HL7 v2 2.7

Segments and their fields in version 2.7. 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
`ABS-2`	Transfer Medical Service Code	CWE	Optional	Once	0069
`ABS-3`	Severity Of Illness Code	CWE	Optional	Once	0421
`ABS-4`	Date/Time Of Attestation	DTM	Optional	Once
`ABS-5`	Attested By	XCN	Optional	Once
`ABS-6`	Triage Code	CWE	Optional	Once	0422
`ABS-7`	Abstract Completion Date/Time	DTM	Optional	Once
`ABS-8`	Abstracted By	XCN	Optional	Once
`ABS-9`	Case Category Code	CWE	Optional	Once	0423
`ABS-10`	Caesarian Section Indicator	ID	Optional	Once	0136	1
`ABS-11`	Gestation Category Code	CWE	Optional	Once	0424
`ABS-12`	Gestation Period - Weeks	NM	Optional	Once
`ABS-13`	Newborn Code	CWE	Optional	Once	0425
`ABS-14`	Stillborn Indicator	ID	Optional	Once	0136	1

Defined in versions2.4 2.5 2.5.1 2.62.72.7.1 2.8

ACCAccident12 fields

Field	Name	Type	Use	Repeats	Table	Length
`ACC-1`	Accident Date/Time	DTM	Optional	Once
`ACC-2`	Accident Code	CWE	Optional	Once	0050
`ACC-3`	Accident Location	ST	Optional	Once
`ACC-4`	Auto Accident State	CWE	Backward	Once	0347
`ACC-5`	Accident Job Related Indicator	ID	Optional	Once	0136	1
`ACC-6`	Accident Death Indicator	ID	Optional	Once	0136	1
`ACC-7`	Entered By	XCN	Optional	Once
`ACC-8`	Accident Description	ST	Optional	Once
`ACC-9`	Brought In By	ST	Optional	Once
`ACC-10`	Police Notified Indicator	ID	Optional	Once	0136	1
`ACC-11`	Accident Address	XAD	Optional	Once
`ACC-12`	Degree Of Patient Liability	NM	Optional	Once

Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

ADDAddendum1 fields

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

Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

ADJAdjustment15 fields

Field	Name	Type	Use	Repeats	Table	Length
`ADJ-1`	Provider Adjustment Number	EI	Required	Once
`ADJ-2`	Payer Adjustment Number	EI	Required	Once
`ADJ-3`	Adjustment Sequence Number	SI	Required	Once		4
`ADJ-4`	Adjustment Category	CWE	Required	Once	0564
`ADJ-5`	Adjustment Amount	CP	Optional	Once
`ADJ-6`	Adjustment Quantity	CQ	Optional	Once
`ADJ-7`	Adjustment Reason Pa	CWE	Conditional	Once	0565
`ADJ-8`	Adjustment Description	ST	Optional	Once
`ADJ-9`	Original Value	NM	Optional	Once
`ADJ-10`	Substitute Value	NM	Optional	Once
`ADJ-11`	Adjustment Action	CWE	Optional	Once	0569
`ADJ-12`	Provider Adjustment Number Cross Reference	EI	Optional	Once
`ADJ-13`	Provider Product/Service Line Item Number Cross Reference	EI	Optional	Once
`ADJ-14`	Adjustment Date	DTM	Required	Once
`ADJ-15`	Responsible Organization	XON	Optional	Once

Defined in versions2.62.72.7.1 2.8

AFFProfessional Affiliation5 fields

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

Defined in versions2.4 2.5 2.5.1 2.62.72.7.1 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	1
`AIG-3`	Resource Id	CWE	Conditional	Once			Appointment.participant.actor
`AIG-4`	Resource Type	CWE	Required	Once			Appointment.participant.type
`AIG-5`	Resource Group	CWE	Optional	Repeats
`AIG-6`	Resource Quantity	NM	Optional	Once
`AIG-7`	Resource Quantity Units	CNE	Optional	Once
`AIG-8`	Start Date/Time	DTM	Conditional	Once			Appointment.participant.period.start
`AIG-9`	Start Date/Time Offset	NM	Conditional	Once			Appointment.participant.period.start
`AIG-10`	Start Date/Time Offset Units	CNE	Conditional	Once
`AIG-11`	Duration	NM	Optional	Once			Appointment.participant.period.end
`AIG-12`	Duration Units	CNE	Optional	Once
`AIG-13`	Allow Substitution Code	CWE	Conditional	Once	0279
`AIG-14`	Filler Status Code	CWE	Conditional	Once	0278

FHIR map of segment AIGDefined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 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	1
`AIL-3`	Location Resource Id	PL	Conditional	Repeats			Appointment.participant.actor
`AIL-4`	Location Type - Ail	CWE	Conditional	Once	0305
`AIL-5`	Location Group	CWE	Optional	Once
`AIL-6`	Start Date/Time	DTM	Conditional	Once			Appointment.participant.period.start
`AIL-7`	Start Date/Time Offset	NM	Conditional	Once			Appointment.participant.period.start
`AIL-8`	Start Date/Time Offset Units	CNE	Conditional	Once
`AIL-9`	Duration	NM	Optional	Once			Appointment.participant.period.end
`AIL-10`	Duration Units	CNE	Optional	Once
`AIL-11`	Allow Substitution Code	CWE	Conditional	Once	0279
`AIL-12`	Filler Status Code	CWE	Conditional	Once	0278

FHIR map of segment AILDefined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 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	1
`AIP-3`	Personnel Resource Id	XCN	Conditional	Repeats			Appointment.participant.actor
`AIP-4`	Resource Type	CWE	Conditional	Once	0182		Appointment.participant.type
`AIP-5`	Resource Group	CWE	Optional	Once
`AIP-6`	Start Date/Time	DTM	Conditional	Once			Appointment.participant.period.start
`AIP-7`	Start Date/Time Offset	NM	Conditional	Once			Appointment.participant.period.start
`AIP-8`	Start Date/Time Offset Units	CNE	Conditional	Once
`AIP-9`	Duration	NM	Optional	Once			Appointment.participant.period.end
`AIP-10`	Duration Units	CNE	Optional	Once
`AIP-11`	Allow Substitution Code	CWE	Conditional	Once	0279
`AIP-12`	Filler Status Code	CWE	Conditional	Once	0278		Appointment.participant.status

FHIR map of segment AIPDefined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 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	1
`AIS-3`	Universal Service Identifier	CWE	Required	Once			Appointment.serviceType ServiceRequest.identifier
`AIS-4`	Start Date/Time	DTM	Conditional	Once			Appointment.participant.period.start ServiceRequest.occurrencePeriod.start
`AIS-5`	Start Date/Time Offset	NM	Conditional	Once			Appointment.participant.period.start ServiceRequest.occurrencePeriod.start
`AIS-6`	Start Date/Time Offset Units	CNE	Conditional	Once
`AIS-7`	Duration	NM	Optional	Once			Appointment.participant.period.end ServiceRequest.occurrencePeriod.end
`AIS-8`	Duration Units	CNE	Optional	Once
`AIS-9`	Allow Substitution Code	CWE	Conditional	Once	0279
`AIS-10`	Filler Status Code	CWE	Conditional	Once	0278		Appointment.status
`AIS-11`	Placer Supplemental Service Information	CWE	Optional	Repeats	0411		ServiceRequest.identifier
`AIS-12`	Filler Supplemental Service Information	CWE	Optional	Repeats	0411		ServiceRequest.identifier

FHIR map of segment AISDefined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 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	CWE	Optional	Once	0127		AllergyIntolerance.category AllergyIntolerance.type+1 more
`AL1-3`	Allergen Code/Mnemonic/Description	CWE	Required	Once			AllergyIntolerance.code
`AL1-4`	Allergy Severity Code	CWE	Optional	Once	0128		AllergyIntolerance.criticality AllergyIntolerance.reaction.severity+1 more
`AL1-5`	Allergy Reaction Code	ST	Optional	Repeats			AllergyIntolerance.reaction.manifestation.text
`AL1-6`	Identification Date	ST	Withdrawn	Once			AllergyIntolerance.onsetDateTime

FHIR map of segment AL1Defined in versions2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

APRAppointment Preferences5 fields

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

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

ARQAppointment Request25 fields

Field	Name	Type	Use	Repeats	Table
`ARQ-1`	Placer Appointment Id	EI	Required	Once
`ARQ-2`	Filler Appointment Id	EI	Conditional	Once
`ARQ-3`	Occurrence Number	NM	Conditional	Once
`ARQ-4`	Placer Group Number	EI	Optional	Once
`ARQ-5`	Schedule Id	CWE	Optional	Once
`ARQ-6`	Request Event Reason	CWE	Optional	Once
`ARQ-7`	Appointment Reason	CWE	Optional	Once	0276
`ARQ-8`	Appointment Type	CWE	Optional	Once	0277
`ARQ-9`	Appointment Duration	NM	Optional	Once
`ARQ-10`	Appointment Duration Units	CNE	Optional	Once
`ARQ-11`	Requested Start Date/Time Range	DR	Optional	Repeats
`ARQ-12`	Priority-arq	ST	Optional	Once
`ARQ-13`	Repeating Interval	RI	Optional	Once
`ARQ-14`	Repeating Interval Duration	ST	Optional	Once
`ARQ-15`	Placer Contact Person	XCN	Required	Repeats
`ARQ-16`	Placer Contact Phone Number	XTN	Optional	Repeats
`ARQ-17`	Placer Contact Address	XAD	Optional	Repeats
`ARQ-18`	Placer Contact Location	PL	Optional	Once
`ARQ-19`	Entered By Person	XCN	Required	Repeats
`ARQ-20`	Entered By Phone Number	XTN	Optional	Repeats
`ARQ-21`	Entered By Location	PL	Optional	Once
`ARQ-22`	Parent Placer Appointment Id	EI	Optional	Once
`ARQ-23`	Parent Filler Appointment Id	EI	Optional	Once
`ARQ-24`	Placer Order Number	EI	Conditional	Repeats
`ARQ-25`	Filler Order Number	EI	Conditional	Repeats

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

ARVAccess Restriction6 fields

Field	Name	Type	Use	Repeats	Table	Length
`ARV-1`	Set Id	SI	Optional	Once		4
`ARV-2`	Access Restriction Action Code	CNE	Required	Once	0206
`ARV-3`	Access Restriction Value	CWE	Required	Once	0717
`ARV-4`	Access Restriction Reason	CWE	Optional	Repeats	0719
`ARV-5`	Special Access Restriction Instructions	ST	Optional	Repeats
`ARV-6`	Access Restriction Date Range	DR	Optional	Once

Defined in versions2.62.72.7.1 2.8

AUTAuthorization Information12 fields

Field	Name	Type	Use	Repeats	Table
`AUT-1`	Authorizing Payor, Plan Id	CWE	Optional	Once	0072
`AUT-2`	Authorizing Payor, Company Id	CWE	Required	Once	0285
`AUT-3`	Authorizing Payor, Company Name	ST	Optional	Once
`AUT-4`	Authorization Effective Date	DTM	Optional	Once
`AUT-5`	Authorization Expiration Date	DTM	Optional	Once
`AUT-6`	Authorization Identifier	EI	Conditional	Once
`AUT-7`	Reimbursement Limit	CP	Optional	Once
`AUT-8`	Requested Number Of Treatments	CQ	Optional	Once
`AUT-9`	Authorized Number Of Treatments	CQ	Optional	Once
`AUT-10`	Process Date	DTM	Optional	Once
`AUT-11`	Requested Discipline(s)	CWE	Optional	Repeats
`AUT-12`	Authorized Discipline(s)	CWE	Optional	Repeats

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

BHSBatch Header14 fields

Field	Name	Type	Use	Repeats	Length
`BHS-1`	Batch Field Separator	ST	Required	Once	1
`BHS-2`	Batch Encoding Characters	ST	Required	Once	5
`BHS-3`	Batch Sending Application	HD	Optional	Once
`BHS-4`	Batch Sending Facility	HD	Optional	Once
`BHS-5`	Batch Receiving Application	HD	Optional	Once
`BHS-6`	Batch Receiving Facility	HD	Optional	Once
`BHS-7`	Batch Creation Date/Time	DTM	Optional	Once
`BHS-8`	Batch Security	ST	Optional	Once
`BHS-9`	Batch Name/Id/Type	ST	Optional	Once
`BHS-10`	Batch Comment	ST	Optional	Once
`BHS-11`	Batch Control Id	ST	Optional	Once
`BHS-12`	Reference Batch Control Id	ST	Optional	Once
`BHS-13`	Batch Sending Network Address	HD	Optional	Once
`BHS-14`	Batch Receiving Network Address	HD	Optional	Once

Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

BLCBlood Code2 fields

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

Defined in versions2.4 2.5 2.5.1 2.62.72.7.1 2.8

BLGBilling4 fields

Field	Name	Type	Use	Repeats	Table	Length
`BLG-1`	When To Charge	CCD	Optional	Once
`BLG-2`	Charge Type	ID	Optional	Once	0122	2
`BLG-3`	Account Id	CX	Optional	Once
`BLG-4`	Charge Type Reason	CWE	Optional	Once	0475

Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 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 Identifier	CWE	Required	Once	9999
`BPO-3`	Bp Processing Requirements	CWE	Optional	Repeats	0508
`BPO-4`	Bp Quantity	NM	Required	Once
`BPO-5`	Bp Amount	NM	Optional	Once
`BPO-6`	Bp Units	CWE	Optional	Once	9999
`BPO-7`	Bp Intended Use Date/Time	DTM	Optional	Once
`BPO-8`	Bp Intended Dispense From Location	PL	Optional	Once
`BPO-9`	Bp Intended Dispense From Address	XAD	Optional	Once
`BPO-10`	Bp Requested Dispense Date/Time	DTM	Optional	Once
`BPO-11`	Bp Requested Dispense To Location	PL	Optional	Once
`BPO-12`	Bp Requested Dispense To Address	XAD	Optional	Once
`BPO-13`	Bp Indication For Use	CWE	Optional	Repeats	0509
`BPO-14`	Bp Informed Consent Indicator	ID	Optional	Once	0136	1

Defined in versions2.5 2.5.1 2.62.72.7.1 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
`BPX-3`	Bp Status	ID	Required	Once	0511	1
`BPX-4`	Bp Date/Time Of Status	DTM	Required	Once
`BPX-5`	Bc Donation Id	EI	Conditional	Once
`BPX-6`	Bc Component	CNE	Conditional	Once	9999
`BPX-7`	Bc Donation Type / Intended Use	CNE	Optional	Once	9999
`BPX-8`	Cp Commercial Product	CWE	Conditional	Once	0512
`BPX-9`	Cp Manufacturer	XON	Conditional	Once
`BPX-10`	Cp Lot Number	EI	Conditional	Once
`BPX-11`	Bp Blood Group	CNE	Optional	Once	9999
`BPX-12`	Bc Special Testing	CNE	Optional	Repeats	9999
`BPX-13`	Bp Expiration Date/Time	DTM	Optional	Once
`BPX-14`	Bp Quantity	NM	Required	Once
`BPX-15`	Bp Amount	NM	Optional	Once
`BPX-16`	Bp Units	CWE	Optional	Once	9999
`BPX-17`	Bp Unique Id	EI	Optional	Once
`BPX-18`	Bp Actual Dispensed To Location	PL	Optional	Once
`BPX-19`	Bp Actual Dispensed To Address	XAD	Optional	Once
`BPX-20`	Bp Dispensed To Receiver	XCN	Optional	Once
`BPX-21`	Bp Dispensing Individual	XCN	Optional	Once

Defined in versions2.5 2.5.1 2.62.72.7.1 2.8

BTSBatch Trailer3 fields

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

Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 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
`BTX-3`	Bc Component	CNE	Conditional	Once	9999
`BTX-4`	Bc Blood Group	CNE	Conditional	Once	9999
`BTX-5`	Cp Commercial Product	CWE	Conditional	Once	0512
`BTX-6`	Cp Manufacturer	XON	Conditional	Once
`BTX-7`	Cp Lot Number	EI	Conditional	Once
`BTX-8`	Bp Quantity	NM	Required	Once
`BTX-9`	Bp Amount	NM	Optional	Once
`BTX-10`	Bp Units	CWE	Optional	Once	9999
`BTX-11`	Bp Transfusion/Disposition Status	CWE	Required	Once	0513
`BTX-12`	Bp Message Status	ID	Required	Once	0511	1
`BTX-13`	Bp Date/Time Of Status	DTM	Required	Once
`BTX-14`	Bp Transfusion Administrator	XCN	Optional	Once
`BTX-15`	Bp Transfusion Verifier	XCN	Optional	Once
`BTX-16`	Bp Transfusion Start Date/Time Of Status	DTM	Optional	Once
`BTX-17`	Bp Transfusion End Date/Time Of Status	DTM	Optional	Once
`BTX-18`	Bp Adverse Reaction Type	CWE	Optional	Repeats	0514
`BTX-19`	Bp Transfusion Interrupted Reason	CWE	Optional	Once	0515

Defined in versions2.5 2.5.1 2.62.72.7.1 2.8

CDMCharge Description Master13 fields

Field	Name	Type	Use	Repeats	Table	Length
`CDM-1`	Primary Key Value - Cdm	CWE	Required	Once	0132
`CDM-2`	Charge Code Alias	CWE	Optional	Repeats	0132
`CDM-3`	Charge Description Short	ST	Required	Once
`CDM-4`	Charge Description Long	ST	Optional	Once
`CDM-5`	Description Override Indicator	CWE	Optional	Once	0268
`CDM-6`	Exploding Charges	CWE	Optional	Repeats	0132
`CDM-7`	Procedure Code	CNE	Optional	Repeats	0088
`CDM-8`	Active/Inactive Flag	ID	Optional	Once	0183	1
`CDM-9`	Inventory Number	CWE	Optional	Repeats	0463
`CDM-10`	Resource Load	NM	Optional	Once
`CDM-11`	Contract Number	CX	Optional	Repeats
`CDM-12`	Contract Organization	XON	Optional	Repeats
`CDM-13`	Room Fee Indicator	ID	Optional	Once	0136	1

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 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
`CER-3`	Version	ST	Optional	Once
`CER-4`	Granting Authority	XON	Optional	Once
`CER-5`	Issuing Authority	XCN	Optional	Once
`CER-6`	Signature	ED	Optional	Once
`CER-7`	Granting Country	ID	Optional	Once	0399	3
`CER-8`	Granting State/Province	CWE	Optional	Once	0347
`CER-9`	Granting County/Parish	CWE	Optional	Once	0289
`CER-10`	Certificate Type	CWE	Optional	Once
`CER-11`	Certificate Domain	CWE	Optional	Once
`CER-12`	Subject Id	EI	Conditional	Once
`CER-13`	Subject Name	ST	Required	Once
`CER-14`	Subject Directory Attribute Extension	CWE	Optional	Repeats
`CER-15`	Subject Public Key Info	CWE	Optional	Once
`CER-16`	Authority Key Identifier	CWE	Optional	Once
`CER-17`	Basic Constraint	ID	Optional	Once	0136	1
`CER-18`	Crl Distribution Point	CWE	Optional	Repeats
`CER-19`	Jurisdiction Country	ID	Optional	Once	0399	3
`CER-20`	Jurisdiction State/Province	CWE	Optional	Once	0347
`CER-21`	Jurisdiction County/Parish	CWE	Optional	Once	0289
`CER-22`	Jurisdiction Breadth	CWE	Optional	Repeats	0547
`CER-23`	Granting Date	DTM	Optional	Once
`CER-24`	Issuing Date	DTM	Optional	Once
`CER-25`	Activation Date	DTM	Optional	Once
`CER-26`	Inactivation Date	DTM	Optional	Once
`CER-27`	Expiration Date	DTM	Optional	Once
`CER-28`	Renewal Date	DTM	Optional	Once
`CER-29`	Revocation Date	DTM	Optional	Once
`CER-30`	Revocation Reason Code	CWE	Optional	Once
`CER-31`	Certificate Status Code	CWE	Optional	Once	0536

Defined in versions2.5 2.5.1 2.62.72.7.1 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
`CM0-3`	Alternate Study Id	EI	Optional	Once
`CM0-4`	Title Of Study	ST	Required	Once
`CM0-5`	Chairman Of Study	XCN	Optional	Repeats
`CM0-6`	Last Irb Approval Date	DT	Optional	Once
`CM0-7`	Total Accrual To Date	NM	Optional	Once
`CM0-8`	Last Accrual Date	DT	Optional	Once
`CM0-9`	Contact For Study	XCN	Optional	Repeats
`CM0-10`	Contact's Telephone Number	XTN	Optional	Once
`CM0-11`	Contact's Address	XAD	Optional	Repeats

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 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	CWE	Required	Once
`CM1-3`	Description Of Study Phase	ST	Required	Once

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 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	CWE	Required	Once
`CM2-3`	Description Of Time Point	ST	Optional	Once
`CM2-4`	Events Scheduled This Time Point	CWE	Required	Once

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

CNSClear Notification6 fields

Field	Name	Type	Use	Repeats	Table
`CNS-1`	Starting Notification Reference Number	NM	Optional	Once
`CNS-2`	Ending Notification Reference Number	NM	Optional	Once
`CNS-3`	Starting Notification Date/Time	DTM	Optional	Once
`CNS-4`	Ending Notification Date/Time	DTM	Optional	Once
`CNS-5`	Starting Notification Code	CWE	Optional	Once	9999
`CNS-6`	Ending Notification Code	CWE	Optional	Once	9999

Defined in versions2.4 2.5 2.5.1 2.62.72.7.1 2.8

CONConsent Segment25 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
`CON-3`	Consent Form Id And Version	ST	Optional	Once
`CON-4`	Consent Form Number	EI	Optional	Once
`CON-5`	Consent Text	FT	Optional	Repeats
`CON-6`	Subject-specific Consent Text	FT	Optional	Repeats
`CON-7`	Consent Background Information	FT	Optional	Repeats
`CON-8`	Subject-specific Consent Background Text	FT	Optional	Repeats
`CON-9`	Consenter-imposed Limitations	FT	Optional	Repeats
`CON-10`	Consent Mode	CNE	Optional	Once	0497
`CON-11`	Consent Status	CNE	Required	Once	0498
`CON-12`	Consent Discussion Date/Time	DTM	Optional	Once
`CON-13`	Consent Decision Date/Time	DTM	Optional	Once
`CON-14`	Consent Effective Date/Time	DTM	Optional	Once
`CON-15`	Consent End Date/Time	DTM	Optional	Once
`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	CWE	Optional	Once	0296
`CON-19`	Informational Material Supplied Indicator	ID	Optional	Once	0136	1
`CON-20`	Consent Bypass Reason	CWE	Optional	Once	0499
`CON-21`	Consent Disclosure Level	ID	Optional	Once	0500	1
`CON-22`	Consent Non-disclosure Reason	CWE	Optional	Once	0501
`CON-23`	Non-subject Consenter Reason	CWE	Optional	Once	0502
`CON-24`	Consenter Id	XPN	Required	Repeats
`CON-25`	Relationship To Subject	CWE	Required	Repeats	0548

Defined in versions2.5 2.5.1 2.62.72.7.1 2.8

CSPClinical Study Phase4 fields

Field	Name	Type	Use	Repeats	Table
`CSP-1`	Study Phase Identifier	CWE	Required	Once
`CSP-2`	Date/Time Study Phase Began	DTM	Required	Once
`CSP-3`	Date/Time Study Phase Ended	DTM	Optional	Once
`CSP-4`	Study Phase Evaluability	CWE	Conditional	Once	9999

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

CSRClinical Study Registration16 fields

Field	Name	Type	Use	Repeats	Table
`CSR-1`	Sponsor Study Id	EI	Required	Once
`CSR-2`	Alternate Study Id	EI	Optional	Once
`CSR-3`	Institution Registering The Patient	CWE	Optional	Once	9999
`CSR-4`	Sponsor Patient Id	CX	Required	Once
`CSR-5`	Alternate Patient Id - Csr	CX	Optional	Once
`CSR-6`	Date/Time Of Patient Study Registration	DTM	Required	Once
`CSR-7`	Person Performing Study Registration	XCN	Optional	Repeats
`CSR-8`	Study Authorizing Provider	XCN	Required	Repeats
`CSR-9`	Date/Time Patient Study Consent Signed	DTM	Conditional	Once
`CSR-10`	Patient Study Eligibility Status	CWE	Conditional	Once	9999
`CSR-11`	Study Randomization Date/Time	DTM	Optional	Once
`CSR-12`	Randomized Study Arm	CWE	Optional	Once	9999
`CSR-13`	Stratum For Study Randomization	CWE	Optional	Once	9999
`CSR-14`	Patient Evaluability Status	CWE	Conditional	Once	9999
`CSR-15`	Date/Time Ended Study	DTM	Conditional	Once
`CSR-16`	Reason Ended Study	CWE	Conditional	Once	9999

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

CSSClinical Study Data Schedule Segment3 fields

Field	Name	Type	Use	Repeats	Table
`CSS-1`	Study Scheduled Time Point	CWE	Required	Once	9999
`CSS-2`	Study Scheduled Patient Time Point	DTM	Optional	Once
`CSS-3`	Study Quality Control Codes	CWE	Optional	Once	9999

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

CTDContact Data7 fields

Field	Name	Type	Use	Repeats	Table
`CTD-1`	Contact Role	CWE	Required	Repeats	0131
`CTD-2`	Contact Name	XPN	Optional	Repeats
`CTD-3`	Contact Address	XAD	Optional	Repeats
`CTD-4`	Contact Location	PL	Optional	Once
`CTD-5`	Contact Communication Information	XTN	Optional	Repeats
`CTD-6`	Preferred Method Of Contact	CWE	Optional	Once	0185
`CTD-7`	Contact Identifiers	PLN	Optional	Repeats

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

CTIClinical Trial Identification3 fields

Field	Name	Type	Use	Repeats	Table
`CTI-1`	Sponsor Study Id	EI	Required	Once
`CTI-2`	Study Phase Identifier	CWE	Conditional	Once
`CTI-3`	Study Scheduled Time Point	CWE	Optional	Once	9999

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 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	CWE	Optional	Once	0334
`DB1-3`	Disabled Person Identifier	CX	Optional	Repeats
`DB1-4`	Disability Indicator	ID	Optional	Once	0136	1
`DB1-5`	Disability Start Date	DT	Optional	Once
`DB1-6`	Disability End Date	DT	Optional	Once
`DB1-7`	Disability Return To Work Date	DT	Optional	Once
`DB1-8`	Disability Unable To Work Date	DT	Optional	Once

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

DG1DiagnosisCondition, Encounter, EpisodeOfCare26 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`DG1-1`	Set Id - Dg1	SI	Required	Once		4
`DG1-2`	Diagnosis Coding Method	ID	Withdrawn	Once
`DG1-3`	Diagnosis Code - Dg1	CWE	Required	Once	0051		Condition.code Encounter.diagnosis.condition+1 more
`DG1-4`	Diagnosis Description	ST	Withdrawn	Once			Condition.code.text Encounter.diagnosis.condition+1 more
`DG1-5`	Diagnosis Date/Time	DTM	Optional	Once			Condition.onsetDateTime Encounter.diagnosis.condition+1 more
`DG1-6`	Diagnosis Type	CWE	Required	Once	0052		Encounter.diagnosis.use EpisodeOfCare.diagnosis.role
`DG1-7`	Major Diagnostic Category	CNE	Withdrawn	Once	0118
`DG1-8`	Diagnostic Related Group	CNE	Withdrawn	Once	0055
`DG1-9`	Drg Approval Indicator	ID	Withdrawn	Once	0136	1
`DG1-10`	Drg Grouper Review Code	CWE	Withdrawn	Once	0056
`DG1-11`	Outlier Type	CWE	Withdrawn	Once	0083
`DG1-12`	Outlier Days	NM	Withdrawn	Once
`DG1-13`	Outlier Cost	CP	Withdrawn	Once
`DG1-14`	Grouper Version And Type	ST	Withdrawn	Once
`DG1-15`	Diagnosis Priority	NM	Optional	Once	0359		Encounter.diagnosis.rank EpisodeOfCare.diagnosis.rank
`DG1-16`	Diagnosing Clinician	XCN	Optional	Repeats			Condition.asserter Encounter.diagnosis.condition+1 more
`DG1-17`	Diagnosis Classification	CWE	Optional	Once	0228
`DG1-18`	Confidential Indicator	ID	Optional	Once	0136	1
`DG1-19`	Attestation Date/Time	DTM	Optional	Once			Condition.recordedDate Encounter.diagnosis.condition+2 more
`DG1-20`	Diagnosis Identifier	EI	Conditional	Once			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
`DG1-22`	Parent Diagnosis	EI	Conditional	Once			Encounter.diagnosis.condition Encounter.diagnosis.condition)+3 more
`DG1-23`	Drg Ccl Value Code	CWE	Optional	Once	0728
`DG1-24`	Drg Grouping Usage	ID	Optional	Once	0136	1
`DG1-25`	Drg Diagnosis Determination Status	CWE	Optional	Once	0731
`DG1-26`	Present On Admission (poa) Indicator	CWE	Optional	Once	0895

FHIR map of segment DG1Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

DMIDrg Master File Information5 fields

Field	Name	Type	Use	Repeats	Table
`DMI-1`	Diagnostic Related Group	CNE	Optional	Once	0055
`DMI-2`	Major Diagnostic Category	CNE	Conditional	Once	0118
`DMI-3`	Lower And Upper Trim Points	NR	Conditional	Once
`DMI-4`	Average Length Of Stay	NM	Conditional	Once
`DMI-5`	Relative Weight	NM	Conditional	Once

Defined in versions2.62.72.7.1 2.8

DRGDiagnosis Related Group33 fields

Field	Name	Type	Use	Repeats	Table	Length
`DRG-1`	Diagnostic Related Group	CNE	Optional	Once	0055
`DRG-2`	Drg Assigned Date/Time	DTM	Optional	Once
`DRG-3`	Drg Approval Indicator	ID	Optional	Once	0136	1
`DRG-4`	Drg Grouper Review Code	CWE	Optional	Once	0056
`DRG-5`	Outlier Type	CWE	Optional	Once	0083
`DRG-6`	Outlier Days	NM	Optional	Once
`DRG-7`	Outlier Cost	CP	Optional	Once
`DRG-8`	Drg Payor	CWE	Optional	Once	0229
`DRG-9`	Outlier Reimbursement	CP	Optional	Once
`DRG-10`	Confidential Indicator	ID	Optional	Once	0136	1
`DRG-11`	Drg Transfer Type	CWE	Optional	Once	0415
`DRG-12`	Name Of Coder	XPN	Optional	Once
`DRG-13`	Grouper Status	CWE	Optional	Once	0734
`DRG-14`	Pccl Value Code	CWE	Optional	Once	0728
`DRG-15`	Effective Weight	NM	Optional	Once
`DRG-16`	Monetary Amount	MO	Optional	Once
`DRG-17`	Status Patient	CWE	Optional	Once	0739
`DRG-18`	Grouper Software Name	ST	Optional	Once
`DRG-19`	Grouper Software Version	ST	Optional	Once
`DRG-20`	Status Financial Calculation	CWE	Optional	Once	0742
`DRG-21`	Relative Discount/Surcharge	MO	Optional	Once
`DRG-22`	Basic Charge	MO	Optional	Once
`DRG-23`	Total Charge	MO	Optional	Once
`DRG-24`	Discount/Surcharge	MO	Optional	Once
`DRG-25`	Calculated Days	NM	Optional	Once
`DRG-26`	Status Gender	CWE	Optional	Once	0749
`DRG-27`	Status Age	CWE	Optional	Once	0749
`DRG-28`	Status Length Of Stay	CWE	Optional	Once	0749
`DRG-29`	Status Same Day Flag	CWE	Optional	Once	0749
`DRG-30`	Status Separation Mode	CWE	Optional	Once	0749
`DRG-31`	Status Weight At Birth	CWE	Optional	Once	0755
`DRG-32`	Status Respiration Minutes	CWE	Optional	Once	0757
`DRG-33`	Status Admission	CWE	Optional	Once	0759

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

DSCContinuation Pointer2 fields

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

Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 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
`DSP-4`	Logical Break Point	ST	Optional	Once
`DSP-5`	Result Id	TX	Optional	Once

Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

ECDEquipment Command5 fields

Field	Name	Type	Use	Repeats	Table	Length
`ECD-1`	Reference Command Number	NM	Required	Once
`ECD-2`	Remote Control Command	CWE	Required	Once	0368
`ECD-3`	Response Required	ID	Optional	Once	0136	1
`ECD-4`	Requested Completion Time	ST	Withdrawn	Once
`ECD-5`	Parameters	TX	Optional	Repeats

Defined in versions2.4 2.5 2.5.1 2.62.72.7.1 2.8

ECREquipment Command Response3 fields

Field	Name	Type	Use	Repeats	Table
`ECR-1`	Command Response	CWE	Required	Once	0387
`ECR-2`	Date/Time Completed	DTM	Required	Once
`ECR-3`	Command Response Parameters	TX	Optional	Repeats

Defined in versions2.4 2.5 2.5.1 2.62.72.7.1 2.8

EDUEducational Detail9 fields

Field	Name	Type	Use	Repeats	Table	Length
`EDU-1`	Set Id - Edu	SI	Required	Once		4
`EDU-2`	Academic Degree	CWE	Optional	Once	0360
`EDU-3`	Academic Degree Program Date Range	DR	Optional	Once
`EDU-4`	Academic Degree Program Participation Date Range	DR	Optional	Once
`EDU-5`	Academic Degree Granted Date	DT	Optional	Once
`EDU-6`	School	XON	Optional	Once
`EDU-7`	School Type Code	CWE	Optional	Once	0402
`EDU-8`	School Address	XAD	Optional	Once
`EDU-9`	Major Field Of Study	CWE	Optional	Repeats

Defined in versions2.4 2.5 2.5.1 2.62.72.7.1 2.8

EQPEquipment/log Service5 fields

Field	Name	Type	Use	Repeats	Table
`EQP-1`	Event Type	CWE	Required	Once	0450
`EQP-2`	File Name	ST	Optional	Once
`EQP-3`	Start Date/Time	DTM	Required	Once
`EQP-4`	End Date/Time	DTM	Optional	Once
`EQP-5`	Transaction Data	FT	Required	Once

Defined in versions2.4 2.5 2.5.1 2.62.72.7.1 2.8

EQUEquipment Detail5 fields

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

Defined in versions2.4 2.5 2.5.1 2.62.72.7.1 2.8

ERRError12 fields

Field	Name	Type	Use	Repeats	Table	Length
`ERR-1`	Error Code And Location	ST	Withdrawn	Once
`ERR-2`	Error Location	ERL	Optional	Repeats
`ERR-3`	Hl7 Error Code	CWE	Required	Once	0357
`ERR-4`	Severity	ID	Required	Once	0516	1
`ERR-5`	Application Error Code	CWE	Optional	Once	0533
`ERR-6`	Application Error Parameter	ST	Optional	Once
`ERR-7`	Diagnostic Information	TX	Optional	Once
`ERR-8`	User Message	TX	Optional	Once
`ERR-9`	Inform Person Indicator	CWE	Optional	Repeats	0517
`ERR-10`	Override Type	CWE	Optional	Once	0518
`ERR-11`	Override Reason Code	CWE	Optional	Repeats	0519
`ERR-12`	Help Desk Contact Point	XTN	Optional	Repeats

Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

EVNEvent TypeProvenance7 fields

Field	Name	Type	Use	Repeats	Table	FHIR
`EVN-1`	Event Type Code	ST	Withdrawn	Once
`EVN-2`	Recorded Date/Time	DTM	Required	Once		Provenance.recorded
`EVN-3`	Date/Time Planned Event	DTM	Optional	Once
`EVN-4`	Event Reason Code	CWE	Optional	Once	0062	Provenance.reason Provenance.reason.extension
`EVN-5`	Operator Id	XCN	Optional	Repeats	0188	Provenance.agent.who
`EVN-6`	Event Occurred	DTM	Optional	Once		Provenance.occurredDateTime
`EVN-7`	Event Facility	HD	Optional	Once		Provenance.location

FHIR map of segment EVNDefined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

FACFacility12 fields

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

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

FHSFile Header14 fields

Field	Name	Type	Use	Repeats	Length
`FHS-1`	File Field Separator	ST	Required	Once	1
`FHS-2`	File Encoding Characters	ST	Required	Once	5
`FHS-3`	File Sending Application	HD	Optional	Once
`FHS-4`	File Sending Facility	HD	Optional	Once
`FHS-5`	File Receiving Application	HD	Optional	Once
`FHS-6`	File Receiving Facility	HD	Optional	Once
`FHS-7`	File Creation Date/Time	DTM	Optional	Once
`FHS-8`	File Security	ST	Optional	Once
`FHS-9`	File Name/Id	ST	Optional	Once
`FHS-10`	File Header Comment	ST	Optional	Once
`FHS-11`	File Control Id	ST	Optional	Once
`FHS-12`	Reference File Control Id	ST	Optional	Once
`FHS-13`	File Sending Network Address	HD	Optional	Once
`FHS-14`	File Receiving Network Address	HD	Optional	Once

Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

FT1Financial Transaction43 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
`FT1-5`	Transaction Posting Date	DTM	Optional	Once
`FT1-6`	Transaction Type	CWE	Required	Once	0017
`FT1-7`	Transaction Code	CWE	Required	Once	0132
`FT1-8`	Transaction Description	ST	Withdrawn	Once
`FT1-9`	Transaction Description - Alt	ST	Withdrawn	Once
`FT1-10`	Transaction Quantity	NM	Optional	Once
`FT1-11`	Transaction Amount - Extended	CP	Optional	Once
`FT1-12`	Transaction Amount - Unit	CP	Optional	Once
`FT1-13`	Department Code	CWE	Optional	Once	0049
`FT1-14`	Health Plan Id	CWE	Optional	Once	0072
`FT1-15`	Insurance Amount	CP	Optional	Once
`FT1-16`	Assigned Patient Location	PL	Optional	Once
`FT1-17`	Fee Schedule	CWE	Optional	Once	0024
`FT1-18`	Patient Type	CWE	Optional	Once	0018
`FT1-19`	Diagnosis Code - Ft1	CWE	Optional	Repeats	0051
`FT1-20`	Performed By Code	XCN	Optional	Repeats	0084
`FT1-21`	Ordered By Code	XCN	Optional	Repeats
`FT1-22`	Unit Cost	CP	Optional	Once
`FT1-23`	Filler Order Number	EI	Optional	Once
`FT1-24`	Entered By Code	XCN	Optional	Repeats
`FT1-25`	Procedure Code	CNE	Optional	Once	0088
`FT1-26`	Procedure Code Modifier	CNE	Optional	Repeats	0340
`FT1-27`	Advanced Beneficiary Notice Code	CWE	Optional	Once	0339
`FT1-28`	Medically Necessary Duplicate Procedure Reason	CWE	Optional	Once	0476
`FT1-29`	Ndc Code	CWE	Optional	Once	0549
`FT1-30`	Payment Reference Id	CX	Optional	Once
`FT1-31`	Transaction Reference Key	SI	Optional	Repeats		4
`FT1-32`	Performing Facility	XON	Optional	Repeats
`FT1-33`	Ordering Facility	XON	Optional	Once
`FT1-34`	Item Number	CWE	Optional	Once
`FT1-35`	Model Number	ST	Optional	Once
`FT1-36`	Special Processing Code	CWE	Optional	Repeats
`FT1-37`	Clinic Code	CWE	Optional	Once
`FT1-38`	Referral Number	CX	Optional	Once
`FT1-39`	Authorization Number	CX	Optional	Once
`FT1-40`	Service Provider Taxonomy Code	CWE	Optional	Once
`FT1-41`	Revenue Code	CWE	Optional	Once	0456
`FT1-42`	Prescription Number	ST	Optional	Once
`FT1-43`	Ndc Qty And Uom	CQ	Optional	Once

Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

FTSFile Trailer2 fields

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

Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

GOLGoal Detail22 fields

Field	Name	Type	Use	Repeats	Table	Length
`GOL-1`	Action Code	ID	Required	Once	0287	2
`GOL-2`	Action Date/Time	DTM	Required	Once
`GOL-3`	Goal Id	CWE	Required	Once
`GOL-4`	Goal Instance Id	EI	Required	Once
`GOL-5`	Episode Of Care Id	EI	Optional	Once
`GOL-6`	Goal List Priority	NM	Optional	Once
`GOL-7`	Goal Established Date/Time	DTM	Optional	Once
`GOL-8`	Expected Goal Achieve Date/Time	DTM	Optional	Once
`GOL-9`	Goal Classification	CWE	Optional	Once
`GOL-10`	Goal Management Discipline	CWE	Optional	Once
`GOL-11`	Current Goal Review Status	CWE	Optional	Once
`GOL-12`	Current Goal Review Date/Time	DTM	Optional	Once
`GOL-13`	Next Goal Review Date/Time	DTM	Optional	Once
`GOL-14`	Previous Goal Review Date/Time	DTM	Optional	Once
`GOL-15`	Goal Review Interval	ST	Withdrawn	Once
`GOL-16`	Goal Evaluation	CWE	Optional	Once
`GOL-17`	Goal Evaluation Comment	ST	Optional	Repeats
`GOL-18`	Goal Life Cycle Status	CWE	Optional	Once
`GOL-19`	Goal Life Cycle Status Date/Time	DTM	Optional	Once
`GOL-20`	Goal Target Type	CWE	Optional	Repeats
`GOL-21`	Goal Target Name	XPN	Optional	Repeats
`GOL-22`	Mood Code	CNE	Conditional	Once	0725

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

GP1Grouping/reimbursement - Visit5 fields

Field	Name	Type	Use	Repeats	Table
`GP1-1`	Type Of Bill Code	CWE	Required	Once	0455
`GP1-2`	Revenue Code	CWE	Optional	Repeats	0456
`GP1-3`	Overall Claim Disposition Code	CWE	Optional	Once	0457
`GP1-4`	Oce Edits Per Visit Code	CWE	Optional	Repeats	0458
`GP1-5`	Outlier Cost	CP	Optional	Once

Defined in versions2.4 2.5 2.5.1 2.62.72.7.1 2.8

GP2Grouping/reimbursement - Procedure Line Item14 fields

Field	Name	Type	Use	Repeats	Table
`GP2-1`	Revenue Code	CWE	Optional	Once	0456
`GP2-2`	Number Of Service Units	NM	Optional	Once
`GP2-3`	Charge	CP	Optional	Once
`GP2-4`	Reimbursement Action Code	CWE	Optional	Once	0459
`GP2-5`	Denial Or Rejection Code	CWE	Optional	Once	0460
`GP2-6`	Oce Edit Code	CWE	Optional	Repeats	0458
`GP2-7`	Ambulatory Payment Classification Code	CWE	Optional	Once	0466
`GP2-8`	Modifier Edit Code	CWE	Optional	Repeats	0467
`GP2-9`	Payment Adjustment Code	CWE	Optional	Once	0468
`GP2-10`	Packaging Status Code	CWE	Optional	Once	0469
`GP2-11`	Expected Cms Payment Amount	CP	Optional	Once
`GP2-12`	Reimbursement Type Code	CWE	Optional	Once	0470
`GP2-13`	Co-pay Amount	CP	Optional	Once
`GP2-14`	Pay Rate Per Service Unit	NM	Optional	Once

Defined in versions2.4 2.5 2.5.1 2.62.72.7.1 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
`GT1-3`	Guarantor Name	XPN	Required	Repeats
`GT1-4`	Guarantor Spouse Name	XPN	Optional	Repeats
`GT1-5`	Guarantor Address	XAD	Optional	Repeats
`GT1-6`	Guarantor Ph Num - Home	XTN	Optional	Repeats
`GT1-7`	Guarantor Ph Num - Business	XTN	Optional	Repeats
`GT1-8`	Guarantor Date/Time Of Birth	DTM	Optional	Once
`GT1-9`	Guarantor Administrative Sex	CWE	Optional	Once	0001
`GT1-10`	Guarantor Type	CWE	Optional	Once	0068
`GT1-11`	Guarantor Relationship	CWE	Optional	Once	0063
`GT1-12`	Guarantor Ssn	ST	Optional	Once
`GT1-13`	Guarantor Date - Begin	DT	Optional	Once
`GT1-14`	Guarantor Date - End	DT	Optional	Once
`GT1-15`	Guarantor Priority	NM	Optional	Once		2
`GT1-16`	Guarantor Employer Name	XPN	Optional	Repeats
`GT1-17`	Guarantor Employer Address	XAD	Optional	Repeats
`GT1-18`	Guarantor Employer Phone Number	XTN	Optional	Repeats
`GT1-19`	Guarantor Employee Id Number	CX	Optional	Repeats
`GT1-20`	Guarantor Employment Status	CWE	Optional	Once	0066
`GT1-21`	Guarantor Organization Name	XON	Optional	Repeats
`GT1-22`	Guarantor Billing Hold Flag	ID	Optional	Once	0136	1
`GT1-23`	Guarantor Credit Rating Code	CWE	Optional	Once	0341
`GT1-24`	Guarantor Death Date And Time	DTM	Optional	Once
`GT1-25`	Guarantor Death Flag	ID	Optional	Once	0136	1
`GT1-26`	Guarantor Charge Adjustment Code	CWE	Optional	Once	0218
`GT1-27`	Guarantor Household Annual Income	CP	Optional	Once
`GT1-28`	Guarantor Household Size	NM	Optional	Once
`GT1-29`	Guarantor Employer Id Number	CX	Optional	Repeats
`GT1-30`	Guarantor Marital Status Code	CWE	Optional	Once	0002
`GT1-31`	Guarantor Hire Effective Date	DT	Optional	Once
`GT1-32`	Employment Stop Date	DT	Optional	Once
`GT1-33`	Living Dependency	CWE	Optional	Once	0223
`GT1-34`	Ambulatory Status	CWE	Optional	Repeats	0009
`GT1-35`	Citizenship	CWE	Optional	Repeats	0171
`GT1-36`	Primary Language	CWE	Optional	Once	0296
`GT1-37`	Living Arrangement	CWE	Optional	Once	0220
`GT1-38`	Publicity Code	CWE	Optional	Once	0215
`GT1-39`	Protection Indicator	ID	Optional	Once	0136	1
`GT1-40`	Student Indicator	CWE	Optional	Once	0231
`GT1-41`	Religion	CWE	Optional	Once	0006
`GT1-42`	Mother's Maiden Name	XPN	Optional	Repeats
`GT1-43`	Nationality	CWE	Optional	Once	0212
`GT1-44`	Ethnic Group	CWE	Optional	Repeats	0189
`GT1-45`	Contact Person's Name	XPN	Optional	Repeats
`GT1-46`	Contact Person's Telephone Number	XTN	Optional	Repeats
`GT1-47`	Contact Reason	CWE	Optional	Once	0222
`GT1-48`	Contact Relationship	CWE	Optional	Once	0063
`GT1-49`	Job Title	ST	Optional	Once
`GT1-50`	Job Code/Class	JCC	Optional	Once
`GT1-51`	Guarantor Employer's Organization Name	XON	Optional	Repeats
`GT1-52`	Handicap	CWE	Optional	Once	0295
`GT1-53`	Job Status	CWE	Optional	Once	0311
`GT1-54`	Guarantor Financial Class	FC	Optional	Once
`GT1-55`	Guarantor Race	CWE	Optional	Repeats	0005
`GT1-56`	Guarantor Birth Place	ST	Optional	Once
`GT1-57`	Vip Indicator	CWE	Optional	Once	0099

Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

HxxAny Hl7 Segment1 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`Hxx-1`	Hxx.1	ST	Optional	Once

Defined in versions2.72.7.1 2.8

IAMPatient Adverse Reaction InformationAllergyIntolerance30 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`IAM-1`	Set Id - Iam	SI	Required	Once		4
`IAM-2`	Allergen Type Code	CWE	Optional	Once	0127		AllergyIntolerance.category AllergyIntolerance.type+1 more
`IAM-3`	Allergen Code/Mnemonic/Description	CWE	Required	Once			AllergyIntolerance.code
`IAM-4`	Allergy Severity Code	CWE	Optional	Once	0128		AllergyIntolerance.reaction.severity AllergyIntolerance.criticality+1 more
`IAM-5`	Allergy Reaction Code	ST	Optional	Repeats			AllergyIntolerance.reaction.manifestation.text
`IAM-6`	Allergy Action Code	CNE	Required	Once	0206
`IAM-7`	Allergy Unique Identifier	EI	Conditional	Once			AllergyIntolerance.identifier
`IAM-8`	Action Reason	ST	Optional	Once
`IAM-9`	Sensitivity To Causative Agent Code	CWE	Optional	Once	0436
`IAM-10`	Allergen Group Code/Mnemonic/Description	CWE	Optional	Once
`IAM-11`	Onset Date	DT	Optional	Once			AllergyIntolerance.onsetDateTime
`IAM-12`	Onset Date Text	ST	Optional	Once			AllergyIntolerance.onsetString
`IAM-13`	Reported Date/Time	DTM	Optional	Once			AllergyIntolerance.recordedDate
`IAM-14`	Reported By	XPN	Optional	Once			AllergyIntolerance.recorder.reference
`IAM-15`	Relationship To Patient Code	CWE	Optional	Once	0063		AllergyIntolerance.recorder.reference
`IAM-16`	Alert Device Code	CWE	Optional	Once	0437
`IAM-17`	Allergy Clinical Status Code	CWE	Optional	Once	0438		AllergyIntolerance.clinicalStatus
`IAM-18`	Statused By Person	XCN	Optional	Once
`IAM-19`	Statused By Organization	XON	Optional	Once
`IAM-20`	Statused At Date/Time	DTM	Optional	Once
`IAM-21`	Inactivated By Person	XCN	Optional	Once
`IAM-22`	Inactivated Date/Time	DTM	Optional	Once
`IAM-23`	Initially Recorded By Person	XCN	Optional	Once
`IAM-24`	Initially Recorded Date/Time	DTM	Optional	Once
`IAM-25`	Modified By Person	XCN	Optional	Once
`IAM-26`	Modified Date/Time	DTM	Optional	Once
`IAM-27`	Clinician Identified Code	CWE	Optional	Once			AllergyIntolerance.code
`IAM-28`	Initially Recorded By Organization	XON	Optional	Once
`IAM-29`	Modified By Organization	XON	Optional	Once
`IAM-30`	Inactivated By Organization	XON	Optional	Once

FHIR map of segment IAMDefined in versions2.4 2.5 2.5.1 2.62.72.7.1 2.8

IARAllergy Reaction4 fields

Field	Name	Type	Use	Repeats	Table
`IAR-1`	Allergy Reaction Code	CWE	Required	Once
`IAR-2`	Allergy Severity Code	CWE	Required	Once	0128
`IAR-3`	Sensitivity To Causative Agent Code	CWE	Optional	Once	0436
`IAR-4`	Management	ST	Optional	Once

Defined in versions2.72.7.1 2.8

IIMInventory Item Master15 fields

Field	Name	Type	Use	Repeats	Table
`IIM-1`	Primary Key Value - Iim	CWE	Required	Once
`IIM-2`	Service Item Code	CWE	Required	Once
`IIM-3`	Inventory Lot Number	ST	Optional	Once
`IIM-4`	Inventory Expiration Date	DTM	Optional	Once
`IIM-5`	Inventory Manufacturer Name	CWE	Optional	Once
`IIM-6`	Inventory Location	CWE	Optional	Once
`IIM-7`	Inventory Received Date	DTM	Optional	Once
`IIM-8`	Inventory Received Quantity	NM	Optional	Once
`IIM-9`	Inventory Received Quantity Unit	CWE	Optional	Once	0818
`IIM-10`	Inventory Received Item Cost	MO	Optional	Once
`IIM-11`	Inventory On Hand Date	DTM	Optional	Once
`IIM-12`	Inventory On Hand Quantity	NM	Optional	Once
`IIM-13`	Inventory On Hand Quantity Unit	CWE	Optional	Once	0818
`IIM-14`	Procedure Code	CNE	Optional	Once	0088
`IIM-15`	Procedure Code Modifier	CNE	Optional	Repeats	0340

Defined in versions2.5 2.5.1 2.62.72.7.1 2.8

ILTMaterial Lot10 fields

Field	Name	Type	Use	Repeats	Table	Length
`ILT-1`	Set Id - Ilt	SI	Required	Once		4
`ILT-2`	Inventory Lot Number	ST	Required	Once
`ILT-3`	Inventory Expiration Date	DTM	Optional	Once
`ILT-4`	Inventory Received Date	DTM	Optional	Once
`ILT-5`	Inventory Received Quantity	NM	Optional	Once
`ILT-6`	Inventory Received Quantity Unit	CWE	Optional	Once	0818
`ILT-7`	Inventory Received Item Cost	MO	Optional	Once
`ILT-8`	Inventory On Hand Date	DTM	Optional	Once
`ILT-9`	Inventory On Hand Quantity	NM	Optional	Once
`ILT-10`	Inventory On Hand Quantity Unit	CWE	Optional	Once	0818

Defined in versions2.62.72.7.1 2.8

IN1InsuranceCoverage54 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`IN1-1`	Set Id - In1	SI	Required	Once		4
`IN1-2`	Health Plan Id	CWE	Required	Once	0072		Coverage.identifier
`IN1-3`	Insurance Company Id	CX	Required	Repeats
`IN1-4`	Insurance Company Name	XON	Optional	Repeats			Coverage.payor
`IN1-5`	Insurance Company Address	XAD	Optional	Repeats			Coverage.payer
`IN1-6`	Insurance Co Contact Person	XPN	Optional	Repeats
`IN1-7`	Insurance Co Phone Number	XTN	Optional	Repeats
`IN1-8`	Group Number	ST	Optional	Once
`IN1-9`	Group Name	XON	Optional	Repeats
`IN1-10`	Insured's Group Emp Id	CX	Optional	Repeats			Coverage.policyHolder Coverage.extension
`IN1-11`	Insured's Group Emp Name	XON	Optional	Repeats			Coverage.policyHolder
`IN1-12`	Plan Effective Date	DT	Optional	Once			Coverage.period.start
`IN1-13`	Plan Expiration Date	DT	Optional	Once			Coverage.period.end
`IN1-14`	Authorization Information	AUI	Optional	Once
`IN1-15`	Plan Type	CWE	Optional	Once	0086		Coverage.type
`IN1-16`	Name Of Insured	XPN	Optional	Repeats			Coverage.subscriber
`IN1-17`	Insured's Relationship To Patient	CWE	Optional	Once	0063		Coverage.relationship
`IN1-18`	Insured's Date Of Birth	DTM	Optional	Once
`IN1-19`	Insured's Address	XAD	Optional	Repeats
`IN1-20`	Assignment Of Benefits	CWE	Optional	Once	0135
`IN1-21`	Coordination Of Benefits	CWE	Optional	Once	0173
`IN1-22`	Coord Of Ben. Priority	ST	Optional	Once
`IN1-23`	Notice Of Admission Flag	ID	Optional	Once	0136	1
`IN1-24`	Notice Of Admission Date	DT	Optional	Once
`IN1-25`	Report Of Eligibility Flag	ID	Optional	Once	0136	1
`IN1-26`	Report Of Eligibility Date	DT	Optional	Once
`IN1-27`	Release Information Code	CWE	Optional	Once	0093
`IN1-28`	Pre-admit Cert (pac)	ST	Optional	Once
`IN1-29`	Verification Date/Time	DTM	Optional	Once
`IN1-30`	Verification By	XCN	Optional	Repeats
`IN1-31`	Type Of Agreement Code	CWE	Optional	Once	0098
`IN1-32`	Billing Status	CWE	Optional	Once	0022
`IN1-33`	Lifetime Reserve Days	NM	Optional	Once
`IN1-34`	Delay Before L.r. Day	NM	Optional	Once
`IN1-35`	Company Plan Code	CWE	Optional	Once	0042
`IN1-36`	Policy Number	ST	Optional	Once
`IN1-37`	Policy Deductible	CP	Optional	Once
`IN1-38`	Policy Limit - Amount	ST	Withdrawn	Once
`IN1-39`	Policy Limit - Days	NM	Optional	Once
`IN1-40`	Room Rate - Semi-private	ST	Withdrawn	Once
`IN1-41`	Room Rate - Private	ST	Withdrawn	Once
`IN1-42`	Insured's Employment Status	CWE	Optional	Once	0066
`IN1-43`	Insured's Administrative Sex	CWE	Optional	Once	0001
`IN1-44`	Insured's Employer's Address	XAD	Optional	Repeats
`IN1-45`	Verification Status	ST	Optional	Once
`IN1-46`	Prior Insurance Plan Id	CWE	Optional	Once	0072
`IN1-47`	Coverage Type	CWE	Optional	Once	0309
`IN1-48`	Handicap	CWE	Optional	Once	0295
`IN1-49`	Insured's Id Number	CX	Optional	Repeats			Coverage.extension
`IN1-50`	Signature Code	CWE	Optional	Once	0535
`IN1-51`	Signature Code Date	DT	Optional	Once
`IN1-52`	Insured's Birth Place	ST	Optional	Once
`IN1-53`	Vip Indicator	CWE	Optional	Once	0099
`IN1-54`	External Health Plan Identifiers	CX	Optional	Repeats

FHIR map of segment IN1Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

IN2Insurance Additional Information72 fields

Field	Name	Type	Use	Repeats	Table	Length
`IN2-1`	Insured's Employee Id	CX	Optional	Repeats
`IN2-2`	Insured's Social Security Number	ST	Optional	Once
`IN2-3`	Insured's Employer's Name And Id	XCN	Optional	Repeats
`IN2-4`	Employer Information Data	CWE	Optional	Once	0139
`IN2-5`	Mail Claim Party	CWE	Optional	Repeats	0137
`IN2-6`	Medicare Health Ins Card Number	ST	Optional	Once
`IN2-7`	Medicaid Case Name	XPN	Optional	Repeats
`IN2-8`	Medicaid Case Number	ST	Optional	Once
`IN2-9`	Military Sponsor Name	XPN	Optional	Repeats
`IN2-10`	Military Id Number	ST	Optional	Once
`IN2-11`	Dependent Of Military Recipient	CWE	Optional	Once	0342
`IN2-12`	Military Organization	ST	Optional	Once
`IN2-13`	Military Station	ST	Optional	Once
`IN2-14`	Military Service	CWE	Optional	Once	0140
`IN2-15`	Military Rank/Grade	CWE	Optional	Once	0141
`IN2-16`	Military Status	CWE	Optional	Once	0142
`IN2-17`	Military Retire Date	DT	Optional	Once
`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
`IN2-22`	Special Coverage Approval Name	XPN	Optional	Repeats
`IN2-23`	Special Coverage Approval Title	ST	Optional	Once
`IN2-24`	Non-covered Insurance Code	CWE	Optional	Repeats	0143
`IN2-25`	Payor Id	CX	Optional	Repeats
`IN2-26`	Payor Subscriber Id	CX	Optional	Repeats
`IN2-27`	Eligibility Source	CWE	Optional	Once	0144
`IN2-28`	Room Coverage Type/Amount	RMC	Optional	Repeats
`IN2-29`	Policy Type/Amount	PTA	Optional	Repeats
`IN2-30`	Daily Deductible	DDI	Optional	Once
`IN2-31`	Living Dependency	CWE	Optional	Once	0223
`IN2-32`	Ambulatory Status	CWE	Optional	Repeats	0009
`IN2-33`	Citizenship	CWE	Optional	Repeats	0171
`IN2-34`	Primary Language	CWE	Optional	Once	0296
`IN2-35`	Living Arrangement	CWE	Optional	Once	0220
`IN2-36`	Publicity Code	CWE	Optional	Once	0215
`IN2-37`	Protection Indicator	ID	Optional	Once	0136	1
`IN2-38`	Student Indicator	CWE	Optional	Once	0231
`IN2-39`	Religion	CWE	Optional	Once	0006
`IN2-40`	Mother's Maiden Name	XPN	Optional	Repeats
`IN2-41`	Nationality	CWE	Optional	Once	0212
`IN2-42`	Ethnic Group	CWE	Optional	Repeats	0189
`IN2-43`	Marital Status	CWE	Optional	Repeats	0002
`IN2-44`	Insured's Employment Start Date	DT	Optional	Once
`IN2-45`	Employment Stop Date	DT	Optional	Once
`IN2-46`	Job Title	ST	Optional	Once
`IN2-47`	Job Code/Class	JCC	Optional	Once
`IN2-48`	Job Status	CWE	Optional	Once	0311
`IN2-49`	Employer Contact Person Name	XPN	Optional	Repeats
`IN2-50`	Employer Contact Person Phone Number	XTN	Optional	Repeats
`IN2-51`	Employer Contact Reason	CWE	Optional	Once	0222
`IN2-52`	Insured's Contact Person's Name	XPN	Optional	Repeats
`IN2-53`	Insured's Contact Person Phone Number	XTN	Optional	Repeats
`IN2-54`	Insured's Contact Person Reason	CWE	Optional	Repeats	0222
`IN2-55`	Relationship To The Patient Start Date	DT	Optional	Once
`IN2-56`	Relationship To The Patient Stop Date	DT	Optional	Repeats
`IN2-57`	Insurance Co Contact Reason	CWE	Optional	Once	0232
`IN2-58`	Insurance Co Contact Phone Number	XTN	Optional	Repeats
`IN2-59`	Policy Scope	CWE	Optional	Once	0312
`IN2-60`	Policy Source	CWE	Optional	Once	0313
`IN2-61`	Patient Member Number	CX	Optional	Once
`IN2-62`	Guarantor's Relationship To Insured	CWE	Optional	Once	0063
`IN2-63`	Insured's Phone Number - Home	XTN	Optional	Repeats
`IN2-64`	Insured's Employer Phone Number	XTN	Optional	Repeats
`IN2-65`	Military Handicapped Program	CWE	Optional	Once	0343
`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
`IN2-70`	Insured Employer Organization Name And Id	XON	Optional	Repeats
`IN2-71`	Race	CWE	Optional	Repeats	0005
`IN2-72`	Patient's Relationship To Insured	CWE	Optional	Once	0344

Defined in versions2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 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
`IN3-3`	Certified By	XCN	Optional	Repeats
`IN3-4`	Certification Required	ID	Optional	Once	0136	1
`IN3-5`	Penalty	MOP	Optional	Once
`IN3-6`	Certification Date/Time	DTM	Optional	Once
`IN3-7`	Certification Modify Date/Time	DTM	Optional	Once
`IN3-8`	Operator	XCN	Optional	Repeats
`IN3-9`	Certification Begin Date	DT	Optional	Once
`IN3-10`	Certification End Date	DT	Optional	Once
`IN3-11`	Days	DTN	Optional	Once
`IN3-12`	Non-concur Code/Description	CWE	Optional	Once	0233
`IN3-13`	Non-concur Effective Date/Time	DTM	Optional	Once
`IN3-14`	Physician Reviewer	XCN	Optional	Repeats	0010
`IN3-15`	Certification Contact	ST	Optional	Once
`IN3-16`	Certification Contact Phone Number	XTN	Optional	Repeats
`IN3-17`	Appeal Reason	CWE	Optional	Once	0345
`IN3-18`	Certification Agency	CWE	Optional	Once	0346
`IN3-19`	Certification Agency Phone Number	XTN	Optional	Repeats
`IN3-20`	Pre-certification Requirement	ICD	Optional	Repeats
`IN3-21`	Case Manager	ST	Optional	Once			CareTeam.participant.role.coding.value CareTeam.participant.role.coding.system+1 more
`IN3-22`	Second Opinion Date	DT	Optional	Once
`IN3-23`	Second Opinion Status	CWE	Optional	Once	0151
`IN3-24`	Second Opinion Documentation Received	CWE	Optional	Repeats	0152
`IN3-25`	Second Opinion Physician	XCN	Optional	Repeats	0010

FHIR map of segment IN3Defined in versions2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

INVInventory Detail20 fields

Field	Name	Type	Use	Repeats	Table
`INV-1`	Substance Identifier	CWE	Required	Once	0451
`INV-2`	Substance Status	CWE	Required	Repeats	0383
`INV-3`	Substance Type	CWE	Optional	Once	0384
`INV-4`	Inventory Container Identifier	CWE	Optional	Once	9999
`INV-5`	Container Carrier Identifier	CWE	Optional	Once	9999
`INV-6`	Position On Carrier	CWE	Optional	Once	9999
`INV-7`	Initial Quantity	NM	Optional	Once
`INV-8`	Current Quantity	NM	Optional	Once
`INV-9`	Available Quantity	NM	Optional	Once
`INV-10`	Consumption Quantity	NM	Optional	Once
`INV-11`	Quantity Units	CWE	Optional	Once	9999
`INV-12`	Expiration Date/Time	DTM	Optional	Once
`INV-13`	First Used Date/Time	DTM	Optional	Once
`INV-14`	On Board Stability Duration	ST	Withdrawn	Once
`INV-15`	Test/Fluid Identifier(s)	CWE	Optional	Repeats	9999
`INV-16`	Manufacturer Lot Number	ST	Optional	Once
`INV-17`	Manufacturer Identifier	CWE	Optional	Once	0385
`INV-18`	Supplier Identifier	CWE	Optional	Once	0386
`INV-19`	On Board Stability Time	CQ	Optional	Once
`INV-20`	Target Value	CQ	Optional	Once

Defined in versions2.4 2.5 2.5.1 2.62.72.7.1 2.8

IPCImaging Procedure Control Segment9 fields

Field	Name	Type	Use	Repeats	Table
`IPC-1`	Accession Identifier	EI	Required	Once
`IPC-2`	Requested Procedure Id	EI	Required	Once
`IPC-3`	Study Instance Uid	EI	Required	Once
`IPC-4`	Scheduled Procedure Step Id	EI	Required	Once
`IPC-5`	Modality	CWE	Optional	Once	9999
`IPC-6`	Protocol Code	CWE	Optional	Repeats	9999
`IPC-7`	Scheduled Station Name	EI	Optional	Once
`IPC-8`	Scheduled Procedure Step Location	CWE	Optional	Repeats	9999
`IPC-9`	Scheduled Station Ae Title	ST	Optional	Once

Defined in versions2.5 2.5.1 2.62.72.7.1 2.8

IPRInvoice Processing Results8 fields

Field	Name	Type	Use	Repeats	Table
`IPR-1`	Ipr Identifier	EI	Required	Once
`IPR-2`	Provider Cross Reference Identifier	EI	Required	Once
`IPR-3`	Payer Cross Reference Identifier	EI	Required	Once
`IPR-4`	Ipr Status	CWE	Required	Once	0571
`IPR-5`	Ipr Date/Time	DTM	Required	Once
`IPR-6`	Adjudicated/Paid Amount	CP	Optional	Once
`IPR-7`	Expected Payment Date/Time	DTM	Optional	Once
`IPR-8`	Ipr Checksum	ST	Required	Once

Defined in versions2.62.72.7.1 2.8

ISDInteraction Status Detail3 fields

Field	Name	Type	Use	Repeats	Table
`ISD-1`	Reference Interaction Number	NM	Required	Once
`ISD-2`	Interaction Type Identifier	CWE	Optional	Once	0368
`ISD-3`	Interaction Active State	CWE	Required	Once	0387

Defined in versions2.4 2.5 2.5.1 2.62.72.7.1 2.8

ITMMaterial Item29 fields

Field	Name	Type	Use	Repeats	Table
`ITM-1`	Item Identifier	EI	Required	Once
`ITM-2`	Item Description	ST	Optional	Once
`ITM-3`	Item Status	CWE	Optional	Once	0776
`ITM-4`	Item Type	CWE	Optional	Once	0778
`ITM-5`	Item Category	CWE	Optional	Once
`ITM-6`	Subject To Expiration Indicator	CNE	Optional	Once	0532
`ITM-7`	Manufacturer Identifier	EI	Optional	Once
`ITM-8`	Manufacturer Name	ST	Optional	Once
`ITM-9`	Manufacturer Catalog Number	ST	Optional	Once
`ITM-10`	Manufacturer Labeler Identification Code	CWE	Optional	Once
`ITM-11`	Patient Chargeable Indicator	CNE	Optional	Once	0532
`ITM-12`	Transaction Code	CWE	Optional	Once	0132
`ITM-13`	Transaction Amount - Unit	CP	Optional	Once
`ITM-14`	Stocked Item Indicator	CNE	Optional	Once	0532
`ITM-15`	Supply Risk Codes	CWE	Optional	Once	0871
`ITM-16`	Approving Regulatory Agency	XON	Optional	Repeats	0790
`ITM-17`	Latex Indicator	CNE	Optional	Once	0532
`ITM-18`	Ruling Act	CWE	Optional	Repeats	0793
`ITM-19`	Item Natural Account Code	CWE	Optional	Once	0320
`ITM-20`	Approved To Buy Quantity	NM	Optional	Once
`ITM-21`	Approved To Buy Price	MO	Optional	Once
`ITM-22`	Taxable Item Indicator	CNE	Optional	Once	0532
`ITM-23`	Freight Charge Indicator	CNE	Optional	Once	0532
`ITM-24`	Item Set Indicator	CNE	Optional	Once	0532
`ITM-25`	Item Set Identifier	EI	Optional	Once
`ITM-26`	Track Department Usage Indicator	CNE	Optional	Once	0532
`ITM-27`	Procedure Code	CNE	Optional	Once	0088
`ITM-28`	Procedure Code Modifier	CNE	Optional	Repeats	0340
`ITM-29`	Special Handling Code	CWE	Optional	Once	0376

Defined in versions2.62.72.7.1 2.8

IVCInvoice Segment30 fields

Field	Name	Type	Use	Repeats	Table	Length
`IVC-1`	Provider Invoice Number	EI	Required	Once
`IVC-2`	Payer Invoice Number	EI	Optional	Once
`IVC-3`	Contract/Agreement Number	EI	Optional	Once
`IVC-4`	Invoice Control	CWE	Required	Once	0553
`IVC-5`	Invoice Reason	CWE	Required	Once	0554
`IVC-6`	Invoice Type	CWE	Required	Once	0555
`IVC-7`	Invoice Date/Time	DTM	Required	Once
`IVC-8`	Invoice Amount	CP	Required	Once
`IVC-9`	Payment Terms	ST	Optional	Once
`IVC-10`	Provider Organization	XON	Required	Once
`IVC-11`	Payer Organization	XON	Required	Once
`IVC-12`	Attention	XCN	Optional	Once
`IVC-13`	Last Invoice Indicator	ID	Optional	Once	0136	1
`IVC-14`	Invoice Booking Period	DTM	Optional	Once
`IVC-15`	Origin	ST	Optional	Once
`IVC-16`	Invoice Fixed Amount	CP	Optional	Once
`IVC-17`	Special Costs	CP	Optional	Once
`IVC-18`	Amount For Doctors Treatment	CP	Optional	Once
`IVC-19`	Responsible Physician	XCN	Optional	Once
`IVC-20`	Cost Center	CX	Optional	Once
`IVC-21`	Invoice Prepaid Amount	CP	Optional	Once
`IVC-22`	Total Invoice Amount Without Prepaid Amount	CP	Optional	Once
`IVC-23`	Total-amount Of Vat	CP	Conditional	Once
`IVC-24`	Vat-rates Applied	NM	Optional	Repeats		5
`IVC-25`	Benefit Group	CWE	Required	Once	0556
`IVC-26`	Provider Tax Id	ST	Optional	Once
`IVC-27`	Payer Tax Id	ST	Optional	Once
`IVC-28`	Provider Tax Status	CWE	Optional	Once	0572
`IVC-29`	Payer Tax Status	CWE	Optional	Once	0572
`IVC-30`	Sales Tax Id	ST	Optional	Once

Defined in versions2.62.72.7.1 2.8

IVTMaterial Location26 fields

Field	Name	Type	Use	Repeats	Table	Length
`IVT-1`	Set Id - Ivt	SI	Required	Once		4
`IVT-2`	Inventory Location Identifier	EI	Required	Once
`IVT-3`	Inventory Location Name	ST	Optional	Once
`IVT-4`	Source Location Identifier	EI	Optional	Once
`IVT-5`	Source Location Name	ST	Optional	Once
`IVT-6`	Item Status	CWE	Optional	Once	0625
`IVT-7`	Bin Location Identifier	EI	Optional	Repeats
`IVT-8`	Order Packaging	CWE	Optional	Once	0818
`IVT-9`	Issue Packaging	CWE	Optional	Once
`IVT-10`	Default Inventory Asset Account	EI	Optional	Once
`IVT-11`	Patient Chargeable Indicator	CNE	Optional	Once	0532
`IVT-12`	Transaction Code	CWE	Optional	Once	0132
`IVT-13`	Transaction Amount - Unit	CP	Optional	Once
`IVT-14`	Item Importance Code	CWE	Optional	Once	0634
`IVT-15`	Stocked Item Indicator	CNE	Optional	Once	0532
`IVT-16`	Consignment Item Indicator	CNE	Optional	Once	0532
`IVT-17`	Reusable Item Indicator	CNE	Optional	Once	0532
`IVT-18`	Reusable Cost	CP	Optional	Once
`IVT-19`	Substitute Item Identifier	EI	Optional	Repeats
`IVT-20`	Latex-free Substitute Item Identifier	EI	Optional	Once
`IVT-21`	Recommended Reorder Theory	CWE	Optional	Once	0642
`IVT-22`	Recommended Safety Stock Days	NM	Optional	Once
`IVT-23`	Recommended Maximum Days Inventory	NM	Optional	Once
`IVT-24`	Recommended Order Point	NM	Optional	Once
`IVT-25`	Recommended Order Amount	NM	Optional	Once
`IVT-26`	Operating Room Par Level Indicator	CNE	Optional	Once	0532

Defined in versions2.62.72.7.1 2.8

LANLanguage Detail4 fields

Field	Name	Type	Use	Repeats	Table	Length
`LAN-1`	Set Id - Lan	SI	Required	Once		4
`LAN-2`	Language Code	CWE	Required	Once	0296
`LAN-3`	Language Ability Code	CWE	Optional	Repeats	0403
`LAN-4`	Language Proficiency Code	CWE	Optional	Once	0404

Defined in versions2.4 2.5 2.5.1 2.62.72.7.1 2.8

LCCLocation Charge Code4 fields

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

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

LCHLocation Characteristic5 fields

Field	Name	Type	Use	Repeats	Table	Length
`LCH-1`	Primary Key Value - Lch	PL	Required	Once
`LCH-2`	Segment Action Code	ID	Optional	Once	0206	1
`LCH-3`	Segment Unique Key	EI	Optional	Once
`LCH-4`	Location Characteristic Id	CWE	Required	Once	0324
`LCH-5`	Location Characteristic Value - Lch	CWE	Required	Once	0136

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

LDPLocation Department12 fields

Field	Name	Type	Use	Repeats	Table	Length
`LDP-1`	Primary Key Value - Ldp	PL	Required	Once
`LDP-2`	Location Department	CWE	Required	Once	0264
`LDP-3`	Location Service	CWE	Optional	Repeats	0069
`LDP-4`	Specialty Type	CWE	Optional	Repeats	0265
`LDP-5`	Valid Patient Classes	CWE	Optional	Repeats	0004
`LDP-6`	Active/Inactive Flag	ID	Optional	Once	0183	1
`LDP-7`	Activation Date - Ldp	DTM	Optional	Once
`LDP-8`	Inactivation Date - Ldp	DTM	Optional	Once
`LDP-9`	Inactivated Reason	ST	Optional	Once
`LDP-10`	Visiting Hours	VH	Optional	Repeats
`LDP-11`	Contact Phone	XTN	Optional	Once
`LDP-12`	Location Cost Center	CWE	Optional	Once	0462

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

LOCLocation Identification9 fields

Field	Name	Type	Use	Repeats	Table
`LOC-1`	Primary Key Value - Loc	PL	Required	Once
`LOC-2`	Location Description	ST	Optional	Once
`LOC-3`	Location Type - Loc	CWE	Required	Repeats	0260
`LOC-4`	Organization Name - Loc	XON	Optional	Repeats
`LOC-5`	Location Address	XAD	Optional	Repeats
`LOC-6`	Location Phone	XTN	Optional	Repeats
`LOC-7`	License Number	CWE	Optional	Repeats	0461
`LOC-8`	Location Equipment	CWE	Optional	Repeats	0261
`LOC-9`	Location Service Code	CWE	Optional	Once	0442

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

LRLLocation Relationship6 fields

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

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 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
`MFA-3`	Event Completion Date/Time	DTM	Optional	Once
`MFA-4`	Mfn Record Level Error Return	CWE	Required	Once	0181
`MFA-5`	Primary Key Value - Mfa	varies	Required	Repeats
`MFA-6`	Primary Key Value Type - Mfa	ID	Required	Repeats	0355	3

Defined in versions2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

MFEMaster File Entry7 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
`MFE-3`	Effective Date/Time	DTM	Optional	Once
`MFE-4`	Primary Key Value - Mfe	varies	Required	Repeats
`MFE-5`	Primary Key Value Type	ID	Required	Repeats	0355	3
`MFE-6`	Entered Date/Time	DTM	Optional	Once
`MFE-7`	Entered By	XCN	Optional	Once

Defined in versions2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

MFIMaster File Identification6 fields

Field	Name	Type	Use	Repeats	Table	Length
`MFI-1`	Master File Identifier	CWE	Required	Once	0175
`MFI-2`	Master File Application Identifier	HD	Optional	Repeats	0361
`MFI-3`	File-level Event Code	ID	Required	Once	0178	3
`MFI-4`	Entered Date/Time	DTM	Optional	Once
`MFI-5`	Effective Date/Time	DTM	Optional	Once
`MFI-6`	Response Level Code	ID	Required	Once	0179	2

Defined in versions2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

MRGMerge Patient InformationAccount7 fields

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

FHIR map of segment MRGDefined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

MSAMessage AcknowledgmentMessageHeader8 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		199	MessageHeader.response.identifier
`MSA-3`	Text Message	ST	Withdrawn	Once
`MSA-4`	Expected Sequence Number	NM	Optional	Once
`MSA-5`	Delayed Acknowledgment Type	ST	Withdrawn	Once
`MSA-6`	Error Condition	ST	Withdrawn	Once
`MSA-7`	Message Waiting Number	NM	Optional	Once
`MSA-8`	Message Waiting Priority	ID	Optional	Once	0520	1

FHIR map of segment MSADefined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

MSHMessage HeaderProvenance, Bundle, Encounter +125 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`MSH-1`	Field Separator	ST	Required	Once		1
`MSH-2`	Encoding Characters	ST	Required	Once		5
`MSH-3`	Sending Application	HD	Optional	Once	0361		Provenance.entity.what Provenance.entity.role+2 more
`MSH-4`	Sending Facility	HD	Optional	Once	0362		Provenance.agent.who Provenance.agent.type.coding.code+2 more
`MSH-5`	Receiving Application	HD	Optional	Once	0361		MessageHeader.destination.target MessageHeader.destination.name+1 more
`MSH-6`	Receiving Facility	HD	Optional	Once	0362		MessageHeader.destination.receiver
`MSH-7`	Date/Time Of Message	DTM	Required	Once			Provenance.recorded Provenance.occurred+1 more
`MSH-8`	Security	ST	Optional	Once			MessageHeader.meta.security
`MSH-9`	Message Type	MSG	Required	Once			Provenance.activity.coding.display Encounter.status+1 more
`MSH-10`	Message Control Id	ST	Required	Once		199	Bundle.identifier.value Bundle.identifier.system
`MSH-11`	Processing Id	PT	Required	Once			MessageHeader.meta
`MSH-12`	Version Id	VID	Required	Once
`MSH-13`	Sequence Number	NM	Optional	Once
`MSH-14`	Continuation Pointer	ST	Optional	Once
`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	15
`MSH-19`	Principal Language Of Message	CWE	Optional	Once			MessageHeader.language
`MSH-20`	Alternate Character Set Handling Scheme	ID	Optional	Once	0356	13
`MSH-21`	Message Profile Identifier	EI	Optional	Repeats
`MSH-22`	Sending Responsible Organization	XON	Optional	Once			Provenance.agent.who Provenance.agent.type.coding.code+2 more
`MSH-23`	Receiving Responsible Organization	XON	Optional	Once			MessageHeader.destination.receiver
`MSH-24`	Sending Network Address	HD	Optional	Once			MessageHeader.source MessageHeader.source.endpoint.extension
`MSH-25`	Receiving Network Address	HD	Optional	Once			MessageHeader.destination MessageHeader.destination.endpoint.extension

FHIR map of segment MSHDefined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

NCKSystem Clock1 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`NCK-1`	System Date/Time	DTM	Required	Once		24

Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

NDSNotification Detail4 fields

Field	Name	Type	Use	Repeats	Table
`NDS-1`	Notification Reference Number	NM	Required	Once
`NDS-2`	Notification Date/Time	DTM	Required	Once
`NDS-3`	Notification Alert Severity	CWE	Required	Once	0367
`NDS-4`	Notification Code	CWE	Required	Once	9999

Defined in versions2.4 2.5 2.5.1 2.62.72.7.1 2.8

NK1Next Of Kin / Associated PartiesPatient, RelatedPerson41 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`NK1-1`	Set Id - Nk1	SI	Required	Once		4
`NK1-2`	Name	XPN	Optional	Repeats			Patient.contact.name RelatedPerson.name
`NK1-3`	Relationship	CWE	Optional	Once	0063		Patient.contact.relationship RelatedPerson.relationship
`NK1-4`	Address	XAD	Optional	Repeats			Patient.contact.address RelatedPerson.address
`NK1-5`	Phone Number	XTN	Backward	Repeats			Patient.contact.telecom RelatedPerson.telecom
`NK1-6`	Business Phone Number	XTN	Backward	Repeats			Patient.contact.telecom Patient.contact.telecom.use+2 more
`NK1-7`	Contact Role	CWE	Optional	Once	0131		Patient.contact.relationship RelatedPerson.relationship
`NK1-8`	Start Date	DT	Optional	Once			Patient.contact.period.start RelatedPerson.period.start
`NK1-9`	End Date	DT	Optional	Once			Patient.contact.period.end RelatedPerson.period.end
`NK1-10`	Next Of Kin / Associated Parties Job Title	ST	Optional	Once
`NK1-11`	Next Of Kin / Associated Parties Job Code/Class	JCC	Optional	Once
`NK1-12`	Next Of Kin / Associated Parties Employee Number	CX	Optional	Once			RelatedPerson.identifier
`NK1-13`	Organization Name - Nk1	XON	Optional	Repeats			Patient.contact.organization
`NK1-14`	Marital Status	CWE	Optional	Once	0002
`NK1-15`	Administrative Sex	CWE	Optional	Once	0001		Patient.contact.gender RelatedPerson.gender
`NK1-16`	Date/Time Of Birth	DTM	Optional	Once			RelatedPerson.birthDate
`NK1-17`	Living Dependency	CWE	Optional	Repeats	0223
`NK1-18`	Ambulatory Status	CWE	Optional	Repeats	0009
`NK1-19`	Citizenship	CWE	Optional	Repeats	0171
`NK1-20`	Primary Language	CWE	Optional	Once	0296		RelatedPerson.communication.language
`NK1-21`	Living Arrangement	CWE	Optional	Once	0220
`NK1-22`	Publicity Code	CWE	Optional	Once	0215
`NK1-23`	Protection Indicator	ID	Optional	Once	0136	1
`NK1-24`	Student Indicator	CWE	Optional	Once	0231
`NK1-25`	Religion	CWE	Optional	Once	0006
`NK1-26`	Mother's Maiden Name	XPN	Optional	Repeats
`NK1-27`	Nationality	CWE	Optional	Once	0212
`NK1-28`	Ethnic Group	CWE	Optional	Repeats	0189
`NK1-29`	Contact Reason	CWE	Optional	Repeats	0222
`NK1-30`	Contact Person's Name	XPN	Optional	Repeats			Patient.contact.organization RelatedPerson.name
`NK1-31`	Contact Person's Telephone Number	XTN	Backward	Repeats			Patient.contact.organization RelatedPerson.telecom
`NK1-32`	Contact Person's Address	XAD	Optional	Repeats			Patient.contact.organization RelatedPerson.address
`NK1-33`	Next Of Kin/Associated Party's Identifiers	CX	Optional	Repeats			RelatedPerson.identifier
`NK1-34`	Job Status	CWE	Optional	Once	0311
`NK1-35`	Race	CWE	Optional	Repeats	0005
`NK1-36`	Handicap	CWE	Optional	Once	0295
`NK1-37`	Contact Person Social Security Number	ST	Optional	Once			RelatedPerson.identifier.value RelatedPerson.identifier.system+1 more
`NK1-38`	Next Of Kin Birth Place	ST	Optional	Once
`NK1-39`	Vip Indicator	CWE	Optional	Once	0099
`NK1-40`	Next Of Kin Telecommunication Information	XTN	Optional	Once			Patient.contact.telecom RelatedPerson.telecom
`NK1-41`	Contact Person's Telecommunication Information	XTN	Optional	Once			Patient.contact.telecom RelatedPerson.telecom

FHIR map of segment NK1Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

NPUBed Status Update2 fields

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

Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

NSCApplication Status Change9 fields

Field	Name	Type	Use	Repeats	Table
`NSC-1`	Application Change Type	CWE	Required	Once	0409
`NSC-2`	Current Cpu	ST	Optional	Once
`NSC-3`	Current Fileserver	ST	Optional	Once
`NSC-4`	Current Application	HD	Optional	Once	0361
`NSC-5`	Current Facility	HD	Optional	Once	0362
`NSC-6`	New Cpu	ST	Optional	Once
`NSC-7`	New Fileserver	ST	Optional	Once
`NSC-8`	New Application	HD	Optional	Once	0361
`NSC-9`	New Facility	HD	Optional	Once	0362

Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 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
`NST-3`	Source Type	ID	Optional	Once	0332
`NST-4`	Statistics Start	DTM	Optional	Once
`NST-5`	Statistics End	DTM	Optional	Once
`NST-6`	Receive Character Count	NM	Optional	Once
`NST-7`	Send Character Count	NM	Optional	Once
`NST-8`	Messages Received	NM	Optional	Once
`NST-9`	Messages Sent	NM	Optional	Once
`NST-10`	Checksum Errors Received	NM	Optional	Once
`NST-11`	Length Errors Received	NM	Optional	Once
`NST-12`	Other Errors Received	NM	Optional	Once
`NST-13`	Connect Timeouts	NM	Optional	Once
`NST-14`	Receive Timeouts	NM	Optional	Once
`NST-15`	Application Control-level Errors	NM	Optional	Once

Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

NTENotes And CommentsAppointment, DocumentReference, Observation +18 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`NTE-1`	Set Id - Nte	SI	Optional	Once
`NTE-2`	Source Of Comment	ID	Optional	Once	0105	1
`NTE-3`	Comment	FT	Optional	Repeats			DocumentReference.content.attachment.data DocumentReference.content.contentType+3 more
`NTE-4`	Comment Type	CWE	Optional	Once	0364		Appointment.extension.extension Appointment.extension
`NTE-5`	Entered By	XCN	Optional	Once			Observation.note.authorReference ServiceRequest.note.authorReference+1 more
`NTE-6`	Entered Date/Time	DTM	Optional	Once			Observation.note.time ServiceRequest.note.time+1 more
`NTE-7`	Effective Start Date	DTM	Optional	Once
`NTE-8`	Expiration Date	DTM	Optional	Once

FHIR map of segment NTEDefined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

OBRObservation RequestDiagnosticReport, ServiceRequest, Specimen53 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			DiagnosticReport.identifier DiagnosticReport.identifier.type.coding.code+5 more
`OBR-3`	Filler Order Number	EI	Conditional	Once			DiagnosticReport.identifier DiagnosticReport.identifier.type.coding.code+4 more
`OBR-4`	Universal Service Identifier	CWE	Required	Once			DiagnosticReport.code ServiceRequest.code
`OBR-5`	Priority	ST	Withdrawn	Once			ServiceRequest.priority
`OBR-6`	Requested Date/Time	ST	Withdrawn	Once			ServiceRequest.occurrenceDateTime
`OBR-7`	Observation Date/Time #	DTM	Conditional	Once			DiagnosticReport.effectiveDateTime DiagnosticReport.effectivePeriod.start+2 more
`OBR-8`	Observation End Date/Time #	DTM	Optional	Once			DiagnosticReport.effectivePeriod.end Specimen.collection.collectedPeriod.end
`OBR-9`	Collection Volume *	CQ	Optional	Once			Specimen.collection.quantity
`OBR-10`	Collector Identifier *	XCN	Backward	Repeats			Specimen.collection.collector
`OBR-11`	Specimen Action Code *	ID	Optional	Once	0065	1	ServiceRequest.intent
`OBR-12`	Danger Code	CWE	Optional	Once	9999
`OBR-13`	Relevant Clinical Information	ST	Optional	Once			Specimen.collection.fastingStatusCodeableConcept Specimen.collection.fastingStatusDuration+2 more
`OBR-14`	Specimen Received Date/Time	ST	Withdrawn	Once			Specimen.receivedTime
`OBR-15`	Specimen Source	ST	Withdrawn	Once			Specimen.$this
`OBR-16`	Ordering Provider	XCN	Backward	Repeats			ServiceRequest.requester
`OBR-17`	Order Callback Phone Number	XTN	Optional	Once			ServiceRequest.requester.extension
`OBR-18`	Placer Field 1	ST	Optional	Once
`OBR-19`	Placer Field 2	ST	Optional	Once
`OBR-20`	Filler Field 1 +	ST	Optional	Once
`OBR-21`	Filler Field 2 +	ST	Optional	Once
`OBR-22`	Results Rpt/Status Chng - Date/Time +	DTM	Conditional	Once			DiagnosticReport.issued
`OBR-23`	Charge To Practice +	MOC	Optional	Once
`OBR-24`	Diagnostic Serv Sect Id	ID	Optional	Once	0074	3	DiagnosticReport.category
`OBR-25`	Result Status +	ID	Conditional	Once	0123	1	DiagnosticReport.status
`OBR-26`	Parent Result +	PRL	Optional	Once
`OBR-27`	Quantity/Timing	ST	Withdrawn	Repeats			ServiceRequest.$this
`OBR-28`	Result Copies To	XCN	Backward	Repeats
`OBR-29`	Parent	EIP	Optional	Once			ServiceRequest.basedOn.identifier ServiceRequest.basedOn.type
`OBR-30`	Transportation Mode	ID	Optional	Once	0124	4
`OBR-31`	Reason For Study	CWE	Optional	Repeats	9999		ServiceRequest.reasonCode
`OBR-32`	Principal Result Interpreter +	NDL	Backward	Once			DiagnosticReport.resultsInterpreter
`OBR-33`	Assistant Result Interpreter +	NDL	Backward	Repeats
`OBR-34`	Technician +	NDL	Backward	Repeats			DiagnosticReport.performer DiagnosticReport.performer.extension+2 more
`OBR-35`	Transcriptionist +	NDL	Backward	Repeats			DiagnosticReport.performer DiagnosticReport.performer.extension+2 more
`OBR-36`	Scheduled Date/Time +	DTM	Optional	Once
`OBR-37`	Number Of Sample Containers *	NM	Optional	Once
`OBR-38`	Transport Logistics Of Collected Sample *	CWE	Optional	Repeats	9999
`OBR-39`	Collector's Comment *	CWE	Optional	Repeats	9999		Specimen.note
`OBR-40`	Transport Arrangement Responsibility	CWE	Optional	Once	9999
`OBR-41`	Transport Arranged	ID	Optional	Once	0224	1
`OBR-42`	Escort Required	ID	Optional	Once	0225	1
`OBR-43`	Planned Patient Transport Comment	CWE	Optional	Repeats	9999
`OBR-44`	Procedure Code	CNE	Optional	Once	0088
`OBR-45`	Procedure Code Modifier	CNE	Optional	Repeats	0340
`OBR-46`	Placer Supplemental Service Information	CWE	Optional	Repeats	0411		ServiceRequest.orderDetail
`OBR-47`	Filler Supplemental Service Information	CWE	Optional	Repeats	0411		ServiceRequest.orderDetail
`OBR-48`	Medically Necessary Duplicate Procedure Reason	CWE	Conditional	Once	0476
`OBR-49`	Result Handling	CWE	Optional	Once	0507
`OBR-50`	Parent Universal Service Identifier	CWE	Backward	Once
`OBR-51`	Observation Group Id	EI	Optional	Once
`OBR-52`	Parent Observation Group Id	EI	Optional	Once
`OBR-53`	Alternate Placer Order Number	CX	Optional	Repeats			ServiceRequest.identifier ServiceRequest.identifier.type.coding.code+1 more

FHIR map of segment OBRDefined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

OBXObservation/resultObservation, DocumentReference26 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`OBX-1`	Set Id - Obx	SI	Optional	Once		4
`OBX-2`	Value Type	ID	Conditional	Once	0125	3
`OBX-3`	Observation Identifier	CWE	Required	Once	9999		Observation.code Observation.component[each].code
`OBX-4`	Observation Sub-id	ST	Conditional	Once			Observation.$this
`OBX-5`	Observation Value	varies	Conditional	Repeats			Observation.component[each].valueQuantity Observation.component[each].valueString+23 more
`OBX-6`	Units	CWE	Optional	Once	9999		Observation.component[each].valueQuantity Observation.component[each].valueRange.low+8 more
`OBX-7`	References Range	ST	Optional	Once			Observation.component[each].referenceRange.text Observation.referenceRange.text
`OBX-8`	Interpretation Codes	CWE	Optional	Repeats			Observation.interpretation
`OBX-9`	Probability	NM	Optional	Once
`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	DTM	Optional	Once
`OBX-13`	User Defined Access Checks	ST	Optional	Once
`OBX-14`	Date/Time Of The Observation	DTM	Optional	Once			Observation.effectiveDateTime
`OBX-15`	Producer's Id	CWE	Backward	Once	9999		Observation.performer
`OBX-16`	Responsible Observer	XCN	Backward	Repeats			Observation.performer)Observation.performer
`OBX-17`	Observation Method	CWE	Optional	Repeats	9999		Observation.method
`OBX-18`	Equipment Instance Identifier	EI	Backward	Repeats			Observation.device
`OBX-19`	Date/Time Of The Analysis	DTM	Optional	Once			Observation.extension
`OBX-20`	Observation Site	CWE	Optional	Repeats	0163		Observation.bodySite
`OBX-21`	Observation Instance Identifier	EI	Optional	Once			Observation.identifier Observation.identifier.type.coding.code
`OBX-22`	Mood Code	CNE	Conditional	Once	0725
`OBX-23`	Performing Organization Name	XON	Backward	Once			Observation.performer Observation.performer)
`OBX-24`	Performing Organization Address	XAD	Backward	Once			Observation.performer Observation.performer)
`OBX-25`	Performing Organization Medical Director	XCN	Backward	Once			Observation.performer
`OBX-26`	Patient Results Release Category	ID	Optional	Once	0909	10

FHIR map of segment OBXDefined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 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	CWE	Optional	Once	9999
`ODS-3`	Diet, Supplement, Or Preference Code	CWE	Required	Once	9999
`ODS-4`	Text Instruction	ST	Optional	Once

Defined in versions2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

ODTDiet Tray Instructions3 fields

Field	Name	Type	Use	Repeats	Table
`ODT-1`	Tray Type	CWE	Required	Once	0160
`ODT-2`	Service Period	CWE	Optional	Once	9999
`ODT-3`	Text Instruction	ST	Optional	Once

Defined in versions2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

OM1General Segment47 fields

Field	Name	Type	Use	Repeats	Table	Length
`OM1-1`	Sequence Number - Test/Observation Master File	NM	Required	Once
`OM1-2`	Producer's Service/Test/Observation Id	CWE	Required	Once	9999
`OM1-3`	Permitted Data Types	ID	Optional	Repeats	0125	3
`OM1-4`	Specimen Required	ID	Required	Once	0136	1
`OM1-5`	Producer Id	CWE	Required	Once	9999
`OM1-6`	Observation Description	TX	Optional	Once
`OM1-7`	Other Service/Test/Observation Ids For The Observation	CWE	Optional	Once	9999
`OM1-8`	Other Names	ST	Required	Repeats
`OM1-9`	Preferred Report Name For The Observation	ST	Optional	Once
`OM1-10`	Preferred Short Name Or Mnemonic For The Observation	ST	Optional	Once		8
`OM1-11`	Preferred Long Name For The Observation	ST	Optional	Once
`OM1-12`	Orderability	ID	Optional	Once	0136	1
`OM1-13`	Identity Of Instrument Used To Perform This Study	CWE	Optional	Repeats	9999
`OM1-14`	Coded Representation Of Method	CWE	Optional	Repeats	9999
`OM1-15`	Portable Device Indicator	ID	Optional	Once	0136	1
`OM1-16`	Observation Producing Department/Section	CWE	Optional	Repeats	9999
`OM1-17`	Telephone Number Of Section	XTN	Optional	Once
`OM1-18`	Nature Of Service/Test/Observation	CWE	Required	Once	0174	1
`OM1-19`	Report Subheader	CWE	Optional	Once	9999
`OM1-20`	Report Display Order	ST	Optional	Once
`OM1-21`	Date/Time Stamp For Any Change In Definition For The Observation	DTM	Optional	Once
`OM1-22`	Effective Date/Time Of Change	DTM	Optional	Once
`OM1-23`	Typical Turn-around Time	NM	Optional	Once
`OM1-24`	Processing Time	NM	Optional	Once
`OM1-25`	Processing Priority	ID	Optional	Repeats	0168	1
`OM1-26`	Reporting Priority	ID	Optional	Once	0169	1
`OM1-27`	Outside Site(s) Where Observation May Be Performed	CWE	Optional	Repeats	9999
`OM1-28`	Address Of Outside Site(s)	XAD	Optional	Repeats
`OM1-29`	Phone Number Of Outside Site	XTN	Optional	Once
`OM1-30`	Confidentiality Code	CWE	Optional	Once	0177
`OM1-31`	Observations Required To Interpret This Observation	CWE	Optional	Once	9999
`OM1-32`	Interpretation Of Observations	TX	Optional	Once
`OM1-33`	Contraindications To Observations	CWE	Optional	Once	9999
`OM1-34`	Reflex Tests/Observations	CWE	Optional	Repeats	9999
`OM1-35`	Rules That Trigger Reflex Testing	TX	Optional	Once
`OM1-36`	Fixed Canned Message	CWE	Optional	Once	9999
`OM1-37`	Patient Preparation	TX	Optional	Once
`OM1-38`	Procedure Medication	CWE	Optional	Once	9999
`OM1-39`	Factors That May Affect The Observation	TX	Optional	Once
`OM1-40`	Service/Test/Observation Performance Schedule	ST	Optional	Repeats
`OM1-41`	Description Of Test Methods	TX	Optional	Once
`OM1-42`	Kind Of Quantity Observed	CWE	Optional	Once	0254
`OM1-43`	Point Versus Interval	CWE	Optional	Once	0255
`OM1-44`	Challenge Information	TX	Optional	Once
`OM1-45`	Relationship Modifier	CWE	Optional	Once	0258
`OM1-46`	Target Anatomic Site Of Test	CWE	Optional	Once	9999
`OM1-47`	Modality Of Imaging Measurement	CWE	Optional	Once	0910

Defined in versions2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

OM2Numeric Observation10 fields

Field	Name	Type	Use	Repeats	Table
`OM2-1`	Sequence Number - Test/Observation Master File	NM	Optional	Once
`OM2-2`	Units Of Measure	CWE	Optional	Once	9999
`OM2-3`	Range Of Decimal Precision	NM	Optional	Repeats
`OM2-4`	Corresponding Si Units Of Measure	CWE	Optional	Once	9999
`OM2-5`	Si Conversion Factor	TX	Optional	Once
`OM2-6`	Reference (normal) Range For Ordinal And Continuous Observations	RFR	Optional	Repeats
`OM2-7`	Critical Range For Ordinal And Continuous Observations	RFR	Optional	Repeats
`OM2-8`	Absolute Range For Ordinal And Continuous Observations	RFR	Optional	Once
`OM2-9`	Delta Check Criteria	DLT	Optional	Repeats
`OM2-10`	Minimum Meaningful Increments	NM	Optional	Once

Defined in versions2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 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
`OM3-2`	Preferred Coding System	CWE	Optional	Once	9999
`OM3-3`	Valid Coded "answers"	CWE	Optional	Repeats	9999
`OM3-4`	Normal Text/Codes For Categorical Observations	CWE	Optional	Repeats	9999
`OM3-5`	Abnormal Text/Codes For Categorical Observations	CWE	Optional	Repeats	9999
`OM3-6`	Critical Text/Codes For Categorical Observations	CWE	Optional	Repeats	9999
`OM3-7`	Value Type	ID	Optional	Once	0125	3

Defined in versions2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 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
`OM4-2`	Derived Specimen	ID	Optional	Once	0170	1
`OM4-3`	Container Description	TX	Optional	Once		60
`OM4-4`	Container Volume	NM	Optional	Once
`OM4-5`	Container Units	CWE	Optional	Once	9999
`OM4-6`	Specimen	CWE	Optional	Once	9999
`OM4-7`	Additive	CWE	Optional	Once	0371
`OM4-8`	Preparation	TX	Optional	Once
`OM4-9`	Special Handling Requirements	TX	Optional	Once
`OM4-10`	Normal Collection Volume	CQ	Optional	Once
`OM4-11`	Minimum Collection Volume	CQ	Optional	Once
`OM4-12`	Specimen Requirements	TX	Optional	Once
`OM4-13`	Specimen Priorities	ID	Optional	Repeats	0027	1
`OM4-14`	Specimen Retention Time	CQ	Optional	Once

Defined in versions2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

OM5Observation Batteries (sets)3 fields

Field	Name	Type	Use	Repeats	Table
`OM5-1`	Sequence Number - Test/Observation Master File	NM	Optional	Once
`OM5-2`	Test/Observations Included Within An Ordered Test Battery	CWE	Optional	Repeats	9999
`OM5-3`	Observation Id Suffixes	ST	Optional	Once

Defined in versions2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 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
`OM6-2`	Derivation Rule	TX	Optional	Once

Defined in versions2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

OM7Additional Basic Attributes24 fields

Field	Name	Type	Use	Repeats	Table	Length
`OM7-1`	Sequence Number - Test/Observation Master File	NM	Required	Once
`OM7-2`	Universal Service Identifier	CWE	Required	Once
`OM7-3`	Category Identifier	CWE	Optional	Repeats	0412
`OM7-4`	Category Description	TX	Optional	Once
`OM7-5`	Category Synonym	ST	Optional	Repeats
`OM7-6`	Effective Test/Service Start Date/Time	DTM	Optional	Once
`OM7-7`	Effective Test/Service End Date/Time	DTM	Optional	Once
`OM7-8`	Test/Service Default Duration Quantity	NM	Optional	Once
`OM7-9`	Test/Service Default Duration Units	CWE	Optional	Once	9999
`OM7-10`	Test/Service Default Frequency	CWE	Optional	Once
`OM7-11`	Consent Indicator	ID	Optional	Once	0136	1
`OM7-12`	Consent Identifier	CWE	Optional	Once	0413
`OM7-13`	Consent Effective Start Date/Time	DTM	Optional	Once
`OM7-14`	Consent Effective End Date/Time	DTM	Optional	Once
`OM7-15`	Consent Interval Quantity	NM	Optional	Once
`OM7-16`	Consent Interval Units	CWE	Conditional	Once	0414
`OM7-17`	Consent Waiting Period Quantity	NM	Optional	Once
`OM7-18`	Consent Waiting Period Units	CWE	Conditional	Once	0414
`OM7-19`	Effective Date/Time Of Change	DTM	Optional	Once
`OM7-20`	Entered By	XCN	Optional	Once
`OM7-21`	Orderable-at Location	PL	Optional	Repeats
`OM7-22`	Formulary Status	CWE	Optional	Once	0473
`OM7-23`	Special Order Indicator	ID	Optional	Once	0136	1
`OM7-24`	Primary Key Value - Cdm	CWE	Optional	Repeats	0132

Defined in versions2.4 2.5 2.5.1 2.62.72.7.1 2.8

ORCCommon OrderDiagnosticReport, Immunization, MedicationAdministration +233 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			DiagnosticReport.identifier DiagnosticReport.identifier.type.coding.code+11 more
`ORC-3`	Filler Order Number	EI	Conditional	Once			DiagnosticReport.identifier DiagnosticReport.identifier.type.coding.code+10 more
`ORC-4`	Placer Group Number	EI	Optional	Once			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	ST	Withdrawn	Repeats			ServiceRequest.$this
`ORC-8`	Parent	EIP	Optional	Once
`ORC-9`	Date/Time Of Transaction	DTM	Optional	Once			Immunization.recorded Provenance.recorded+4 more
`ORC-10`	Entered By	XCN	Backward	Repeats			Provenance.agent.who Provenance.agent.type.coding.code+1 more
`ORC-11`	Verified By	XCN	Backward	Repeats			Provenance.agent.who Provenance.agent.type.coding.code+1 more
`ORC-12`	Ordering Provider	XCN	Backward	Repeats			Immunization.performer.actor Immunization.performer.function.coding.code+8 more
`ORC-13`	Enterer's Location	PL	Optional	Once
`ORC-14`	Call Back Phone Number	XTN	Optional	Once			ServiceRequest.extension
`ORC-15`	Order Effective Date/Time	DTM	Optional	Once
`ORC-16`	Order Control Code Reason	CWE	Optional	Once	9999		DiagnosticReport.extension ServiceRequest.extension
`ORC-17`	Entering Organization	CWE	Backward	Once	9999		Provenance.agent.onBehalfOf
`ORC-18`	Entering Device	CWE	Backward	Once	9999		Provenance.agent.who
`ORC-19`	Action By	XCN	Backward	Repeats			Provenance.agent.type.coding.code Provenance.agent.type.coding.system+1 more
`ORC-20`	Advanced Beneficiary Notice Code	CWE	Optional	Once	0339
`ORC-21`	Ordering Facility Name	XON	Backward	Repeats			Provenance.location ServiceRequest.requester)
`ORC-22`	Ordering Facility Address	XAD	Backward	Repeats			Provenance.location ServiceRequest.requester)
`ORC-23`	Ordering Facility Phone Number	XTN	Backward	Repeats			Provenance.location ServiceRequest.requester)
`ORC-24`	Ordering Provider Address	XAD	Backward	Repeats			Provenance.agent.who ServiceRequest.requester)
`ORC-25`	Order Status Modifier	CWE	Optional	Once	9999
`ORC-26`	Advanced Beneficiary Notice Override Reason	CWE	Conditional	Once	0552
`ORC-27`	Filler's Expected Availability Date/Time	DTM	Optional	Once
`ORC-28`	Confidentiality Code	CWE	Optional	Once	0177		DiagnosticReport.meta.security Immunization.meta.security+3 more
`ORC-29`	Order Type	CWE	Optional	Once	0482		ServiceRequest.locationCode
`ORC-30`	Enterer Authorization Mode	CNE	Optional	Once	0483
`ORC-31`	Parent Universal Service Identifier	CWE	Backward	Once
`ORC-32`	Advanced Beneficiary Notice Date	DT	Optional	Once
`ORC-33`	Alternate Placer Order Number	CX	Optional	Repeats			ServiceRequest.identifier ServiceRequest.identifier.type.coding.code+1 more

FHIR map of segment ORCDefined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

ORGPractitioner Organization Unit Segment13 fields

Field	Name	Type	Use	Repeats	Table	Length
`ORG-1`	Set Id - Org	SI	Required	Once		4
`ORG-2`	Organization Unit Code	CWE	Optional	Once	0405
`ORG-3`	Organization Unit Type Code	CWE	Optional	Once	0474
`ORG-4`	Primary Org Unit Indicator	ID	Optional	Once	0136	1
`ORG-5`	Practitioner Org Unit Identifier	CX	Optional	Once
`ORG-6`	Health Care Provider Type Code	CWE	Optional	Once	0452
`ORG-7`	Health Care Provider Classification Code	CWE	Optional	Once	0453
`ORG-8`	Health Care Provider Area Of Specialization Code	CWE	Optional	Once	0454
`ORG-9`	Effective Date Range	DR	Optional	Once
`ORG-10`	Employment Status Code	CWE	Optional	Once	0066
`ORG-11`	Board Approval Indicator	ID	Optional	Once	0136	1
`ORG-12`	Primary Care Physician Indicator	ID	Optional	Once	0136	1
`ORG-13`	Cost Center Code	CWE	Optional	Repeats	0539

Defined in versions2.4 2.5 2.5.1 2.62.72.7.1 2.8

OVROverride Segment5 fields

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

Defined in versions2.5 2.5.1 2.62.72.7.1 2.8

PACShipment Package8 fields

Field	Name	Type	Use	Repeats	Table	Length
`PAC-1`	Set Id - Pac	SI	Required	Once		4
`PAC-2`	Package Id	EI	Conditional	Once
`PAC-3`	Parent Package Id	EI	Optional	Once
`PAC-4`	Position In Parent Package	NA	Optional	Once
`PAC-5`	Package Type	CWE	Required	Once	0908
`PAC-6`	Package Condition	CWE	Optional	Repeats	0544
`PAC-7`	Package Handling Code	CWE	Optional	Repeats	0376
`PAC-8`	Package Risk Code	CWE	Optional	Repeats	0489

Defined in versions2.72.7.1 2.8

PCEPatient Charge Cost Center Exceptions4 fields

Field	Name	Type	Use	Repeats	Table	Length
`PCE-1`	Set Id - Pce	SI	Required	Once		4
`PCE-2`	Cost Center Account Number	CX	Optional	Once	0319
`PCE-3`	Transaction Code	CWE	Optional	Once	0132
`PCE-4`	Transaction Amount - Unit	CP	Optional	Once

Defined in versions2.62.72.7.1 2.8

PCRPossible Causal Relationship23 fields

Field	Name	Type	Use	Repeats	Table	Length
`PCR-1`	Implicated Product	CWE	Required	Once	9999
`PCR-2`	Generic Product	IS	Optional	Once	0249
`PCR-3`	Product Class	CWE	Optional	Once	9999
`PCR-4`	Total Duration Of Therapy	CQ	Optional	Once
`PCR-5`	Product Manufacture Date	DTM	Optional	Once
`PCR-6`	Product Expiration Date	DTM	Optional	Once
`PCR-7`	Product Implantation Date	DTM	Optional	Once
`PCR-8`	Product Explantation Date	DTM	Optional	Once
`PCR-9`	Single Use Device	CWE	Optional	Once	0244
`PCR-10`	Indication For Product Use	CWE	Optional	Once	9999
`PCR-11`	Product Problem	CWE	Optional	Once	0245
`PCR-12`	Product Serial/Lot Number	ST	Optional	Once
`PCR-13`	Product Available For Inspection	CWE	Optional	Once	0246
`PCR-14`	Product Evaluation Performed	CWE	Optional	Once	9999
`PCR-15`	Product Evaluation Status	CWE	Optional	Once	0247
`PCR-16`	Product Evaluation Results	CWE	Optional	Once	9999
`PCR-17`	Evaluated Product Source	ID	Optional	Once	0248	1
`PCR-18`	Date Product Returned To Manufacturer	DTM	Optional	Once
`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 2.5 2.5.1 2.62.72.7.1 2.8

PD1Patient Additional DemographicObservation, Patient22 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`PD1-1`	Living Dependency	CWE	Optional	Repeats	0223
`PD1-2`	Living Arrangement	CWE	Optional	Once	0220
`PD1-3`	Patient Primary Facility	XON	Optional	Repeats			Patient.generalPractitioner
`PD1-4`	Patient Primary Care Provider Name & Id No.	ST	Withdrawn	Once			Patient.generalPractitioner
`PD1-5`	Student Indicator	CWE	Optional	Once	0231
`PD1-6`	Handicap	CWE	Optional	Once	0295		Patient.extension
`PD1-7`	Living Will Code	CWE	Optional	Once	0315		Observation.valueCodeableConcept
`PD1-8`	Organ Donor Code	CWE	Optional	Once	0316
`PD1-9`	Separate Bill	ID	Optional	Once	0136	1
`PD1-10`	Duplicate Patient	CX	Optional	Repeats
`PD1-11`	Publicity Code	CWE	Optional	Once	0215
`PD1-12`	Protection Indicator	ID	Backward	Once	0136	1
`PD1-13`	Protection Indicator Effective Date	DT	Backward	Once
`PD1-14`	Place Of Worship	XON	Optional	Repeats			Patient.extension
`PD1-15`	Advance Directive Code	CWE	Conditional	Repeats	0435
`PD1-16`	Immunization Registry Status	CWE	Optional	Once	0441
`PD1-17`	Immunization Registry Status Effective Date	DT	Optional	Once
`PD1-18`	Publicity Code Effective Date	DT	Optional	Once
`PD1-19`	Military Branch	CWE	Optional	Once	0140
`PD1-20`	Military Rank/Grade	CWE	Optional	Once	0141
`PD1-21`	Military Status	CWE	Optional	Once	0142
`PD1-22`	Advance Directive Last Verified Date	DT	Optional	Once

FHIR map of segment PD1Defined in versions2.1 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

PDAPatient Death And Autopsy9 fields

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

Defined in versions2.4 2.5 2.5.1 2.62.72.7.1 2.8

PDCProduct Detail Country15 fields

Field	Name	Type	Use	Repeats	Table	Length
`PDC-1`	Manufacturer/Distributor	XON	Required	Repeats
`PDC-2`	Country	CWE	Required	Once	9999
`PDC-3`	Brand Name	ST	Required	Once
`PDC-4`	Device Family Name	ST	Optional	Once
`PDC-5`	Generic Name	CWE	Optional	Once	9999
`PDC-6`	Model Identifier	ST	Optional	Repeats
`PDC-7`	Catalogue Identifier	ST	Optional	Once
`PDC-8`	Other Identifier	ST	Optional	Repeats
`PDC-9`	Product Code	CWE	Optional	Once	9999
`PDC-10`	Marketing Basis	ID	Optional	Once	0330	4
`PDC-11`	Marketing Approval Id	ST	Optional	Once
`PDC-12`	Labeled Shelf Life	CQ	Optional	Once
`PDC-13`	Expected Shelf Life	CQ	Optional	Once
`PDC-14`	Date First Marketed	DTM	Optional	Once
`PDC-15`	Date Last Marketed	DTM	Optional	Once

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

PEOProduct Experience Observation25 fields

Field	Name	Type	Use	Repeats	Table	Length
`PEO-1`	Event Identifiers Used	CWE	Optional	Repeats	9999
`PEO-2`	Event Symptom/Diagnosis Code	CWE	Optional	Repeats	9999
`PEO-3`	Event Onset Date/Time	DTM	Required	Once
`PEO-4`	Event Exacerbation Date/Time	DTM	Optional	Once
`PEO-5`	Event Improved Date/Time	DTM	Optional	Once
`PEO-6`	Event Ended Data/Time	DTM	Optional	Once
`PEO-7`	Event Location Occurred Address	XAD	Optional	Repeats
`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
`PEO-14`	Event Description From Original Reporter	FT	Optional	Repeats
`PEO-15`	Event Description From Patient	FT	Optional	Repeats
`PEO-16`	Event Description From Practitioner	FT	Optional	Repeats
`PEO-17`	Event Description From Autopsy	FT	Optional	Repeats
`PEO-18`	Cause Of Death	CWE	Optional	Repeats	9999
`PEO-19`	Primary Observer Name	XPN	Optional	Repeats
`PEO-20`	Primary Observer Address	XAD	Optional	Repeats
`PEO-21`	Primary Observer Telephone	XTN	Optional	Repeats
`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	DTM	Optional	Once
`PEO-25`	Primary Observer's Identity May Be Divulged	ID	Optional	Once	0243	2

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

PESProduct Experience Sender13 fields

Field	Name	Type	Use	Repeats	Table	Length
`PES-1`	Sender Organization Name	XON	Optional	Repeats
`PES-2`	Sender Individual Name	XCN	Optional	Repeats
`PES-3`	Sender Address	XAD	Optional	Repeats
`PES-4`	Sender Telephone	XTN	Optional	Repeats
`PES-5`	Sender Event Identifier	EI	Optional	Once
`PES-6`	Sender Sequence Number	NM	Optional	Once
`PES-7`	Sender Event Description	FT	Optional	Repeats
`PES-8`	Sender Comment	FT	Optional	Once
`PES-9`	Sender Aware Date/Time	DTM	Optional	Once
`PES-10`	Event Report Date	DTM	Required	Once
`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 2.5 2.5.1 2.62.72.7.1 2.8

PIDPatient IdentificationProvenance, Account, Appointment +140 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`PID-1`	Set Id - Pid	SI	Optional	Once		4
`PID-2`	Patient Id	ST	Withdrawn	Once			Appointment.participant.actor Patient.identifier+1 more
`PID-3`	Patient Identifier List	CX	Required	Repeats			Appointment.participant.actor Patient.identifier+1 more
`PID-4`	Alternate Patient Id - Pid	ST	Withdrawn	Once			Appointment.participant.actor Patient.identifier+1 more
`PID-5`	Patient Name	XPN	Required	Repeats			Patient.name
`PID-6`	Mother's Maiden Name	XPN	Optional	Repeats			Patient.extension
`PID-7`	Date/Time Of Birth	DTM	Optional	Once			Patient.birthDate Patient.birthDate.extension
`PID-8`	Administrative Sex	CWE	Optional	Once	0001		Patient.gender
`PID-9`	Patient Alias	ST	Withdrawn	Once			Patient.name
`PID-10`	Race	CWE	Optional	Repeats	0005
`PID-11`	Patient Address	XAD	Optional	Repeats			Patient.address
`PID-12`	County Code	ST	Withdrawn	Once			Patient.address.district
`PID-13`	Phone Number - Home	XTN	Backward	Repeats			Patient.telecom Patient.telecom.use
`PID-14`	Phone Number - Business	XTN	Backward	Repeats			Patient.telecom Patient.telecom.use
`PID-15`	Primary Language	CWE	Optional	Once	0296		Patient.communication.language
`PID-16`	Marital Status	CWE	Optional	Once	0002		Patient.maritalStatus
`PID-17`	Religion	CWE	Optional	Once	0006		Patient.extension
`PID-18`	Patient Account Number	CX	Optional	Once			Account.identifier
`PID-19`	Ssn Number - Patient	ST	Withdrawn	Once			Patient.identifier.value Patient.identifier.type.coding.code+2 more
`PID-20`	Driver's License Number - Patient	ST	Withdrawn	Once			Patient.identifier
`PID-21`	Mother's Identifier	CX	Optional	Repeats			Patient.$this
`PID-22`	Ethnic Group	CWE	Optional	Repeats	0189
`PID-23`	Birth Place	ST	Optional	Once			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			Patient.multipleBirthInteger
`PID-26`	Citizenship	CWE	Optional	Repeats	0171		Patient.extension Patient.extension.extension
`PID-27`	Veterans Military Status	CWE	Optional	Once	0172
`PID-28`	Nationality	CWE	Withdrawn	Once	0212		Patient.extension Patient.extension.extension
`PID-29`	Patient Death Date And Time	DTM	Optional	Once			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	CWE	Optional	Repeats	0445
`PID-33`	Last Update Date/Time	DTM	Optional	Once			Provenance.occurredDateTime
`PID-34`	Last Update Facility	HD	Optional	Once			Provenance.agent.who Provenance.agent.type.coding.code+1 more
`PID-35`	Species Code	CWE	Conditional	Once	0446		Patient.extension Patient.extension.extension
`PID-36`	Breed Code	CWE	Conditional	Once	0447		Patient.extension Patient.extension.extension
`PID-37`	Strain	ST	Optional	Once
`PID-38`	Production Class Code	CWE	Optional	Once	0429
`PID-39`	Tribal Citizenship	CWE	Optional	Repeats	0171		Patient.extension Patient.extension.extension
`PID-40`	Patient Telecommunication Information	XTN	Optional	Repeats			Patient.telecom

FHIR map of segment PIDDefined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

PKGItem Packaging7 fields

Field	Name	Type	Use	Repeats	Table	Length
`PKG-1`	Set Id - Pkg	SI	Required	Once		4
`PKG-2`	Packaging Units	CWE	Optional	Once	0818
`PKG-3`	Default Order Unit Of Measure Indicator	CNE	Optional	Once	0532
`PKG-4`	Package Quantity	NM	Optional	Once
`PKG-5`	Price	CP	Optional	Once
`PKG-6`	Future Item Price	CP	Optional	Once
`PKG-7`	Future Item Price Effective Date	DTM	Optional	Once

Defined in versions2.62.72.7.1 2.8

PMTPayment Information12 fields

Field	Name	Type	Use	Repeats	Table
`PMT-1`	Payment/Remittance Advice Number	EI	Required	Once
`PMT-2`	Payment/Remittance Effective Date/Time	DTM	Required	Once
`PMT-3`	Payment/Remittance Expiration Date/Time	DTM	Required	Once
`PMT-4`	Payment Method	CWE	Required	Once	0570
`PMT-5`	Payment/Remittance Date/Time	DTM	Required	Once
`PMT-6`	Payment/Remittance Amount	CP	Required	Once
`PMT-7`	Check Number	EI	Optional	Once
`PMT-8`	Payee Bank Identification	XON	Optional	Once
`PMT-9`	Payee Transit Number	ST	Optional	Once
`PMT-10`	Payee Bank Account Id	CX	Optional	Once
`PMT-11`	Payment Organization	XON	Required	Once
`PMT-12`	Esr-code-line	ST	Optional	Once

Defined in versions2.62.72.7.1 2.8

PR1ProceduresProcedure25 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`PR1-1`	Set Id - Pr1	SI	Required	Once		4
`PR1-2`	Procedure Coding Method	ST	Withdrawn	Once
`PR1-3`	Procedure Code	CNE	Required	Once	0088		Procedure.code
`PR1-4`	Procedure Description	ST	Withdrawn	Once			Procedure.code.text
`PR1-5`	Procedure Date/Time	DTM	Required	Once			Procedure.performedDateTime Procedure.performedPeriod.start
`PR1-6`	Procedure Functional Type	CWE	Optional	Once	0230		Procedure.category
`PR1-7`	Procedure Minutes	NM	Optional	Once			Procedure.performedPeriod.end
`PR1-8`	Anesthesiologist	ST	Withdrawn	Once			Procedure.performer.actor Procedure.performer.function.coding.code+1 more
`PR1-9`	Anesthesia Code	CWE	Optional	Once	0019
`PR1-10`	Anesthesia Minutes	NM	Optional	Once
`PR1-11`	Surgeon	ST	Withdrawn	Once			Procedure.performer.actor Procedure.performer.function.coding.code+1 more
`PR1-12`	Procedure Practitioner	ST	Withdrawn	Once			Procedure.performer.actor
`PR1-13`	Consent Code	CWE	Optional	Once	0059
`PR1-14`	Procedure Priority	NM	Optional	Once	0418	2
`PR1-15`	Associated Diagnosis Code	CWE	Optional	Once	0051		Procedure.reasonCode
`PR1-16`	Procedure Code Modifier	CNE	Optional	Repeats	0340		Procedure.code.value
`PR1-17`	Procedure Drg Type	CWE	Optional	Once	0416
`PR1-18`	Tissue Type Code	CWE	Optional	Repeats	0417
`PR1-19`	Procedure Identifier	EI	Conditional	Once			Procedure.identifier
`PR1-20`	Procedure Action Code	ID	Conditional	Once	0206	1
`PR1-21`	Drg Procedure Determination Status	CWE	Optional	Once	0761
`PR1-22`	Drg Procedure Relevance	CWE	Optional	Once	0763
`PR1-23`	Treating Organizational Unit	PL	Optional	Repeats			Procedure.location
`PR1-24`	Respiratory Within Surgery	ID	Optional	Once	0136	1
`PR1-25`	Parent Procedure Id	EI	Optional	Once			Procedure.partOf

FHIR map of segment PR1Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

PRAPractitioner Detail12 fields

Field	Name	Type	Use	Repeats	Table	Length
`PRA-1`	Primary Key Value - Pra	CWE	Conditional	Once	9999
`PRA-2`	Practitioner Group	CWE	Optional	Repeats	0358
`PRA-3`	Practitioner Category	CWE	Optional	Repeats	0186
`PRA-4`	Provider Billing	ID	Optional	Once	0187	1
`PRA-5`	Specialty	SPD	Optional	Repeats
`PRA-6`	Practitioner Id Numbers	PLN	Backward	Repeats
`PRA-7`	Privileges	PIP	Optional	Repeats
`PRA-8`	Date Entered Practice	DT	Optional	Once
`PRA-9`	Institution	CWE	Optional	Once	0537
`PRA-10`	Date Left Practice	DT	Optional	Once
`PRA-11`	Government Reimbursement Billing Eligibility	CWE	Optional	Repeats	0401
`PRA-12`	Set Id - Pra	SI	Conditional	Once		4

Defined in versions2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

PRBProblem Details28 fields

Field	Name	Type	Use	Repeats	Table	Length
`PRB-1`	Action Code	ID	Required	Once	0287	2
`PRB-2`	Action Date/Time	DTM	Required	Once
`PRB-3`	Problem Id	CWE	Required	Once
`PRB-4`	Problem Instance Id	EI	Required	Once
`PRB-5`	Episode Of Care Id	EI	Optional	Once
`PRB-6`	Problem List Priority	NM	Optional	Once
`PRB-7`	Problem Established Date/Time	DTM	Optional	Once
`PRB-8`	Anticipated Problem Resolution Date/Time	DTM	Optional	Once
`PRB-9`	Actual Problem Resolution Date/Time	DTM	Optional	Once
`PRB-10`	Problem Classification	CWE	Optional	Once
`PRB-11`	Problem Management Discipline	CWE	Optional	Repeats
`PRB-12`	Problem Persistence	CWE	Optional	Once
`PRB-13`	Problem Confirmation Status	CWE	Optional	Once
`PRB-14`	Problem Life Cycle Status	CWE	Optional	Once
`PRB-15`	Problem Life Cycle Status Date/Time	DTM	Optional	Once
`PRB-16`	Problem Date Of Onset	DTM	Optional	Once
`PRB-17`	Problem Onset Text	ST	Optional	Once
`PRB-18`	Problem Ranking	CWE	Optional	Once
`PRB-19`	Certainty Of Problem	CWE	Optional	Once
`PRB-20`	Probability Of Problem (0-1)	NM	Optional	Once
`PRB-21`	Individual Awareness Of Problem	CWE	Optional	Once
`PRB-22`	Problem Prognosis	CWE	Optional	Once
`PRB-23`	Individual Awareness Of Prognosis	CWE	Optional	Once
`PRB-24`	Family/Significant Other Awareness Of Problem/Prognosis	ST	Optional	Once
`PRB-25`	Security/Sensitivity	CWE	Optional	Once
`PRB-26`	Problem Severity	CWE	Optional	Once	0836
`PRB-27`	Problem Perspective	CWE	Optional	Once	0838
`PRB-28`	Mood Code	CNE	Conditional	Once	0725

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

PRCPricing18 fields

Field	Name	Type	Use	Repeats	Table	Length
`PRC-1`	Primary Key Value - Prc	CWE	Required	Once	0132
`PRC-2`	Facility Id - Prc	CWE	Optional	Repeats	0464
`PRC-3`	Department	CWE	Optional	Repeats	0184
`PRC-4`	Valid Patient Classes	CWE	Optional	Repeats	0004
`PRC-5`	Price	CP	Conditional	Repeats
`PRC-6`	Formula	ST	Optional	Repeats
`PRC-7`	Minimum Quantity	NM	Optional	Once
`PRC-8`	Maximum Quantity	NM	Optional	Once
`PRC-9`	Minimum Price	MO	Optional	Once
`PRC-10`	Maximum Price	MO	Optional	Once
`PRC-11`	Effective Start Date	DTM	Optional	Once
`PRC-12`	Effective End Date	DTM	Optional	Once
`PRC-13`	Price Override Flag	CWE	Optional	Once	0268
`PRC-14`	Billing Category	CWE	Optional	Repeats	0293
`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
`PRC-18`	Charge On Indicator	CWE	Optional	Once	0269

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

PRDProvider Data14 fields

Field	Name	Type	Use	Repeats	Table
`PRD-1`	Provider Role	CWE	Required	Repeats	0286
`PRD-2`	Provider Name	XPN	Optional	Repeats
`PRD-3`	Provider Address	XAD	Optional	Repeats
`PRD-4`	Provider Location	PL	Optional	Once
`PRD-5`	Provider Communication Information	XTN	Optional	Repeats
`PRD-6`	Preferred Method Of Contact	CWE	Optional	Once	0185
`PRD-7`	Provider Identifiers	PLN	Optional	Repeats
`PRD-8`	Effective Start Date Of Provider Role	DTM	Optional	Once
`PRD-9`	Effective End Date Of Provider Role	DTM	Optional	Repeats
`PRD-10`	Provider Organization Name And Identifier	XON	Optional	Once
`PRD-11`	Provider Organization Address	XAD	Optional	Repeats
`PRD-12`	Provider Organization Location Information	PL	Optional	Repeats
`PRD-13`	Provider Organization Communication Information	XTN	Optional	Repeats
`PRD-14`	Provider Organization Method Of Contact	CWE	Optional	Once	0185

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

PRTParticipation InformationPatient, Observation, CareTeam +315 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`PRT-1`	Participation Instance Id	EI	Conditional	Once		4
`PRT-2`	Action Code	ID	Required	Once	0287	2	Patient.Operation
`PRT-3`	Action Reason	CWE	Optional	Once
`PRT-4`	Participation	CWE	Required	Once	0912		Patient.generalPractitioner CareTeam.participant.role+2 more
`PRT-5`	Participation Person	XCN	Conditional	Repeats			Patient.generalPractitioner CareTeam.participant.member+2 more
`PRT-6`	Participation Person Provider Type	CWE	Conditional	Once			CareTeam.participant.member PractitionerRole.specialty
`PRT-7`	Participant Organization Unit Type	CWE	Conditional	Once	0406		PractitionerRole.organization
`PRT-8`	Participation Organization	XON	Conditional	Repeats			Patient.generalPractitioner)CareTeam.participant.member+2 more
`PRT-9`	Participant Location	PL	Conditional	Repeats			Patient.generalPractitioner)PractitionerRole.location+1 more
`PRT-10`	Participation Device	EI	Conditional	Repeats			Device.udiCarrier Device.identifier
`PRT-11`	Participation Begin Date/Time (arrival Time)	DTM	Optional	Once			Patient.generalPractitioner CareTeam.participant.coveragePeriod.start+2 more
`PRT-12`	Participation End Date/Time (departure Time)	DTM	Optional	Once			Patient.generalPractitioner CareTeam.participant.coveragePeriod.end+2 more
`PRT-13`	Participation Qualitative Duration	CWE	Optional	Once
`PRT-14`	Participation Address	XAD	Conditional	Repeats			Patient.generalPractitioner)CareTeam.participant.member+4 more
`PRT-15`	Participant Telecommunication Address	XTN	Optional	Repeats			Patient.generalPractitioner CareTeam.participant.member+3 more

FHIR map of segment PRTDefined in versions2.72.7.1 2.8

PSGProduct/service Group6 fields

Field	Name	Type	Use	Repeats	Table	Length
`PSG-1`	Provider Product/Service Group Number	EI	Required	Once
`PSG-2`	Payer Product/Service Group Number	EI	Optional	Once
`PSG-3`	Product/Service Group Sequence Number	SI	Required	Once		4
`PSG-4`	Adjudicate As Group	ID	Required	Once	0136	1
`PSG-5`	Product/Service Group Billed Amount	CP	Required	Once
`PSG-6`	Product/Service Group Description	ST	Required	Once

Defined in versions2.62.72.7.1 2.8

PSHProduct Summary Header14 fields

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

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

PSLProduct/service Line Item48 fields

Field	Name	Type	Use	Repeats	Table	Length
`PSL-1`	Provider Product/Service Line Item Number	EI	Required	Once
`PSL-2`	Payer Product/Service Line Item Number	EI	Optional	Once
`PSL-3`	Product/Service Line Item Sequence Number	SI	Required	Once		4
`PSL-4`	Provider Tracking Id	EI	Optional	Once
`PSL-5`	Payer Tracking Id	EI	Optional	Once
`PSL-6`	Product/Service Line Item Status	CWE	Required	Once	0559
`PSL-7`	Product/Service Code	CWE	Required	Once	0879
`PSL-8`	Product/Service Code Modifier	CWE	Optional	Once	0880
`PSL-9`	Product/Service Code Description	ST	Optional	Once
`PSL-10`	Product/Service Effective Date	DTM	Conditional	Once
`PSL-11`	Product/Service Expiration Date	DTM	Optional	Once
`PSL-12`	Product/Service Quantity	CQ	Conditional	Once
`PSL-13`	Product/Service Unit Cost	CP	Conditional	Once
`PSL-14`	Number Of Items Per Unit	NM	Conditional	Once
`PSL-15`	Product/Service Gross Amount	CP	Conditional	Once
`PSL-16`	Product/Service Billed Amount	CP	Conditional	Once
`PSL-17`	Product/Service Clarification Code Type	CWE	Optional	Once	0561
`PSL-18`	Product/Service Clarification Code Value	ST	Optional	Once
`PSL-19`	Health Document Reference Identifier	EI	Optional	Once
`PSL-20`	Processing Consideration Code	CWE	Optional	Once	0562
`PSL-21`	Restricted Disclosure Indicator	ID	Required	Once	0532	4
`PSL-22`	Related Product/Service Code Indicator	CWE	Optional	Once	0879
`PSL-23`	Product/Service Amount For Physician	CP	Optional	Once
`PSL-24`	Product/Service Cost Factor	NM	Optional	Once
`PSL-25`	Cost Center	CX	Optional	Once
`PSL-26`	Billing Period	DR	Optional	Once
`PSL-27`	Days Without Billing	NM	Optional	Once
`PSL-28`	Session-no	NM	Optional	Once		4
`PSL-29`	Executing Physician Id	XCN	Optional	Once
`PSL-30`	Responsible Physician Id	XCN	Optional	Once
`PSL-31`	Role Executing Physician	CWE	Optional	Once	0881
`PSL-32`	Medical Role Executing Physician	CWE	Optional	Once	0882
`PSL-33`	Side Of Body	CWE	Optional	Once	0894
`PSL-34`	Number Of Tp's Pp	NM	Optional	Once
`PSL-35`	Tp-value Pp	CP	Optional	Once
`PSL-36`	Internal Scaling Factor Pp	NM	Optional	Once
`PSL-37`	External Scaling Factor Pp	NM	Optional	Once
`PSL-38`	Amount Pp	CP	Optional	Once
`PSL-39`	Number Of Tp's Technical Part	NM	Optional	Once
`PSL-40`	Tp-value Technical Part	CP	Optional	Once
`PSL-41`	Internal Scaling Factor Technical Part	NM	Optional	Once
`PSL-42`	External Scaling Factor Technical Part	NM	Optional	Once
`PSL-43`	Amount Technical Part	CP	Optional	Once
`PSL-44`	Total Amount Professional Part + Technical Part	CP	Optional	Once
`PSL-45`	Vat-rate	NM	Optional	Once
`PSL-46`	Main-service	ID	Optional	Once		20
`PSL-47`	Validation	ID	Optional	Once	0136	1
`PSL-48`	Comment	ST	Optional	Once

Defined in versions2.62.72.7.1 2.8

PSSProduct/service Section5 fields

Field	Name	Type	Use	Repeats	Length
`PSS-1`	Provider Product/Service Section Number	EI	Required	Once
`PSS-2`	Payer Product/Service Section Number	EI	Optional	Once
`PSS-3`	Product/Service Section Sequence Number	SI	Required	Once	4
`PSS-4`	Billed Amount	CP	Required	Once
`PSS-5`	Section Description Or Heading	ST	Required	Once

Defined in versions2.62.72.7.1 2.8

PTHPathway7 fields

Field	Name	Type	Use	Repeats	Table	Length
`PTH-1`	Action Code	ID	Required	Once	0287	2
`PTH-2`	Pathway Id	CWE	Required	Once
`PTH-3`	Pathway Instance Id	EI	Required	Once
`PTH-4`	Pathway Established Date/Time	DTM	Required	Once
`PTH-5`	Pathway Life Cycle Status	CWE	Optional	Once
`PTH-6`	Change Pathway Life Cycle Status Date/Time	DTM	Conditional	Once
`PTH-7`	Mood Code	CNE	Conditional	Once	0725

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

PV1Patient VisitBasic, Coverage, Encounter +154 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`PV1-1`	Set Id - Pv1	SI	Optional	Once		4
`PV1-2`	Patient Class	CWE	Required	Once	0004		Encounter.class Encounter.status
`PV1-3`	Assigned Patient Location	PL	Optional	Once			Encounter.location.location Encounter.location.status
`PV1-4`	Admission Type	CWE	Optional	Once	0007		Encounter.type
`PV1-5`	Preadmit Number	CX	Optional	Once			Encounter.hospitalization.preAdmissionIdentifier
`PV1-6`	Prior Patient Location	PL	Optional	Once			Encounter.location.location Encounter.location.status
`PV1-7`	Attending Doctor	XCN	Optional	Repeats	0010		Encounter.participant.individual Encounter.participant.type.coding.code+2 more
`PV1-8`	Referring Doctor	XCN	Optional	Repeats	0010		Encounter.participant.individual Encounter.participant.type.coding.code+2 more
`PV1-9`	Consulting Doctor	XCN	Backward	Repeats			Encounter.participant.individual Encounter.participant.type.coding.code+2 more
`PV1-10`	Hospital Service	CWE	Optional	Once	0069		Encounter.serviceType
`PV1-11`	Temporary Location	PL	Optional	Once			Encounter.location.location Encounter.location.status+6 more
`PV1-12`	Preadmit Test Indicator	CWE	Optional	Once	0087
`PV1-13`	Re-admission Indicator	CWE	Optional	Once	0092		Encounter.hospitalization.reAdmission
`PV1-14`	Admit Source	CWE	Optional	Once	0023		Encounter.hospitalization.admitSource
`PV1-15`	Ambulatory Status	CWE	Optional	Repeats	0009		Encounter.hospitalization.specialArrangement
`PV1-16`	Vip Indicator	CWE	Optional	Once	0099		Encounter.hospitalization.specialCourtesy Patient.extension
`PV1-17`	Admitting Doctor	XCN	Optional	Repeats	0010		Encounter.participant.individual Encounter.participant.type.coding.code+2 more
`PV1-18`	Patient Type	CWE	Optional	Once	0018
`PV1-19`	Visit Number	CX	Optional	Once			Encounter.identifier Encounter.identifier.type.coding.code+2 more
`PV1-20`	Financial Class	FC	Optional	Repeats			Coverage.type
`PV1-21`	Charge Price Indicator	CWE	Optional	Once	0032
`PV1-22`	Courtesy Code	CWE	Optional	Once	0045
`PV1-23`	Credit Rating	CWE	Optional	Once	0046
`PV1-24`	Contract Code	CWE	Optional	Repeats	0044
`PV1-25`	Contract Effective Date	DT	Optional	Repeats
`PV1-26`	Contract Amount	NM	Optional	Repeats
`PV1-27`	Contract Period	NM	Optional	Repeats
`PV1-28`	Interest Code	CWE	Optional	Once	0073
`PV1-29`	Transfer To Bad Debt Code	CWE	Optional	Once	0110
`PV1-30`	Transfer To Bad Debt Date	DT	Optional	Once
`PV1-31`	Bad Debt Agency Code	CWE	Optional	Once	0021
`PV1-32`	Bad Debt Transfer Amount	NM	Optional	Once
`PV1-33`	Bad Debt Recovery Amount	NM	Optional	Once
`PV1-34`	Delete Account Indicator	CWE	Optional	Once	0111
`PV1-35`	Delete Account Date	DT	Optional	Once
`PV1-36`	Discharge Disposition	CWE	Optional	Once	0112		Encounter.hospitalization.dischargeDisposition
`PV1-37`	Discharged To Location	DLD	Optional	Once			Encounter.hospitalization.destination
`PV1-38`	Diet Type	CWE	Optional	Once	0114		Encounter.hospitalization.dietPreference
`PV1-39`	Servicing Facility	CWE	Optional	Once	0115
`PV1-40`	Bed Status	CWE	Withdrawn	Once	0116		Encounter.location.location
`PV1-41`	Account Status	CWE	Optional	Once	0117
`PV1-42`	Pending Location	PL	Optional	Once			Encounter.location.location Encounter.location.status
`PV1-43`	Prior Temporary Location	PL	Optional	Once			Basic.extension Basic.extension.valueExtension.url+4 more
`PV1-44`	Admit Date/Time	DTM	Optional	Once			Encounter.period.start
`PV1-45`	Discharge Date/Time	DTM	Optional	Once			Encounter.period.end Encounter.status
`PV1-46`	Current Patient Balance	NM	Optional	Once
`PV1-47`	Total Charges	NM	Optional	Once
`PV1-48`	Total Adjustments	NM	Optional	Once
`PV1-49`	Total Payments	NM	Optional	Once
`PV1-50`	Alternate Visit Id	CX	Optional	Once			Encounter.identifier
`PV1-51`	Visit Indicator	CWE	Optional	Once	0326
`PV1-52`	Other Healthcare Provider	ST	Withdrawn	Once			Encounter.participant.individual Encounter.participant.type.coding.code+2 more
`PV1-53`	Service Episode Description	ST	Optional	Once			Encounter.episodeOfCare
`PV1-54`	Service Episode Identifier	CX	Optional	Once			Encounter.episodeOfCare

FHIR map of segment PV1Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

PV2Patient Visit - Additional InformationEncounter50 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`PV2-1`	Prior Pending Location	PL	Conditional	Once			Encounter.location.location Encounter.location.status
`PV2-2`	Accommodation Code	CWE	Optional	Once	0129
`PV2-3`	Admit Reason	CWE	Optional	Once			Encounter.reasonCode
`PV2-4`	Transfer Reason	CWE	Optional	Once
`PV2-5`	Patient Valuables	ST	Optional	Repeats
`PV2-6`	Patient Valuables Location	ST	Optional	Once
`PV2-7`	Visit User Code	CWE	Optional	Repeats	0130
`PV2-8`	Expected Admit Date/Time	DTM	Optional	Once			Encounter.extension
`PV2-9`	Expected Discharge Date/Time	DTM	Optional	Once			Encounter.extension
`PV2-10`	Estimated Length Of Inpatient Stay	NM	Optional	Once
`PV2-11`	Actual Length Of Inpatient Stay	NM	Optional	Once			Encounter.length
`PV2-12`	Visit Description	ST	Optional	Once			Encounter.text.div
`PV2-13`	Referral Source Code	XCN	Optional	Repeats			Encounter.participant.individual Encounter.participant.type.coding.code+2 more
`PV2-14`	Previous Service Date	DT	Optional	Once
`PV2-15`	Employment Illness Related Indicator	ID	Optional	Once	0136	1
`PV2-16`	Purge Status Code	CWE	Optional	Once	0213
`PV2-17`	Purge Status Date	DT	Optional	Once
`PV2-18`	Special Program Code	CWE	Optional	Once	0214
`PV2-19`	Retention Indicator	ID	Optional	Once	0136	1
`PV2-20`	Expected Number Of Insurance Plans	NM	Optional	Once
`PV2-21`	Visit Publicity Code	CWE	Optional	Once	0215
`PV2-22`	Visit Protection Indicator	ID	Backward	Once	0136	1	Encounter.meta.security
`PV2-23`	Clinic Organization Name	XON	Optional	Repeats
`PV2-24`	Patient Status Code	CWE	Optional	Once	0216
`PV2-25`	Visit Priority Code	CWE	Optional	Once	0217		Encounter.priority
`PV2-26`	Previous Treatment Date	DT	Optional	Once
`PV2-27`	Expected Discharge Disposition	CWE	Optional	Once	0112
`PV2-28`	Signature On File Date	DT	Optional	Once
`PV2-29`	First Similar Illness Date	DT	Optional	Once
`PV2-30`	Patient Charge Adjustment Code	CWE	Optional	Once	0218
`PV2-31`	Recurring Service Code	CWE	Optional	Once	0219
`PV2-32`	Billing Media Code	ID	Optional	Once	0136	1
`PV2-33`	Expected Surgery Date And Time	DTM	Optional	Once
`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	CWE	Optional	Once	0430		Encounter.extension
`PV2-39`	Recreational Drug Use Code	CWE	Optional	Repeats	0431
`PV2-40`	Admission Level Of Care Code	CWE	Optional	Once	0432
`PV2-41`	Precaution Code	CWE	Optional	Repeats	0433
`PV2-42`	Patient Condition Code	CWE	Optional	Once	0434
`PV2-43`	Living Will Code	CWE	Optional	Once	0315
`PV2-44`	Organ Donor Code	CWE	Optional	Once	0316
`PV2-45`	Advance Directive Code	CWE	Conditional	Repeats	0435
`PV2-46`	Patient Status Effective Date	DT	Optional	Once
`PV2-47`	Expected Loa Return Date/Time	DTM	Conditional	Once
`PV2-48`	Expected Pre-admission Testing Date/Time	DTM	Optional	Once
`PV2-49`	Notify Clergy Code	CWE	Optional	Repeats	0534
`PV2-50`	Advance Directive Last Verified Date	DT	Optional	Once

FHIR map of segment PV2Defined in versions2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

PYEPayee Information7 fields

Field	Name	Type	Use	Repeats	Table	Length
`PYE-1`	Set Id - Pye	SI	Required	Once		4
`PYE-2`	Payee Type	CWE	Required	Once	0557
`PYE-3`	Payee Relationship To Invoice (patient)	CWE	Conditional	Once	0558
`PYE-4`	Payee Identification List	XON	Conditional	Once
`PYE-5`	Payee Person Name	XPN	Conditional	Once
`PYE-6`	Payee Address	XAD	Conditional	Once
`PYE-7`	Payment Method	CWE	Optional	Once	0570

Defined in versions2.62.72.7.1 2.8

QAKQuery Acknowledgment6 fields

Field	Name	Type	Use	Repeats	Table	Length
`QAK-1`	Query Tag	ST	Conditional	Once
`QAK-2`	Query Response Status	ID	Optional	Once	0208	2
`QAK-3`	Message Query Name	CWE	Optional	Once	0471
`QAK-4`	Hit Count Total	NM	Optional	Once
`QAK-5`	This Payload	NM	Optional	Once
`QAK-6`	Hits Remaining	NM	Optional	Once

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

QIDQuery Identification2 fields

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

Defined in versions2.4 2.5 2.5.1 2.62.72.7.1 2.8

QPDQuery Parameter Definition3 fields

Field	Name	Type	Use	Repeats	Table
`QPD-1`	Message Query Name	CWE	Required	Once	0471
`QPD-2`	Query Tag	ST	Conditional	Once
`QPD-3`	User Parameters (in Successive Fields)	varies	Optional	Once

Defined in versions2.4 2.5 2.5.1 2.62.72.7.1 2.8

QRDWithdrawn1 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`QRD-1`	QRD.1	ST	Optional	Once

Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

QRFWithdrawn1 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`QRF-1`	QRF.1	ST	Optional	Once

Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

QRIQuery Response Instance3 fields

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

Defined in versions2.4 2.5 2.5.1 2.62.72.7.1 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
`RCP-3`	Response Modality	CNE	Optional	Once	0394
`RCP-4`	Execution And Delivery Time	DTM	Conditional	Once
`RCP-5`	Modify Indicator	ID	Optional	Once	0395	1
`RCP-6`	Sort-by Field	SRT	Optional	Repeats
`RCP-7`	Segment Group Inclusion	ID	Optional	Repeats	0391	256

Defined in versions2.4 2.5 2.5.1 2.62.72.7.1 2.8

RDFTable Row Definition2 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`RDF-1`	Number Of Columns Per Row	NM	Required	Once
`RDF-2`	Column Description	RCD	Required	Repeats

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

RDTTable Row Data1 fields

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

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

RELClinical Relationship Segment16 fields

Field	Name	Type	Use	Repeats	Table	Length
`REL-1`	Set Id -rel	SI	Conditional	Once		4
`REL-2`	Relationship Type	CWE	Required	Once
`REL-3`	This Relationship Instance Identifier	EI	Required	Once
`REL-4`	Source Information Instance Identifier	EI	Required	Once
`REL-5`	Target Information Instance Identifier	EI	Required	Once
`REL-6`	Asserting Entity Instance Id	EI	Optional	Once
`REL-7`	Asserting Person	XCN	Optional	Once
`REL-8`	Asserting Organization	XON	Optional	Once
`REL-9`	Assertor Address	XAD	Optional	Once
`REL-10`	Assertor Contact	XTN	Optional	Once
`REL-11`	Assertion Date Range	DR	Optional	Once
`REL-12`	Negation Indicator	ID	Optional	Once	0136	1
`REL-13`	Certainty Of Relationship	CWE	Optional	Once
`REL-14`	Priority No	NM	Optional	Once
`REL-15`	Priority Sequence No (rel Preference For Consideration)	NM	Optional	Once
`REL-16`	Separability Indicator	ID	Optional	Once	0136	1

Defined in versions2.62.72.7.1 2.8

RF1Referral Information12 fields

Field	Name	Type	Use	Repeats	Table
`RF1-1`	Referral Status	CWE	Optional	Once	0283
`RF1-2`	Referral Priority	CWE	Optional	Once	0280
`RF1-3`	Referral Type	CWE	Optional	Once	0281
`RF1-4`	Referral Disposition	CWE	Optional	Repeats	0282
`RF1-5`	Referral Category	CWE	Optional	Once	0284
`RF1-6`	Originating Referral Identifier	EI	Required	Once
`RF1-7`	Effective Date	DTM	Optional	Once
`RF1-8`	Expiration Date	DTM	Optional	Once
`RF1-9`	Process Date	DTM	Optional	Once
`RF1-10`	Referral Reason	CWE	Optional	Repeats	0336
`RF1-11`	External Referral Identifier	EI	Optional	Repeats
`RF1-12`	Referral Documentation Completion Status	CWE	Optional	Once	0865

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

RFIRequest For Information4 fields

Field	Name	Type	Use	Repeats	Table	Length
`RFI-1`	Request Date	DTM	Required	Once
`RFI-2`	Response Due Date	DTM	Required	Once
`RFI-3`	Patient Consent	ID	Optional	Once	0136	1
`RFI-4`	Date Additional Information Was Submitted	DTM	Optional	Once

Defined in versions2.62.72.7.1 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	1
`RGS-3`	Resource Group Id	CWE	Optional	Once

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

RMIRisk Management Incident3 fields

Field	Name	Type	Use	Repeats	Table
`RMI-1`	Risk Management Incident Code	CWE	Optional	Once	0427
`RMI-2`	Date/Time Incident	DTM	Optional	Once
`RMI-3`	Incident Type Code	CWE	Optional	Once	0428

Defined in versions2.4 2.5 2.5.1 2.62.72.7.1 2.8

ROLRolePatient, Encounter, CareTeam +114 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`ROL-1`	Role Instance Id	EI	Conditional	Once			Patient.generalPractitioner Encounter.participant.individual.reference+2 more
`ROL-2`	Action Code	ID	Required	Once	0287	2
`ROL-3`	Role-rol	CWE	Required	Once	0443		Patient.generalPractitioner Encounter.participant.type+2 more
`ROL-4`	Role Person	XCN	Required	Repeats			Patient.generalPractitioner Encounter.participant.individual+2 more
`ROL-5`	Role Begin Date/Time	DTM	Optional	Once			Patient.generalPractitioner Encounter.participant.period.start+2 more
`ROL-6`	Role End Date/Time	DTM	Optional	Once			Patient.generalPractitioner Encounter.participant.period.end+2 more
`ROL-7`	Role Duration	CWE	Optional	Once
`ROL-8`	Role Action Reason	CWE	Optional	Once			CareTeam.reasonCode
`ROL-9`	Provider Type	CWE	Optional	Repeats			CareTeam.participant.role
`ROL-10`	Organization Unit Type	CWE	Optional	Once	0406		CareTeam.participant.onBehalfOf CareTeam.participant.member
`ROL-11`	Office/Home Address/Birthplace	XAD	Optional	Repeats			Patient.generalPractitioner)Encounter.participant.individual)+1 more
`ROL-12`	Phone	XTN	Optional	Repeats			Patient.generalPractitioner Encounter.participant.individual+2 more
`ROL-13`	Person's Location	PL	Optional	Once			Patient.generalPractitioner)Encounter.participant.individual)
`ROL-14`	Organization	XON	Optional	Once			Patient.generalPractitioner)Encounter.participant.individual)+2 more

FHIR map of segment ROLDefined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

RQ1Requisition Detail-17 fields

Field	Name	Type	Use	Repeats	Table	Length
`RQ1-1`	Anticipated Price	ST	Optional	Once
`RQ1-2`	Manufacturer Identifier	CWE	Conditional	Once	0385
`RQ1-3`	Manufacturer's Catalog	ST	Conditional	Once
`RQ1-4`	Vendor Id	CWE	Conditional	Once	9999
`RQ1-5`	Vendor Catalog	ST	Conditional	Once
`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 2.5 2.5.1 2.62.72.7.1 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	CWE	Conditional	Once	9999
`RQD-3`	Item Code - External	CWE	Conditional	Once	9999
`RQD-4`	Hospital Item Code	CWE	Conditional	Once	9999
`RQD-5`	Requisition Quantity	NM	Optional	Once
`RQD-6`	Requisition Unit Of Measure	CWE	Optional	Once	9999
`RQD-7`	Cost Center Account Number	CX	Optional	Once	0319
`RQD-8`	Item Natural Account Code	CWE	Optional	Once	0320
`RQD-9`	Deliver To Id	CWE	Optional	Once	9999
`RQD-10`	Date Needed	DT	Optional	Once

Defined in versions2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

RXAPharmacy/treatment AdministrationImmunization28 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`RXA-1`	Give Sub-id Counter	NM	Required	Once
`RXA-2`	Administration Sub-id Counter	NM	Required	Once
`RXA-3`	Date/Time Start Of Administration	DTM	Required	Once			Immunization.occurrenceDateTime
`RXA-4`	Date/Time End Of Administration	DTM	Required	Once
`RXA-5`	Administered Code	CWE	Required	Once	0292		Immunization.vaccineCode
`RXA-6`	Administered Amount	NM	Required	Once			Immunization.doseQuantity.value
`RXA-7`	Administered Units	CWE	Conditional	Once	9999		Immunization.doseQuantity
`RXA-8`	Administered Dosage Form	CWE	Optional	Once	9999
`RXA-9`	Administration Notes	CWE	Optional	Repeats	9999
`RXA-10`	Administering Provider	XCN	Backward	Repeats			Immunization.performer.actor Immunization.performer.function.coding.code+1 more
`RXA-11`	Administered-at Location	LA2	Backward	Once
`RXA-12`	Administered Per (time Unit)	ST	Conditional	Once
`RXA-13`	Administered Strength	NM	Optional	Once
`RXA-14`	Administered Strength Units	CWE	Optional	Once	9999
`RXA-15`	Substance Lot Number	ST	Optional	Repeats			Immunization.lotNumber
`RXA-16`	Substance Expiration Date	DTM	Optional	Repeats			Immunization.expirationDate
`RXA-17`	Substance Manufacturer Name	CWE	Optional	Repeats	0227		Immunization.manufacturer
`RXA-18`	Substance/Treatment Refusal Reason	CWE	Optional	Repeats	9999		Immunization.statusReason
`RXA-19`	Indication	CWE	Optional	Repeats	9999		Immunization.reasonCode
`RXA-20`	Completion Status	ID	Optional	Once	0322	2	Immunization.status
`RXA-21`	Action Code - Rxa	ID	Optional	Once	0206	1	Immunization.status
`RXA-22`	System Entry Date/Time	DTM	Optional	Once			Immunization.recorded
`RXA-23`	Administered Drug Strength Volume	NM	Optional	Once
`RXA-24`	Administered Drug Strength Volume Units	CWE	Optional	Once	9999
`RXA-25`	Administered Barcode Identifier	CWE	Optional	Once	9999
`RXA-26`	Pharmacy Order Type	ID	Optional	Once	0480	1
`RXA-27`	Administer-at	PL	Optional	Once			Immunization.location
`RXA-28`	Administered-at Address	XAD	Optional	Once			Immunization.location

FHIR map of segment RXADefined in versions2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 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	CWE	Required	Once	9999
`RXC-3`	Component Amount	NM	Required	Once
`RXC-4`	Component Units	CWE	Required	Once	9999
`RXC-5`	Component Strength	NM	Optional	Once
`RXC-6`	Component Strength Units	CWE	Optional	Once	9999
`RXC-7`	Supplementary Code	CWE	Optional	Repeats	9999
`RXC-8`	Component Drug Strength Volume	NM	Optional	Once
`RXC-9`	Component Drug Strength Volume Units	CWE	Optional	Once	9999

Defined in versions2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

RXDPharmacy/treatment Dispense34 fields

Field	Name	Type	Use	Repeats	Table	Length
`RXD-1`	Dispense Sub-id Counter	NM	Required	Once
`RXD-2`	Dispense/Give Code	CWE	Required	Once	0292
`RXD-3`	Date/Time Dispensed	DTM	Required	Once
`RXD-4`	Actual Dispense Amount	NM	Required	Once
`RXD-5`	Actual Dispense Units	CWE	Conditional	Once	9999
`RXD-6`	Actual Dosage Form	CWE	Optional	Once	9999
`RXD-7`	Prescription Number	ST	Required	Once
`RXD-8`	Number Of Refills Remaining	NM	Conditional	Once
`RXD-9`	Dispense Notes	ST	Optional	Repeats
`RXD-10`	Dispensing Provider	XCN	Backward	Repeats
`RXD-11`	Substitution Status	ID	Optional	Once	0167	1
`RXD-12`	Total Daily Dose	CQ	Optional	Once
`RXD-13`	Dispense-to Location	LA2	Backward	Once
`RXD-14`	Needs Human Review	ID	Optional	Once	0136	1
`RXD-15`	Pharmacy/Treatment Supplier's Special Dispensing Instructions	CWE	Optional	Repeats	9999
`RXD-16`	Actual Strength	NM	Optional	Once
`RXD-17`	Actual Strength Unit	CWE	Optional	Once	9999
`RXD-18`	Substance Lot Number	ST	Optional	Repeats
`RXD-19`	Substance Expiration Date	DTM	Optional	Repeats
`RXD-20`	Substance Manufacturer Name	CWE	Optional	Repeats	0227
`RXD-21`	Indication	CWE	Optional	Repeats	9999
`RXD-22`	Dispense Package Size	NM	Optional	Once
`RXD-23`	Dispense Package Size Unit	CWE	Optional	Once	9999
`RXD-24`	Dispense Package Method	ID	Optional	Once	0321	2
`RXD-25`	Supplementary Code	CWE	Optional	Repeats	9999
`RXD-26`	Initiating Location	CWE	Optional	Once	9999
`RXD-27`	Packaging/Assembly Location	CWE	Optional	Once	9999
`RXD-28`	Actual Drug Strength Volume	NM	Optional	Once
`RXD-29`	Actual Drug Strength Volume Units	CWE	Optional	Once	9999
`RXD-30`	Dispense To Pharmacy	CWE	Backward	Once	9999
`RXD-31`	Dispense To Pharmacy Address	XAD	Backward	Once
`RXD-32`	Pharmacy Order Type	ID	Optional	Once	0480	1
`RXD-33`	Dispense Type	CWE	Optional	Once	0484
`RXD-34`	Pharmacy Phone Number	XTN	Optional	Repeats

Defined in versions2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

RXEPharmacy/treatment Encoded Order45 fields

Field	Name	Type	Use	Repeats	Table	Length
`RXE-1`	Quantity/Timing	ST	Withdrawn	Once
`RXE-2`	Give Code	CWE	Required	Once	0292
`RXE-3`	Give Amount - Minimum	NM	Required	Once
`RXE-4`	Give Amount - Maximum	NM	Optional	Once
`RXE-5`	Give Units	CWE	Required	Once	9999
`RXE-6`	Give Dosage Form	CWE	Optional	Once	9999
`RXE-7`	Provider's Administration Instructions	CWE	Optional	Repeats	9999
`RXE-8`	Deliver-to Location	LA1	Withdrawn	Once
`RXE-9`	Substitution Status	ID	Optional	Once	0167	1
`RXE-10`	Dispense Amount	NM	Conditional	Once
`RXE-11`	Dispense Units	CWE	Conditional	Once	9999
`RXE-12`	Number Of Refills	NM	Optional	Once
`RXE-13`	Ordering Provider's Dea Number	XCN	Backward	Repeats
`RXE-14`	Pharmacist/Treatment Supplier's Verifier Id	XCN	Backward	Repeats
`RXE-15`	Prescription Number	ST	Conditional	Once
`RXE-16`	Number Of Refills Remaining	NM	Conditional	Once
`RXE-17`	Number Of Refills/Doses Dispensed	NM	Conditional	Once
`RXE-18`	D/T Of Most Recent Refill Or Dose Dispensed	DTM	Conditional	Once
`RXE-19`	Total Daily Dose	CQ	Conditional	Once
`RXE-20`	Needs Human Review	ID	Optional	Once	0136	1
`RXE-21`	Pharmacy/Treatment Supplier's Special Dispensing Instructions	CWE	Optional	Repeats	9999
`RXE-22`	Give Per (time Unit)	ST	Conditional	Once
`RXE-23`	Give Rate Amount	ST	Optional	Once
`RXE-24`	Give Rate Units	CWE	Optional	Once	9999
`RXE-25`	Give Strength	NM	Optional	Once
`RXE-26`	Give Strength Units	CWE	Optional	Once	9999
`RXE-27`	Give Indication	CWE	Optional	Repeats	9999
`RXE-28`	Dispense Package Size	NM	Optional	Once
`RXE-29`	Dispense Package Size Unit	CWE	Optional	Once	9999
`RXE-30`	Dispense Package Method	ID	Optional	Once	0321	2
`RXE-31`	Supplementary Code	CWE	Optional	Repeats	9999
`RXE-32`	Original Order Date/Time	DTM	Optional	Once
`RXE-33`	Give Drug Strength Volume	NM	Optional	Once
`RXE-34`	Give Drug Strength Volume Units	CWE	Optional	Once	9999
`RXE-35`	Controlled Substance Schedule	CWE	Optional	Once	0477
`RXE-36`	Formulary Status	ID	Optional	Once	0478	1
`RXE-37`	Pharmaceutical Substance Alternative	CWE	Optional	Repeats	9999
`RXE-38`	Pharmacy Of Most Recent Fill	CWE	Optional	Once	9999
`RXE-39`	Initial Dispense Amount	NM	Optional	Once
`RXE-40`	Dispensing Pharmacy	CWE	Backward	Once	9999
`RXE-41`	Dispensing Pharmacy Address	XAD	Backward	Once
`RXE-42`	Deliver-to Patient Location	PL	Optional	Once
`RXE-43`	Deliver-to Address	XAD	Optional	Once
`RXE-44`	Pharmacy Order Type	ID	Optional	Once	0480	1
`RXE-45`	Pharmacy Phone Number	XTN	Optional	Repeats

Defined in versions2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

RXGPharmacy/treatment Give30 fields

Field	Name	Type	Use	Repeats	Table	Length
`RXG-1`	Give Sub-id Counter	NM	Required	Once
`RXG-2`	Dispense Sub-id Counter	NM	Optional	Once
`RXG-3`	Quantity/Timing	ST	Withdrawn	Once
`RXG-4`	Give Code	CWE	Required	Once	0292
`RXG-5`	Give Amount - Minimum	NM	Required	Once
`RXG-6`	Give Amount - Maximum	NM	Optional	Once
`RXG-7`	Give Units	CWE	Required	Once	9999
`RXG-8`	Give Dosage Form	CWE	Optional	Once	9999
`RXG-9`	Administration Notes	CWE	Optional	Repeats	9999
`RXG-10`	Substitution Status	ID	Optional	Once	0167	1
`RXG-11`	Dispense-to Location	LA2	Backward	Once
`RXG-12`	Needs Human Review	ID	Optional	Once	0136	1
`RXG-13`	Pharmacy/Treatment Supplier's Special Administration Instructions	CWE	Optional	Repeats	9999	250
`RXG-14`	Give Per (time Unit)	ST	Conditional	Once
`RXG-15`	Give Rate Amount	ST	Optional	Once
`RXG-16`	Give Rate Units	CWE	Optional	Once	9999
`RXG-17`	Give Strength	NM	Optional	Once
`RXG-18`	Give Strength Units	CWE	Optional	Once	9999
`RXG-19`	Substance Lot Number	ST	Optional	Repeats
`RXG-20`	Substance Expiration Date	DTM	Optional	Repeats
`RXG-21`	Substance Manufacturer Name	CWE	Optional	Repeats	0227
`RXG-22`	Indication	CWE	Optional	Repeats	9999
`RXG-23`	Give Drug Strength Volume	NM	Optional	Once
`RXG-24`	Give Drug Strength Volume Units	CWE	Optional	Once	9999
`RXG-25`	Give Barcode Identifier	CWE	Optional	Once	9999
`RXG-26`	Pharmacy Order Type	ID	Optional	Once	0480	1
`RXG-27`	Dispense To Pharmacy	CWE	Backward	Once	9999
`RXG-28`	Dispense To Pharmacy Address	XAD	Backward	Once
`RXG-29`	Deliver-to Patient Location	PL	Optional	Once
`RXG-30`	Deliver-to Address	XAD	Optional	Once

Defined in versions2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

RXOPharmacy/treatment OrderMedicationRequest36 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`RXO-1`	Requested Give Code	CWE	Conditional	Once	9999		MedicationRequest.medication
`RXO-2`	Requested Give Amount - Minimum	NM	Conditional	Once			MedicationRequest.dosageInstruction.doseAndRate.doseRange.low.value MedicationRequest.dosageInstruction.doseAndRate.type
`RXO-3`	Requested Give Amount - Maximum	NM	Optional	Once			MedicationRequest.dosageInstruction.doseAndRate.doseRange.high.value
`RXO-4`	Requested Give Units	CWE	Conditional	Once	9999		MedicationRequest.dosageInstruction.doseAndRate.doseRange.low.code MedicationRequest.dosageInstruction.doseAndRate.doseRange.low.unit+2 more
`RXO-5`	Requested Dosage Form	CWE	Conditional	Once	9999		MedicationRequest.medication
`RXO-6`	Provider's Pharmacy/Treatment Instructions	CWE	Optional	Repeats	9999
`RXO-7`	Provider's Administration Instructions	CWE	Optional	Repeats	9999
`RXO-8`	Deliver-to Location	LA1	Backward	Once
`RXO-9`	Allow Substitutions	ID	Optional	Once	0161	1	MedicationRequest.substitution.allowedCodeableConcept
`RXO-10`	Requested Dispense Code	CWE	Optional	Once	9999
`RXO-11`	Requested Dispense Amount	NM	Optional	Once			MedicationRequest.dispenseRequest.quantity.value
`RXO-12`	Requested Dispense Units	CWE	Optional	Once	9999		MedicationRequest.dispenseRequest.quantity.code MedicationRequest.dispenseRequest.quantity.unit
`RXO-13`	Number Of Refills	NM	Optional	Once			MedicationRequest.dispenseRequest.numberOfRepeatsAllowed
`RXO-14`	Ordering Provider's Dea Number	XCN	Backward	Repeats			MedicationRequest.requester
`RXO-15`	Pharmacist/Treatment Supplier's Verifier Id	XCN	Conditional	Repeats
`RXO-16`	Needs Human Review	ID	Optional	Once	0136	1
`RXO-17`	Requested Give Per (time Unit)	ST	Conditional	Once
`RXO-18`	Requested Give Strength	NM	Optional	Once			MedicationRequest.medicationReference(Medication.ingredient.strength.numerator.value
`RXO-19`	Requested Give Strength Units	CWE	Optional	Once	9999		MedicationRequest.medicationReference(Medication.ingredient.strength.numerator.code MedicationRequest.medicationReference(Medication.ingredient.strength.numerator.unit+3 more
`RXO-20`	Indication	CWE	Optional	Repeats	9999
`RXO-21`	Requested Give Rate Amount	ST	Optional	Once
`RXO-22`	Requested Give Rate Units	CWE	Optional	Once	9999
`RXO-23`	Total Daily Dose	CQ	Optional	Once
`RXO-24`	Supplementary Code	CWE	Optional	Repeats	9999
`RXO-25`	Requested Drug Strength Volume	NM	Optional	Once			MedicationRequest.medicationReference(Medication.ingredient.strength.denominator.value
`RXO-26`	Requested Drug Strength Volume Units	CWE	Optional	Once	9999		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
`RXO-29`	Medication Instance Identifier	EI	Optional	Once
`RXO-30`	Segment Instance Identifier	EI	Optional	Once
`RXO-31`	Mood Code	CNE	Conditional	Once	0725
`RXO-32`	Dispensing Pharmacy	CWE	Backward	Once	9999
`RXO-33`	Dispensing Pharmacy Address	XAD	Backward	Once
`RXO-34`	Deliver-to Patient Location	PL	Optional	Once
`RXO-35`	Deliver-to Address	XAD	Optional	Once
`RXO-36`	Pharmacy Phone Number	XTN	Optional	Repeats

FHIR map of segment RXODefined in versions2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

RXRPharmacy/treatment RouteImmunization, MedicationRequest6 fields

Field	Name	Type	Use	Repeats	Table	FHIR
`RXR-1`	Route	CWE	Required	Once	0162	Immunization.route MedicationRequest.dosageInstruction.route
`RXR-2`	Administration Site	CWE	Optional	Once	0550	Immunization.site MedicationRequest.dosageInstruction.site
`RXR-3`	Administration Device	CWE	Optional	Once	0164
`RXR-4`	Administration Method	CWE	Optional	Once	0165	MedicationRequest.dosageInstruction.method
`RXR-5`	Routing Instruction	CWE	Optional	Once	9999	MedicationRequest.dosageInstruction.additionalInstruction
`RXR-6`	Administration Site Modifier	CWE	Optional	Once	0495

FHIR map of segment RXRDefined in versions2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

SACSpecimen Container Detail44 fields

Field	Name	Type	Use	Repeats	Table
`SAC-1`	External Accession Identifier	EI	Optional	Once
`SAC-2`	Accession Identifier	EI	Optional	Once
`SAC-3`	Container Identifier	EI	Conditional	Once
`SAC-4`	Primary (parent) Container Identifier	EI	Conditional	Once
`SAC-5`	Equipment Container Identifier	EI	Optional	Once
`SAC-6`	Specimen Source	ST	Withdrawn	Once
`SAC-7`	Registration Date/Time	DTM	Optional	Once
`SAC-8`	Container Status	CWE	Optional	Once	0370
`SAC-9`	Carrier Type	CWE	Optional	Once	0378
`SAC-10`	Carrier Identifier	EI	Optional	Once
`SAC-11`	Position In Carrier	NA	Optional	Once
`SAC-12`	Tray Type - Sac	CWE	Optional	Once	0379
`SAC-13`	Tray Identifier	EI	Optional	Once
`SAC-14`	Position In Tray	NA	Optional	Once
`SAC-15`	Location	CWE	Optional	Repeats	9999
`SAC-16`	Container Height	NM	Optional	Once
`SAC-17`	Container Diameter	NM	Optional	Once
`SAC-18`	Barrier Delta	NM	Optional	Once
`SAC-19`	Bottom Delta	NM	Optional	Once
`SAC-20`	Container Height/Diameter/Delta Units	CWE	Optional	Once	9999
`SAC-21`	Container Volume	NM	Optional	Once
`SAC-22`	Available Specimen Volume	NM	Optional	Once
`SAC-23`	Initial Specimen Volume	NM	Optional	Once
`SAC-24`	Volume Units	CWE	Optional	Once	9999
`SAC-25`	Separator Type	CWE	Optional	Once	0380
`SAC-26`	Cap Type	CWE	Optional	Once	0381
`SAC-27`	Additive	CWE	Optional	Repeats	0371
`SAC-28`	Specimen Component	CWE	Optional	Once	0372
`SAC-29`	Dilution Factor	SN	Optional	Once
`SAC-30`	Treatment	CWE	Optional	Once	0373
`SAC-31`	Temperature	SN	Optional	Once
`SAC-32`	Hemolysis Index	NM	Optional	Once
`SAC-33`	Hemolysis Index Units	CWE	Optional	Once	9999
`SAC-34`	Lipemia Index	NM	Optional	Once
`SAC-35`	Lipemia Index Units	CWE	Optional	Once	9999
`SAC-36`	Icterus Index	NM	Optional	Once
`SAC-37`	Icterus Index Units	CWE	Optional	Once	9999
`SAC-38`	Fibrin Index	NM	Optional	Once
`SAC-39`	Fibrin Index Units	CWE	Optional	Once	9999
`SAC-40`	System Induced Contaminants	CWE	Optional	Repeats	0374
`SAC-41`	Drug Interference	CWE	Optional	Repeats	0382
`SAC-42`	Artificial Blood	CWE	Optional	Once	0375
`SAC-43`	Special Handling Code	CWE	Optional	Repeats	0376
`SAC-44`	Other Environmental Factors	CWE	Optional	Repeats	0377

Defined in versions2.4 2.5 2.5.1 2.62.72.7.1 2.8

SCDAnti-microbial Cycle Data37 fields

Field	Name	Type	Use	Repeats	Table
`SCD-1`	Cycle Start Time	TM	Optional	Once
`SCD-2`	Cycle Count	NM	Optional	Once
`SCD-3`	Temp Max	CQ	Optional	Once
`SCD-4`	Temp Min	CQ	Optional	Once
`SCD-5`	Load Number	NM	Optional	Once
`SCD-6`	Condition Time	CQ	Optional	Once
`SCD-7`	Sterilize Time	CQ	Optional	Once
`SCD-8`	Exhaust Time	CQ	Optional	Once
`SCD-9`	Total Cycle Time	CQ	Optional	Once
`SCD-10`	Device Status	CWE	Optional	Once	0682
`SCD-11`	Cycle Start Date/Time	DTM	Optional	Once
`SCD-12`	Dry Time	CQ	Optional	Once
`SCD-13`	Leak Rate	CQ	Optional	Once
`SCD-14`	Control Temperature	CQ	Optional	Once
`SCD-15`	Sterilizer Temperature	CQ	Optional	Once
`SCD-16`	Cycle Complete Time	TM	Optional	Once
`SCD-17`	Under Temperature	CQ	Optional	Once
`SCD-18`	Over Temperature	CQ	Optional	Once
`SCD-19`	Abort Cycle	CNE	Optional	Once	0532
`SCD-20`	Alarm	CNE	Optional	Once	0532
`SCD-21`	Long In Charge Phase	CNE	Optional	Once	0532
`SCD-22`	Long In Exhaust Phase	CNE	Optional	Once	0532
`SCD-23`	Long In Fast Exhaust Phase	CNE	Optional	Once	0532
`SCD-24`	Reset	CNE	Optional	Once	0532
`SCD-25`	Operator - Unload	XCN	Optional	Once
`SCD-26`	Door Open	CNE	Optional	Once	0532
`SCD-27`	Reading Failure	CNE	Optional	Once	0532
`SCD-28`	Cycle Type	CWE	Optional	Once	0702
`SCD-29`	Thermal Rinse Time	CQ	Optional	Once
`SCD-30`	Wash Time	CQ	Optional	Once
`SCD-31`	Injection Rate	CQ	Optional	Once
`SCD-32`	Procedure Code	CNE	Optional	Once	0088
`SCD-33`	Patient Identifier List	CX	Optional	Repeats
`SCD-34`	Attending Doctor	XCN	Optional	Once	0010
`SCD-35`	Dilution Factor	SN	Optional	Once
`SCD-36`	Fill Time	CQ	Optional	Once
`SCD-37`	Inlet Temperature	CQ	Optional	Once

Defined in versions2.62.72.7.1 2.8

SCHScheduling Activity InformationAppointment, Provenance, ServiceRequest27 fields

Field	Name	Type	Use	Repeats	Table	FHIR
`SCH-1`	Placer Appointment Id	EI	Conditional	Once		Appointment.identifier
`SCH-2`	Filler Appointment Id	EI	Conditional	Once		Appointment.identifier
`SCH-3`	Occurrence Number	NM	Conditional	Once
`SCH-4`	Placer Group Number	EI	Optional	Once
`SCH-5`	Schedule Id	CWE	Optional	Once
`SCH-6`	Event Reason	CWE	Required	Once		ServiceRequest.intent
`SCH-7`	Appointment Reason	CWE	Optional	Once	0276	Appointment.reasonCode Appointment.appointmentType
`SCH-8`	Appointment Type	CWE	Optional	Once	0277	Appointment.appointmentType
`SCH-9`	Appointment Duration	NM	Withdrawn	Once		Appointment.minutesDuration
`SCH-10`	Appointment Duration Units	CNE	Backward	Once
`SCH-11`	Appointment Timing Quantity	ST	Withdrawn	Once		Appointment.$this
`SCH-12`	Placer Contact Person	XCN	Optional	Repeats		Appointment.participant.actor Appointment.participant.type.coding.code+1 more
`SCH-13`	Placer Contact Phone Number	XTN	Optional	Once
`SCH-14`	Placer Contact Address	XAD	Optional	Repeats
`SCH-15`	Placer Contact Location	PL	Optional	Once
`SCH-16`	Filler Contact Person	XCN	Required	Repeats		Appointment.participant.actor Appointment.participant.type.coding.code+1 more
`SCH-17`	Filler Contact Phone Number	XTN	Optional	Once
`SCH-18`	Filler Contact Address	XAD	Optional	Repeats
`SCH-19`	Filler Contact Location	PL	Optional	Once
`SCH-20`	Entered By Person	XCN	Required	Repeats		Appointment.participant.actor Appointment.participant.type.coding.code+4 more
`SCH-21`	Entered By Phone Number	XTN	Optional	Repeats
`SCH-22`	Entered By Location	PL	Optional	Once
`SCH-23`	Parent Placer Appointment Id	EI	Optional	Once
`SCH-24`	Parent Filler Appointment Id	EI	Conditional	Once
`SCH-25`	Filler Status Code	CWE	Optional	Once	0278	Appointment.status ServiceRequest.status
`SCH-26`	Placer Order Number	EI	Conditional	Repeats		Appointment.basedOn ServiceRequest.identifier
`SCH-27`	Filler Order Number	EI	Conditional	Repeats		Appointment.basedOn ServiceRequest.identifier

FHIR map of segment SCHDefined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

SCPSterilizer Configuration (anti-microbial Devices)8 fields

Field	Name	Type	Use	Repeats	Table
`SCP-1`	Number Of Decontamination/Sterilization Devices	NM	Optional	Once
`SCP-2`	Labor Calculation Type	CWE	Optional	Once	0651
`SCP-3`	Date Format	CWE	Optional	Once	0653
`SCP-4`	Device Number	EI	Optional	Once
`SCP-5`	Device Name	ST	Optional	Once
`SCP-6`	Device Model Name	ST	Optional	Once
`SCP-7`	Device Type	CWE	Optional	Once	0657
`SCP-8`	Lot Control	CWE	Optional	Once	0659

Defined in versions2.62.72.7.1 2.8

SDDSterilization Device Data7 fields

Field	Name	Type	Use	Repeats	Table
`SDD-1`	Lot Number	EI	Optional	Once
`SDD-2`	Device Number	EI	Optional	Once
`SDD-3`	Device Name	ST	Optional	Once
`SDD-4`	Device Data State	CWE	Optional	Once	0667
`SDD-5`	Load Status	CWE	Optional	Once	0669
`SDD-6`	Control Code	NM	Optional	Once
`SDD-7`	Operator Name	ST	Optional	Once

Defined in versions2.62.72.7.1 2.8

SFTSoftware SegmentDevice, MessageHeader6 fields

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

FHIR map of segment SFTDefined in versions2.5 2.5.1 2.62.72.7.1 2.8

SHPShipment11 fields

Field	Name	Type	Use	Repeats	Table
`SHP-1`	Shipment Id	EI	Required	Once
`SHP-2`	Internal Shipment Id	EI	Optional	Repeats
`SHP-3`	Shipment Status	CWE	Optional	Once	0905
`SHP-4`	Shipment Status Date/Time	DTM	Required	Once
`SHP-5`	Shipment Status Reason	TX	Optional	Once
`SHP-6`	Shipment Priority	CWE	Optional	Once	0906
`SHP-7`	Shipment Confidentiality	CWE	Optional	Repeats	0907
`SHP-8`	Number Of Packages In Shipment	NM	Optional	Once
`SHP-9`	Shipment Condition	CWE	Optional	Repeats	0544
`SHP-10`	Shipment Handling Code	CWE	Optional	Repeats	0376
`SHP-11`	Shipment Risk Code	CWE	Optional	Repeats	0489

Defined in versions2.72.7.1 2.8

SIDSubstance Identifier4 fields

Field	Name	Type	Use	Repeats	Table
`SID-1`	Application/Method Identifier	CWE	Conditional	Once	9999
`SID-2`	Substance Lot Number	ST	Conditional	Once
`SID-3`	Substance Container Identifier	ST	Conditional	Once
`SID-4`	Substance Manufacturer Identifier	CWE	Conditional	Once	0385

Defined in versions2.4 2.5 2.5.1 2.62.72.7.1 2.8

SLTSterilization Lot5 fields

Field	Name	Type	Use	Repeats
`SLT-1`	Device Number	EI	Optional	Once
`SLT-2`	Device Name	ST	Optional	Once
`SLT-3`	Lot Number	EI	Optional	Once
`SLT-4`	Item Identifier	EI	Optional	Once
`SLT-5`	Bar Code	ST	Optional	Once

Defined in versions2.62.72.7.1 2.8

SPMSpecimenSpecimen32 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			Specimen.identifier
`SPM-3`	Specimen Parent Ids	EIP	Optional	Repeats			Specimen.parent
`SPM-4`	Specimen Type	CWE	Required	Once	0487		Specimen.type
`SPM-5`	Specimen Type Modifier	CWE	Optional	Repeats	0541
`SPM-6`	Specimen Additives	CWE	Optional	Repeats	0371		Specimen.container.additiveCodeableConcept
`SPM-7`	Specimen Collection Method	CWE	Optional	Once	0488		Specimen.collection.method
`SPM-8`	Specimen Source Site	CWE	Optional	Once	9999		Specimen.collection.bodySite
`SPM-9`	Specimen Source Site Modifier	CWE	Optional	Repeats	0542
`SPM-10`	Specimen Collection Site	CWE	Optional	Once	0543
`SPM-11`	Specimen Role	CWE	Optional	Repeats	0369
`SPM-12`	Specimen Collection Amount	CQ	Optional	Once			Specimen.collection.quantity
`SPM-13`	Grouped Specimen Count	NM	Conditional	Once
`SPM-14`	Specimen Description	ST	Optional	Repeats			Specimen.note
`SPM-15`	Specimen Handling Code	CWE	Optional	Repeats	0376
`SPM-16`	Specimen Risk Code	CWE	Optional	Repeats	0489
`SPM-17`	Specimen Collection Date/Time	DR	Optional	Once			Specimen.collection.collectedPeriod Specimen.collection.collectedDateTime
`SPM-18`	Specimen Received Date/Time	DTM	Optional	Once			Specimen.receivedTime
`SPM-19`	Specimen Expiration Date/Time	DTM	Optional	Once
`SPM-20`	Specimen Availability	ID	Optional	Once	0136	1	Specimen.status
`SPM-21`	Specimen Reject Reason	CWE	Optional	Repeats	0490
`SPM-22`	Specimen Quality	CWE	Optional	Once	0491
`SPM-23`	Specimen Appropriateness	CWE	Optional	Once	0492
`SPM-24`	Specimen Condition	CWE	Optional	Repeats	0493		Specimen.condition
`SPM-25`	Specimen Current Quantity	CQ	Optional	Once
`SPM-26`	Number Of Specimen Containers	NM	Optional	Once
`SPM-27`	Container Type	CWE	Optional	Once	9999		Specimen.container.type
`SPM-28`	Container Condition	CWE	Optional	Once	0544
`SPM-29`	Specimen Child Role	CWE	Optional	Once	0494
`SPM-30`	Accession Id	CX	Optional	Repeats			Specimen.accessionIdentifier
`SPM-31`	Other Specimen Id	CX	Optional	Repeats			Specimen.identifier
`SPM-32`	Shipment Id	EI	Optional	Once			Specimen.identifier Specimen.identifier.type.coding.code+1 more

FHIR map of segment SPMDefined in versions2.5 2.5.1 2.62.72.7.1 2.8

STFStaff Identification41 fields

Field	Name	Type	Use	Repeats	Table	Length
`STF-1`	Primary Key Value - Stf	CWE	Conditional	Once	9999
`STF-2`	Staff Identifier List	CX	Optional	Repeats
`STF-3`	Staff Name	XPN	Optional	Repeats
`STF-4`	Staff Type	CWE	Optional	Repeats	0182
`STF-5`	Administrative Sex	CWE	Optional	Once	0001
`STF-6`	Date/Time Of Birth	DTM	Optional	Once
`STF-7`	Active/Inactive Flag	ID	Optional	Once	0183	1
`STF-8`	Department	CWE	Optional	Repeats	0184
`STF-9`	Hospital Service - Stf	CWE	Optional	Repeats	0069
`STF-10`	Phone	XTN	Optional	Repeats
`STF-11`	Office/Home Address/Birthplace	XAD	Optional	Repeats
`STF-12`	Institution Activation Date	DIN	Optional	Repeats
`STF-13`	Institution Inactivation Date	DIN	Optional	Repeats
`STF-14`	Backup Person Id	CWE	Optional	Repeats
`STF-15`	E-mail Address	ST	Backward	Repeats
`STF-16`	Preferred Method Of Contact	CWE	Optional	Once	0185
`STF-17`	Marital Status	CWE	Optional	Once	0002
`STF-18`	Job Title	ST	Optional	Once
`STF-19`	Job Code/Class	JCC	Optional	Once
`STF-20`	Employment Status Code	CWE	Optional	Once	0066
`STF-21`	Additional Insured On Auto	ID	Optional	Once	0136	1
`STF-22`	Driver's License Number - Staff	DLN	Optional	Once
`STF-23`	Copy Auto Ins	ID	Optional	Once	0136	1
`STF-24`	Auto Ins Expires	DT	Optional	Once
`STF-25`	Date Last Dmv Review	DT	Optional	Once
`STF-26`	Date Next Dmv Review	DT	Optional	Once
`STF-27`	Race	CWE	Optional	Once	0005
`STF-28`	Ethnic Group	CWE	Optional	Once	0189
`STF-29`	Re-activation Approval Indicator	ID	Optional	Once	0136	1
`STF-30`	Citizenship	CWE	Optional	Repeats	0171
`STF-31`	Date/Time Of Death	DTM	Optional	Once
`STF-32`	Death Indicator	ID	Optional	Once	0136	1
`STF-33`	Institution Relationship Type Code	CWE	Optional	Once	0538
`STF-34`	Institution Relationship Period	DR	Optional	Once
`STF-35`	Expected Return Date	DT	Optional	Once
`STF-36`	Cost Center Code	CWE	Optional	Repeats	0539
`STF-37`	Generic Classification Indicator	ID	Optional	Once	0136	1
`STF-38`	Inactive Reason Code	CWE	Optional	Once	0540
`STF-39`	Generic Resource Type Or Category	CWE	Optional	Repeats	0771
`STF-40`	Religion	CWE	Optional	Once	0006
`STF-41`	Signature	ED	Optional	Once

Defined in versions2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

STZSterilization Parameter4 fields

Field	Name	Type	Use	Repeats	Table
`STZ-1`	Sterilization Type	CWE	Optional	Once	0806
`STZ-2`	Sterilization Cycle	CWE	Optional	Once	0702
`STZ-3`	Maintenance Cycle	CWE	Optional	Once	0809
`STZ-4`	Maintenance Type	CWE	Optional	Once	0811

Defined in versions2.62.72.7.1 2.8

TCCTest Code Configuration14 fields

Field	Name	Type	Use	Repeats	Table	Length
`TCC-1`	Universal Service Identifier	CWE	Required	Once
`TCC-2`	Equipment Test Application Identifier	EI	Required	Once
`TCC-3`	Specimen Source	ST	Withdrawn	Once
`TCC-4`	Auto-dilution Factor Default	SN	Optional	Once
`TCC-5`	Rerun Dilution Factor Default	SN	Optional	Once
`TCC-6`	Pre-dilution Factor Default	SN	Optional	Once
`TCC-7`	Endogenous Content Of Pre-dilution Diluent	SN	Optional	Once
`TCC-8`	Inventory Limits Warning Level	NM	Optional	Once
`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
`TCC-13`	Units	CWE	Optional	Once	9999
`TCC-14`	Processing Type	CWE	Optional	Once	0388

Defined in versions2.4 2.5 2.5.1 2.62.72.7.1 2.8

TCDTest Code Detail8 fields

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

Defined in versions2.4 2.5 2.5.1 2.62.72.7.1 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			MedicationRequest.dosageInstruction.doseAndRate.doseQuantity ServiceRequest.quantityQuantity
`TQ1-3`	Repeat Pattern	RPT	Optional	Repeats			MedicationRequest.dosageInstruction.timing ServiceRequest.occurrenceTiming
`TQ1-4`	Explicit Time	TM	Optional	Repeats			MedicationRequest.dosageInstruction.timing.event ServiceRequest.occurrenceTiming.repeat.timeOfDay
`TQ1-5`	Relative Time And Units	CQ	Optional	Repeats			MedicationRequest.dosageInstruction.timing.repeat.offset ServiceRequest.occurrenceTIming.repeat.offset
`TQ1-6`	Service Duration	CQ	Optional	Once			MedicationRequest.occurrenceTiming.boundsDuration MedicationRequest.occurrenceTiming.boundsPeriod.end+4 more
`TQ1-7`	Start Date/Time	DTM	Optional	Once			MedicationRequest.dosageInstruction.timing.repeat.boundsPeriod.start ServiceRequest.occurrenceTiming.repeat.boundsPeriod.start
`TQ1-8`	End Date/Time	DTM	Optional	Once			MedicationRequest.dosageInstruction.timing.repeat.boundsPeriod.end ServiceRequest.occurrenceTiming.repeat.boundsPeriod.end
`TQ1-9`	Priority	CWE	Optional	Repeats	0485		MedicationRequest.priority ServiceRequest.priority
`TQ1-10`	Condition Text	TX	Optional	Once			MedicationRequest.dosageInstruction.additionalInstruction.text
`TQ1-11`	Text Instruction	TX	Optional	Once			MedicationRequest.text ServiceRequest.note
`TQ1-12`	Conjunction	ID	Conditional	Once	0472	1
`TQ1-13`	Occurrence Duration	CQ	Optional	Once			MedicationRequest.dosageInstruction.timing.repeat.duration MedicationRequest.dosageInstruction.timing.repeat.durationUnit+2 more
`TQ1-14`	Total Occurrences	NM	Optional	Once			MedicationRequest.dosageInstruction.timing.repeat.countMax ServiceRequest.occurrenceTiming.repeat.countMax

FHIR map of segment TQ1Defined in versions2.5 2.5.1 2.62.72.7.1 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
`TQ2-4`	Related Filler Number	EI	Conditional	Repeats
`TQ2-5`	Related Placer Group Number	EI	Conditional	Repeats
`TQ2-6`	Sequence Condition Code	ID	Conditional	Once	0504
`TQ2-7`	Cyclic Entry/Exit Indicator	ID	Conditional	Once	0505	1
`TQ2-8`	Sequence Condition Time Interval	CQ	Optional	Once
`TQ2-9`	Cyclic Group Maximum Number Of Repeats	NM	Optional	Once
`TQ2-10`	Special Service Request Relationship	ID	Conditional	Once	0506	1

Defined in versions2.5 2.5.1 2.62.72.7.1 2.8

TXATranscription Document HeaderDocumentReference, Provenance26 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`TXA-1`	Set Id- Txa	SI	Required	Once		4
`TXA-2`	Document Type	CWE	Required	Once	0270		DocumentReference.type
`TXA-3`	Document Content Presentation	ID	Conditional	Once	0191		DocumentReference.content.attachment.contentType
`TXA-4`	Activity Date/Time	DTM	Optional	Once
`TXA-5`	Primary Activity Provider Code/Name	XCN	Conditional	Repeats
`TXA-6`	Origination Date/Time	DTM	Optional	Once			DocumentReference.date DocumentReference.extension
`TXA-7`	Transcription Date/Time	DTM	Conditional	Once
`TXA-8`	Edit Date/Time	DTM	Optional	Repeats
`TXA-9`	Originator Code/Name	XCN	Optional	Repeats			DocumentReference.author
`TXA-10`	Assigned Document Authenticator	XCN	Optional	Repeats			DocumentReference.authenticator
`TXA-11`	Transcriptionist Code/Name	XCN	Conditional	Repeats
`TXA-12`	Unique Document Number	EI	Required	Once			DocumentReference.masterIdentifier
`TXA-13`	Parent Document Number	EI	Conditional	Once
`TXA-14`	Placer Order Number	EI	Optional	Repeats
`TXA-15`	Filler Order Number	EI	Optional	Once
`TXA-16`	Unique Document File Name	ST	Optional	Once			DocumentReference.identifier
`TXA-17`	Document Completion Status	ID	Required	Once	0271	2	DocumentReference.docStatus
`TXA-18`	Document Confidentiality Status	ID	Optional	Once	0272	1	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	Optional	Once
`TXA-22`	Authentication Person, Time Stamp (set)	PPN	Conditional	Repeats
`TXA-23`	Distributed Copies (code And Name Of Recipient(s) )	XCN	Optional	Repeats
`TXA-24`	Folder Assignment	CWE	Optional	Repeats
`TXA-25`	Document Title	ST	Optional	Repeats			DocumentReference.description
`TXA-26`	Agreed Due Date/Time	DTM	Optional	Once

FHIR map of segment TXADefined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

UACUser Authentication Credential Segment2 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`UAC-1`	User Authentication Credential Type Code	CWE	Required	Once	0615
`UAC-2`	User Authentication Credential	ED	Required	Once

Defined in versions2.62.72.7.1 2.8

UB1Ub8223 fields

Field	Name	Type	Use	Repeats
`UB1-1`	Set Id - Ub1	SI	Withdrawn	Once
`UB1-2`	Blood Deductible	ST	Withdrawn	Once
`UB1-3`	Blood Furnished-pints	ST	Withdrawn	Once
`UB1-4`	Blood Replaced-pints	ST	Withdrawn	Once
`UB1-5`	Blood Not Replaced-pints	ST	Withdrawn	Once
`UB1-6`	Co-insurance Days	ST	Withdrawn	Once
`UB1-7`	Condition Code	ST	Withdrawn	Once
`UB1-8`	Covered Days	ST	Withdrawn	Once
`UB1-9`	Non Covered Days	ST	Withdrawn	Once
`UB1-10`	Value Amount & Code	ST	Withdrawn	Once
`UB1-11`	Number Of Grace Days	ST	Withdrawn	Once
`UB1-12`	Special Program Indicator	ST	Withdrawn	Once
`UB1-13`	Psro/Ur Approval Indicator	ST	Withdrawn	Once
`UB1-14`	Psro/Ur Approved Stay-fm	ST	Withdrawn	Once
`UB1-15`	Psro/Ur Approved Stay-to	ST	Withdrawn	Once
`UB1-16`	Occurrence	ST	Withdrawn	Once
`UB1-17`	Occurrence Span	ST	Withdrawn	Once
`UB1-18`	Occur Span Start Date	ST	Withdrawn	Once
`UB1-19`	Occur Span End Date	ST	Withdrawn	Once
`UB1-20`	Ub-82 Locator 2	ST	Withdrawn	Once
`UB1-21`	Ub-82 Locator 9	ST	Withdrawn	Once
`UB1-22`	Ub-82 Locator 27	ST	Withdrawn	Once
`UB1-23`	Ub-82 Locator 45	ST	Withdrawn	Once

Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

UB2Uniform Billing 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)	CWE	Optional	Once	0043
`UB2-4`	Covered Days (7)	ST	Optional	Once		3
`UB2-5`	Non-covered Days (8)	ST	Optional	Once		4
`UB2-6`	Value Amount & Code	UVC	Optional	Once
`UB2-7`	Occurrence Code & Date (32-35)	OCD	Optional	Once
`UB2-8`	Occurrence Span Code/Dates (36)	OSP	Optional	Once
`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 2.5 2.5.1 2.62.72.7.1 2.8

URDWithdrawn1 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`URD-1`	URD.1	ST	Optional	Once

Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

URSWithdrawn1 fields

Field	Name	Type	Use	Repeats	Table	Length	FHIR
`URS-1`	URS.1	ST	Optional	Once

Defined in versions2.1 2.2 2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

VARVariance6 fields

Field	Name	Type	Use	Repeats
`VAR-1`	Variance Instance Id	EI	Required	Once
`VAR-2`	Documented Date/Time	DTM	Required	Once
`VAR-3`	Stated Variance Date/Time	DTM	Optional	Once
`VAR-4`	Variance Originator	XCN	Optional	Repeats
`VAR-5`	Variance Classification	CWE	Optional	Once
`VAR-6`	Variance Description	ST	Optional	Repeats

Defined in versions2.3 2.3.1 2.4 2.5 2.5.1 2.62.72.7.1 2.8

VNDPurchasing Vendor5 fields

Field	Name	Type	Use	Repeats	Table	Length
`VND-1`	Set Id - Vnd	SI	Required	Once		4
`VND-2`	Vendor Identifier	EI	Required	Once
`VND-3`	Vendor Name	ST	Optional	Once
`VND-4`	Vendor Catalog Number	EI	Optional	Once
`VND-5`	Primary Vendor Indicator	CNE	Optional	Once	0532

Defined in versions2.62.72.7.1 2.8