HL7 Lookup/Crosswalk Table

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ABS

Field	Field Description
ABS-1	Discharge Care Provider
ABS-2	Transfer Medical Service Code
ABS-3	Severity of Illness Code
ABS-4	Date/Time of Attestation
ABS-5	Attested By
ABS-6	Triage Code
ABS-7	Abstract Completion Date/Time
ABS-8	Abstracted By
ABS-9	Case Category Code
ABS-10	Caesarian Section Indicator
ABS-11	Gestation Category Code
ABS-12	Gestation Period - Weeks
ABS-13	Newborn Code
ABS-14	Stillborn Indicator

ACC

Field	Field Description
ACC-1	Accident Date/Time
ACC-2	Accident Code
ACC-3	Accident Location
ACC-4	Auto Accident State
ACC-5	Accident Job Related Indicator
ACC-6	Accident Death Indicator
ACC-7	Entered By
ACC-8	Accident Description
ACC-9	Brought In By
ACC-10	Police Notified Indicator
ACC-11	Accident Address
ACC-12	Degree of patient liability
ACC-13	Accident Identifier

ADD

Field	Field Description
ADD-1	Addendum Continuation Pointer

ADJ

Field	Field Description
ADJ-1	Provider Adjustment Number
ADJ-2	Payer Adjustment Number
ADJ-3	Adjustment Sequence Number
ADJ-4	Adjustment Category
ADJ-5	Adjustment Amount
ADJ-6	Adjustment Quantity
ADJ-7	Adjustment Reason PA
ADJ-8	Adjustment Description
ADJ-9	Original Value
ADJ-10	Substitute Value
ADJ-11	Adjustment Action
ADJ-12	Provider Adjustment Number Cross Reference
ADJ-13	Provider Product/Service Line Item Number Cross Reference
ADJ-14	Adjustment Date
ADJ-15	Responsible Organization

AFF

Field	Field Description
AFF-1	Set ID - AFF
AFF-2	Professional Organization
AFF-3	Professional Organization Address
AFF-4	Professional Organization Affiliation Date Range
AFF-5	Professional Affiliation Additional Information

AIG

Field	Field Description
AIG-1	Set ID - AIG
AIG-2	Segment Action Code
AIG-3	Resource ID
AIG-4	Resource Type
AIG-5	Resource Group
AIG-6	Resource Quantity
AIG-7	Resource Quantity Units
AIG-8	Start Date/Time
AIG-9	Start Date/Time Offset
AIG-10	Start Date/Time Offset Units
AIG-11	Duration
AIG-12	Duration Units
AIG-13	Allow Substitution Code
AIG-14	Filler Status Code

AIL

Field	Field Description
AIL-1	Set ID - AIL
AIL-2	Segment Action Code
AIL-3	Location Resource ID
AIL-4	Location Type - AIL
AIL-5	Location Group
AIL-6	Start Date/Time
AIL-7	Start Date/Time Offset
AIL-8	Start Date/Time Offset Units
AIL-9	Duration
AIL-10	Duration Units
AIL-11	Allow Substitution Code
AIL-12	Filler Status Code

AIP

Field	Field Description
AIP-1	Set ID - AIP
AIP-2	Segment Action Code
AIP-3	Personnel Resource ID
AIP-4	Resource Type
AIP-5	Resource Group
AIP-6	Start Date/Time
AIP-7	Start Date/Time Offset
AIP-8	Start Date/Time Offset Units
AIP-9	Duration
AIP-10	Duration Units
AIP-11	Allow Substitution Code
AIP-12	Filler Status Code

AIS

Field	Field Description
AIS-1	Set ID - AIS
AIS-2	Segment Action Code
AIS-3	Universal Service Identifier
AIS-4	Start Date/Time
AIS-5	Start Date/Time Offset
AIS-6	Start Date/Time Offset Units
AIS-7	Duration
AIS-8	Duration Units
AIS-9	Allow Substitution Code
AIS-10	Filler Status Code
AIS-11	Placer Supplemental Service Information
AIS-12	Filler Supplemental Service Information

AL1

Field	Field Description
AL1-1	Set ID - AL1
AL1-2	Allergen Type Code
AL1-3	Allergen Code/Mnemonic/Description
AL1-4	Allergy Severity Code
AL1-5	Allergy Reaction Code
AL1-6	Identification Date

APR

Field	Field Description
APR-1	Time Selection Criteria
APR-2	Resource Selection Criteria
APR-3	Location Selection Criteria
APR-4	Slot Spacing Criteria
APR-5	Filler Override Criteria

ARQ

Field	Field Description
ARQ-1	Placer Appointment ID
ARQ-2	Filler Appointment ID
ARQ-3	Occurrence Number
ARQ-4	Placer Group Number
ARQ-5	Schedule ID
ARQ-6	Request Event Reason
ARQ-7	Appointment Reason
ARQ-8	Appointment Type
ARQ-9	Appointment Duration
ARQ-10	Appointment Duration Units
ARQ-11	Requested Start Date/Time Range
ARQ-12	Priority-ARQ
ARQ-13	Repeating Interval
ARQ-14	Repeating Interval Duration
ARQ-15	Placer Contact Person
ARQ-16	Placer Contact Phone Number
ARQ-17	Placer Contact Address
ARQ-18	Placer Contact Location
ARQ-19	Entered By Person
ARQ-20	Entered By Phone Number
ARQ-21	Entered By Location
ARQ-22	Parent Placer Appointment ID
ARQ-23	Parent Filler Appointment ID
ARQ-24	Placer Order Number
ARQ-25	Filler Order Number

ARV

Field	Field Description
ARV-1	Set ID
ARV-2	Access Restriction Action Code
ARV-3	Access Restriction Value
ARV-4	Access Restriction Reason
ARV-5	Special Access Restriction Instructions
ARV-6	Access Restriction Date Range

AUT

Field	Field Description
AUT-1	Authorizing Payor, Plan ID
AUT-2	Authorizing Payor, Company ID
AUT-3	Authorizing Payor, Company Name
AUT-4	Authorization Effective Date
AUT-5	Authorization Expiration Date
AUT-6	Authorization Identifier
AUT-7	Reimbursement Limit
AUT-8	Requested Number of Treatments
AUT-9	Authorized Number of Treatments
AUT-10	Process Date
AUT-11	Requested Discipline(s)
AUT-12	Authorized Discipline(s)
AUT-13	Authorization Referral Type
AUT-14	Approval Status
AUT-15	Planned Treatment Stop Date
AUT-16	Clinical Service
AUT-17	Reason Text
AUT-18	Number of Authorized Treatments/Units
AUT-19	Number of Used Treatments/Units
AUT-20	Number of Schedule Treatments/Units
AUT-21	Encounter Type
AUT-22	Remaining Benefit Amount
AUT-23	Authorized Provider
AUT-24	Authorized Health Professional
AUT-25	Source Text
AUT-26	Source Date
AUT-27	Source Phone
AUT-28	Comment
AUT-29	Action Code

BHS

Field	Field Description
BHS-1	Batch Field Separator
BHS-2	Batch Encoding Characters
BHS-3	Batch Sending Application
BHS-4	Batch Sending Facility
BHS-5	Batch Receiving Application
BHS-6	Batch Receiving Facility
BHS-7	Batch Creation Date/Time
BHS-8	Batch Security
BHS-9	Batch Name/ID/Type
BHS-10	Batch Comment
BHS-11	Batch Control ID
BHS-12	Reference Batch Control ID
BHS-13	Batch Sending Network Address
BHS-14	Batch Receiving Network Address

BLC

Field	Field Description
BLC-1	Blood Product Code
BLC-2	Blood Amount

BLG

Field	Field Description
BLG-1	When to Charge
BLG-2	Charge Type
BLG-3	Account ID
BLG-4	Charge Type Reason

BPO

Field	Field Description
BPO-1	Set ID - BPO
BPO-2	BP Universal Service Identifier
BPO-3	BP Processing Requirements
BPO-4	BP Quantity
BPO-5	BP Amount
BPO-6	BP Units
BPO-7	BP Intended Use Date/Time
BPO-8	BP Intended Dispense From Location
BPO-9	BP Intended Dispense From Address
BPO-10	BP Requested Dispense Date/Time
BPO-11	BP Requested Dispense To Location
BPO-12	BP Requested Dispense To Address
BPO-13	BP Indication for Use
BPO-14	BP Informed Consent Indicator

BPX

Field	Field Description
BPX-1	Set ID - BPX
BPX-2	BP Dispense Status
BPX-3	BP Status
BPX-4	BP Date/Time of Status
BPX-5	BC Donation ID
BPX-6	BC Component
BPX-7	BC Donation Type / Intended Use
BPX-8	CP Commercial Product
BPX-9	CP Manufacturer
BPX-10	CP Lot Number
BPX-11	BP Blood Group
BPX-12	BC Special Testing
BPX-13	BP Expiration Date/Time
BPX-14	BP Quantity
BPX-15	BP Amount
BPX-16	BP Units
BPX-17	BP Unique ID
BPX-18	BP Actual Dispensed To Location
BPX-19	BP Actual Dispensed To Address
BPX-20	BP Dispensed to Receiver
BPX-21	BP Dispensing Individual

BTS

Field	Field Description
BTS-1	Batch Message Count
BTS-2	Batch Comment
BTS-3	Batch Totals

BTX

Field	Field Description
BTX-1	Set ID - BTX
BTX-2	BC Donation ID
BTX-3	BC Component
BTX-4	BC Blood Group
BTX-5	CP Commercial Product
BTX-6	CP Manufacturer
BTX-7	CP Lot Number
BTX-8	BP Quantity
BTX-9	BP Amount
BTX-10	BP Units
BTX-11	BP Transfusion/Disposition Status
BTX-12	BP Message Status
BTX-13	BP Date/Time of Status
BTX-14	BP Transfusion Administrator
BTX-15	BP Transfusion Verifier
BTX-16	BP Transfusion Start Date/Time of Status
BTX-17	BP Transfusion End Date/Time of Status
BTX-18	BP Adverse Reaction Type
BTX-19	BP Transfusion Interrupted Reason
BTX-20	BP Unique ID

BUI

Field	Field Description
BUI-1	Set ID - BUI
BUI-2	Blood Unit Identifier
BUI-3	Blood Unit Type
BUI-4	Blood Unit Weight
BUI-5	Weight Units
BUI-6	Blood Unit Volume
BUI-7	Volume Units
BUI-8	Container Catalog Number
BUI-9	Container Lot Number
BUI-10	Container Manufacturer
BUI-11	Transport Temperature
BUI-12	Transport Temperature Units

CDM

Field	Field Description
CDM-1	Primary Key Value - CDM
CDM-2	Charge Code Alias
CDM-3	Charge Description Short
CDM-4	Charge Description Long
CDM-5	Description Override Indicator
CDM-6	Exploding Charges
CDM-7	Procedure Code
CDM-8	Active/Inactive Flag
CDM-9	Inventory Number
CDM-10	Resource Load
CDM-11	Contract Number
CDM-12	Contract Organization
CDM-13	Room Fee Indicator

CDO

Field	Field Description
CDO-1	Set ID - CDO
CDO-2	Action Code
CDO-3	Cumulative Dosage Limit
CDO-4	Cumulative Dosage Limit Time Interval

CER

Field	Field Description
CER-1	Set ID - CER
CER-2	Serial Number
CER-3	Version
CER-4	Granting Authority
CER-5	Issuing Authority
CER-6	Signature
CER-7	Granting Country
CER-8	Granting State/Province
CER-9	Granting County/Parish
CER-10	Certificate Type
CER-11	Certificate Domain
CER-12	Subject ID
CER-13	Subject Name
CER-14	Subject Directory Attribute Extension
CER-15	Subject Public Key Info
CER-16	Authority Key Identifier
CER-17	Basic Constraint
CER-18	CRL Distribution Point
CER-19	Jurisdiction Country
CER-20	Jurisdiction State/Province
CER-21	Jurisdiction County/Parish
CER-22	Jurisdiction Breadth
CER-23	Granting Date
CER-24	Issuing Date
CER-25	Activation Date
CER-26	Inactivation Date
CER-27	Expiration Date
CER-28	Renewal Date
CER-29	Revocation Date
CER-30	Revocation Reason Code
CER-31	Certificate Status Code

CM0

Field	Field Description
CM0-1	Set ID - CM0
CM0-2	Sponsor Study ID
CM0-3	Alternate Study ID
CM0-4	Title of Study
CM0-5	Chairman of Study
CM0-6	Last IRB Approval Date
CM0-7	Total Accrual to Date
CM0-8	Last Accrual Date
CM0-9	Contact for Study
CM0-10	Contact's Telephone Number
CM0-11	Contact's Address

CM1

Field	Field Description
CM1-1	Set ID - CM1
CM1-2	Study Phase Identifier
CM1-3	Description of Study Phase

CM2

Field	Field Description
CM2-1	Set ID- CM2
CM2-2	Scheduled Time Point
CM2-3	Description of Time Point
CM2-4	Events Scheduled This Time Point

CNS

Field	Field Description
CNS-1	Starting Notification Reference Number
CNS-2	Ending Notification Reference Number
CNS-3	Starting Notification Date/Time
CNS-4	Ending Notification Date/Time
CNS-5	Starting Notification Code
CNS-6	Ending Notification Code

CON

Field	Field Description
CON-1	Set ID - CON
CON-2	Consent Type
CON-3	Consent Form ID and Version
CON-4	Consent Form Number
CON-5	Consent Text
CON-6	Subject-specific Consent Text
CON-7	Consent Background Information
CON-8	Subject-specific Consent Background Text
CON-9	Consenter-imposed limitations
CON-10	Consent Mode
CON-11	Consent Status
CON-12	Consent Discussion Date/Time
CON-13	Consent Decision Date/Time
CON-14	Consent Effective Date/Time
CON-15	Consent End Date/Time
CON-16	Subject Competence Indicator
CON-17	Translator Assistance Indicator
CON-18	Language Translated To
CON-19	Informational Material Supplied Indicator
CON-20	Consent Bypass Reason
CON-21	Consent Disclosure Level
CON-22	Consent Non-disclosure Reason
CON-23	Non-subject Consenter Reason
CON-24	Consenter ID
CON-25	Relationship to Subject

CSP

Field	Field Description
CSP-1	Study Phase Identifier
CSP-2	Date/time Study Phase Began
CSP-3	Date/time Study Phase Ended
CSP-4	Study Phase Evaluability

CSR

Field	Field Description
CSR-1	Sponsor Study ID
CSR-2	Alternate Study ID
CSR-3	Institution Registering the Patient
CSR-4	Sponsor Patient ID
CSR-5	Alternate Patient ID - CSR
CSR-6	Date/Time of Patient Study Registration
CSR-7	Person Performing Study Registration
CSR-8	Study Authorizing Provider
CSR-9	Date/Time Patient Study Consent Signed
CSR-10	Patient Study Eligibility Status
CSR-11	Study Randomization Date/time
CSR-12	Randomized Study Arm
CSR-13	Stratum for Study Randomization
CSR-14	Patient Evaluability Status
CSR-15	Date/Time Ended Study
CSR-16	Reason Ended Study

CSS

Field	Field Description
CSS-1	Study Scheduled Time Point
CSS-2	Study Scheduled Patient Time Point
CSS-3	Study Quality Control Codes

CTD

Field	Field Description
CTD-1	Contact Role
CTD-2	Contact Name
CTD-3	Contact Address
CTD-4	Contact Location
CTD-5	Contact Communication Information
CTD-6	Preferred Method of Contact
CTD-7	Contact Identifiers

CTI

Field	Field Description
CTI-1	Sponsor Study ID
CTI-2	Study Phase Identifier
CTI-3	Study Scheduled Time Point

DB1

Field	Field Description
DB1-1	Set ID - DB1
DB1-2	Disabled Person Code
DB1-3	Disabled Person Identifier
DB1-4	Disability Indicator
DB1-5	Disability Start Date
DB1-6	Disability End Date
DB1-7	Disability Return to Work Date
DB1-8	Disability Unable to Work Date

DG1

Field	Field Description
DG1-1	Set ID - DG1
DG1-2	Diagnosis Coding Method
DG1-3	Diagnosis Code - DG1
DG1-4	Diagnosis Description
DG1-5	Diagnosis Date/Time
DG1-6	Diagnosis Type
DG1-7	Major Diagnostic Category
DG1-8	Diagnostic Related Group
DG1-9	DRG Approval Indicator
DG1-10	DRG Grouper Review Code
DG1-11	Outlier Type
DG1-12	Outlier Days
DG1-13	Outlier Cost
DG1-14	Grouper Version And Type
DG1-15	Diagnosis Priority
DG1-16	Diagnosing Clinician
DG1-17	Diagnosis Classification
DG1-18	Confidential Indicator
DG1-19	Attestation Date/Time
DG1-20	Diagnosis Identifier
DG1-21	Diagnosis Action Code
DG1-22	Parent Diagnosis
DG1-23	DRG CCL Value Code
DG1-24	DRG Grouping Usage
DG1-25	DRG Diagnosis Determination Status
DG1-26	Present On Admission (POA) Indicator

DMI

Field	Field Description
DMI-1	Diagnostic Related Group
DMI-2	Major Diagnostic Category
DMI-3	Lower and Upper Trim Points
DMI-4	Average Length of Stay
DMI-5	Relative Weight

DON

Field	Field Description
DON-1	Donation Identification Number - DIN
DON-2	Donation Type
DON-3	Phlebotomy Start Date/Time
DON-4	Phlebotomy End Date/Time
DON-5	Donation Duration
DON-6	Donation Duration Units
DON-7	Intended Procedure Type
DON-8	Actual Procedure Type
DON-9	Donor Eligibility Flag
DON-10	Donor Eligibility Procedure Type
DON-11	Donor Eligibility Date
DON-12	Process Interruption
DON-13	Process Interruption Reason
DON-14	Phlebotomy Issue
DON-15	Intended Recipient Blood Relative
DON-16	Intended Recipient Name
DON-17	Intended Recipient DOB
DON-18	Intended Recipient Facility
DON-19	Intended Recipient Procedure Date
DON-20	Intended Recipient Ordering Provider
DON-21	Phlebotomy Status
DON-22	Arm Stick
DON-23	Bleed Start Phlebotomist
DON-24	Bleed End Phlebotomist
DON-25	Aphaeresis Type Machine
DON-26	Aphaeresis Machine Serial Number
DON-27	Donor Reaction
DON-28	Final Review Staff ID
DON-29	Final Review Date/Time
DON-30	Number of Tubes Collected
DON-31	Donation Sample Identifier
DON-32	Donation Accept Staff
DON-33	Donation Material Review Staff

DRG

Field	Field Description
DRG-1	Diagnostic Related Group
DRG-2	DRG Assigned Date/Time
DRG-3	DRG Approval Indicator
DRG-4	DRG Grouper Review Code
DRG-5	Outlier Type
DRG-6	Outlier Days
DRG-7	Outlier Cost
DRG-8	DRG Payor
DRG-9	Outlier Reimbursement
DRG-10	Confidential Indicator
DRG-11	DRG Transfer Type
DRG-12	Name of Coder
DRG-13	Grouper Status
DRG-14	PCCL Value Code
DRG-15	Effective Weight
DRG-16	Monetary Amount
DRG-17	Status Patient
DRG-18	Grouper Software Name
DRG-19	Grouper Software Version
DRG-20	Status Financial Calculation
DRG-21	Relative Discount/Surcharge
DRG-22	Basic Charge
DRG-23	Total Charge
DRG-24	Discount/Surcharge
DRG-25	Calculated Days
DRG-26	Status Gender
DRG-27	Status Age
DRG-28	Status Length of Stay
DRG-29	Status Same Day Flag
DRG-30	Status Separation Mode
DRG-31	Status Weight at Birth
DRG-32	Status Respiration Minutes
DRG-33	Status Admission

DSC

Field	Field Description
DSC-1	Continuation Pointer
DSC-2	Continuation Style

DSP

Field	Field Description
DSP-1	Set ID - DSP
DSP-2	Display Level
DSP-3	Data Line
DSP-4	Logical Break Point
DSP-5	Result ID

ECD

Field	Field Description
ECD-1	Reference Command Number
ECD-2	Remote Control Command
ECD-3	Response Required
ECD-4	Requested Completion Time
ECD-5	Parameters

ECR

Field	Field Description
ECR-1	Command Response
ECR-2	Date/Time Completed
ECR-3	Command Response Parameters

EDU

Field	Field Description
EDU-1	Set ID - EDU
EDU-2	Academic Degree
EDU-3	Academic Degree Program Date Range
EDU-4	Academic Degree Program Participation Date Range
EDU-5	Academic Degree Granted Date
EDU-6	School
EDU-7	School Type Code
EDU-8	School Address
EDU-9	Major Field of Study

EQP

Field	Field Description
EQP-1	Event type
EQP-2	File Name
EQP-3	Start Date/Time
EQP-4	End Date/Time
EQP-5	Transaction Data

EQU

Field	Field Description
EQU-1	Equipment Instance Identifier
EQU-2	Event Date/Time
EQU-3	Equipment State
EQU-4	Local/Remote Control State
EQU-5	Alert Level

ERR

Field	Field Description
ERR-1	Error Code and Location
ERR-2	Error Location
ERR-3	HL7 Error Code
ERR-4	Severity
ERR-5	Application Error Code
ERR-6	Application Error Parameter
ERR-7	Diagnostic Information
ERR-8	User Message
ERR-9	Inform Person Indicator
ERR-10	Override Type
ERR-11	Override Reason Code
ERR-12	Help Desk Contact Point

EVN

Field	Field Description
EVN-1	Event Type Code
EVN-2	Recorded Date/Time
EVN-3	Date/Time Planned Event
EVN-4	Event Reason Code
EVN-5	Operator ID
EVN-6	Event Occurred
EVN-7	Event Facility

FAC

Field	Field Description
FAC-1	Facility ID-FAC
FAC-2	Facility Type
FAC-3	Facility Address
FAC-4	Facility Telecommunication
FAC-5	Contact Person
FAC-6	Contact Title
FAC-7	Contact Address
FAC-8	Contact Telecommunication
FAC-9	Signature Authority
FAC-10	Signature Authority Title
FAC-11	Signature Authority Address
FAC-12	Signature Authority Telecommunication

FHS

Field	Field Description
FHS-1	File Field Separator
FHS-2	File Encoding Characters
FHS-3	File Sending Application
FHS-4	File Sending Facility
FHS-5	File Receiving Application
FHS-6	File Receiving Facility
FHS-7	File Creation Date/Time
FHS-8	File Security
FHS-9	File Name/ID
FHS-10	File Header Comment
FHS-11	File Control ID
FHS-12	Reference File Control ID
FHS-13	File Sending Network Address
FHS-14	File Receiving Network Address

FT1

Field	Field Description
FT1-1	Set ID - FT1
FT1-2	Transaction ID
FT1-3	Transaction Batch ID
FT1-4	Transaction Date
FT1-5	Transaction Posting Date
FT1-6	Transaction Type
FT1-7	Transaction Code
FT1-8	Transaction Description
FT1-9	Transaction Description - Alt
FT1-10	Transaction Quantity
FT1-11	Transaction Amount - Extended
FT1-12	Transaction amount - unit
FT1-13	Department Code
FT1-14	Health Plan ID
FT1-15	Insurance Amount
FT1-16	Assigned Patient Location
FT1-17	Fee Schedule
FT1-18	Patient Type
FT1-19	Diagnosis Code - FT1
FT1-20	Performed By Code
FT1-21	Ordered By Code
FT1-22	Unit Cost
FT1-23	Filler Order Number
FT1-24	Entered By Code
FT1-25	Procedure Code
FT1-26	Procedure Code Modifier
FT1-27	Advanced Beneficiary Notice Code
FT1-28	Medically Necessary Duplicate Procedure Reason
FT1-29	NDC Code
FT1-30	Payment Reference ID
FT1-31	Transaction Reference Key
FT1-32	Performing Facility
FT1-33	Ordering Facility
FT1-34	Item Number
FT1-35	Model Number
FT1-36	Special Processing Code
FT1-37	Clinic Code
FT1-38	Referral Number
FT1-39	Authorization Number
FT1-40	Service Provider Taxonomy Code
FT1-41	Revenue Code
FT1-42	Prescription Number
FT1-43	NDC Qty and UOM

FTS

Field	Field Description
FTS-1	File Batch Count
FTS-2	File Trailer Comment

GOL

Field	Field Description
GOL-1	Action Code
GOL-2	Action Date/Time
GOL-3	Goal ID
GOL-4	Goal Instance ID
GOL-5	Episode of Care ID
GOL-6	Goal List Priority
GOL-7	Goal Established Date/Time
GOL-8	Expected Goal Achieve Date/Time
GOL-9	Goal Classification
GOL-10	Goal Management Discipline
GOL-11	Current Goal Review Status
GOL-12	Current Goal Review Date/Time
GOL-13	Next Goal Review Date/Time
GOL-14	Previous Goal Review Date/Time
GOL-15	Goal Review Interval
GOL-16	Goal Evaluation
GOL-17	Goal Evaluation Comment
GOL-18	Goal Life Cycle Status
GOL-19	Goal Life Cycle Status Date/Time
GOL-20	Goal Target Type
GOL-21	Goal Target Name
GOL-22	Mood Code

GP1

Field	Field Description
GP1-1	Type of Bill Code
GP1-2	Revenue Code
GP1-3	Overall Claim Disposition Code
GP1-4	OCE Edits per Visit Code
GP1-5	Outlier Cost

GP2

Field	Field Description
GP2-1	Revenue Code
GP2-2	Number of Service Units
GP2-3	Charge
GP2-4	Reimbursement Action Code
GP2-5	Denial or Rejection Code
GP2-6	OCE Edit Code
GP2-7	Ambulatory Payment Classification Code
GP2-8	Modifier Edit Code
GP2-9	Payment Adjustment Code
GP2-10	Packaging Status Code
GP2-11	Expected CMS Payment Amount
GP2-12	Reimbursement Type Code
GP2-13	Co-Pay Amount
GP2-14	Pay Rate per Service Unit

GT1

Field	Field Description
GT1-1	Set ID - GT1
GT1-2	Guarantor Number
GT1-3	Guarantor Name
GT1-4	Guarantor Spouse Name
GT1-5	Guarantor Address
GT1-6	Guarantor Ph Num - Home
GT1-7	Guarantor Ph Num - Business
GT1-8	Guarantor Date/Time Of Birth
GT1-9	Guarantor Administrative Sex
GT1-10	Guarantor Type
GT1-11	Guarantor Relationship
GT1-12	Guarantor SSN
GT1-13	Guarantor Date - Begin
GT1-14	Guarantor Date - End
GT1-15	Guarantor Priority
GT1-16	Guarantor Employer Name
GT1-17	Guarantor Employer Address
GT1-18	Guarantor Employer Phone Number
GT1-19	Guarantor Employee ID Number
GT1-20	Guarantor Employment Status
GT1-21	Guarantor Organization Name
GT1-22	Guarantor Billing Hold Flag
GT1-23	Guarantor Credit Rating Code
GT1-24	Guarantor Death Date And Time
GT1-25	Guarantor Death Flag
GT1-26	Guarantor Charge Adjustment Code
GT1-27	Guarantor Household Annual Income
GT1-28	Guarantor Household Size
GT1-29	Guarantor Employer ID Number
GT1-30	Guarantor Marital Status Code
GT1-31	Guarantor Hire Effective Date
GT1-32	Employment Stop Date
GT1-33	Living Dependency
GT1-34	Ambulatory Status
GT1-35	Citizenship
GT1-36	Primary Language
GT1-37	Living Arrangement
GT1-38	Publicity Code
GT1-39	Protection Indicator
GT1-40	Student Indicator
GT1-41	Religion
GT1-42	Mother's Maiden Name
GT1-43	Nationality
GT1-44	Ethnic Group
GT1-45	Contact Person's Name
GT1-46	Contact Person's Telephone Number
GT1-47	Contact Reason
GT1-48	Contact Relationship
GT1-49	Job Title
GT1-50	Job Code/Class
GT1-51	Guarantor Employer's Organization Name
GT1-52	Handicap
GT1-53	Job Status
GT1-54	Guarantor Financial Class
GT1-55	Guarantor Race
GT1-56	Guarantor Birth Place
GT1-57	VIP Indicator

IAM

Field	Field Description
IAM-1	Set ID - IAM
IAM-2	Allergen Type Code
IAM-3	Allergen Code/Mnemonic/Description
IAM-4	Allergy Severity Code
IAM-5	Allergy Reaction Code
IAM-6	Allergy Action Code
IAM-7	Allergy Unique Identifier
IAM-8	Action Reason
IAM-9	Sensitivity to Causative Agent Code
IAM-10	Allergen Group Code/Mnemonic/Description
IAM-11	Onset Date
IAM-12	Onset Date Text
IAM-13	Reported Date/Time
IAM-14	Reported By
IAM-15	Relationship to Patient Code
IAM-16	Alert Device Code
IAM-17	Allergy Clinical Status Code
IAM-18	Statused by Person
IAM-19	Statused by Organization
IAM-20	Statused at Date/Time
IAM-21	Inactivated by Person
IAM-22	Inactivated Date/Time
IAM-23	Initially Recorded by Person
IAM-24	Initially Recorded Date/Time
IAM-25	Modified by Person
IAM-26	Modified Date/Time
IAM-27	Clinician Identified Code
IAM-28	Initially Recorded by Organization
IAM-29	Modified by Organization
IAM-30	Inactivated by Organization

IAR

Field	Field Description
IAR-1	Allergy Reaction Code
IAR-2	Allergy Severity Code
IAR-3	Sensitivity to Causative Agent Code
IAR-4	Management

IIM

Field	Field Description
IIM-1	Primary Key Value - IIM
IIM-2	Service Item Code
IIM-3	Inventory Lot Number
IIM-4	Inventory Expiration Date
IIM-5	Inventory Manufacturer Name
IIM-6	Inventory Location
IIM-7	Inventory Received Date
IIM-8	Inventory Received Quantity
IIM-9	Inventory Received Quantity Unit
IIM-10	Inventory Received Item Cost
IIM-11	Inventory On Hand Date
IIM-12	Inventory On Hand Quantity
IIM-13	Inventory On Hand Quantity Unit
IIM-14	Procedure Code
IIM-15	Procedure Code Modifier

ILT

Field	Field Description
ILT-1	Set Id - ILT
ILT-2	Inventory Lot Number
ILT-3	Inventory Expiration Date
ILT-4	Inventory Received Date
ILT-5	Inventory Received Quantity
ILT-6	Inventory Received Quantity Unit
ILT-7	Inventory Received Item Cost
ILT-8	Inventory On Hand Date
ILT-9	Inventory On Hand Quantity
ILT-10	Inventory On Hand Quantity Unit

IN1

Field	Field Description
IN1-1	Set ID - IN1
IN1-2	Health Plan ID
IN1-3	Insurance Company ID
IN1-4	Insurance Company Name
IN1-5	Insurance Company Address
IN1-6	Insurance Co Contact Person
IN1-7	Insurance Co Phone Number
IN1-8	Group Number
IN1-9	Group Name
IN1-10	Insured's Group Emp ID
IN1-11	Insured's Group Emp Name
IN1-12	Plan Effective Date
IN1-13	Plan Expiration Date
IN1-14	Authorization Information
IN1-15	Plan Type
IN1-16	Name Of Insured
IN1-17	Insured's Relationship To Patient
IN1-18	Insured's Date Of Birth
IN1-19	Insured's Address
IN1-20	Assignment Of Benefits
IN1-21	Coordination Of Benefits
IN1-22	Coord Of Ben. Priority
IN1-23	Notice Of Admission Flag
IN1-24	Notice Of Admission Date
IN1-25	Report Of Eligibility Flag
IN1-26	Report Of Eligibility Date
IN1-27	Release Information Code
IN1-28	Pre-Admit Cert (PAC)
IN1-29	Verification Date/Time
IN1-30	Verification By
IN1-31	Type Of Agreement Code
IN1-32	Billing Status
IN1-33	Lifetime Reserve Days
IN1-34	Delay Before L.R. Day
IN1-35	Company Plan Code
IN1-36	Policy Number
IN1-37	Policy Deductible
IN1-38	Policy Limit - Amount
IN1-39	Policy Limit - Days
IN1-40	Room Rate - Semi-Private
IN1-41	Room Rate - Private
IN1-42	Insured's Employment Status
IN1-43	Insured's Administrative Sex
IN1-44	Insured's Employer's Address
IN1-45	Verification Status
IN1-46	Prior Insurance Plan ID
IN1-47	Coverage Type
IN1-48	Handicap
IN1-49	Insured's ID Number
IN1-50	Signature Code
IN1-51	Signature Code Date
IN1-52	Insured's Birth Place
IN1-53	VIP Indicator
IN1-54	External Health Plan Identifiers
IN1-55	Insurance Action Code

IN2

Field	Field Description
IN2-1	Insured's Employee ID
IN2-2	Insured's Social Security Number
IN2-3	Insured's Employer's Name and ID
IN2-4	Employer Information Data
IN2-5	Mail Claim Party
IN2-6	Medicare Health Ins Card Number
IN2-7	Medicaid Case Name
IN2-8	Medicaid Case Number
IN2-9	Military Sponsor Name
IN2-10	Military ID Number
IN2-11	Dependent Of Military Recipient
IN2-12	Military Organization
IN2-13	Military Station
IN2-14	Military Service
IN2-15	Military Rank/Grade
IN2-16	Military Status
IN2-17	Military Retire Date
IN2-18	Military Non-Avail Cert On File
IN2-19	Baby Coverage
IN2-20	Combine Baby Bill
IN2-21	Blood Deductible
IN2-22	Special Coverage Approval Name
IN2-23	Special Coverage Approval Title
IN2-24	Non-Covered Insurance Code
IN2-25	Payor ID
IN2-26	Payor Subscriber ID
IN2-27	Eligibility Source
IN2-28	Room Coverage Type/Amount
IN2-29	Policy Type/Amount
IN2-30	Daily Deductible
IN2-31	Living Dependency
IN2-32	Ambulatory Status
IN2-33	Citizenship
IN2-34	Primary Language
IN2-35	Living Arrangement
IN2-36	Publicity Code
IN2-37	Protection Indicator
IN2-38	Student Indicator
IN2-39	Religion
IN2-40	Mother's Maiden Name
IN2-41	Nationality
IN2-42	Ethnic Group
IN2-43	Marital Status
IN2-44	Insured's Employment Start Date
IN2-45	Employment Stop Date
IN2-46	Job Title
IN2-47	Job Code/Class
IN2-48	Job Status
IN2-49	Employer Contact Person Name
IN2-50	Employer Contact Person Phone Number
IN2-51	Employer Contact Reason
IN2-52	Insured's Contact Person's Name
IN2-53	Insured's Contact Person Phone Number
IN2-54	Insured's Contact Person Reason
IN2-55	Relationship to the Patient Start Date
IN2-56	Relationship to the Patient Stop Date
IN2-57	Insurance Co Contact Reason
IN2-58	Insurance Co Contact Phone Number
IN2-59	Policy Scope
IN2-60	Policy Source
IN2-61	Patient Member Number
IN2-62	Guarantor's Relationship to Insured
IN2-63	Insured's Phone Number - Home
IN2-64	Insured's Employer Phone Number
IN2-65	Military Handicapped Program
IN2-66	Suspend Flag
IN2-67	Copay Limit Flag
IN2-68	Stoploss Limit Flag
IN2-69	Insured Organization Name and ID
IN2-70	Insured Employer Organization Name and ID
IN2-71	Race
IN2-72	Patient's Relationship to Insured

IN3

Field	Field Description
IN3-1	Set ID - IN3
IN3-2	Certification Number
IN3-3	Certified By
IN3-4	Certification Required
IN3-5	Penalty
IN3-6	Certification Date/Time
IN3-7	Certification Modify Date/Time
IN3-8	Operator
IN3-9	Certification Begin Date
IN3-10	Certification End Date
IN3-11	Days
IN3-12	Non-Concur Code/Description
IN3-13	Non-Concur Effective Date/Time
IN3-14	Physician Reviewer
IN3-15	Certification Contact
IN3-16	Certification Contact Phone Number
IN3-17	Appeal Reason
IN3-18	Certification Agency
IN3-19	Certification Agency Phone Number
IN3-20	Pre-Certification Requirement
IN3-21	Case Manager
IN3-22	Second Opinion Date
IN3-23	Second Opinion Status
IN3-24	Second Opinion Documentation Received
IN3-25	Second Opinion Physician
IN3-26	Certification Type
IN3-27	Certification Category

INV

Field	Field Description
INV-1	Substance Identifier
INV-2	Substance Status
INV-3	Substance Type
INV-4	Inventory Container Identifier
INV-5	Container Carrier Identifier
INV-6	Position on Carrier
INV-7	Initial Quantity
INV-8	Current Quantity
INV-9	Available Quantity
INV-10	Consumption Quantity
INV-11	Quantity Units
INV-12	Expiration Date/Time
INV-13	First Used Date/Time
INV-14	On Board Stability Duration
INV-15	Test/Fluid Identifier(s)
INV-16	Manufacturer Lot Number
INV-17	Manufacturer Identifier
INV-18	Supplier Identifier
INV-19	On Board Stability Time
INV-20	Target Value

IPC

Field	Field Description
IPC-1	Accession Identifier
IPC-2	Requested Procedure ID
IPC-3	Study Instance UID
IPC-4	Scheduled Procedure Step ID
IPC-5	Modality
IPC-6	Protocol Code
IPC-7	Scheduled Station Name
IPC-8	Scheduled Procedure Step Location
IPC-9	Scheduled Station AE Title

IPR

Field	Field Description
IPR-1	IPR Identifier
IPR-2	Provider Cross Reference Identifier
IPR-3	Payer Cross Reference Identifier
IPR-4	IPR Status
IPR-5	IPR Date/Time
IPR-6	Adjudicated/Paid Amount
IPR-7	Expected Payment Date/Time
IPR-8	IPR Checksum

ISD

Field	Field Description
ISD-1	Reference Interaction Number
ISD-2	Interaction Type Identifier
ISD-3	Interaction Active State

ITM

Field	Field Description
ITM-1	Item Identifier
ITM-2	Item Description
ITM-3	Item Status
ITM-4	Item Type
ITM-5	Item Category
ITM-6	Subject to Expiration Indicator
ITM-7	Manufacturer Identifier
ITM-8	Manufacturer Name
ITM-9	Manufacturer Catalog Number
ITM-10	Manufacturer Labeler Identification Code
ITM-11	Patient Chargeable Indicator
ITM-12	Transaction Code
ITM-13	Transaction amount - unit
ITM-14	Stocked Item Indicator
ITM-15	Supply Risk Codes
ITM-16	Approving Regulatory Agency
ITM-17	Latex Indicator
ITM-18	Ruling Act
ITM-19	Item Natural Account Code
ITM-20	Approved To Buy Quantity
ITM-21	Approved To Buy Price
ITM-22	Taxable Item Indicator
ITM-23	Freight Charge Indicator
ITM-24	Item Set Indicator
ITM-25	Item Set Identifier
ITM-26	Track Department Usage Indicator
ITM-27	Procedure Code
ITM-28	Procedure Code Modifier
ITM-29	Special Handling Code
ITM-30	Hazardous Indicator
ITM-31	Sterile Indicator
ITM-32	Material Data Safety Sheet Number
ITM-33	United Nations Standard Products and Services Code (UNSPSC)

IVC

Field	Field Description
IVC-1	Provider Invoice Number
IVC-2	Payer Invoice Number
IVC-3	Contract/Agreement Number
IVC-4	Invoice Control
IVC-5	Invoice Reason
IVC-6	Invoice Type
IVC-7	Invoice Date/Time
IVC-8	Invoice Amount
IVC-9	Payment Terms
IVC-10	Provider Organization
IVC-11	Payer Organization
IVC-12	Attention
IVC-13	Last Invoice Indicator
IVC-14	Invoice Booking Period
IVC-15	Origin
IVC-16	Invoice Fixed Amount
IVC-17	Special Costs
IVC-18	Amount for Doctors Treatment
IVC-19	Responsible Physician
IVC-20	Cost Center
IVC-21	Invoice Prepaid Amount
IVC-22	Total Invoice Amount without Prepaid Amount
IVC-23	Total-Amount of VAT
IVC-24	VAT-Rates applied
IVC-25	Benefit Group
IVC-26	Provider Tax ID
IVC-27	Payer Tax ID
IVC-28	Provider Tax Status
IVC-29	Payer Tax Status
IVC-30	Sales Tax ID

IVT

Field	Field Description
IVT-1	Set Id - IVT
IVT-2	Inventory Location Identifier
IVT-3	Inventory Location Name
IVT-4	Source Location Identifier
IVT-5	Source Location Name
IVT-6	Item Status
IVT-7	Bin Location Identifier
IVT-8	Order Packaging
IVT-9	Issue Packaging
IVT-10	Default Inventory Asset Account
IVT-11	Patient Chargeable Indicator
IVT-12	Transaction Code
IVT-13	Transaction amount - unit
IVT-14	Item Importance Code
IVT-15	Stocked Item Indicator
IVT-16	Consignment Item Indicator
IVT-17	Reusable Item Indicator
IVT-18	Reusable Cost
IVT-19	Substitute Item Identifier
IVT-20	Latex-Free Substitute Item Identifier
IVT-21	Recommended Reorder Theory
IVT-22	Recommended Safety Stock Days
IVT-23	Recommended Maximum Days Inventory
IVT-24	Recommended Order Point
IVT-25	Recommended Order Amount
IVT-26	Operating Room Par Level Indicator

LAN

Field	Field Description
LAN-1	Set ID - LAN
LAN-2	Language Code
LAN-3	Language Ability Code
LAN-4	Language Proficiency Code

LCC

Field	Field Description
LCC-1	Primary Key Value - LCC
LCC-2	Location Department
LCC-3	Accommodation Type
LCC-4	Charge Code

LCH

Field	Field Description
LCH-1	Primary Key Value - LCH
LCH-2	Segment Action Code
LCH-3	Segment Unique Key
LCH-4	Location Characteristic ID
LCH-5	Location Characteristic Value - LCH

LDP

Field	Field Description
LDP-1	Primary Key Value - LDP
LDP-2	Location Department
LDP-3	Location Service
LDP-4	Specialty Type
LDP-5	Valid Patient Classes
LDP-6	Active/Inactive Flag
LDP-7	Activation Date - LDP
LDP-8	Inactivation Date - LDP
LDP-9	Inactivated Reason
LDP-10	Visiting Hours
LDP-11	Contact Phone
LDP-12	Location Cost Center

LOC

Field	Field Description
LOC-1	Primary Key Value - LOC
LOC-2	Location Description
LOC-3	Location Type - LOC
LOC-4	Organization Name - LOC
LOC-5	Location Address
LOC-6	Location Phone
LOC-7	License Number
LOC-8	Location Equipment
LOC-9	Location Service Code

LRL

Field	Field Description
LRL-1	Primary Key Value - LRL
LRL-2	Segment Action Code
LRL-3	Segment Unique Key
LRL-4	Location Relationship ID
LRL-5	Organizational Location Relationship Value
LRL-6	Patient Location Relationship Value

MFA

Field	Field Description
MFA-1	Record-Level Event Code
MFA-2	MFN Control ID
MFA-3	Event Completion Date/Time
MFA-4	MFN Record Level Error Return
MFA-5	Primary Key Value - MFA
MFA-6	Primary Key Value Type - MFA

MFE

Field	Field Description
MFE-1	Record-Level Event Code
MFE-2	MFN Control ID
MFE-3	Effective Date/Time
MFE-4	Primary Key Value - MFE
MFE-5	Primary Key Value Type
MFE-6	Entered Date/Time
MFE-7	Entered By

MFI

Field	Field Description
MFI-1	Master File Identifier
MFI-2	Master File Application Identifier
MFI-3	File-Level Event Code
MFI-4	Entered Date/Time
MFI-5	Effective Date/Time
MFI-6	Response Level Code

MRG

Field	Field Description
MRG-1	Prior Patient Identifier List
MRG-2	Prior Alternate Patient ID
MRG-3	Prior Patient Account Number
MRG-4	Prior Patient ID
MRG-5	Prior Visit Number
MRG-6	Prior Alternate Visit ID
MRG-7	Prior Patient Name

MSA

Field	Field Description
MSA-1	Acknowledgment Code
MSA-2	Message Control ID
MSA-3	Text Message
MSA-4	Expected Sequence Number
MSA-5	Delayed Acknowledgment Type
MSA-6	Error Condition
MSA-7	Message Waiting Number
MSA-8	Message Waiting Priority

MSH

Field	Field Description
MSH-1	Field Separator
MSH-2	Encoding Characters
MSH-3	Sending Application
MSH-4	Sending Facility
MSH-5	Receiving Application
MSH-6	Receiving Facility
MSH-7	Date/Time of Message
MSH-8	Security
MSH-9	Message Type
MSH-10	Message Control ID
MSH-11	Processing ID
MSH-12	Version ID
MSH-13	Sequence Number
MSH-14	Continuation Pointer
MSH-15	Accept Acknowledgment Type
MSH-16	Application Acknowledgment Type
MSH-17	Country Code
MSH-18	Character Set
MSH-19	Principal Language Of Message
MSH-20	Alternate Character Set Handling Scheme
MSH-21	Message Profile Identifier
MSH-22	Sending Responsible Organization
MSH-23	Receiving Responsible Organization
MSH-24	Sending Network Address
MSH-25	Receiving Network Address

NCK

Field	Field Description
NCK-1	System Date/Time

NDS

Field	Field Description
NDS-1	Notification Reference Number
NDS-2	Notification Date/Time
NDS-3	Notification Alert Severity
NDS-4	Notification Code

NK1

Field	Field Description
NK1-1	Set ID - NK1
NK1-2	Name
NK1-3	Relationship
NK1-4	Address
NK1-5	Phone Number
NK1-6	Business Phone Number
NK1-7	Contact Role
NK1-8	Start Date
NK1-9	End Date
NK1-10	Next of Kin / Associated Parties Job Title
NK1-11	Next of Kin / Associated Parties Job Code/Class
NK1-12	Next of Kin / Associated Parties Employee Number
NK1-13	Organization Name - NK1
NK1-14	Marital Status
NK1-15	Administrative Sex
NK1-16	Date/Time of Birth
NK1-17	Living Dependency
NK1-18	Ambulatory Status
NK1-19	Citizenship
NK1-20	Primary Language
NK1-21	Living Arrangement
NK1-22	Publicity Code
NK1-23	Protection Indicator
NK1-24	Student Indicator
NK1-25	Religion
NK1-26	Mother's Maiden Name
NK1-27	Nationality
NK1-28	Ethnic Group
NK1-29	Contact Reason
NK1-30	Contact Person's Name
NK1-31	Contact Person's Telephone Number
NK1-32	Contact Person's Address
NK1-33	Next of Kin/Associated Party's Identifiers
NK1-34	Job Status
NK1-35	Race
NK1-36	Handicap
NK1-37	Contact Person Social Security Number
NK1-38	Next of Kin Birth Place
NK1-39	VIP Indicator
NK1-40	Next of Kin Telecommunication Information
NK1-41	Contact Person's Telecommunication Information

NPU

Field	Field Description
NPU-1	Bed Location
NPU-2	Bed Status

NSC

Field	Field Description
NSC-1	Application Change Type
NSC-2	Current CPU
NSC-3	Current Fileserver
NSC-4	Current Application
NSC-5	Current Facility
NSC-6	New CPU
NSC-7	New Fileserver
NSC-8	New Application
NSC-9	New Facility

NST

Field	Field Description
NST-1	Statistics Available
NST-2	Source Identifier
NST-3	Source Type
NST-4	Statistics Start
NST-5	Statistics End
NST-6	Receive Character Count
NST-7	Send Character Count
NST-8	Messages Received
NST-9	Messages Sent
NST-10	Checksum Errors Received
NST-11	Length Errors Received
NST-12	Other Errors Received
NST-13	Connect Timeouts
NST-14	Receive Timeouts
NST-15	Application control-level Errors

NTE

Field	Field Description
NTE-1	Set ID - NTE
NTE-2	Source of Comment
NTE-3	Comment
NTE-4	Comment Type
NTE-5	Entered By
NTE-6	Entered Date/Time
NTE-7	Effective Start Date
NTE-8	Expiration Date

OBR

Field	Field Description
OBR-1	Set ID - OBR
OBR-2	Placer Order Number
OBR-3	Filler Order Number
OBR-4	Universal Service Identifier
OBR-5	Priority
OBR-6	Requested Date/Time
OBR-7	Observation Date/Time #
OBR-8	Observation End Date/Time #
OBR-9	Collection Volume *
OBR-10	Collector Identifier *
OBR-11	Specimen Action Code *
OBR-12	Danger Code
OBR-13	Relevant Clinical Information
OBR-14	Specimen Received Date/Time
OBR-15	Specimen Source
OBR-16	Ordering Provider
OBR-17	Order Callback Phone Number
OBR-18	Placer Field 1
OBR-19	Placer Field 2
OBR-20	Filler Field 1 +
OBR-21	Filler Field 2 +
OBR-22	Results Rpt/Status Chng - Date/Time +
OBR-23	Charge to Practice +
OBR-24	Diagnostic Serv Sect ID
OBR-25	Result Status +
OBR-26	Parent Result +
OBR-27	Quantity/Timing
OBR-28	Result Copies To
OBR-29	Parent Results Observation Identifier
OBR-30	Transportation Mode
OBR-31	Reason for Study
OBR-32	Principal Result Interpreter +
OBR-33	Assistant Result Interpreter +
OBR-34	Technician +
OBR-35	Transcriptionist +
OBR-36	Scheduled Date/Time +
OBR-37	Number of Sample Containers *
OBR-38	Transport Logistics of Collected Sample *
OBR-39	Collector's Comment *
OBR-40	Transport Arrangement Responsibility
OBR-41	Transport Arranged
OBR-42	Escort Required
OBR-43	Planned Patient Transport Comment
OBR-44	Procedure Code
OBR-45	Procedure Code Modifier
OBR-46	Placer Supplemental Service Information
OBR-47	Filler Supplemental Service Information
OBR-48	Medically Necessary Duplicate Procedure Reason
OBR-49	Result Handling
OBR-50	Parent Universal Service Identifier
OBR-51	Observation Group ID
OBR-52	Parent Observation Group ID
OBR-53	Alternate Placer Order Number
OBR-54	Parent Order

OBX

Field	Field Description
OBX-1	Set ID - OBX
OBX-2	Value Type
OBX-3	Observation Identifier
OBX-4	Observation Sub-ID
OBX-5	Observation Value
OBX-6	Units
OBX-7	References Range
OBX-8	Interpretation Codes
OBX-9	Probability
OBX-10	Nature of Abnormal Test
OBX-11	Observation Result Status
OBX-12	Effective Date of Reference Range
OBX-13	User Defined Access Checks
OBX-14	Date/Time of the Observation
OBX-15	Producer's ID
OBX-16	Responsible Observer
OBX-17	Observation Method
OBX-18	Equipment Instance Identifier
OBX-19	Date/Time of the Analysis
OBX-20	Observation Site
OBX-21	Observation Instance Identifier
OBX-22	Mood Code
OBX-23	Performing Organization Name
OBX-24	Performing Organization Address
OBX-25	Performing Organization Medical Director
OBX-26	Patient Results Release Category
OBX-27	Root Cause
OBX-28	Local Process Control

ODS

Field	Field Description
ODS-1	Type
ODS-2	Service Period
ODS-3	Diet, Supplement, or Preference Code
ODS-4	Text Instruction

ODT

Field	Field Description
ODT-1	Tray Type
ODT-2	Service Period
ODT-3	Text Instruction

OM1

Field	Field Description
OM1-1	Sequence Number - Test/Observation Master File
OM1-2	Producer's Service/Test/Observation ID
OM1-3	Permitted Data Types
OM1-4	Specimen Required
OM1-5	Producer ID
OM1-6	Observation Description
OM1-7	Other Service/Test/Observation IDs for the Observation
OM1-8	Other Names
OM1-9	Preferred Report Name for the Observation
OM1-10	Preferred Short Name or Mnemonic for the Observation
OM1-11	Preferred Long Name for the Observation
OM1-12	Orderability
OM1-13	Identity of Instrument Used to Perform this Study
OM1-14	Coded Representation of Method
OM1-15	Portable Device Indicator
OM1-16	Observation Producing Department/Section
OM1-17	Telephone Number of Section
OM1-18	Nature of Service/Test/Observation
OM1-19	Report Subheader
OM1-20	Report Display Order
OM1-21	Date/Time Stamp for Any Change in Definition for the Observation
OM1-22	Effective Date/Time of Change
OM1-23	Typical Turn-Around Time
OM1-24	Processing Time
OM1-25	Processing Priority
OM1-26	Reporting Priority
OM1-27	Outside Site(s) Where Observation May Be Performed
OM1-28	Address of Outside Site(s)
OM1-29	Phone Number of Outside Site
OM1-30	Confidentiality Code
OM1-31	Observations Required to Interpret this Observation
OM1-32	Interpretation of Observations
OM1-33	Contraindications to Observations
OM1-34	Reflex Tests/Observations
OM1-35	Rules that Trigger Reflex Testing
OM1-36	Fixed Canned Message
OM1-37	Patient Preparation
OM1-38	Procedure Medication
OM1-39	Factors that may Affect the Observation
OM1-40	Service/Test/Observation Performance Schedule
OM1-41	Description of Test Methods
OM1-42	Kind of Quantity Observed
OM1-43	Point Versus Interval
OM1-44	Challenge Information
OM1-45	Relationship Modifier
OM1-46	Target Anatomic Site Of Test
OM1-47	Modality of Imaging Measurement
OM1-48	Exclusive Test
OM1-49	Diagnostic Serv Sect ID
OM1-50	Taxonomic Classification Code
OM1-51	Other Names

OM2

Field	Field Description
OM2-1	Sequence Number - Test/Observation Master File
OM2-2	Units of Measure
OM2-3	Range of Decimal Precision
OM2-4	Corresponding SI Units of Measure
OM2-5	SI Conversion Factor
OM2-6	Reference (Normal) Range for Ordinal and Continuous Observations
OM2-7	Critical Range for Ordinal and Continuous Observations
OM2-8	Absolute Range for Ordinal and Continuous Observations
OM2-9	Delta Check Criteria
OM2-10	Minimum Meaningful Increments

OM3

Field	Field Description
OM3-1	Sequence Number - Test/Observation Master File
OM3-2	Preferred Coding System
OM3-3	Valid Coded Answers
OM3-4	Normal Text/Codes for Categorical Observations
OM3-5	Abnormal Text/Codes for Categorical Observations
OM3-6	Critical Text/Codes for Categorical Observations
OM3-7	Value Type

OM4

Field	Field Description
OM4-1	Sequence Number - Test/Observation Master File
OM4-2	Derived Specimen
OM4-3	Container Description
OM4-4	Container Volume
OM4-5	Container Units
OM4-6	Specimen
OM4-7	Additive
OM4-8	Preparation
OM4-9	Special Handling Requirements
OM4-10	Normal Collection Volume
OM4-11	Minimum Collection Volume
OM4-12	Specimen Requirements
OM4-13	Specimen Priorities
OM4-14	Specimen Retention Time
OM4-15	Specimen Handling Code
OM4-16	Specimen Preference
OM4-17	Preferred Specimen/Attribture Sequence ID
OM4-18	Taxonomic Classification Code

OM5

Field	Field Description
OM5-1	Sequence Number - Test/Observation Master File
OM5-2	Test/Observations Included Within an Ordered Test Battery
OM5-3	Observation ID Suffixes

OM6

Field	Field Description
OM6-1	Sequence Number - Test/Observation Master File
OM6-2	Derivation Rule

OM7

Field	Field Description
OM7-1	Sequence Number - Test/Observation Master File
OM7-2	Universal Service Identifier
OM7-3	Category Identifier
OM7-4	Category Description
OM7-5	Category Synonym
OM7-6	Effective Test/Service Start Date/Time
OM7-7	Effective Test/Service End Date/Time
OM7-8	Test/Service Default Duration Quantity
OM7-9	Test/Service Default Duration Units
OM7-10	Test/Service Default Frequency
OM7-11	Consent Indicator
OM7-12	Consent Identifier
OM7-13	Consent Effective Start Date/Time
OM7-14	Consent Effective End Date/Time
OM7-15	Consent Interval Quantity
OM7-16	Consent Interval Units
OM7-17	Consent Waiting Period Quantity
OM7-18	Consent Waiting Period Units
OM7-19	Effective Date/Time of Change
OM7-20	Entered By
OM7-21	Orderable-at Location
OM7-22	Formulary Status
OM7-23	Special Order Indicator
OM7-24	Primary Key Value - CDM

ORC

Field	Field Description
ORC-1	Order Control
ORC-2	Placer Order Number
ORC-3	Filler Order Number
ORC-4	Placer Group Number
ORC-5	Order Status
ORC-6	Response Flag
ORC-7	Quantity/Timing
ORC-8	Parent Order
ORC-9	Date/Time of Transaction
ORC-10	Entered By
ORC-11	Verified By
ORC-12	Ordering Provider
ORC-13	Enterer's Location
ORC-14	Call Back Phone Number
ORC-15	Order Effective Date/Time
ORC-16	Order Control Code Reason
ORC-17	Entering Organization
ORC-18	Entering Device
ORC-19	Action By
ORC-20	Advanced Beneficiary Notice Code
ORC-21	Ordering Facility Name
ORC-22	Ordering Facility Address
ORC-23	Ordering Facility Phone Number
ORC-24	Ordering Provider Address
ORC-25	Order Status Modifier
ORC-26	Advanced Beneficiary Notice Override Reason
ORC-27	Filler's Expected Availability Date/Time
ORC-28	Confidentiality Code
ORC-29	Order Type
ORC-30	Enterer Authorization Mode
ORC-31	Parent Universal Service Identifier
ORC-32	Advanced Beneficiary Notice Date
ORC-33	Alternate Placer Order Number
ORC-34	Order Workflow Profile

ORG

Field	Field Description
ORG-1	Set ID - ORG
ORG-2	Organization Unit Code
ORG-3	Organization Unit Type Code
ORG-4	Primary Org Unit Indicator
ORG-5	Practitioner Org Unit Identifier
ORG-6	Health Care Provider Type Code
ORG-7	Health Care Provider Classification Code
ORG-8	Health Care Provider Area of Specialization Code
ORG-9	Effective Date Range
ORG-10	Employment Status Code
ORG-11	Board Approval Indicator
ORG-12	Primary Care Physician Indicator
ORG-13	Cost Center Code

OVR

Field	Field Description
OVR-1	Business Rule Override Type
OVR-2	Business Rule Override Code
OVR-3	Override Comments
OVR-4	Override Entered By
OVR-5	Override Authorized By

PAC

Field	Field Description
PAC-1	Set Id - PAC
PAC-2	Package ID
PAC-3	Parent Package ID
PAC-4	Position in Parent Package
PAC-5	Package Type
PAC-6	Package Condition
PAC-7	Package Handling Code
PAC-8	Package Risk Code

PCE

Field	Field Description
PCE-1	Set ID - PCE
PCE-2	Cost Center Account Number
PCE-3	Transaction Code
PCE-4	Transaction amount - unit

PCR

Field	Field Description
PCR-1	Implicated Product
PCR-2	Generic Product
PCR-3	Product Class
PCR-4	Total Duration Of Therapy
PCR-5	Product Manufacture Date
PCR-6	Product Expiration Date
PCR-7	Product Implantation Date
PCR-8	Product Explantation Date
PCR-9	Single Use Device
PCR-10	Indication For Product Use
PCR-11	Product Problem
PCR-12	Product Serial/Lot Number
PCR-13	Product Available For Inspection
PCR-14	Product Evaluation Performed
PCR-15	Product Evaluation Status
PCR-16	Product Evaluation Results
PCR-17	Evaluated Product Source
PCR-18	Date Product Returned To Manufacturer
PCR-19	Device Operator Qualifications
PCR-20	Relatedness Assessment
PCR-21	Action Taken In Response To The Event
PCR-22	Event Causality Observations
PCR-23	Indirect Exposure Mechanism

PD1

Field	Field Description
PD1-1	Living Dependency
PD1-2	Living Arrangement
PD1-3	Patient Primary Facility
PD1-4	Patient Primary Care Provider Name & ID No.
PD1-5	Student Indicator
PD1-6	Handicap
PD1-7	Living Will Code
PD1-8	Organ Donor Code
PD1-9	Separate Bill
PD1-10	Duplicate Patient
PD1-11	Publicity Code
PD1-12	Protection Indicator
PD1-13	Protection Indicator Effective Date
PD1-14	Place of Worship
PD1-15	Advance Directive Code
PD1-16	Immunization Registry Status
PD1-17	Immunization Registry Status Effective Date
PD1-18	Publicity Code Effective Date
PD1-19	Military Branch
PD1-20	Military Rank/Grade
PD1-21	Military Status
PD1-22	Advance Directive Last Verified Date

PDA

Field	Field Description
PDA-1	Death Cause Code
PDA-2	Death Location
PDA-3	Death Certified Indicator
PDA-4	Death Certificate Signed Date/Time
PDA-5	Death Certified By
PDA-6	Autopsy Indicator
PDA-7	Autopsy Start and End Date/Time
PDA-8	Autopsy Performed By
PDA-9	Coroner Indicator

PDC

Field	Field Description
PDC-1	Manufacturer/Distributor
PDC-2	Country
PDC-3	Brand Name
PDC-4	Device Family Name
PDC-5	Generic Name
PDC-6	Model Identifier
PDC-7	Catalogue Identifier
PDC-8	Other Identifier
PDC-9	Product Code
PDC-10	Marketing Basis
PDC-11	Marketing Approval ID
PDC-12	Labeled Shelf Life
PDC-13	Expected Shelf Life
PDC-14	Date First Marketed
PDC-15	Date Last Marketed

PEO

Field	Field Description
PEO-1	Event Identifiers Used
PEO-2	Event Symptom/Diagnosis Code
PEO-3	Event Onset Date/Time
PEO-4	Event Exacerbation Date/Time
PEO-5	Event Improved Date/Time
PEO-6	Event Ended Data/Time
PEO-7	Event Location Occurred Address
PEO-8	Event Qualification
PEO-9	Event Serious
PEO-10	Event Expected
PEO-11	Event Outcome
PEO-12	Patient Outcome
PEO-13	Event Description from Others
PEO-14	Event Description from Original Reporter
PEO-15	Event Description from Patient
PEO-16	Event Description from Practitioner
PEO-17	Event Description from Autopsy
PEO-18	Cause Of Death
PEO-19	Primary Observer Name
PEO-20	Primary Observer Address
PEO-21	Primary Observer Telephone
PEO-22	Primary Observer's Qualification
PEO-23	Confirmation Provided By
PEO-24	Primary Observer Aware Date/Time
PEO-25	Primary Observer's identity May Be Divulged

PES

Field	Field Description
PES-1	Sender Organization Name
PES-2	Sender Individual Name
PES-3	Sender Address
PES-4	Sender Telephone
PES-5	Sender Event Identifier
PES-6	Sender Sequence Number
PES-7	Sender Event Description
PES-8	Sender Comment
PES-9	Sender Aware Date/Time
PES-10	Event Report Date
PES-11	Event Report Timing/Type
PES-12	Event Report Source
PES-13	Event Reported To

PID

Field	Field Description
PID-1	Set ID - PID
PID-2	Patient ID
PID-3	Patient Identifier List
PID-4	Alternate Patient ID - PID
PID-5	Patient Name
PID-6	Mother's Maiden Name
PID-7	Date/Time of Birth
PID-8	Administrative Sex
PID-9	Patient Alias
PID-10	Race
PID-11	Patient Address
PID-12	County Code
PID-13	Phone Number - Home
PID-14	Phone Number - Business
PID-15	Primary Language
PID-16	Marital Status
PID-17	Religion
PID-18	Patient Account Number
PID-19	SSN Number - Patient
PID-20	Driver's License Number - Patient
PID-21	Mother's Identifier
PID-22	Ethnic Group
PID-23	Birth Place
PID-24	Multiple Birth Indicator
PID-25	Birth Order
PID-26	Citizenship
PID-27	Veterans Military Status
PID-28	Nationality
PID-29	Patient Death Date and Time
PID-30	Patient Death Indicator
PID-31	Identity Unknown Indicator
PID-32	Identity Reliability Code
PID-33	Last Update Date/Time
PID-34	Last Update Facility
PID-35	Taxonomic Classification Code
PID-36	Breed Code
PID-37	Strain
PID-38	Production Class Code
PID-39	Tribal Citizenship
PID-40	Patient Telecommunication Information

PKG

Field	Field Description
PKG-1	Set Id - PKG
PKG-2	Packaging Units
PKG-3	Default Order Unit Of Measure Indicator
PKG-4	Package Quantity
PKG-5	Price
PKG-6	Future Item Price
PKG-7	Future Item Price Effective Date
PKG-8	Global Trade Item Number

PMT

Field	Field Description
PMT-1	Payment/Remittance Advice Number
PMT-2	Payment/Remittance Effective Date/Time
PMT-3	Payment/Remittance Expiration Date/Time
PMT-4	Payment Method
PMT-5	Payment/Remittance Date/Time
PMT-6	Payment/Remittance Amount
PMT-7	Check Number
PMT-8	Payee Bank Identification
PMT-9	Payee Transit Number
PMT-10	Payee Bank Account ID
PMT-11	Payment Organization
PMT-12	ESR-Code-Line

PR1

Field	Field Description
PR1-1	Set ID - PR1
PR1-2	Procedure Coding Method
PR1-3	Procedure Code
PR1-4	Procedure Description
PR1-5	Procedure Date/Time
PR1-6	Procedure Functional Type
PR1-7	Procedure Minutes
PR1-8	Anesthesiologist
PR1-9	Anesthesia Code
PR1-10	Anesthesia Minutes
PR1-11	Surgeon
PR1-12	Procedure Practitioner
PR1-13	Consent Code
PR1-14	Procedure Priority
PR1-15	Associated Diagnosis Code
PR1-16	Procedure Code Modifier
PR1-17	Procedure DRG Type
PR1-18	Tissue Type Code
PR1-19	Procedure Identifier
PR1-20	Procedure Action Code
PR1-21	DRG Procedure Determination Status
PR1-22	DRG Procedure Relevance
PR1-23	Treating Organizational Unit
PR1-24	Respiratory Within Surgery
PR1-25	Parent Procedure ID

PRA

Field	Field Description
PRA-1	Primary Key Value - PRA
PRA-2	Practitioner Group
PRA-3	Practitioner Category
PRA-4	Provider Billing
PRA-5	Specialty
PRA-6	Practitioner ID Numbers
PRA-7	Privileges
PRA-8	Date Entered Practice
PRA-9	Institution
PRA-10	Date Left Practice
PRA-11	Government Reimbursement Billing Eligibility
PRA-12	Set ID - PRA

PRB

Field	Field Description
PRB-1	Action Code
PRB-2	Action Date/Time
PRB-3	Problem ID
PRB-4	Problem Instance ID
PRB-5	Episode of Care ID
PRB-6	Problem List Priority
PRB-7	Problem Established Date/Time
PRB-8	Anticipated Problem Resolution Date/Time
PRB-9	Actual Problem Resolution Date/Time
PRB-10	Problem Classification
PRB-11	Problem Management Discipline
PRB-12	Problem Persistence
PRB-13	Problem Confirmation Status
PRB-14	Problem Life Cycle Status
PRB-15	Problem Life Cycle Status Date/Time
PRB-16	Problem Date of Onset
PRB-17	Problem Onset Text
PRB-18	Problem Ranking
PRB-19	Certainty of Problem
PRB-20	Probability of Problem (0-1)
PRB-21	Individual Awareness of Problem
PRB-22	Problem Prognosis
PRB-23	Individual Awareness of Prognosis
PRB-24	Family/Significant Other Awareness of Problem/Prognosis
PRB-25	Security/Sensitivity
PRB-26	Problem Severity
PRB-27	Problem Perspective
PRB-28	Mood Code

PRC

Field	Field Description
PRC-1	Primary Key Value - PRC
PRC-2	Facility ID - PRC
PRC-3	Department
PRC-4	Valid Patient Classes
PRC-5	Price
PRC-6	Formula
PRC-7	Minimum Quantity
PRC-8	Maximum Quantity
PRC-9	Minimum Price
PRC-10	Maximum Price
PRC-11	Effective Start Date
PRC-12	Effective End Date
PRC-13	Price Override Flag
PRC-14	Billing Category
PRC-15	Chargeable Flag
PRC-16	Active/Inactive Flag
PRC-17	Cost
PRC-18	Charge on Indicator

PRD

Field	Field Description
PRD-1	Provider Role
PRD-2	Provider Name
PRD-3	Provider Address
PRD-4	Provider Location
PRD-5	Provider Communication Information
PRD-6	Preferred Method of Contact
PRD-7	Provider Identifiers
PRD-8	Effective Start Date of Provider Role
PRD-9	Effective End Date of Provider Role
PRD-10	Provider Organization Name and Identifier
PRD-11	Provider Organization Address
PRD-12	Provider Organization Location Information
PRD-13	Provider Organization Communication Information
PRD-14	Provider Organization Method of Contact

PRT

Field	Field Description
PRT-1	Participation Instance ID
PRT-2	Action Code
PRT-3	Action Reason
PRT-4	Participation
PRT-5	Participation Person
PRT-6	Participation Person Provider Type
PRT-7	Participant Organization Unit Type
PRT-8	Participation Organization
PRT-9	Participant Location
PRT-10	Participation Device
PRT-11	Participation Begin Date/Time (arrival time)
PRT-12	Participation End Date/Time (departure time)
PRT-13	Participation Qualitative Duration
PRT-14	Participation Address
PRT-15	Participant Telecommunication Address

PSG

Field	Field Description
PSG-1	Provider Product/Service Group Number
PSG-2	Payer Product/Service Group Number
PSG-3	Product/Service Group Sequence Number
PSG-4	Adjudicate as Group
PSG-5	Product/Service Group Billed Amount
PSG-6	Product/Service Group Description

PSH

Field	Field Description
PSH-1	Report Type
PSH-2	Report Form Identifier
PSH-3	Report Date
PSH-4	Report Interval Start Date
PSH-5	Report Interval End Date
PSH-6	Quantity Manufactured
PSH-7	Quantity Distributed
PSH-8	Quantity Distributed Method
PSH-9	Quantity Distributed Comment
PSH-10	Quantity in Use
PSH-11	Quantity in Use Method
PSH-12	Quantity in Use Comment
PSH-13	Number of Product Experience Reports Filed by Facility
PSH-14	Number of Product Experience Reports Filed by Distributor

PSL

Field	Field Description
PSL-1	Provider Product/Service Line Item Number
PSL-2	Payer Product/Service Line Item Number
PSL-3	Product/Service Line Item Sequence Number
PSL-4	Provider Tracking ID
PSL-5	Payer Tracking ID
PSL-6	Product/Service Line Item Status
PSL-7	Product/Service Code
PSL-8	Product/Service Code Modifier
PSL-9	Product/Service Code Description
PSL-10	Product/Service Effective Date
PSL-11	Product/Service Expiration Date
PSL-12	Product/Service Quantity
PSL-13	Product/Service Unit Cost
PSL-14	Number of Items per Unit
PSL-15	Product/Service Gross Amount
PSL-16	Product/Service Billed Amount
PSL-17	Product/Service Clarification Code Type
PSL-18	Product/Service Clarification Code Value
PSL-19	Health Document Reference Identifier
PSL-20	Processing Consideration Code
PSL-21	Restricted Disclosure Indicator
PSL-22	Related Product/Service Code Indicator
PSL-23	Product/Service Amount for Physician
PSL-24	Product/Service Cost Factor
PSL-25	Cost Center
PSL-26	Billing Period
PSL-27	Days without Billing
PSL-28	Session-No
PSL-29	Executing Physician ID
PSL-30	Responsible Physician ID
PSL-31	Role Executing Physician
PSL-32	Medical Role Executing Physician
PSL-33	Side of body
PSL-34	Number of TP's PP
PSL-35	TP-Value PP
PSL-36	Internal Scaling Factor PP
PSL-37	External Scaling Factor PP
PSL-38	Amount PP
PSL-39	Number of TP's Technical Part
PSL-40	TP-Value Technical Part
PSL-41	Internal Scaling Factor Technical Part
PSL-42	External Scaling Factor Technical Part
PSL-43	Amount Technical Part
PSL-44	Total Amount Professional Part + Technical Part
PSL-45	VAT-Rate
PSL-46	Main-Service
PSL-47	Validation
PSL-48	Comment

PSS

Field	Field Description
PSS-1	Provider Product/Service Section Number
PSS-2	Payer Product/Service Section Number
PSS-3	Product/Service Section Sequence Number
PSS-4	Billed Amount
PSS-5	Section Description or Heading

PTH

Field	Field Description
PTH-1	Action Code
PTH-2	Pathway ID
PTH-3	Pathway Instance ID
PTH-4	Pathway Established Date/Time
PTH-5	Pathway Life Cycle Status
PTH-6	Change Pathway Life Cycle Status Date/Time
PTH-7	Mood Code

PV1

Field	Field Description
PV1-1	Set ID - PV1
PV1-2	Patient Class
PV1-3	Assigned Patient Location
PV1-4	Admission Type
PV1-5	Preadmit Number
PV1-6	Prior Patient Location
PV1-7	Attending Doctor
PV1-8	Referring Doctor
PV1-9	Consulting Doctor
PV1-10	Hospital Service
PV1-11	Temporary Location
PV1-12	Preadmit Test Indicator
PV1-13	Re-admission Indicator
PV1-14	Admit Source
PV1-15	Ambulatory Status
PV1-16	VIP Indicator
PV1-17	Admitting Doctor
PV1-18	Patient Type
PV1-19	Visit Number
PV1-20	Financial Class
PV1-21	Charge Price Indicator
PV1-22	Courtesy Code
PV1-23	Credit Rating
PV1-24	Contract Code
PV1-25	Contract Effective Date
PV1-26	Contract Amount
PV1-27	Contract Period
PV1-28	Interest Code
PV1-29	Transfer to Bad Debt Code
PV1-30	Transfer to Bad Debt Date
PV1-31	Bad Debt Agency Code
PV1-32	Bad Debt Transfer Amount
PV1-33	Bad Debt Recovery Amount
PV1-34	Delete Account Indicator
PV1-35	Delete Account Date
PV1-36	Discharge Disposition
PV1-37	Discharged to Location
PV1-38	Diet Type
PV1-39	Servicing Facility
PV1-40	Bed Status
PV1-41	Account Status
PV1-42	Pending Location
PV1-43	Prior Temporary Location
PV1-44	Admit Date/Time
PV1-45	Discharge Date/Time
PV1-46	Current Patient Balance
PV1-47	Total Charges
PV1-48	Total Adjustments
PV1-49	Total Payments
PV1-50	Alternate Visit ID
PV1-51	Visit Indicator
PV1-52	Other Healthcare Provider
PV1-53	Service Episode Description
PV1-54	Service Episode Identifier

PV2

Field	Field Description
PV2-1	Prior Pending Location
PV2-2	Accommodation Code
PV2-3	Admit Reason
PV2-4	Transfer Reason
PV2-5	Patient Valuables
PV2-6	Patient Valuables Location
PV2-7	Visit User Code
PV2-8	Expected Admit Date/Time
PV2-9	Expected Discharge Date/Time
PV2-10	Estimated Length of Inpatient Stay
PV2-11	Actual Length of Inpatient Stay
PV2-12	Visit Description
PV2-13	Referral Source Code
PV2-14	Previous Service Date
PV2-15	Employment Illness Related Indicator
PV2-16	Purge Status Code
PV2-17	Purge Status Date
PV2-18	Special Program Code
PV2-19	Retention Indicator
PV2-20	Expected Number of Insurance Plans
PV2-21	Visit Publicity Code
PV2-22	Visit Protection Indicator
PV2-23	Clinic Organization Name
PV2-24	Patient Status Code
PV2-25	Visit Priority Code
PV2-26	Previous Treatment Date
PV2-27	Expected Discharge Disposition
PV2-28	Signature on File Date
PV2-29	First Similar Illness Date
PV2-30	Patient Charge Adjustment Code
PV2-31	Recurring Service Code
PV2-32	Billing Media Code
PV2-33	Expected Surgery Date and Time
PV2-34	Military Partnership Code
PV2-35	Military Non-Availability Code
PV2-36	Newborn Baby Indicator
PV2-37	Baby Detained Indicator
PV2-38	Mode of Arrival Code
PV2-39	Recreational Drug Use Code
PV2-40	Admission Level of Care Code
PV2-41	Precaution Code
PV2-42	Patient Condition Code
PV2-43	Living Will Code
PV2-44	Organ Donor Code
PV2-45	Advance Directive Code
PV2-46	Patient Status Effective Date
PV2-47	Expected LOA Return Date/Time
PV2-48	Expected Pre-admission Testing Date/Time
PV2-49	Notify Clergy Code
PV2-50	Advance Directive Last Verified Date

PYE

Field	Field Description
PYE-1	Set ID - PYE
PYE-2	Payee Type
PYE-3	Payee Relationship to Invoice (Patient)
PYE-4	Payee Identification List
PYE-5	Payee Person Name
PYE-6	Payee Address
PYE-7	Payment Method

QAK

Field	Field Description
QAK-1	Query Tag
QAK-2	Query Response Status
QAK-3	Message Query Name
QAK-4	Hit Count Total
QAK-5	This payload
QAK-6	Hits remaining

QID

Field	Field Description
QID-1	Query Tag
QID-2	Message Query Name

QPD

Field	Field Description
QPD-1	Message Query Name
QPD-2	Query Tag
QPD-3	User Parameters (in successive fields)

QRI

Field	Field Description
QRI-1	Candidate Confidence
QRI-2	Match Reason Code
QRI-3	Algorithm Descriptor

RCP

Field	Field Description
RCP-1	Query Priority
RCP-2	Quantity Limited Request
RCP-3	Response Modality
RCP-4	Execution and Delivery Time
RCP-5	Modify Indicator
RCP-6	Sort-by Field
RCP-7	Segment group inclusion

RDF

Field	Field Description
RDF-1	Number of Columns per Row
RDF-2	Column Description

RDT

Field	Field Description
RDT-1	Column Value

REL

Field	Field Description
REL-1	Set ID -REL
REL-2	Relationship Type
REL-3	This Relationship Instance Identifier
REL-4	Source Information Instance Identifier
REL-5	Target Information Instance Identifier
REL-6	Asserting Entity Instance ID
REL-7	Asserting Person
REL-8	Asserting Organization
REL-9	Assertor Address
REL-10	Assertor Contact
REL-11	Assertion Date Range
REL-12	Negation Indicator
REL-13	Certainty of Relationship
REL-14	Priority No
REL-15	Priority Sequence No (rel preference for consideration)
REL-16	Separability Indicator

RF1

Field	Field Description
RF1-1	Referral Status
RF1-2	Referral Priority
RF1-3	Referral Type
RF1-4	Referral Disposition
RF1-5	Referral Category
RF1-6	Originating Referral Identifier
RF1-7	Effective Date
RF1-8	Expiration Date
RF1-9	Process Date
RF1-10	Referral Reason
RF1-11	External Referral Identifier
RF1-12	Referral Documentation Completion Status
RF1-13	Planned Treatment Stop Date
RF1-14	Referral Reason Text
RF1-15	Number of Authorized Treatments/Units
RF1-16	Number of Used Treatments/Units
RF1-17	Number of Schedule Treatments/Units
RF1-18	Remaining Benefit Amount
RF1-19	Authorized Provider
RF1-20	Authorized Health Professional
RF1-21	Source Text
RF1-22	Source Date
RF1-23	Source Phone
RF1-24	Comment
RF1-25	Action Code

RFI

Field	Field Description
RFI-1	Request Date
RFI-2	Response Due Date
RFI-3	Patient Consent
RFI-4	Date Additional Information Was Submitted

RGS

Field	Field Description
RGS-1	Set ID - RGS
RGS-2	Segment Action Code
RGS-3	Resource Group ID

RMI

Field	Field Description
RMI-1	Risk Management Incident Code
RMI-2	Date/Time Incident
RMI-3	Incident Type Code

ROL

Field	Field Description
ROL-1	Role Instance ID
ROL-2	Action Code
ROL-3	Role-ROL
ROL-4	Role Person
ROL-5	Role Begin Date/Time
ROL-6	Role End Date/Time
ROL-7	Role Duration
ROL-8	Role Action Reason
ROL-9	Provider Type
ROL-10	Organization Unit Type
ROL-11	Office/Home Address/Birthplace
ROL-12	Phone
ROL-13	Person's Location
ROL-14	Organization

RQ1

Field	Field Description
RQ1-1	Anticipated Price
RQ1-2	Manufacturer Identifier
RQ1-3	Manufacturer's Catalog
RQ1-4	Vendor ID
RQ1-5	Vendor Catalog
RQ1-6	Taxable
RQ1-7	Substitute Allowed

RQD

Field	Field Description
RQD-1	Requisition Line Number
RQD-2	Item Code - Internal
RQD-3	Item Code - External
RQD-4	Hospital Item Code
RQD-5	Requisition Quantity
RQD-6	Requisition Unit of Measure
RQD-7	Cost Center Account Number
RQD-8	Item Natural Account Code
RQD-9	Deliver To ID
RQD-10	Date Needed

RXA

Field	Field Description
RXA-1	Give Sub-ID Counter
RXA-2	Administration Sub-ID Counter
RXA-3	Date/Time Start of Administration
RXA-4	Date/Time End of Administration
RXA-5	Administered Code
RXA-6	Administered Amount
RXA-7	Administered Units
RXA-8	Administered Dosage Form
RXA-9	Administration Notes
RXA-10	Administering Provider
RXA-11	Administered-at Location
RXA-12	Administered Per (Time Unit)
RXA-13	Administered Strength
RXA-14	Administered Strength Units
RXA-15	Substance Lot Number
RXA-16	Substance Expiration Date
RXA-17	Substance Manufacturer Name
RXA-18	Substance/Treatment Refusal Reason
RXA-19	Indication
RXA-20	Completion Status
RXA-21	Action Code - RXA
RXA-22	System Entry Date/Time
RXA-23	Administered Drug Strength Volume
RXA-24	Administered Drug Strength Volume Units
RXA-25	Administered Barcode Identifier
RXA-26	Pharmacy Order Type
RXA-27	Administer-at
RXA-28	Administered-at Address
RXA-29	Administered Tag Identifier

RXC

Field	Field Description
RXC-1	RX Component Type
RXC-2	Component Code
RXC-3	Component Amount
RXC-4	Component Units
RXC-5	Component Strength
RXC-6	Component Strength Units
RXC-7	Supplementary Code
RXC-8	Component Drug Strength Volume
RXC-9	Component Drug Strength Volume Units
RXC-10	Dispense Amount
RXC-11	Dispense Units

RXD

Field	Field Description
RXD-1	Dispense Sub-ID Counter
RXD-2	Dispense/Give Code
RXD-3	Date/Time Dispensed
RXD-4	Actual Dispense Amount
RXD-5	Actual Dispense Units
RXD-6	Actual Dosage Form
RXD-7	Prescription Number
RXD-8	Number of Refills Remaining
RXD-9	Dispense Notes
RXD-10	Dispensing Provider
RXD-11	Substitution Status
RXD-12	Total Daily Dose
RXD-13	Dispense-to Location
RXD-14	Needs Human Review
RXD-15	Special Dispensing Instructions
RXD-16	Actual Strength
RXD-17	Actual Strength Unit
RXD-18	Substance Lot Number
RXD-19	Substance Expiration Date
RXD-20	Substance Manufacturer Name
RXD-21	Indication
RXD-22	Dispense Package Size
RXD-23	Dispense Package Size Unit
RXD-24	Dispense Package Method
RXD-25	Supplementary Code
RXD-26	Initiating Location
RXD-27	Packaging/Assembly Location
RXD-28	Actual Drug Strength Volume
RXD-29	Actual Drug Strength Volume Units
RXD-30	Dispense to Pharmacy
RXD-31	Dispense to Pharmacy Address
RXD-32	Pharmacy Order Type
RXD-33	Dispense Type
RXD-34	Pharmacy Phone Number
RXD-35	Dispense Tag Identifier

RXE

Field	Field Description
RXE-1	Quantity/Timing
RXE-2	Give Code
RXE-3	Give Amount - Minimum
RXE-4	Give Amount - Maximum
RXE-5	Give Units
RXE-6	Give Dosage Form
RXE-7	Provider's Administration Instructions
RXE-8	Deliver-To Location
RXE-9	Substitution Status
RXE-10	Dispense Amount
RXE-11	Dispense Units
RXE-12	Number Of Refills
RXE-13	Ordering Provider's DEA Number
RXE-14	Pharmacist/Treatment Supplier's Verifier ID
RXE-15	Prescription Number
RXE-16	Number of Refills Remaining
RXE-17	Number of Refills/Doses Dispensed
RXE-18	D/T of Most Recent Refill or Dose Dispensed
RXE-19	Total Daily Dose
RXE-20	Needs Human Review
RXE-21	Special Dispensing Instructions
RXE-22	Give Per (Time Unit)
RXE-23	Give Rate Amount
RXE-24	Give Rate Units
RXE-25	Give Strength
RXE-26	Give Strength Units
RXE-27	Give Indication
RXE-28	Dispense Package Size
RXE-29	Dispense Package Size Unit
RXE-30	Dispense Package Method
RXE-31	Supplementary Code
RXE-32	Original Order Date/Time
RXE-33	Give Drug Strength Volume
RXE-34	Give Drug Strength Volume Units
RXE-35	Controlled Substance Schedule
RXE-36	Formulary Status
RXE-37	Pharmaceutical Substance Alternative
RXE-38	Pharmacy of Most Recent Fill
RXE-39	Initial Dispense Amount
RXE-40	Dispensing Pharmacy
RXE-41	Dispensing Pharmacy Address
RXE-42	Deliver-to Patient Location
RXE-43	Deliver-to Address
RXE-44	Pharmacy Order Type
RXE-45	Pharmacy Phone Number

RXG

Field	Field Description
RXG-1	Give Sub-ID Counter
RXG-2	Dispense Sub-ID Counter
RXG-3	Quantity/Timing
RXG-4	Give Code
RXG-5	Give Amount - Minimum
RXG-6	Give Amount - Maximum
RXG-7	Give Units
RXG-8	Give Dosage Form
RXG-9	Administration Notes
RXG-10	Substitution Status
RXG-11	Dispense-to Location
RXG-12	Needs Human Review
RXG-13	Special Administration Instructions
RXG-14	Give Per (Time Unit)
RXG-15	Give Rate Amount
RXG-16	Give Rate Units
RXG-17	Give Strength
RXG-18	Give Strength Units
RXG-19	Substance Lot Number
RXG-20	Substance Expiration Date
RXG-21	Substance Manufacturer Name
RXG-22	Indication
RXG-23	Give Drug Strength Volume
RXG-24	Give Drug Strength Volume Units
RXG-25	Give Barcode Identifier
RXG-26	Pharmacy Order Type
RXG-27	Dispense to Pharmacy
RXG-28	Dispense to Pharmacy Address
RXG-29	Deliver-to Patient Location
RXG-30	Deliver-to Address
RXG-31	Give Tag Identifier
RXG-32	Dispense Amount
RXG-33	Dispense Units

RXO

Field	Field Description
RXO-1	Requested Give Code
RXO-2	Requested Give Amount - Minimum
RXO-3	Requested Give Amount - Maximum
RXO-4	Requested Give Units
RXO-5	Requested Dosage Form
RXO-6	Provider's Pharmacy/Treatment Instructions
RXO-7	Provider's Administration Instructions
RXO-8	Deliver-To Location
RXO-9	Allow Substitutions
RXO-10	Requested Dispense Code
RXO-11	Requested Dispense Amount
RXO-12	Requested Dispense Units
RXO-13	Number Of Refills
RXO-14	Ordering Provider's DEA Number
RXO-15	Pharmacist/Treatment Supplier's Verifier ID
RXO-16	Needs Human Review
RXO-17	Requested Give Per (Time Unit)
RXO-18	Requested Give Strength
RXO-19	Requested Give Strength Units
RXO-20	Indication
RXO-21	Requested Give Rate Amount
RXO-22	Requested Give Rate Units
RXO-23	Total Daily Dose
RXO-24	Supplementary Code
RXO-25	Requested Drug Strength Volume
RXO-26	Requested Drug Strength Volume Units
RXO-27	Pharmacy Order Type
RXO-28	Dispensing Interval
RXO-29	Medication Instance Identifier
RXO-30	Segment Instance Identifier
RXO-31	Mood Code
RXO-32	Dispensing Pharmacy
RXO-33	Dispensing Pharmacy Address
RXO-34	Deliver-to Patient Location
RXO-35	Deliver-to Address
RXO-36	Pharmacy Phone Number

RXR

Field	Field Description
RXR-1	Route
RXR-2	Administration Site
RXR-3	Administration Device
RXR-4	Administration Method
RXR-5	Routing Instruction
RXR-6	Administration Site Modifier

RXV

Field	Field Description
RXV-1	Set ID - RXV
RXV-2	Bolus Type
RXV-3	Bolus Dose Amount
RXV-4	Bolus Dose Amount Units
RXV-5	Bolus Dose Volume
RXV-6	Bolus Dose Volume Units
RXV-7	PCA Type
RXV-8	PCA Dose Amount
RXV-9	PCA Dose Amount Units
RXV-10	PCA Dose Amount Volume
RXV-11	PCA Dose Amount Volume Units
RXV-12	Max Dose Amount
RXV-13	Max Dose Amount Units
RXV-14	Max Dose Amount Volume
RXV-15	Max Dose Amount Volume Units
RXV-16	Max Dose per Time
RXV-17	Lockout Interval
RXV-18	Syringe Manufacturer
RXV-19	Syringe Model Number
RXV-20	Syringe Size
RXV-21	Syringe Size Units
RXV-22	Action Code

SAC

Field	Field Description
SAC-1	External Accession Identifier
SAC-2	Accession Identifier
SAC-3	Container Identifier
SAC-4	Primary (Parent) Container Identifier
SAC-5	Equipment Container Identifier
SAC-6	Specimen Source
SAC-7	Registration Date/Time
SAC-8	Container Status
SAC-9	Carrier Type
SAC-10	Carrier Identifier
SAC-11	Position in Carrier
SAC-12	Tray Type - SAC
SAC-13	Tray Identifier
SAC-14	Position in Tray
SAC-15	Location
SAC-16	Container Height
SAC-17	Container Diameter
SAC-18	Barrier Delta
SAC-19	Bottom Delta
SAC-20	Container Height/Diameter/Delta Units
SAC-21	Container Volume
SAC-22	Available Specimen Volume
SAC-23	Initial Specimen Volume
SAC-24	Volume Units
SAC-25	Separator Type
SAC-26	Cap Type
SAC-27	Additive
SAC-28	Specimen Component
SAC-29	Dilution Factor
SAC-30	Treatment
SAC-31	Temperature
SAC-32	Hemolysis Index
SAC-33	Hemolysis Index Units
SAC-34	Lipemia Index
SAC-35	Lipemia Index Units
SAC-36	Icterus Index
SAC-37	Icterus Index Units
SAC-38	Fibrin Index
SAC-39	Fibrin Index Units
SAC-40	System Induced Contaminants
SAC-41	Drug Interference
SAC-42	Artificial Blood
SAC-43	Special Handling Code
SAC-44	Other Environmental Factors

SCD

Field	Field Description
SCD-1	Cycle Start Time
SCD-2	Cycle Count
SCD-3	Temp Max
SCD-4	Temp Min
SCD-5	Load Number
SCD-6	Condition Time
SCD-7	Sterilize Time
SCD-8	Exhaust Time
SCD-9	Total Cycle Time
SCD-10	Device Status
SCD-11	Cycle Start Date/Time
SCD-12	Dry Time
SCD-13	Leak Rate
SCD-14	Control Temperature
SCD-15	Sterilizer Temperature
SCD-16	Cycle Complete Time
SCD-17	Under Temperature
SCD-18	Over Temperature
SCD-19	Abort Cycle
SCD-20	Alarm
SCD-21	Long in Charge Phase
SCD-22	Long in Exhaust Phase
SCD-23	Long in Fast Exhaust Phase
SCD-24	Reset
SCD-25	Operator - Unload
SCD-26	Door Open
SCD-27	Reading Failure
SCD-28	Cycle Type
SCD-29	Thermal Rinse Time
SCD-30	Wash Time
SCD-31	Injection Rate
SCD-32	Procedure Code
SCD-33	Patient Identifier List
SCD-34	Attending Doctor
SCD-35	Dilution Factor
SCD-36	Fill Time
SCD-37	Inlet Temperature

SCH

Field	Field Description
SCH-1	Placer Appointment ID
SCH-2	Filler Appointment ID
SCH-3	Occurrence Number
SCH-4	Placer Group Number
SCH-5	Schedule ID
SCH-6	Event Reason
SCH-7	Appointment Reason
SCH-8	Appointment Type
SCH-9	Appointment Duration
SCH-10	Appointment Duration Units
SCH-11	Appointment Timing Quantity
SCH-12	Placer Contact Person
SCH-13	Placer Contact Phone Number
SCH-14	Placer Contact Address
SCH-15	Placer Contact Location
SCH-16	Filler Contact Person
SCH-17	Filler Contact Phone Number
SCH-18	Filler Contact Address
SCH-19	Filler Contact Location
SCH-20	Entered By Person
SCH-21	Entered By Phone Number
SCH-22	Entered By Location
SCH-23	Parent Placer Appointment ID
SCH-24	Parent Filler Appointment ID
SCH-25	Filler Status Code
SCH-26	Placer Order Number
SCH-27	Filler Order Number

SCP

Field	Field Description
SCP-1	Number Of Decontamination/Sterilization Devices
SCP-2	Labor Calculation Type
SCP-3	Date Format
SCP-4	Device Number
SCP-5	Device Name
SCP-6	Device Model Name
SCP-7	Device Type
SCP-8	Lot Control

SDD

Field	Field Description
SDD-1	Lot Number
SDD-2	Device Number
SDD-3	Device Name
SDD-4	Device Data State
SDD-5	Load Status
SDD-6	Control Code
SDD-7	Operator Name

SFT

Field	Field Description
SFT-1	Software Vendor Organization
SFT-2	Software Certified Version or Release Number
SFT-3	Software Product Name
SFT-4	Software Binary ID
SFT-5	Software Product Information
SFT-6	Software Install Date

SGH

Field	Field Description
SGH-1	Set ID - SGH
SGH-2	Segment Group Name

SGT

Field	Field Description
SGT-1	Set ID - SGT
SGT-2	Segment Group Name

SHP

Field	Field Description
SHP-1	Shipment ID
SHP-2	Internal Shipment ID
SHP-3	Shipment Status
SHP-4	Shipment Status Date/Time
SHP-5	Shipment Status Reason
SHP-6	Shipment Priority
SHP-7	Shipment Confidentiality
SHP-8	Number of Packages in Shipment
SHP-9	Shipment Condition
SHP-10	Shipment Handling Code
SHP-11	Shipment Risk Code

SID

Field	Field Description
SID-1	Application/Method Identifier
SID-2	Substance Lot Number
SID-3	Substance Container Identifier
SID-4	Substance Manufacturer Identifier

SLT

Field	Field Description
SLT-1	Device Number
SLT-2	Device Name
SLT-3	Lot Number
SLT-4	Item Identifier
SLT-5	Bar Code

SPM

Field	Field Description
SPM-1	Set ID - SPM
SPM-2	Specimen ID
SPM-3	Specimen Parent IDs
SPM-4	Specimen Type
SPM-5	Specimen Type Modifier
SPM-6	Specimen Additives
SPM-7	Specimen Collection Method
SPM-8	Specimen Source Site
SPM-9	Specimen Source Site Modifier
SPM-10	Specimen Collection Site
SPM-11	Specimen Role
SPM-12	Specimen Collection Amount
SPM-13	Grouped Specimen Count
SPM-14	Specimen Description
SPM-15	Specimen Handling Code
SPM-16	Specimen Risk Code
SPM-17	Specimen Collection Date/Time
SPM-18	Specimen Received Date/Time
SPM-19	Specimen Expiration Date/Time
SPM-20	Specimen Availability
SPM-21	Specimen Reject Reason
SPM-22	Specimen Quality
SPM-23	Specimen Appropriateness
SPM-24	Specimen Condition
SPM-25	Specimen Current Quantity
SPM-26	Number of Specimen Containers
SPM-27	Container Type
SPM-28	Container Condition
SPM-29	Specimen Child Role
SPM-30	Accession ID
SPM-31	Other Specimen ID
SPM-32	Shipment ID

STF

Field	Field Description
STF-1	Primary Key Value - STF
STF-2	Staff Identifier List
STF-3	Staff Name
STF-4	Staff Type
STF-5	Administrative Sex
STF-6	Date/Time of Birth
STF-7	Active/Inactive Flag
STF-8	Department
STF-9	Hospital Service - STF
STF-10	Phone
STF-11	Office/Home Address/Birthplace
STF-12	Institution Activation Date
STF-13	Institution Inactivation Date
STF-14	Backup Person ID
STF-15	E-Mail Address
STF-16	Preferred Method of Contact
STF-17	Marital Status
STF-18	Job Title
STF-19	Job Code/Class
STF-20	Employment Status Code
STF-21	Additional Insured on Auto
STF-22	Driver's License Number - Staff
STF-23	Copy Auto Ins
STF-24	Auto Ins Expires
STF-25	Date Last DMV Review
STF-26	Date Next DMV Review
STF-27	Race
STF-28	Ethnic Group
STF-29	Re-activation Approval Indicator
STF-30	Citizenship
STF-31	Date/Time of Death
STF-32	Death Indicator
STF-33	Institution Relationship Type Code
STF-34	Institution Relationship Period
STF-35	Expected Return Date
STF-36	Cost Center Code
STF-37	Generic Classification Indicator
STF-38	Inactive Reason Code
STF-39	Generic resource type or category
STF-40	Religion
STF-41	Signature

STZ

Field	Field Description
STZ-1	Sterilization Type
STZ-2	Sterilization Cycle
STZ-3	Maintenance Cycle
STZ-4	Maintenance Type

TCC

Field	Field Description
TCC-1	Universal Service Identifier
TCC-2	Equipment Test Application Identifier
TCC-3	Specimen Source
TCC-4	Auto-Dilution Factor Default
TCC-5	Rerun Dilution Factor Default
TCC-6	Pre-Dilution Factor Default
TCC-7	Endogenous Content of Pre-Dilution Diluent
TCC-8	Inventory Limits Warning Level
TCC-9	Automatic Rerun Allowed
TCC-10	Automatic Repeat Allowed
TCC-11	Automatic Reflex Allowed
TCC-12	Equipment Dynamic Range
TCC-13	Units
TCC-14	Processing Type
TCC-15	Test Criticality

TCD

Field	Field Description
TCD-1	Universal Service Identifier
TCD-2	Auto-Dilution Factor
TCD-3	Rerun Dilution Factor
TCD-4	Pre-Dilution Factor
TCD-5	Endogenous Content of Pre-Dilution Diluent
TCD-6	Automatic Repeat Allowed
TCD-7	Reflex Allowed
TCD-8	Analyte Repeat Status

TQ1

Field	Field Description
TQ1-1	Set ID - TQ1
TQ1-2	Quantity
TQ1-3	Repeat Pattern
TQ1-4	Explicit Time
TQ1-5	Relative Time and Units
TQ1-6	Service Duration
TQ1-7	Start date/time
TQ1-8	End date/time
TQ1-9	Priority
TQ1-10	Condition text
TQ1-11	Text instruction
TQ1-12	Conjunction
TQ1-13	Occurrence duration
TQ1-14	Total occurrences

TQ2

Field	Field Description
TQ2-1	Set ID - TQ2
TQ2-2	Sequence/Results Flag
TQ2-3	Related Placer Number
TQ2-4	Related Filler Number
TQ2-5	Related Placer Group Number
TQ2-6	Sequence Condition Code
TQ2-7	Cyclic Entry/Exit Indicator
TQ2-8	Sequence Condition Time Interval
TQ2-9	Cyclic Group Maximum Number of Repeats
TQ2-10	Special Service Request Relationship

TXA

Field	Field Description
TXA-1	Set ID- TXA
TXA-2	Document Type
TXA-3	Document Content Presentation
TXA-4	Activity Date/Time
TXA-5	Primary Activity Provider Code/Name
TXA-6	Origination Date/Time
TXA-7	Transcription Date/Time
TXA-8	Edit Date/Time
TXA-9	Originator Code/Name
TXA-10	Assigned Document Authenticator
TXA-11	Transcriptionist Code/Name
TXA-12	Unique Document Number
TXA-13	Parent Document Number
TXA-14	Placer Order Number
TXA-15	Filler Order Number
TXA-16	Unique Document File Name
TXA-17	Document Completion Status
TXA-18	Document Confidentiality Status
TXA-19	Document Availability Status
TXA-20	Document Storage Status
TXA-21	Document Change Reason
TXA-22	Authentication Person, Time Stamp (set)
TXA-23	Distributed Copies (Code and Name of Recipient(s) )
TXA-24	Folder Assignment
TXA-25	Document Title
TXA-26	Agreed Due Date/Time

UAC

Field	Field Description
UAC-1	User Authentication Credential Type Code
UAC-2	User Authentication Credential

UB1

Field	Field Description
UB1-1	Set ID - UB1
UB1-2	Blood Deductible
UB1-3	Blood Furnished-Pints
UB1-4	Blood Replaced-Pints
UB1-5	Blood Not Replaced-Pints
UB1-6	Co-Insurance Days
UB1-7	Condition Code
UB1-8	Covered Days
UB1-9	Non Covered Days
UB1-10	Value Amount & Code
UB1-11	Number Of Grace Days
UB1-12	Special Program Indicator
UB1-13	PSRO/UR Approval Indicator
UB1-14	PSRO/UR Approved Stay-Fm
UB1-15	PSRO/UR Approved Stay-To
UB1-16	Occurrence
UB1-17	Occurrence Span
UB1-18	Occur Span Start Date
UB1-19	Occur Span End Date
UB1-20	UB-82 Locator 2
UB1-21	UB-82 Locator 9
UB1-22	UB-82 Locator 27
UB1-23	UB-82 Locator 45

UB2

Field	Field Description
UB2-1	Set ID - UB2
UB2-2	Co-Insurance Days (9)
UB2-3	Condition Code (24-30)
UB2-4	Covered Days (7)
UB2-5	Non-Covered Days (8)
UB2-6	Value Amount & Code (39-41)
UB2-7	Occurrence Code & Date (32-35)
UB2-8	Occurrence Span Code/Dates (36)
UB2-9	Uniform Billing Locator 2 (state)
UB2-10	Uniform Billing Locator 11 (state)
UB2-11	Uniform Billing Locator 31 (national)
UB2-12	Document Control Number
UB2-13	Uniform Billing Locator 49 (national)
UB2-14	Uniform Billing Locator 56 (state)
UB2-15	Uniform Billing Locator 57 (sational)
UB2-16	Uniform Billing Locator 78 (state)
UB2-17	Special Visit Count

VAR

Field	Field Description
VAR-1	Variance Instance ID
VAR-2	Documented Date/Time
VAR-3	Stated Variance Date/Time
VAR-4	Variance Originator
VAR-5	Variance Classification
VAR-6	Variance Description

VND

Field	Field Description
VND-1	Set Id - VND
VND-2	Vendor Identifier
VND-3	Vendor Name
VND-4	Vendor Catalog Number
VND-5	Primary Vendor Indicator