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IIS: HL7 Local Business Rule Template

   HL7 2.5.1, release 1.4 - VXU_V04 template [XLSX, 1051 KB]

Note: This spreadsheet is designed to track local IIS business rules applied during an HL7 2.5.1 VXU transmission. The related "VXU_V04 Detail" tab has mapped out the entire VXU profile provided in the CDC Implementation Guide. It is not anticipated that your IIS will support all of these segments and fields. Many of the fields have been listed as "Optional" or "Not supported" but have been included for completeness. Components and sub-components have also been included for further detail.
The purpose of this spreadsheet is to quickly and accurately identify where your IIS further constrains the CDC IG and what the local business rules are on a given field. This spreadsheet is likely better viewed electronically rather than as printed media based on its size and the use of Excel filters.

Order
id
SegmentSeqNameTypeDTLenCDC
usage
Local
usage
Local
usage
constraint
CDC cardLocal cardLocal
card
constraint
TblFixed valueExpected valuePredicate
1001MSH1 Field SeparatorF ST 1R R No [1 .. 1] [1 .. 1] No True |
1002MSH2 Encoding CharactersF ST 4R R No [1 .. 1] [1 .. 1] No True ^~\&
1003MSH3 Sending ApplicationF HD 227RE RE No [0 .. 1] [0 .. 1] No 0361
1004MSH3.1 Namespace IDC IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 If HD.2 (Universal ID) is not valued
1005MSH3.2 Universal IDC ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No If HD.1 (Namespace ID) is not valued
1006MSH3.3 Universal ID TypeC ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 If HD.2 (Universal ID) is valued
1007MSH4 Sending FacilityF HD 227RE RE No [0 .. 1] [0 .. 1] No 0362
1008MSH4.1 Namespace IDC IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 If HD.2 (Universal ID) is not valued
1009MSH4.2 Universal IDC ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No If HD.1 (Namespace ID) is not valued
1010MSH4.3 Universal ID TypeC ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 If HD.2 (Universal ID) is valued
1011MSH5 Receiving ApplicationF HD 227RE RE No [0 .. 1] [0 .. 1] No 0361
1012MSH5.1 Namespace IDC IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 If HD.2 (Universal ID) is not valued
1013MSH5.2 Universal IDC ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No If HD.1 (Namespace ID) is not valued
1014MSH5.3 Universal ID TypeC ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 If HD.2 (Universal ID) is valued
1015MSH6 Receiving FacilityF HD 227RE RE No [0 .. 1] [0 .. 1] No 0362
1016MSH6.1 Namespace IDC IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 If HD.2 (Universal ID) is not valued
1017MSH6.2 Universal IDC ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No If HD.1 (Namespace ID) is not valued
1018MSH6.3 Universal ID TypeC ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 If HD.2 (Universal ID) is valued
1019MSH7 Date/Time Of MessageF TS 26R R No [1 .. 1] [1 .. 1] No
1020MSH7.1 TimeC DTM 24R R No [1 .. 1] [1 .. 1] No
1021MSH7.2 Degree of PrecisionC ID 0X X No [0 .. 0] [0 .. 0] No 0529
1022MSH8 SecurityF ST 40O O No [0 .. 1] [0 .. 1] No
1023MSH9 Message TypeF MSG 15R R No [1 .. 1] [1 .. 1] No
1024MSH9.1 Message CodeC ID 3R R No [1 .. 1] [1 .. 1] No 0076 True VXU
1025MSH9.2 Trigger EventC ID 3R R No [1 .. 1] [1 .. 1] No 0003 True V04
1026MSH9.3 Message StructureC ID 7R R No [1 .. 1] [1 .. 1] No 0354 True VXU_V04
1027MSH10 Message Control IDF ST 20R R No [1 .. 1] [1 .. 1] No
1028MSH11 Processing IDF PT 3R R No [1 .. 1] [1 .. 1] No
1029MSH11.1 Processing IDC ID 1R R No [1 .. 1] [1 .. 1] No 0103 P
1030MSH11.2 Processing ModeC ID 1O O No [0 .. 1] [0 .. 1] No 0207
1031MSH12 Version IDF VID 973R R No [1 .. 1] [1 .. 1] No
1032MSH12.1 Version IDC ID 5R R No [1 .. 1] [1 .. 1] No 0104 2.5.1
1033MSH12.2 Internationalization CodeC CE 483O O No [0 .. 1] [0 .. 1] No 0399
1034MSH12.2.1 IdentifierS ST 20R R No [0 .. 1] [0 .. 1] No
1035MSH12.2.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
1036MSH12.2.3 Name of Coding SystemS ID 20R R No [0 .. 1] [0 .. 1] No 0396
1037MSH12.2.4 Alternate IdentifierS ST 20O O No [0 .. 1] [0 .. 1] No
1038MSH12.2.5 Alternate TextS ST 199O O No [0 .. 1] [0 .. 1] No
1039MSH12.2.6 Name of Alternate Coding SystemS ID 20O O No [0 .. 1] [0 .. 1] No 0396
1040MSH12.3 International Version IDC CE 483O O No [0 .. 1] [0 .. 1] No
1041MSH12.3.1 IdentifierS ST 20R R No [0 .. 1] [0 .. 1] No
1042MSH12.3.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
1043MSH12.3.3 Name of Coding SystemS ID 20R R No [0 .. 1] [0 .. 1] No 0396
1044MSH12.3.4 Alternate IdentifierS ST 20O O No [0 .. 1] [0 .. 1] No
1045MSH12.3.5 Alternate TextS ST 199O O No [0 .. 1] [0 .. 1] No
1046MSH12.3.6 Name of Alternate Coding SystemS ID 20O O No [0 .. 1] [0 .. 1] No 0396
1047MSH13 Sequence NumberF NM 15O O No [0 .. 1] [0 .. 1] No
1048MSH14 Continuation PointerF ST 180O O No [0 .. 1] [0 .. 1] No
1049MSH15 Accept Acknowledgment TypeF ID 2RE RE No [0 .. 1] [0 .. 1] No 0155 NE
1050MSH16 Application Acknowledgment TypeF ID 2RE RE No [0 .. 1] [0 .. 1] No 0155 AL
1051MSH17 Country CodeF ID 3O O No [0 .. 1] [0 .. 1] No 0399
1052MSH18 Character SetF ID 16O O No [0 .. 1] [0 .. 1] No 0211
1053MSH19 Principal Language Of MessageF CE 483O O No [0 .. 1] [0 .. 1] No
1054MSH19.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
1055MSH19.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
1056MSH19.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
1057MSH19.4 Alternate IdentifierC ST 20O O No [0 .. 1] [0 .. 1] No
1058MSH19.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
1059MSH19.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
1060MSH20 Alternate Character Set Handling SchemeF ID 20O O No [0 .. 1] [0 .. 1] No 0356
1061MSH21 Message Profile IdentifierF EI 427C(R/X) C(R/X) No [0 .. *] [0 .. *] No If MSH-9.1 is valued "QBP" or "RSP"
1062MSH21.1 Entity IdentifierC ST 199RE RE No [0 .. 1] [0 .. 1] No
1063MSH21.2 Namespace IDC IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0363 If EI.3 (Universal ID) is not valued
1064MSH21.3 Universal IDC ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No If EI.2 (Namespace ID) is not valued
1065MSH21.4 Universal ID TypeC ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 If EI.3 (Universal ID) is valued
2001SFT1 Software Vendor OrganizationF XON 567R R No [1 .. 1] [1 .. 1] No
2002SFT1.1 Organization NameC ST 50RE RE No [0 .. 1] [0 .. 1] No
2003SFT1.2 Organization Name Type CodeC IS 20O O No [0 .. 1] [0 .. 1] No 0204
2004SFT1.3 ID NumberC NM 0X X No [0 .. 0] [0 .. 0] No
2005SFT1.4 Check DigitC NM 1O O No [0 .. 1] [0 .. 1] No
2006SFT1.5 Check Digit SchemeC ID 3O O No [0 .. 1] [0 .. 1] No 0061
2007SFT1.6 Assigning AuthorityC HD 227C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0363 If XON.10 (Organization Identifier) is valued
2008SFT1.6.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 If HD.2 (Universal ID) is not valued
2009SFT1.6.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No If HD.1 (Namespace ID) is not valued
2010SFT1.6.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 If HD.2 (Universal ID) is valued
2011SFT1.7 Identifier Type CodeC ID 5C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0203 If XON.10 (Organization Identifier) is valued
2012SFT1.8 Assigning FacilityC HD 227O O No [0 .. 1] [0 .. 1] No
2013SFT1.8.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 If HD.2 (Universal ID) is not valued
2014SFT1.8.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No If HD.1 (Namespace ID) is not valued
2015SFT1.8.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 If HD.2 (Universal ID) is valued
2016SFT1.9 Name Representation CodeC ID 1O O No [0 .. 1] [0 .. 1] No 0465
2017SFT1.10 Organization IdentifierC ST 20C(R/RE) C(R/RE) No [0 .. 1] [0 .. 1] No If XON.1 (Organization Name) is not valued
2018SFT2 Software Certified Version or Release NumberF ST 15R R No [1 .. 1] [1 .. 1] No
2019SFT3 Software Product NameF ST 20R R No [1 .. 1] [1 .. 1] No
2020SFT4 Software Binary IDF ST 20R R No [1 .. 1] [1 .. 1] No
2021SFT5 Software Product InformationF TX 1024O O No [0 .. 1] [0 .. 1] No
2022SFT6 Software Install DateF TS 26O O No [0 .. 1] [0 .. 1] No
2023SFT6.1 TimeC DTM 24R R No [1 .. 1] [1 .. 1] No
2024SFT6.2 Degree of PrecisionC ID 0X X No [0 .. 0] [0 .. 0] No   0529
3001PID1 Set ID - PIDF SI 4R R No [1 .. 1] [1 .. 1] No True 1
3002PID2 Patient IDF CX 1913X X No [0 .. 0] [0 .. 0] No
3003PID3 Patient Identifier ListF CX 1913R R No [1 .. *] [1 .. *] No
3004PID3.1 ID NumberC ST 15R R No [1 .. 1] [1 .. 1] No
3005PID3.2 Check DigitC ST 1O O No [0 .. 1] [0 .. 1] No
3006PID3.3 Check Digit SchemeC ID 3C(O/X) C(O/X) No [0 .. 1] [0 .. 1] No 0061 If CX.2 (check digit) is valued
3007PID3.4 Assigning AuthorityC HD 227R R No [1 .. 1] [1 .. 1] No 0363
3008PID3.4.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 If HD.2 (Universal ID) is not valued
3009PID3.4.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No If HD.1 (Namespace ID) is not valued
3010PID3.4.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 If HD.2 (Universal ID) is valued
3011PID3.5 Identifier Type CodeC ID 5R R No [1 .. 1] [1 .. 1] No 0203
3012PID3.6 Assigning FacilityC HD 227O O No [0 .. 1] [0 .. 1] No
3013PID3.6.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 If HD.2 (Universal ID) is not valued
3014PID3.6.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No If HD.1 (Namespace ID) is not valued
3015PID3.6.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 If HD.2 (Universal ID) is valued
3016PID3.7 Effective DateC DT 8O O No [0 .. 1] [0 .. 1] No
3017PID3.8 Expiration DateC DT 8O O No [0 .. 1] [0 .. 1] No
3018PID3.9 Assigning JurisdictionC CWE 705O O No [0 .. 1] [0 .. 1] No
3019PID3.9.1 IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
3020PID3.9.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
3021PID3.9.3 Name of Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.1 (Identifier) is valued
3022PID3.9.4 Alternate IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
3023PID3.9.5 Alternate TextS ST 199C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If CWE.4 (Alternate Identifier) is valued
3024PID3.9.6 Name of Alternate Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.4 (Alternate Identifier) is valued
3025PID3.9.7 Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
3026PID3.9.8 Alternate Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
3027PID3.9.9 Original TextS ST 199O O No [0 .. 1] [0 .. 1] No
3028PID3.10 Assigning Agency or DepartmentC CWE 705O O No [0 .. 1] [0 .. 1] No
3029PID3.10.1 IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
3030PID3.10.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
3031PID3.10.3 Name of Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.1 (Identifier) is valued
3032PID3.10.4 Alternate IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
3033PID3.10.5 Alternate TextS ST 199C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If CWE.4 (Alternate Identifier) is valued
3034PID3.10.6 Name of Alternate Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.4 (Alternate Identifier) is valued
3035PID3.10.7 Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
3036PID3.10.8 Alternate Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
3037PID3.10.9 Original TextS ST 199O O No [0 .. 1] [0 .. 1] No
3038PID4 Alternate Patient ID - PIDF CX 1913X X No [0 .. 0] [0 .. 0] No
3039PID5 Patient NameF XPN 1044R R No [1 .. *] [1 .. *] No
3040PID5.1 Family NameC FN 194R R No [1 .. 1] [1 .. 1] No
3041PID5.1.1 SurnameS ST 50R R No [1 .. 1] [1 .. 1] No
3042PID5.1.2 Own Surname PrefixS ST 20O O No [0 .. 1] [0 .. 1] No
3043PID5.1.3 Own SurnameS ST 50O O No [0 .. 1] [0 .. 1] No
3044PID5.1.4 Surname Prefix From Partner/SpouseS ST 20O O No [0 .. 1] [0 .. 1] No
3045PID5.1.5 Surname From Partner/SpouseS ST 50O O No [0 .. 1] [0 .. 1] No
3046PID5.2 Given NameC ST 30R R No [1 .. 1] [1 .. 1] No
3047PID5.3 Second and Further Given Names or Initials ThereofC ST 30RE RE No [0 .. 1] [0 .. 1] No
3048PID5.4 Suffix (e.g., JR or III)C ST 20O O No [0 .. 1] [0 .. 1] No
3049PID5.5 Prefix (e.g., DR)C ST 20O O No [0 .. 1] [0 .. 1] No
3050PID5.6 Degree (e.g., MD)C IS 0X X No [0 .. 0] [0 .. 0] No 0360
3051PID5.7 Name Type CodeC ID 1RE RE No [0 .. 1] [0 .. 1] No 0200
3052PID5.8 Name Representation CodeC ID 1O O No [0 .. 1] [0 .. 1] No 0465
3053PID5.9 Name ContextC CE 483O O No [0 .. 1] [0 .. 1] No 0448
3054PID5.9.1 IdentifierS ST 20R R No [0 .. 1] [0 .. 1] No
3055PID5.9.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
3056PID5.9.3 Name of Coding SystemS ID 20R R No [0 .. 1] [0 .. 1] No 0396
3057PID5.9.4 Alternate IdentifierS ST 20O O No [0 .. 1] [0 .. 1] No
3058PID5.9.5 Alternate TextS ST 199O O No [0 .. 1] [0 .. 1] No
3059PID5.9.6 Name of Alternate Coding SystemS ID 20O O No [0 .. 1] [0 .. 1] No 0396
3060PID5.10 Name Validity RangeC DR 0X X No [0 .. 0] [0 .. 0] No
3061PID5.11 Name Assembly OrderC ID 1O O No [0 .. 1] [0 .. 1] No 0444
3062PID5.12 Effective DateC TS 26O O No [0 .. 1] [0 .. 1] No
3063PID5.12.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No
3064PID5.12.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529
3065PID5.13 Expiration DateC TS 26O O No [0 .. 1] [0 .. 1] No
3066PID5.13.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No
3067PID5.13.3 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529
3068PID5.14 Professional SuffixC ST 199O O No [0 .. 1] [0 .. 1] No
3069PID6 Mother's Maiden NameF XPN 1044RE RE No [0 .. 1] [0 .. 1] No
3070PID6.1 Family NameC FN 194R R No [1 .. 1] [1 .. 1] No
3071PID6.1.1 SurnameS ST 50R R No [1 .. 1] [1 .. 1] No
3072PID6.1.2 Own Surname PrefixS ST 20O O No [0 .. 1] [0 .. 1] No
3073PID6.1.3 Own SurnameS ST 50O O No [0 .. 1] [0 .. 1] No
3074PID6.1.4 Surname Prefix From Partner/SpouseS ST 20O O No [0 .. 1] [0 .. 1] No
3075PID6.1.5 Surname From Partner/SpouseS ST 50O O No [0 .. 1] [0 .. 1] No
3076PID6.2 Given NameC ST 30R R No [1 .. 1] [1 .. 1] No
3077PID6.3 Second and Further Given Names or Initials ThereofC ST 30RE RE No [0 .. 1] [0 .. 1] No
3078PID6.4 Suffix (e.g., JR or III)C ST 20O O No [0 .. 1] [0 .. 1] No
3079PID6.5 Prefix (e.g., DR)C ST 20O O No [0 .. 1] [0 .. 1] No
3080PID6.6 Degree (e.g., MD)C IS 0X X No [0 .. 0] [0 .. 0] No 0360
3081PID6.7 Name Type CodeC ID 1RE RE No [1 .. 1] [1 .. 1] No 0200
3082PID6.8 Name Representation CodeC ID 1O O No [0 .. 1] [0 .. 1] No 0465
3083PID6.9 Name ContextC CE 483O O No [0 .. 1] [0 .. 1] No 0448
3084PID6.9.1 IdentifierS ST 20R R No [0 .. 1] [0 .. 1] No
3085PID6.9.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
3086PID6.9.3 Name of Coding SystemS ID 20R R No [0 .. 1] [0 .. 1] No 0396
3087PID6.9.4 Alternate IdentifierS ST 20O O No [0 .. 1] [0 .. 1] No
3088PID6.9.5 Alternate TextS ST 199O O No [0 .. 1] [0 .. 1] No
3089PID6.9.6 Name of Alternate Coding SystemS ID 20O O No [0 .. 1] [0 .. 1] No 0396
3090PID6.10 Name Validity RangeC DR 0X X No [0 .. 0] [0 .. 0] No
3091PID6.11 Name Assembly OrderC ID 1O O No [0 .. 1] [0 .. 1] No 0444
3092PID6.12 Effective DateC TS 26O O No [0 .. 1] [0 .. 1] No
3093PID6.12.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No
3094PID6.12.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529
3095PID6.13 Expiration DateC TS 26O O No [0 .. 1] [0 .. 1] No
3096PID6.13.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No
3097PID6.13.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529
3098PID6.14 Professional SuffixC ST 199O O No [0 .. 1] [0 .. 1] No
3099PID7 Date/Time of BirthF TS 26R R No [1 .. 1] [1 .. 1] No
3100PID7.1 TimeC DTM 24R R No [1 .. 1] [1 .. 1] No
3101PID7.2 Degree of PrecisionC ID 0X X No [0 .. 0] [0 .. 0] No 0529
3102PID8 Administrative SexF IS 1RE RE No [0 .. 1] [0 .. 1] No 0001
3103PID9 Patient AliasF XPN 1044X X No [0 .. 0] [0 .. 0] No
3104PID10 RaceF CE 483RE RE No [0 .. *] [0 .. *] No 0005
3105PID10.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
3106PID10.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
3107PID10.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
3108PID10.4 Alternate IdentifierC ST 20O O No [0 .. 1] [0 .. 1] No
3109PID10.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
3110PID10.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
3111PID11 Patient AddressF XAD 578RE RE No [0 .. *] [0 .. *] No
3112PID11.1 Street AddressC SAD 184RE RE No [0 .. 1] [0 .. 1] No
3113PID11.1.1 Street or Mailing AddressS ST 120R R No [1 .. 1] [1 .. 1] No
3114PID11.1.2 Street NameS ST 50O O No [0 .. 1] [0 .. 1] No
3115PID11.1.3 Dwelling NumberS ST 12O O No [0 .. 1] [0 .. 1] No
3116PID11.2 Other DesignationC ST 120RE RE No [0 .. 1] [0 .. 1] No
3117PID11.3 CityC ST 50RE RE No [0 .. 1] [0 .. 1] No
3118PID11.4 State or ProvinceC ST 50RE RE No [0 .. 1] [0 .. 1] No
3119PID11.5 Zip or Postal CodeC ST 12RE RE No [0 .. 1] [0 .. 1] No
3120PID11.6 CountryC ID 3RE RE No [0 .. 1] [0 .. 1] No 0399
3121PID11.7 Address TypeC ID 3R R No [1 .. 1] [1 .. 1] No 0190
3122PID11.8 Other Geographic DesignationC ST 50O O No [0 .. 1] [0 .. 1] No
3123PID11.9 County/Parish CodeC IS 20O O No [0 .. 1] [0 .. 1] No 0289
3124PID11.10 Census TractC IS 20O O No [0 .. 1] [0 .. 1] No 0288
3125PID11.11 Address Representation CodeC ID 1O O No [0 .. 1] [0 .. 1] No 0465
3126PID11.12 Address Validity RangeC DR 0X X No [0 .. 0] [0 .. 0] No
3127PID11.13 Effective DateC TS 26O O No [0 .. 1] [0 .. 1] No
3128PID11.13.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No
3129PID11.13.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529
3130PID11.14 Expiration DateC TS 26O O No [0 .. 1] [0 .. 1] No
3131PID11.14.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No
3132PID11.14.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529
3133PID12 County CodeF IS 4X X No [0 .. 0] [0 .. 0] No 0289
3134PID13 Phone Number - HomeF XTN 651RE RE No [0 .. *] [0 .. *] No
3135PID13.1 Telephone NumberC ST 0X X No [0 .. 0] [0 .. 0] No
3136PID13.2 Telecommunication Use CodeC ID 3R R No [1 .. 1] [1 .. 1] No 0201
3137PID13.3 Telecommunication Equipment TypeC ID 8RE RE No [0 .. 1] [0 .. 1] No 0202
3138PID13.4 Email AddressC ST 199C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No If XTN.2 (telecommunication use code) is valued "NET"
3139PID13.5 Country CodeC NM 3O O No [0 .. 1] [0 .. 1] No
3140PID13.6 Area/City CodeC NM 5C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If XTN.2 (telecommunication use code) is not valued "NET"
3141PID13.7 Local NumberC NM 9C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No If XTN.2 (telecommunication use code) is not valued "NET"
3142PID13.8 ExtensionC NM 5O O No [0 .. 1] [0 .. 1] No
3143PID13.9 Any TextC ST 199O O No [0 .. 1] [0 .. 1] No
3144PID13.10 Extension PrefixC ST 4O O No [0 .. 1] [0 .. 1] No
3145PID13.11 Speed Dial CodeC ST 6O O No [0 .. 1] [0 .. 1] No
3146PID13.12 Unformatted Telephone numberC ST 199O O No [0 .. 1] [0 .. 1] No
3147PID14 Phone Number - BusinessF XTN 651O O No [0 .. *] [0 .. *] No
3148PID14.1 Telephone NumberC ST 0X X No [0 .. 0] [0 .. 0] No
3149PID14.2 Telecommunication Use CodeC ID 3R R No [1 .. 1] [1 .. 1] No 0201
3150PID14.3 Telecommunication Equipment TypeC ID 8RE RE No [0 .. 1] [0 .. 1] No 0202
3151PID14.4 Email AddressC ST 199C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No If XTN.2 (telecommunication use code) is valued "NET"
3152PID14.5 Country CodeC NM 3O O No [0 .. 1] [0 .. 1] No
3153PID14.6 Area/City CodeC NM 5C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If XTN.2 (telecommunication use code) is not valued "NET"
3154PID14.7 Local NumberC NM 9C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No If XTN.2 (telecommunication use code) is not valued "NET"
3155PID14.8 ExtensionC NM 5O O No [0 .. 1] [0 .. 1] No
3156PID14.9 Any TextC ST 199O O No [0 .. 1] [0 .. 1] No
3157PID14.10 Extension PrefixC ST 4O O No [0 .. 1] [0 .. 1] No
3158PID14.11 Speed Dial CodeC ST 6O O No [0 .. 1] [0 .. 1] No
3159PID14.12 Unformatted Telephone numberC ST 199O O No [0 .. 1] [0 .. 1] No
3160PID15 Primary LanguageF CE 483O O No [0 .. 1] [0 .. 1] No 0296
3161PID15.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
3162PID15.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
3163PID15.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
3164PID15.4 Alternate IdentifierC ST 20O O No [0 .. 1] [0 .. 1] No
3165PID15.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
3166PID15.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
3167PID16 Marital StatusF CE 483O O No [0 .. 1] [0 .. 1] No 0002
3168PID16.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
3169PID16.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
3170PID16.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
3171PID16.4 Alternate IdentifierC ST 20O O No [0 .. 1] [0 .. 1] No
3172PID16.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
3173PID16.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
3174PID17 ReligionF CE 483O O No [0 .. 1] [0 .. 1] No 0006
3175PID17.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
3176PID17.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
3177PID17.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
3178PID17.4 Alternate IdentifierC ST 20O O No [0 .. 1] [0 .. 1] No
3179PID17.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
3180PID17.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
3181PID18 Patient Account NumberF CX 1913O O No [0 .. 1] [0 .. 1] No
3182PID18.1 ID NumberC ST 15R R No [1 .. 1] [1 .. 1] No
3183PID18.2 Check DigitC ST 1O O No [0 .. 1] [0 .. 1] No
3184PID18.3 Check Digit SchemeC ID 3C(O/X) C(O/X) No [0 .. 1] [0 .. 1] No 0061 If CX.2 (check digit) is valued
3185PID18.4 Assigning AuthorityC HD 227R R No [1 .. 1] [1 .. 1] No 0363
3186PID18.4.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 If HD.2 (Universal ID) is not valued
3187PID18.4.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No If HD.1 (Namespace ID) is not valued
3188PID18.4.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 If HD.2 (Universal ID) is valued
3189PID18.5 Identifier Type CodeC ID 5R R No [1 .. 1] [1 .. 1] No 0203
3190PID18.6 Assigning FacilityC HD 227O O No [0 .. 1] [0 .. 1] No
3191PID18.6.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 If HD.2 (Universal ID) is not valued
3192PID18.6.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No If HD.1 (Namespace ID) is not valued
3193PID18.6.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 If HD.2 (Universal ID) is valued
3194PID18.7 Effective DateC DT 8O O No [0 .. 1] [0 .. 1] No
3195PID18.8 Expiration DateC DT 8O O No [0 .. 1] [0 .. 1] No
3196PID18.9 Assigning JurisdictionC CWE 705O O No [0 .. 1] [0 .. 1] No
3197PID18.9.1 IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
3198PID18.9.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
3199PID18.9.3 Name of Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.1 (Identifier) is valued
3200PID18.9.4 Alternate IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
3201PID18.9.5 Alternate TextS ST 199C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If CWE.4 (Alternate Identifier) is valued
3202PID18.9.6 Name of Alternate Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.4 (Alternate Identifier) is valued
3203PID18.9.7 Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
3204PID18.9.8 Alternate Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
3205PID18.9.9 Original TextS ST 199O O No [0 .. 1] [0 .. 1] No
3206PID18.10 Assigning Agency or DepartmentC CWE 705O O No [0 .. 1] [0 .. 1] No
3207PID18.10.1 IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
3208PID18.10.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
3209PID18.10.3 Name of Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.1 (Identifier) is valued
3210PID18.10.4 Alternate IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
3211PID18.10.5 Alternate TextS ST 199C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If CWE.4 (Alternate Identifier) is valued
3212PID18.10.6 Name of Alternate Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.4 (Alternate Identifier) is valued
3213PID18.10.7 Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
3214PID18.10.8 Alternate Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
3215PID18.10.9 Original TextS ST 199O O No [0 .. 1] [0 .. 1] No
3216PID19 SSN Number - PatientF ST 16X X No [0 .. 0] [0 .. 0] No
3217PID20 Driver's License Number - PatientF DLN 66X X No [0 .. 0] [0 .. 0] No
3218PID21 Mother's IdentifierF CX 1913X X No [0 .. 0] [0 .. 0] No
3219PID21.1 ID NumberC ST 15R R No [1 .. 1] [1 .. 1] No
3220PID21.2 Check DigitC ST 1O O No [0 .. 1] [0 .. 1] No
3221PID21.3 Check Digit SchemeC ID 3C(O/X) C(O/X) No [0 .. 1] [0 .. 1] No 0061 If CX.2 (check digit) is valued
3222PID21.4 Assigning AuthorityC HD 227R R No [1 .. 1] [1 .. 1] No 0363
3223PID21.4.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 If HD.2 (Universal ID) is not valued
3224PID21.4.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No If HD.1 (Namespace ID) is not valued
3225PID21.4.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 If HD.2 (Universal ID) is valued
3226PID21.5 Identifier Type CodeC ID 5R R No [1 .. 1] [1 .. 1] No 0203
3227PID21.6 Assigning FacilityC HD 227O O No [0 .. 1] [0 .. 1] No
3228PID21.6.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 If HD.2 (Universal ID) is not valued
3229PID21.6.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No If HD.1 (Namespace ID) is not valued
3230PID21.6.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 If HD.2 (Universal ID) is valued
3231PID21.7 Effective DateC DT 8O O No [0 .. 1] [0 .. 1] No
3232PID21.8 Expiration DateC DT 8O O No [0 .. 1] [0 .. 1] No
3233PID21.9 Assigning JurisdictionC CWE 705O O No [0 .. 1] [0 .. 1] No
3234PID21.9.1 IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
3235PID21.9.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
3236PID21.9.3 Name of Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.1 (Identifier) is valued
3237PID21.9.4 Alternate IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
3238PID21.9.5 Alternate TextS ST 199C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If CWE.4 (Alternate Identifier) is valued
3239PID21.9.6 Name of Alternate Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.4 (Alternate Identifier) is valued
3240PID21.9.7 Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
3241PID21.9.8 Alternate Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
3242PID21.9.9 Original TextS ST 199O O No [0 .. 1] [0 .. 1] No
3243PID21.10 Assigning Agency or DepartmentC CWE 705O O No [0 .. 1] [0 .. 1] No
3244PID21.10.1 IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
3245PID21.10.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
3246PID21.10.3 Name of Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.1 (Identifier) is valued
3247PID21.10.4 Alternate IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
3248PID21.10.5 Alternate TextS ST 199C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If CWE.4 (Alternate Identifier) is valued
3249PID21.10.6 Name of Alternate Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.4 (Alternate Identifier) is valued
3250PID21.10.7 Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
3251PID21.10.8 Alternate Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
3252PID21.10.9 Original TextS ST 199O O No [0 .. 1] [0 .. 1] No
3253PID22 Ethnic GroupF CE 483RE RE No [0 .. 1] [0 .. 1] No 0189
3254PID22.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
3255PID22.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
3256PID22.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
3257PID22.4 Alternate IdentifierC ST 20O O No [0 .. 1] [0 .. 1] No
3258PID22.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
3259PID22.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
3260PID23 Birth PlaceF ST 60O O No [0 .. 1] [0 .. 1] No
3261PID24 Multiple Birth IndicatorF ID 1RE RE No [0 .. 1] [0 .. 1] No 0136
3262PID25 Birth OrderF NM 2C(RE/O) C(RE/O) No [0 .. 1] [0 .. 1] No If PID.24 (Multiple Birth Indicator) is valued "Y"
3263PID26 CitizenshipF CE 483O O No [0 .. 1] [0 .. 1] No 0171
3264PID26.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
3265PID26.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
3266PID26.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
3267PID26.4 Alternate IdentifierC ST 20O O No [0 .. 1] [0 .. 1] No
3268PID26.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
3269PID26.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
3270PID27 Veterans Military StatusF CE 483O O No [0 .. 1] [0 .. 1] No 0172
3271PID27.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
3272PID27.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
3273PID27.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
3274PID27.4 Alternate IdentifierC ST 20O O No [0 .. 1] [0 .. 1] No
3275PID27.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
3276PID27.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
3277PID28 NationalityF CE 483O O No [0 .. 1] [0 .. 1] No 0212
3278PID29 Patient Death Date and TimeF TS 26C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If PID.30 (Patient Death Indicator) is valued "Y"
3279PID29.1 TimeC DTM 24R R No [1 .. 1] [1 .. 1] No
3280PID29.2 Degree of PrecisionC ID 0X X No [0 .. 0] [0 .. 0] No 0529
3281PID30 Patient Death IndicatorF ID 1RE RE No [0 .. 1] [0 .. 1] No 0136
3282PID31 Identity Unknown IndicatorF ID 1O O No [0 .. 1] [0 .. 1] No 0136
3283PID32 Identity Reliability CodeF IS 20O O No [0 .. 1] [0 .. 1] No 0445
3284PID33 Last Update Date/TimeF TS 26O O No [0 .. 1] [0 .. 1] No
3285PID33.1 TimeC DTM 24R R No [1 .. 1] [1 .. 1] No
3286PID33.2 Degree of PrecisionC ID 0X X No [0 .. 0] [0 .. 0] No 0529
3287PID34 Last Update FacilityF HD 241O O No [0 .. 1] [0 .. 1] No
3288PID34.1 Namespace IDC IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 If HD.2 (Universal ID) is not valued
3289PID34.2 Universal IDC ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No If HD.1 (Namespace ID) is not valued
3290PID34.3 Universal ID TypeC ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 If HD.2 (Universal ID) is valued
3291PID35 Species CodeF CE 483O O No [0 .. 1] [0 .. 1] No 0446
3292PID36 Breed CodeF CE 483O O No [0 .. 1] [0 .. 1] No 0447
3293PID37 StrainF ST 80O O No [0 .. 1] [0 .. 1] No
3294PID38 Production Class CodeF CE 483O O No [0 .. 1] [0 .. 1] No 0429
3295PID38.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
3296PID38.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
3297PID38.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
3298PID38.4 Alternate IdentifierC ST 20O O No [0 .. 1] [0 .. 1] No
3299PID38.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
3300PID38.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
3301PID39 Tribal CitizenshipF CWE 705O O No [0 .. 1] [0 .. 1] No 0171
3302PID39.1 IdentifierC ST 20RE RE No [0 .. 1] [0 .. 1] No
3303PID39.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
3304PID39.3 Name of Coding SystemC ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.1 (Identifier) is valued
3305PID39.4 Alternate IdentifierC ST 20RE RE No [0 .. 1] [0 .. 1] No
3306PID39.5 Alternate TextC ST 199C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If CWE.4 (Alternate Identifier) is valued
3307PID39.6 Name of Alternate Coding SystemC ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.4 (Alternate Identifier) is valued
3308PID39.7 Coding System Version IDC ST 10O O No [0 .. 1] [0 .. 1] No
3309PID39.8 Alternate Coding System Version IDC ST 10O O No [0 .. 1] [0 .. 1] No
3310PID39.9 Original TextC ST 199O O No [0 .. 1] [0 .. 1] No
4001PD11 Living DependencyF IS 2O O No [0 .. 1] [0 .. 1] No 0223 NULL
4002PD12 Living ArrangementF IS 2O O No [0 .. 1] [0 .. 1] No 0220 NULL
4003PD13 Patient Primary FacilityF XON 563O O No [0 .. 1] [0 .. 1] No NULL
4004PD13.1 Organization NameC ST 50RE RE No [0 .. 1] [0 .. 1] No
4005PD13.2 Organization Name Type CodeC IS 20O O No [0 .. 1] [0 .. 1] No 0204
4006PD13.3 ID NumberC NM 0X X No [0 .. 0] [0 .. 0] No
4007PD13.4 Check DigitC NM 1O O No [0 .. 1] [0 .. 1] No
4008PD13.5 Check Digit SchemeC ID 3O O No [0 .. 1] [0 .. 1] No 0061
4009PD13.6 Assigning AuthorityC HD 227C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0363 If XON.10 (Organization Identifier) is valued
4010PD13.6.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 NULL If HD.2 (Universal ID) is not valued
4011PD13.6.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
4012PD13.6.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
4013PD13.7 Identifier Type CodeC ID 5C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0203 If XON.10 (Organization Identifier) is valued
4014PD13.8 Assigning FacilityC HD 227O O No [0 .. 1] [0 .. 1] No NULL
4015PD13.8.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 NULL If HD.2 (Universal ID) is not valued
4016PD13.8.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
4017PD13.8.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
4018PD13.9 Name Representation CodeC ID 1O O No [0 .. 1] [0 .. 1] No 0465 NULL
4019PD13.10 Organization IdentifierC ST 20C(R/RE) C(R/RE) No [0 .. 1] [0 .. 1] No If XON.1 (Organization Name) is not valued
4020PD14 Patient Primary Care Provider Name & ID No.F XCN 2945O O No [0 .. 1] [0 .. 1] No NULL
4021PD15 Student IndicatorF IS 2O O No [0 .. 1] [0 .. 1] No 0231 NULL
4022PD16 HandicapF IS 2O O No [0 .. 1] [0 .. 1] No 0295 NULL
4023PD17 Living Will CodeF IS 2O O No [0 .. 1] [0 .. 1] No 0315 NULL
4024PD18 Organ Donor CodeF IS 2O O No [0 .. 1] [0 .. 1] No 0316 NULL
4025PD19 Separate BillF ID 1O O No [0 .. 1] [0 .. 1] No 0136 NULL
4026PD110 Duplicate PatientF CX 1913O O No [0 .. 1] [0 .. 1] No NULL
4027PD110.1 ID NumberC ST 15R R No [1 .. 1] [1 .. 1] No NULL
4028PD110.2 Check DigitC ST 1O O No [0 .. 1] [0 .. 1] No NULL
4029PD110.3 Check Digit SchemeC ID 3C(O/X) C(O/X) No [0 .. 1] [0 .. 1] No 0061 If CX.2 (check digit) is valued
4030PD110.4 Assigning AuthorityC HD 227R R No [1 .. 1] [1 .. 1] No 0363 NULL
4031PD110.4.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 NULL If HD.2 (Universal ID) is not valued
4032PD110.4.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
4033PD110.4.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
4034PD110.5 Identifier Type CodeC ID 5R R No [1 .. 1] [1 .. 1] No 0203 NULL
4035PD110.6 Assigning FacilityC HD 227O O No [0 .. 1] [0 .. 1] No NULL
4036PD110.6.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 NULL If HD.2 (Universal ID) is not valued
4037PD110.6.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
4038PD110.6.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
4039PD110.7 Effective DateC DT 8O O No [0 .. 1] [0 .. 1] No NULL
4040PD110.8 Expiration DateC DT 8O O No [0 .. 1] [0 .. 1] No NULL
4041PD110.9 Assigning JurisdictionC CWE 705O O No [0 .. 1] [0 .. 1] No NULL
4042PD110.9.1 IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
4043PD110.9.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
4044PD110.9.3 Name of Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.1 (Identifier) is valued
4045PD110.9.4 Alternate IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
4046PD110.9.5 Alternate TextS ST 199C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If CWE.4 (Alternate Identifier) is valued
4047PD110.9.6 Name of Alternate Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.4 (Alternate Identifier) is valued
4048PD110.9.7 Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
4049PD110.9.8 Alternate Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
4050PD110.9.9 Original TextS ST 199O O No [0 .. 1] [0 .. 1] No
4051PD110.10 Assigning Agency or DepartmentC CWE 705O O No [0 .. 1] [0 .. 1] No NULL
4052PD110.10.1 IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
4053PD110.10.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
4054PD110.10.3 Name of Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.1 (Identifier) is valued
4055PD110.10.4 Alternate IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
4056PD110.10.5 Alternate TextS ST 199C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If CWE.4 (Alternate Identifier) is valued
4057PD110.10.6 Name of Alternate Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.4 (Alternate Identifier) is valued
4058PD110.10.7 Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
4059PD110.10.8 Alternate Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
4060PD110.10.9 Original TextS ST 199O O No [0 .. 1] [0 .. 1] No
4061PD111 Publicity CodeF CE 483RE RE No [0 .. 1] [0 .. 1] No 0215 NULL
4062PD111.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
4063PD111.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
4064PD111.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
4065PD111.4 Alternate IdentifierC ST 20O O No [0 .. 1] [0 .. 1] No
4066PD111.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
4067PD111.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
4068PD112 Protection IndicatorF ID 1RE RE No [0 .. 1] [0 .. 1] No 0136 NULL
4069PD113 Protection Indicator Effective DateF DT 8C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No NULL If PD1.12 (Protection Indicator) is valued
4070PD114 Place of WorshipF XON 563O O No [0 .. 1] [0 .. 1] No NULL
4071PD114.1 Organization NameC ST 50RE RE No [0 .. 1] [0 .. 1] No
4072PD114.2 Organization Name Type CodeC IS 20O O No [0 .. 1] [0 .. 1] No 0204
4073PD114.3 ID NumberC NM 0X X No [0 .. 0] [0 .. 0] No
4074PD114.4 Check DigitC NM 1O O No [0 .. 1] [0 .. 1] No
4075PD114.5 Check Digit SchemeC ID 3O O No [0 .. 1] [0 .. 1] No 0061
4076PD115.6 Assigning AuthorityC HD 227C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0363 If XON.10 (Organization Identifier) is valued
4077PD114.6.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 NULL If HD.2 (Universal ID) is not valued
4078PD114.6.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
4079PD114.6.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
4080PD114.7 Identifier Type CodeC ID 5C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0203 If XON.10 (Organization Identifier) is valued
4081PD114.8 Assigning FacilityC HD 227O O No [0 .. 1] [0 .. 1] No NULL
4082PD114.8.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 NULL If HD.2 (Universal ID) is not valued
4083PD114.8.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
4084PD114.8.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
4085PD114.9 Name Representation CodeC ID 1O O No [0 .. 1] [0 .. 1] No 0465 NULL
4086PD114.10 Organization IdentifierC ST 20C(R/RE) C(R/RE) No [0 .. 1] [0 .. 1] No If XON.1 (Organization Name) is not valued
4087PD115 Advance Directive CodeF CE 483O O No [0 .. 1] [0 .. 1] No 0435 NULL
4088PD115.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
4089PD115.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
4090PD115.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
4091PD115.4 Alternate IdentifierC ST 20O O No [0 .. 1] [0 .. 1] No
4092PD115.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
4093PD115.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
4094PD116 Immunization Registry StatusF IS 1RE RE No [0 .. 1] [0 .. 1] No 0441 NULL
4095PD117 Immunization Registry Status Effective DateF DT 8C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No NULL If PD1.16 (Immunization Registry Status) is valued
4096PD118 Publicity Code Effective DateF DT 8C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No NULL If PD1.11 (Publicity Code) is valued
4097PD119 Military BranchF IS 5O O No [0 .. 1] [0 .. 1] No 0140 NULL
4098PD120 Military Rank/GradeF IS 2O O No [0 .. 1] [0 .. 1] No 0141 NULL
4099PD121 Military StatusF IS 3O O No [0 .. 1] [0 .. 1] No 0142 NULL
5001NK11 Set ID - NK1F SI 4R R No [1 .. 1] [1 .. 1] No NULL
5002NK12 NameF XPN 1044R R No [1 .. *] [1 .. *] No NULL
5003NK12.1 Family NameC FN 194R R No [1 .. 1] [1 .. 1] No NULL
5004NK12.1.1 SurnameS ST 50R R No [1 .. 1] [1 .. 1] No NULL
5005NK12.1.2 Own Surname PrefixS ST 20O O No [0 .. 1] [0 .. 1] No NULL
5006NK12.1.3 Own SurnameS ST 50O O No [0 .. 1] [0 .. 1] No NULL
5007NK12.1.4 Surname Prefix From Partner/SpouseS ST 20O O No [0 .. 1] [0 .. 1] No NULL
5008NK12.1.5 Surname From Partner/SpouseS ST 50O O No [0 .. 1] [0 .. 1] No NULL
5009NK12.2 Given NameC ST 30R R No [1 .. 1] [1 .. 1] No NULL
5010NK12.3 Second and Further Given Names or Initials ThereofC ST 30RE RE No [0 .. 1] [0 .. 1] No NULL
5011NK12.4 Suffix (e.g., JR or III)C ST 20O O No [0 .. 1] [0 .. 1] No NULL
5012NK12.5 Prefix (e.g., DR)C ST 20O O No [0 .. 1] [0 .. 1] No NULL
5013NK12.6 Degree (e.g., MD)C IS 0X X No [0 .. 0] [0 .. 0] No 0360 NULL
5014NK12.7 Name Type CodeC ID 1RE RE No [0 .. 1] [0 .. 1] No 0200 NULL
5015NK12.8 Name Representation CodeC ID 1O O No [0 .. 1] [0 .. 1] No 0465 NULL
5016NK12.9 Name ContextC CE 483O O No [0 .. 1] [0 .. 1] No 0448 NULL
5017NK12.9.1 IdentifierS ST 20R R No [0 .. 1] [0 .. 1] No
5018NK12.9.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
5019NK12.9.3 Name of Coding SystemS ID 20R R No [0 .. 1] [0 .. 1] No 0396
5020NK12.9.4 Alternate IdentifierS ST 20O O No [0 .. 1] [0 .. 1] No
5021NK12.9.5 Alternate TextS ST 199O O No [0 .. 1] [0 .. 1] No
5022NK12.9.6 Name of Alternate Coding SystemS ID 20O O No [0 .. 1] [0 .. 1] No 0396
5023NK12.10 Name Validity RangeC DR 0X X No [0 .. 0] [0 .. 0] No NULL
5024NK12.11 Name Assembly OrderC ID 1O O No [0 .. 1] [0 .. 1] No 0444 NULL
5025NK12.12 Effective DateC TS 26O O No [0 .. 1] [0 .. 1] No NULL
5026NK12.12.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No NULL
5027NK12.12.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529 NULL
5028NK12.13 Expiration DateC TS 26O O No [0 .. 1] [0 .. 1] No NULL
5029NK12.13.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No NULL
5030NK12.13.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529 NULL
5031NK12.14 Professional SuffixC ST 199O O No [0 .. 1] [0 .. 1] No NULL
5032NK13 RelationshipF CE 483R R No [1 .. 1] [1 .. 1] No 0063 NULL
5033NK13.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
5034NK13.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
5035NK13.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
5036NK13.4 Alternate IdentifierC ST 1O O No [0 .. 1] [0 .. 1] No
5037NK13.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
5038NK13.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
5039NK14 AddressF XAD 578RE RE No [0 .. *] [0 .. *] No NULL
5040NK14.1 Street AddressC SAD 184RE RE No [0 .. 1] [0 .. 1] No NULL
5041NK14.1.1 Street or Mailing AddressS ST 120R R No [1 .. 1] [1 .. 1] No NULL
5042NK14.1.2 Street NameS ST 50O O No [0 .. 1] [0 .. 1] No NULL
5043NK14.1.3 Dwelling NumberS ST 12O O No [0 .. 1] [0 .. 1] No NULL
5044NK14.2 Other DesignationC ST 120RE RE No [0 .. 1] [0 .. 1] No NULL
5045NK14.3 CityC ST 50RE RE No [0 .. 1] [0 .. 1] No NULL
5046NK14.4 State or ProvinceC ST 50RE RE No [0 .. 1] [0 .. 1] No NULL
5047NK14.5 Zip or Postal CodeC ST 12RE RE No [0 .. 1] [0 .. 1] No NULL
5048NK14.6 CountryC ID 3RE RE No [0 .. 1] [0 .. 1] No 0399 NULL
5049NK14.7 Address TypeC ID 1R R No [1 .. 1] [1 .. 1] No 0190 NULL
5050NK14.8 Other Geographic DesignationC ST 50O O No [0 .. 1] [0 .. 1] No NULL
5051NK14.9 County/Parish CodeC IS 20O O No [0 .. 1] [0 .. 1] No 0289 NULL
5052NK14.10 Census TractC IS 20O O No [0 .. 1] [0 .. 1] No 0288 NULL
5053NK14.11 Address Representation CodeC ID 1O O No [0 .. 1] [0 .. 1] No 0465 NULL
5054NK14.12 Address Validity RangeC DR 0X X No [0 .. 0] [0 .. 0] No NULL
5055NK14.13 Effective DateC TS 26O O No [0 .. 1] [0 .. 1] No NULL
5056NK14.13.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No NULL
5057NK14.13.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529 NULL
5058NK14.14 Expiration DateC TS 26O O No [0 .. 1] [0 .. 1] No NULL
5059NK14.14.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No NULL
5060NK14.14.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529 NULL
5061NK15 Phone NumberF XTN 651RE RE No [0 .. *] [0 .. *] No NULL
5062NK15.1 Telephone NumberC ST 0X X No [0 .. 0] [0 .. 0] No
5063NK15.2 Telecommunication Use CodeC ID 3R R No [1 .. 1] [1 .. 1] No 0201
5064NK15.3 Telecommunication Equipment TypeC ID 8RE RE No [0 .. 1] [0 .. 1] No 0202
5065NK15.4 Email AddressC ST 199C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No If XTN.2 (telecommunication use code) is valued "NET"
5066NK15.5 Country CodeC NM 3O O No [0 .. 1] [0 .. 1] No
5067NK15.6 Area/City CodeC NM 5C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If XTN.2 (telecommunication use code) is not valued "NET"
5068NK15.7 Local NumberC NM 9C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No If XTN.2 (telecommunication use code) is not valued "NET"
5069NK15.8 ExtensionC NM 5O O No [0 .. 1] [0 .. 1] No
5070NK15.9 Any TextC ST 199O O No [0 .. 1] [0 .. 1] No
5071NK15.10 Extension PrefixC ST 4O O No [0 .. 1] [0 .. 1] No
5072NK15.11 Speed Dial CodeC ST 6O O No [0 .. 1] [0 .. 1] No
5073NK15.12 Unformatted Telephone numberC ST 0O O No [0 .. 1] [0 .. 1] No
5074NK16 Business Phone NumberF XTN 651O O No [0 .. *] [0 .. *] No NULL
5075NK16.1 Telephone NumberC ST 0X X No [0 .. 0] [0 .. 0] No
5076NK16.2 Telecommunication Use CodeC ID 3R R No [1 .. 1] [1 .. 1] No 0201
5077NK16.3 Telecommunication Equipment TypeC ID 8RE RE No [0 .. 1] [0 .. 1] No 0202
5078NK16.4 Email AddressC ST 199C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No If XTN.2 (telecommunication use code) is valued "NET"
5079NK16.5 Country CodeC NM 3O O No [0 .. 1] [0 .. 1] No
5080NK16.6 Area/City CodeC NM 5C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If XTN.2 (telecommunication use code) is not valued "NET"
5081NK16.7 Local NumberC NM 9C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No If XTN.2 (telecommunication use code) is not valued "NET"
5082NK16.8 ExtensionC NM 5O O No [0 .. 1] [0 .. 1] No
5083NK16.9 Any TextC ST 199O O No [0 .. 1] [0 .. 1] No
5084NK16.10 Extension PrefixC ST 4O O No [0 .. 1] [0 .. 1] No
5085NK16.11 Speed Dial CodeC ST 6O O No [0 .. 1] [0 .. 1] No
5086NK16.12 Unformatted Telephone numberC ST 199O O No [0 .. 1] [0 .. 1] No
5087NK17 Contact RoleF CE 483O O No [0 .. 1] [0 .. 1] No 0131 NULL
5088NK17.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
5089NK17.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
5090NK17.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
5091NK17.4 Alternate IdentifierC ST 20O O No [0 .. 1] [0 .. 1] No
5092NK17.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
5093NK17.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
5094NK18 Start DateF DT 8O O No [0 .. 1] [0 .. 1] No NULL
5095NK19 End DateF DT 8O O No [0 .. 1] [0 .. 1] No NULL
5096NK110 Next of Kin / Associated Parties Job TitleF ST 60O O No [0 .. 1] [0 .. 1] No NULL
5097NK111 Next of Kin / Associated Parties Job Code/ClassF JCC 292O O No [0 .. 1] [0 .. 1] No 0327 / 032NULL
5098NK111.1 Job CodeC IS 20O O No [0 .. 1] [0 .. 1] No 0327 NULL
5099NK111.2 Job ClassC IS 20O O No [0 .. 1] [0 .. 1] No 0328 NULL
5100NK111.3 Job Description TextC TX 250O O No [0 .. 1] [0 .. 1] No NULL
5101NK112 Next of Kin / Associated Parties Employee NumberF CX 1913O O No [0 .. 1] [0 .. 1] No NULL
5102NK112.1 ID NumberC ST 15R R No [1 .. 1] [1 .. 1] No NULL
5103NK112.2 Check DigitC ST 1O O No [0 .. 1] [0 .. 1] No NULL
5104NK112.3 Check Digit SchemeC ID 3C(O/X) C(O/X) No [0 .. 1] [0 .. 1] No 0061 If CX.2 (check digit) is valued
5105NK112.4 Assigning AuthorityC HD 227R R No [1 .. 1] [1 .. 1] No 0363 NULL
5106NK112.4.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 NULL If HD.2 (Universal ID) is not valued
5107NK112.4.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
5108NK112.4.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
5109NK112.5 Identifier Type CodeC ID 5R R No [1 .. 1] [1 .. 1] No 0203 NULL
5110NK112.6 Assigning FacilityC HD 227O O No [0 .. 1] [0 .. 1] No NULL
5111NK112.6.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 NULL If HD.2 (Universal ID) is not valued
5112NK112.6.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
5113NK112.6.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
5114NK112.7 Effective DateC DT 8O O No [0 .. 1] [0 .. 1] No NULL
5115NK112.8 Expiration DateC DT 8O O No [0 .. 1] [0 .. 1] No NULL
5116NK112.9 Assigning JurisdictionC CWE 705O O No [0 .. 1] [0 .. 1] No NULL
5117NK112.9.1 IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
5118NK112.9.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
5119NK112.9.3 Name of Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.1 (Identifier) is valued
5120NK112.9.4 Alternate IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
5121NK112.9.5 Alternate TextS ST 199C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If CWE.4 (Alternate Identifier) is valued
5122NK112.9.6 Name of Alternate Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.4 (Alternate Identifier) is valued
5123NK112.9.7 Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
5124NK112.9.8 Alternate Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
5125NK112.9.9 Original TextS ST 199O O No [0 .. 1] [0 .. 1] No
5126NK112.10 Assigning Agency or DepartmentC CWE 705O O No [0 .. 1] [0 .. 1] No NULL
5127NK112.10.1 IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
5128NK112.10.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
5129NK112.10.3 Name of Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.1 (Identifier) is valued
5130NK112.10.4 Alternate IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
5131NK112.10.5 Alternate TextS ST 199C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If CWE.4 (Alternate Identifier) is valued
5132NK112.10.6 Name of Alternate Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.4 (Alternate Identifier) is valued
5133NK112.10.7 Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
5134NK112.10.8 Alternate Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
5135NK112.10.9 Original TextS ST 199O O No [0 .. 1] [0 .. 1] No
5136NK113 Organization Name - NK1F XON 563O O No [0 .. 1] [0 .. 1] No NULL
5137NK113.1 Organization NameC ST 50RE RE No [0 .. 1] [0 .. 1] No
5138NK113.2 Organization Name Type CodeC IS 20O O No [0 .. 1] [0 .. 1] No 0204
5139NK113.3 ID NumberC NM 0X X No [0 .. 0] [0 .. 0] No
5140NK113.4 Check DigitC NM 1O O No [0 .. 1] [0 .. 1] No
5141NK113.5 Check Digit SchemeC ID 3O O No [0 .. 1] [0 .. 1] No 0061
5142NK113.6 Assigning AuthorityC HD 227C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0363 If XON.10 (Organization Identifier) is valued
5143NK113.6.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 NULL If HD.2 (Universal ID) is not valued
5144NK113.6.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
5145NK113.6.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
5146NK113.7 Identifier Type CodeC ID 5C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0203 If XON.10 (Organization Identifier) is valued
5147NK113.8 Assigning FacilityC HD 227O O No [0 .. 1] [0 .. 1] No NULL
5148NK113.8.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 NULL If HD.2 (Universal ID) is not valued
5149NK113.8.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
5150NK113.8.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
5151NK113.9 Name Representation CodeC ID 1O O No [0 .. 1] [0 .. 1] No 0465 NULL
5152NK113.10 Organization IdentifierC ST 20C(R/RE) C(R/RE) No [0 .. 1] [0 .. 1] No If XON.1 (Organization Name) is not valued
5153NK114 Marital StatusF CE 483O O No [0 .. 1] [0 .. 1] No 0002 NULL
5154NK114.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
5155NK114.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
5156NK114.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
5157NK114.4 Alternate IdentifierC ST 20O O No [0 .. 1] [0 .. 1] No
5158NK114.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
5159NK114.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
5160NK115 Administrative SexF IS 1O O No [0 .. 1] [0 .. 1] No 0001 NULL
5161NK116 Date/Time of BirthF TS 26O O No [0 .. 1] [0 .. 1] No NULL
5162NK116.1 TimeC DTM 24R R No [1 .. 1] [1 .. 1] No NULL
5163NK116.2 Degree of PrecisionC ID 0X X No [0 .. 0] [0 .. 0] No 0529 NULL
5164NK117 Living DependencyF IS 2O O No [0 .. 1] [0 .. 1] No 0223 NULL
5165NK118 Ambulatory StatusF IS 2O O No [0 .. 1] [0 .. 1] No 0009 NULL
5166NK119 CitizenshipF CE 483O O No [0 .. 1] [0 .. 1] No 0171 NULL
5167NK119.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
5168NK119.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
5169NK119.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
5170NK119.4 Alternate IdentifierC ST 20O O No [0 .. 1] [0 .. 1] No
5171NK119.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
5172NK119.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
5173NK120 Primary LanguageF CE 483O O No [0 .. 1] [0 .. 1] No 0296 NULL
5174NK120.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
5175NK120.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
5176NK120.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
5177NK120.4 Alternate IdentifierC ST 20O O No [0 .. 1] [0 .. 1] No
5178NK120.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
5179NK120.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
5180NK121 Living ArrangementF IS 2O O No [0 .. 1] [0 .. 1] No 0220 NULL
5181NK122 Publicity CodeF CE 483O O No [0 .. 1] [0 .. 1] No 0215 NULL
5182NK122.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
5183NK122.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
5184NK122.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
5185NK122.4 Alternate IdentifierC ST 20O O No [0 .. 1] [0 .. 1] No
5186NK122.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
5187NK122.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
5188NK123 Protection IndicatorF ID 1O O No [0 .. 1] [0 .. 1] No 0136 NULL
5189NK124 Student IndicatorF IS 2O O No [0 .. 1] [0 .. 1] No 0231 NULL
5190NK125 ReligionF CE 483O O No [0 .. 1] [0 .. 1] No 0006 NULL
5191NK125.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
5192NK125.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
5193NK125.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
5194NK125.4 Alternate IdentifierC ST 20O O No [0 .. 1] [0 .. 1] No
5195NK125.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
5196NK125.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
5197NK126 Mother's Maiden NameF XPN 1044O O No [0 .. 1] [0 .. 1] No NULL
5198NK126.1 Family NameC FN 194R R No [1 .. 1] [1 .. 1] No NULL
5199NK126.1.1 SurnameS ST 50R R No [1 .. 1] [1 .. 1] No NULL
5200NK126.1.2 Own Surname PrefixS ST 20O O No [0 .. 1] [0 .. 1] No NULL
5201NK126.1.3 Own SurnameS ST 50O O No [0 .. 1] [0 .. 1] No NULL
5202NK126.1.4 Surname Prefix From Partner/SpouseS ST 20O O No [0 .. 1] [0 .. 1] No NULL
5203NK126.1.5 Surname From Partner/SpouseS ST 50O O No [0 .. 1] [0 .. 1] No NULL
5204NK126.2 Given NameC ST 30R R No [1 .. 1] [1 .. 1] No NULL
5205NK126.3 Second and Further Given Names or Initials ThereofC ST 30RE RE No [0 .. 1] [0 .. 1] No NULL
5206NK126.4 Suffix (e.g., JR or III)C ST 20O O No [0 .. 1] [0 .. 1] No NULL
5207NK126.5 Prefix (e.g., DR)C ST 20O O No [0 .. 1] [0 .. 1] No NULL
5208NK126.6 Degree (e.g., MD)C IS 0X X No [0 .. 0] [0 .. 0] No 0360 NULL
5209NK126.7 Name Type CodeC ID 1RE RE No [0 .. 1] [0 .. 1] No 0200 NULL
5210NK126.8 Name Representation CodeC ID 1O O No [0 .. 1] [0 .. 1] No 0465 NULL
5211NK126.9 Name ContextC CE 483O O No [0 .. 1] [0 .. 1] No 0448 NULL
5212NK126.9.1 IdentifierS ST 20R R No [0 .. 1] [0 .. 1] No
5213NK126.9.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
5214NK126.9.3 Name of Coding SystemS ID 20R R No [0 .. 1] [0 .. 1] No 0396
5215NK126.9.4 Alternate IdentifierS ST 20O O No [0 .. 1] [0 .. 1] No
5216NK126.9.5 Alternate TextS ST 199O O No [0 .. 1] [0 .. 1] No
5217NK126.9.6 Name of Alternate Coding SystemS ID 20O O No [0 .. 1] [0 .. 1] No 0396
5218NK126.10 Name Validity RangeC DR 0X X No [0 .. 0] [0 .. 0] No NULL
5219NK126.11 Name Assembly OrderC ID 1O O No [0 .. 1] [0 .. 1] No 0444 NULL
5220NK126.12 Effective DateC TS 26O O No [0 .. 1] [0 .. 1] No NULL
5221NK126.12.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No NULL
5222NK126.12.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529 NULL
5223NK126.13 Expiration DateC TS 26O O No [0 .. 1] [0 .. 1] No NULL
5224NK126.13.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No NULL
5225NK126.13.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529 NULL
5226NK126.14 Professional SuffixC ST 199O O No [0 .. 1] [0 .. 1] No NULL
5227NK127 NationalityF CE 483O O No [0 .. 1] [0 .. 1] No 0212 NULL
5228NK127.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
5229NK127.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
5230NK127.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
5231NK127.4 Alternate IdentifierC ST 20O O No [0 .. 1] [0 .. 1] No
5232NK127.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
5233NK127.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
5234NK128 Ethnic GroupF CE 483O O No [0 .. 1] [0 .. 1] No 0189 NULL
5235NK128.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
5236NK128.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
5237NK128.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
5238NK128.4 Alternate IdentifierC ST 20O O No [0 .. 1] [0 .. 1] No
5239NK128.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
5240NK128.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
5241NK129 Contact ReasonF CE 483O O No [0 .. 1] [0 .. 1] No 0222 NULL
5242NK129.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
5243NK129.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
5244NK129.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
5245NK129.4 Alternate IdentifierC ST 20O O No [0 .. 1] [0 .. 1] No
5246NK129.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
5247NK129.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
5248NK130 Contact Person's NameF XPN 1044O O No [0 .. 1] [0 .. 1] No NULL
5249NK130.1 Family NameC FN 194R R No [1 .. 1] [1 .. 1] No NULL
5250NK130.1.1 SurnameS ST 50R R No [1 .. 1] [1 .. 1] No NULL
5251NK130.1.2 Own Surname PrefixS ST 20O O No [0 .. 1] [0 .. 1] No NULL
5252NK130.1.3 Own SurnameS ST 50O O No [0 .. 1] [0 .. 1] No NULL
5253NK130.1.4 Surname Prefix From Partner/SpouseS ST 20O O No [0 .. 1] [0 .. 1] No NULL
5254NK130.1.5 Surname From Partner/SpouseS ST 50O O No [0 .. 1] [0 .. 1] No NULL
5255NK130.2 Given NameC ST 30R R No [1 .. 1] [1 .. 1] No NULL
5256NK130.3 Second and Further Given Names or Initials ThereofC ST 30RE RE No [0 .. 1] [0 .. 1] No NULL
5257NK130.4 Suffix (e.g., JR or III)C ST 20O O No [0 .. 1] [0 .. 1] No NULL
5258NK130.5 Prefix (e.g., DR)C ST 20O O No [0 .. 1] [0 .. 1] No NULL
5259NK130.6 Degree (e.g., MD)C IS 0X X No [0 .. 0] [0 .. 0] No 0360 NULL
5260NK130.7 Name Type CodeC ID 1RE RE No [0 .. 1] [0 .. 1] No 0200 NULL
5261NK130.8 Name Representation CodeC ID 1O O No [0 .. 1] [0 .. 1] No 0465 NULL
5262NK130.9 Name ContextC CE 483O O No [0 .. 1] [0 .. 1] No 0448 NULL
5263NK130.9.1 IdentifierS ST 20R R No [0 .. 1] [0 .. 1] No
5264NK130.9.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
5265NK130.9.3 Name of Coding SystemS ID 20R R No [0 .. 1] [0 .. 1] No 0396
5266NK130.9.4 Alternate IdentifierS ST 20O O No [0 .. 1] [0 .. 1] No
5267NK130.9.5 Alternate TextS ST 199O O No [0 .. 1] [0 .. 1] No
5268NK130.9.6 Name of Alternate Coding SystemS ID 20O O No [0 .. 1] [0 .. 1] No 0396
5269NK130.10 Name Validity RangeC DR 0X X No [0 .. 0] [0 .. 0] No NULL
5270NK130.11 Name Assembly OrderC ID 1O O No [0 .. 1] [0 .. 1] No 0444 NULL
5271NK130.12 Effective DateC TS 26O O No [0 .. 1] [0 .. 1] No NULL
5272NK130.12.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No NULL
5273NK130.12.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529 NULL
5274NK130.13 Expiration DateC TS 26O O No [0 .. 1] [0 .. 1] No NULL
5275NK130.13.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No NULL
5276NK130.13.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529 NULL
5277NK130.14 Professional SuffixC ST 199O O No [0 .. 1] [0 .. 1] No NULL
5278NK131 Contact Person's Telephone NumberF XTN 651O O No [0 .. 1] [0 .. 1] No NULL
5279NK131.1 Telephone NumberC ST 0X X No [0 .. 0] [0 .. 0] No
5280NK131.2 Telecommunication Use CodeC ID 3R R No [1 .. 1] [1 .. 1] No 0201
5281NK131.3 Telecommunication Equipment TypeC ID 8RE RE No [0 .. 1] [0 .. 1] No 0202
5282NK131.4 Email AddressC ST 199C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No If XTN.2 (telecommunication use code) is valued "NET"
5283NK131.5 Country CodeC NM 3O O No [0 .. 1] [0 .. 1] No
5284NK131.6 Area/City CodeC NM 5C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If XTN.2 (telecommunication use code) is not valued "NET"
5285NK131.7 Local NumberC NM 9C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No If XTN.2 (telecommunication use code) is not valued "NET"
5286NK131.8 ExtensionC NM 5O O No [0 .. 1] [0 .. 1] No
5287NK131.9 Any TextC ST 199O O No [0 .. 1] [0 .. 1] No
5288NK131.10 Extension PrefixC ST 4O O No [0 .. 1] [0 .. 1] No
5289NK131.11 Speed Dial CodeC ST 6O O No [0 .. 1] [0 .. 1] No
5290NK131.12 Unformatted Telephone numberC ST 199O O No [0 .. 1] [0 .. 1] No
5291NK132 Contact Person's AddressF XAD 578O O No [0 .. 1] [0 .. 1] No NULL
5292NK132.1 Street AddressC SAD 184RE RE No [0 .. 1] [0 .. 1] No NULL
5293NK132.1.1 Street or Mailing AddressS ST 120R R No [1 .. 1] [1 .. 1] No NULL
5294NK132.1.2 Street NameS ST 50O O No [0 .. 1] [0 .. 1] No NULL
5295NK132.1.3 Dwelling NumberS ST 12O O No [0 .. 1] [0 .. 1] No NULL
5296NK132.2 Other DesignationC ST 120RE RE No [0 .. 1] [0 .. 1] No NULL
5297NK132.3 CityC ST 50RE RE No [0 .. 1] [0 .. 1] No NULL
5298NK132.4 State or ProvinceC ST 50RE RE No [0 .. 1] [0 .. 1] No NULL
5299NK132.5 Zip or Postal CodeC ST 12RE RE No [0 .. 1] [0 .. 1] No NULL
5300NK132.6 CountryC ID 3RE RE No [0 .. 1] [0 .. 1] No 0399 NULL
5301NK132.7 Address TypeC ID 3R R No [1 .. 1] [1 .. 1] No 0190 NULL
5302NK132.8 Other Geographic DesignationC ST 50O O No [0 .. 1] [0 .. 1] No NULL
5303NK132.9 County/Parish CodeC IS 20O O No [0 .. 1] [0 .. 1] No 0289 NULL
5304NK132.10 Census TractC IS 20O O No [0 .. 1] [0 .. 1] No 0288 NULL
5305NK132.11 Address Representation CodeC ID 1O O No [0 .. 1] [0 .. 1] No 0465 NULL
5306NK132.12 Address Validity RangeC DR 0X X No [0 .. 0] [0 .. 0] No NULL
5307NK132.13 Effective DateC TS 26O O No [0 .. 1] [0 .. 1] No NULL
5308NK132.13.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No NULL
5309NK132.13.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529 NULL
5310NK132.14 Expiration DateC TS 26O O No [0 .. 1] [0 .. 1] No NULL
5311NK132.14.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No NULL
5312NK132.14.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529 NULL
5313NK133 Next of Kin/Associated Party's IdentifiersF CX 1913O O No [0 .. 1] [0 .. 1] No NULL
5314NK133.1 ID NumberC ST 15R R No [1 .. 1] [1 .. 1] No NULL
5315NK133.2 Check DigitC ST 1O O No [0 .. 1] [0 .. 1] No NULL
5316NK133.3 Check Digit SchemeC ID 3C(O/X) C(O/X) No [0 .. 1] [0 .. 1] No 0061 If CX.2 (check digit) is valued
5317NK133.4 Assigning AuthorityC HD 227R R No [1 .. 1] [1 .. 1] No 0363 NULL
5318NK133.4.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 3000 NULL If HD.2 (Universal ID) is not valued
5319NK133.4.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
5320NK133.4.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
5321NK133.5 Identifier Type CodeC ID 5R R No [1 .. 1] [1 .. 1] No 0203 NULL
5322NK133.6 Assigning FacilityC HD 227O O No [0 .. 1] [0 .. 1] No NULL
5323NK133.6.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 NULL If HD.2 (Universal ID) is not valued
5324NK133.6.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
5325NK133.6.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
5326NK133.7 Effective DateC DT 8O O No [0 .. 1] [0 .. 1] No NULL
5327NK133.8 Expiration DateC DT 8O O No [0 .. 1] [0 .. 1] No NULL
5328NK133.9 Assigning JurisdictionC CWE 705O O No [0 .. 1] [0 .. 1] No NULL
5329NK133.9.1 IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
5330NK133.9.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
5331NK133.9.3 Name of Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.1 (Identifier) is valued
5332NK133.9.4 Alternate IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
5333NK133.9.5 Alternate TextS ST 199C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If CWE.4 (Alternate Identifier) is valued
5334NK133.9.6 Name of Alternate Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.4 (Alternate Identifier) is valued
5335NK133.9.7 Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
5336NK133.9.8 Alternate Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
5337NK133.9.9 Original TextS ST 199O O No [0 .. 1] [0 .. 1] No
5338NK133.10 Assigning Agency or DepartmentC CWE 705O O No [0 .. 1] [0 .. 1] No NULL
5339NK133.10.1 IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
5340NK133.10.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
5341NK133.10.3 Name of Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.1 (Identifier) is valued
5342NK133.10.4 Alternate IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
5343NK133.10.5 Alternate TextS ST 199C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If CWE.4 (Alternate Identifier) is valued
5344NK133.10.6 Name of Alternate Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.4 (Alternate Identifier) is valued
5345NK133.10.7 Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
5346NK133.10.8 Alternate Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
5347NK133.10.9 Original TextS ST 199O O No [0 .. 1] [0 .. 1] No
5348NK134 Job StatusF IS 2O O No [0 .. 1] [0 .. 1] No 0311 NULL
5349NK135 RaceF CE 483O O No [0 .. 1] [0 .. 1] No 0005 NULL
5350NK135.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
5351NK135.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
5352NK135.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
5353NK135.4 Alternate IdentifierC ST 20O O No [0 .. 1] [0 .. 1] No
5354NK135.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
5355NK135.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
5356NK136 HandicapF IS 2O O No [0 .. 1] [0 .. 1] No 0295 NULL
5357NK137 Contact Person Social Security NumberF ST 16O O No [0 .. 1] [0 .. 1] No NULL
5358NK138 Next of Kin Birth PlaceF ST 250O O No [0 .. 1] [0 .. 1] No NULL
5359NK139 VIP IndicatorF IS 2O O No [0 .. 1] [0 .. 1] No 0099 NULL
6001PV11 Set ID - PV1F SI 4O O No [0 .. 1] [0 .. 1] No NULL
6002PV12 Patient ClassF IS 1R R No [1 .. 1] [1 .. 1] No 0004 R
6003PV13 Assigned Patient LocationF PL 1230O O No [0 .. 1] [0 .. 1] No NULL
6004PV13.1 Point of CareC IS 20O O No [0 .. 1] [0 .. 1] No 0302 NULL
6005PV13.2 RoomC IS 20O O No [0 .. 1] [0 .. 1] No 0303 NULL
6006PV13.3 BedC IS 20O O No [0 .. 1] [0 .. 1] No 0304 NULL
6007PV13.4 FacilityC HD 227O O No [0 .. 1] [0 .. 1] No NULL
6008PV13.4.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 NULL If HD.2 (Universal ID) is not valued
6009PV13.4.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
6010PV13.4.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
6011PV13.5 Location StatusC IS 20O O No [0 .. 1] [0 .. 1] No 0306 NULL
6012PV13.6 Person Location TypeC IS 20C C No [0 .. 1] [0 .. 1] No 0305 NULL
6013PV13.7 BuildingC IS 20O O No [0 .. 1] [0 .. 1] No 0307 NULL
6014PV13.8 FloorC IS 20O O No [0 .. 1] [0 .. 1] No 0308 NULL
6015PV13.9 Location DescriptionC ST 199O O No [0 .. 1] [0 .. 1] No NULL
6016PV13.10 Comprehensive Location IdentifierC EI 427O O No [0 .. 1] [0 .. 1] No NULL
6017PV13.10.1 Entity IdentifierS ST 199RE RE No [0 .. 1] [0 .. 1] No NULL
6018PV13.10.2 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0363 NULL If EI.3 (Universal ID) is not valued
6019PV13.10.3 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If EI.2 (Namespace ID) is not valued
6020PV13.10.4 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If EI.3 (Universal ID) is valued
6021PV13.11 Assigning Authority for LocationC HD 227O O No [0 .. 1] [0 .. 1] No NULL
6022PV13.11.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 NULL If HD.2 (Universal ID) is not valued
6023PV13.11.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
6024PV13.11.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
6025PV14 Admission TypeF IS 2O O No [0 .. 1] [0 .. 1] No 0007 NULL
6026PV15 Preadmit NumberF CX 1913O O No [0 .. 1] [0 .. 1] No NULL
6027PV15.1 ID NumberC ST 15R R No [1 .. 1] [1 .. 1] No NULL
6028PV15.2 Check DigitC ST 1O O No [0 .. 1] [0 .. 1] No NULL
6029PV15.3 Check Digit SchemeC ID 3C(O/X) C(O/X) No [0 .. 1] [0 .. 1] No 0061 If CX.2 (check digit) is valued
6030PV15.4 Assigning AuthorityC HD 227R R No [1 .. 1] [1 .. 1] No 0363 NULL
6031PV15.4.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 NULL If HD.2 (Universal ID) is not valued
6032PV15.4.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
6033PV15.4.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
6034PV15.5 Identifier Type CodeC ID 5R R No [1 .. 1] [1 .. 1] No 0203 NULL
6035PV15.6 Assigning FacilityC HD 227O O No [0 .. 1] [0 .. 1] No NULL
6036PV15.6.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 NULL If HD.2 (Universal ID) is not valued
6037PV15.6.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
6038PV15.6.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
6039PV15.7 Effective DateC DT 8O O No [0 .. 1] [0 .. 1] No NULL
6040PV15.8 Expiration DateC DT 8O O No [0 .. 1] [0 .. 1] No NULL
6041PV15.9 Assigning JurisdictionC CWE 705O O No [0 .. 1] [0 .. 1] No NULL
6042PV15.9.1 IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
6043PV15.9.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
6044PV15.9.3 Name of Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.1 (Identifier) is valued
6045PV15.9.4 Alternate IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
6046PV15.9.5 Alternate TextS ST 199C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If CWE.4 (Alternate Identifier) is valued
6047PV15.9.6 Name of Alternate Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.4 (Alternate Identifier) is valued
6048PV15.9.7 Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
6049PV15.9.8 Alternate Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
6050PV15.9.9 Original TextS ST 199O O No [0 .. 1] [0 .. 1] No
6051PV15.10 Assigning Agency or DepartmentC CWE 705O O No [0 .. 1] [0 .. 1] No NULL
6052PV15.10.1 IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
6053PV15.10.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
6054PV15.10.3 Name of Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.1 (Identifier) is valued
6055PV15.10.4 Alternate IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
6056PV15.10.5 Alternate TextS ST 199C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If CWE.4 (Alternate Identifier) is valued
6057PV15.10.6 Name of Alternate Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.4 (Alternate Identifier) is valued
6058PV15.10.7 Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
6059PV15.10.8 Alternate Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
6060PV15.10.9 Original TextS ST 199O O No [0 .. 1] [0 .. 1] No
6061PV16 Prior Patient LocationF PL 1230O O No [0 .. 1] [0 .. 1] No NULL
6062PV16.1 Point of CareC IS 20O O No [0 .. 1] [0 .. 1] No 0302 NULL
6063PV16.2 RoomC IS 20O O No [0 .. 1] [0 .. 1] No 0303 NULL
6064PV16.3 BedC IS 20O O No [0 .. 1] [0 .. 1] No 0304 NULL
6065PV16.4 FacilityC HD 227O O No [0 .. 1] [0 .. 1] No NULL
6066PV16.4.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 NULL If HD.2 (Universal ID) is not valued
6067PV16.4.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
6068PV16.4.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
6069PV16.5 Location StatusC IS 20O O No [0 .. 1] [0 .. 1] No 0306 NULL
6070PV16.6 Person Location TypeC IS 20C C No [0 .. 1] [0 .. 1] No 0305 NULL
6071PV16.7 BuildingC IS 20O O No [0 .. 1] [0 .. 1] No 0307 NULL
6072PV16.8 FloorC IS 20O O No [0 .. 1] [0 .. 1] No 0308 NULL
6073PV16.9 Location DescriptionC ST 199O O No [0 .. 1] [0 .. 1] No NULL
6074PV16.10 Comprehensive Location IdentifierC EI 427O O No [0 .. 1] [0 .. 1] No NULL
6075PV16.10.1 Entity IdentifierS ST 199RE RE No [0 .. 1] [0 .. 1] No NULL
6076PV16.10.2 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0363 NULL If EI.3 (Universal ID) is not valued
6077PV16.10.3 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If EI.2 (Namespace ID) is not valued
6078PV16.10.4 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If EI.3 (Universal ID) is valued
6079PV16.11 Assigning Authority for LocationC HD 227O O No [0 .. 1] [0 .. 1] No NULL
6080PV16.11.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 NULL If HD.2 (Universal ID) is not valued
6081PV16.11.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
6082PV16.11.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
6083PV17 Attending DoctorF XCN 2945O O No [0 .. 1] [0 .. 1] No 0010 NULL
6084PV17.1 ID NumberC ST 15C(R/RE) C(R/RE) No [0 .. 1] [0 .. 1] No NULL If XCN.2.1 (Surname) and XCN.3 (Given Name are not valued
6085PV17.2 Family NameC FN 194RE RE No [0 .. 1] [0 .. 1] No NULL
6086PV17.2.1 SurnameS ST 50R R No [1 .. 1] [1 .. 1] No NULL
6087PV17.2.2 Own Surname PrefixS ST 20O O No [0 .. 1] [0 .. 1] No NULL
6088PV17.2.3 Own SurnameS ST 50O O No [0 .. 1] [0 .. 1] No NULL
6089PV17.2.4 Surname Prefix From Partner/SpouseS ST 20O O No [0 .. 1] [0 .. 1] No NULL
6090PV17.2.5 Surname From Partner/SpouseS ST 50O O No [0 .. 1] [0 .. 1] No NULL
6091PV17.3 Given NameC ST 30RE RE No [0 .. 1] [0 .. 1] No NULL
6092PV17.4 Second and Further Given Names or Initials ThereofC ST 30RE RE No [0 .. 1] [0 .. 1] No NULL
6093PV17.5 Suffix (e.g., JR or III)C ST 20O O No [0 .. 1] [0 .. 1] No NULL
6094PV17.6 Prefix (e.g., DR)C ST 20O O No [0 .. 1] [0 .. 1] No NULL
6095PV17.7 Degree (e.g., MD)C IS 0X X No [0 .. 0] [0 .. 0] No 0360 NULL
6096PV17.8 Source TableC IS 4O O No [0 .. 1] [0 .. 1] No 0297 NULL
6097PV17.9 Assigning AuthorityC HD 227C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0363 NULL If XCN.1 (ID Number) is valued
6098PV17.9.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 NULL If HD.2 (Universal ID) is not valued
6099PV17.9.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
6100PV17.9.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
6101PV17.10 Name Type CodeC ID 1RE RE No [0 .. 1] [0 .. 1] No 0200 NULL
6102PV17.11 Identifier Check DigitC ST 1O O No [0 .. 1] [0 .. 1] No NULL
6103PV17.12 Check Digit SchemeC ID 3C(O/X) C(O/X) No [0 .. 1] [0 .. 1] No 0061 NULL If XCN.11 (check digit identifier) is valued
6104PV17.13 Identifier Type CodeC ID 5O O No [0 .. 1] [0 .. 1] No 0203 NULL
6105PV17.14 Assigning FacilityC HD 227O O No [0 .. 1] [0 .. 1] No NULL
6106PV17.14.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 NULL If HD.2 (Universal ID) is not valued
6107PV17.14.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
6108PV17.14.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
6109PV17.15 Name Representation CodeC ID 1O O No [0 .. 1] [0 .. 1] No 0465 NULL
6110PV17.16 Name ContextC CE 483O O No [0 .. 1] [0 .. 1] No 0448 NULL
6111PV17.16.1 IdentifierS ST 20R R No [0 .. 1] [0 .. 1] No
6112PV17.16.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
6113PV17.16.3 Name of Coding SystemS ID 20R R No [0 .. 1] [0 .. 1] No 0396
6114PV17.16.4 Alternate IdentifierS ST 20O O No [0 .. 1] [0 .. 1] No
6115PV17.16.5 Alternate TextS ST 199O O No [0 .. 1] [0 .. 1] No
6116PV17.16.6 Name of Alternate Coding SystemS ID 20O O No [0 .. 1] [0 .. 1] No 0396
6117PV17.17 Name Validity RangeC DR 0X X No [0 .. 0] [0 .. 0] No NULL
6118PV17.18 Name Assembly OrderC ID 1X X No [0 .. 0] [0 .. 0] No 0444 NULL
6119PV17.19 Effective DateC TS 26O O No [0 .. 1] [0 .. 1] No NULL
6120PV17.19.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No NULL
6121PV17.19.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529 NULL
6122PV17.20 Expiration DateC TS 26O O No [0 .. 1] [0 .. 1] No NULL
6123PV17.20.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No NULL
6124PV17.20.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529 NULL
6125PV17.21 Professional SuffixC ST 199O O No [0 .. 1] [0 .. 1] No NULL
6126PV17.22 Assigning JurisdictionC CWE 705O O No [0 .. 1] [0 .. 1] No NULL
6127PV17.22.1 IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
6128PV17.22.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
6129PV17.22.3 Name of Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.1 (Identifier) is valued
6130PV17.22.4 Alternate IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
6131PV17.22.5 Alternate TextS ST 199C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If CWE.4 (Alternate Identifier) is valued
6132PV17.22.6 Name of Alternate Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.4 (Alternate Identifier) is valued
6133PV17.22.7 Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
6134PV17.22.8 Alternate Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
6135PV17.22.9 Original TextS ST 199O O No [0 .. 1] [0 .. 1] No
6136PV17.23 Assigning Agency or DepartmentC CWE 705O O No [0 .. 1] [0 .. 1] No NULL
6137PV17.23.1 IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
6138PV17.23.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
6139PV17.23.3 Name of Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.1 (Identifier) is valued
6140PV17.23.4 Alternate IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
6141PV17.23.5 Alternate TextS ST 199C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If CWE.4 (Alternate Identifier) is valued
6142PV17.23.6 Name of Alternate Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.4 (Alternate Identifier) is valued
6143PV17.23.7 Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
6144PV17.23.8 Alternate Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
6145PV17.23.9 Original TextS ST 199O O No [0 .. 1] [0 .. 1] No
6146PV18 Referring DoctorF XCN 2945O O No [0 .. 1] [0 .. 1] No 0010 NULL
6147PV18.1 ID NumberC ST 15C(R/RE) C(R/RE) No [0 .. 1] [0 .. 1] No NULL If XCN.2.1 (Surname) and XCN.3 (Given Name are not valued
6148PV18.2 Family NameC FN 194RE RE No [0 .. 1] [0 .. 1] No NULL
6149PV18.2.1 SurnameS ST 50R R No [1 .. 1] [1 .. 1] No NULL
6150PV18.2.2 Own Surname PrefixS ST 20O O No [0 .. 1] [0 .. 1] No NULL
6151PV18.2.3 Own SurnameS ST 50O O No [0 .. 1] [0 .. 1] No NULL
6152PV18.2.4 Surname Prefix From Partner/SpouseS ST 20O O No [0 .. 1] [0 .. 1] No NULL
6153PV18.2.5 Surname From Partner/SpouseS ST 50O O No [0 .. 1] [0 .. 1] No NULL
6154PV18.3 Given NameC ST 30RE RE No [0 .. 1] [0 .. 1] No NULL
6155PV18.4 Second and Further Given Names or Initials ThereofC ST 30RE RE No [0 .. 1] [0 .. 1] No NULL
6156PV18.5 Suffix (e.g., JR or III)C ST 20O O No [0 .. 1] [0 .. 1] No NULL
6157PV18.6 Prefix (e.g., DR)C ST 20O O No [0 .. 1] [0 .. 1] No NULL
6158PV18.7 Degree (e.g., MD)C IS 0X X No [0 .. 0] [0 .. 0] No 0360 NULL
6159PV18.8 Source TableC IS 4O O No [0 .. 1] [0 .. 1] No 0297 NULL
6160PV18.9 Assigning AuthorityC HD 227C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0363 NULL If XCN.1 (ID Number) is valued
6161PV18.9.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 NULL If HD.2 (Universal ID) is not valued
6162PV18.9.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
6163PV18.9.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
6164PV18.10 Name Type CodeC ID 1RE RE No [0 .. 1] [0 .. 1] No 0200 NULL
6165PV18.11 Identifier Check DigitC ST 1O O No [0 .. 1] [0 .. 1] No NULL
6166PV18.12 Check Digit SchemeC ID 3C(O/X) C(O/X) No [0 .. 1] [0 .. 1] No 0061 NULL If XCN.11 (check digit identifier) is valued
6167PV18.13 Identifier Type CodeC ID 5O O No [0 .. 1] [0 .. 1] No 0203 NULL
6168PV18.14 Assigning FacilityC HD 227O O No [0 .. 1] [0 .. 1] No NULL
6169PV18.14.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 NULL If HD.2 (Universal ID) is not valued
6170PV18.14.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
6171PV18.14.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
6172PV18.15 Name Representation CodeC ID 1O O No [0 .. 1] [0 .. 1] No 0465 NULL
6173PV18.16 Name ContextC CE 483O O No [0 .. 1] [0 .. 1] No 0448 NULL
6174PV18.16.1 IdentifierS ST 20R R No [0 .. 1] [0 .. 1] No
6175PV18.16.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
6176PV18.16.3 Name of Coding SystemS ID 20R R No [0 .. 1] [0 .. 1] No 0396
6177PV18.16.4 Alternate IdentifierS ST 20O O No [0 .. 1] [0 .. 1] No
6178PV18.16.5 Alternate TextS ST 199O O No [0 .. 1] [0 .. 1] No
6179PV18.16.6 Name of Alternate Coding SystemS ID 20O O No [0 .. 1] [0 .. 1] No 0396
6180PV18.17 Name Validity RangeC DR 0X X No [0 .. 0] [0 .. 0] No NULL
6181PV18.18 Name Assembly OrderC ID 1X X No [0 .. 0] [0 .. 0] No 0444 NULL
6182PV18.19 Effective DateC TS 26O O No [0 .. 1] [0 .. 1] No NULL
6183PV18.19.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No NULL
6184PV18.19.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529 NULL
6185PV18.20 Expiration DateC TS 26O O No [0 .. 1] [0 .. 1] No NULL
6186PV18.20.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No NULL
6187PV18.20.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529 NULL
6188PV18.21 Professional SuffixC ST 199O O No [0 .. 1] [0 .. 1] No NULL
6189PV18.22 Assigning JurisdictionC CWE 705O O No [0 .. 1] [0 .. 1] No NULL
6190PV18.22.1 IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
6191PV18.22.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
6192PV18.22.3 Name of Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.1 (Identifier) is valued
6193PV18.22.4 Alternate IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
6194PV18.22.5 Alternate TextS ST 199C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If CWE.4 (Alternate Identifier) is valued
6195PV18.22.6 Name of Alternate Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.4 (Alternate Identifier) is valued
6196PV18.22.7 Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
6197PV18.22.8 Alternate Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
6198PV18.22.9 Original TextS ST 199O O No [0 .. 1] [0 .. 1] No
6199PV18.23 Assigning Agency or DepartmentC CWE 705O O No [0 .. 1] [0 .. 1] No NULL
6200PV18.23.1 IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
6201PV18.23.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
6202PV18.23.3 Name of Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.1 (Identifier) is valued
6203PV18.23.4 Alternate IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
6204PV18.23.5 Alternate TextS ST 199C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If CWE.4 (Alternate Identifier) is valued
6205PV18.23.6 Name of Alternate Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.4 (Alternate Identifier) is valued
6206PV18.23.7 Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
6207PV18.23.8 Alternate Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
6208PV18.23.9 Original TextS ST 199O O No [0 .. 1] [0 .. 1] No
6209PV19 Consulting DoctorF XCN 2945O O No [0 .. 1] [0 .. 1] No 0010 NULL
6210PV110 Hospital ServiceF IS 3O O No [0 .. 1] [0 .. 1] No 0069 NULL
6211PV111 Temporary LocationF PL 1230O O No [0 .. 1] [0 .. 1] No NULL
6212PV111.1 Point of CareC IS 20O O No [0 .. 1] [0 .. 1] No 0302 NULL
6213PV111.2 RoomC IS 20O O No [0 .. 1] [0 .. 1] No 0303 NULL
6214PV111.3 BedC IS 20O O No [0 .. 1] [0 .. 1] No 0304 NULL
6215PV111.4 FacilityC HD 227O O No [0 .. 1] [0 .. 1] No NULL
6216PV111.4.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 NULL If HD.2 (Universal ID) is not valued
6217PV111.4.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
6218PV111.4.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
6219PV111.5 Location StatusC IS 20O O No [0 .. 1] [0 .. 1] No 0306 NULL
6220PV111.6 Person Location TypeC IS 20C C No [0 .. 1] [0 .. 1] No 0305 NULL
6221PV111.7 BuildingC IS 20O O No [0 .. 1] [0 .. 1] No 0307 NULL
6222PV111.8 FloorC IS 20O O No [0 .. 1] [0 .. 1] No 0308 NULL
6223PV111.9 Location DescriptionC ST 199O O No [0 .. 1] [0 .. 1] No NULL
6224PV111.10 Comprehensive Location IdentifierC EI 427O O No [0 .. 1] [0 .. 1] No NULL
6225PV111.10.1 Entity IdentifierS ST 199RE RE No [0 .. 1] [0 .. 1] No NULL
6226PV111.10.2 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0363 NULL If EI.3 (Universal ID) is not valued
6227PV111.10.3 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If EI.2 (Namespace ID) is not valued
6228PV111.10.4 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If EI.3 (Universal ID) is valued
6229PV111.11 Assigning Authority for LocationC HD 227O O No [0 .. 1] [0 .. 1] No NULL
6230PV111.11.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 NULL If HD.2 (Universal ID) is not valued
6231PV111.11.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
6232PV111.11.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
6233PV112 Preadmit Test IndicatorF IS 2O O No [0 .. 1] [0 .. 1] No 0087 NULL
6234PV113 Re-admission IndicatorF IS 2O O No [0 .. 1] [0 .. 1] No 0092 NULL
6235PV114 Admit SourceF IS 6O O No [0 .. 1] [0 .. 1] No 0023 NULL
6236PV115 Ambulatory StatusF IS 2O O No [0 .. 1] [0 .. 1] No 0009 NULL
6237PV116 VIP IndicatorF IS 2O O No [0 .. 1] [0 .. 1] No 0099 NULL
6238PV117 Admitting DoctorF XCN 2945O O No [0 .. 1] [0 .. 1] No 0010 NULL
6239PV117.1 ID NumberC ST 15C(R/RE) C(R/RE) No [0 .. 1] [0 .. 1] No NULL If XCN.2.1 (Surname) and XCN.3 (Given Name are not valued
6240PV117.2 Family NameC FN 194RE RE No [0 .. 1] [0 .. 1] No NULL
6241PV117.2.1 SurnameS ST 50R R No [1 .. 1] [1 .. 1] No NULL
6242PV117.2.2 Own Surname PrefixS ST 20O O No [0 .. 1] [0 .. 1] No NULL
6243PV117.2.3 Own SurnameS ST 50O O No [0 .. 1] [0 .. 1] No NULL
6244PV117.2.4 Surname Prefix From Partner/SpouseS ST 20O O No [0 .. 1] [0 .. 1] No NULL
6245PV117.2.5 Surname From Partner/SpouseS ST 50O O No [0 .. 1] [0 .. 1] No NULL
6246PV117.3 Given NameC ST 30RE RE No [0 .. 1] [0 .. 1] No NULL
6247PV117.4 Second and Further Given Names or Initials ThereofC ST 30RE RE No [0 .. 1] [0 .. 1] No NULL
6248PV117.5 Suffix (e.g., JR or III)C ST 20O O No [0 .. 1] [0 .. 1] No NULL
6249PV117.6 Prefix (e.g., DR)C ST 20O O No [0 .. 1] [0 .. 1] No NULL
6250PV117.7 Degree (e.g., MD)C IS 0X X No [0 .. 0] [0 .. 0] No 0360 NULL
6251PV117.8 Source TableC IS 4O O No [0 .. 1] [0 .. 1] No 0297 NULL
6252PV117.9 Assigning AuthorityC HD 227C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0363 NULL If XCN.1 (ID Number) is valued
6253PV117.9.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 NULL If HD.2 (Universal ID) is not valued
6254PV117.9.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
6255PV117.9.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
6256PV117.10 Name Type CodeC ID 1RE RE No [0 .. 1] [0 .. 1] No 0200 NULL
6257PV117.11 Identifier Check DigitC ST 1O O No [0 .. 1] [0 .. 1] No NULL
6258PV117.12 Check Digit SchemeC ID 3C(O/X) C(O/X) No [0 .. 1] [0 .. 1] No 0061 NULL If XCN.11 (check digit identifier) is valued
6259PV117.13 Identifier Type CodeC ID 5O O No [0 .. 1] [0 .. 1] No 0203 NULL
6260PV117.14 Assigning FacilityC HD 227O O No [0 .. 1] [0 .. 1] No NULL
6261PV117.14.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 NULL If HD.2 (Universal ID) is not valued
6262PV117.14.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
6263PV117.14.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
6264PV117.15 Name Representation CodeC ID 1O O No [0 .. 1] [0 .. 1] No 0465 NULL
6265PV117.16 Name ContextC CE 483O O No [0 .. 1] [0 .. 1] No 0448 NULL
6266PV117.16.1 IdentifierS ST 20R R No [0 .. 1] [0 .. 1] No
6267PV117.16.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
6268PV117.16.3 Name of Coding SystemS ID 20R R No [0 .. 1] [0 .. 1] No 0396
6269PV117.16.4 Alternate IdentifierS ST 20O O No [0 .. 1] [0 .. 1] No
6270PV117.16.5 Alternate TextS ST 199O O No [0 .. 1] [0 .. 1] No
6271PV117.16.6 Name of Alternate Coding SystemS ID 20O O No [0 .. 1] [0 .. 1] No 0396
6272PV117.17 Name Validity RangeC DR 0X X No [0 .. 0] [0 .. 0] No NULL
6273PV117.18 Name Assembly OrderC ID 1X X No [0 .. 0] [0 .. 0] No 0444 NULL
6274PV117.19 Effective DateC TS 26O O No [0 .. 1] [0 .. 1] No NULL
6275PV117.19.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No NULL
6276PV117.19.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529 NULL
6277PV117.20 Expiration DateC TS 26O O No [0 .. 1] [0 .. 1] No NULL
6278PV117.20.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No NULL
6279PV117.20.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529 NULL
6280PV117.21 Professional SuffixC ST 199O O No [0 .. 1] [0 .. 1] No NULL
6281PV117.22 Assigning JurisdictionC CWE 705O O No [0 .. 1] [0 .. 1] No NULL
6282PV117.22.1 IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
6283PV117.22.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
6284PV117.22.3 Name of Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.1 (Identifier) is valued
6285PV117.22.4 Alternate IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
6286PV117.22.5 Alternate TextS ST 199C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If CWE.4 (Alternate Identifier) is valued
6287PV117.22.6 Name of Alternate Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.4 (Alternate Identifier) is valued
6288PV117.22.7 Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
6289PV117.22.8 Alternate Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
6290PV117.22.9 Original TextS ST 199O O No [0 .. 1] [0 .. 1] No
6291PV117.23 Assigning Agency or DepartmentC CWE 705O O No [0 .. 1] [0 .. 1] No NULL
6292PV117.23.1 IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
6293PV117.23.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
6294PV117.23.3 Name of Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.1 (Identifier) is valued
6295PV117.23.4 Alternate IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
6296PV117.23.5 Alternate TextS ST 199C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If CWE.4 (Alternate Identifier) is valued
6297PV117.23.6 Name of Alternate Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.4 (Alternate Identifier) is valued
6298PV117.23.7 Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
6299PV117.23.8 Alternate Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
6300PV117.23.9 Original TextS ST 199O O No [0 .. 1] [0 .. 1] No
6301PV118 Patient TypeF IS 2O O No [0 .. 1] [0 .. 1] No 0018 NULL
6302PV119 Visit NumberF CX 1913O O No [0 .. 1] [0 .. 1] No NULL
6303PV119.1 ID NumberC ST 15R R No [1 .. 1] [1 .. 1] No NULL
6304PV119.2 Check DigitC ST 1O O No [0 .. 1] [0 .. 1] No NULL
6305PV119.3 Check Digit SchemeC ID 3C(O/X) C(O/X) No [0 .. 1] [0 .. 1] No 0061 If CX.2 (check digit) is valued
6306PV119.4 Assigning AuthorityC HD 227R R No [1 .. 1] [1 .. 1] No 0363 NULL
6307PV119.4.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 NULL If HD.2 (Universal ID) is not valued
6308PV119.4.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
6309PV119.4.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
6310PV119.5 Identifier Type CodeC ID 5R R No [1 .. 1] [1 .. 1] No 0203 NULL
6311PV119.6 Assigning FacilityC HD 227O O No [0 .. 1] [0 .. 1] No NULL
6312PV119.6.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 NULL If HD.2 (Universal ID) is not valued
6313PV119.6.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
6314PV119.6.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
6315PV119.7 Effective DateC DT 8R R No [1 .. 1] [1 .. 1] No NULL
6316PV119.8 Expiration DateC DT 8R R No [1 .. 1] [1 .. 1] No NULL
6317PV119.9 Assigning JurisdictionC CWE 705O O No [0 .. 1] [0 .. 1] No NULL
6318PV119.9.1 IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
6319PV119.9.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
6320PV119.9.3 Name of Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.1 (Identifier) is valued
6321PV119.9.4 Alternate IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
6322PV119.9.5 Alternate TextS ST 199C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If CWE.4 (Alternate Identifier) is valued
6323PV119.9.6 Name of Alternate Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.4 (Alternate Identifier) is valued
6324PV119.9.7 Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
6325PV119.9.8 Alternate Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
6326PV119.9.9 Original TextS ST 199O O No [0 .. 1] [0 .. 1] No
6327PV119.10 Assigning Agency or DepartmentC CWE 705O O No [0 .. 1] [0 .. 1] No NULL
6328PV119.10.1 IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
6329PV119.10.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
6330PV119.10.3 Name of Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.1 (Identifier) is valued
6331PV119.10.4 Alternate IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
6332PV119.10.5 Alternate TextS ST 199C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If CWE.4 (Alternate Identifier) is valued
6333PV119.10.6 Name of Alternate Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.4 (Alternate Identifier) is valued
6334PV119.10.7 Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
6335PV119.10.8 Alternate Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
6336PV119.10.9 Original TextS ST 199O O No [0 .. 1] [0 .. 1] No
6337PV120 Financial ClassF FC 50O O No [1 .. *] [1 .. *] No 0064 NULL
6338PV120.1 Financial Class CodeC IS 20R R No [1 .. 1] [1 .. 1] No 0064 NULL
6339PV120.2 Effective DateC TS 26RE RE No [0 .. 1] [0 .. 1] No NULL
6340PV120.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No NULL
6341PV120.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529 NULL
6342PV121 Charge Price IndicatorF IS 2O O No [0 .. 1] [0 .. 1] No 0032 NULL
6343PV122 Courtesy CodeF IS 2O O No [0 .. 1] [0 .. 1] No 0045 NULL
6344PV123 Credit RatingF IS 2O O No [0 .. 1] [0 .. 1] No 0046 NULL
6345PV124 Contract CodeF IS 2O O No [0 .. 1] [0 .. 1] No 0044 NULL
6346PV125 Contract Effective DateF DT 8O O No [0 .. 1] [0 .. 1] No NULL
6347PV126 Contract AmountF NM 12O O No [0 .. 1] [0 .. 1] No NULL
6348PV127 Contract PeriodF NM 3O O No [0 .. 1] [0 .. 1] No NULL
6349PV128 Interest CodeF IS 2O O No [0 .. 1] [0 .. 1] No 0073 NULL
6350PV129 Transfer to Bad Debt CodeF IS 4O O No [0 .. 1] [0 .. 1] No 0110 NULL
6351PV130 Transfer to Bad Debt DateF DT 8O O No [0 .. 1] [0 .. 1] No NULL
6352PV131 Bad Debt Agency CodeF IS 10O O No [0 .. 1] [0 .. 1] No 0021 NULL
6353PV132 Bad Debt Transfer AmountF NM 12O O No [0 .. 1] [0 .. 1] No NULL
6354PV133 Bad Debt Recovery AmountF NM 12O O No [0 .. 1] [0 .. 1] No NULL
6355PV134 Delete Account IndicatorF IS 1O O No [0 .. 1] [0 .. 1] No 0111 NULL
6356PV135 Delete Account DateF DT 8O O No [0 .. 1] [0 .. 1] No NULL
6357PV136 Discharge DispositionF IS 3O O No [0 .. 1] [0 .. 1] No 0112 NULL
6358PV137 Discharged to LocationF DLD 47O O No [0 .. 1] [0 .. 1] No 0113 NULL
6359PV137.1 Discharge LocationC IS 20R R No [1 .. 1] [1 .. 1] No 0113 NULL
6360PV137.2 Effective DateC TS 26O O No [0 .. 1] [0 .. 1] No NULL
6361PV137.2.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No NULL
6362PV137.2.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529 NULL
6363PV138 Diet TypeF CE 483O O No [0 .. 1] [0 .. 1] No 0114 NULL
6364PV138.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
6365PV138.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
6366PV138.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
6367PV138.4 Alternate IdentifierC ST 20O O No [0 .. 1] [0 .. 1] No
6368PV138.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
6369PV138.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
6370PV139 Servicing FacilityF IS 2O O No [0 .. 1] [0 .. 1] No 0115 NULL
6371PV140 Bed StatusF IS 1O O No [0 .. 1] [0 .. 1] No 0116 NULL
6372PV141 Account StatusF IS 2O O No [0 .. 1] [0 .. 1] No 0117 NULL
6373PV142 Pending LocationF PL 1230O O No [0 .. 1] [0 .. 1] No NULL
6374PV142.1 Point of CareC IS 20O O No [0 .. 1] [0 .. 1] No 0302 NULL
6375PV142.2 RoomC IS 20O O No [0 .. 1] [0 .. 1] No 0303 NULL
6376PV142.3 BedC IS 20O O No [0 .. 1] [0 .. 1] No 0304 NULL
6377PV142.4 FacilityC HD 227O O No [0 .. 1] [0 .. 1] No NULL
6378PV142.4.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 NULL If HD.2 (Universal ID) is not valued
6379PV142.4.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
6380PV142.4.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
6381PV142.5 Location StatusC IS 20O O No [0 .. 1] [0 .. 1] No 0306 NULL
6382PV142.6 Person Location TypeC IS 20C C No [0 .. 1] [0 .. 1] No 0305 NULL
6383PV142.7 BuildingC IS 20O O No [0 .. 1] [0 .. 1] No 0307 NULL
6384PV142.8 FloorC IS 20O O No [0 .. 1] [0 .. 1] No 0308 NULL
6385PV142.9 Location DescriptionC ST 199O O No [0 .. 1] [0 .. 1] No NULL
6386PV142.10 Comprehensive Location IdentifierC EI 427O O No [0 .. 1] [0 .. 1] No NULL
6387PV142.10.1 Entity IdentifierS ST 199RE RE No [0 .. 1] [0 .. 1] No NULL
6388PV142.10.2 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0363 NULL If EI.3 (Universal ID) is not valued
6389PV142.10.3 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If EI.2 (Namespace ID) is not valued
6390PV142.10.4 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If EI.3 (Universal ID) is valued
6391PV142.11 Assigning Authority for LocationC HD 227O O No [0 .. 1] [0 .. 1] No NULL
6392PV142.11.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 NULL If HD.2 (Universal ID) is not valued
6393PV142.11.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
6394PV142.11.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
6395PV143 Prior Temporary LocationF PL 1230O O No [0 .. 1] [0 .. 1] No NULL
6396PV143.1 Point of CareC IS 20O O No [0 .. 1] [0 .. 1] No 0302 NULL
6397PV143.2 RoomC IS 20O O No [0 .. 1] [0 .. 1] No 0303 NULL
6398PV143.3 BedC IS 20O O No [0 .. 1] [0 .. 1] No 0304 NULL
6399PV143.4 FacilityC HD 227O O No [0 .. 1] [0 .. 1] No NULL
6400PV143.4.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 NULL If HD.2 (Universal ID) is not valued
6401PV143.4.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
6402PV143.4.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
6403PV143.5 Location StatusC IS 20O O No [0 .. 1] [0 .. 1] No 0306 NULL
6404PV143.6 Person Location TypeC IS 20C C No [0 .. 1] [0 .. 1] No 0305 NULL
6405PV143.7 BuildingC IS 20O O No [0 .. 1] [0 .. 1] No 0307 NULL
6406PV143.8 FloorC IS 20O O No [0 .. 1] [0 .. 1] No 0308 NULL
6407PV143.9 Location DescriptionC ST 199O O No [0 .. 1] [0 .. 1] No NULL
6408PV143.10 Comprehensive Location IdentifierC EI 427O O No [0 .. 1] [0 .. 1] No NULL
6409PV143.10.1 Entity IdentifierS ST 199RE RE No [0 .. 1] [0 .. 1] No NULL
6410PV143.10.2 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0363 NULL If EI.3 (Universal ID) is not valued
6411PV143.10.3 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If EI.2 (Namespace ID) is not valued
6412PV143.10.4 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If EI.3 (Universal ID) is valued
6413PV143.11 Assigning Authority for LocationC HD 227O O No [0 .. 1] [0 .. 1] No NULL
6414PV143.11.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 NULL If HD.2 (Universal ID) is not valued
6415PV143.11.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
6416PV143.11.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
6417PV144 Admit Date/TimeF TS 26O O No [0 .. 1] [0 .. 1] No NULL
6418PV144.1 TimeC DTM 24R R No [1 .. 1] [1 .. 1] No NULL
6419PV144.2 Degree of PrecisionC ID 0X X No [0 .. 0] [0 .. 0] No 0529 NULL
6420PV145 Discharge Date/TimeF TS 26O O No [0 .. 1] [0 .. 1] No NULL
6421PV145.1 TimeC DTM 24R R No [1 .. 1] [1 .. 1] No NULL
6422PV145.2 Degree of PrecisionC ID 0X X No [0 .. 0] [0 .. 0] No 0529 NULL
6423PV146 Current Patient BalanceF NM 12O O No [0 .. 1] [0 .. 1] No NULL
6424PV147 Total ChargesF NM 12O O No [0 .. 1] [0 .. 1] No NULL
6425PV148 Total AdjustmentsF NM 12O O No [0 .. 1] [0 .. 1] No NULL
6426PV149 Total PaymentsF NM 12O O No [0 .. 1] [0 .. 1] No NULL
6427PV150 Alternate Visit IDF CX 1913O O No [0 .. 1] [0 .. 1] No 0203 NULL
6428PV150.1 ID NumberC ST 15R R No [1 .. 1] [1 .. 1] No NULL
6429PV150.2 Check DigitC ST 1O O No [0 .. 1] [0 .. 1] No NULL
6430PV150.3 Check Digit SchemeC ID 3C(O/X) C(O/X) No [0 .. 1] [0 .. 1] No 0061 If CX.2 (check digit) is valued
6431PV150.4 Assigning AuthorityC HD 227R R No [1 .. 1] [1 .. 1] No 0363 NULL
6432PV150.4.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 NULL If HD.2 (Universal ID) is not valued
6433PV150.4.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
6434PV150.4.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
6435PV150.5 Identifier Type CodeC ID 5R R No [1 .. 1] [1 .. 1] No 0203 NULL
6436PV150.6 Assigning FacilityC HD 227O O No [0 .. 1] [0 .. 1] No NULL
6437PV150.6.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 NULL If HD.2 (Universal ID) is not valued
6438PV150.6.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No NULL If HD.1 (Namespace ID) is not valued
6439PV150.6.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 NULL If HD.2 (Universal ID) is valued
6440PV150.7 Effective DateC DT 8O O No [0 .. 1] [0 .. 1] No NULL
6441PV150.8 Expiration DateC DT 8O O No [0 .. 1] [0 .. 1] No NULL
6442PV150.9 Assigning JurisdictionC CWE 705O O No [0 .. 1] [0 .. 1] No NULL
6443PV150.9.1 IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
6444PV150.9.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
6445PV150.9.3 Name of Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.1 (Identifier) is valued
6446PV150.9.4 Alternate IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
6447PV150.9.5 Alternate TextS ST 199C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If CWE.4 (Alternate Identifier) is valued
6448PV150.9.6 Name of Alternate Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.4 (Alternate Identifier) is valued
6449PV150.9.7 Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
6450PV150.9.8 Alternate Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
6451PV150.9.9 Original TextS ST 199O O No [0 .. 1] [0 .. 1] No
6452PV150.10 Assigning Agency or DepartmentC CWE 705O O No [0 .. 1] [0 .. 1] No NULL
6453PV150.10.1 IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
6454PV150.10.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
6455PV150.10.3 Name of Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.1 (Identifier) is valued
6456PV150.10.4 Alternate IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
6457PV150.10.5 Alternate TextS ST 199C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If CWE.4 (Alternate Identifier) is valued
6458PV150.10.6 Name of Alternate Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.4 (Alternate Identifier) is valued
6459PV150.10.7 Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
6460PV150.10.8 Alternate Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
6461PV150.10.9 Original TextS ST 199O O No [0 .. 1] [0 .. 1] No
6462PV151 Visit IndicatorF IS 1O O No [0 .. 1] [0 .. 1] No 0326 NULL
6463PV152 Other Healthcare ProviderF XCN 2945O O No [0 .. 1] [0 .. 1] No 0010 NULL
7001PV21 Prior Pending LocationF PL 1230C C No [0 .. 1] [0 .. 1] No
7002PV21.1 Point of CareC IS 20O O No [0 .. 1] [0 .. 1] No 0302
7003PV21.2 RoomC IS 20O O No [0 .. 1] [0 .. 1] No 0303
7004PV21.3 BedC IS 20O O No [0 .. 1] [0 .. 1] No 0304
7005PV21.4 FacilityC HD 227O O No [0 .. 1] [0 .. 1] No
7006PV21.4.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 If HD.2 (Universal ID) is not valued
7007PV21.4.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No If HD.1 (Namespace ID) is not valued
7008PV21.4.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 If HD.2 (Universal ID) is valued
7009PV21.5 Location StatusC IS 20O O No [0 .. 1] [0 .. 1] No 0306
7010PV21.6 Person Location TypeC IS 20C C No [0 .. 1] [0 .. 1] No 0305
7011PV21.7 BuildingC IS 20O O No [0 .. 1] [0 .. 1] No 0307
7012PV21.8 FloorC IS 20O O No [0 .. 1] [0 .. 1] No 0308
7013PV21.9 Location DescriptionC ST 199O O No [0 .. 1] [0 .. 1] No
7014PV21.10 Comprehensive Location IdentifierC EI 427O O No [0 .. 1] [0 .. 1] No
7015PV21.10.1 Entity IdentifierS ST 199RE RE No [0 .. 1] [0 .. 1] No
7016PV21.10.2 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0363 If EI.3 (Universal ID) is not valued
7017PV21.10.3 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No If EI.2 (Namespace ID) is not valued
7018PV21.10.4 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 If EI.3 (Universal ID) is valued
7019PV21.11 Assigning Authority for LocationC HD 227O O No [0 .. 1] [0 .. 1] No
7020PV21.11.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 If HD.2 (Universal ID) is not valued
7021PV21.11.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No If HD.1 (Namespace ID) is not valued
7022PV21.11.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 If HD.2 (Universal ID) is valued
7023PV22 Accommodation CodeF CE 483O O No [0 .. 1] [0 .. 1] No 0129
7024PV22.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
7025PV22.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
7026PV22.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
7027PV22.4 Alternate IdentifierC ST 20O O No [0 .. 1] [0 .. 1] No
7028PV22.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
7029PV22.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
7030PV23 Admit ReasonF CE 483O O No [0 .. 1] [0 .. 1] No
7031PV23.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
7032PV23.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
7033PV23.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
7034PV23.4 Alternate IdentifierC ST 20O O No [0 .. 1] [0 .. 1] No
7035PV23.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
7036PV23.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
7037PV24 Transfer ReasonF CE 483O O No [0 .. 1] [0 .. 1] No
7038PV24.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
7039PV24.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
7040PV24.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
7041PV24.4 Alternate IdentifierC ST 20O O No [0 .. 1] [0 .. 1] No
7042PV24.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
7043PV24.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
7044PV25 Patient ValuablesF ST 25O O No [0 .. *] [0 .. *] No
7045PV26 Patient Valuables LocationF ST 25O O No [0 .. 1] [0 .. 1] No
7046PV27 Visit User CodeF IS 2O O No [0 .. *] [0 .. *] No 0130
7047PV28 Expected Admit Date/TimeF TS 26O O No [0 .. 1] [0 .. 1] No
7048PV28.1 TimeC DTM 24R R No [1 .. 1] [1 .. 1] No
7049PV28.2 Degree of PrecisionC ID 0X X No [0 .. 0] [0 .. 0] No 0529
7050PV29 Expected Discharge Date/TimeF TS 26O O No [0 .. 1] [0 .. 1] No
7051PV29.1 TimeC DTM 24R R No [1 .. 1] [1 .. 1] No
7052PV29.2 Degree of PrecisionC ID 0X X No [0 .. 0] [0 .. 0] No 0529
7053PV210 Estimated Length of Inpatient StayF NM 3O O No [0 .. 1] [0 .. 1] No
7054PV211 Actual Length of Inpatient StayF NM 3O O No [0 .. 1] [0 .. 1] No
7055PV212 Visit DescriptionF ST 50O O No [0 .. 1] [0 .. 1] No
7056PV213 Referral Source CodeF XCN 2945O O No [0 .. *] [0 .. *] No
7057PV213.1 ID NumberC ST 15C(R/RE) C(R/RE) No [0 .. 1] [0 .. 1] No NULL If XCN.2.1 (Surname) and XCN.3 (Given Name are not valued
7058PV213.2 Family NameC FN 194RE RE No [0 .. 1] [0 .. 1] No
7059PV213.2.1 SurnameS ST 50R R No [1 .. 1] [1 .. 1] No
7060PV213.2.2 Own Surname PrefixS ST 20O O No [0 .. 1] [0 .. 1] No
7061PV213.2.3 Own SurnameS ST 50O O No [0 .. 1] [0 .. 1] No
7062PV213.2.4 Surname Prefix From Partner/SpouseS ST 20O O No [0 .. 1] [0 .. 1] No
7063PV213.2.5 Surname From Partner/SpouseS ST 50O O No [0 .. 1] [0 .. 1] No
7064PV213.3 Given NameC ST 30RE RE No [0 .. 1] [0 .. 1] No
7065PV213.4 Second and Further Given Names or Initials ThereofC ST 30RE RE No [0 .. 1] [0 .. 1] No
7066PV213.5 Suffix (e.g., JR or III)C ST 20O O No [0 .. 1] [0 .. 1] No
7067PV213.6 Prefix (e.g., DR)C ST 20O O No [0 .. 1] [0 .. 1] No
7068PV213.7 Degree (e.g., MD)C IS 0X X No [0 .. 0] [0 .. 0] No 0360
7069PV213.8 Source TableC IS 4O O No [0 .. 1] [0 .. 1] No 0297
7070PV213.9 Assigning AuthorityC HD 227C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0363 NULL If XCN.1 (ID Number) is valued
7071PV213.9.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 If HD.2 (Universal ID) is not valued
7072PV213.9.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No If HD.1 (Namespace ID) is not valued
7073PV213.9.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 If HD.2 (Universal ID) is valued
7074PV213.10 Name Type CodeC ID 1RE RE No [0 .. 1] [0 .. 1] No 0200 NULL
7075PV213.11 Identifier Check DigitC ST 1O O No [0 .. 1] [0 .. 1] No NULL
7076PV213.12 Check Digit SchemeC ID 3C(O/X) C(O/X) No [0 .. 1] [0 .. 1] No 0061 NULL If XCN.11 (check digit identifier) is valued
7077PV213.13 Identifier Type CodeC ID 5O O No [0 .. 1] [0 .. 1] No 0203
7078PV213.14 Assigning FacilityC HD 227O O No [0 .. 1] [0 .. 1] No
7079PV213.14.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 If HD.2 (Universal ID) is not valued
7080PV213.14.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No If HD.1 (Namespace ID) is not valued
7081PV213.14.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 If HD.2 (Universal ID) is valued
7082PV213.15 Name Representation CodeC ID 1O O No [0 .. 1] [0 .. 1] No 0465
7083PV213.16 Name ContextC CE 483O O No [0 .. 1] [0 .. 1] No 0448
7084PV213.16.1 IdentifierS ST 20R R No [0 .. 1] [0 .. 1] No
7085PV213.16.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
7086PV213.16.3 Name of Coding SystemS ID 20R R No [0 .. 1] [0 .. 1] No 0396
7087PV213.16.4 Alternate IdentifierS ST 20O O No [0 .. 1] [0 .. 1] No
7088PV213.16.5 Alternate TextS ST 199O O No [0 .. 1] [0 .. 1] No
7089PV213.16.6 Name of Alternate Coding SystemS ID 20O O No [0 .. 1] [0 .. 1] No 0396
7090PV213.17 Name Validity RangeC DR 0X X No [0 .. 0] [0 .. 0] No
7091PV213.18 Name Assembly OrderC ID 1X X No [0 .. 0] [0 .. 0] No 0444
7092PV213.19 Effective DateC TS 26O O No [0 .. 1] [0 .. 1] No
7093PV213.19.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No
7094PV213.19.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529
7095PV213.20 Expiration DateC TS 26O O No [0 .. 1] [0 .. 1] No
7096PV213.20.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No
7097PV213.20.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529
7098PV213.21 Professional SuffixC ST 199O O No [0 .. 1] [0 .. 1] No
7099PV213.22 Assigning JurisdictionC CWE 705O O No [0 .. 1] [0 .. 1] No
7100PV213.22.1 IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
7101PV213.22.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
7102PV213.22.3 Name of Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.1 (Identifier) is valued
7103PV213.22.4 Alternate IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
7104PV213.22.5 Alternate TextS ST 199C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If CWE.4 (Alternate Identifier) is valued
7105PV213.22.6 Name of Alternate Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.4 (Alternate Identifier) is valued
7106PV213.22.7 Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
7107PV213.22.8 Alternate Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
7108PV213.22.9 Original TextS ST 199O O No [0 .. 1] [0 .. 1] No
7109PV213.23 Assigning Agency or DepartmentC CWE 705O O No [0 .. 1] [0 .. 1] No
7110PV213.23.1 IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
7111PV213.23.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
7112PV213.23.3 Name of Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.1 (Identifier) is valued
7113PV213.23.4 Alternate IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
7114PV213.23.5 Alternate TextS ST 199C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If CWE.4 (Alternate Identifier) is valued
7115PV213.23.6 Name of Alternate Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.4 (Alternate Identifier) is valued
7116PV213.23.7 Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
7117PV213.23.8 Alternate Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
7118PV213.23.9 Original TextS ST 199O O No [0 .. 1] [0 .. 1] No
7119PV214 Previous Service DateF DT 8O O No [0 .. 1] [0 .. 1] No
7120PV215 Employment Illness Related IndicatorF ID 1O O No [0 .. 1] [0 .. 1] No 0136
7121PV216 Purge Status CodeF IS 1O O No [0 .. 1] [0 .. 1] No 0213
7122PV217 Purge Status DateF DT 8O O No [0 .. 1] [0 .. 1] No
7123PV218 Special Program CodeF IS 2O O No [0 .. 1] [0 .. 1] No 0214
7124PV219 Retention IndicatorF ID 1O O No [0 .. 1] [0 .. 1] No 0136
7125PV220 Expected Number of Insurance PlansF NM 1O O No [0 .. 1] [0 .. 1] No
7126PV221 Visit Publicity CodeF IS 1O O No [0 .. 1] [0 .. 1] No 0215
7127PV222 Visit Protection IndicatorF ID 1O O No [0 .. 1] [0 .. 1] No 0136
7128PV223 Clinic Organization NameF XON 563O O No [0 .. *] [0 .. *] No
7129PV223.1 Organization NameC ST 50RE RE No [0 .. 1] [0 .. 1] No
7130PV223.2 Organization Name Type CodeC IS 20O O No [0 .. 1] [0 .. 1] No 0204
7131PV223.3 ID NumberC NM 0X X No [0 .. 0] [0 .. 0] No
7132PV223.4 Check DigitC NM 1O O No [0 .. 1] [0 .. 1] No
7133PV223.5 Check Digit SchemeC ID 3O O No [0 .. 1] [0 .. 1] No 0061
7134PV223.6 Assigning AuthorityC HD 227C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0363 If XON.10 (Organization Identifier) is valued
7135PV223.6.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 If HD.2 (Universal ID) is not valued
7136PV223.6.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No If HD.1 (Namespace ID) is not valued
7137PV223.6.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 If HD.2 (Universal ID) is valued
7138PV223.7 Identifier Type CodeC ID 5C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0203 If XON.10 (Organization Identifier) is valued
7139PV223.8 Assigning FacilityC HD 227O O No [0 .. 1] [0 .. 1] No
7140PV223.8.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 If HD.2 (Universal ID) is not valued
7141PV223.8.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No If HD.1 (Namespace ID) is not valued
7142PV223.8.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 If HD.2 (Universal ID) is valued
7143PV223.9 Name Representation CodeC ID 1O O No [0 .. 1] [0 .. 1] No 0465
7144PV223.10 Organization IdentifierC ST 20C(R/RE) C(R/RE) No [0 .. 1] [0 .. 1] No If XON.1 (Organization Name) is not valued
7145PV224 Patient Status CodeF IS 2O O No [0 .. 1] [0 .. 1] No 0216
7146PV225 Visit Priority CodeF IS 1O O No [0 .. 1] [0 .. 1] No 0217
7147PV226 Previous Treatment DateF DT 8O O No [0 .. 1] [0 .. 1] No
7148PV227 Expected Discharge DispositionF IS 2O O No [0 .. 1] [0 .. 1] No 0112
7149PV228 Signature on File DateF DT 8O O No [0 .. 1] [0 .. 1] No
7150PV229 First Similar Illness DateF DT 8O O No [0 .. 1] [0 .. 1] No
7151PV230 Patient Charge Adjustment CodeF CE 483O O No [0 .. 1] [0 .. 1] No 0218
7152PV230.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
7153PV230.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
7154PV230.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
7155PV230.4 Alternate IdentifierC ST 20O O No [0 .. 1] [0 .. 1] No
7156PV230.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
7157PV230.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
7158PV231 Recurring Service CodeF IS 2O O No [0 .. 1] [0 .. 1] No 0219
7159PV232 Billing Media CodeF ID 1O O No [0 .. 1] [0 .. 1] No 0136
7160PV233 Expected Surgery Date and TimeF TS 26O O No [0 .. 1] [0 .. 1] No
7161PV233.1 TimeC DTM 24R R No [1 .. 1] [1 .. 1] No
7162PV233.2 Degree of PrecisionC ID 0X X No [0 .. 0] [0 .. 0] No 0529
7163PV234 Military Partnership CodeF ID 1O O No [0 .. 1] [0 .. 1] No 0136
7164PV235 Military Non-Availability CodeF ID 1O O No [0 .. 1] [0 .. 1] No 0136
7165PV236 Newborn Baby IndicatorF ID 1O O No [0 .. 1] [0 .. 1] No 0136
7166PV237 Baby Detained IndicatorF ID 1O O No [0 .. 1] [0 .. 1] No 0136
7167PV238 Mode of Arrival CodeF CE 483O O No [0 .. 1] [0 .. 1] No 0430
7168PV238.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
7169PV238.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
7170PV238.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
7171PV238.4 Alternate IdentifierC ST 20O O No [0 .. 1] [0 .. 1] No
7172PV238.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
7173PV238.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
7174PV239 Recreational Drug Use CodeF CE 483O O No [0 .. *] [0 .. *] No 0431
7175PV239.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
7176PV239.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
7177PV239.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
7178PV239.4 Alternate IdentifierC ST 20O O No [0 .. 1] [0 .. 1] No
7179PV239.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
7180PV239.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
7181PV240 Admission Level of Care CodeF CE 483O O No [0 .. 1] [0 .. 1] No 0432
7182PV240.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
7183PV240.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
7184PV240.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
7185PV240.4 Alternate IdentifierC ST 20O O No [0 .. 1] [0 .. 1] No
7186PV240.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
7187PV240.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
7188PV241 Precaution CodeF CE 483O O No [0 .. *] [0 .. *] No 0433
7189PV241.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
7190PV241.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
7191PV241.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
7192PV241.4 Alternate IdentifierC ST 20O O No [0 .. 1] [0 .. 1] No
7193PV241.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
7194PV241.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
7195PV242 Patient Condition CodeF CE 483O O No [0 .. 1] [0 .. 1] No 0434
7196PV242.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
7197PV242.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
7198PV242.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
7199PV242.4 Alternate IdentifierC ST 20O O No [0 .. 1] [0 .. 1] No
7200PV242.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
7201PV242.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
7202PV243 Living Will CodeF IS 2O O No [0 .. 1] [0 .. 1] No 0315
7203PV244 Organ Donor CodeF IS 2O O No [0 .. 1] [0 .. 1] No 0316
7204PV245 Advance Directive CodeF CE 483O O No [0 .. *] [0 .. *] No 0435
7205PV245.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
7206PV245.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
7207PV245.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
7208PV245.4 Alternate IdentifierC ST 20O O No [0 .. 1] [0 .. 1] No
7209PV245.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
7210PV245.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
7211PV246 Patient Status Effective DateF DT 8O O No [0 .. 1] [0 .. 1] No
7212PV247 Expected LOA Return Date/TimeF TS 26C C No [0 .. 1] [0 .. 1] No
7213PV247.1 TimeC DTM 24R R No [1 .. 1] [1 .. 1] No
7214PV247.2 Degree of PrecisionC ID 0X X No [0 .. 0] [0 .. 0] No 0529
7215PV248 Expected Pre-admission Testing Date/TimeF TS 26O O No [0 .. 1] [0 .. 1] No
7216PV248.1 TimeC DTM 24R R No [1 .. 1] [1 .. 1] No
7217PV248.2 Degree of PrecisionC ID 0X X No [0 .. 0] [0 .. 0] No 0529
7218PV249 Notify Clergy CodeF IS 20O O No [0 .. *] [0 .. *] No 0534
8001GT11 Set ID - GT1F SI 4R R No [1 .. 1] [1 .. 1] No
8002GT12 Guarantor NumberF CX 1913O O No [0 .. *] [0 .. *] No
8003GT11.1 ID NumberC ST 15R R No [1 .. 1] [1 .. 1] No
8004GT11.2 Check DigitC ST 1O O No [0 .. 1] [0 .. 1] No
8005GT11.3 Check Digit SchemeC ID 3C(O/X) C(O/X) No [0 .. 1] [0 .. 1] No 0061 If CX.2 (check digit) is valued
8006GT11.4 Assigning Agency or DepartmentC HD 227R R No [1 .. 1] [1 .. 1] No 0363
8007GT11.4.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 If HD.2 (Universal ID) is not valued
8008GT11.4.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No If HD.1 (Namespace ID) is not valued
8009GT11.4.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 If HD.2 (Universal ID) is valued
8010GT11.5 Identifier Type CodeC ID 5R R No [1 .. 1] [1 .. 1] No 0203
8011GT11.6 Assigning FacilityC HD 227O O No [0 .. 1] [0 .. 1] No
8012GT11.6.1 Namespace IDS IS 20C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No 0300 If HD.2 (Universal ID) is not valued
8013GT11.6.2 Universal IDS ST 199C(R/O) C(R/O) No [0 .. 1] [0 .. 1] No If HD.1 (Namespace ID) is not valued
8014GT11.6.3 Universal ID TypeS ID 6C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0301 If HD.2 (Universal ID) is valued
8015GT11.7 Effective DateC DT 8O O No [0 .. 1] [0 .. 1] No
8016GT11.8 Expiration DateC DT 8O O No [0 .. 1] [0 .. 1] No
8017GT11.9 Assigning JurisdictionC CWE 705O O No [0 .. 1] [0 .. 1] No
8018GT11.9.1 IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
8019GT11.9.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
8020GT11.9.3 Name of Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.1 (Identifier) is valued
8021GT11.9.4 Alternate IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
8022GT11.9.5 Alternate TextS ST 199C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If CWE.4 (Alternate Identifier) is valued
8023GT11.9.6 Name of Alternate Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.4 (Alternate Identifier) is valued
8024GT11.9.7 Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
8025GT11.9.8 Alternate Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
8026GT11.9.9 Original TextS ST 199O O No [0 .. 1] [0 .. 1] No
8027GT11.10 Assigning Agency or DepartmentC CWE 705O O No [0 .. 1] [0 .. 1] No
8028GT11.10.1 IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
8029GT11.10.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
8030GT11.10.3 Name of Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.1 (Identifier) is valued
8031GT11.10.4 Alternate IdentifierS ST 20RE RE No [0 .. 1] [0 .. 1] No
8032GT11.10.5 Alternate TextS ST 199C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If CWE.4 (Alternate Identifier) is valued
8033GT11.10.6 Name of Alternate Coding SystemS ID 20C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No 0396 If CWE.4 (Alternate Identifier) is valued
8034GT11.10.7 Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
8035GT11.10.8 Alternate Coding System Version IDS ST 10O O No [0 .. 1] [0 .. 1] No
8036GT11.10.9 Original TextS ST 199O O No [0 .. 1] [0 .. 1] No
8037GT13 Guarantor NameF XPN 1044R R No [1 .. *] [1 .. *] No
8038GT13.1 Family NameC FN 194R R No [1 .. 1] [1 .. 1] No
8039GT13.1.1 SurnameS ST 50R R No [1 .. 1] [1 .. 1] No
8040GT13.1.2 Own Surname PrefixS ST 20O O No [0 .. 1] [0 .. 1] No
8041GT13.1.3 Own SurnameS ST 50O O No [0 .. 1] [0 .. 1] No
8042GT13.1.4 Surname Prefix From Partner/SpouseS ST 20O O No [0 .. 1] [0 .. 1] No
8043GT13.1.5 Surname From Partner/SpouseS ST 50O O No [0 .. 1] [0 .. 1] No
8044GT13.2 Given NameC ST 30R R No [1 .. 1] [1 .. 1] No
8045GT13.3 Second and Further Given Names or Initials ThereofC ST 30RE RE No [0 .. 1] [0 .. 1] No
8046GT13.4 Suffix (e.g., JR or III)C ST 20O O No [0 .. 1] [0 .. 1] No
8047GT13.5 Prefix (e.g., DR)C ST 20O O No [0 .. 1] [0 .. 1] No
8048GT13.6 Degree (e.g., MD)C IS 0X X No [0 .. 0] [0 .. 0] No 0360
8049GT13.7 Name Type CodeC ID 1RE RE No [0 .. 1] [0 .. 1] No 0200
8050GT13.8 Name Representation CodeC ID 1O O No [0 .. 1] [0 .. 1] No 0465
8051GT13.9 Name ContextC CE 483O O No [0 .. 1] [0 .. 1] No 0448
8052GT13.9.1 IdentifierS ST 20R R No [0 .. 1] [0 .. 1] No
8053GT13.9.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
8054GT13.9.3 Name of Coding SystemS ID 20R R No [0 .. 1] [0 .. 1] No 0396
8055GT13.9.4 Alternate IdentifierS ST 20O O No [0 .. 1] [0 .. 1] No
8056GT13.9.5 Alternate TextS ST 199O O No [0 .. 1] [0 .. 1] No
8057GT13.9.6 Name of Alternate Coding SystemS ID 20O O No [0 .. 1] [0 .. 1] No 0396
8058GT13.10 Name Validity RangeC DR 0X X No [0 .. 0] [0 .. 0] No
8059GT13.11 Name Assembly OrderC ID 1O O No [0 .. 1] [0 .. 1] No 0444
8060GT13.12 Effective DateC TS 26O O No [0 .. 1] [0 .. 1] No
8061GT13.12.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No
8062GT13.12.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529
8063GT13.13 Expiration DateC TS 26O O No [0 .. 1] [0 .. 1] No
8064GT13.13.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No
8065GT13.13.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529
8066GT13.14 Professional SuffixC ST 199O O No [0 .. 1] [0 .. 1] No
8067GT14 Guarantor Spouse NameF XPN 1044O O No [0 .. *] [0 .. *] No
8068GT14.1 Family NameC FN 194R R No [1 .. 1] [1 .. 1] No
8069GT14.1.1 SurnameS ST 50R R No [1 .. 1] [1 .. 1] No
8070GT14.1.2 Own Surname PrefixS ST 20O O No [0 .. 1] [0 .. 1] No
8071GT14.1.3 Own SurnameS ST 50O O No [0 .. 1] [0 .. 1] No
8072GT14.1.4 Surname Prefix From Partner/SpouseS ST 20O O No [0 .. 1] [0 .. 1] No
8073GT14.1.5 Surname From Partner/SpouseS ST 50O O No [0 .. 1] [0 .. 1] No
8074GT14.2 Given NameC ST 30R R No [1 .. 1] [1 .. 1] No
8075GT14.3 Second and Further Given Names or Initials ThereofC ST 30RE RE No [0 .. 1] [0 .. 1] No
8076GT14.4 Suffix (e.g., JR or III)C ST 20O O No [0 .. 1] [0 .. 1] No
8077GT14.5 Prefix (e.g., DR)C ST 20O O No [0 .. 1] [0 .. 1] No
8078GT14.6 Degree (e.g., MD)C IS 0X X No [0 .. 0] [0 .. 0] No 0360
8079GT14.7 Name Type CodeC ID 1RE RE No [0 .. 1] [0 .. 1] No 0200
8080GT14.8 Name Representation CodeC ID 1O O No [0 .. 1] [0 .. 1] No 0465
8081GT14.9 Name ContextC CE 483O O No [0 .. 1] [0 .. 1] No 0448
8082GT14.9.1 IdentifierS ST 20R R No [0 .. 1] [0 .. 1] No
8083GT14.9.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
8084GT14.9.3 Name of Coding SystemS ID 20R R No [0 .. 1] [0 .. 1] No 0396
8085GT14.9.4 Alternate IdentifierS ST 20O O No [0 .. 1] [0 .. 1] No
8086GT14.9.5 Alternate TextS ST 199O O No [0 .. 1] [0 .. 1] No
8087GT14.9.6 Name of Alternate Coding SystemS ID 20O O No [0 .. 1] [0 .. 1] No 0396
8088GT14.10 Name Validity RangeC DR 0X X No [0 .. 0] [0 .. 0] No
8089GT14.11 Name Assembly OrderC ID 1O O No [0 .. 1] [0 .. 1] No 0444
8090GT14.12 Effective DateC TS 26O O No [0 .. 1] [0 .. 1] No
8091GT14.12.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No
8092GT14.12.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529
8093GT14.13 Expiration DateC TS 26O O No [0 .. 1] [0 .. 1] No
8094GT14.13.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No
8095GT14.13.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529
8096GT14.14 Professional SuffixC ST 199O O No [0 .. 1] [0 .. 1] No
8097GT15 Guarantor AddressF XAD 578O O No [0 .. *] [0 .. *] No
8098GT15.1 Street AddressC SAD 184RE RE No [0 .. 1] [0 .. 1] No
8099GT15.1.1 Street or Mailing AddressS ST 120R R No [1 .. 1] [1 .. 1] No
8100GT15.1.2 Street NameS ST 50O O No [0 .. 1] [0 .. 1] No
8101GT15.1.3 Dwelling NumberS ST 12O O No [0 .. 1] [0 .. 1] No
8102GT15.2 Other DesignationC ST 120RE RE No [0 .. 1] [0 .. 1] No
8103GT15.3 CityC ST 50RE RE No [0 .. 1] [0 .. 1] No
8104GT15.4 State or ProvinceC ST 50RE RE No [0 .. 1] [0 .. 1] No
8105GT15.5 Zip or Postal CodeC ST 12RE RE No [0 .. 1] [0 .. 1] No
8106GT15.6 CountryC ID 3RE RE No [0 .. 1] [0 .. 1] No 0399
8107GT15.7 Address TypeC ID 3R R No [1 .. 1] [1 .. 1] No 0190
8108GT15.8 Other Geographic DesignationC ST 50O O No [0 .. 1] [0 .. 1] No
8109GT15.9 County/Parish CodeC IS 20O O No [0 .. 1] [0 .. 1] No 0289
8110GT15.10 Census TractC IS 20O O No [0 .. 1] [0 .. 1] No 0288
8111GT15.11 Address Representation CodeC ID 1O O No [0 .. 1] [0 .. 1] No 0465
8112GT15.12 Address Validity RangeC DR 0X X No [0 .. 0] [0 .. 0] No
8113GT15.13 Effective DateC TS 26O O No [0 .. 1] [0 .. 1] No
8114GT15.13.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No
8115GT15.13.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529
8116GT15.14 Expiration DateC TS 26O O No [0 .. 1] [0 .. 1] No
8117GT15.14.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No
8118GT15.14.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529
8119GT16 Guarantor Ph Num - HomeF XTN 651O O No [0 .. *] [0 .. *] No
8120GT16.1 Telephone NumberC ST 0X X No [0 .. 0] [0 .. 0] No
8121GT16.2 Telecommunication Use CodeC ID 3R R No [1 .. 1] [1 .. 1] No 0201
8122GT16.3 Telecommunication Equipment TypeC ID 8RE RE No [0 .. 1] [0 .. 1] No 0202
8123GT16.4 Email AddressC ST 199C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No If XTN.2 (telecommunication use code) is valued "NET"
8124GT16.5 Country CodeC NM 3O O No [0 .. 1] [0 .. 1] No
8125GT16.6 Area/City CodeC NM 5C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If XTN.2 (telecommunication use code) is not valued "NET"
8126GT16.7 Local NumberC NM 9C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No If XTN.2 (telecommunication use code) is not valued "NET"
8127GT16.8 ExtensionC NM 5O O No [0 .. 1] [0 .. 1] No
8128GT16.9 Any TextC ST 199O O No [0 .. 1] [0 .. 1] No
8129GT16.10 Extension PrefixC ST 4O O No [0 .. 1] [0 .. 1] No
8130GT16.11 Speed Dial CodeC ST 6O O No [0 .. 1] [0 .. 1] No
8131GT16.12 Unformatted Telephone numberC ST 199O O No [0 .. 1] [0 .. 1] No
8132GT17 Guarantor Ph Num - BusinessF XTN 651O O No [0 .. *] [0 .. *] No
8133GT17.1 Telephone NumberC ST 0X X No [0 .. 0] [0 .. 0] No
8134GT17.2 Telecommunication Use CodeC ID 3R R No [1 .. 1] [1 .. 1] No 0201
8135GT17.3 Telecommunication Equipment TypeC ID 8RE RE No [0 .. 1] [0 .. 1] No 0202
8136GT17.4 Email AddressC ST 199C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No If XTN.2 (telecommunication use code) is valued "NET"
8137GT17.5 Country CodeC NM 3O O No [0 .. 1] [0 .. 1] No
8138GT17.6 Area/City CodeC NM 5C(RE/X) C(RE/X) No [0 .. 1] [0 .. 1] No If XTN.2 (telecommunication use code) is not valued "NET"
8139GT17.7 Local NumberC NM 9C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No If XTN.2 (telecommunication use code) is not valued "NET"
8140GT17.8 ExtensionC NM 5O O No [0 .. 1] [0 .. 1] No
8141GT17.9 Any TextC ST 199O O No [0 .. 1] [0 .. 1] No
8142GT17.10 Extension PrefixC ST 4O O No [0 .. 1] [0 .. 1] No
8143GT17.11 Speed Dial CodeC ST 6O O No [0 .. 1] [0 .. 1] No
8144GT17.12 Unformatted Telephone numberC ST 199O O No [0 .. 1] [0 .. 1] No
8145GT18 Guarantor Date/Time Of BirthF TS 26O O No [0 .. 1] [0 .. 1] No
8146GT18.1 TimeC DTM 24R R No [1 .. 1] [1 .. 1] No
8147GT18.2 Degree of PrecisionC ID 0X X No [0 .. 0] [0 .. 0] No 0529
8148GT19 Guarantor Administrative SexF IS 1O O No [0 .. 1] [0 .. 1] No 0001
8149GT110 Guarantor TypeF IS 2O O No [0 .. 1] [0 .. 1] No 0068
8150GT111 Guarantor RelationshipF CE 483O O No [0 .. 1] [0 .. 1] No 0063
8151GT111.1 IdentifierC ST 20R R No [0 .. 1] [0 .. 1] No
8152GT111.2 TextC ST 199RE RE No [0 .. 1] [0 .. 1] No
8153GT111.3 Name of Coding SystemC ID 20R R No [0 .. 1] [0 .. 1] No 0396
8154GT111.4 Alternate IdentifierC ST 20O O No [0 .. 1] [0 .. 1] No
8155GT111.5 Alternate TextC ST 199O O No [0 .. 1] [0 .. 1] No
8156GT111.6 Name of Alternate Coding SystemC ID 20O O No [0 .. 1] [0 .. 1] No 0396
8157GT112 Guarantor SSNF ST 11O O No [0 .. 1] [0 .. 1] No
8158GT113 Guarantor Date - BeginF DT 8O O No [0 .. 1] [0 .. 1] No
8159GT114 Guarantor Date - EndF DT 8O O No [0 .. 1] [0 .. 1] No
8160GT115 Guarantor PriorityF NM 2O O No [0 .. 1] [0 .. 1] No
8161GT116 Guarantor Employer NameF XPN 1044O O No [0 .. *] [0 .. *] No
8162GT116.1 Family NameC FN 194R R No [1 .. 1] [1 .. 1] No
8163GT116.1.1 SurnameS ST 50R R No [1 .. 1] [1 .. 1] No
8164GT116.1.2 Own Surname PrefixS ST 20O O No [0 .. 1] [0 .. 1] No
8165GT116.1.3 Own SurnameS ST 50O O No [0 .. 1] [0 .. 1] No
8166GT116.1.4 Surname Prefix From Partner/SpouseS ST 20O O No [0 .. 1] [0 .. 1] No
8167GT116.1.5 Surname From Partner/SpouseS ST 50O O No [0 .. 1] [0 .. 1] No
8168GT116.2 Given NameC ST 30R R No [1 .. 1] [1 .. 1] No
8169GT116.3 Second and Further Given Names or Initials ThereofC ST 30RE RE No [0 .. 1] [0 .. 1] No
8170GT116.4 Suffix (e.g., JR or III)C ST 20O O No [0 .. 1] [0 .. 1] No
8171GT116.5 Prefix (e.g., DR)C ST 20O O No [0 .. 1] [0 .. 1] No
8172GT116.6 Degree (e.g., MD)C IS 0X X No [0 .. 0] [0 .. 0] No 0360
8173GT116.7 Name Type CodeC ID 1RE RE No [0 .. 1] [0 .. 1] No 0200
8174GT116.8 Name Representation CodeC ID 1O O No [0 .. 1] [0 .. 1] No 0465
8175GT116.9 Name ContextC CE 483O O No [0 .. 1] [0 .. 1] No 0448
8176GT116.9.1 IdentifierS ST 20R R No [0 .. 1] [0 .. 1] No
8177GT116.9.2 TextS ST 199RE RE No [0 .. 1] [0 .. 1] No
8178GT116.9.3 Name of Coding SystemS ID 20R R No [0 .. 1] [0 .. 1] No 0396
8179GT116.9.4 Alternate IdentifierS ST 20O O No [0 .. 1] [0 .. 1] No
8180GT116.9.5 Alternate TextS ST 199O O No [0 .. 1] [0 .. 1] No
8181GT116.9.6 Name of Alternate Coding SystemS ID 20O O No [0 .. 1] [0 .. 1] No 0396
8182GT116.10 Name Validity RangeC DR 0X X No [0 .. 0] [0 .. 0] No
8183GT116.11 Name Assembly OrderC ID 1O O No [0 .. 1] [0 .. 1] No 0444
8184GT116.12 Effective DateC TS 26O O No [0 .. 1] [0 .. 1] No
8185GT116.12.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No
8186GT116.12.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529
8187GT116.13 Expiration DateC TS 26O O No [0 .. 1] [0 .. 1] No
8188GT116.13.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No
8189GT116.13.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529
8190GT116.14 Professional SuffixC ST 199O O No [0 .. 1] [0 .. 1] No
8191GT117 Guarantor Employer AddressF XAD 578O O No [0 .. *] [0 .. *] No
8192GT117.1 Street AddressC SAD 184RE RE No [0 .. 1] [0 .. 1] No
8193GT117.1.1 Street or Mailing AddressS ST 120R R No [1 .. 1] [1 .. 1] No
8194GT117.1.2 Street NameS ST 50O O No [0 .. 1] [0 .. 1] No
8195GT117.1.3 Dwelling NumberS ST 12O O No [0 .. 1] [0 .. 1] No
8196GT117.2 Other DesignationC ST 120RE RE No [0 .. 1] [0 .. 1] No
8197GT117.3 CityC ST 50RE RE No [0 .. 1] [0 .. 1] No
8198GT117.4 State or ProvinceC ST 50RE RE No [0 .. 1] [0 .. 1] No
8199GT117.5 Zip or Postal CodeC ST 12RE RE No [0 .. 1] [0 .. 1] No
8200GT117.6 CountryC ID 3RE RE No [0 .. 1] [0 .. 1] No 0399
8201GT117.7 Address TypeC ID 3R R No [1 .. 1] [1 .. 1] No 0190
8202GT117.8 Other Geographic DesignationC ST 50O O No [0 .. 1] [0 .. 1] No
8203GT117.9 County/Parish CodeC IS 20O O No [0 .. 1] [0 .. 1] No 0289
8204GT117.10 Census TractC IS 20O O No [0 .. 1] [0 .. 1] No 0288
8205GT117.11 Address Representation CodeC ID 1O O No [0 .. 1] [0 .. 1] No 0465
8206GT117.12 Address Validity RangeC DR 0X X No [0 .. 0] [0 .. 0] No
8207GT117.13 Effective DateC TS 26O O No [0 .. 1] [0 .. 1] No
8208GT117.13.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No
8209GT117.13.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529
8210GT117.14 Expiration DateC TS 26O O No [0 .. 1] [0 .. 1] No
8211GT117.14.1 TimeS DTM 24R R No [1 .. 1] [1 .. 1] No
8212GT117.14.2 Degree of PrecisionS ID 0X X No [0 .. 0] [0 .. 0] No 0529
8213GT118 Guarantor Employer Phone NumberF XTN 651O O No [0 .. *] [0 .. *] No
8214GT118.1 Telephone NumberC ST 0X X No [0 .. 0] [0 .. 0] No
8215GT118.2 Telecommunication Use CodeC ID 3R R No [1 .. 1] [1 .. 1] No 0201
8216GT118.3 Telecommunication Equipment TypeC ID 8RE RE No [0 .. 1] [0 .. 1] No 0202
8217GT118.4 Email AddressC ST 199C(R/X) C(R/X) No [0 .. 1] [0 .. 1] No If XTN.2 (telecommunication use code) is valued "NET"
8218GT118.5 Country CodeC NM 3O O No [0 .. 1] [0 .. 1] No
8219GT118.6 Area/City CodeC NM 5C(RE