HL7 v2 2.5.1

Segments and their fields in version 2.5.1. 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.

ABSAbstract14 fields

Field	Name	Type	Use	Repeats	Table	Length
`ABS-1`	Discharge Care Provider	XCN	Optional	Once	0010	250
`ABS-2`	Transfer Medical Service Code	CE	Optional	Once	0069	250
`ABS-3`	Severity of Illness Code	CE	Optional	Once	0421	250
`ABS-4`	Date/Time of Attestation	TS	Optional	Once		26
`ABS-5`	Attested By	XCN	Optional	Once		250
`ABS-6`	Triage Code	CE	Optional	Once	0422	250
`ABS-7`	Abstract Completion Date/Time	TS	Optional	Once		26
`ABS-8`	Abstracted By	XCN	Optional	Once		250
`ABS-9`	Case Category Code	CE	Optional	Once	0423	250
`ABS-10`	Caesarian Section Indicator	ID	Optional	Once	0136	1
`ABS-11`	Gestation Category Code	CE	Optional	Once	0424	250
`ABS-12`	Gestation Period - Weeks	NM	Optional	Once		3
`ABS-13`	Newborn Code	CE	Optional	Once	0425	250
`ABS-14`	Stillborn Indicator	ID	Optional	Once	0136	1

Defined in versions2.4 2.52.5.12.6 2.7 2.7.1 2.8

ACCAccident11 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	250
`ACC-3`	Accident Location	ST	Optional	Once		25
`ACC-4`	Auto Accident State	CE	Backward	Once	0347	250
`ACC-5`	Accident Job Related Indicator	ID	Optional	Once	0136	1
`ACC-6`	Accident Death Indicator	ID	Optional	Once	0136	12
`ACC-7`	Entered By	XCN	Optional	Once		250
`ACC-8`	Accident Description	ST	Optional	Once		25
`ACC-9`	Brought In By	ST	Optional	Once		80
`ACC-10`	Police Notified Indicator	ID	Optional	Once	0136	1
`ACC-11`	Accident Address	XAD	Optional	Once		250

Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

ADDAddendum1 fields

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

Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

AFFProfessional Affiliation5 fields

Field	Name	Type	Use	Repeats	Length
`AFF-1`	Set ID - AFF	SI	Required	Once	60
`AFF-2`	Professional Organization	XON	Required	Once	250
`AFF-3`	Professional Organization Address	XAD	Optional	Once	250
`AFF-4`	Professional Organization Affiliation Date Range	DR	Optional	Repeats	52
`AFF-5`	Professional Affiliation Additional Information	ST	Optional	Once	60

Defined in versions2.4 2.52.5.12.6 2.7 2.7.1 2.8

AIGAppointment Information - General ResourceAppointment14 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`AIG-1`	Set ID - AIG	SI	Required	Once		4
`AIG-2`	Segment Action Code	ID	Conditional	Once	0206	3
`AIG-3`	Resource ID	CE	Conditional	Once		250	Appointment.participant.actor
`AIG-4`	Resource Type	CE	Required	Once		250	Appointment.participant.type
`AIG-5`	Resource Group	CE	Optional	Repeats		250
`AIG-6`	Resource Quantity	NM	Optional	Once		5
`AIG-7`	Resource Quantity Units	CE	Optional	Once		250
`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		250
`AIG-11`	Duration	NM	Optional	Once		20	Appointment.participant.period.end
`AIG-12`	Duration Units	CE	Optional	Once		250
`AIG-13`	Allow Substitution Code	IS	Conditional	Once	0279	10
`AIG-14`	Filler Status Code	CE	Conditional	Once	0278	250

FHIR map of segment AIGDefined in versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

AILAppointment Information - Location ResourceAppointment12 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	Repeats		80	Appointment.participant.actor
`AIL-4`	Location Type-AIL	CE	Conditional	Once	0305	250
`AIL-5`	Location Group	CE	Optional	Once		250
`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		250
`AIL-9`	Duration	NM	Optional	Once		20	Appointment.participant.period.end
`AIL-10`	Duration Units	CE	Optional	Once		250
`AIL-11`	Allow Substitution Code	IS	Conditional	Once	0279	10
`AIL-12`	Filler Status Code	CE	Conditional	Once	0278	250

FHIR map of segment AILDefined in versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

AIPAppointment Information - Personnel ResourceAppointment12 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`AIP-1`	Set ID - AIP	SI	Required	Once		4
`AIP-2`	Segment Action Code	ID	Conditional	Once	0206	3
`AIP-3`	Personnel Resource ID	XCN	Conditional	Repeats		250	Appointment.participant.actor
`AIP-4`	Resource Type	CE	Conditional	Once	0182	250	Appointment.participant.type
`AIP-5`	Resource Group	CE	Optional	Once		250
`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		250
`AIP-9`	Duration	NM	Optional	Once		20	Appointment.participant.period.end
`AIP-10`	Duration Units	CE	Optional	Once		250
`AIP-11`	Allow Substitution Code	IS	Conditional	Once	0279	10
`AIP-12`	Filler Status Code	CE	Conditional	Once	0278	250	Appointment.participant.status

FHIR map of segment AIPDefined in versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

AISAppointment InformationAppointment, ServiceRequest12 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`AIS-1`	Set ID - AIS	SI	Required	Once		4
`AIS-2`	Segment Action Code	ID	Conditional	Once	0206	3
`AIS-3`	Universal Service Identifier	CE	Required	Once		250	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		250
`AIS-7`	Duration	NM	Optional	Once		20	Appointment.participant.period.end ServiceRequest.occurrencePeriod.end
`AIS-8`	Duration Units	CE	Optional	Once		250
`AIS-9`	Allow Substitution Code	IS	Conditional	Once	0279	10
`AIS-10`	Filler Status Code	CE	Conditional	Once	0278	250	Appointment.status
`AIS-11`	Placer Supplemental Service Information	CE	Optional	Repeats	0411	250	ServiceRequest.identifier
`AIS-12`	Filler Supplemental Service Information	CE	Optional	Repeats	0411	250	ServiceRequest.identifier

FHIR map of segment AISDefined in versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

AL1Patient Allergy InformationAllergyIntolerance6 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`AL1-1`	Set ID - AL1	SI	Required	Once		4
`AL1-2`	Allergen Type Code	CE	Optional	Once	0127	250	AllergyIntolerance.category AllergyIntolerance.type+1 more
`AL1-3`	Allergen Code/Mnemonic/Description	CE	Required	Once		250	AllergyIntolerance.code
`AL1-4`	Allergy Severity Code	CE	Optional	Once	0128	250	AllergyIntolerance.criticality AllergyIntolerance.reaction.severity+1 more
`AL1-5`	Allergy Reaction Code	ST	Optional	Repeats		15	AllergyIntolerance.reaction.manifestation.text
`AL1-6`	Identification Date	DT	Backward	Once		8	AllergyIntolerance.onsetDateTime

FHIR map of segment AL1Defined in versions2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

APRAppointment Preferences5 fields

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

Defined in versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

ARQAppointment Request25 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		250
`ARQ-6`	Request Event Reason	CE	Optional	Once		250
`ARQ-7`	Appointment Reason	CE	Optional	Once	0276	250
`ARQ-8`	Appointment Type	CE	Optional	Once	0277	250
`ARQ-9`	Appointment Duration	NM	Optional	Once		20
`ARQ-10`	Appointment Duration Units	CE	Optional	Once		250
`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		250
`ARQ-16`	Placer Contact Phone Number	XTN	Optional	Repeats		250
`ARQ-17`	Placer Contact Address	XAD	Optional	Repeats		250
`ARQ-18`	Placer Contact Location	PL	Optional	Once		80
`ARQ-19`	Entered By Person	XCN	Required	Repeats		250
`ARQ-20`	Entered By Phone Number	XTN	Optional	Repeats		250
`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
`ARQ-24`	Placer Order Number	EI	Conditional	Repeats		22
`ARQ-25`	Filler Order Number	EI	Conditional	Repeats		22

Defined in versions2.3 2.3.1 2.4 2.52.5.12.6 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	250
`AUT-2`	Authorizing Payor, Company ID	CE	Required	Once	0285	250
`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 versions2.3 2.3.1 2.4 2.52.5.12.6 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	HD	Optional	Once	227
`BHS-4`	Batch Sending Facility	HD	Optional	Once	227
`BHS-5`	Batch Receiving Application	HD	Optional	Once	227
`BHS-6`	Batch Receiving Facility	HD	Optional	Once	227
`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 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

BLCBlood Code2 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`BLC-1`	Blood Product Code	CE	Optional	Once	0426	250
`BLC-2`	Blood Amount	CQ	Optional	Once		267

Defined in versions2.4 2.52.5.12.6 2.7 2.7.1 2.8

BLGBilling4 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
`BLG-4`	Charge Type Reason	CWE	Optional	Once	0475	60

Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

BPOBlood product order14 fields

Field	Name	Type	Use	Repeats	Table	Length
`BPO-1`	Set ID - BPO	SI	Required	Once		4
`BPO-2`	BP Universal Service ID	CWE	Required	Once		250
`BPO-3`	BP Processing Requirements	CWE	Optional	Repeats	0508	250
`BPO-4`	BP Quantity	NM	Required	Once		5
`BPO-5`	BP Amount	NM	Optional	Once		5
`BPO-6`	BP Units	CE	Optional	Once		250
`BPO-7`	BP Intended Use Date/Time	TS	Optional	Once		26
`BPO-8`	BP Intended Dispense From Location	PL	Optional	Once		80
`BPO-9`	BP Intended Dispense From Address	XAD	Optional	Once		250
`BPO-10`	BP Requested Dispense Date/Time	TS	Optional	Once		26
`BPO-11`	BP Requested Dispense To Location	PL	Optional	Once		80
`BPO-12`	BP Requested Dispense To Address	XAD	Optional	Once		250
`BPO-13`	BP Indication for Use	CWE	Optional	Repeats	0509	250
`BPO-14`	BP Informed Consent Indicator	ID	Optional	Once	0136	1

Defined in versions2.52.5.12.6 2.7 2.7.1 2.8

BPXBlood product dispense status21 fields

Field	Name	Type	Use	Repeats	Table	Length
`BPX-1`	Set ID - BPX	SI	Required	Once		4
`BPX-2`	BP Dispense Status	CWE	Required	Once	0510	250
`BPX-3`	BP Status	ID	Required	Once	0511	1
`BPX-4`	BP Date/Time of Status	TS	Required	Once		26
`BPX-5`	BC Donation ID	EI	Conditional	Once		22
`BPX-6`	BC Component	CNE	Conditional	Once		250
`BPX-7`	BC Donation Type / Intended Use	CNE	Optional	Once		250
`BPX-8`	CP Commercial Product	CWE	Conditional	Once	0512	250
`BPX-9`	CP Manufacturer	XON	Conditional	Once		250
`BPX-10`	CP Lot Number	EI	Conditional	Once		22
`BPX-11`	BP Blood Group	CNE	Optional	Once		250
`BPX-12`	BC Special Testing	CNE	Optional	Repeats		250
`BPX-13`	BP Expiration Date/Time	TS	Optional	Once		26
`BPX-14`	BP Quantity	NM	Required	Once		5
`BPX-15`	BP Amount	NM	Optional	Once		5
`BPX-16`	BP Units	CE	Optional	Once		250
`BPX-17`	BP Unique ID	EI	Optional	Once		22
`BPX-18`	BP Actual Dispensed To Location	PL	Optional	Once		80
`BPX-19`	BP Actual Dispensed To Address	XAD	Optional	Once		250
`BPX-20`	BP Dispensed to Receiver	XCN	Optional	Once		250
`BPX-21`	BP Dispensing Individual	XCN	Optional	Once		250

Defined in versions2.52.5.12.6 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 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

BTXBlood Product Transfusion/Disposition19 fields

Field	Name	Type	Use	Repeats	Table	Length
`BTX-1`	Set ID - BTX	SI	Required	Once		4
`BTX-2`	BC Donation ID	EI	Conditional	Once		22
`BTX-3`	BC Component	CNE	Conditional	Once		250
`BTX-4`	BC Blood Group	CNE	Conditional	Once		250
`BTX-5`	CP Commercial Product	CWE	Conditional	Once	0512	250
`BTX-6`	CP Manufacturer	XON	Conditional	Once		250
`BTX-7`	CP Lot Number	EI	Conditional	Once		22
`BTX-8`	BP Quantity	NM	Required	Once		5
`BTX-9`	BP Amount	NM	Optional	Once		5
`BTX-10`	BP Units	CE	Optional	Once		250
`BTX-11`	BP Transfusion/Disposition Status	CWE	Required	Once	0513	250
`BTX-12`	BP Message Status	ID	Required	Once	0511	1
`BTX-13`	BP Date/Time of Status	TS	Required	Once		26
`BTX-14`	BP Administrator	XCN	Optional	Once		250
`BTX-15`	BP Verifier	XCN	Optional	Once		250
`BTX-16`	BP Transfusion Start Date/Time of Status	TS	Optional	Once		26
`BTX-17`	BP Transfusion End Date/Time of Status	TS	Optional	Once		26
`BTX-18`	BP Adverse Reaction Type	CWE	Optional	Repeats	0514	250
`BTX-19`	BP Transfusion Interrupted Reason	CWE	Optional	Once	0515	250

Defined in versions2.52.5.12.6 2.7 2.7.1 2.8

CDMCharge Description Master13 fields

Field	Name	Type	Use	Repeats	Table	Length
`CDM-1`	Primary Key Value - CDM	CE	Required	Once	0132	250
`CDM-2`	Charge Code Alias	CE	Optional	Repeats		250
`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		250
`CDM-7`	Procedure Code	CE	Optional	Repeats	0088	250
`CDM-8`	Active/Inactive Flag	ID	Optional	Once	0183	1
`CDM-9`	Inventory Number	CE	Optional	Repeats	0463	250
`CDM-10`	Resource Load	NM	Optional	Once		12
`CDM-11`	Contract Number	CX	Optional	Repeats		250
`CDM-12`	Contract Organization	XON	Optional	Repeats		250
`CDM-13`	Room Fee Indicator	ID	Optional	Once	0136	1

Defined in versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

CERCertificate Detail31 fields

Field	Name	Type	Use	Repeats	Table	Length
`CER-1`	Set ID - CER	SI	Required	Once		4
`CER-2`	Serial Number	ST	Optional	Once		80
`CER-3`	Version	ST	Optional	Once		80
`CER-4`	Granting Authority	XON	Optional	Once		250
`CER-5`	Issuing Authority	XCN	Optional	Once		250
`CER-6`	Signature of Issuing Authority	ED	Optional	Once		65536
`CER-7`	Granting Country	ID	Optional	Once	0399	3
`CER-8`	Granting State/Province	CWE	Optional	Once	0347	250
`CER-9`	Granting County/Parish	CWE	Optional	Once	0289	250
`CER-10`	Certificate Type	CWE	Optional	Once		250
`CER-11`	Certificate Domain	CWE	Optional	Once		250
`CER-12`	Subject ID	ID	Conditional	Once		250
`CER-13`	Subject Name	ST	Required	Once		250
`CER-14`	Subject Directory Attribute Extension (Health Professional Data)	CWE	Optional	Repeats		250
`CER-15`	Subject Public Key Info	CWE	Optional	Once		250
`CER-16`	Authority Key Identifier	CWE	Optional	Once		250
`CER-17`	Basic Constraint	ID	Optional	Once	0136	250
`CER-18`	CRL Distribution Point	CWE	Optional	Repeats		250
`CER-19`	Jurisdiction Country	ID	Optional	Once	0399	3
`CER-20`	Jurisdiction State/Province	CWE	Optional	Once	0347	250
`CER-21`	Jurisdiction County/Parish	CWE	Optional	Once	0289	250
`CER-22`	Jurisdiction Breadth	CWE	Optional	Repeats	0547	250
`CER-23`	Granting Date	TS	Optional	Once		26
`CER-24`	Issuing Date	TS	Optional	Once		26
`CER-25`	Activation Date	TS	Optional	Once		26
`CER-26`	Inactivation Date	TS	Optional	Once		26
`CER-27`	Expiration Date	TS	Optional	Once		26
`CER-28`	Renewal Date	TS	Optional	Once		26
`CER-29`	Revocation Date	TS	Optional	Once		26
`CER-30`	Revocation Reason Code	CE	Optional	Once		250
`CER-31`	Certificate Status	CWE	Optional	Once	0536	250

Defined in versions2.52.5.12.6 2.7 2.7.1 2.8

CM0Clinical Study Master11 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	250
`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	250
`CM0-10`	Contact's Telephone Number	XTN	Optional	Once	250
`CM0-11`	Contact's Address	XAD	Optional	Repeats	250

Defined in versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

CM1Clinical Study Phase Master3 fields

Field	Name	Type	Use	Repeats	Length
`CM1-1`	Set ID - CM1	SI	Required	Once	4
`CM1-2`	Study Phase Identifier	CE	Required	Once	250
`CM1-3`	Description of Study Phase	ST	Required	Once	300

Defined in versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

CM2Clinical Study Schedule Master4 fields

Field	Name	Type	Use	Repeats	Length
`CM2-1`	Set ID - CM2	SI	Optional	Once	4
`CM2-2`	Scheduled Time Point	CE	Required	Once	250
`CM2-3`	Description of Time Point	ST	Optional	Once	300
`CM2-4`	Events Scheduled This Time Point	CE	Required	Once	250

Defined in versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

CNSClear Notification6 fields

Field	Name	Type	Use	Repeats	Length
`CNS-1`	Starting Notification Reference Number	NM	Optional	Once	20
`CNS-2`	Ending Notification Reference Number	NM	Optional	Once	20
`CNS-3`	Starting Notification Date/Time	TS	Optional	Once	26
`CNS-4`	Ending Notification Date/Time	TS	Optional	Once	26
`CNS-5`	Starting Notification Code	CE	Optional	Once	250
`CNS-6`	Ending Notification Code	CE	Optional	Once	250

Defined in versions2.4 2.52.5.12.6 2.7 2.7.1 2.8

CONConsent25 fields

Field	Name	Type	Use	Repeats	Table	Length
`CON-1`	Set ID - CON	SI	Required	Once		4
`CON-2`	Consent Type	CWE	Optional	Once	0496	250
`CON-3`	Consent Form ID	ST	Optional	Once		40
`CON-4`	Consent Form Number	EI	Optional	Once		180
`CON-5`	Consent Text	FT	Optional	Repeats		65536
`CON-6`	Subject-specific Consent Text	FT	Optional	Repeats		65536
`CON-7`	Consent Background	FT	Optional	Repeats		65536
`CON-8`	Subject-specific Consent Background	FT	Optional	Repeats		65536
`CON-9`	Consenter-imposed limitations	FT	Optional	Repeats		65536
`CON-10`	Consent Mode	CNE	Optional	Once	0497	2
`CON-11`	Consent Status	CNE	Required	Once	0498	2
`CON-12`	Consent Discussion Date/Time	TS	Optional	Once		26
`CON-13`	Consent Decision Date/Time	TS	Optional	Once		26
`CON-14`	Consent Effective Date/Time	TS	Optional	Once		26
`CON-15`	Consent End Date/Time	TS	Optional	Once		26
`CON-16`	Subject Competence Indicator	ID	Optional	Once	0136	1
`CON-17`	Translator Assistance Indicator	ID	Optional	Once	0136	1
`CON-18`	Language Translated To	ID	Optional	Once	0296	1
`CON-19`	Informational Material Supplied Indicator	ID	Optional	Once	0136	1
`CON-20`	Consent Bypass Reason	CWE	Optional	Once	0499	250
`CON-21`	Consent Disclosure Level	ID	Optional	Once	0500	1
`CON-22`	Consent Non-disclosure Reason	CWE	Optional	Once	0501	250
`CON-23`	Non-subject Consenter Reason	CWE	Optional	Once	0502	250
`CON-24`	Consenter ID	XPN	Required	Repeats		250
`CON-25`	Relationship to Subject Table	IS	Required	Repeats	0548	100

Defined in versions2.52.5.12.6 2.7 2.7.1 2.8

CSPClinical Study Phase4 fields

Field	Name	Type	Use	Repeats	Length
`CSP-1`	Study Phase Identifier	CE	Required	Once	250
`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	250

Defined in versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

CSRClinical Study Registration16 fields

Field	Name	Type	Use	Repeats	Length
`CSR-1`	Sponsor Study ID	EI	Required	Once	60
`CSR-2`	Alternate Study ID	EI	Optional	Once	60
`CSR-3`	Institution Registering the Patient	CE	Optional	Once	250
`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	250
`CSR-8`	Study Authorizing Provider	XCN	Required	Repeats	250
`CSR-9`	Date/time Patient Study Consent Signed	TS	Conditional	Once	26
`CSR-10`	Patient Study Eligibility Status	CE	Conditional	Once	250
`CSR-11`	Study Randomization Date/time	TS	Optional	Once	26
`CSR-12`	Randomized Study Arm	CE	Optional	Once	250
`CSR-13`	Stratum for Study Randomization	CE	Optional	Once	250
`CSR-14`	Patient Evaluability Status	CE	Conditional	Once	250
`CSR-15`	Date/time Ended Study	TS	Conditional	Once	26
`CSR-16`	Reason Ended Study	CE	Conditional	Once	250

Defined in versions2.3 2.3.1 2.4 2.52.5.12.6 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	250
`CSS-2`	Study Scheduled Patient Time Point	TS	Optional	Once	26
`CSS-3`	Study Quality Control Codes	CE	Optional	Once	250

Defined in versions2.3 2.3.1 2.4 2.52.5.12.6 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	250
`CTD-2`	Contact Name	XPN	Optional	Repeats		250
`CTD-3`	Contact Address	XAD	Optional	Repeats		250
`CTD-4`	Contact Location	PL	Optional	Once		60
`CTD-5`	Contact Communication Information	XTN	Optional	Repeats		250
`CTD-6`	Preferred Method of Contact	CE	Optional	Once	0185	250
`CTD-7`	Contact Identifiers	PLN	Optional	Repeats		100

Defined in versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

CTIClinical Trial Identification3 fields

Field	Name	Type	Use	Repeats	Length
`CTI-1`	Sponsor Study ID	EI	Required	Once	60
`CTI-2`	Study Phase Identifier	CE	Conditional	Once	250
`CTI-3`	Study Scheduled Time Point	CE	Optional	Once	250

Defined in versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

DB1Disability8 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		250
`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 versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

DG1DiagnosisCondition, Encounter, EpisodeOfCare21 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	250	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	250
`DG1-8`	Diagnostic Related Group	CE	Backward	Once	0055	250
`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	250
`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		250	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
`DG1-20`	Diagnosis Identifier	EI	Conditional	Once		427	Condition.identifier Encounter.diagnosis.condition+1 more
`DG1-21`	Diagnosis Action Code	ID	Conditional	Once	0206	1	Condition.verificationStatus.coding.code Condition.verificationStatus.coding.system+3 more

FHIR map of segment DG1Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

DRGDiagnosis Related Group11 fields

Field	Name	Type	Use	Repeats	Table	Length
`DRG-1`	Diagnostic Related Group	CE	Optional	Once	0055	250
`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	250
`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
`DRG-11`	DRG Transfer Type	IS	Optional	Once	0415	21

Defined in versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

DSCContinuation Pointer2 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`DSC-1`	Continuation Pointer	ST	Optional	Once		180
`DSC-2`	Continuation Style	ID	Optional	Once	0398	1

Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

DSPDisplay Data5 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 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

ECDEquipment Command5 fields

Field	Name	Type	Use	Repeats	Table	Length
`ECD-1`	Reference Command Number	NM	Required	Once		20
`ECD-2`	Remote Control Command	CE	Required	Once	0368	250
`ECD-3`	Response Required	ID	Optional	Once	0136	80
`ECD-4`	Requested Completion Time	TQ	Backward	Once		200
`ECD-5`	Parameters	TX	Optional	Repeats		65536

Defined in versions2.4 2.52.5.12.6 2.7 2.7.1 2.8

ECREquipment Command Response3 fields

Field	Name	Type	Use	Repeats	Table	Length
`ECR-1`	Command Response	CE	Required	Once	0387	250
`ECR-2`	Date/Time Completed	TS	Required	Once		26
`ECR-3`	Command Response Parameters	TX	Optional	Repeats		65536

Defined in versions2.4 2.52.5.12.6 2.7 2.7.1 2.8

EDUEducational Detail9 fields

Field	Name	Type	Use	Repeats	Table	Length
`EDU-1`	Set ID - EDU	SI	Required	Once		60
`EDU-2`	Academic Degree	IS	Optional	Once	0360	10
`EDU-3`	Academic Degree Program Date Range	DR	Optional	Once		52
`EDU-4`	Academic Degree Program Participation Date Range	DR	Optional	Once		52
`EDU-5`	Academic Degree Granted Date	DT	Optional	Once		8
`EDU-6`	School	XON	Optional	Once		250
`EDU-7`	School Type Code	CE	Optional	Once	0402	250
`EDU-8`	School Address	XAD	Optional	Once		250
`EDU-9`	Major Field of Study	CWE	Optional	Repeats		250

Defined in versions2.4 2.52.5.12.6 2.7 2.7.1 2.8

EQLEmbedded Query Language4 fields

Field	Name	Type	Use	Repeats	Table	Length
`EQL-1`	Query Tag	ST	Optional	Once		32
`EQL-2`	Query/Response Format Code	ID	Required	Once	0106	1
`EQL-3`	EQL Query Name	CE	Required	Once		250
`EQL-4`	EQL Query Statement	ST	Required	Once		4096

Defined in versions2.3 2.3.1 2.4 2.52.5.12.6

EQPEquipment/log Service5 fields

Field	Name	Type	Use	Repeats	Table	Length
`EQP-1`	Event type	CE	Required	Once	0450	250
`EQP-2`	File Name	ST	Optional	Once		20
`EQP-3`	Start Date/Time	TS	Required	Once		26
`EQP-4`	End Date/Time	TS	Optional	Once		26
`EQP-5`	Transaction Data	FT	Required	Once		65536

Defined in versions2.4 2.52.5.12.6 2.7 2.7.1 2.8

EQUEquipment Detail5 fields

Field	Name	Type	Use	Repeats	Table	Length
`EQU-1`	Equipment Instance Identifier	EI	Required	Once		22
`EQU-2`	Event Date/Time	TS	Required	Once		26
`EQU-3`	Equipment State	CE	Conditional	Once	0365	250
`EQU-4`	Local/Remote Control State	CE	Optional	Once	0366	250
`EQU-5`	Alert Level	CE	Optional	Once	0367	250

Defined in versions2.4 2.52.5.12.6 2.7 2.7.1 2.8

ERQEvent replay query3 fields

Field	Name	Type	Use	Repeats	Length
`ERQ-1`	Query Tag	ST	Optional	Once	32
`ERQ-2`	Event Identifier	CE	Required	Once	250
`ERQ-3`	Input Parameter List	QIP	Optional	Repeats	256

Defined in versions2.3 2.3.1 2.4 2.52.5.12.6

ERRError12 fields

Field	Name	Type	Use	Repeats	Table	Length
`ERR-1`	Error Code and Location	ELD	Backward	Repeats		493
`ERR-2`	Error Location	ERL	Optional	Repeats		18
`ERR-3`	HL7 Error Code	CWE	Required	Once	0357	705
`ERR-4`	Severity	ID	Required	Once	0516	2
`ERR-5`	Application Error Code	CWE	Optional	Once	0533	705
`ERR-6`	Application Error Parameter	ST	Optional	Once		80
`ERR-7`	Diagnostic Information	TX	Optional	Once		2048
`ERR-8`	User Message	TX	Optional	Once		250
`ERR-9`	Inform Person Indicator	IS	Optional	Repeats	0517	20
`ERR-10`	Override Type	CWE	Optional	Once	0518	705
`ERR-11`	Override Reason Code	CWE	Optional	Repeats	0519	705
`ERR-12`	Help Desk Contact Point	XTN	Optional	Repeats		652

Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

EVNEvent TypeProvenance7 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	250	Provenance.agent.who
`EVN-6`	Event Occurred	TS	Optional	Once		26	Provenance.occurredDateTime
`EVN-7`	Event Facility	HD	Optional	Once		241	Provenance.location

FHIR map of segment EVNDefined in versions2.1 2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

FACFacility12 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		250
`FAC-4`	Facility Telecommunication	XTN	Required	Once		250
`FAC-5`	Contact Person	XCN	Optional	Repeats		250
`FAC-6`	Contact Title	ST	Optional	Repeats		60
`FAC-7`	Contact Address	XAD	Optional	Repeats		250
`FAC-8`	Contact Telecommunication	XTN	Optional	Repeats		250
`FAC-9`	Signature Authority	XCN	Required	Repeats		250
`FAC-10`	Signature Authority Title	ST	Optional	Once		60
`FAC-11`	Signature Authority Address	XAD	Optional	Repeats		250
`FAC-12`	Signature Authority Telecommunication	XTN	Optional	Once		250

Defined in versions2.3 2.3.1 2.4 2.52.5.12.6 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	HD	Optional	Once	227
`FHS-4`	File Sending Facility	HD	Optional	Once	227
`FHS-5`	File Receiving Application	HD	Optional	Once	227
`FHS-6`	File Receiving Facility	HD	Optional	Once	227
`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 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

FT1Financial Transaction31 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	DR	Required	Once		53
`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	250
`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	250
`FT1-14`	Insurance Plan ID	CE	Optional	Once	0072	250
`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	250
`FT1-20`	Performed By Code	XCN	Optional	Repeats	0084	250
`FT1-21`	Ordered By Code	XCN	Optional	Repeats		250
`FT1-22`	Unit Cost	CP	Optional	Once		12
`FT1-23`	Filler Order Number	EI	Optional	Once		427
`FT1-24`	Entered By Code	XCN	Optional	Repeats		250
`FT1-25`	Procedure Code	CE	Optional	Once	0088	250
`FT1-26`	Procedure Code Modifier	CE	Optional	Repeats	0340	250
`FT1-27`	Advanced Beneficiary Notice Code	CE	Optional	Once	0339	250
`FT1-28`	Medically Necessary Duplicate Procedure Reason.	CWE	Optional	Once	0476	250
`FT1-29`	NDC Code	CNE	Optional	Once	0549	250
`FT1-30`	Payment Reference ID	CX	Optional	Once		250
`FT1-31`	Transaction Reference Key	SI	Optional	Repeats		4

Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.52.5.12.6 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 2.3 2.3.1 2.4 2.52.5.12.6 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		250
`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		250
`GOL-10`	Goal Management Discipline	CE	Optional	Once		250
`GOL-11`	Current Goal Review Status	CE	Optional	Once		250
`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		250
`GOL-17`	Goal Evaluation Comment	ST	Optional	Repeats		300
`GOL-18`	Goal Life Cycle Status	CE	Optional	Once		250
`GOL-19`	Goal Life Cycle Status Date/Time	TS	Optional	Once		26
`GOL-20`	Goal Target Type	CE	Optional	Repeats		250
`GOL-21`	Goal Target Name	XPN	Optional	Repeats		250

Defined in versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

GP1Grouping/Reimbursement - Visit5 fields

Field	Name	Type	Use	Repeats	Table	Length
`GP1-1`	Type of Bill Code	IS	Required	Once	0455	3
`GP1-2`	Revenue Code	IS	Optional	Repeats	0456	3
`GP1-3`	Overall Claim Disposition Code	IS	Optional	Once	0457	1
`GP1-4`	OCE Edits per Visit Code	IS	Optional	Repeats	0458	2
`GP1-5`	Outlier Cost	CP	Optional	Once		12

Defined in versions2.4 2.52.5.12.6 2.7 2.7.1 2.8

GP2Grouping/Reimbursement - Procedure Line Item14 fields

Field	Name	Type	Use	Repeats	Table	Length
`GP2-1`	Revenue Code	IS	Optional	Once	0456	3
`GP2-2`	Number of Service Units	NM	Optional	Once		7
`GP2-3`	Charge	CP	Optional	Once		12
`GP2-4`	Reimbursement Action Code	IS	Optional	Once	0459	1
`GP2-5`	Denial or Rejection Code	IS	Optional	Once	0460	1
`GP2-6`	OCE Edit Code	IS	Optional	Repeats	0458	3
`GP2-7`	Ambulatory Payment Classification Code	CE	Optional	Once	0466	250
`GP2-8`	Modifier Edit Code	IS	Optional	Repeats	0467	1
`GP2-9`	Payment Adjustment Code	IS	Optional	Once	0468	1
`GP2-10`	Packaging Status Code	IS	Optional	Once	0469	1
`GP2-11`	Expected CMS Payment Amount	CP	Optional	Once		12
`GP2-12`	Reimbursement Type Code	IS	Optional	Once	0470	2
`GP2-13`	Co-Pay Amount	CP	Optional	Once		12
`GP2-14`	Pay Rate per Service Unit	NM	Optional	Once		4

Defined in versions2.4 2.52.5.12.6 2.7 2.7.1 2.8

GT1Guarantor57 fields

Field	Name	Type	Use	Repeats	Table	Length
`GT1-1`	Set ID - GT1	SI	Required	Once		4
`GT1-2`	Guarantor Number	CX	Optional	Repeats		250
`GT1-3`	Guarantor Name	XPN	Required	Repeats		250
`GT1-4`	Guarantor Spouse Name	XPN	Optional	Repeats		250
`GT1-5`	Guarantor Address	XAD	Optional	Repeats		250
`GT1-6`	Guarantor Ph Num - Home	XTN	Optional	Repeats		250
`GT1-7`	Guarantor Ph Num - Business	XTN	Optional	Repeats		250
`GT1-8`	Guarantor Date/Time Of Birth	TS	Optional	Once		26
`GT1-9`	Guarantor Administrative Sex	IS	Optional	Once	0001	1
`GT1-10`	Guarantor Type	IS	Optional	Once	0068	2
`GT1-11`	Guarantor Relationship	CE	Optional	Once	0063	250
`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		250
`GT1-17`	Guarantor Employer Address	XAD	Optional	Repeats		250
`GT1-18`	Guarantor Employer Phone Number	XTN	Optional	Repeats		250
`GT1-19`	Guarantor Employee ID Number	CX	Optional	Repeats		250
`GT1-20`	Guarantor Employment Status	IS	Optional	Once	0066	2
`GT1-21`	Guarantor Organization Name	XON	Optional	Repeats		250
`GT1-22`	Guarantor Billing Hold Flag	ID	Optional	Once	0136	1
`GT1-23`	Guarantor Credit Rating Code	CE	Optional	Once	0341	250
`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	250
`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		250
`GT1-30`	Guarantor Marital Status Code	CE	Optional	Once	0002	250
`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	250
`GT1-36`	Primary Language	CE	Optional	Once	0296	250
`GT1-37`	Living Arrangement	IS	Optional	Once	0220	2
`GT1-38`	Publicity Code	CE	Optional	Once	0215	250
`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	250
`GT1-42`	Mother's Maiden Name	XPN	Optional	Repeats		250
`GT1-43`	Nationality	CE	Optional	Once	0212	250
`GT1-44`	Ethnic Group	CE	Optional	Repeats	0189	250
`GT1-45`	Contact Person's Name	XPN	Optional	Repeats		250
`GT1-46`	Contact Person's Telephone Number	XTN	Optional	Repeats		250
`GT1-47`	Contact Reason	CE	Optional	Once	0222	250
`GT1-48`	Contact Relationship	IS	Optional	Once	0063	3
`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		250
`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	250
`GT1-56`	Guarantor Birth Place	ST	Optional	Once		250
`GT1-57`	VIP Indicator	IS	Optional	Once	0099	2

Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

IAMPatient Adverse Reaction InformationAllergyIntolerance20 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`IAM-1`	Set ID - IAM	SI	Required	Once		4
`IAM-2`	Allergen Type Code	CE	Optional	Once	0127	250	AllergyIntolerance.category AllergyIntolerance.type+1 more
`IAM-3`	Allergen Code/Mnemonic/Description	CE	Required	Once		250	AllergyIntolerance.code
`IAM-4`	Allergy Severity Code	CE	Optional	Once	0128	250	AllergyIntolerance.reaction.severity AllergyIntolerance.criticality+1 more
`IAM-5`	Allergy Reaction Code	ST	Optional	Repeats		15	AllergyIntolerance.reaction.manifestation.text
`IAM-6`	Allergy Action Code	CNE	Required	Once	0323	250
`IAM-7`	Allergy Unique Identifier	EI	Conditional	Once		427	AllergyIntolerance.identifier
`IAM-8`	Action Reason	ST	Optional	Once		60
`IAM-9`	Sensitivity to Causative Agent Code	CE	Optional	Once	0436	250
`IAM-10`	Allergen Group Code/Mnemonic/Description	CE	Optional	Once		250
`IAM-11`	Onset Date	DT	Optional	Once		8	AllergyIntolerance.onsetDateTime
`IAM-12`	Onset Date Text	ST	Optional	Once		60	AllergyIntolerance.onsetString
`IAM-13`	Reported Date/Time	TS	Optional	Once		8	AllergyIntolerance.recordedDate
`IAM-14`	Reported By	XPN	Optional	Once		250	AllergyIntolerance.recorder.reference
`IAM-15`	Relationship to Patient Code	CE	Optional	Once	0063	250	AllergyIntolerance.recorder.reference
`IAM-16`	Alert Device Code	CE	Optional	Once	0437	250
`IAM-17`	Allergy Clinical Status Code	CE	Optional	Once	0438	250	AllergyIntolerance.clinicalStatus
`IAM-18`	Statused by Person	XCN	Optional	Once		250
`IAM-19`	Statused by Organization	XON	Optional	Once		250
`IAM-20`	Statused at Date/Time	TS	Optional	Once		8

FHIR map of segment IAMDefined in versions2.4 2.52.5.12.6 2.7 2.7.1 2.8

IIMInventory Item Master15 fields

Field	Name	Type	Use	Repeats	Table	Length
`IIM-1`	Primary Key Value - IIM	CWE	Required	Once		250
`IIM-2`	Service Item Code	CWE	Required	Once		250
`IIM-3`	Inventory Lot Number	ST	Optional	Once		250
`IIM-4`	Inventory Expiration Date	TS	Optional	Once		26
`IIM-5`	Inventory Manufacturer Name	CWE	Optional	Once		250
`IIM-6`	Inventory Location	CWE	Optional	Once		250
`IIM-7`	Inventory Received Date	TS	Optional	Once		26
`IIM-8`	Inventory Received Quantity	NM	Optional	Once		12
`IIM-9`	Inventory Received Quantity Unit	CWE	Optional	Once		250
`IIM-10`	Inventory Received Item Cost	MO	Optional	Once		12
`IIM-11`	Inventory On Hand Date	TS	Optional	Once		26
`IIM-12`	Inventory On Hand Quantity	NM	Optional	Once		12
`IIM-13`	Inventory On Hand Quantity Unit	CWE	Optional	Once		250
`IIM-14`	Procedure Code	CE	Optional	Once	0088	250
`IIM-15`	Procedure Code Modifier	CE	Optional	Repeats	0340	250

Defined in versions2.52.5.12.6 2.7 2.7.1 2.8

IN1InsuranceCoverage53 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	250	Coverage.identifier
`IN1-3`	Insurance Company ID	CX	Required	Repeats		250
`IN1-4`	Insurance Company Name	XON	Optional	Repeats		250	Coverage.payor
`IN1-5`	Insurance Company Address	XAD	Optional	Repeats		250	Coverage.payer
`IN1-6`	Insurance Co Contact Person	XPN	Optional	Repeats		250
`IN1-7`	Insurance Co Phone Number	XTN	Optional	Repeats		250
`IN1-8`	Group Number	ST	Optional	Once		12
`IN1-9`	Group Name	XON	Optional	Repeats		250
`IN1-10`	Insured's Group Emp ID	CX	Optional	Repeats		250	Coverage.policyHolder Coverage.extension
`IN1-11`	Insured's Group Emp Name	XON	Optional	Repeats		250	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		239
`IN1-15`	Plan Type	IS	Optional	Once	0086	3	Coverage.type
`IN1-16`	Name Of Insured	XPN	Optional	Repeats		250	Coverage.subscriber
`IN1-17`	Insured's Relationship To Patient	CE	Optional	Once	0063	250	Coverage.relationship
`IN1-18`	Insured's Date Of Birth	TS	Optional	Once		26
`IN1-19`	Insured's Address	XAD	Optional	Repeats		250
`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 (PAC)	ST	Optional	Once		15
`IN1-29`	Verification Date/Time	TS	Optional	Once		26
`IN1-30`	Verification By	XCN	Optional	Repeats		250
`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	250
`IN1-43`	Insured's Administrative Sex	IS	Optional	Once	0001	1
`IN1-44`	Insured's Employer's Address	XAD	Optional	Repeats		250
`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		250	Coverage.extension
`IN1-50`	Signature Code	IS	Optional	Once	0535	1
`IN1-51`	Signature Code Date	DT	Optional	Once		8
`IN1-52`	Insured's Birth Place	ST	Optional	Once		250
`IN1-53`	VIP Indicator	IS	Optional	Once	0099	2

FHIR map of segment IN1Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

IN2Insurance Additional Information72 fields

Field	Name	Type	Use	Repeats	Table	Length
`IN2-1`	Insured's Employee ID	CX	Optional	Repeats		250
`IN2-2`	Insured's Social Security Number	ST	Optional	Once		11
`IN2-3`	Insured's Employer's Name and ID	XCN	Optional	Repeats		250
`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		250
`IN2-8`	Medicaid Case Number	ST	Optional	Once		15
`IN2-9`	Military Sponsor Name	XPN	Optional	Repeats		250
`IN2-10`	Military ID Number	ST	Optional	Once		20
`IN2-11`	Dependent Of Military Recipient	CE	Optional	Once	0342	250
`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		250
`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		250
`IN2-26`	Payor Subscriber ID	CX	Optional	Repeats		250
`IN2-27`	Eligibility Source	IS	Optional	Once	0144	1
`IN2-28`	Room Coverage Type/Amount	RMC	Optional	Repeats		82
`IN2-29`	Policy Type/Amount	PTA	Optional	Repeats		56
`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	250
`IN2-34`	Primary Language	CE	Optional	Once	0296	250
`IN2-35`	Living Arrangement	IS	Optional	Once	0220	2
`IN2-36`	Publicity Code	CE	Optional	Once	0215	250
`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	250
`IN2-40`	Mother's Maiden Name	XPN	Optional	Repeats		250
`IN2-41`	Nationality	CE	Optional	Once	0212	250
`IN2-42`	Ethnic Group	CE	Optional	Repeats	0189	250
`IN2-43`	Marital Status	CE	Optional	Repeats	0002	250
`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		250
`IN2-50`	Employer Contact Person Phone Number	XTN	Optional	Repeats		250
`IN2-51`	Employer Contact Reason	IS	Optional	Once	0222	2
`IN2-52`	Insured's Contact Person's Name	XPN	Optional	Repeats		250
`IN2-53`	Insured's Contact Person Phone Number	XTN	Optional	Repeats		250
`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		250
`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		250
`IN2-62`	Guarantor's Relationship To Insured	CE	Optional	Once	0063	250
`IN2-63`	Insured's Phone Number - Home	XTN	Optional	Repeats		250
`IN2-64`	Insured's Employer Phone Number	XTN	Optional	Repeats		250
`IN2-65`	Military Handicapped Program	CE	Optional	Once	0343	250
`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		250
`IN2-70`	Insured Employer Organization Name and ID	XON	Optional	Repeats		250
`IN2-71`	Race	CE	Optional	Repeats	0005	250
`IN2-72`	CMS Patient's Relationship to Insured	CE	Optional	Once	0344	250

Defined in versions2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

IN3Insurance Additional Information, CertificationCareTeam25 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		250
`IN3-3`	Certified By	XCN	Optional	Repeats		250
`IN3-4`	Certification Required	ID	Optional	Once	0136	1
`IN3-5`	Penalty	MOP	Optional	Once		23
`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		250
`IN3-9`	Certification Begin Date	DT	Optional	Once		8
`IN3-10`	Certification End Date	DT	Optional	Once		8
`IN3-11`	Days	DTN	Optional	Once		6
`IN3-12`	Non-Concur Code/Description	CE	Optional	Once	0233	250
`IN3-13`	Non-Concur Effective Date/Time	TS	Optional	Once		26
`IN3-14`	Physician Reviewer	XCN	Optional	Repeats	0010	250
`IN3-15`	Certification Contact	ST	Optional	Once		48
`IN3-16`	Certification Contact Phone Number	XTN	Optional	Repeats		250
`IN3-17`	Appeal Reason	CE	Optional	Once	0345	250
`IN3-18`	Certification Agency	CE	Optional	Once	0346	250
`IN3-19`	Certification Agency Phone Number	XTN	Optional	Repeats		250
`IN3-20`	Pre-Certification Requirement	ICD	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	250

FHIR map of segment IN3Defined in versions2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

INVInventory Detail20 fields

Field	Name	Type	Use	Repeats	Table	Length
`INV-1`	Substance Identifier	CE	Required	Once	0451	250
`INV-2`	Substance Status	CE	Required	Repeats	0383	250
`INV-3`	Substance Type	CE	Optional	Once	0384	250
`INV-4`	Inventory Container Identifier	CE	Optional	Once		250
`INV-5`	Container Carrier Identifier	CE	Optional	Once		250
`INV-6`	Position on Carrier	CE	Optional	Once		250
`INV-7`	Initial Quantity	NM	Optional	Once		20
`INV-8`	Current Quantity	NM	Optional	Once		20
`INV-9`	Available Quantity	NM	Optional	Once		20
`INV-10`	Consumption Quantity	NM	Optional	Once		20
`INV-11`	Quantity Units	CE	Optional	Once		250
`INV-12`	Expiration Date/Time	TS	Optional	Once		26
`INV-13`	First Used Date/Time	TS	Optional	Once		26
`INV-14`	On Board Stability Duration	TQ	Backward	Once		200
`INV-15`	Test/Fluid Identifier(s)	CE	Optional	Repeats		250
`INV-16`	Manufacturer Lot Number	ST	Optional	Once		200
`INV-17`	Manufacturer Identifier	CE	Optional	Once	0385	250
`INV-18`	Supplier Identifier	CE	Optional	Once	0386	250
`INV-19`	On Board Stability Time	CQ	Optional	Once		20
`INV-20`	Target Value	CQ	Optional	Once		20

Defined in versions2.4 2.52.5.12.6 2.7 2.7.1 2.8

IPCImaging Procedure Control Segment9 fields

Field	Name	Type	Use	Repeats	Length
`IPC-1`	Accession Identifier	EI	Required	Once	80
`IPC-2`	Requested Procedure ID	EI	Required	Once	22
`IPC-3`	Study Instance UID	EI	Required	Once	70
`IPC-4`	Scheduled Procedure Step ID	EI	Required	Once	22
`IPC-5`	Modality	CE	Optional	Once	16
`IPC-6`	Protocol Code	CE	Optional	Repeats	250
`IPC-7`	Scheduled Station Name	EI	Optional	Once	22
`IPC-8`	Scheduled Procedure Step Location	CE	Optional	Repeats	250
`IPC-9`	Scheduled AE Title	ST	Optional	Once	16

Defined in versions2.52.5.12.6 2.7 2.7.1 2.8

ISDInteraction Status Detail3 fields

Field	Name	Type	Use	Repeats	Table	Length
`ISD-1`	Reference Interaction Number (unique identifier)	NM	Required	Once		20
`ISD-2`	Interaction Type Identifier	CE	Optional	Once	0368	250
`ISD-3`	Interaction Active State	CE	Required	Once	0387	250

Defined in versions2.4 2.52.5.12.6 2.7 2.7.1 2.8

LANLanguage Detail4 fields

Field	Name	Type	Use	Repeats	Table	Length
`LAN-1`	Set ID - LAN	SI	Required	Once		60
`LAN-2`	Language Code	CE	Required	Once	0296	250
`LAN-3`	Language Ability Code	CE	Optional	Repeats	0403	250
`LAN-4`	Language Proficiency Code	CE	Optional	Once	0404	250

Defined in versions2.4 2.52.5.12.6 2.7 2.7.1 2.8

LCCLocation Charge Code4 fields

Field	Name	Type	Use	Repeats	Table	Length
`LCC-1`	Primary Key Value - LCC	PL	Required	Once		200
`LCC-2`	Location Department	CE	Required	Once	0264	250
`LCC-3`	Accommodation Type	CE	Optional	Repeats	0129	250
`LCC-4`	Charge Code	CE	Required	Repeats	0132	250

Defined in versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

LCHLocation Characteristic5 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	250
`LCH-5`	Location Characteristic Value-LCH	CE	Required	Once		250

Defined in versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

LDPLocation Department12 fields

Field	Name	Type	Use	Repeats	Table	Length
`LDP-1`	Primary Key Value - LDP	PL	Required	Once		200
`LDP-2`	Location Department	CE	Required	Once	0264	250
`LDP-3`	Location Service	IS	Optional	Repeats	0069	3
`LDP-4`	Specialty Type	CE	Optional	Repeats	0265	250
`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		250
`LDP-12`	Location Cost Center	CE	Optional	Once	0462	250

Defined in versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

LOCLocation Identification9 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		250
`LOC-5`	Location Address	XAD	Optional	Repeats		250
`LOC-6`	Location Phone	XTN	Optional	Repeats		250
`LOC-7`	License Number	CE	Optional	Repeats	0461	250
`LOC-8`	Location Equipment	IS	Optional	Repeats	0261	3
`LOC-9`	Location Service Code	IS	Optional	Once	0442	1

Defined in versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

LRLLocation Relationship6 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	250
`LRL-5`	Organizational Location Relationship Value	XON	Conditional	Repeats		250
`LRL-6`	Patient Location Relationship Value	PL	Conditional	Once		80

Defined in versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

MFAMaster File Acknowledgment6 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	250
`MFA-5`	Primary Key Value - MFA	VARIES	Required	Repeats		250
`MFA-6`	Primary Key Value Type - MFA	ID	Required	Repeats	0355	3

Defined in versions2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

MFEMaster File Entry5 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 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

MFIMaster File Identification6 fields

Field	Name	Type	Use	Repeats	Table	Length
`MFI-1`	Master File Identifier	CE	Required	Once	0175	250
`MFI-2`	Master File Application Identifier	HD	Optional	Once	0361	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 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

MRGMerge Patient InformationAccount7 fields

Field	Name	Type	Use	Repeats	Length	FHIR
`MRG-1`	Prior Patient Identifier List	CX	Required	Repeats	250
`MRG-2`	Prior Alternate Patient ID	CX	Backward	Repeats	250
`MRG-3`	Prior Patient Account Number	CX	Optional	Once	250	Account.identifier
`MRG-4`	Prior Patient ID	CX	Backward	Once	250
`MRG-5`	Prior Visit Number	CX	Optional	Once	250
`MRG-6`	Prior Alternate Visit ID	CX	Optional	Once	250
`MRG-7`	Prior Patient Name	XPN	Optional	Repeats	250

FHIR map of segment MRGDefined in versions2.1 2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

MSAMessage AcknowledgmentMessageHeader6 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`MSA-1`	Acknowledgment 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	Backward	Once		80
`MSA-4`	Expected Sequence Number	NM	Optional	Once		15
`MSA-5`	Delayed Acknowledgment Type	ST	Withdrawn	Once
`MSA-6`	Error Condition	CE	Backward	Once	0357	250

FHIR map of segment MSADefined in versions2.1 2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

MSHMessage HeaderProvenance, Bundle, Encounter +121 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	227	Provenance.entity.what Provenance.entity.role+2 more
`MSH-4`	Sending Facility	HD	Optional	Once	0362	227	Provenance.agent.who Provenance.agent.type.coding.code+2 more
`MSH-5`	Receiving Application	HD	Optional	Once	0361	227	MessageHeader.destination.target MessageHeader.destination.name+1 more
`MSH-6`	Receiving Facility	HD	Optional	Once	0362	227	MessageHeader.destination.receiver
`MSH-7`	Date/Time Of Message	TS	Required	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		15	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	0399	3	MessageHeader.sender
`MSH-18`	Character Set	ID	Optional	Repeats	0211	16
`MSH-19`	Principal Language Of Message	CE	Optional	Once		250	MessageHeader.language
`MSH-20`	Alternate Character Set Handling Scheme	ID	Optional	Once	0356	20
`MSH-21`	Message Profile Identifier	EI	Optional	Repeats		427

FHIR map of segment MSHDefined in versions2.1 2.2 2.3 2.3.1 2.4 2.52.5.12.6 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 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

NDSNotification Detail4 fields

Field	Name	Type	Use	Repeats	Table	Length
`NDS-1`	Notification Reference Number	NM	Required	Once		20
`NDS-2`	Notification Date/Time	TS	Required	Once		26
`NDS-3`	Notification Alert Severity	CE	Required	Once	0367	250
`NDS-4`	Notification Code	CE	Required	Once		250

Defined in versions2.4 2.52.5.12.6 2.7 2.7.1 2.8

NK1Next of Kin / Associated PartiesPatient, RelatedPerson39 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		250	Patient.contact.name RelatedPerson.name
`NK1-3`	Relationship	CE	Optional	Once	0063	250	Patient.contact.relationship RelatedPerson.relationship
`NK1-4`	Address	XAD	Optional	Repeats		250	Patient.contact.address RelatedPerson.address
`NK1-5`	Phone Number	XTN	Optional	Repeats		250	Patient.contact.telecom RelatedPerson.telecom
`NK1-6`	Business Phone Number	XTN	Optional	Repeats		250	Patient.contact.telecom Patient.contact.telecom.use+2 more
`NK1-7`	Contact Role	CE	Optional	Once	0131	250	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		250	RelatedPerson.identifier
`NK1-13`	Organization Name - NK1	XON	Optional	Repeats		250	Patient.contact.organization
`NK1-14`	Marital Status	CE	Optional	Once	0002	250
`NK1-15`	Administrative 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	250
`NK1-20`	Primary Language	CE	Optional	Once	0296	250	RelatedPerson.communication.language
`NK1-21`	Living Arrangement	IS	Optional	Once	0220	2
`NK1-22`	Publicity Code	CE	Optional	Once	0215	250
`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	250
`NK1-26`	Mother's Maiden Name	XPN	Optional	Repeats		250
`NK1-27`	Nationality	CE	Optional	Once	0212	250
`NK1-28`	Ethnic Group	CE	Optional	Repeats	0189	250
`NK1-29`	Contact Reason	CE	Optional	Repeats	0222	250
`NK1-30`	Contact Person's Name	XPN	Optional	Repeats		250	Patient.contact.organization RelatedPerson.name
`NK1-31`	Contact Person's Telephone Number	XTN	Optional	Repeats		250	Patient.contact.organization RelatedPerson.telecom
`NK1-32`	Contact Person's Address	XAD	Optional	Repeats		250	Patient.contact.organization RelatedPerson.address
`NK1-33`	Next of Kin/Associated Party's Identifiers	CX	Optional	Repeats		250	RelatedPerson.identifier
`NK1-34`	Job Status	IS	Optional	Once	0311	2
`NK1-35`	Race	CE	Optional	Repeats	0005	250
`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
`NK1-38`	Next of Kin Birth Place	ST	Optional	Once		250
`NK1-39`	VIP Indicator	IS	Optional	Once	0099	2

FHIR map of segment NK1Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

NPUBed Status Update2 fields

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

Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

NSCApplication Status Change9 fields

Field	Name	Type	Use	Repeats	Table	Length
`NSC-1`	Application Change Type	IS	Required	Once	0409	4
`NSC-2`	Current CPU	ST	Optional	Once		30
`NSC-3`	Current Fileserver	ST	Optional	Once		30
`NSC-4`	Current Application	HD	Optional	Once		30
`NSC-5`	Current Facility	HD	Optional	Once		30
`NSC-6`	New CPU	ST	Optional	Once		30
`NSC-7`	New Fileserver	ST	Optional	Once		30
`NSC-8`	New Application	HD	Optional	Once		30
`NSC-9`	New Facility	HD	Optional	Once		30

Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

NSTApplication control level statistics15 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`	Application control-level Errors	NM	Optional	Once		10

Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

NTENotes and CommentsAppointment, 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	250	Appointment.extension.extension Appointment.extension

FHIR map of segment NTEDefined in versions2.1 2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

OBRObservation RequestDiagnosticReport, ServiceRequest, Specimen50 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 Identifier	CE	Required	Once		250	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		250	Specimen.collection.collector
`OBR-11`	Specimen Action Code	ID	Optional	Once	0065	1	ServiceRequest.intent
`OBR-12`	Danger Code	CE	Optional	Once		250
`OBR-13`	Relevant Clinical Information	ST	Optional	Once		300	Specimen.collection.fastingStatusCodeableConcept Specimen.collection.fastingStatusDuration+2 more
`OBR-14`	Specimen Received Date/Time	TS	Backward	Once		26	Specimen.receivedTime
`OBR-15`	Specimen Source	SPS	Backward	Once		300	Specimen.$this
`OBR-16`	Ordering Provider	XCN	Optional	Repeats		250	ServiceRequest.requester
`OBR-17`	Order Callback Phone Number	XTN	Optional	Once		250	ServiceRequest.requester.extension
`OBR-18`	Placer Field 1	ST	Optional	Once		60
`OBR-19`	Placer Field 2	ST	Optional	Once		60
`OBR-20`	Filler Field 1	ST	Optional	Once		60
`OBR-21`	Filler Field 2	ST	Optional	Once		60
`OBR-22`	Results Rpt/Status Chng - Date/Time	TS	Conditional	Once		26	DiagnosticReport.issued
`OBR-23`	Charge to Practice	MOC	Optional	Once		40
`OBR-24`	Diagnostic Serv Sect ID	ID	Optional	Once	0074	10	DiagnosticReport.category
`OBR-25`	Result Status	ID	Conditional	Once	0123	1	DiagnosticReport.status
`OBR-26`	Parent Result	PRL	Optional	Once		400
`OBR-27`	Quantity/Timing	TQ	Backward	Repeats		200	ServiceRequest.$this
`OBR-28`	Result Copies To	XCN	Optional	Repeats		250
`OBR-29`	Parent	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		250	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		250
`OBR-39`	Collector's Comment	CE	Optional	Repeats		250	Specimen.note
`OBR-40`	Transport Arrangement Responsibility	CE	Optional	Once		250
`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		250
`OBR-44`	Procedure Code	CE	Optional	Once	0088	250
`OBR-45`	Procedure Code Modifier	CE	Optional	Repeats	0340	250
`OBR-46`	Placer Supplemental Service Information	CE	Optional	Repeats	0411	250	ServiceRequest.orderDetail
`OBR-47`	Filler Supplemental Service Information	CE	Optional	Repeats	0411	250	ServiceRequest.orderDetail
`OBR-48`	Medically Necessary Duplicate Procedure Reason.	CWE	Conditional	Once	0476	250
`OBR-49`	Result Handling	IS	Optional	Once	0507	2
`OBR-50`	Parent Universal Service Identifier	CWE	Optional	Once		250

FHIR map of segment OBRDefined in versions2.1 2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

OBXObservation/ResultObservation, DocumentReference25 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	2
`OBX-3`	Observation Identifier	CE	Required	Once		250	Observation.code Observation.component[each].code
`OBX-4`	Observation Sub-ID	ST	Conditional	Once		20	Observation.$this
`OBX-5`	Observation Value	VARIES	Conditional	Repeats		99999	Observation.component[each].valueQuantity Observation.component[each].valueString+23 more
`OBX-6`	Units	CE	Optional	Once		250	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	IS	Optional	Repeats	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`	Effective Date of Reference Range	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		250	Observation.performer
`OBX-16`	Responsible Observer	XCN	Optional	Repeats		250	Observation.performer)Observation.performer
`OBX-17`	Observation Method	CE	Optional	Repeats		250	Observation.method
`OBX-18`	Equipment Instance Identifier	EI	Optional	Repeats		22	Observation.device
`OBX-19`	Date/Time of the Analysis	TS	Optional	Once		26	Observation.extension
`OBX-20`	Reserved for harmonization with V2.6	ST	Not supported	Once			Observation.bodySite
`OBX-21`	Reserved for harmonization with V2.6	ST	Not supported	Once			Observation.identifier Observation.identifier.type.coding.code
`OBX-22`	Reserved for harmonization with V2.6	ST	Not supported	Once
`OBX-23`	Performing Organization Name	XON	Optional	Once		567	Observation.performer Observation.performer)
`OBX-24`	Performing Organization Address	XAD	Optional	Once		631	Observation.performer Observation.performer)
`OBX-25`	Performing Organization Medical Director	XCN	Optional	Once		3002	Observation.performer

FHIR map of segment OBXDefined in versions2.1 2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

ODSDietary Orders, Supplements, and Preferences4 fields

Field	Name	Type	Use	Repeats	Table	Length
`ODS-1`	Type	ID	Required	Once	0159	1
`ODS-2`	Service Period	CE	Optional	Once		250
`ODS-3`	Diet, Supplement, or Preference Code	CE	Required	Once		250
`ODS-4`	Text Instruction	ST	Optional	Once		80

Defined in versions2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

ODTDiet Tray Instructions3 fields

Field	Name	Type	Use	Repeats	Table	Length
`ODT-1`	Tray Type	CE	Required	Once	0160	250
`ODT-2`	Service Period	CE	Optional	Once		250
`ODT-3`	Text Instruction	ST	Optional	Once		80

Defined in versions2.2 2.3 2.3.1 2.4 2.52.5.12.6 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 Service/Test/Observation ID	CE	Required	Once		250
`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		250
`OM1-6`	Observation Description	TX	Optional	Once		200
`OM1-7`	Other Service/Test/Observation IDs for the Observation	CE	Optional	Once		250
`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		250
`OM1-14`	Coded Representation of Method	CE	Optional	Repeats		250
`OM1-15`	Portable Device Indicator	ID	Optional	Once	0136	1
`OM1-16`	Observation Producing Department/Section	CE	Optional	Repeats		250
`OM1-17`	Telephone Number of Section	XTN	Optional	Once		250
`OM1-18`	Nature of Service/Test/Observation	IS	Required	Once	0174	1
`OM1-19`	Report Subheader	CE	Optional	Once		250
`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(s) Where Observation may be Performed	CE	Optional	Repeats		250
`OM1-28`	Address of Outside Site(s)	XAD	Optional	Repeats		250
`OM1-29`	Phone Number of Outside Site	XTN	Optional	Once		250
`OM1-30`	Confidentiality Code	CWE	Optional	Once	0177	250
`OM1-31`	Observations Required to Interpret the Observation	CE	Optional	Once		250
`OM1-32`	Interpretation of Observations	TX	Optional	Once		65536
`OM1-33`	Contraindications to Observations	CE	Optional	Once		250
`OM1-34`	Reflex Tests/Observations	CE	Optional	Repeats		250
`OM1-35`	Rules that Trigger Reflex Testing	TX	Optional	Once		80
`OM1-36`	Fixed Canned Message	CE	Optional	Once		250
`OM1-37`	Patient Preparation	TX	Optional	Once		200
`OM1-38`	Procedure Medication	CE	Optional	Once		250
`OM1-39`	Factors that may Affect the Observation	TX	Optional	Once		200
`OM1-40`	Service/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	250
`OM1-43`	Point Versus Interval	CE	Optional	Once	0255	250
`OM1-44`	Challenge Information	TX	Optional	Once		200
`OM1-45`	Relationship Modifier	CE	Optional	Once	0258	250
`OM1-46`	Target Anatomic Site Of Test	CE	Optional	Once		250
`OM1-47`	Modality Of Imaging Measurement	CE	Optional	Once	0259	250

Defined in versions2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

OM2Numeric Observation10 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	250
`OM2-3`	Range of Decimal Precision	NM	Optional	Repeats	10
`OM2-4`	Corresponding SI Units of Measure	CE	Optional	Once	250
`OM2-5`	SI Conversion Factor	TX	Optional	Once	60
`OM2-6`	Reference (Normal) Range - Ordinal and Continuous Observations	RFR	Optional	Repeats	250
`OM2-7`	Critical Range for Ordinal and Continuous Observations	RFR	Optional	Repeats	205
`OM2-8`	Absolute Range for Ordinal and Continuous Observations	RFR	Optional	Once	250
`OM2-9`	Delta Check Criteria	DLT	Optional	Repeats	250
`OM2-10`	Minimum Meaningful Increments	NM	Optional	Once	20

Defined in versions2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

OM3Categorical Service/Test/Observation7 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		250
`OM3-3`	Valid Coded 'Answers'	CE	Optional	Once		250
`OM3-4`	Normal Text/Codes for Categorical Observations	CE	Optional	Repeats		250
`OM3-5`	Abnormal Text/Codes for Categorical Observations	CE	Optional	Repeats		250
`OM3-6`	Critical Text/Codes for Categorical Observations	CE	Optional	Repeats		250
`OM3-7`	Value Type	ID	Optional	Once	0125	2

Defined in versions2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

OM4Observations that Require Specimens14 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		250
`OM4-6`	Specimen	CE	Optional	Once		250
`OM4-7`	Additive	CWE	Optional	Once	0371	250
`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 2.3 2.3.1 2.4 2.52.5.12.6 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	250
`OM5-3`	Observation ID Suffixes	ST	Optional	Once	250

Defined in versions2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

OM6Observations that are Calculated from Other Observations2 fields

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

Defined in versions2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

OM7Additional Basic Attributes24 fields

Field	Name	Type	Use	Repeats	Table	Length
`OM7-1`	Sequence Number - Test/Observation Master File	NM	Required	Once		4
`OM7-2`	Universal Service Identifier	CE	Required	Once		250
`OM7-3`	Category Identifier	CE	Optional	Repeats	0412	250
`OM7-4`	Category Description	TX	Optional	Once		200
`OM7-5`	Category Synonym	ST	Optional	Repeats		200
`OM7-6`	Effective Test/Service Start Date/Time	TS	Optional	Once		26
`OM7-7`	Effective Test/Service End Date/Time	TS	Optional	Once		26
`OM7-8`	Test/Service Default Duration Quantity	NM	Optional	Once		5
`OM7-9`	Test/Service Default Duration Units	CE	Optional	Once		250
`OM7-10`	Test/Service Default Frequency	IS	Optional	Once	0335	60
`OM7-11`	Consent Indicator	ID	Optional	Once	0136	1
`OM7-12`	Consent Identifier	CE	Optional	Once	0413	250
`OM7-13`	Consent Effective Start Date/Time	TS	Optional	Once		26
`OM7-14`	Consent Effective End Date/Time	TS	Optional	Once		26
`OM7-15`	Consent Interval Quantity	NM	Optional	Once		5
`OM7-16`	Consent Interval Units	CE	Conditional	Once	0414	250
`OM7-17`	Consent Waiting Period Quantity	NM	Optional	Once		5
`OM7-18`	Consent Waiting Period Units	CE	Conditional	Once	0414	250
`OM7-19`	Effective Date/Time of Change	TS	Optional	Once		26
`OM7-20`	Entered By	XCN	Optional	Once		250
`OM7-21`	Orderable-at Location	PL	Optional	Repeats		200
`OM7-22`	Formulary Status	IS	Optional	Once	0473	1
`OM7-23`	Special Order Indicator	ID	Optional	Once	0136	1
`OM7-24`	Primary Key Value - CDM	CE	Optional	Repeats	0132	250

Defined in versions2.4 2.52.5.12.6 2.7 2.7.1 2.8

ORCCommon OrderDiagnosticReport, Immunization, MedicationAdministration +231 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	Backward	Repeats		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		250	Provenance.agent.who Provenance.agent.type.coding.code+1 more
`ORC-11`	Verified By	XCN	Optional	Repeats		250	Provenance.agent.who Provenance.agent.type.coding.code+1 more
`ORC-12`	Ordering Provider	XCN	Optional	Repeats		250	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		250	ServiceRequest.extension
`ORC-15`	Order Effective Date/Time	TS	Optional	Once		26
`ORC-16`	Order Control Code Reason	CE	Optional	Once		250	DiagnosticReport.extension ServiceRequest.extension
`ORC-17`	Entering Organization	CE	Optional	Once		250	Provenance.agent.onBehalfOf
`ORC-18`	Entering Device	CE	Optional	Once		250	Provenance.agent.who
`ORC-19`	Action By	XCN	Optional	Repeats		250	Provenance.agent.type.coding.code Provenance.agent.type.coding.system+1 more
`ORC-20`	Advanced Beneficiary Notice Code	CE	Optional	Once	0339	250
`ORC-21`	Ordering Facility Name	XON	Optional	Repeats		250	Provenance.location ServiceRequest.requester)
`ORC-22`	Ordering Facility Address	XAD	Optional	Repeats		250	Provenance.location ServiceRequest.requester)
`ORC-23`	Ordering Facility Phone Number	XTN	Optional	Repeats		250	Provenance.location ServiceRequest.requester)
`ORC-24`	Ordering Provider Address	XAD	Optional	Repeats		250	Provenance.agent.who ServiceRequest.requester)
`ORC-25`	Order Status Modifier	CWE	Optional	Once		250
`ORC-26`	Advanced Beneficiary Notice Override Reason	CWE	Conditional	Once	0552	60
`ORC-27`	Filler's Expected Availability Date/Time	TS	Optional	Once		26
`ORC-28`	Confidentiality Code	CWE	Optional	Once	0177	250	DiagnosticReport.meta.security Immunization.meta.security+3 more
`ORC-29`	Order Type	CWE	Optional	Once	0482	250	ServiceRequest.locationCode
`ORC-30`	Enterer Authorization Mode	CNE	Optional	Once	0483	250
`ORC-31`	Parent Universal Service Identifier	CWE	Optional	Once		250

FHIR map of segment ORCDefined in versions2.1 2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

ORGPractitioner Organization Unit12 fields

Field	Name	Type	Use	Repeats	Table	Length
`ORG-1`	Set ID - ORG	SI	Required	Once		60
`ORG-2`	Organization Unit Code	CE	Optional	Once	0405	250
`ORG-3`	Organization Unit Type Code	CE	Optional	Once	0474	250
`ORG-4`	Primary Org Unit Indicator	ID	Optional	Once	0136	1
`ORG-5`	Practitioner Org Unit Identifier	CX	Optional	Once		60
`ORG-6`	Health Care Provider Type Code	CE	Optional	Once	0452	250
`ORG-7`	Health Care Provider Classification Code	CE	Optional	Once	0453	250
`ORG-8`	Health Care Provider Area of Specialization Code	CE	Optional	Once	0454	250
`ORG-9`	Effective Date Range	DR	Optional	Once		52
`ORG-10`	Employment Status Code	CE	Optional	Once	0066	250
`ORG-11`	Board Approval Indicator	ID	Optional	Once	0136	1
`ORG-12`	Primary Care Physician Indicator	ID	Optional	Once	0136	1

Defined in versions2.4 2.52.5.12.6 2.7 2.7.1 2.8

OVROverride Segment5 fields

Field	Name	Type	Use	Repeats	Table	Length
`OVR-1`	Business Rule Override Type	CWE	Optional	Once	0518	705
`OVR-2`	Business Rule Override Code	CWE	Optional	Once	0521	705
`OVR-3`	Override Comments	TX	Optional	Once		200
`OVR-4`	Override Entered By	XCN	Optional	Once		250
`OVR-5`	Override Authorized By	XCN	Optional	Once		250

Defined in versions2.52.5.12.6 2.7 2.7.1 2.8

PCRPossible Causal Relationship23 fields

Field	Name	Type	Use	Repeats	Table	Length
`PCR-1`	Implicated Product	CE	Required	Once		250
`PCR-2`	Generic Product	IS	Optional	Once	0249	1
`PCR-3`	Product Class	CE	Optional	Once		250
`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		250
`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		250
`PCR-15`	Product Evaluation Status	CE	Optional	Once	0247	250
`PCR-16`	Product Evaluation Results	CE	Optional	Once		250
`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 versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

PD1Patient Additional DemographicObservation, Patient21 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		250	Patient.generalPractitioner
`PD1-4`	Patient Primary Care Provider Name and ID No.	XCN	Backward	Repeats		250	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 Code	IS	Optional	Once	0315	2	Observation.valueCodeableConcept
`PD1-8`	Organ Donor Code	IS	Optional	Once	0316	2
`PD1-9`	Separate Bill	ID	Optional	Once	0136	1
`PD1-10`	Duplicate Patient	CX	Optional	Repeats		250
`PD1-11`	Publicity Code	CE	Optional	Once	0215	250
`PD1-12`	Protection Indicator	ID	Optional	Once	0136	1
`PD1-13`	Protection Indicator Effective Date	DT	Optional	Once		8
`PD1-14`	Place of Worship	XON	Optional	Repeats		250	Patient.extension
`PD1-15`	Advance Directive Code	CE	Optional	Repeats	0435	250
`PD1-16`	Immunization Registry Status	IS	Optional	Once	0441	1
`PD1-17`	Immunization Registry Status Effective Date	DT	Optional	Once		8
`PD1-18`	Publicity Code Effective Date	DT	Optional	Once		8
`PD1-19`	Military Branch	IS	Optional	Once	0140	5
`PD1-20`	Military Rank/Grade	IS	Optional	Once	0141	2
`PD1-21`	Military Status	IS	Optional	Once	0142	3

FHIR map of segment PD1Defined in versions2.1 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

PDAPatient Death and Autopsy9 fields

Field	Name	Type	Use	Repeats	Table	Length
`PDA-1`	Death Cause Code	CE	Optional	Repeats		250
`PDA-2`	Death Location	PL	Optional	Once		80
`PDA-3`	Death Certified Indicator	ID	Optional	Once	0136	1
`PDA-4`	Death Certificate Signed Date/Time	TS	Optional	Once		26
`PDA-5`	Death Certified By	XCN	Optional	Once		250
`PDA-6`	Autopsy Indicator	ID	Optional	Once	0136	1
`PDA-7`	Autopsy Start and End Date/Time	DR	Optional	Once		53
`PDA-8`	Autopsy Performed By	XCN	Optional	Once		250
`PDA-9`	Coroner Indicator	ID	Optional	Once	0136	1

Defined in versions2.4 2.52.5.12.6 2.7 2.7.1 2.8

PDCProduct Detail Country15 fields

Field	Name	Type	Use	Repeats	Table	Length
`PDC-1`	Manufacturer/Distributor	XON	Required	Repeats		250
`PDC-2`	Country	CE	Required	Once		250
`PDC-3`	Brand Name	ST	Required	Once		60
`PDC-4`	Device Family Name	ST	Optional	Once		60
`PDC-5`	Generic Name	CE	Optional	Once		250
`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		250
`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 versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

PEOProduct Experience Observation25 fields

Field	Name	Type	Use	Repeats	Table	Length
`PEO-1`	Event Identifiers Used	CE	Optional	Repeats		250
`PEO-2`	Event Symptom/Diagnosis Code	CE	Optional	Repeats		250
`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		250
`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		250
`PEO-19`	Primary Observer Name	XPN	Optional	Repeats		250
`PEO-20`	Primary Observer Address	XAD	Optional	Repeats		250
`PEO-21`	Primary Observer Telephone	XTN	Optional	Repeats		250
`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 versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

PESProduct Experience Sender13 fields

Field	Name	Type	Use	Repeats	Table	Length
`PES-1`	Sender Organization Name	XON	Optional	Repeats		250
`PES-2`	Sender Individual Name	XCN	Optional	Repeats		250
`PES-3`	Sender Address	XAD	Optional	Repeats		250
`PES-4`	Sender Telephone	XTN	Optional	Repeats		250
`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 versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

PIDPatient IdentificationProvenance, Account, Appointment +139 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		250	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		250	Patient.name
`PID-6`	Mother's Maiden Name	XPN	Optional	Repeats		250	Patient.extension
`PID-7`	Date/Time of Birth	TS	Optional	Once		26	Patient.birthDate Patient.birthDate.extension
`PID-8`	Administrative Sex	IS	Optional	Once	0001	1	Patient.gender
`PID-9`	Patient Alias	XPN	Backward	Repeats		250	Patient.name
`PID-10`	Race	CE	Optional	Repeats	0005	250
`PID-11`	Patient Address	XAD	Optional	Repeats		250	Patient.address
`PID-12`	County Code	IS	Backward	Once	0289	4	Patient.address.district
`PID-13`	Phone Number - Home	XTN	Optional	Repeats		250	Patient.telecom Patient.telecom.use
`PID-14`	Phone Number - Business	XTN	Optional	Repeats		250	Patient.telecom Patient.telecom.use
`PID-15`	Primary Language	CE	Optional	Once	0296	250	Patient.communication.language
`PID-16`	Marital Status	CE	Optional	Once	0002	250	Patient.maritalStatus
`PID-17`	Religion	CE	Optional	Once	0006	250	Patient.extension
`PID-18`	Patient Account Number	CX	Optional	Once		250	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	Backward	Once		25	Patient.identifier
`PID-21`	Mother's Identifier	CX	Optional	Repeats		250	Patient.$this
`PID-22`	Ethnic Group	CE	Optional	Repeats	0189	250
`PID-23`	Birth Place	ST	Optional	Once		250	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	250	Patient.extension Patient.extension.extension
`PID-27`	Veterans Military Status	CE	Optional	Once	0172	250
`PID-28`	Nationality	CE	Backward	Once	0212	250	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
`PID-31`	Identity Unknown Indicator	ID	Optional	Once	0136	1
`PID-32`	Identity Reliability Code	IS	Optional	Repeats	0445	20
`PID-33`	Last Update Date/Time	TS	Optional	Once		26	Provenance.occurredDateTime
`PID-34`	Last Update Facility	HD	Optional	Once		241	Provenance.agent.who Provenance.agent.type.coding.code+1 more
`PID-35`	Species Code	CE	Conditional	Once	0446	250	Patient.extension Patient.extension.extension
`PID-36`	Breed Code	CE	Conditional	Once	0447	250	Patient.extension Patient.extension.extension
`PID-37`	Strain	ST	Optional	Once		80
`PID-38`	Production Class Code	CE	Optional	Once	0429	250
`PID-39`	Tribal Citizenship	CWE	Optional	Repeats	0171	250	Patient.extension Patient.extension.extension

FHIR map of segment PIDDefined in versions2.1 2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

PR1ProceduresProcedure20 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	3
`PR1-3`	Procedure Code	CE	Required	Once	0088	250	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	Optional	Once	0230	2	Procedure.category
`PR1-7`	Procedure Minutes	NM	Optional	Once		4	Procedure.performedPeriod.end
`PR1-8`	Anesthesiologist	XCN	Backward	Repeats	0010	250	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	250	Procedure.performer.actor Procedure.performer.function.coding.code+1 more
`PR1-12`	Procedure Practitioner	XCN	Backward	Repeats	0010	250	Procedure.performer.actor
`PR1-13`	Consent Code	CE	Optional	Once	0059	250
`PR1-14`	Procedure Priority	ID	Optional	Once	0418	2
`PR1-15`	Associated Diagnosis Code	CE	Optional	Once	0051	250	Procedure.reasonCode
`PR1-16`	Procedure Code Modifier	CE	Optional	Repeats	0340	250	Procedure.code.value
`PR1-17`	Procedure DRG Type	IS	Optional	Once	0416	20
`PR1-18`	Tissue Type Code	CE	Optional	Repeats	0417	250
`PR1-19`	Procedure Identifier	EI	Conditional	Once		427	Procedure.identifier
`PR1-20`	Procedure Action Code	ID	Conditional	Once	0206	1

FHIR map of segment PR1Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

PRAPractitioner Detail12 fields

Field	Name	Type	Use	Repeats	Table	Length
`PRA-1`	Primary Key Value - PRA	CE	Conditional	Once		250
`PRA-2`	Practitioner Group	CE	Optional	Repeats	0358	250
`PRA-3`	Practitioner Category	IS	Optional	Repeats	0186	3
`PRA-4`	Provider Billing	ID	Optional	Once	0187	1
`PRA-5`	Specialty	SPD	Optional	Repeats		112
`PRA-6`	Practitioner ID Numbers	PLN	Backward	Repeats		99
`PRA-7`	Privileges	PIP	Optional	Repeats		770
`PRA-8`	Date Entered Practice	DT	Optional	Once		8
`PRA-9`	Institution	CE	Optional	Once	0537	250
`PRA-10`	Date Left Practice	DT	Optional	Once		8
`PRA-11`	Government Reimbursement Billing Eligibility	CE	Optional	Repeats	0401	250
`PRA-12`	Set ID - PRA	SI	Conditional	Once		60

Defined in versions2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

PRBProblem Details25 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		250
`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		250
`PRB-11`	Problem Management Discipline	CE	Optional	Repeats		250
`PRB-12`	Problem Persistence	CE	Optional	Once		250
`PRB-13`	Problem Confirmation Status	CE	Optional	Once		250
`PRB-14`	Problem Life Cycle Status	CE	Optional	Once		250
`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		250
`PRB-19`	Certainty of Problem (0-1)	CE	Optional	Once		250
`PRB-20`	Probability of Problem	NM	Optional	Once		5
`PRB-21`	Individual Awareness of Problem	CE	Optional	Once		250
`PRB-22`	Problem Prognosis	CE	Optional	Once		250
`PRB-23`	Individual Awareness of Prognosis	CE	Optional	Once		250
`PRB-24`	Family/Significant Other Awareness of Problem/Prognosis	ST	Optional	Once		200
`PRB-25`	Security/Sensitivity	CE	Optional	Once		250

Defined in versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

PRCPricing18 fields

Field	Name	Type	Use	Repeats	Table	Length
`PRC-1`	Primary Key Value - PRC	CE	Required	Once	0132	250
`PRC-2`	Facility ID - PRC	CE	Optional	Repeats	0464	250
`PRC-3`	Department	CE	Optional	Repeats	0184	250
`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	250
`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 versions2.3 2.3.1 2.4 2.52.5.12.6 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	250
`PRD-2`	Provider Name	XPN	Optional	Repeats		250
`PRD-3`	Provider Address	XAD	Optional	Repeats		250
`PRD-4`	Provider Location	PL	Optional	Once		60
`PRD-5`	Provider Communication Information	XTN	Optional	Repeats		250
`PRD-6`	Preferred Method of Contact	CE	Optional	Once	0185	250
`PRD-7`	Provider Identifiers	PLN	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 versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

PSHProduct Summary Header14 fields

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

Defined in versions2.3 2.3.1 2.4 2.52.5.12.6 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		250
`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		250
`PTH-6`	Change Pathway Life Cycle Status Date/Time	TS	Conditional	Once		26

Defined in versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

PV1Patient VisitBasic, Coverage, Encounter +152 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`PV1-1`	Set ID - 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		250	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	250	Encounter.participant.individual Encounter.participant.type.coding.code+2 more
`PV1-8`	Referring Doctor	XCN	Optional	Repeats	0010	250	Encounter.participant.individual Encounter.participant.type.coding.code+2 more
`PV1-9`	Consulting Doctor	XCN	Backward	Repeats	0010	250	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	6	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	250	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		250	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	4
`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		47	Encounter.hospitalization.destination
`PV1-38`	Diet Type	CE	Optional	Once	0114	250	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	Repeats		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		250	Encounter.identifier
`PV1-51`	Visit Indicator	IS	Optional	Once	0326	1
`PV1-52`	Other Healthcare Provider	XCN	Backward	Repeats	0010	250	Encounter.participant.individual Encounter.participant.type.coding.code+2 more

FHIR map of segment PV1Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

PV2Patient Visit - Additional InformationEncounter49 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	250
`PV2-3`	Admit Reason	CE	Optional	Once		250	Encounter.reasonCode
`PV2-4`	Transfer Reason	CE	Optional	Once		250
`PV2-5`	Patient Valuables	ST	Optional	Repeats		25
`PV2-6`	Patient Valuables Location	ST	Optional	Once		25
`PV2-7`	Visit User Code	IS	Optional	Repeats	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		250	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		250
`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	250
`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 and 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
`PV2-38`	Mode of Arrival Code	CE	Optional	Once	0430	250	Encounter.extension
`PV2-39`	Recreational Drug Use Code	CE	Optional	Repeats	0431	250
`PV2-40`	Admission Level of Care Code	CE	Optional	Once	0432	250
`PV2-41`	Precaution Code	CE	Optional	Repeats	0433	250
`PV2-42`	Patient Condition Code	CE	Optional	Once	0434	250
`PV2-43`	Living Will Code	IS	Optional	Once	0315	2
`PV2-44`	Organ Donor Code	IS	Optional	Once	0316	2
`PV2-45`	Advance Directive Code	CE	Optional	Repeats	0435	250
`PV2-46`	Patient Status Effective Date	DT	Optional	Once		8
`PV2-47`	Expected LOA Return Date/Time	TS	Conditional	Once		26
`PV2-48`	Expected Pre-admission Testing Date/Time	TS	Optional	Once		26
`PV2-49`	Notify Clergy Code	IS	Optional	Repeats	0534	20

FHIR map of segment PV2Defined in versions2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

QAKQuery Acknowledgment6 fields

Field	Name	Type	Use	Repeats	Table	Length
`QAK-1`	Query Tag	ST	Conditional	Once		32
`QAK-2`	Query Response Status	ID	Optional	Once	0208	2
`QAK-3`	Message Query Name	CE	Optional	Once	0471	250
`QAK-4`	Hit Count	NM	Optional	Once		10
`QAK-5`	This payload	NM	Optional	Once		10
`QAK-6`	Hits remaining	NM	Optional	Once		10

Defined in versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

QIDQuery Identification2 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`QID-1`	Query Tag	ST	Required	Once		32
`QID-2`	Message Query Name	CE	Required	Once	0471	250

Defined in versions2.4 2.52.5.12.6 2.7 2.7.1 2.8

QPDQuery Parameter Definition3 fields

Field	Name	Type	Use	Repeats	Table	Length
`QPD-1`	Message Query Name	CE	Required	Once	0471	250
`QPD-2`	Query Tag	ST	Conditional	Once		32
`QPD-3`	User Parameters (in successive fields)	VARIES	Optional	Once		256

Defined in versions2.4 2.52.5.12.6 2.7 2.7.1 2.8

QRDOriginal-Style Query Definition12 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		250
`QRD-9`	What Subject Filter	CE	Required	Repeats	0048	250
`QRD-10`	What Department Data Code	CE	Required	Repeats		250
`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 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

QRFOriginal style query filter10 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	Backward	Once		26
`QRF-3`	When Data End Date/Time	TS	Backward	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
`QRF-10`	Search Confidence Threshold	NM	Optional	Once		10

Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

QRIQuery Response Instance3 fields

Field	Name	Type	Use	Repeats	Table	Length
`QRI-1`	Candidate Confidence	NM	Optional	Once		10
`QRI-2`	Match Reason Code	IS	Optional	Repeats	0392	2
`QRI-3`	Algorithm Descriptor	CE	Optional	Once	0393	250

Defined in versions2.4 2.52.5.12.6 2.7 2.7.1 2.8

RCPResponse Control Parameter7 fields

Field	Name	Type	Use	Repeats	Table	Length
`RCP-1`	Query Priority	ID	Optional	Once	0091	1
`RCP-2`	Quantity Limited Request	CQ	Optional	Once		10
`RCP-3`	Response Modality	CE	Optional	Once	0394	250
`RCP-4`	Execution and Delivery Time	TS	Conditional	Once		26
`RCP-5`	Modify Indicator	ID	Optional	Once	0395	1
`RCP-6`	Sort-by Field	SRT	Optional	Repeats		512
`RCP-7`	Segment group inclusion	ID	Optional	Repeats	0391	256

Defined in versions2.4 2.52.5.12.6 2.7 2.7.1 2.8

RDFTable Row Definition2 fields

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

Defined in versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

RDTTable Row Data1 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`RDT-1`	Column Value	VARIES	Required	Once		99999

Defined in versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

RF1Referral Information11 fields

Field	Name	Type	Use	Repeats	Table	Length
`RF1-1`	Referral Status	CE	Optional	Once	0283	250
`RF1-2`	Referral Priority	CE	Optional	Once	0280	250
`RF1-3`	Referral Type	CE	Optional	Once	0281	250
`RF1-4`	Referral Disposition	CE	Optional	Repeats	0282	250
`RF1-5`	Referral Category	CE	Optional	Once	0284	250
`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	250
`RF1-11`	External Referral Identifier	EI	Optional	Repeats		30

Defined in versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

RGSResource Group3 fields

Field	Name	Type	Use	Repeats	Table	Length
`RGS-1`	Set ID - RGS	SI	Required	Once		4
`RGS-2`	Segment Action Code	ID	Conditional	Once	0206	3
`RGS-3`	Resource Group ID	CE	Optional	Once		250

Defined in versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

RMIRisk Management Incident3 fields

Field	Name	Type	Use	Repeats	Table	Length
`RMI-1`	Risk Management Incident Code	CE	Optional	Once	0427	250
`RMI-2`	Date/Time Incident	TS	Optional	Once		26
`RMI-3`	Incident Type Code	CE	Optional	Once	0428	250

Defined in versions2.4 2.52.5.12.6 2.7 2.7.1 2.8

ROLRolePatient, Encounter, CareTeam +112 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`ROL-1`	Role Instance ID	EI	Conditional	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	0443	250	Patient.generalPractitioner Encounter.participant.type+2 more
`ROL-4`	Role Person	XCN	Required	Repeats		250	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		250
`ROL-8`	Role Action Reason	CE	Optional	Once		250	CareTeam.reasonCode
`ROL-9`	Provider Type	CE	Optional	Repeats		250	CareTeam.participant.role
`ROL-10`	Organization Unit Type	CE	Optional	Once	0406	250	CareTeam.participant.onBehalfOf CareTeam.participant.member
`ROL-11`	Office/Home Address/Birthplace	XAD	Optional	Repeats		250	Patient.generalPractitioner)Encounter.participant.individual)+1 more
`ROL-12`	Phone	XTN	Optional	Repeats		250	Patient.generalPractitioner Encounter.participant.individual+2 more

FHIR map of segment ROLDefined in versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

RQ1Requisition Detail-17 fields

Field	Name	Type	Use	Repeats	Table	Length
`RQ1-1`	Anticipated Price	ST	Optional	Once		10
`RQ1-2`	Manufacturer Identifier	CE	Conditional	Once	0385	250
`RQ1-3`	Manufacturer's Catalog	ST	Conditional	Once		16
`RQ1-4`	Vendor ID	CE	Conditional	Once		250
`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 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

RQDRequisition Detail10 fields

Field	Name	Type	Use	Repeats	Table	Length
`RQD-1`	Requisition Line Number	SI	Optional	Once		4
`RQD-2`	Item Code - Internal	CE	Conditional	Once		250
`RQD-3`	Item Code - External	CE	Conditional	Once		250
`RQD-4`	Hospital Item Code	CE	Conditional	Once		250
`RQD-5`	Requisition Quantity	NM	Optional	Once		6
`RQD-6`	Requisition Unit of Measure	CE	Optional	Once		250
`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		250
`RQD-10`	Date Needed	DT	Optional	Once		8

Defined in versions2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

RXAPharmacy/Treatment AdministrationImmunization26 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	250	Immunization.vaccineCode
`RXA-6`	Administered Amount	NM	Required	Once		20	Immunization.doseQuantity.value
`RXA-7`	Administered Units	CE	Conditional	Once		250	Immunization.doseQuantity
`RXA-8`	Administered Dosage Form	CE	Optional	Once		250
`RXA-9`	Administration Notes	CE	Optional	Repeats		250
`RXA-10`	Administering Provider	XCN	Optional	Repeats		250	Immunization.performer.actor Immunization.performer.function.coding.code+1 more
`RXA-11`	Administered-at Location	LA2	Conditional	Once		200
`RXA-12`	Administered Per (Time Unit)	ST	Conditional	Once		20
`RXA-13`	Administered Strength	NM	Optional	Once		20
`RXA-14`	Administered Strength Units	CE	Optional	Once		250
`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	250	Immunization.manufacturer
`RXA-18`	Substance/Treatment Refusal Reason	CE	Optional	Repeats		250	Immunization.statusReason
`RXA-19`	Indication	CE	Optional	Repeats		250	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
`RXA-23`	Administered Drug Strength Volume	NM	Optional	Once		5
`RXA-24`	Administered Drug Strength Volume Units	CWE	Optional	Once		250
`RXA-25`	Administered Barcode Identifier	CWE	Optional	Once		60
`RXA-26`	Pharmacy Order Type	ID	Optional	Once	0480	1

FHIR map of segment RXADefined in versions2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

RXCPharmacy/Treatment Component Order9 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		250
`RXC-3`	Component Amount	NM	Required	Once		20
`RXC-4`	Component Units	CE	Required	Once		250
`RXC-5`	Component Strength	NM	Optional	Once		20
`RXC-6`	Component Strength Units	CE	Optional	Once		250
`RXC-7`	Supplementary Code	CE	Optional	Repeats		250
`RXC-8`	Component Drug Strength Volume	NM	Optional	Once		5
`RXC-9`	Component Drug Strength Volume Units	CWE	Optional	Once		250

Defined in versions2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

RXDPharmacy/Treatment Dispense33 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	250
`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		250
`RXD-6`	Actual Dosage Form	CE	Optional	Once		250
`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		250
`RXD-16`	Actual Strength	NM	Optional	Once		20
`RXD-17`	Actual Strength Unit	CE	Optional	Once		250
`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	250
`RXD-21`	Indication	CE	Optional	Repeats		250
`RXD-22`	Dispense Package Size	NM	Optional	Once		20
`RXD-23`	Dispense Package Size Unit	CE	Optional	Once		250
`RXD-24`	Dispense Package Method	ID	Optional	Once	0321	2
`RXD-25`	Supplementary Code	CE	Optional	Repeats		250
`RXD-26`	Initiating Location	CE	Optional	Once		250
`RXD-27`	Packaging/Assembly Location	CE	Optional	Once		250
`RXD-28`	Actual Drug Strength Volume	NM	Optional	Once		5
`RXD-29`	Actual Drug Strength Volume Units	CWE	Optional	Once		250
`RXD-30`	Dispense to Pharmacy	CWE	Optional	Once		180
`RXD-31`	Dispense to Pharmacy Address	XAD	Optional	Once		106
`RXD-32`	Pharmacy Order Type	ID	Optional	Once	0480	1
`RXD-33`	Dispense Type	CWE	Optional	Once	0484	250

Defined in versions2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

RXEPharmacy/Treatment Encoded Order44 fields

Field	Name	Type	Use	Repeats	Table	Length
`RXE-1`	Quantity/Timing	TQ	Backward	Once		200
`RXE-2`	Give Code	CE	Required	Once		250
`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		250
`RXE-6`	Give Dosage Form	CE	Optional	Once		250
`RXE-7`	Provider's Administration Instructions	CE	Optional	Repeats		250
`RXE-8`	Deliver-To Location	LA1	Backward	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		250
`RXE-12`	Number Of Refills	NM	Optional	Once		3
`RXE-13`	Ordering Provider's DEA Number	XCN	Conditional	Repeats		250
`RXE-14`	Pharmacist/Treatment Supplier's Verifier ID	XCN	Optional	Repeats		250
`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		250
`RXE-22`	Give Per (Time Units)	ST	Conditional	Once		20
`RXE-23`	Give Rate Amount	ST	Optional	Once		6
`RXE-24`	Give Rate Units	CE	Optional	Once		250
`RXE-25`	Give Strength	NM	Optional	Once		20
`RXE-26`	Give Strength Units	CE	Optional	Once		250
`RXE-27`	Give Indication	CE	Optional	Repeats		250
`RXE-28`	Dispense Package Size	NM	Optional	Once		20
`RXE-29`	Dispense Package Size Unit	CE	Optional	Once		250
`RXE-30`	Dispense Package Method	ID	Optional	Once	0321	2
`RXE-31`	Supplementary Code	CE	Optional	Repeats		250
`RXE-32`	Original Order Date/Time	TS	Optional	Once		26
`RXE-33`	Give Drug Strength Volume	NM	Optional	Once		5
`RXE-34`	Give Drug Strength Volume Units	CWE	Optional	Once		250
`RXE-35`	Controlled Substance Schedule	CWE	Optional	Once	0477	60
`RXE-36`	Formulary Status	ID	Optional	Once	0478	1
`RXE-37`	Pharmaceutical Substance Alternative	CWE	Optional	Repeats		60
`RXE-38`	Pharmacy of Most Recent Fill	CWE	Optional	Once		250
`RXE-39`	Initial Dispense Amount	NM	Optional	Once		250
`RXE-40`	Dispensing Pharmacy	CWE	Optional	Once		250
`RXE-41`	Dispensing Pharmacy Address	XAD	Optional	Once		250
`RXE-42`	Deliver-to Patient Location	PL	Optional	Once		80
`RXE-43`	Deliver-to Address	XAD	Optional	Once		250
`RXE-44`	Pharmacy Order Type	ID	Optional	Once	0480	1

Defined in versions2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

RXGPharmacy/Treatment Give26 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	Backward	Once		200
`RXG-4`	Give Code	CE	Required	Once	0292	250
`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		250
`RXG-8`	Give Dosage Form	CE	Optional	Once		250
`RXG-9`	Administration Notes	CE	Optional	Repeats		250
`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		250
`RXG-14`	Give Per (Time Unit)	ST	Conditional	Once		20
`RXG-15`	Give Rate Amount	ST	Optional	Once		6
`RXG-16`	Give Rate Units	CE	Optional	Once		250
`RXG-17`	Give Strength	NM	Optional	Once		20
`RXG-18`	Give Strength Units	CE	Optional	Once		250
`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	250
`RXG-22`	Indication	CE	Optional	Repeats		250
`RXG-23`	Give Drug Strength Volume	NM	Optional	Once		5
`RXG-24`	Give Drug Strength Volume Units	CWE	Optional	Once		250
`RXG-25`	Give Barcode Identifier	CWE	Optional	Once		60
`RXG-26`	Pharmacy Order Type	ID	Optional	Once	0480	1

Defined in versions2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

RXOPharmacy/Treatment OrderMedicationRequest28 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`RXO-1`	Requested Give Code	CE	Conditional	Once		250	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		250	MedicationRequest.dosageInstruction.doseAndRate.doseRange.low.code MedicationRequest.dosageInstruction.doseAndRate.doseRange.low.unit+2 more
`RXO-5`	Requested Dosage Form	CE	Conditional	Once		250	MedicationRequest.medication
`RXO-6`	Provider's Pharmacy/Treatment Instructions	CE	Optional	Repeats		250
`RXO-7`	Provider's Administration Instructions	CE	Optional	Repeats		250
`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		250
`RXO-11`	Requested Dispense Amount	NM	Optional	Once		20	MedicationRequest.dispenseRequest.quantity.value
`RXO-12`	Requested Dispense Units	CE	Optional	Once		250	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		250	MedicationRequest.requester
`RXO-15`	Pharmacist/Treatment Supplier's Verifier ID	XCN	Conditional	Repeats		250
`RXO-16`	Needs Human Review	ID	Optional	Once	0136	1
`RXO-17`	Requested Give Per (Time Unit)	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		250	MedicationRequest.medicationReference(Medication.ingredient.strength.numerator.code MedicationRequest.medicationReference(Medication.ingredient.strength.numerator.unit+3 more
`RXO-20`	Indication	CE	Optional	Repeats		250
`RXO-21`	Requested Give Rate Amount	ST	Optional	Once		6
`RXO-22`	Requested Give Rate Units	CE	Optional	Once		250
`RXO-23`	Total Daily Dose	CQ	Optional	Once		10
`RXO-24`	Supplementary Code	CE	Optional	Repeats		250
`RXO-25`	Requested Drug Strength Volume	NM	Optional	Once		5	MedicationRequest.medicationReference(Medication.ingredient.strength.denominator.value
`RXO-26`	Requested Drug Strength Volume Units	CWE	Optional	Once		250	MedicationRequest.medicationReference(Medication.ingredient.strength.denominator.code MedicationRequest.medicationReference(Medication.ingredient.strength.denominator.unit
`RXO-27`	Pharmacy Order Type	ID	Optional	Once	0480	1
`RXO-28`	Dispensing Interval	NM	Optional	Once		20

FHIR map of segment RXODefined in versions2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

RXRPharmacy/Treatment RouteImmunization, MedicationRequest6 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`RXR-1`	Route	CE	Required	Once	0162	250	Immunization.route MedicationRequest.dosageInstruction.route
`RXR-2`	Administration Site	CWE	Optional	Once	0163	250	Immunization.site MedicationRequest.dosageInstruction.site
`RXR-3`	Administration Device	CE	Optional	Once	0164	250
`RXR-4`	Administration Method	CWE	Optional	Once	0165	250	MedicationRequest.dosageInstruction.method
`RXR-5`	Routing Instruction	CE	Optional	Once		250	MedicationRequest.dosageInstruction.additionalInstruction
`RXR-6`	Administration Site Modifier	CWE	Optional	Once	0495	250

FHIR map of segment RXRDefined in versions2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

SACSpecimen Container detail44 fields

Field	Name	Type	Use	Repeats	Table	Length
`SAC-1`	External Accession Identifier	EI	Optional	Once		80
`SAC-2`	Accession Identifier	EI	Optional	Once		80
`SAC-3`	Container Identifier	EI	Conditional	Once		80
`SAC-4`	Primary (parent) Container Identifier	EI	Conditional	Once		80
`SAC-5`	Equipment Container Identifier	EI	Optional	Once		80
`SAC-6`	Specimen Source	SPS	Conditional	Once		300
`SAC-7`	Registration Date/Time	TS	Optional	Once		26
`SAC-8`	Container Status	CE	Optional	Once	0370	250
`SAC-9`	Carrier Type	CE	Optional	Once	0378	250
`SAC-10`	Carrier Identifier	EI	Optional	Once		80
`SAC-11`	Position in Carrier	NA	Optional	Once		80
`SAC-12`	Tray Type - SAC	CE	Optional	Once	0379	250
`SAC-13`	Tray Identifier	EI	Optional	Once		80
`SAC-14`	Position in Tray	NA	Optional	Once		80
`SAC-15`	Location	CE	Optional	Repeats		250
`SAC-16`	Container Height	NM	Optional	Once		20
`SAC-17`	Container Diameter	NM	Optional	Once		20
`SAC-18`	Barrier Delta	NM	Optional	Once		20
`SAC-19`	Bottom Delta	NM	Optional	Once		20
`SAC-20`	Container Height/Diameter/Delta Units	CE	Optional	Once		250
`SAC-21`	Container Volume	NM	Optional	Once		20
`SAC-22`	Available Specimen Volume	NM	Optional	Once		20
`SAC-23`	Initial Specimen Volume	NM	Optional	Once		20
`SAC-24`	Volume Units	CE	Optional	Once		250
`SAC-25`	Separator Type	CE	Optional	Once	0380	250
`SAC-26`	Cap Type	CE	Optional	Once	0381	250
`SAC-27`	Additive	CWE	Optional	Repeats	0371	250
`SAC-28`	Specimen Component	CE	Optional	Once		250
`SAC-29`	Dilution Factor	SN	Optional	Once		20
`SAC-30`	Treatment	CE	Optional	Once	0373	250
`SAC-31`	Temperature	SN	Optional	Once		20
`SAC-32`	Hemolysis Index	NM	Optional	Once		20
`SAC-33`	Hemolysis Index Units	CE	Optional	Once		250
`SAC-34`	Lipemia Index	NM	Optional	Once		20
`SAC-35`	Lipemia Index Units	CE	Optional	Once		250
`SAC-36`	Icterus Index	NM	Optional	Once		20
`SAC-37`	Icterus Index Units	CE	Optional	Once		250
`SAC-38`	Fibrin Index	NM	Optional	Once		20
`SAC-39`	Fibrin Index Units	CE	Optional	Once		250
`SAC-40`	System Induced Contaminants	CE	Optional	Repeats	0374	250
`SAC-41`	Drug Interference	CE	Optional	Repeats	0382	250
`SAC-42`	Artificial Blood	CE	Optional	Once	0375	250
`SAC-43`	Special Handling Code	CWE	Optional	Repeats	0376	250
`SAC-44`	Other Environmental Factors	CE	Optional	Repeats	0377	250

Defined in versions2.4 2.52.5.12.6 2.7 2.7.1 2.8

SCHScheduling Activity InformationAppointment, Provenance, ServiceRequest27 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		250
`SCH-6`	Event Reason	CE	Required	Once		250	ServiceRequest.intent
`SCH-7`	Appointment Reason	CE	Optional	Once	0276	250	Appointment.reasonCode Appointment.appointmentType
`SCH-8`	Appointment Type	CE	Optional	Once	0277	250	Appointment.appointmentType
`SCH-9`	Appointment Duration	NM	Backward	Once		20	Appointment.minutesDuration
`SCH-10`	Appointment Duration Units	CE	Backward	Once		250
`SCH-11`	Appointment Timing Quantity	TQ	Backward	Repeats		200	Appointment.$this
`SCH-12`	Placer Contact Person	XCN	Optional	Repeats		250	Appointment.participant.actor Appointment.participant.type.coding.code+1 more
`SCH-13`	Placer Contact Phone Number	XTN	Optional	Once		250
`SCH-14`	Placer Contact Address	XAD	Optional	Repeats		250
`SCH-15`	Placer Contact Location	PL	Optional	Once		80
`SCH-16`	Filler Contact Person	XCN	Required	Repeats		250	Appointment.participant.actor Appointment.participant.type.coding.code+1 more
`SCH-17`	Filler Contact Phone Number	XTN	Optional	Once		250
`SCH-18`	Filler Contact Address	XAD	Optional	Repeats		250
`SCH-19`	Filler Contact Location	PL	Optional	Once		80
`SCH-20`	Entered By Person	XCN	Required	Repeats		250	Appointment.participant.actor Appointment.participant.type.coding.code+4 more
`SCH-21`	Entered By Phone Number	XTN	Optional	Repeats		250
`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	250	Appointment.status ServiceRequest.status
`SCH-26`	Placer Order Number	EI	Conditional	Repeats		22	Appointment.basedOn ServiceRequest.identifier
`SCH-27`	Filler Order Number	EI	Conditional	Repeats		22	Appointment.basedOn ServiceRequest.identifier

FHIR map of segment SCHDefined in versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

SFTSoftware SegmentDevice, MessageHeader6 fields

Field	Name	Type	Use	Repeats	Length	FHIR
`SFT-1`	Software Vendor Organization	XON	Required	Once	567	Device.manufacturer
`SFT-2`	Software Certified Version or Release Number	ST	Required	Once	15	Device.version.value MessageHeader.source.version
`SFT-3`	Software Product Name	ST	Required	Once	20	Device.deviceName.name Device.deviceName.type+1 more
`SFT-4`	Software Binary ID	ST	Required	Once	20	Device.modelNumber
`SFT-5`	Software Product Information	TX	Optional	Once	1024	Device.note.text
`SFT-6`	Software Install Date	TS	Optional	Once	26	Device.version.extension

FHIR map of segment SFTDefined in versions2.52.5.12.6 2.7 2.7.1 2.8

SIDSubstance Identifier4 fields

Field	Name	Type	Use	Repeats	Table	Length
`SID-1`	Application / Method Identifier	CE	Conditional	Once		250
`SID-2`	Substance Lot Number	ST	Conditional	Once		20
`SID-3`	Substance Container Identifier	ST	Conditional	Once		200
`SID-4`	Substance Manufacturer Identifier	CE	Conditional	Once	0385	250

Defined in versions2.4 2.52.5.12.6 2.7 2.7.1 2.8

SPMSpecimenSpecimen29 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`SPM-1`	Set ID - SPM	SI	Optional	Once		4
`SPM-2`	Specimen ID	EIP	Optional	Once		80	Specimen.identifier
`SPM-3`	Specimen Parent IDs	EIP	Optional	Repeats		80	Specimen.parent
`SPM-4`	Specimen Type	CWE	Required	Once	0487	250	Specimen.type
`SPM-5`	Specimen Type Modifier	CWE	Optional	Repeats	0541	250
`SPM-6`	Specimen Additives	CWE	Optional	Repeats	0371	250	Specimen.container.additiveCodeableConcept
`SPM-7`	Specimen Collection Method	CWE	Optional	Once	0488	250	Specimen.collection.method
`SPM-8`	Specimen Source Site	CWE	Optional	Once		250	Specimen.collection.bodySite
`SPM-9`	Specimen Source Site Modifier	CWE	Optional	Repeats	0542	250
`SPM-10`	Specimen Collection Site	CWE	Optional	Once	0543	250
`SPM-11`	Specimen Role	CWE	Optional	Repeats	0369	250
`SPM-12`	Specimen Collection Amount	CQ	Optional	Once		20	Specimen.collection.quantity
`SPM-13`	Grouped Specimen Count	NM	Conditional	Once		6
`SPM-14`	Specimen Description	ST	Optional	Repeats		250	Specimen.note
`SPM-15`	Specimen Handling Code	CWE	Optional	Repeats	0376	250
`SPM-16`	Specimen Risk Code	CWE	Optional	Repeats	0489	250
`SPM-17`	Specimen Collection Date/Time	DR	Optional	Once		26	Specimen.collection.collectedPeriod Specimen.collection.collectedDateTime
`SPM-18`	Specimen Received Date/Time	TS	Optional	Once		26	Specimen.receivedTime
`SPM-19`	Specimen Expiration Date/Time	TS	Optional	Once		26
`SPM-20`	Specimen Availability	ID	Optional	Once	0136	1	Specimen.status
`SPM-21`	Specimen Reject Reason	CWE	Optional	Repeats	0490	250
`SPM-22`	Specimen Quality	CWE	Optional	Once	0491	250
`SPM-23`	Specimen Appropriateness	CWE	Optional	Once	0492	250
`SPM-24`	Specimen Condition	CWE	Optional	Repeats	0493	250	Specimen.condition
`SPM-25`	Specimen Current Quantity	CQ	Optional	Once		20
`SPM-26`	Number of Specimen Containers	NM	Optional	Once		4
`SPM-27`	Container Type	CWE	Optional	Once		250	Specimen.container.type
`SPM-28`	Container Condition	CWE	Optional	Once	0544	250
`SPM-29`	Specimen Child Role	CWE	Optional	Once	0494	250

FHIR map of segment SPMDefined in versions2.52.5.12.6 2.7 2.7.1 2.8

SPRStored Procedure Request Definition4 fields

Field	Name	Type	Use	Repeats	Table	Length
`SPR-1`	Query Tag	ST	Optional	Once		32
`SPR-2`	Query/Response Format Code	ID	Required	Once	0106	1
`SPR-3`	Stored Procedure Name	CE	Required	Once		250
`SPR-4`	Input Parameter List	QIP	Optional	Repeats		256

Defined in versions2.3 2.3.1 2.4 2.52.5.12.6

STFStaff Identification38 fields

Field	Name	Type	Use	Repeats	Table	Length
`STF-1`	Primary Key Value - STF	CE	Conditional	Once		250
`STF-2`	Staff Identifier List	CX	Optional	Repeats		250
`STF-3`	Staff Name	XPN	Optional	Repeats		250
`STF-4`	Staff Type	IS	Optional	Repeats	0182	2
`STF-5`	Administrative 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	250
`STF-9`	Hospital Service - STF	CE	Optional	Repeats	0069	250
`STF-10`	Phone	XTN	Optional	Repeats		250
`STF-11`	Office/Home Address/Birthplace	XAD	Optional	Repeats		250
`STF-12`	Institution Activation Date	DIN	Optional	Repeats		276
`STF-13`	Institution Inactivation Date	DIN	Optional	Repeats		276
`STF-14`	Backup Person ID	CE	Optional	Repeats		250
`STF-15`	E-Mail Address	ST	Optional	Repeats		40
`STF-16`	Preferred Method of Contact	CE	Optional	Once	0185	250
`STF-17`	Marital Status	CE	Optional	Once	0002	250
`STF-18`	Job Title	ST	Optional	Once		20
`STF-19`	Job Code/Class	JCC	Optional	Once		20
`STF-20`	Employment Status Code	CE	Optional	Once	0066	250
`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
`STF-27`	Race	CE	Optional	Once	0005	250
`STF-28`	Ethnic Group	CE	Optional	Once	0189	250
`STF-29`	Re-activation Approval Indicator	ID	Optional	Once	0136	1
`STF-30`	Citizenship	CWE	Optional	Repeats	0171	250
`STF-31`	Death Date and Time	TS	Optional	Once		8
`STF-32`	Death Indicator	ID	Optional	Once	0136	1
`STF-33`	Institution Relationship Type Code	CWE	Optional	Once	0538	250
`STF-34`	Institution Relationship Period	DR	Optional	Once		52
`STF-35`	Expected Return Date	DT	Optional	Once		8
`STF-36`	Cost Center Code	CWE	Optional	Repeats	0539	250
`STF-37`	Generic Classification Indicator	ID	Optional	Once	0136	1
`STF-38`	Inactive Reason Code	CWE	Optional	Once	0540	250

Defined in versions2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

TCCTest Code Configuration14 fields

Field	Name	Type	Use	Repeats	Table	Length
`TCC-1`	Universal Service Identifier	CE	Required	Once		250
`TCC-2`	Test Application Identifier	EI	Required	Once		80
`TCC-3`	Specimen Source	SPS	Backward	Once		300
`TCC-4`	Auto-Dilution Factor Default	SN	Optional	Once		20
`TCC-5`	Rerun Dilution Factor Default	SN	Optional	Once		20
`TCC-6`	Pre-Dilution Factor Default	SN	Optional	Once		20
`TCC-7`	Endogenous Content of Pre-Dilution Diluent	SN	Optional	Once		20
`TCC-8`	Inventory Limits Warning Level	NM	Optional	Once		10
`TCC-9`	Automatic Rerun Allowed	ID	Optional	Once	0136	1
`TCC-10`	Automatic Repeat Allowed	ID	Optional	Once	0136	1
`TCC-11`	Automatic Reflex Allowed	ID	Optional	Once	0136	1
`TCC-12`	Equipment Dynamic Range	SN	Optional	Once		20
`TCC-13`	Units	CE	Optional	Once		250
`TCC-14`	Processing Type	CE	Optional	Once	0388	250

Defined in versions2.4 2.52.5.12.6 2.7 2.7.1 2.8

TCDTest Code Detail8 fields

Field	Name	Type	Use	Repeats	Table	Length
`TCD-1`	Universal Service Identifier	CE	Required	Once		250
`TCD-2`	Auto-Dilution Factor	SN	Optional	Once		20
`TCD-3`	Rerun Dilution Factor	SN	Optional	Once		20
`TCD-4`	Pre-Dilution Factor	SN	Optional	Once		20
`TCD-5`	Endogenous Content of Pre-Dilution Diluent	SN	Optional	Once		20
`TCD-6`	Automatic Repeat Allowed	ID	Optional	Once	0136	1
`TCD-7`	Reflex Allowed	ID	Optional	Once	0136	1
`TCD-8`	Analyte Repeat Status	CE	Optional	Once	0389	250

Defined in versions2.4 2.52.5.12.6 2.7 2.7.1 2.8

TQ1Timing/QuantityMedicationRequest, ServiceRequest14 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`TQ1-1`	Set ID - TQ1	SI	Optional	Once		4
`TQ1-2`	Quantity	CQ	Optional	Once		20	MedicationRequest.dosageInstruction.doseAndRate.doseQuantity ServiceRequest.quantityQuantity
`TQ1-3`	Repeat Pattern	RPT	Optional	Repeats		540	MedicationRequest.dosageInstruction.timing ServiceRequest.occurrenceTiming
`TQ1-4`	Explicit Time	TM	Optional	Repeats		20	MedicationRequest.dosageInstruction.timing.event ServiceRequest.occurrenceTiming.repeat.timeOfDay
`TQ1-5`	Relative Time and Units	CQ	Optional	Repeats		20	MedicationRequest.dosageInstruction.timing.repeat.offset ServiceRequest.occurrenceTIming.repeat.offset
`TQ1-6`	Service Duration	CQ	Optional	Once		20	MedicationRequest.occurrenceTiming.boundsDuration MedicationRequest.occurrenceTiming.boundsPeriod.end+4 more
`TQ1-7`	Start date/time	TS	Optional	Once		26	MedicationRequest.dosageInstruction.timing.repeat.boundsPeriod.start ServiceRequest.occurrenceTiming.repeat.boundsPeriod.start
`TQ1-8`	End date/time	TS	Optional	Once		26	MedicationRequest.dosageInstruction.timing.repeat.boundsPeriod.end ServiceRequest.occurrenceTiming.repeat.boundsPeriod.end
`TQ1-9`	Priority	CWE	Optional	Repeats	0485	250	MedicationRequest.priority ServiceRequest.priority
`TQ1-10`	Condition text	TX	Optional	Once		250	MedicationRequest.dosageInstruction.additionalInstruction.text
`TQ1-11`	Text instruction	TX	Optional	Once		250	MedicationRequest.text ServiceRequest.note
`TQ1-12`	Conjunction	ID	Conditional	Once	0427	10
`TQ1-13`	Occurrence duration	CQ	Optional	Once		20	MedicationRequest.dosageInstruction.timing.repeat.duration MedicationRequest.dosageInstruction.timing.repeat.durationUnit+2 more
`TQ1-14`	Total occurrences	NM	Optional	Once		10	MedicationRequest.dosageInstruction.timing.repeat.countMax ServiceRequest.occurrenceTiming.repeat.countMax

FHIR map of segment TQ1Defined in versions2.52.5.12.6 2.7 2.7.1 2.8

TQ2Timing/Quantity Relationship10 fields

Field	Name	Type	Use	Repeats	Table	Length
`TQ2-1`	Set ID - TQ2	SI	Optional	Once		4
`TQ2-2`	Sequence/Results Flag	ID	Optional	Once	0503	1
`TQ2-3`	Related Placer Number	EI	Conditional	Repeats		22
`TQ2-4`	Related Filler Number	EI	Conditional	Repeats		22
`TQ2-5`	Related Placer Group Number	EI	Conditional	Repeats		22
`TQ2-6`	Sequence Condition Code	ID	Conditional	Once	0504	2
`TQ2-7`	Cyclic Entry/Exit Indicator	ID	Conditional	Once	0505	1
`TQ2-8`	Sequence Condition Time Interval	CQ	Optional	Once		20
`TQ2-9`	Cyclic Group Maximum Number of Repeats	NM	Optional	Once		10
`TQ2-10`	Special Service Request Relationship	ID	Conditional	Once	0506	1

Defined in versions2.52.5.12.6 2.7 2.7.1 2.8

TXATranscription Document HeaderDocumentReference, 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		250
`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		250	DocumentReference.author
`TXA-10`	Assigned Document Authenticator	XCN	Optional	Repeats		250	DocumentReference.authenticator
`TXA-11`	Transcriptionist Code/Name	XCN	Conditional	Repeats		250
`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		250
`TXA-23`	Distributed Copies (Code and Name of Recipients)	XCN	Optional	Repeats		250

FHIR map of segment TXADefined in versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

UB1UB82 Data23 fields

Field	Name	Type	Use	Repeats	Table	Length
`UB1-1`	Set ID - UB1	SI	Optional	Once		4
`UB1-2`	Blood Deductible (43)	NM	Backward	Once		1
`UB1-3`	Blood Furnished-Pints Of (40)	NM	Optional	Once		2
`UB1-4`	Blood Replaced-Pints (41)	NM	Optional	Once		2
`UB1-5`	Blood Not Replaced-Pints (42)	NM	Optional	Once		2
`UB1-6`	Co-Insurance Days (25)	NM	Optional	Once		2
`UB1-7`	Condition Code (35-39)	IS	Optional	Once	0043	14
`UB1-8`	Covered Days (23)	NM	Optional	Once		3
`UB1-9`	Non Covered Days (24)	NM	Optional	Once		3
`UB1-10`	Value Amount and Code (46-49)	UVC	Optional	Once		41
`UB1-11`	Number Of Grace Days (90)	NM	Optional	Once		2
`UB1-12`	Special Program Indicator (44)	CE	Optional	Once	0348	250
`UB1-13`	PSRO/UR Approval Indicator (87)	CE	Optional	Once	0349	250
`UB1-14`	PSRO/UR Approved Stay-Fm (88)	DT	Optional	Once		8
`UB1-15`	PSRO/UR Approved Stay-To (89)	DT	Optional	Once		8
`UB1-16`	Occurrence (28-32)	OCD	Optional	Once		259
`UB1-17`	Occurrence Span (33)	CE	Optional	Once	0351	250
`UB1-18`	Occur Span Start Date (33)	DT	Optional	Once		8
`UB1-19`	Occur Span End Date (33)	DT	Optional	Once		8
`UB1-20`	UB-82 Locator 2	ST	Backward	Once		30
`UB1-21`	UB-82 Locator 9	ST	Backward	Once		7
`UB1-22`	UB-82 Locator 27	ST	Backward	Once		8
`UB1-23`	UB-82 Locator 45	ST	Backward	Once		17

Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

UB2UB92 Data17 fields

Field	Name	Type	Use	Repeats	Table	Length
`UB2-1`	Set ID - UB2	SI	Optional	Once		4
`UB2-2`	Co-Insurance Days (9)	ST	Optional	Once		3
`UB2-3`	Condition Code (24-30)	IS	Optional	Once	0043	2
`UB2-4`	Covered Days (7)	ST	Optional	Once		3
`UB2-5`	Non-Covered Days (8)	ST	Optional	Once		4
`UB2-6`	Value Amount and Code (39-41)	UVC	Optional	Once		41
`UB2-7`	Occurrence Code and Date (32-35)	OCD	Optional	Once		259
`UB2-8`	Occurrence Span Code/Dates (36)	OSP	Optional	Once		268
`UB2-9`	UB92 Locator 2 (State)	ST	Optional	Once		29
`UB2-10`	UB92 Locator 11 (State)	ST	Optional	Once		12
`UB2-11`	UB92 Locator 31 (National)	ST	Optional	Once		5
`UB2-12`	Document Control Number	ST	Optional	Once		23
`UB2-13`	UB92 Locator 49 (National)	ST	Optional	Once		4
`UB2-14`	UB92 Locator 56 (State)	ST	Optional	Once		14
`UB2-15`	UB92 Locator 57 (National)	ST	Optional	Once		27
`UB2-16`	UB92 Locator 78 (State)	ST	Optional	Once		2
`UB2-17`	Special Visit Count	NM	Optional	Once		3

Defined in versions2.2 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

URDResults/update Definition7 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		250
`URD-4`	R/U What Subject Definition	CE	Optional	Repeats	0048	250
`URD-5`	R/U What Department Code	CE	Optional	Repeats		250
`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 2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

URSUnsolicited Selection9 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 2.3 2.3.1 2.4 2.52.5.12.6 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	250
`VAR-5`	Variance Classification	CE	Optional	Once	250
`VAR-6`	Variance Description	ST	Optional	Repeats	512

Defined in versions2.3 2.3.1 2.4 2.52.5.12.6 2.7 2.7.1 2.8

VTQVirtual Table Query Request5 fields

Field	Name	Type	Use	Repeats	Table	Length
`VTQ-1`	Query Tag	ST	Optional	Once		32
`VTQ-2`	Query/Response Format Code	ID	Required	Once	0106	1
`VTQ-3`	VT Query Name	CE	Required	Once		250
`VTQ-4`	Virtual Table Name	CE	Required	Once		250
`VTQ-5`	Selection Criteria	QSC	Optional	Repeats		256

Defined in versions2.3 2.3.1 2.4 2.52.5.12.6