60
`PEO-2`	Event Symptom/Diagnosis Code	CE	Optional	Repeats		60
`PEO-3`	Event Onset Date/Time	TS	Required	Once		26
`PEO-4`	Event Exacerbation Date/Time	TS	Optional	Once		26
`PEO-5`	Event Improved Date/Time	TS	Optional	Once		26
`PEO-6`	Event Ended Data/Time	TS	Optional	Once		26
`PEO-7`	Event Location Occurred Address	XAD	Optional	Once		106
`PEO-8`	Event Qualification	ID	Optional	Repeats	0237	1
`PEO-9`	Event Serious	ID	Optional	Once	0238	1
`PEO-10`	Event Expected	ID	Optional	Once	0239	1
`PEO-11`	Event Outcome	ID	Optional	Repeats	0240	1
`PEO-12`	Patient Outcome	ID	Optional	Once	0241	1
`PEO-13`	Event Description From Others	FT	Optional	Repeats		600
`PEO-14`	Event From Original Reporter	FT	Optional	Repeats		600
`PEO-15`	Event Description From Patient	FT	Optional	Repeats		600
`PEO-16`	Event Description From Practitioner	FT	Optional	Repeats		600
`PEO-17`	Event Description From Autopsy	FT	Optional	Repeats		600
`PEO-18`	Cause Of Death	CE	Optional	Repeats		60
`PEO-19`	Primary Observer Name	XPN	Optional	Once		46
`PEO-20`	Primary Observer Address	XAD	Optional	Repeats		106
`PEO-21`	Primary Observer Telephone	XTN	Optional	Repeats		40
`PEO-22`	Primary Observer s Qualification	ID	Optional	Once	0242	1
`PEO-23`	Confirmation Provided By	ID	Optional	Once	0242	1
`PEO-24`	Primary Observer Aware Date/Time	TS	Optional	Once		26
`PEO-25`	Primary Observer s Identity May Be Divulged	ID	Optional	Once	0243	1

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

PESProduct Experience Sender13 fields

Field	Name	Type	Use	Repeats	Table	Length
`PES-1`	Sender Organization Name	XON	Optional	Once		80
`PES-2`	Sender Individual Name	XCN	Optional	Repeats		60
`PES-3`	Sender Address	XAD	Optional	Repeats		200
`PES-4`	Sender Telephone	XTN	Optional	Repeats		44
`PES-5`	Sender Event Identifier	EI	Optional	Once		30
`PES-6`	Sender Sequence Number	NM	Optional	Once		2
`PES-7`	Sender Event Description	FT	Optional	Repeats		600
`PES-8`	Sender Comment	FT	Optional	Once		600
`PES-9`	Sender Aware Date/Time	TS	Optional	Once		26
`PES-10`	Event Report Date	TS	Required	Once		26
`PES-11`	Event Report Timing/Type	ID	Optional	Once	0234	3
`PES-12`	Event Report Source	ID	Optional	Once	0235	1
`PES-13`	Event Reported To	ID	Optional	Repeats	0236	1

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

PIDPatient IdentificationProvenance, Account, Appointment +130 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`PID-1`	Set ID - Patient ID	SI	Optional	Once		4
`PID-2`	Patient ID (External ID)	CX	Optional	Once		20	Appointment.participant.actor Patient.identifier+1 more
`PID-3`	Patient ID (Internal ID)	CX	Required	Repeats		20	Appointment.participant.actor Patient.identifier+1 more
`PID-4`	Alternate Patient ID	CX	Optional	Repeats		20	Appointment.participant.actor Patient.identifier+1 more
`PID-5`	Patient Name	XPN	Required	Repeats		48	Patient.name
`PID-6`	Mother's Maiden Name	XPN	Optional	Once		48	Patient.extension
`PID-7`	Date of Birth	TS	Optional	Once		26	Patient.birthDate Patient.birthDate.extension
`PID-8`	Sex	IS	Optional	Once	0001	1	Patient.gender
`PID-9`	Patient Alias	XPN	Optional	Repeats		48	Patient.name
`PID-10`	Race	IS	Optional	Once	0005	1
`PID-11`	Patient Address	XAD	Optional	Repeats		106	Patient.address
`PID-12`	County Code	IS	Backward	Once	0289	4	Patient.address.district
`PID-13`	Phone Number - Home	XTN	Optional	Repeats		40	Patient.telecom Patient.telecom.use
`PID-14`	Phone Number - Business	XTN	Optional	Repeats		40	Patient.telecom Patient.telecom.use
`PID-15`	Primary Language	CE	Optional	Once	0296	60	Patient.communication.language
`PID-16`	Marital Status	IS	Optional	Once	0002	1	Patient.maritalStatus
`PID-17`	Religion	IS	Optional	Once	0006	3	Patient.extension
`PID-18`	Patient Account Number	CX	Optional	Once		20	Account.identifier
`PID-19`	SSN Number - Patient	ST	Optional	Once		16	Patient.identifier.value Patient.identifier.type.coding.code+2 more
`PID-20`	Driver's License Number	DLN	Optional	Once		25	Patient.identifier
`PID-21`	Mother's Identifier	CX	Optional	Repeats		20	Patient.$this
`PID-22`	Ethnic Group	IS	Optional	Once	0189	3
`PID-23`	Birth Place	ST	Optional	Once		60	Patient.extension Patient.extension.valueAddress.text
`PID-24`	Multiple Birth Indicator	ID	Optional	Once	0136	2	Patient.multipleBirthBoolean
`PID-25`	Birth Order	NM	Optional	Once		2	Patient.multipleBirthInteger
`PID-26`	Citizenship	IS	Optional	Repeats	0171	4	Patient.extension Patient.extension.extension
`PID-27`	Veterans Military Status	CE	Optional	Once	0172	60
`PID-28`	Nationality Code	CE	Optional	Once	0212	80	Patient.extension Patient.extension.extension
`PID-29`	Patient Death Date and Time	TS	Optional	Once		26	Patient.deceasedDateTime
`PID-30`	Patient Death Indicator	ID	Optional	Once	0136	1	Patient.deceasedBoolean

FHIR map of segment PIDDefined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

PR1ProceduresProcedure15 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`PR1-1`	Set ID - Procedure	SI	Required	Once		4
`PR1-2`	Procedure Coding Method	IS	Backward	Once	0089	2
`PR1-3`	Procedure Code	CE	Required	Once	0088	80	Procedure.code
`PR1-4`	Procedure Description	ST	Backward	Once		40	Procedure.code.text
`PR1-5`	Procedure Date/Time	TS	Required	Once		26	Procedure.performedDateTime Procedure.performedPeriod.start
`PR1-6`	Procedure Type	IS	Required	Once	0230	2	Procedure.category
`PR1-7`	Procedure Minutes	NM	Optional	Once		4	Procedure.performedPeriod.end
`PR1-8`	Anesthesiologist	XCN	Backward	Repeats	0010	120	Procedure.performer.actor Procedure.performer.function.coding.code+1 more
`PR1-9`	Anesthesia Code	IS	Optional	Once	0019	2
`PR1-10`	Anesthesia Minutes	NM	Optional	Once		4
`PR1-11`	Surgeon	XCN	Backward	Repeats	0010	120	Procedure.performer.actor Procedure.performer.function.coding.code+1 more
`PR1-12`	Procedure Practitioner	XCN	Backward	Repeats	0010	230	Procedure.performer.actor
`PR1-13`	Consent Code	CE	Optional	Once	0059	60
`PR1-14`	Procedure Priority	NM	Optional	Once		2
`PR1-15`	Associated Diagnosis Code	CE	Optional	Once		80	Procedure.reasonCode

FHIR map of segment PR1Defined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

PRAPractitioner detail segment8 fields

Field	Name	Type	Use	Repeats	Table	Length
`PRA-1`	PRA - Primary Key Value	ST	Required	Once		20
`PRA-2`	Practioner Group	CE	Optional	Repeats		60
`PRA-3`	Practioner Category	IS	Optional	Repeats	0186	3
`PRA-4`	Provider Billing	ID	Optional	Once	0187	1
`PRA-5`	Specialty	CM_SPD	Optional	Repeats		100
`PRA-6`	Practitioner ID Numbers	CM_PLN	Optional	Repeats		100
`PRA-7`	Privileges	CM_PIP	Optional	Repeats		200
`PRA-8`	Date Entered Practice	DT	Optional	Once		8

Defined in versions2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

PRBProblem Detail25 fields

Field	Name	Type	Use	Repeats	Table	Length
`PRB-1`	Action Code	ID	Required	Once	0287	2
`PRB-2`	Action Date/Time	TS	Required	Once		26
`PRB-3`	Problem ID	CE	Required	Once		80
`PRB-4`	Problem Instance ID	EI	Required	Once		60
`PRB-5`	Episode of Care ID	EI	Optional	Once		60
`PRB-6`	Problem List Priority	NM	Optional	Once		60
`PRB-7`	Problem Established Date/Time	TS	Optional	Once		26
`PRB-8`	Anticipated Problem Resolution Date/Time	TS	Optional	Once		26
`PRB-9`	Actual Problem Resolution Date/Time	TS	Optional	Once		26
`PRB-10`	Problem Classification	CE	Optional	Once		80
`PRB-11`	Problem Management Discipline	CE	Optional	Repeats		80
`PRB-12`	Problem Persistence	CE	Optional	Once		80
`PRB-13`	Problem Confirmation Status	CE	Optional	Once		80
`PRB-14`	Problem Life Cycle Status	CE	Optional	Once		80
`PRB-15`	Problem Life Cycle Status Date/Time	TS	Optional	Once		26
`PRB-16`	Problem Date of Onset	TS	Optional	Once		26
`PRB-17`	Problem Onset Text	ST	Optional	Once		80
`PRB-18`	Problem Ranking	CE	Optional	Once		80
`PRB-19`	Certainty of Problem	CE	Optional	Once		60
`PRB-20`	Probability of Problem	NM	Optional	Once		5
`PRB-21`	Individual Awareness of Problem	CE	Optional	Once		80
`PRB-22`	Problem Prognosis	CE	Optional	Once		80
`PRB-23`	Individual Awareness of Prognosis	CE	Optional	Once		80
`PRB-24`	Family/Significant Other Awareness of Problem/Prognosis	ST	Optional	Once		200
`PRB-25`	Security/Sensitivity	CE	Optional	Once		80

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

PRCPricing18 fields

Field	Name	Type	Use	Repeats	Table	Length
`PRC-1`	Primary Key Value	CE	Required	Once	0132	200
`PRC-2`	Facility ID	CE	Optional	Repeats		60
`PRC-3`	Department	CE	Optional	Repeats		30
`PRC-4`	Valid Patient Classes	IS	Optional	Repeats	0004	1
`PRC-5`	Price	CP	Conditional	Repeats		12
`PRC-6`	Formula	ST	Optional	Repeats		200
`PRC-7`	Minimum Quantity	NM	Optional	Once		4
`PRC-8`	Maximum Quantity	NM	Optional	Once		4
`PRC-9`	Minimum Price	MO	Optional	Once		12
`PRC-10`	Maximum Price	MO	Optional	Once		12
`PRC-11`	Effective Start Date	TS	Optional	Once		26
`PRC-12`	Effective End Date	TS	Optional	Once		26
`PRC-13`	Price Override Flag	IS	Optional	Once	0268	1
`PRC-14`	Billing Category	CE	Optional	Repeats	0293	60
`PRC-15`	Chargeable Flag	ID	Optional	Once	0136	1
`PRC-16`	Active/Inactive Flag	ID	Optional	Once	0183	1
`PRC-17`	Cost	MO	Optional	Once		12
`PRC-18`	Charge On Indicator	IS	Optional	Once	0269	1

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

PRDProvider Data9 fields

Field	Name	Type	Use	Repeats	Table	Length
`PRD-1`	Role	CE	Required	Repeats	0286	200
`PRD-2`	Provider Name	XPN	Optional	Repeats		106
`PRD-3`	Provider Address	XAD	Optional	Once		60
`PRD-4`	Provider Location	PL	Optional	Once		60
`PRD-5`	Provider Communication Information	XTN	Optional	Repeats		100
`PRD-6`	Preferred Method of Contact	CE	Optional	Once	0185	200
`PRD-7`	Provider Identifiers	CM_PI	Optional	Repeats		100
`PRD-8`	Effective Start Date of Role	TS	Optional	Once		26
`PRD-9`	Effective End Date of Role	TS	Optional	Once		26

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

PSHProduct Summary Header14 fields

Field	Name	Type	Use	Repeats	Table	Length
`PSH-1`	Report Type	ST	Required	Once		60
`PSH-2`	Report Form Identifier	ST	Optional	Once		60
`PSH-3`	Report Date	TS	Required	Once		26
`PSH-4`	Report Interval Start Date	TS	Optional	Once		26
`PSH-5`	Report Interval End Date	TS	Optional	Once		26
`PSH-6`	Quantity Manufactured	CQ	Optional	Once		12
`PSH-7`	Quantity Distributed	CQ	Optional	Once		12
`PSH-8`	Quantity Distributed Method	ID	Optional	Once	0329	1
`PSH-9`	Quantity Distributed Comment	FT	Optional	Once		600
`PSH-10`	Quantity in Use	CQ	Optional	Once		12
`PSH-11`	Quantity in Use Method	ID	Optional	Once	0329	1
`PSH-12`	Quantity in Use Comment	FT	Optional	Once		600
`PSH-13`	Number of Product Experience Reports Filed by Facility	NM	Optional	Once		2
`PSH-14`	Number of Product Experience Reports Filed by Distributor	NM	Optional	Once		2

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

PTHPathway6 fields

Field	Name	Type	Use	Repeats	Table	Length
`PTH-1`	Action Code	ID	Required	Once	0287	2
`PTH-2`	Pathway ID	CE	Required	Once		80
`PTH-3`	Pathway Instance ID	EI	Required	Once		60
`PTH-4`	Pathway Established Date/Time	TS	Required	Once		26
`PTH-5`	Pathway Lifecycle Status	CE	Optional	Once		80
`PTH-6`	Change Pathway Lifecycle Status Date/Time	TS	Conditional	Once		26

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

PV1Patient visitBasic, Coverage, Encounter +152 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`PV1-1`	Set ID - Patient Visit	SI	Optional	Once		4
`PV1-2`	Patient Class	ID	Required	Once	0004	1	Encounter.class Encounter.status
`PV1-3`	Assigned Patient Location	PL	Optional	Once		80	Encounter.location.location Encounter.location.status
`PV1-4`	Admission Type	ID	Optional	Once	0007	2	Encounter.type
`PV1-5`	Preadmit Number	CX	Optional	Once		20	Encounter.hospitalization.preAdmissionIdentifier
`PV1-6`	Prior Patient Location	PL	Optional	Once		12	Encounter.location.location Encounter.location.status
`PV1-7`	Attending Doctor	XCN	Optional	Repeats	0010	60	Encounter.participant.individual Encounter.participant.type.coding.code+2 more
`PV1-8`	Referring Doctor	XCN	Optional	Repeats	0010	60	Encounter.participant.individual Encounter.participant.type.coding.code+2 more
`PV1-9`	Consulting Doctor	XCN	Optional	Repeats	0010	60	Encounter.participant.individual Encounter.participant.type.coding.code+2 more
`PV1-10`	Hospital Service	IS	Optional	Once	0069	3	Encounter.serviceType
`PV1-11`	Temporary Location	PL	Optional	Once		80	Encounter.location.location Encounter.location.status+6 more
`PV1-12`	Preadmit Test Indicator	IS	Optional	Once	0087	2
`PV1-13`	Readmission Indicator	IS	Optional	Once	0092	2	Encounter.hospitalization.reAdmission
`PV1-14`	Admit Source	IS	Optional	Once	0023	3	Encounter.hospitalization.admitSource
`PV1-15`	Ambulatory Status	IS	Optional	Repeats	0009	2	Encounter.hospitalization.specialArrangement
`PV1-16`	VIP Indicator	IS	Optional	Once	0099	2	Encounter.hospitalization.specialCourtesy Patient.extension
`PV1-17`	Admitting Doctor	XCN	Optional	Repeats		60	Encounter.participant.individual Encounter.participant.type.coding.code+2 more
`PV1-18`	Patient Type	IS	Optional	Once	0018	2
`PV1-19`	Visit Number	CX	Optional	Once		20	Encounter.identifier Encounter.identifier.type.coding.code+2 more
`PV1-20`	Financial Class	FC	Optional	Repeats		50	Coverage.type
`PV1-21`	Charge Price Indicator	IS	Optional	Once	0032	2
`PV1-22`	Courtesy Code	IS	Optional	Once	0045	2
`PV1-23`	Credit Rating	IS	Optional	Once	0046	2
`PV1-24`	Contract Code	IS	Optional	Repeats	0044	2
`PV1-25`	Contract Effective Date	DT	Optional	Repeats		8
`PV1-26`	Contract Amount	NM	Optional	Repeats		12
`PV1-27`	Contract Period	NM	Optional	Repeats		3
`PV1-28`	Interest Code	IS	Optional	Once	0073	2
`PV1-29`	Transfer to Bad Debt Code	IS	Optional	Once	0110	1
`PV1-30`	Transfer to Bad Debt Date	DT	Optional	Once		8
`PV1-31`	Bad Debt Agency Code	IS	Optional	Once	0021	10
`PV1-32`	Bad Debt Transfer Amount	NM	Optional	Once		12
`PV1-33`	Bad Debt Recovery Amount	NM	Optional	Once		12
`PV1-34`	Delete Account Indicator	IS	Optional	Once	0111	1
`PV1-35`	Delete Account Date	DT	Optional	Once		8
`PV1-36`	Discharge Disposition	IS	Optional	Once	0112	3	Encounter.hospitalization.dischargeDisposition
`PV1-37`	Discharged to Location	CM_DLD	Optional	Once		25	Encounter.hospitalization.destination
`PV1-38`	Diet Type	IS	Optional	Once	0114	2	Encounter.hospitalization.dietPreference
`PV1-39`	Servicing Facility	IS	Optional	Once	0115	2
`PV1-40`	Bed Status	IS	Backward	Once	0116	1	Encounter.location.location
`PV1-41`	Account Status	IS	Optional	Once	0117	2
`PV1-42`	Pending Location	PL	Optional	Once		80	Encounter.location.location Encounter.location.status
`PV1-43`	Prior Temporary Location	PL	Optional	Once		80	Basic.extension Basic.extension.valueExtension.url+4 more
`PV1-44`	Admit Date/Time	TS	Optional	Once		26	Encounter.period.start
`PV1-45`	Discharge Date/Time	TS	Optional	Once		26	Encounter.period.end Encounter.status
`PV1-46`	Current Patient Balance	NM	Optional	Once		12
`PV1-47`	Total Charges	NM	Optional	Once		12
`PV1-48`	Total Adjustments	NM	Optional	Once		12
`PV1-49`	Total Payments	NM	Optional	Once		12
`PV1-50`	Alternate Visit ID	CX	Optional	Once		20	Encounter.identifier
`PV1-51`	Visit Indicator	IS	Optional	Once	0326	1
`PV1-52`	Other Healthcare Provider	XCN	Optional	Repeats	0010	60	Encounter.participant.individual Encounter.participant.type.coding.code+2 more

FHIR map of segment PV1Defined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

PV2Patient visit - additional informationEncounter37 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`PV2-1`	Prior Pending Location	PL	Conditional	Once		80	Encounter.location.location Encounter.location.status
`PV2-2`	Accommodation Code	CE	Optional	Once	0129	60
`PV2-3`	Admit Reason	CE	Optional	Once		60	Encounter.reasonCode
`PV2-4`	Transfer Reason	CE	Optional	Once		60
`PV2-5`	Patient Valuables	ST	Optional	Repeats		25
`PV2-6`	Patient Valuables Location	ST	Optional	Once		25
`PV2-7`	Visit User Code	IS	Optional	Once	0130	2
`PV2-8`	Expected Admit Date	TS	Optional	Once		26	Encounter.extension
`PV2-9`	Expected Discharge Date	TS	Optional	Once		26	Encounter.extension
`PV2-10`	Estimated Length of Inpatient Stay	NM	Optional	Once		3
`PV2-11`	Actual Length of Inpatient Stay	NM	Optional	Once		3	Encounter.length
`PV2-12`	Visit Description	ST	Optional	Once		50	Encounter.text.div
`PV2-13`	Referral Source Code	XCN	Optional	Once		90	Encounter.participant.individual Encounter.participant.type.coding.code+2 more
`PV2-14`	Previous Service Date	DT	Optional	Once		8
`PV2-15`	Employment Illness Related Indicator	ID	Optional	Once	0136	1
`PV2-16`	Purge Status Code	IS	Optional	Once	0213	1
`PV2-17`	Purge Status Date	DT	Optional	Once		8
`PV2-18`	Special Program Code	IS	Optional	Once	0214	2
`PV2-19`	Retention Indicator	ID	Optional	Once	0136	1
`PV2-20`	Expected Number of Insurance Plans	NM	Optional	Once		1
`PV2-21`	Visit Publicity Code	IS	Optional	Once	0215	1
`PV2-22`	Visit Protection Indicator	ID	Optional	Once	0136	1	Encounter.meta.security
`PV2-23`	Clinic Organization Name	XON	Optional	Repeats		90
`PV2-24`	Patient Status Code	IS	Optional	Once	0216	2
`PV2-25`	Visit Priority Code	IS	Optional	Once	0217	1	Encounter.priority
`PV2-26`	Previous Treatment Date	DT	Optional	Once		8
`PV2-27`	Expected Discharge Disposition	IS	Optional	Once	0112	2
`PV2-28`	Signature on File Date	DT	Optional	Once		8
`PV2-29`	First Similar Illness Date	DT	Optional	Once		8
`PV2-30`	Patient Charge Adjustment Code	IS	Optional	Once	0218	3
`PV2-31`	Recurring Service Code	IS	Optional	Once	0219	2
`PV2-32`	Billing Media Code	ID	Optional	Once	0136	1
`PV2-33`	Expected Surgery Date & Time	TS	Optional	Once		26
`PV2-34`	Military Partnership Code	ID	Optional	Once	0136	2
`PV2-35`	Military Non-Availabiltiy Code	ID	Optional	Once	0136	2
`PV2-36`	Newborn Baby Indicator	ID	Optional	Once	0136	1
`PV2-37`	Baby Detained Indicator	ID	Optional	Once	0136	1

FHIR map of segment PV2Defined in versions2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

QAKQuery Acknowledgement2 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`QAK-1`	Query tag	ST	Conditional	Once		32
`QAK-2`	Query response status	ID	Optional	Once	0208	2

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

QRDQuery definition segment12 fields

Field	Name	Type	Use	Repeats	Table	Length
`QRD-1`	Query Date/Time	TS	Required	Once		26
`QRD-2`	Query Format Code	ID	Required	Once	0106	1
`QRD-3`	Query Priority	ID	Required	Once	0091	1
`QRD-4`	Query ID	ST	Required	Once		10
`QRD-5`	Deferred Response Type	ID	Optional	Once	0107	1
`QRD-6`	Deferred Response Date/Time	TS	Optional	Once		26
`QRD-7`	Quantity Limited Request	CQ	Required	Once		10
`QRD-8`	Who Subject Filter	XCN	Required	Repeats		60
`QRD-9`	What Subject Filter	CE	Required	Repeats	0048	60
`QRD-10`	What Department Data Code	CE	Required	Repeats		60
`QRD-11`	What Data Code Value Qualifier	CM_VR	Optional	Repeats		20
`QRD-12`	Query Results Level	ID	Optional	Once	0108	1

Defined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

QRFQuery filter segment9 fields

Field	Name	Type	Use	Repeats	Table	Length
`QRF-1`	Where Subject Filter	ST	Required	Repeats		20
`QRF-2`	When Data Start Date/Time	TS	Optional	Once		26
`QRF-3`	When Data End Date/Time	TS	Optional	Once		26
`QRF-4`	What User Qualifier	ST	Optional	Repeats		60
`QRF-5`	Other QRY Subject Filter	ST	Optional	Repeats		60
`QRF-6`	Which Date/Time Qualifier	ID	Optional	Repeats	0156	12
`QRF-7`	Which Date/Time Status Qualifier	ID	Optional	Repeats	0157	12
`QRF-8`	Date/Time Selection Qualifier	ID	Optional	Repeats	0158	12
`QRF-9`	When Quantity/Timing Qualifier	TQ	Optional	Once		60

Defined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

RDFTable Row Definition2 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`RDF-1`	Number of Columns per Row	NM	Required	Once		3
`RDF-2`	Column Description	RCD	Required	Repeats		40

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

RDTTable Row Data1 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`RDT-1`	Column value	VARIES	Required	Once

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

RF1Referral Information Segment11 fields

Field	Name	Type	Use	Repeats	Table	Length
`RF1-1`	Referral Status	CE	Optional	Once	0283	200
`RF1-2`	Referral Priority	CE	Optional	Once	0280	200
`RF1-3`	Referral Type	CE	Optional	Once	0281	200
`RF1-4`	Referral Disposition	CE	Optional	Repeats	0282	200
`RF1-5`	Referral Category	CE	Optional	Once	0284	200
`RF1-6`	Originating Referral Identifier	EI	Required	Once		30
`RF1-7`	Effective Date	TS	Optional	Once		26
`RF1-8`	Expiration Date	TS	Optional	Once		26
`RF1-9`	Process Date	TS	Optional	Once		26
`RF1-10`	Referral Reason	CE	Optional	Repeats	0336	200
`RF1-11`	External Referral Identifier	EI	Optional	Repeats		30

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

RGSResource Group3 fields

Field	Name	Type	Use	Repeats	Table	Length
`RGS-1`	Set ID - RGS	SI	Required	Once		4
`RGS-2`	Segment Action Code	ID	Conditional	Once	0206	3
`RGS-3`	Resource Group ID	CE	Optional	Once		200

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

ROLRolePatient, Encounter, CareTeam +18 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`ROL-1`	Role Instance ID	EI	Required	Once		60	Patient.generalPractitioner Encounter.participant.individual.reference+2 more
`ROL-2`	Action Code	ID	Required	Once	0287	2
`ROL-3`	Role	CE	Required	Once		80	Patient.generalPractitioner Encounter.participant.type+2 more
`ROL-4`	Role Person	XCN	Required	Once		80	Patient.generalPractitioner Encounter.participant.individual+2 more
`ROL-5`	Role Begin Date/Time	TS	Optional	Once		26	Patient.generalPractitioner Encounter.participant.period.start+2 more
`ROL-6`	Role End Date/Time	TS	Optional	Once		26	Patient.generalPractitioner Encounter.participant.period.end+2 more
`ROL-7`	Role Duration	CE	Optional	Once		80
`ROL-8`	Role Action	CE	Optional	Once		80	CareTeam.reasonCode

FHIR map of segment ROLDefined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

RQ1Requisition detail-1 segment7 fields

Field	Name	Type	Use	Repeats	Table	Length
`RQ1-1`	Anticipated Price	ST	Optional	Once		10
`RQ1-2`	Manufactured ID	CE	Conditional	Once		60
`RQ1-3`	Manufacturer's Catalog	ST	Conditional	Once		16
`RQ1-4`	Vendor ID	CE	Conditional	Once		60
`RQ1-5`	Vendor Catalog	ST	Conditional	Once		16
`RQ1-6`	Taxable	ID	Optional	Once	0136	1
`RQ1-7`	Substitute Allowed	ID	Optional	Once	0136	1

Defined in versions2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

RQDRequisition detail10 fields

Field	Name	Type	Use	Repeats	Table	Length
`RQD-1`	Requisition Line Number	SI	Optional	Once		4
`RQD-2`	Item Code - Internal	CE	Conditional	Once		60
`RQD-3`	Item Code - External	CE	Conditional	Once		60
`RQD-4`	Hospital Item Code	CE	Conditional	Once		60
`RQD-5`	Requisition Quantity	NM	Optional	Once		6
`RQD-6`	Requisition Unit of Measure	CE	Optional	Once		60
`RQD-7`	Department Cost Center	ID	Optional	Once	0319	30
`RQD-8`	Item Natural Account Code	ID	Optional	Once	0320	30
`RQD-9`	Deliver To ID	CE	Optional	Once		60
`RQD-10`	Date Needed	DT	Optional	Once		8

Defined in versions2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

RXAPharmacy administration segmentImmunization22 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`RXA-1`	Give Sub-ID Counter	NM	Required	Once		4
`RXA-2`	Administration Sub-ID Counter	NM	Required	Once		4
`RXA-3`	Date/Time Start of Administration	TS	Required	Once		26	Immunization.occurrenceDateTime
`RXA-4`	Date/Time End of Administration	TS	Required	Once		26
`RXA-5`	Administered Code	CE	Required	Once	0292	100	Immunization.vaccineCode
`RXA-6`	Administered Amount	NM	Required	Once		20	Immunization.doseQuantity.value
`RXA-7`	Administered Units	CE	Conditional	Once		60	Immunization.doseQuantity
`RXA-8`	Administered Dosage Form	CE	Optional	Once		60
`RXA-9`	Administration Notes	CE	Optional	Repeats		200
`RXA-10`	Administering Provider	XCN	Optional	Once		200	Immunization.performer.actor Immunization.performer.function.coding.code+1 more
`RXA-11`	Administered-at Location	LA2	Conditional	Once		200
`RXA-12`	Administered Per	ST	Conditional	Once		20
`RXA-13`	Administered Strength	NM	Optional	Once		20
`RXA-14`	Administered Strength Units	CE	Optional	Once		60
`RXA-15`	Substance Lot Number	ST	Optional	Repeats		20	Immunization.lotNumber
`RXA-16`	Substance Expiration Date	TS	Optional	Repeats		26	Immunization.expirationDate
`RXA-17`	Substance Manufacturer Name	CE	Optional	Repeats	0227	60	Immunization.manufacturer
`RXA-18`	Substance Refusal Reason	CE	Optional	Repeats		60	Immunization.statusReason
`RXA-19`	Indication	CE	Optional	Repeats		200	Immunization.reasonCode
`RXA-20`	Completion Status	ID	Optional	Once	0322	2	Immunization.status
`RXA-21`	Action Code-RXA	ID	Optional	Once	0323	2	Immunization.status
`RXA-22`	System Entry Date/Time	TS	Optional	Once		26	Immunization.recorded

FHIR map of segment RXADefined in versions2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

RXCPharmacy component order segment6 fields

Field	Name	Type	Use	Repeats	Table	Length
`RXC-1`	RX Component Type	ID	Required	Once	0166	1
`RXC-2`	Component Code	CE	Required	Once		100
`RXC-3`	Component Amount	NM	Required	Once		20
`RXC-4`	Component Units	CE	Required	Once		60
`RXC-5`	Component Strength	NM	Optional	Once		20
`RXC-6`	Component Strength Units	CE	Optional	Once		60

Defined in versions2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

RXDPharmacy dispense segment24 fields

Field	Name	Type	Use	Repeats	Table	Length
`RXD-1`	Dispense Sub-ID Counter	NM	Required	Once		4
`RXD-2`	Dispense/Give Code	CE	Required	Once	0292	100
`RXD-3`	Date/Time Dispensed	TS	Required	Once		26
`RXD-4`	Actual Dispense Amount	NM	Required	Once		20
`RXD-5`	Actual Dispense Units	CE	Conditional	Once		60
`RXD-6`	Actual Dosage Form	CE	Optional	Once		60
`RXD-7`	Prescription Number	ST	Required	Once		20
`RXD-8`	Number of Refills Remaining	NM	Conditional	Once		20
`RXD-9`	Dispense Notes	ST	Optional	Repeats		200
`RXD-10`	Dispensing Provider	XCN	Optional	Once		200
`RXD-11`	Substitution Status	ID	Optional	Once	0167	1
`RXD-12`	Total Daily Dose	NM	Optional	Once		10
`RXD-13`	Dispense-To Location	LA2	Conditional	Once		200
`RXD-14`	Needs Human Review	ID	Optional	Once	0136	1
`RXD-15`	Pharmacy/Treatment Supplier's Special Dispensing Instructions	CE	Optional	Repeats		200
`RXD-16`	Actual Strength	NM	Optional	Once		20
`RXD-17`	Actual Strength Unit	CE	Optional	Once		60
`RXD-18`	Substance Lot Number	ST	Optional	Repeats		20
`RXD-19`	Substance Expiration Date	TS	Optional	Repeats		26
`RXD-20`	Substance Manufacturer Name	CE	Optional	Repeats		60
`RXD-21`	Indication	CE	Optional	Repeats		200
`RXD-22`	Dispense Package Size	NM	Optional	Once		20
`RXD-23`	Dispense Package Size Unit	CE	Optional	Once		60
`RXD-24`	Dispense Package Method	ID	Optional	Once	0321	2

Defined in versions2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

RXEPharmacy encoded order segment30 fields

Field	Name	Type	Use	Repeats	Table	Length
`RXE-1`	Quantity/Timing	TQ	Required	Once		200
`RXE-2`	Give Code	CE	Required	Once	0292	100
`RXE-3`	Give Amount - Minimum	NM	Required	Once		20
`RXE-4`	Give Amount - Maximum	NM	Optional	Once		20
`RXE-5`	Give Units	CE	Required	Once		60
`RXE-6`	Give Dosage Form	CE	Optional	Once		60
`RXE-7`	Provider's Administration Instructions	CE	Optional	Repeats		200
`RXE-8`	Deliver To Location	LA2	Conditional	Once		200
`RXE-9`	Substitution Status	ID	Optional	Once	0167	1
`RXE-10`	Dispense Amount	NM	Conditional	Once		20
`RXE-11`	Dispense Units	CE	Conditional	Once		60
`RXE-12`	Number of Refills	NM	Optional	Once		3
`RXE-13`	Ordering Provider's DEA Number	XCN	Conditional	Once		60
`RXE-14`	Pharmacist/Treatment Supplier's Verifier ID	XCN	Optional	Once		60
`RXE-15`	Prescription Number	ST	Conditional	Once		20
`RXE-16`	Number of Refills Remaining	NM	Conditional	Once		20
`RXE-17`	Number of Refills/Doses Dispensed	NM	Conditional	Once		20
`RXE-18`	Date / time of most recent refill or dose dispensed	TS	Conditional	Once		26
`RXE-19`	Total Daily Dose	CQ	Conditional	Once		10
`RXE-20`	Needs Human Review	ID	Optional	Once	0136	1
`RXE-21`	Pharmacy/Treatment Supplier's Special Dispensing Instructions	CE	Optional	Repeats		200
`RXE-22`	Give Per	ST	Conditional	Once		20
`RXE-23`	Give Rate Amount	ST	Optional	Once		6
`RXE-24`	Give Rate Units	CE	Optional	Once		60
`RXE-25`	Give Strength	NM	Optional	Once		20
`RXE-26`	Give Strength Units	CE	Optional	Once		60
`RXE-27`	Give Indication	CE	Optional	Repeats		200
`RXE-28`	Dispense Package Size	NM	Optional	Once		20
`RXE-29`	Dispense Package Size Unit	CE	Optional	Once		60
`RXE-30`	Dispense Package Method	ID	Optional	Once	0321	2

Defined in versions2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

RXGPharmacy give segment22 fields

Field	Name	Type	Use	Repeats	Table	Length
`RXG-1`	Give Sub-ID Counter	NM	Required	Once		4
`RXG-2`	Dispense Sub-ID Counter	NM	Optional	Once		4
`RXG-3`	Quantity/Timing	TQ	Required	Once		200
`RXG-4`	Give Code	CE	Required	Once	0292	100
`RXG-5`	Give Amount - Minimum	NM	Required	Once		20
`RXG-6`	Give Amount - Maximum	NM	Optional	Once		20
`RXG-7`	Give Units	CE	Required	Once		60
`RXG-8`	Give Dosage Form	CE	Optional	Once		60
`RXG-9`	Administration Notes	CE	Optional	Repeats		200
`RXG-10`	Substitution Status	ID	Optional	Once	0167	1
`RXG-11`	Dispense-To Location	LA2	Optional	Once		200
`RXG-12`	Needs Human Review	ID	Optional	Once	0136	1
`RXG-13`	Pharmacy Special Administration Instructions	CE	Optional	Repeats		200
`RXG-14`	Give Per	ST	Conditional	Once		20
`RXG-15`	Give Rate Amount	ST	Optional	Once		6
`RXG-16`	Give Rate Units	CE	Optional	Once		60
`RXG-17`	Give Strength	NM	Optional	Once		20
`RXG-18`	Give Strength Units	CE	Optional	Once		60
`RXG-19`	Substance Lot Number	ST	Optional	Repeats		20
`RXG-20`	Substance Expiration Date	TS	Optional	Repeats		26
`RXG-21`	Substance Manufacturer Name	CE	Optional	Repeats		60
`RXG-22`	Indication	CE	Optional	Repeats		200

Defined in versions2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

RXOPharmacy prescription order segmentMedicationRequest22 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`RXO-1`	Requested Give Code	CE	Required	Once		100	MedicationRequest.medication
`RXO-2`	Requested Give Amount - Minimum	NM	Required	Once		20	MedicationRequest.dosageInstruction.doseAndRate.doseRange.low.value MedicationRequest.dosageInstruction.doseAndRate.type
`RXO-3`	Requested Give Amount - Maximum	NM	Optional	Once		20	MedicationRequest.dosageInstruction.doseAndRate.doseRange.high.value
`RXO-4`	Requested Give Units	CE	Required	Once		60	MedicationRequest.dosageInstruction.doseAndRate.doseRange.low.code MedicationRequest.dosageInstruction.doseAndRate.doseRange.low.unit+2 more
`RXO-5`	Requested Dosage Form	CE	Optional	Once		60	MedicationRequest.medication
`RXO-6`	Provider's Pharmacy Instructions	CE	Optional	Repeats		200
`RXO-7`	Provider's Administration Instructions	CE	Optional	Repeats		200
`RXO-8`	Deliver To Location	LA1	Optional	Once		200
`RXO-9`	Allow Substitutions	ID	Optional	Once	0161	1	MedicationRequest.substitution.allowedCodeableConcept
`RXO-10`	Requested Dispense Code	CE	Optional	Once		100
`RXO-11`	Requested Dispense Amount	NM	Optional	Once		20	MedicationRequest.dispenseRequest.quantity.value
`RXO-12`	Requested Dispense Units	CE	Optional	Once		60	MedicationRequest.dispenseRequest.quantity.code MedicationRequest.dispenseRequest.quantity.unit
`RXO-13`	Number of Refills	NM	Optional	Once		3	MedicationRequest.dispenseRequest.numberOfRepeatsAllowed
`RXO-14`	Ordering Provider's DEA Number	XCN	Conditional	Once		60	MedicationRequest.requester
`RXO-15`	Pharmacist/Treatment Supplier's Verifier ID	XCN	Conditional	Once		60
`RXO-16`	Needs Human Review	ID	Optional	Once	0136	1
`RXO-17`	Requested Give Per	ST	Conditional	Once		20
`RXO-18`	Requested Give Strength	NM	Optional	Once		20	MedicationRequest.medicationReference(Medication.ingredient.strength.numerator.value
`RXO-19`	Requested Give Strength Units	CE	Optional	Once		60	MedicationRequest.medicationReference(Medication.ingredient.strength.numerator.code MedicationRequest.medicationReference(Medication.ingredient.strength.numerator.unit+3 more
`RXO-20`	Indication	CE	Optional	Once		200
`RXO-21`	Requested Give Rate Amount	ST	Optional	Once		6
`RXO-22`	Requested Give Rate Units	CE	Optional	Once		60

FHIR map of segment RXODefined in versions2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

RXRPharmacy route segmentImmunization, MedicationRequest4 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`RXR-1`	Route	CE	Required	Once	0162	60	Immunization.route MedicationRequest.dosageInstruction.route
`RXR-2`	Site	CE	Optional	Once	0163	60	Immunization.site MedicationRequest.dosageInstruction.site
`RXR-3`	Administration Device	CE	Optional	Once	0164	60
`RXR-4`	Administration Method	CE	Optional	Once	0165	60	MedicationRequest.dosageInstruction.method

FHIR map of segment RXRDefined in versions2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

SCHSchedule Activity InformationAppointment, Provenance, ServiceRequest25 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`SCH-1`	Placer Appointment ID	EI	Required	Once		75	Appointment.identifier
`SCH-2`	Filler Appointment ID	EI	Conditional	Once		75	Appointment.identifier
`SCH-3`	Occurrence Number	NM	Conditional	Once		5
`SCH-4`	Placer Group Number	EI	Optional	Once		75
`SCH-5`	Schedule ID	CE	Optional	Once		200
`SCH-6`	Event Reason	CE	Required	Once		200	ServiceRequest.intent
`SCH-7`	Appointment Reason	CE	Optional	Once	0276	200	Appointment.reasonCode Appointment.appointmentType
`SCH-8`	Appointment Type	CE	Optional	Once	0277	200	Appointment.appointmentType
`SCH-9`	Appointment Duration	NM	Optional	Once		20	Appointment.minutesDuration
`SCH-10`	Appointment Duration Units	CE	Optional	Once		200
`SCH-11`	Appointment Timing Quantity	TQ	Required	Repeats		200	Appointment.$this
`SCH-12`	Placer Contact Person	XCN	Optional	Once		48	Appointment.participant.actor Appointment.participant.type.coding.code+1 more
`SCH-13`	Placer Contact Phone Number	XTN	Optional	Once		40
`SCH-14`	Placer Contact Address	XAD	Optional	Once		106
`SCH-15`	Placer Contact Location	PL	Optional	Once		80
`SCH-16`	Filler Contact Person	XCN	Required	Once		38	Appointment.participant.actor Appointment.participant.type.coding.code+1 more
`SCH-17`	Filler Contact Phone Number	XTN	Optional	Once		40
`SCH-18`	Filler Contact Address	XAD	Optional	Once		106
`SCH-19`	Filler Contact Location	PL	Optional	Once		80
`SCH-20`	Entered By Person	XCN	Required	Once		48	Appointment.participant.actor Appointment.participant.type.coding.code+4 more
`SCH-21`	Entered By Phone Number	XTN	Optional	Repeats		40
`SCH-22`	Entered By Location	PL	Optional	Once		80
`SCH-23`	Parent Placer Appointment ID	EI	Optional	Once		75
`SCH-24`	Parent Filler Appointment ID	EI	Conditional	Once		75
`SCH-25`	Filler Status Code	CE	Optional	Once	0278	200	Appointment.status ServiceRequest.status

FHIR map of segment SCHDefined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

SPRStored Procedure Request Definition4 fields

Field	Name	Type	Use	Repeats	Table	Length
`SPR-1`	Query tag	ST	Optional	Once		32
`SPR-2`	Query/ Response Format Code	ID	Required	Once	0106	1
`SPR-3`	Stored procedure name	CE	Required	Once		60
`SPR-4`	Input parameter list	QIP	Optional	Repeats		256

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6

STFStaff identification segment26 fields

Field	Name	Type	Use	Repeats	Table	Length
`STF-1`	STF - Primary Key Value	CE	Required	Once		60
`STF-2`	Staff ID Code	CX	Optional	Repeats		60
`STF-3`	Staff Name	XPN	Optional	Once		48
`STF-4`	Staff Type	ID	Optional	Repeats	0182	2
`STF-5`	Sex	IS	Optional	Once	0001	1
`STF-6`	Date of Birth	TS	Optional	Once		26
`STF-7`	Active/Inactive Flag	ID	Optional	Once	0183	1
`STF-8`	Department	CE	Optional	Repeats	0184	200
`STF-9`	Service	CE	Optional	Repeats	0069	200
`STF-10`	Phone	XTN	Optional	Repeats		40
`STF-11`	Office/Home Address	XAD	Optional	Repeats		106
`STF-12`	Activation Date	CM_DIN	Optional	Repeats		26
`STF-13`	Inactivation Date	CM_DIN	Optional	Repeats		26
`STF-14`	Backup Person ID	CE	Optional	Repeats		60
`STF-15`	E-mail Address	ST	Optional	Repeats		40
`STF-16`	Preferred Method of Contact	ID	Optional	Once	0185	1
`STF-17`	Marital Status	IS	Optional	Once	0002	1
`STF-18`	Job Title	ST	Optional	Once		20
`STF-19`	Job Code/Class	JCC	Optional	Once		20
`STF-20`	Employment Status	IS	Optional	Once	0066	2
`STF-21`	Additional Insured on Auto	ID	Optional	Once	0136	1
`STF-22`	Driver's License Number	DLN	Optional	Once		25
`STF-23`	Copy Auto Ins	ID	Optional	Once	0136	1
`STF-24`	Auto Ins. Expires	DT	Optional	Once		8
`STF-25`	Date Last DMV Review	DT	Optional	Once		8
`STF-26`	Date Next DMV Review	DT	Optional	Once		8

Defined in versions2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

TXADocument notification segmentDocumentReference, Provenance23 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`TXA-1`	Set ID- TXA	SI	Required	Once		4
`TXA-2`	Document Type	IS	Required	Once	0270	30	DocumentReference.type
`TXA-3`	Document Content Presentation	ID	Conditional	Once	0191	2	DocumentReference.content.attachment.contentType
`TXA-4`	Activity Date/Time	TS	Optional	Once		26
`TXA-5`	Primary Activity Provider Code/Name	XCN	Conditional	Once		60
`TXA-6`	Origination Date/Time	TS	Optional	Once		26	DocumentReference.date DocumentReference.extension
`TXA-7`	Transcription Date/Time	TS	Conditional	Once		26
`TXA-8`	Edit Date/Time	TS	Optional	Repeats		26
`TXA-9`	Originator Code/Name	XCN	Optional	Once		60	DocumentReference.author
`TXA-10`	Assigned Document Authenticator	XCN	Optional	Repeats		60	DocumentReference.authenticator
`TXA-11`	Transcriptionist Code/Name	XCN	Conditional	Once		48
`TXA-12`	Unique Document Number	EI	Required	Once		30	DocumentReference.masterIdentifier
`TXA-13`	Parent Document Number	EI	Conditional	Once		30
`TXA-14`	Placer Order Number	EI	Optional	Repeats		22
`TXA-15`	Filler Order Number	EI	Optional	Once		22
`TXA-16`	Unique Document File Name	ST	Optional	Once		30	DocumentReference.identifier
`TXA-17`	Document Completion Status	ID	Required	Once	0271	2	DocumentReference.docStatus
`TXA-18`	Document Confidentiality Status	ID	Optional	Once	0272	2	DocumentReference.securityLabel
`TXA-19`	Document Availability Status	ID	Optional	Once	0273	2	DocumentReference.status DocumentReference.status.extension
`TXA-20`	Document Storage Status	ID	Optional	Once	0275	2
`TXA-21`	Document Change Reason	ST	Conditional	Once		30
`TXA-22`	Authentication Person, Time Stamp	PPN	Conditional	Repeats		60
`TXA-23`	Distributed Copies	XCN	Optional	Repeats		60

FHIR map of segment TXADefined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

UB1UB82 data23 fields

Field	Name	Type	Use	Repeats	Table	Length
`UB1-1`	Set ID - UB1	SI	Optional	Once		4
`UB1-2`	Blood Deductible	NM	Backward	Once		1
`UB1-3`	Blood Furnished Pints Of	NM	Optional	Once		2
`UB1-4`	Blood Replaced Pints	NM	Optional	Once		2
`UB1-5`	Blood Not Replaced Pints	NM	Optional	Once		2
`UB1-6`	Co Insurance Days	NM	Optional	Once		2
`UB1-7`	Condition Code	IS	Optional	Once	0043	14
`UB1-8`	Covered Days	NM	Optional	Once		3
`UB1-9`	Non Covered Days	NM	Optional	Once		3
`UB1-10`	Value Amount & Code	CM_UVC	Optional	Once		12
`UB1-11`	Number Of Grace Days	NM	Optional	Once		2
`UB1-12`	Spec Program Indicator	CE	Optional	Once		60
`UB1-13`	PSRO/UR Approval Indicator	CE	Optional	Once		60
`UB1-14`	PSRO/UR Approved Stay Fm	DT	Optional	Once		8
`UB1-15`	PSRO/UR Approved Stay To	DT	Optional	Once		8
`UB1-16`	Occurrence	CM_OCD	Optional	Once		20
`UB1-17`	Occurrence Span	CE	Optional	Once		60
`UB1-18`	Occur Span Start Date	DT	Optional	Once		8
`UB1-19`	Occur Span End Date	DT	Optional	Once		8
`UB1-20`	UB 82 Locator 2	ST	Optional	Once		30
`UB1-21`	UB 82 Locator 9	ST	Optional	Once		7
`UB1-22`	UB 82 Locator 27	ST	Optional	Once		8
`UB1-23`	UB 82 Locator 45	ST	Optional	Once		17

Defined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

UB2UB92 data17 fields

Field	Name	Type	Use	Repeats	Table	Length
`UB2-1`	Set ID - UB2	SI	Optional	Once		4
`UB2-2`	Co-Insurance Days	ST	Optional	Once		3
`UB2-3`	Condition Code	IS	Optional	Once	0043	2
`UB2-4`	Covered Days	ST	Optional	Once		3
`UB2-5`	Non-Covered Days	ST	Optional	Once		4
`UB2-6`	Value Amount & Code	CM_UVC	Optional	Once		11
`UB2-7`	Occurrence Code & Date	CM_OCD	Optional	Once		11
`UB2-8`	Occurrence Span Code/Dates	CM_OSP	Optional	Once		28
`UB2-9`	UB92 Locator 2	ST	Optional	Once		29
`UB2-10`	UB92 Locator 11	ST	Optional	Once		12
`UB2-11`	UB92 Locator 31	ST	Optional	Once		5
`UB2-12`	Document Control Number	ST	Optional	Once		23
`UB2-13`	UB92 Locator 49	ST	Optional	Once		4
`UB2-14`	UB92 Locator 56	ST	Optional	Once		14
`UB2-15`	UB92 Locator 57	ST	Optional	Once		27
`UB2-16`	UB92 Locator 78	ST	Optional	Once		2
`UB2-17`	Special Visit Count	NM	Optional	Once		3

Defined in versions2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

URDResults/update definition segment7 fields

Field	Name	Type	Use	Repeats	Table	Length
`URD-1`	R/U Date/Time	TS	Optional	Once		26
`URD-2`	Report Priority	ID	Optional	Once	0109	1
`URD-3`	R/U Who Subject Definition	XCN	Required	Repeats		60
`URD-4`	R/U What Subject Definition	CE	Optional	Repeats	0048	60
`URD-5`	R/U What Department Code	CE	Optional	Repeats		60
`URD-6`	R/U Display/Print Locations	ST	Optional	Repeats		20
`URD-7`	R/U Results Level	ID	Optional	Once	0108	1

Defined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

URSUnsolicited selection segment9 fields

Field	Name	Type	Use	Repeats	Table	Length
`URS-1`	R/U Where Subject Definition	ST	Required	Repeats		20
`URS-2`	R/U When Data Start Date/Time	TS	Optional	Once		26
`URS-3`	R/U When Data End Date/Time	TS	Optional	Once		26
`URS-4`	R/U What User Qualifier	ST	Optional	Repeats		20
`URS-5`	R/U Other Results Subject Definition	ST	Optional	Repeats		20
`URS-6`	R/U Which Date/Time Qualifier	ID	Optional	Repeats	0156	12
`URS-7`	R/U Which Date/Time Status Qualifier	ID	Optional	Repeats	0157	12
`URS-8`	R/U Date/Time Selection Qualifier	ID	Optional	Repeats	0158	12
`URS-9`	R/U Quantity/Timing Qualifier	TQ	Optional	Once		60

Defined in versions2.1 2.22.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

VARVariance6 fields

Field	Name	Type	Use	Repeats	Length
`VAR-1`	Variance Instance ID	EI	Required	Once	60
`VAR-2`	Documented Date/Time	TS	Required	Once	26
`VAR-3`	Stated Variance Date/Time	TS	Optional	Once	26
`VAR-4`	Variance Originator	XCN	Optional	Once	860
`VAR-5`	Variance Classification	CE	Optional	Once	60
`VAR-6`	Variance Description	ST	Optional	Repeats	512

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

VTQVirtual Table Query Request5 fields

Field	Name	Type	Use	Repeats	Table	Length
`VTQ-1`	Query tag	ST	Optional	Once		32
`VTQ-2`	Query/ Response Format Code	ID	Required	Once	0106	1
`VTQ-3`	VT Query Name	CE	Required	Once		60
`VTQ-4`	Virtual Table Name	CE	Required	Once		60
`VTQ-5`	Selection Criteria	QSC	Optional	Repeats		256

Defined in versions2.32.3.1 2.4 2.5 2.5.1 2.6