HL7 v2 2.3.1

Segments and their fields in version 2.3.1. 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.

ACCAccident segment6 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	0347	60
`ACC-5`	Accident Job Related Indicator	ID	Optional	Once	0136	1
`ACC-6`	Accident Death Indicator	ID	Optional	Once	0136	12

Defined in versions2.1 2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

ADDAddendum segment1 fields

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

Defined in versions2.1 2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

AIGAppointment information - general resource segmentAppointment14 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 versions2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

AILAppointment information - location resource segmentAppointment12 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	3
`AIL-3`	Location Resource ID	PL	Conditional	Once		80	Appointment.participant.actor
`AIL-4`	Location Type-AIL	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 versions2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

AIPAppointment information - personnel resource segmentAppointment12 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	Repeats		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 versions2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

AISAppointment information - service segmentAppointment, 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 ID	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 versions2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

AL1Patient allergy information segmentAllergyIntolerance6 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	Repeats		15	AllergyIntolerance.reaction.manifestation.text
`AL1-6`	Identification Date	DT	Optional	Once		8	AllergyIntolerance.onsetDateTime

FHIR map of segment AL1Defined in versions2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

APRAppointment preferences segment5 fields

Field	Name	Type	Use	Repeats	Length
`APR-1`	Time Selection Criteria	SCV	Optional	Repeats	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 versions2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

ARQAppointment request segment23 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		22
`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-ARQ	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	Repeats		48
`ARQ-16`	Placer Contact Phone Number	XTN	Optional	Repeats		40
`ARQ-17`	Placer Contact Address	XAD	Optional	Repeats		106
`ARQ-18`	Placer Contact Location	PL	Optional	Once		80
`ARQ-19`	Entered by Person	XCN	Required	Repeats		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 versions2.32.3.12.4 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 ID	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 versions2.32.3.12.4 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 2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

BLGBilling segment3 fields

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

Defined in versions2.1 2.2 2.32.3.12.4 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 2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

CDMCharge description master segment13 fields

Field	Name	Type	Use	Repeats	Table	Length
`CDM-1`	Primary Key Value - CDM	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	0088	80
`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	Repeats		200
`CDM-13`	Room Fee Indicator	ID	Optional	Once	0136	1

Defined in versions2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

CM0Clinical study master segment11 fields

Field	Name	Type	Use	Repeats	Length
`CM0-1`	Set ID - CM0	SI	Optional	Once	4
`CM0-2`	Sponsor Study ID	EI	Required	Once	60
`CM0-3`	Alternate Study ID	EI	Optional	Once	60
`CM0-4`	Title of Study	ST	Required	Once	300
`CM0-5`	Chairman of Study	XCN	Optional	Repeats	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	Repeats	60
`CM0-10`	Contact's Tel. Number	XTN	Optional	Once	40
`CM0-11`	Contact's Address	XAD	Optional	Repeats	100

Defined in versions2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

CM1Clinical study phase master segment3 fields

Field	Name	Type	Use	Repeats	Length
`CM1-1`	Set ID - CM1	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 versions2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

CM2Clinical study schedule master segment4 fields

Field	Name	Type	Use	Repeats	Length
`CM2-1`	Set ID - CM2	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 versions2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

CSPClinical study phase segment4 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 versions2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

CSRClinical study registration segment16 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 - CSR	CX	Optional	Once	30
`CSR-6`	Date/Time Of Patient Study Registration	TS	Required	Once	26
`CSR-7`	Person Performing Study Registration	XCN	Optional	Repeats	60
`CSR-8`	Study Authorizing Provider	XCN	Required	Repeats	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`	Randomized Study 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 versions2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

CSSClinical study data schedule segment3 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 versions2.32.3.12.4 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	Repeats		200
`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	PI	Optional	Repeats		100

Defined in versions2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

CTIClinical trial identification segment3 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 versions2.32.3.12.4 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 versions2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

DG1Diagnosis segmentCondition, Encounter, EpisodeOfCare19 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`DG1-1`	Set ID - DG1	SI	Required	Once		4
`DG1-2`	Diagnosis Coding Method	ID	Backward	Once	0053	2
`DG1-3`	Diagnosis Code - DG1	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	1
`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	ID	Optional	Once	0359	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 2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

DRGDiagnosis related group segment10 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	1
`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 versions2.32.3.12.4 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 2.2 2.32.3.12.4 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 - DSP	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 2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

EQLEmbedded query language segment4 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 versions2.32.3.12.4 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 versions2.32.3.12.4 2.5 2.5.1 2.6

ERRError segment1 fields

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

Defined in versions2.1 2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

EVNEvent type segmentProvenance6 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	Repeats	0188	60	Provenance.agent.who
`EVN-6`	Event Occurred	TS	Optional	Once		26	Provenance.occurredDateTime

FHIR map of segment EVNDefined in versions2.1 2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

FACFacility segment12 fields

Field	Name	Type	Use	Repeats	Table	Length
`FAC-1`	Facility ID-FAC	EI	Required	Once		20
`FAC-2`	Facility Type	ID	Optional	Once	0331	1
`FAC-3`	Facility Address	XAD	Required	Repeats		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	Repeats		60
`FAC-10`	Signature Authority Title	ST	Optional	Once		60
`FAC-11`	Signature Authority Address	XAD	Optional	Repeats		200
`FAC-12`	Signature Authority Telecommunication	XTN	Optional	Once		44

Defined in versions2.32.3.12.4 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 2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

FT1Financial transaction segment26 fields

Field	Name	Type	Use	Repeats	Table	Length
`FT1-1`	Set ID - FT1	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 - Alt	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 - FT1	CE	Optional	Repeats	0051	60
`FT1-20`	Performed By Code	XCN	Optional	Repeats	0084	120
`FT1-21`	Ordered By Code	XCN	Optional	Repeats		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	Repeats		120
`FT1-25`	Procedure Code	CE	Optional	Once	0088	80
`FT1-26`	Procedure Code Modifier	CE	Optional	Repeats	0340	80

Defined in versions2.1 2.2 2.32.3.12.4 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 2.2 2.32.3.12.4 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 Achieve 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 versions2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

GT1Guarantor segment55 fields

Field	Name	Type	Use	Repeats	Table	Length
`GT1-1`	Set ID - GT1	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	CE	Optional	Once	0063	80
`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 Employer 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 Name	XON	Optional	Repeats		130
`GT1-22`	Guarantor Billing Hold Flag	ID	Optional	Once	0136	1
`GT1-23`	Guarantor Credit Rating Code	CE	Optional	Once	0341	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	CE	Optional	Once	0002	80
`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	IS	Optional	Repeats	0009	2
`GT1-35`	Citizenship	CE	Optional	Repeats	0171	80
`GT1-36`	Primary Language	CE	Optional	Once	0296	60
`GT1-37`	Living Arrangement	IS	Optional	Once	0220	2
`GT1-38`	Publicity Code	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	CE	Optional	Once	0006	80
`GT1-42`	Mother s Maiden Name	XPN	Optional	Repeats		48
`GT1-43`	Nationality	CE	Optional	Once	0212	80
`GT1-44`	Ethnic Group	CE	Optional	Repeats	0063	80
`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	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	0295	2
`GT1-53`	Job Status	IS	Optional	Once	0311	2
`GT1-54`	Guarantor Financial Class	FC	Optional	Once		50
`GT1-55`	Guarantor Race	CE	Optional	Repeats	0005	80

Defined in versions2.1 2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

IN1Insurance segmentCoverage49 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`IN1-1`	Set ID - IN1	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 Emp 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	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	CE	Optional	Once	0063	80	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 Flag	ID	Optional	Once	0136	1
`IN1-24`	Notice Of Admission Date	DT	Optional	Once		8
`IN1-25`	Report Of Eligibility Flag	ID	Optional	Once	0136	1
`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	Repeats		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 L.R. Day	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 s 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	0295	2
`IN1-49`	Insured s ID Number	CX	Optional	Repeats		12	Coverage.extension

FHIR map of segment IN1Defined in versions2.1 2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

IN2Insurance additional information segment72 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 s Name and ID	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`	Military Sponsor Name	XPN	Optional	Repeats		48
`IN2-10`	Military ID Number	ST	Optional	Once		20
`IN2-11`	Dependent Of Military Recipient	CE	Optional	Once	0342	80
`IN2-12`	Military Organization	ST	Optional	Once		25
`IN2-13`	Military Station	ST	Optional	Once		25
`IN2-14`	Military Service	IS	Optional	Once	0140	14
`IN2-15`	Military Rank/Grade	IS	Optional	Once	0141	2
`IN2-16`	Military Status	IS	Optional	Once	0142	3
`IN2-17`	Military Retire Date	DT	Optional	Once		8
`IN2-18`	Military 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	RMC	Optional	Repeats		25
`IN2-29`	Policy Type/Amount	PTA	Optional	Repeats		25
`IN2-30`	Daily Deductible	DDI	Optional	Once		25
`IN2-31`	Living Dependency	IS	Optional	Once	0223	2
`IN2-32`	Ambulatory Status	IS	Optional	Repeats	0009	2
`IN2-33`	Citizenship	CE	Optional	Repeats	0171	80
`IN2-34`	Primary Language	CE	Optional	Once	0296	60
`IN2-35`	Living Arrangement	IS	Optional	Once	0220	2
`IN2-36`	Publicity Code	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	CE	Optional	Once	0006	80
`IN2-40`	Mother s Maiden Name	XPN	Optional	Repeats		48
`IN2-41`	Nationality	CE	Optional	Once	0212	80
`IN2-42`	Ethnic Group	CE	Optional	Repeats	0189	80
`IN2-43`	Marital Status	CE	Optional	Repeats	0002	80
`IN2-44`	Insured s 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 s Name	XPN	Optional	Repeats		48
`IN2-53`	Insured s Contact Person Phone 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 Co. Contact Reason	IS	Optional	Once	0232	2
`IN2-58`	Insurance Co 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	CE	Optional	Once	0063	80
`IN2-63`	Insured s Phone Number - Home	XTN	Optional	Repeats		40
`IN2-64`	Insured s Employer Phone Number	XTN	Optional	Repeats		40
`IN2-65`	Military Handicapped Program	CE	Optional	Once	0343	60
`IN2-66`	Suspend Flag	ID	Optional	Once	0136	1
`IN2-67`	Copay Limit Flag	ID	Optional	Once	0136	1
`IN2-68`	Stoploss Limit Flag	ID	Optional	Once	0136	1
`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	CE	Optional	Repeats	0005	80
`IN2-72`	HCFA Patient s Relationship to Insured	CE	Optional	Once	0344	60

Defined in versions2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

IN3Insurance additional information, certification segmentCareTeam25 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`IN3-1`	Set ID - IN3	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	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	0010	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	0345	60
`IN3-18`	Certification Agency	CE	Optional	Once	0346	60
`IN3-19`	Certification Agency Phone Number	XTN	Optional	Repeats		40
`IN3-20`	Pre-Certification Req/Window	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 versions2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

LCCLocation charge code segment4 fields

Field	Name	Type	Use	Repeats	Table	Length
`LCC-1`	Primary Key Value - LCC	PL	Required	Once		200
`LCC-2`	Location Department	IS	Required	Once	0264	10
`LCC-3`	Accommodation Type	CE	Optional	Repeats	0129	60
`LCC-4`	Charge Code	CE	Required	Repeats	0132	60

Defined in versions2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

LCHLocation characteristic segment5 fields

Field	Name	Type	Use	Repeats	Table	Length
`LCH-1`	Primary Key Value - LCH	PL	Required	Once		200
`LCH-2`	Segment Action Code	ID	Optional	Once	0206	3
`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 versions2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

LDPLocation department segment11 fields

Field	Name	Type	Use	Repeats	Table	Length
`LDP-1`	Primary Key Value - LDP	PL	Required	Once		200
`LDP-2`	Location Department	IS	Required	Once	0264	10
`LDP-3`	Location Service	IS	Optional	Repeats	0069	3
`LDP-4`	Specialty 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 LDP	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 versions2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

LOCLocation identification segment8 fields

Field	Name	Type	Use	Repeats	Table	Length
`LOC-1`	Primary Key Value - LOC	PL	Required	Once		200
`LOC-2`	Location Description	ST	Optional	Once		48
`LOC-3`	Location Type - LOC	IS	Required	Repeats	0260	2
`LOC-4`	Organization Name - LOC	XON	Optional	Repeats		90
`LOC-5`	Location Address	XAD	Optional	Repeats		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 versions2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

LRLLocation relationship segment6 fields

Field	Name	Type	Use	Repeats	Table	Length
`LRL-1`	Primary Key Value - LRL	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	Repeats		80
`LRL-6`	Patient Location Relationship Value	PL	Conditional	Once		80

Defined in versions2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

MFAMaster file acknowledgment segment6 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`	MFN Record Level Error Return	CE	Required	Once	0181	60
`MFA-5`	Primary Key Value MFA	CE	Required	Repeats		60
`MFA-6`	Primary Key Value Type - MFA	ID	Required	Repeats	0355	3

Defined in versions2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

MFEMaster file entry segment5 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 - MFE	VARIES	Required	Repeats		200
`MFE-5`	Primary Key Value Type	ID	Required	Repeats	0355	3

Defined in versions2.2 2.32.3.12.4 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 versions2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

MRGMerge patient information segment-Account7 fields

Field	Name	Type	Use	Repeats	Length	FHIR
`MRG-1`	Prior Patient Identifier List	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	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	Repeats	48

FHIR map of segment MRGDefined in versions2.1 2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

MSAMessage acknowledgment 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 Acknowledgment Type	ID	Backward	Once	0102	1
`MSA-6`	Error Condition	CE	Optional	Once		100

FHIR map of segment MSADefined in versions2.1 2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

MSHMessage header segmentProvenance, Bundle, Encounter +120 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	0361	180	Provenance.entity.what Provenance.entity.role+2 more
`MSH-4`	Sending Facility	HD	Optional	Once	0362	180	Provenance.agent.who Provenance.agent.type.coding.code+2 more
`MSH-5`	Receiving Application	HD	Optional	Once	0361	180	MessageHeader.destination.target MessageHeader.destination.name+1 more
`MSH-6`	Receiving Facility	HD	Optional	Once	0362	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	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	VID	Required	Once		60
`MSH-13`	Sequence Number	NM	Optional	Once		15
`MSH-14`	Continuation Pointer	ST	Optional	Once		180
`MSH-15`	Accept Acknowledgment Type	ID	Optional	Once	0155	2
`MSH-16`	Application Acknowledgment Type	ID	Optional	Once	0155	2
`MSH-17`	Country Code	ID	Optional	Once	`ISO3166`	2	MessageHeader.sender
`MSH-18`	Character Set	ID	Optional	Repeats	0211	16
`MSH-19`	Principal Language Of Message	CE	Optional	Once		60	MessageHeader.language
`MSH-20`	Alternate Character Set Handling Scheme	ID	Optional	Once	0356	20

FHIR map of segment MSHDefined in versions2.1 2.2 2.32.3.12.4 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 2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

NK1Next of kin / associated parties segmentPatient, RelatedPerson37 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`NK1-1`	Set ID - NK1	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 / Associated Parties Job 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 - NK1	XON	Optional	Repeats		90	Patient.contact.organization
`NK1-14`	Marital Status	CE	Optional	Once	0002	80
`NK1-15`	Sex	IS	Optional	Once	0001	1	Patient.contact.gender RelatedPerson.gender
`NK1-16`	Date/Time 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	CE	Optional	Repeats	0171	80
`NK1-20`	Primary Language	CE	Optional	Once	0296	60	RelatedPerson.communication.language
`NK1-21`	Living Arrangement	IS	Optional	Once	0220	2
`NK1-22`	Publicity Code	CE	Optional	Once	0215	80
`NK1-23`	Protection Indicator	ID	Optional	Once	0136	1
`NK1-24`	Student Indicator	IS	Optional	Once	0231	2
`NK1-25`	Religion	CE	Optional	Once	0006	80
`NK1-26`	Mother s Maiden Name	XPN	Optional	Repeats		48
`NK1-27`	Nationality	CE	Optional	Once	0212	80
`NK1-28`	Ethnic Group	CE	Optional	Repeats	0189	80
`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 s Identifiers	CX	Optional	Repeats		32	RelatedPerson.identifier
`NK1-34`	Job Status	IS	Optional	Once	0311	2
`NK1-35`	Race	CE	Optional	Repeats	0005	80
`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 2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

NPUBed status update segment2 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 2.2 2.32.3.12.4 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 2.2 2.32.3.12.4 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 2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

NTENotes and comments segmentAppointment, DocumentReference, Observation +14 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`NTE-1`	Set ID - NTE	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
`NTE-4`	Comment Type	CE	Optional	Once	0364	60	Appointment.extension.extension Appointment.extension

FHIR map of segment NTEDefined in versions2.1 2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

OBRObservation request segmentDiagnosticReport, ServiceRequest, Specimen45 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`OBR-1`	Set ID - OBR	SI	Optional	Once		4
`OBR-2`	Placer Order Number	EI	Conditional	Once		22	DiagnosticReport.identifier DiagnosticReport.identifier.type.coding.code+5 more
`OBR-3`	Filler Order Number	EI	Conditional	Once		22	DiagnosticReport.identifier DiagnosticReport.identifier.type.coding.code+4 more
`OBR-4`	Universal Service ID	CE	Required	Once		200	DiagnosticReport.code ServiceRequest.code
`OBR-5`	Priority-OBR	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 Info.	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	SPS	Optional	Once		300	Specimen.$this
`OBR-16`	Ordering Provider	XCN	Optional	Repeats		80	ServiceRequest.requester
`OBR-17`	Order Callback Phone Number	XTN	Optional	Once		40	ServiceRequest.requester.extension
`OBR-18`	Placer Field 1	ST	Optional	Once		60
`OBR-19`	Placer Field 2	ST	Optional	Once		60
`OBR-20`	Filler Field 1 +	ST	Optional	Once		60
`OBR-21`	Filler Field 2 +	ST	Optional	Once		60
`OBR-22`	Results Rpt/Status Chng - Date/Time +	TS	Conditional	Once		26	DiagnosticReport.issued
`OBR-23`	Charge to Practice +	MOC	Optional	Once		40
`OBR-24`	Diagnostic Serv Sect ID	ID	Optional	Once	0074	10	DiagnosticReport.category
`OBR-25`	Result Status +	ID	Conditional	Once	0123	1	DiagnosticReport.status
`OBR-26`	Parent Result +	PRL	Optional	Once		400
`OBR-27`	Quantity/Timing	TQ	Optional	Repeats		200	ServiceRequest.$this
`OBR-28`	Result Copies To	XCN	Optional	Once		150
`OBR-29`	Parent Number	EIP	Optional	Once		200	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 +	NDL	Optional	Once		200	DiagnosticReport.resultsInterpreter
`OBR-33`	Assistant Result Interpreter +	NDL	Optional	Repeats		200
`OBR-34`	Technician +	NDL	Optional	Repeats		200	DiagnosticReport.performer DiagnosticReport.performer.extension+2 more
`OBR-35`	Transcriptionist +	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
`OBR-44`	Procedure Code	CE	Optional	Once	0088	80
`OBR-45`	Procedure Code Modifier	CE	Optional	Repeats	0340	80

FHIR map of segment OBRDefined in versions2.1 2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

OBXObservation/result segmentObservation, DocumentReference17 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`OBX-1`	Set ID - OBX	SI	Optional	Once		4
`OBX-2`	Value Type	ID	Conditional	Once	0125	3
`OBX-3`	Observation Identifier	CE	Required	Once		80	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		60	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`	Observation 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	Repeats		80	Observation.performer)Observation.performer
`OBX-17`	Observation Method	CE	Optional	Repeats		60	Observation.method

FHIR map of segment OBXDefined in versions2.1 2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

ODSDietary orders, supplements, and preferences segment4 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 versions2.2 2.32.3.12.4 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 versions2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

OM1General segment47 fields

Field	Name	Type	Use	Repeats	Table	Length
`OM1-1`	Sequence Number - Test/Observation Master File	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 Perform 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 Definition for the Observation	TS	Optional	Once		26
`OM1-22`	Effective Date/Time of Change	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	Repeats		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 Obs	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 versions2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

OM2Numeric observation segment10 fields

Field	Name	Type	Use	Repeats	Length
`OM2-1`	Sequence Number - Test/Observation Master File	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	RFR	Optional	Once	200
`OM2-7`	Critical Range for Ordinal & Continuous Obs	NR	Optional	Once	200
`OM2-8`	Absolute Range for Ordinal & Continuous Obs	CM_ABS_RANGE	Optional	Once	200
`OM2-9`	Delta Check Criteria	DLT	Optional	Repeats	200
`OM2-10`	Minimum Meaningful Increments	NM	Optional	Once	20

Defined in versions2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

OM3Categorical test/observation segment7 fields

Field	Name	Type	Use	Repeats	Table	Length
`OM3-1`	Sequence Number - Test/Observation Master File	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 versions2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

OM4Observations that require specimens segment14 fields

Field	Name	Type	Use	Repeats	Table	Length
`OM4-1`	Sequence Number - Test/Observation Master File	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 versions2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

OM5Observation batteries (sets)3 fields

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

Defined in versions2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

OM6Observations that are calculated from other observations segment2 fields

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

Defined in versions2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

ORCCommon order segmentDiagnosticReport, Immunization, MedicationAdministration +224 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	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	Repeats		120	Provenance.agent.who Provenance.agent.type.coding.code+1 more
`ORC-11`	Verified By	XCN	Optional	Repeats		120	Provenance.agent.who Provenance.agent.type.coding.code+1 more
`ORC-12`	Ordering Provider	XCN	Optional	Repeats		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	Repeats		120	Provenance.agent.type.coding.code Provenance.agent.type.coding.system+1 more
`ORC-20`	Advanced Beneficiary Notice Code	CE	Optional	Once	0339	40
`ORC-21`	Ordering Facility Name	XON	Optional	Repeats		60	Provenance.location ServiceRequest.requester)
`ORC-22`	Ordering Facility Address	XAD	Optional	Repeats		106	Provenance.location ServiceRequest.requester)
`ORC-23`	Ordering Facility Phone Number	XTN	Optional	Repeats		48	Provenance.location ServiceRequest.requester)
`ORC-24`	Ordering Provider Address	XAD	Optional	Repeats		106	Provenance.agent.who ServiceRequest.requester)

FHIR map of segment ORCDefined in versions2.1 2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

PCRPossible causal relationship segment23 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 versions2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

PD1Patient Additional 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	1
`PD1-10`	Duplicate Patient	CX	Optional	Repeats		20
`PD1-11`	Publicity Code	CE	Optional	Once	0215	80
`PD1-12`	Protection Indicator	ID	Optional	Once	0136	1

FHIR map of segment PD1Defined in versions2.1 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

PDCProduct detail country segment15 fields

Field	Name	Type	Use	Repeats	Table	Length
`PDC-1`	Manufacturer/Distributor	XON	Required	Repeats		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 ID	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 Marketed	TS	Optional	Once		26
`PDC-15`	Date Last Marketed	TS	Optional	Once		26

Defined in versions2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

PEOProduct experience observation segment25 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	Repeats		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	Repeats		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 versions2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

PESProduct experience sender segment13 fields

Field	Name	Type	Use	Repeats	Table	Length
`PES-1`	Sender Organization Name	XON	Optional	Repeats		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		75
`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 versions2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

PIDPatient identification segmentProvenance, Account, Appointment +130 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`PID-1`	Set ID - PID	SI	Optional	Once		4
`PID-2`	Patient ID	CX	Backward	Once		20	Appointment.participant.actor Patient.identifier+1 more
`PID-3`	Patient Identifier List	CX	Required	Repeats		20	Appointment.participant.actor Patient.identifier+1 more
`PID-4`	Alternate Patient ID - PID	CX	Backward	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	Repeats		48	Patient.extension
`PID-7`	Date/Time 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	CE	Optional	Repeats	0005	80
`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	CE	Optional	Once	0002	80	Patient.maritalStatus
`PID-17`	Religion	CE	Optional	Once	0006	80	Patient.extension
`PID-18`	Patient Account Number	CX	Optional	Once		20	Account.identifier
`PID-19`	SSN Number - Patient	ST	Backward	Once		16	Patient.identifier.value Patient.identifier.type.coding.code+2 more
`PID-20`	Driver's License Number - Patient	DLN	Optional	Once		25	Patient.identifier
`PID-21`	Mother's Identifier	CX	Optional	Repeats		20	Patient.$this
`PID-22`	Ethnic Group	CE	Optional	Repeats	0189	80
`PID-23`	Birth Place	ST	Optional	Once		60	Patient.extension Patient.extension.valueAddress.text
`PID-24`	Multiple Birth Indicator	ID	Optional	Once	0136	1	Patient.multipleBirthBoolean
`PID-25`	Birth Order	NM	Optional	Once		2	Patient.multipleBirthInteger
`PID-26`	Citizenship	CE	Optional	Repeats	0171	80	Patient.extension Patient.extension.extension
`PID-27`	Veterans Military Status	CE	Optional	Once	0172	60
`PID-28`	Nationality	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 2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

PR1Procedures segmentProcedure16 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`PR1-1`	Set ID - PR1	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 Functional 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	0051	80	Procedure.reasonCode
`PR1-16`	Procedure Code Modifier	CE	Optional	Repeats	0340	80	Procedure.code.value

FHIR map of segment PR1Defined in versions2.1 2.2 2.32.3.12.4 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`	Primary Key Value - PRA	CE	Required	Once		60
`PRA-2`	Practitioner Group	CE	Optional	Repeats		60
`PRA-3`	Practitioner Category	IS	Optional	Repeats	0186	3
`PRA-4`	Provider Billing	ID	Optional	Once	0187	1
`PRA-5`	Specialty	SPD	Optional	Repeats		100
`PRA-6`	Practitioner ID Numbers	PLN	Optional	Repeats		100
`PRA-7`	Privileges	PIP	Optional	Repeats		200
`PRA-8`	Date Entered Practice	DT	Optional	Once		8

Defined in versions2.2 2.32.3.12.4 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 versions2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

PRCPricing segment18 fields

Field	Name	Type	Use	Repeats	Table	Length
`PRC-1`	Primary Key Value - PRC	CE	Required	Once	0132	200
`PRC-2`	Facility ID - PRC	CE	Optional	Repeats		60
`PRC-3`	Department	CE	Optional	Repeats	0184	200
`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 versions2.32.3.12.4 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`	Provider Role	CE	Required	Repeats	0286	200
`PRD-2`	Provider Name	XPN	Optional	Repeats		106
`PRD-3`	Provider Address	XAD	Optional	Repeats		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	PI	Optional	Repeats		100
`PRD-8`	Effective Start Date of Provider Role	TS	Optional	Once		26
`PRD-9`	Effective End Date of Provider Role	TS	Optional	Once		26

Defined in versions2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

PSHProduct summary header segment14 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 versions2.32.3.12.4 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 Life Cycle Status	CE	Optional	Once		80
`PTH-6`	Change Pathway Life Cycle Status Date/Time	TS	Conditional	Once		26

Defined in versions2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

PV1Patient visit segmentBasic, Coverage, Encounter +152 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`PV1-1`	Set ID - PV1	SI	Optional	Once		4
`PV1-2`	Patient Class	IS	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	IS	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		80	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`	Re-admission 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	0010	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	DLD	Optional	Once		25	Encounter.hospitalization.destination
`PV1-38`	Diet Type	CE	Optional	Once	0114	80	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 2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

PV2Patient visit - additional information segmentEncounter37 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/Time	TS	Optional	Once		26	Encounter.extension
`PV2-9`	Expected Discharge Date/Time	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	Repeats		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	CE	Optional	Once	0218	80
`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	1
`PV2-35`	Military Non-Availability Code	ID	Optional	Once	0136	1
`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 versions2.2 2.32.3.12.4 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 versions2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

QRDOriginal-style query 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 Qual.	VR	Optional	Repeats		20
`QRD-12`	Query Results Level	ID	Optional	Once	0108	1

Defined in versions2.1 2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

QRFOriginal style query 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 2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

RDFTable row definition segment2 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 versions2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

RDTTable row data segment1 fields

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

Defined in versions2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

RF1Referral Infomation11 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 versions2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

RGSResource group segment3 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 versions2.32.3.12.4 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-ROL	CE	Required	Once		80	Patient.generalPractitioner Encounter.participant.type+2 more
`ROL-4`	Role Person	XCN	Required	Repeats		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 Reason	CE	Optional	Once		80	CareTeam.reasonCode

FHIR map of segment ROLDefined in versions2.32.3.12.4 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`	Manufacturer 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 versions2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

RQDRequisition detail segment10 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`	Dept. Cost Center	IS	Optional	Once	0319	30
`RQD-8`	Item Natural Account Code	IS	Optional	Once	0320	30
`RQD-9`	Deliver To ID	CE	Optional	Once		60
`RQD-10`	Date Needed	DT	Optional	Once		8

Defined in versions2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

RXAPharmacy/treatment 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	Repeats		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		200	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 versions2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

RXCPharmacy/treatment 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 versions2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

RXDPharmacy/treatment 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	Repeats		200
`RXD-11`	Substitution Status	ID	Optional	Once	0167	1
`RXD-12`	Total Daily Dose	CQ	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	0227	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 versions2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

RXEPharmacy/treatment 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 Administration Instructions	CE	Optional	Repeats		200
`RXE-8`	Deliver-to Location	LA1	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	Repeats		60
`RXE-14`	Pharmacist/Treatment Supplier s Verifier ID	XCN	Optional	Repeats		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`	D/T 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 versions2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

RXGPharmacy/treatment 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/Treatment Supplier s 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	0227	60
`RXG-22`	Indication	CE	Optional	Repeats		200

Defined in versions2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

RXOPharmacy/treatment order segmentMedicationRequest23 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`RXO-1`	Requested Give Code	CE	Conditional	Once		100	MedicationRequest.medication
`RXO-2`	Requested Give Amount - Minimum	NM	Conditional	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	Conditional	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/Treatment 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	Repeats		60	MedicationRequest.requester
`RXO-15`	Pharmacist/Treatment Supplier s Verifier ID	XCN	Conditional	Repeats		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	Repeats		200
`RXO-21`	Requested Give Rate Amount	ST	Optional	Once		6
`RXO-22`	Requested Give Rate Units	CE	Optional	Once		60
`RXO-23`	Total Daily Dose	CQ	Optional	Once		10

FHIR map of segment RXODefined in versions2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

RXRPharmacy/treatment route segmentImmunization, MedicationRequest5 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
`RXR-5`	Routing Instruction	CE	Optional	Once		60	MedicationRequest.dosageInstruction.additionalInstruction

FHIR map of segment RXRDefined in versions2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

SCHSchedule activity information segmentAppointment, Provenance, ServiceRequest25 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`SCH-1`	Placer Appointment ID	EI	Conditional	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		22
`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	Repeats		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	Repeats		106
`SCH-15`	Placer Contact Location	PL	Optional	Once		80
`SCH-16`	Filler Contact Person	XCN	Required	Repeats		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	Repeats		106
`SCH-19`	Filler Contact Location	PL	Optional	Once		80
`SCH-20`	Entered by Person	XCN	Required	Repeats		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 versions2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

SPRStored procedure request definition segment4 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 versions2.32.3.12.4 2.5 2.5.1 2.6

STFStaff identification segment26 fields

Field	Name	Type	Use	Repeats	Table	Length
`STF-1`	Primary Key Value - STF	CE	Required	Once		60
`STF-2`	Staff ID Code	CX	Optional	Repeats		60
`STF-3`	Staff Name	XPN	Optional	Repeats		48
`STF-4`	Staff Type	IS	Optional	Repeats	0182	2
`STF-5`	Sex	IS	Optional	Once	0001	1
`STF-6`	Date/Time 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`	Hospital Service	CE	Optional	Repeats	0069	200
`STF-10`	Phone	XTN	Optional	Repeats		40
`STF-11`	Office/Home Address	XAD	Optional	Repeats		106
`STF-12`	Institution Activation Date	DIN	Optional	Repeats		26
`STF-13`	Institution Inactivation Date	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	CE	Optional	Once	0185	200
`STF-17`	Marital Status	CE	Optional	Once	0002	80
`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 - Staff	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 versions2.2 2.32.3.12.4 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	Repeats		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	Repeats		60	DocumentReference.author
`TXA-10`	Assigned Document Authenticator	XCN	Optional	Repeats		60	DocumentReference.authenticator
`TXA-11`	Transcriptionist Code/Name	XCN	Conditional	Repeats		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 versions2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

UB1UB82 data segment23 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	UVC	Optional	Once		12
`UB1-11`	Number Of Grace Days	NM	Optional	Once		2
`UB1-12`	Special Program Indicator	CE	Optional	Once	0348	60
`UB1-13`	PSRO/UR Approval Indicator	CE	Optional	Once	0349	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	OCD	Optional	Once		20
`UB1-17`	Occurrence Span	CE	Optional	Once	0351	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 2.2 2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

UB2UB92 data segment17 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	UVC	Optional	Once		11
`UB2-7`	Occurrence Code & Date	OCD	Optional	Once		11
`UB2-8`	Occurrence Span Code/Dates	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 versions2.2 2.32.3.12.4 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 2.2 2.32.3.12.4 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 2.2 2.32.3.12.4 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	Repeats	80
`VAR-5`	Variance Classification	CE	Optional	Once	60
`VAR-6`	Variance Description	ST	Optional	Repeats	512

Defined in versions2.32.3.12.4 2.5 2.5.1 2.6 2.7 2.7.1 2.8

VTQVirtual table query request segment5 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 versions2.32.3.12.4 2.5 2.5.1 2.6