{"aaData": [["ACKNOWLEDGEMENT CODE", "0008\n", "", "", "00002\n", "", "", "", "MSA\n", "", "1\n", "\n- \n\n
\n", "2\n", "ID\n", "REQUIRED\n", ""], ["DATE/TIME OF MESSAGE", "", "", "", "00010\n", "", "", "", "MSH\n", "", "7\n", "\n- \n\n
\n", "19\n", "TS\n", "NOT REQUIRED\n", ""], ["PHONE NUMBER - HOME", "", "", "(518)555-1212\n", "00049\n", "", "", "\nThis field will contain the patient's home phone number as found in the\n.131 field of the PATIENT file. The data will be returned in HL7 TN\n(Telephone Number) format as follows [(999)999-9999X888]. The optional\n'X' portion gives an extension.\n
\n\n", "PID\n", "", "13\n", "\n- \n\n
\n", "40\n", "TN\n", "NOT REQUIRED\n", "3\n"], ["PHONE NUMBER - BUSINESS", "", "", "(518)555-1212\n", "00050\n", "", "", "\nThis field will contain the patient's work phone number as found in the\n.132 field of the PATIENT file.\n
\n\n", "PID\n", "", "14\n", "\n- \n\n
\n", "40\n", "TN\n", "NOT REQUIRED\n", "3\n"], ["MARITAL STATUS", "0002\n", "MARRIED\n", "M\n", "00046\n", "", "", "\nThe patient's current marital status (as found in field .05 of the\n S Single Single (S)\n W Widowed Widow/Widower (W)\nPATIENT file via pointer to the MARITAL STATUS FILE) will be returned\nin this field. The data will be returned as defined by HL7 Table 0002.\nIf the patient's marital status is listed as UNKNOWN, nothing will be\nreturned. The codes (as found in HL7 Table 0002-Marital Status) are:\n HL7 VALUE DESCRIPTION EQUIVALENT DHCP CODE\n A Separated Separated (S)\n D Divorced Divorced (D)\n M Married Married (M)\n
\n\n", "PID\n", "", "16\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["RELIGION", "0006\n", "", "", "00045\n", "", "", "\nDue to the wide variations between the HL7 table for religion (Table 0006)\nand the DHCP RELIGION file, this HL7 field will not be used at this time.\nThe DHCP RELIGION field will be transmitted with the ZPD segment.\n \n
\n\n", "PID\n", "", "17\n", "\n- \n\n
\n", "3\n", "ID\n", "NOT REQUIRED\n", ""], ["PATIENT ACCOUNT NUMBER", "0061\n", "", "", "00035\n", "", "", "\nThere is no corresponding DHCP field at this time.\n
\n\n", "PID\n", "", "18\n", "\n- \n\n
\n", "20\n", "CK\n", "NOT REQUIRED\n", ""], ["DRIVER'S LIC NUM - PATIENT", "", "", "", "00453\n", "", "", "\nThere is no corresponding DHCP field at this time.\n
\n\n", "PID\n", "", "20\n", "\n- \n\n
\n", "25\n", "CM\n", "NOT REQUIRED\n", ""], ["SET ID - PATIENT VISIT", "", "", "", "00458\n", "", "", "", "QRF\n", "", "1\n", "\n- \n\n
\n", "4\n", "SI\n", "NOT REQUIRED\n", ""], ["PATIENT CLASS", "0004\n", "", "", "00052\n", "", "", "", "QRF\n", "", "2\n", "\n- \n\n
\n", "1\n", "ID\n", "REQUIRED\n", ""], ["ASSIGNED PATIENT LOCATION", "0079\n", "", "", "00053\n", "", "", "", "QRF\n", "", "3\n", "\n- \n\n
\n", "12\n", "ID\n", "REQUIRED\n", ""], ["ADMISSION TYPE", "0007\n", "", "", "00218\n", "", "", "", "QRF\n", "", "4\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["SECURITY", "", "", "", "00008\n", "", "", "", "MSH\n", "", "8\n", "\n- \n\n
\n", "40\n", "ST\n", "NOT REQUIRED\n", ""], ["PRE-ADMIT NUMBER", "", "", "", "00219\n", "", "", "", "QRF\n", "", "5\n", "\n- \n\n
\n", "20\n", "ST\n", "NOT REQUIRED\n", ""], ["PRIOR PATIENT LOCATION", "0079\n", "", "", "00056\n", "", "", "", "QRF\n", "", "6\n", "\n- \n\n
\n", "12\n", "ID\n", "NOT REQUIRED\n", ""], ["ATTENDING DOCTOR", "0010\n", "", "", "00057\n", "", "", "", "QRF\n", "", "7\n", "\n- \n\n
\n", "60\n", "CN\n", "NOT REQUIRED\n", ""], ["REFERRING DOCTOR", "0010\n", "", "", "00579\n", "", "", "", "QRF\n", "", "8\n", "\n- \n\n
\n", "60\n", "CN\n", "NOT REQUIRED\n", ""], ["CONSULTING DOCTOR", "0010\n", "", "", "00580\n", "", "", "", "QRF\n", "", "9\n", "\n- \n\n
\n", "60\n", "CN\n", "NOT REQUIRED\n", "100\n"], ["HOSPITAL SERVICE", "0069\n", "", "", "00059\n", "", "", "", "QRF\n", "", "10\n", "\n- \n\n
\n", "3\n", "ID\n", "NOT REQUIRED\n", ""], ["TEMPORARY LOCATION", "0079\n", "", "", "00060\n", "", "", "", "QRF\n", "", "11\n", "\n- \n\n
\n", "12\n", "ID\n", "NOT REQUIRED\n", ""], ["PRE-ADMIT TEST INDICATOR", "0087\n", "", "", "00220\n", "", "", "", "QRF\n", "", "12\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["RE-ADMISSION INDICATOR", "0092\n", "", "", "00221\n", "", "", "", "QRF\n", "", "13\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["ADMIT SOURCE", "0023\n", "", "", "00063\n", "", "", "", "QRF\n", "", "14\n", "\n- \n\n
\n", "3\n", "ID\n", "NOT REQUIRED\n", ""], ["MESSAGE TYPE", "0076\n", "", "", "00012\n", "", "", "", "MSH\n", "", "9\n", "\n- \n\n
\n", "7\n", "ID\n", "REQUIRED\n", ""], ["AMBULATORY STATUS", "0009\n", "", "", "00064\n", "", "", "", "QRF\n", "", "15\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["VIP INDICATOR", "0099\n", "", "", "00193\n", "", "", "", "QRF\n", "", "16\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["ADMITTING DOCTOR", "0010\n", "", "", "00189\n", "", "", "", "QRF\n", "", "17\n", "\n- \n\n
\n", "60\n", "CN\n", "NOT REQUIRED\n", ""], ["PATIENT TYPE", "0018\n", "", "", "00191\n", "", "", "", "QRF\n", "", "18\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["VISIT NUMBER", "", "", "", "00194\n", "", "", "", "QRF\n", "", "19\n", "\n- \n\n
\n", "4\n", "NM\n", "NOT REQUIRED\n", ""], ["FINANCIAL CLASS", "0064\n", "", "", "00195\n", "", "", "", "QRF\n", "", "20\n", "\n- \n\n
\n", "11\n", "ID\n", "NOT REQUIRED\n", "4\n"], ["CHARGE PRICE INDICATOR", "0032\n", "", "", "00199\n", "", "", "", "QRF\n", "", "21\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["COURTESY CODE", "0045\n", "", "", "00386\n", "", "", "", "QRF\n", "", "22\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["CREDIT RATING", "0046\n", "", "", "00200\n", "", "", "", "QRF\n", "", "23\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["CONTRACT CODE", "0044\n", "", "", "00201\n", "", "", "", "QRF\n", "", "24\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", "100\n"], ["MESSAGE CONTROL ID", "", "", "", "00013\n", "", "", "", "MSH\n", "", "10\n", "\n- \n\n
\n", "20\n", "ST\n", "REQUIRED\n", ""], ["CONTRACT EFFECTIVE DATE", "", "", "", "00202\n", "", "", "", "QRF\n", "", "25\n", "\n- \n\n
\n", "8\n", "DT\n", "NOT REQUIRED\n", "100\n"], ["CONTRACT AMOUNT", "", "", "", "00203\n", "", "", "", "QRF\n", "", "26\n", "\n- \n\n
\n", "12\n", "NM\n", "NOT REQUIRED\n", "100\n"], ["CONTRACT PERIOD", "", "", "", "00204\n", "", "", "", "QRF\n", "", "27\n", "\n- \n\n
\n", "3\n", "NM\n", "NOT REQUIRED\n", "100\n"], ["INTEREST CODE", "0073\n", "", "", "00387\n", "", "", "", "QRF\n", "", "28\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["TRANSFER TO BAD DEBT CODE", "0110\n", "", "", "00205\n", "", "", "", "QRF\n", "", "29\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["TRANSFER TO BAD DEBT DATE", "", "", "", "00388\n", "", "", "", "QRF\n", "", "30\n", "\n- \n\n
\n", "8\n", "DT\n", "NOT REQUIRED\n", ""], ["BAD DEBT AGENCY CODE", "0021\n", "", "", "00206\n", "", "", "", "QRF\n", "", "31\n", "\n- \n\n
\n", "10\n", "ST\n", "NOT REQUIRED\n", ""], ["BAD DEBT TRANSFER AMOUNT", "", "", "", "00389\n", "", "", "", "QRF\n", "", "32\n", "\n- \n\n
\n", "12\n", "NM\n", "NOT REQUIRED\n", ""], ["BAD DEBT RECOVERY AMOUNT", "", "", "", "00390\n", "", "", "", "QRF\n", "", "33\n", "\n- \n\n
\n", "12\n", "NM\n", "NOT REQUIRED\n", ""], ["DELETE ACCOUNT INDICATOR", "0111\n", "", "", "00207\n", "", "", "", "QRF\n", "", "34\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["PROCESSING ID", "0103\n", "", "", "00014\n", "", "", "", "MSH\n", "", "11\n", "\n- \n\n
\n", "1\n", "ID\n", "REQUIRED\n", ""], ["DELETE ACCOUNT DATE", "", "", "", "00208\n", "", "", "", "QRF\n", "", "35\n", "\n- \n\n
\n", "8\n", "DT\n", "NOT REQUIRED\n", ""], ["DISCHARGE DISPOSITION", "0112\n", "", "", "00613\n", "", "", "", "QRF\n", "", "36\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["DISCHARGED TO LOCATION", "0113\n", "", "", "00614\n", "", "", "", "QRF\n", "", "37\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["DIET TYPE", "0114\n", "", "", "00615\n", "", "", "", "QRF\n", "", "38\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["SERVICING FACILITY", "0115\n", "", "", "00616\n", "", "", "", "QRF\n", "", "39\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["BED LOCATION", "0079\n", "", "", "00785\n", "", "", "", "NSC\n", "", "1\n", "\n- \n\n
\n", "12\n", "ID\n", "REQUIRED\n", ""], ["BED STATUS", "0116\n", "", "", "00671\n", "", "", "", "NSC\n", "", "2\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["SET ID - NEXT OF KIN", "", "", "", "00712\n", "", "", "", "NPU\n", "", "1\n", "\n- \n\n
\n", "4\n", "SI\n", "REQUIRED\n", ""], ["NEXT OF KIN NAME", "", "", "", "00048\n", "", "", "", "NPU\n", "", "2\n", "\n- \n\n
\n", "48\n", "PN\n", "NOT REQUIRED\n", ""], ["NEXT OF KIN RELATIONSHIP", "0063\n", "", "", "00047\n", "", "", "", "NPU\n", "", "3\n", "\n- \n\n
\n", "15\n", "ST\n", "NOT REQUIRED\n", ""], ["VERSION ID", "0104\n", "", "", "00015\n", "", "", "", "MSH\n", "", "12\n", "\n- \n\n
\n", "8\n", "NM\n", "REQUIRED\n", ""], ["NEXT OF KIN - ADDRESS", "", "", "", "00225\n", "", "", "", "NPU\n", "", "4\n", "\n- \n\n
\n", "106\n", "AD\n", "NOT REQUIRED\n", ""], ["BATCH COMMENT", "", "", "", "00665\n", "", "", "", "DG1\n", "", "2\n", "\n- \n\n
\n", "80\n", "ST\n", "NOT REQUIRED\n", ""], ["PLACER ORDER #", "", "", "", "00715\n", "", "", "", "ORC\n", "", "2\n", "\n- \n\n
\n", "75\n", "CM\n", "NOT REQUIRED\n", ""], ["FILLER ORDER #", "", "", "", "00716\n", "", "", "", "ORC\n", "", "3\n", "\n- \n\n
\n", "75\n", "CM\n", "NOT REQUIRED\n", ""], ["PLACER GROUP #", "", "", "", "00717\n", "", "", "", "ORC\n", "", "4\n", "\n- \n\n
\n", "75\n", "CM\n", "NOT REQUIRED\n", ""], ["RESPONSE FLAG", "0121\n", "", "", "00719\n", "", "", "", "ORC\n", "", "6\n", "\n- \n\n
\n", "1\n", "ST\n", "NOT REQUIRED\n", ""], ["TIMING/QUANTITY", "", "", "", "00720\n", "", "", "", "ORC\n", "", "7\n", "\n- \n\n
\n", "200\n", "CM\n", "NOT REQUIRED\n", ""], ["PARENT", "", "", "", "00721\n", "", "", "", "ORC\n", "", "8\n", "\n- \n\n
\n", "200\n", "CM\n", "NOT REQUIRED\n", ""], ["ENTERED BY", "", "", "", "00723\n", "", "", "", "ORC\n", "", "10\n", "\n- \n\n
\n", "80\n", "CN\n", "NOT REQUIRED\n", ""], ["UNIVERSAL SERVICE IDENTIFIER", "", "", "", "00523\n", "", "", "", "OBR\n", "", "4\n", "\n- \n\n
\n", "200\n", "CE\n", "REQUIRED\n", ""], ["VERIFIED BY", "", "", "", "00724\n", "", "", "", "ORC\n", "", "11\n", "\n- \n\n
\n", "80\n", "CN\n", "NOT REQUIRED\n", ""], ["ENTERER'S LOCATION", "", "", "", "00726\n", "", "", "", "ORC\n", "", "13\n", "\n- \n\n
\n", "80\n", "CM\n", "NOT REQUIRED\n", ""], ["WHEN TO CHARGE", "0100\n", "", "", "00066\n", "", "", "", "BTS\n", "", "1\n", "\n- \n\n
\n", "15\n", "CM\n", "NOT REQUIRED\n", ""], ["CHARGE TYPE", "0122\n", "", "", "00729\n", "", "", "", "BTS\n", "", "2\n", "\n- \n\n
\n", "50\n", "CM\n", "NOT REQUIRED\n", ""], ["ACCOUNT ID", "", "", "", "00730\n", "", "", "", "BTS\n", "", "3\n", "\n- \n\n
\n", "100\n", "CM\n", "NOT REQUIRED\n", ""], ["ROUTE", "0033\n", "", "", "00129\n", "", "", "", "UB1\n", "", "3\n", "\n- \n\n
\n", "8\n", "ST\n", "NOT REQUIRED\n", ""], ["SITE ADMINISTERED", "0034\n", "", "", "00130\n", "", "", "", "UB1\n", "", "4\n", "\n- \n\n
\n", "20\n", "ST\n", "NOT REQUIRED\n", ""], ["IV SOLUTION RATE", "", "", "", "00131\n", "", "", "", "UB1\n", "", "5\n", "\n- \n\n
\n", "10\n", "CQ\n", "NOT REQUIRED\n", ""], ["DRUG STRENGTH", "", "", "", "00133\n", "", "", "", "UB1\n", "", "6\n", "\n- \n\n
\n", "14\n", "CQ\n", "NOT REQUIRED\n", ""], ["FINAL CONCENTRATION", "", "", "", "00137\n", "", "", "", "UB1\n", "", "7\n", "\n- \n\n
\n", "10\n", "NM\n", "NOT REQUIRED\n", ""], ["OBSERVATION DATE/TIME", "", "", "", "00530\n", "", "", "", "OBR\n", "", "7\n", "\n- \n\n
\n", "19\n", "TS\n", "REQUIRED\n", ""], ["FINAL VOLUME IN ML.", "", "", "", "00138\n", "", "", "", "UB1\n", "", "8\n", "\n- \n\n
\n", "10\n", "NM\n", "NOT REQUIRED\n", ""], ["DRUG DOSE", "", "", "", "00135\n", "", "", "", "UB1\n", "", "9\n", "\n- \n\n
\n", "10\n", "CM\n", "NOT REQUIRED\n", ""], ["DRUG ROLE", "", "", "", "00139\n", "", "", "", "UB1\n", "", "10\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["PRESCRIPTION SEQUENCE #", "", "", "", "00469\n", "", "", "", "UB1\n", "", "11\n", "\n- \n\n
\n", "3\n", "NM\n", "NOT REQUIRED\n", ""], ["QUANTITY DISPENSED", "", "", "", "00470\n", "", "", "", "UB1\n", "", "12\n", "\n- \n\n
\n", "4\n", "CQ\n", "NOT REQUIRED\n", ""], ["DRUG ID", "0057\n", "", "", "00473\n", "", "", "", "UB1\n", "", "14\n", "\n- \n\n
\n", "5\n", "CE\n", "NOT REQUIRED\n", ""], ["COMPONENT DRUG IDS", "", "", "", "00474\n", "", "", "", "UB1\n", "", "15\n", "\n- \n\n
\n", "5\n", "ID\n", "NOT REQUIRED\n", "5\n"], ["PRESCRIPTION TYPE", "", "", "", "00479\n", "", "", "", "UB1\n", "", "16\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["SUBSTITUTION STATUS", "", "", "", "00480\n", "", "", "", "UB1\n", "", "17\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["RX ORDER STATUS", "0038\n", "", "", "00588\n", "", "", "", "UB1\n", "", "18\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["OBSERVATION END DATE/TIME", "", "", "", "00531\n", "", "", "", "OBR\n", "", "8\n", "\n- \n\n
\n", "19\n", "TS\n", "REQUIRED\n", ""], ["NUMBER OF REFILLS", "", "", "", "00481\n", "", "", "", "UB1\n", "", "19\n", "\n- \n\n
\n", "3\n", "NM\n", "NOT REQUIRED\n", ""], ["REFILLS REMAINING", "", "", "", "00482\n", "", "", "", "UB1\n", "", "21\n", "\n- \n\n
\n", "3\n", "NM\n", "NOT REQUIRED\n", ""], ["DEA CLASS", "", "", "", "00619\n", "", "", "", "UB1\n", "", "22\n", "\n- \n\n
\n", "5\n", "ID\n", "NOT REQUIRED\n", ""], ["ORDERING MD'S DEA NUMBER", "", "", "", "00620\n", "", "", "", "UB1\n", "", "23\n", "\n- \n\n
\n", "10\n", "NM\n", "NOT REQUIRED\n", ""], ["LAST REFILL DATE/TIME", "", "", "", "00483\n", "", "", "", "UB1\n", "", "25\n", "\n- \n\n
\n", "19\n", "TS\n", "NOT REQUIRED\n", ""], ["RX NUMBER", "", "", "", "00596\n", "", "", "", "UB1\n", "", "26\n", "\n- \n\n
\n", "20\n", "ST\n", "NOT REQUIRED\n", ""], ["PRN STATUS", "", "", "", "00621\n", "", "", "", "UB1\n", "", "27\n", "\n- \n\n
\n", "5\n", "ID\n", "NOT REQUIRED\n", ""], ["PHARMACY INSTRUCTIONS", "", "", "", "00484\n", "", "", "", "UB1\n", "", "28\n", "\n- \n\n
\n", "80\n", "TX\n", "NOT REQUIRED\n", "5\n"], ["PATIENT INSTRUCTIONS", "", "", "", "00489\n", "", "", "", "UB1\n", "", "29\n", "\n- \n\n
\n", "80\n", "TX\n", "NOT REQUIRED\n", "5\n"], ["INSTRUCTIONS (SIG)", "", "", "", "00618\n", "", "", "", "UB1\n", "", "30\n", "\n- \n\n
\n", "500\n", "TX\n", "NOT REQUIRED\n", "100\n"], ["COLLECTION VOLUME", "0036\n", "", "", "00532\n", "", "", "", "OBR\n", "", "9\n", "\n- \n\n
\n", "20\n", "CQ\n", "REQUIRED\n", ""], ["ORDER ITEM ID", "", "", "", "00731\n", "", "", "", "PR1\n", "", "1\n", "\n- \n\n
\n", "200\n", "CE\n", "NOT REQUIRED\n", ""], ["SUBSTITUTE ALLOWED", "", "", "", "00120\n", "", "", "", "PR1\n", "", "2\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["RESULTS COPIES TO", "", "", "", "00586\n", "", "", "", "PR1\n", "", "3\n", "\n- \n\n
\n", "80\n", "CN\n", "NOT REQUIRED\n", "100\n"], ["STOCK LOCATION", "0012\n", "", "", "00068\n", "", "", "", "PR1\n", "", "4\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["CONTINUATION POINTER", "", "", "", "00167\n", "", "", "", "DSP\n", "", "1\n", "\n- \n\n
\n", "60\n", "ST\n", "NOT REQUIRED\n", ""], ["SET ID - DISPLAY DATA", "", "", "", "00570\n", "", "", "", "ERR\n", "", "1\n", "\n- \n\n
\n", "4\n", "SI\n", "NOT REQUIRED\n", ""], ["DISPLAY LEVEL", "", "", "", "00571\n", "", "", "", "ERR\n", "", "2\n", "\n- \n\n
\n", "4\n", "SI\n", "NOT REQUIRED\n", ""], ["DATA LINE", "", "", "", "00153\n", "", "", "", "ERR\n", "", "3\n", "\n- \n\n
\n", "300\n", "TX\n", "REQUIRED\n", ""], ["LOGICAL BREAK POINT", "", "", "", "00154\n", "", "", "", "ERR\n", "", "4\n", "\n- \n\n
\n", "2\n", "ST\n", "NOT REQUIRED\n", ""], ["RESULT ID", "", "", "", "00599\n", "", "", "", "ERR\n", "", "5\n", "\n- \n\n
\n", "20\n", "TX\n", "NOT REQUIRED\n", ""], ["MESSAGE CONTROL ID", "", "", "", "00003\n", "", "", "", "MSA\n", "FILE\n", "2\n", "\n- \n\n
\n", "20\n", "ST\n", "REQUIRED\n", ""], ["SPECIMEN RECEIVED DATE/TIME", "", "", "", "00537\n", "", "", "", "OBR\n", "", "14\n", "\n- \n\n
\n", "19\n", "TS\n", "REQUIRED\n", ""], ["DEFERRED RESPONSE TYPE", "0107\n", "", "", "00161\n", "", "", "", "QRD\n", "", "5\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["DEFERRED RESPONSE DATE/TIME", "", "", "", "00162\n", "", "", "", "QRD\n", "", "6\n", "\n- \n\n
\n", "19\n", "TS\n", "NOT REQUIRED\n", ""], ["WHAT DATA CODE VALUE QUAL.", "", "", "", "00171\n", "", "", "", "QRD\n", "", "11\n", "\n- \n\n
\n", "20\n", "ST\n", "NOT REQUIRED\n", "100\n"], ["QUERY RESULTS LEVEL", "0108\n", "", "", "00701\n", "", "", "", "QRD\n", "", "12\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["WHERE SUBJECT FILTER", "", "", "", "00173\n", "", "", "", "RX1\n", "", "1\n", "\n- \n\n
\n", "20\n", "ST\n", "REQUIRED\n", "100\n"], ["WHEN DATA START DATE/TIME", "", "", "", "00174\n", "", "", "", "RX1\n", "", "2\n", "\n- \n\n
\n", "19\n", "TS\n", "NOT REQUIRED\n", ""], ["WHEN DATA END DATE/TIME", "", "", "", "00176\n", "", "", "", "RX1\n", "", "3\n", "\n- \n\n
\n", "19\n", "TS\n", "NOT REQUIRED\n", ""], ["WHAT USER QUALIFIER", "", "", "", "00178\n", "", "", "", "RX1\n", "", "4\n", "\n- \n\n
\n", "20\n", "ST\n", "NOT REQUIRED\n", "100\n"], ["OTHER QRY SUBJECT FILTER", "", "", "", "00179\n", "", "", "", "RX1\n", "", "5\n", "\n- \n\n
\n", "20\n", "ST\n", "NOT REQUIRED\n", "100\n"], ["R/U DATE/TIME", "", "", "", "00600\n", "", "", "", "URS\n", "", "1\n", "\n- \n\n
\n", "19\n", "TS\n", "NOT REQUIRED\n", ""], ["ORDERING PROVIDER", "0010\n", "", "", "00539\n", "", "", "", "OBR\n", "", "16\n", "\n- \n\n
\n", "60\n", "CN\n", "NOT REQUIRED\n", "100\n"], ["REPORT PRIORITY", "0109\n", "", "", "00601\n", "", "", "", "URS\n", "", "2\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["R/U WHO SUBJECT DEFINITION", "", "", "", "00602\n", "", "", "", "URS\n", "", "3\n", "\n- \n\n
\n", "20\n", "ST\n", "REQUIRED\n", "14\n"], ["R/U WHAT SUBJECT DEFINITION", "0048\n", "", "", "00603\n", "", "", "", "URS\n", "", "4\n", "\n- \n\n
\n", "3\n", "ID\n", "NOT REQUIRED\n", "1\n"], ["R/U WHAT DEPARTMENT CODE", "", "", "", "00605\n", "", "", "", "URS\n", "", "5\n", "\n- \n\n
\n", "20\n", "ST\n", "NOT REQUIRED\n", "100\n"], ["R/U DISPLAY/PRINT LOCATIONS", "", "", "", "00607\n", "", "", "", "URS\n", "", "6\n", "\n- \n\n
\n", "20\n", "ST\n", "NOT REQUIRED\n", "100\n"], ["R/U RESULTS LEVEL", "0108\n", "", "", "00702\n", "", "", "", "URS\n", "", "7\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["R/U WHERE SUBJECT DEFINITION", "", "", "", "00608\n", "", "", "", "ZCT\n", "", "1\n", "\n- \n\n
\n", "20\n", "ST\n", "REQUIRED\n", "100\n"], ["R/U WHEN DATA START DATE/TIME", "", "", "", "00609\n", "", "", "", "ZCT\n", "", "2\n", "\n- \n\n
\n", "19\n", "TS\n", "NOT REQUIRED\n", ""], ["R/U WHEN DATA END DATE/TIME", "", "", "", "00610\n", "", "", "", "ZCT\n", "", "3\n", "\n- \n\n
\n", "19\n", "TS\n", "NOT REQUIRED\n", ""], ["R/U WHAT USER QUALIFIER", "", "", "", "00611\n", "", "", "", "ZCT\n", "", "4\n", "\n- \n\n
\n", "20\n", "ST\n", "NOT REQUIRED\n", "100\n"], ["FILLERS FIELD #1", "", "", "", "00543\n", "", "", "", "OBR\n", "", "20\n", "\n- \n\n
\n", "60\n", "ST\n", "NOT REQUIRED\n", ""], ["R/U OTHER RESULTS SUBJECT DEFINITION", "", "", "", "00612\n", "", "", "", "ZCT\n", "", "5\n", "\n- \n\n
\n", "20\n", "ST\n", "NOT REQUIRED\n", "100\n"], ["ACCIDENT DATE/TIME", "", "", "", "00182\n", "", "", "", "ADD\n", "", "1\n", "\n- \n\n
\n", "19\n", "TS\n", "NOT REQUIRED\n", ""], ["ACCIDENT CODE", "0050\n", "", "", "00184\n", "", "", "", "ADD\n", "", "2\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["ACCIDENT LOCATION", "", "", "", "00185\n", "", "", "", "ADD\n", "", "3\n", "\n- \n\n
\n", "25\n", "ST\n", "NOT REQUIRED\n", ""], ["SET ID - DIAGNOSIS", "", "", "", "00506\n", "", "", "", "DSC\n", "", "1\n", "\n- \n\n
\n", "4\n", "SI\n", "REQUIRED\n", ""], ["DIAGNOSIS CODING METHOD", "0053\n", "", "", "00394\n", "", "", "", "DSC\n", "", "2\n", "\n- \n\n
\n", "2\n", "ID\n", "REQUIRED\n", ""], ["DIAGNOSIS CODE", "0051\n", "", "", "00293\n", "", "", "", "DSC\n", "", "3\n", "\n- \n\n
\n", "8\n", "ID\n", "NOT REQUIRED\n", ""], ["DIAGNOSIS DESCRIPTION", "", "", "", "00294\n", "", "", "", "DSC\n", "", "4\n", "\n- \n\n
\n", "40\n", "ST\n", "NOT REQUIRED\n", ""], ["DIAGNOSIS DATE/TIME", "", "", "", "00295\n", "", "", "", "DSC\n", "", "5\n", "\n- \n\n
\n", "19\n", "TS\n", "NOT REQUIRED\n", ""], ["DIAGNOSIS/DRG TYPE", "0052\n", "", "", "00297\n", "", "", "", "DSC\n", "", "6\n", "\n- \n\n
\n", "2\n", "ID\n", "REQUIRED\n", ""], ["RESULTS RPT/STATUS CHNG-DATE/TIME", "", "", "", "00546\n", "", "", "", "OBR\n", "", "22\n", "\n- \n\n
\n", "19\n", "TS\n", "REQUIRED\n", ""], ["MAJOR DIAGNOSTIC CATEGORY", "0118\n", "", "", "00298\n", "", "", "", "DSC\n", "", "7\n", "\n- \n\n
\n", "4\n", "ST\n", "NOT REQUIRED\n", ""], ["DIAGNOSTIC RELATED GROUP", "0055\n", "", "", "00299\n", "", "", "", "DSC\n", "", "8\n", "\n- \n\n
\n", "4\n", "ID\n", "NOT REQUIRED\n", ""], ["DRG APPROVAL INDICATOR", "", "", "", "00373\n", "", "", "", "DSC\n", "", "9\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["DRG GROUPER REVIEW CODE", "0056\n", "", "", "00374\n", "", "", "", "DSC\n", "", "10\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["OUTLIER TYPE", "0083\n", "", "", "00375\n", "", "", "", "DSC\n", "", "11\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["OUTLIER DAYS", "", "", "", "00300\n", "", "", "", "DSC\n", "", "12\n", "\n- \n\n
\n", "3\n", "NM\n", "NOT REQUIRED\n", ""], ["OUTLIER COST", "", "", "", "00376\n", "", "", "", "DSC\n", "", "13\n", "\n- \n\n
\n", "12\n", "NM\n", "NOT REQUIRED\n", ""], ["GROUPER VERSION AND TYPE", "", "", "", "00781\n", "", "", "", "DSC\n", "", "14\n", "\n- \n\n
\n", "4\n", "ST\n", "NOT REQUIRED\n", ""], ["SET ID - FINANCIAL TRANSACTION", "", "", "", "00507\n", "", "", "", "FHS\n", "", "1\n", "\n- \n\n
\n", "4\n", "SI\n", "NOT REQUIRED\n", ""], ["TRANSACTION ID", "", "", "", "00366\n", "", "", "", "FHS\n", "", "2\n", "\n- \n\n
\n", "12\n", "ST\n", "NOT REQUIRED\n", ""], ["VALUE TYPE", "0125\n", "", "", "00676\n", "", "", "", "OBX\n", "", "2\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["TRANSACTION BATCH ID", "", "", "", "00503\n", "", "", "", "FHS\n", "", "3\n", "\n- \n\n
\n", "5\n", "ST\n", "NOT REQUIRED\n", ""], ["TRANSACTION DATE", "", "", "", "00351\n", "", "", "", "FHS\n", "", "4\n", "\n- \n\n
\n", "8\n", "DT\n", "REQUIRED\n", ""], ["TRANSACTION POSTING DATE", "", "", "", "00352\n", "", "", "", "FHS\n", "", "5\n", "\n- \n\n
\n", "8\n", "DT\n", "NOT REQUIRED\n", ""], ["TRANSACTION TYPE", "0017\n", "", "", "00353\n", "", "", "", "FHS\n", "", "6\n", "\n- \n\n
\n", "8\n", "ID\n", "REQUIRED\n", ""], ["TRANSACTION CODE", "0096\n", "", "", "00354\n", "", "", "", "FHS\n", "", "7\n", "\n- \n\n
\n", "20\n", "ID\n", "REQUIRED\n", ""], ["TRANSACTION DESCRIPTION", "", "", "", "00356\n", "", "", "", "FHS\n", "", "8\n", "\n- \n\n
\n", "40\n", "ST\n", "NOT REQUIRED\n", ""], ["TRANSACTION DESCRIPTION - ALT", "", "", "", "00706\n", "", "", "", "FHS\n", "", "9\n", "\n- \n\n
\n", "40\n", "ST\n", "NOT REQUIRED\n", ""], ["TRANSACTION QUANTITY", "", "", "", "00357\n", "", "", "", "FHS\n", "", "10\n", "\n- \n\n
\n", "4\n", "NM\n", "NOT REQUIRED\n", ""], ["TRANSACTION AMOUNT - EXTENDED", "", "", "", "00358\n", "", "", "", "FHS\n", "", "11\n", "\n- \n\n
\n", "12\n", "NM\n", "NOT REQUIRED\n", ""], ["TRANSACTION AMOUNT - UNIT", "", "", "", "00782\n", "", "", "", "FHS\n", "", "12\n", "\n- \n\n
\n", "12\n", "NM\n", "NOT REQUIRED\n", ""], ["OBSERVATION IDENTIFIER", "", "", "", "00560\n", "", "", "", "OBX\n", "", "3\n", "\n- \n\n
\n", "80\n", "CE\n", "REQUIRED\n", ""], ["DEPARTMENT CODE", "0049\n", "", "", "00355\n", "", "", "", "FHS\n", "", "13\n", "\n- \n\n
\n", "16\n", "ST\n", "NOT REQUIRED\n", ""], ["INSURANCE PLAN ID", "0072\n", "", "", "00359\n", "", "", "", "FHS\n", "", "14\n", "\n- \n\n
\n", "8\n", "ID\n", "NOT REQUIRED\n", ""], ["INSURANCE AMOUNT", "", "", "", "00360\n", "", "", "", "FHS\n", "", "15\n", "\n- \n\n
\n", "12\n", "NM\n", "NOT REQUIRED\n", ""], ["PATIENT LOCATION", "0079\n", "", "", "00361\n", "", "", "", "FHS\n", "", "16\n", "\n- \n\n
\n", "12\n", "ST\n", "NOT REQUIRED\n", ""], ["FEE SCHEDULE", "0024\n", "", "", "00362\n", "", "", "", "FHS\n", "", "17\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["PATIENT TYPE", "0018\n", "", "", "00363\n", "", "", "", "FHS\n", "", "18\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["DIAGNOSIS CODE", "0051\n", "", "", "00364\n", "", "", "", "FHS\n", "", "19\n", "\n- \n\n
\n", "8\n", "ID\n", "NOT REQUIRED\n", ""], ["PERFORMED BY CODE", "0084\n", "", "", "00377\n", "", "", "", "FHS\n", "", "20\n", "\n- \n\n
\n", "60\n", "CN\n", "NOT REQUIRED\n", ""], ["ORDERED BY CODE", "", "", "", "00783\n", "", "", "", "FHS\n", "", "21\n", "\n- \n\n
\n", "60\n", "CN\n", "NOT REQUIRED\n", ""], ["UNIT COST", "", "", "", "00784\n", "", "", "", "FHS\n", "", "22\n", "\n- \n\n
\n", "12\n", "NM\n", "NOT REQUIRED\n", ""], ["OBSERVATION RESULTS", "", "", "", "00561\n", "", "", "", "OBX\n", "", "5\n", "\n- \n\n
\n", "80\n", "ST\n", "REQUIRED\n", ""], ["SET ID - GUARANTOR", "", "", "", "00321\n", "", "", "", "IN1\n", "", "1\n", "\n- \n\n
\n", "4\n", "SI\n", "REQUIRED\n", ""], ["GUARANTOR NUMBER", "", "", "", "00322\n", "", "", "", "IN1\n", "", "2\n", "\n- \n\n
\n", "20\n", "ID\n", "NOT REQUIRED\n", ""], ["GUARANTOR NAME", "", "", "", "00323\n", "", "", "", "IN1\n", "", "3\n", "\n- \n\n
\n", "48\n", "PN\n", "REQUIRED\n", ""], ["GUARANTOR SPOUSE NAME", "", "", "", "00707\n", "", "", "", "IN1\n", "", "4\n", "\n- \n\n
\n", "48\n", "PN\n", "NOT REQUIRED\n", ""], ["GUARANTOR ADDRESS", "", "", "", "00324\n", "", "", "", "IN1\n", "", "5\n", "\n- \n\n
\n", "106\n", "AD\n", "NOT REQUIRED\n", ""], ["GUARANTOR PH. NUM. - HOME", "", "", "", "00329\n", "", "", "", "IN1\n", "", "6\n", "\n- \n\n
\n", "40\n", "TN\n", "NOT REQUIRED\n", ""], ["GUARANTOR PH. NUM-BUSINESS", "", "", "", "00330\n", "", "", "", "IN1\n", "", "7\n", "\n- \n\n
\n", "40\n", "TN\n", "NOT REQUIRED\n", ""], ["GUARANTOR DATE OF BIRTH", "", "", "", "00331\n", "", "", "", "IN1\n", "", "8\n", "\n- \n\n
\n", "8\n", "DT\n", "NOT REQUIRED\n", ""], ["GUARANTOR SEX", "0001\n", "", "", "00332\n", "", "", "", "IN1\n", "", "9\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["GUARANTOR TYPE", "0068\n", "", "", "00333\n", "", "", "", "IN1\n", "", "10\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["PATIENT ID (INTERNAL ID)", "0061\n", "", "4567~0~M11\n", "00034\n", "", "", "\nThe internal entry number (DFN) of the patient (as found in the site's\nPATIENT file) will be passed in this HL7 field.\n
\n\n", "PID\n", "", "3\n", "\n- \n\n
\n", "16\n", "CK\n", "REQUIRED\n", ""], ["GUARANTOR RELATIONSHIP", "0063\n", "", "", "00334\n", "", "", "", "IN1\n", "", "11\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["GUARANTOR SSN", "", "", "", "00335\n", "", "", "", "IN1\n", "", "12\n", "\n- \n\n
\n", "11\n", "ST\n", "NOT REQUIRED\n", ""], ["GUARANTOR DATE - BEGIN", "", "", "", "00338\n", "", "", "", "IN1\n", "", "13\n", "\n- \n\n
\n", "8\n", "DT\n", "NOT REQUIRED\n", ""], ["GUARANTOR DATE - END", "", "", "", "00339\n", "", "", "", "IN1\n", "", "14\n", "\n- \n\n
\n", "8\n", "DT\n", "NOT REQUIRED\n", ""], ["GUARANTOR PRIORITY", "", "", "", "00340\n", "", "", "", "IN1\n", "", "15\n", "\n- \n\n
\n", "2\n", "NM\n", "NOT REQUIRED\n", ""], ["GUARANTOR EMPLOYER NAME", "", "", "", "00341\n", "", "", "", "IN1\n", "", "16\n", "\n- \n\n
\n", "45\n", "ST\n", "NOT REQUIRED\n", ""], ["GUARANTOR EMPLOYER ADDRESS", "", "", "", "00342\n", "", "", "", "IN1\n", "", "17\n", "\n- \n\n
\n", "106\n", "AD\n", "NOT REQUIRED\n", ""], ["GUARANTOR EMPLOYER PHONE #", "", "", "", "00347\n", "", "", "", "IN1\n", "", "18\n", "\n- \n\n
\n", "40\n", "TN\n", "NOT REQUIRED\n", ""], ["GUARANTOR EMPLOYEE ID NUM", "", "", "", "00391\n", "", "", "", "IN1\n", "", "19\n", "\n- \n\n
\n", "20\n", "ST\n", "NOT REQUIRED\n", ""], ["GUARANTOR EMPLOYMENT STATUS", "0066\n", "", "", "00392\n", "", "", "", "IN1\n", "", "20\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["PATIENT NAME", "", "SMITH,JOHN J JR\n", "SMITH~JOHN~J~JR\n", "00041\n", "", "", "\nThe patient's name (as found in the .01 field of the PATIENT file) will\nbe returned in this field. The family name (last name), given name\n(first name), middle initial or name, and suffix (JR or III) may be\nreturned separated by the designated HL7 component separator.\n
\n\n", "PID\n", "", "5\n", "\n- \n\n
\n", "48\n", "PN\n", "REQUIRED\n", ""], ["SET ID - INSURANCE", "", "", "", "00234\n", "", "", "", "MRG\n", "", "1\n", "\n- \n\n
\n", "4\n", "SI\n", "REQUIRED\n", ""], ["INSURANCE PLAN ID", "0072\n", "", "", "00378\n", "", "", "", "MRG\n", "", "2\n", "\n- \n\n
\n", "8\n", "ID\n", "REQUIRED\n", ""], ["INSURANCE COMPANY ID", "", "", "", "00235\n", "", "", "", "MRG\n", "", "3\n", "\n- \n\n
\n", "6\n", "ST\n", "REQUIRED\n", ""], ["INSURANCE COMPANY NAME", "", "", "", "00236\n", "", "", "", "MRG\n", "", "4\n", "\n- \n\n
\n", "45\n", "ST\n", "NOT REQUIRED\n", ""], ["INSURANCE COMPANY ADDRESS", "", "", "", "00237\n", "", "", "", "MRG\n", "", "5\n", "\n- \n\n
\n", "106\n", "AD\n", "NOT REQUIRED\n", ""], ["INSURANCE CO. CONTACT PERS", "", "", "", "00242\n", "", "", "", "MRG\n", "", "6\n", "\n- \n\n
\n", "48\n", "PN\n", "NOT REQUIRED\n", ""], ["INSURANCE CO. PHONE NUMBER", "", "", "", "00243\n", "", "", "", "MRG\n", "", "7\n", "\n- \n\n
\n", "40\n", "TN\n", "NOT REQUIRED\n", ""], ["GROUP NUMBER", "", "", "", "00248\n", "", "", "", "MRG\n", "", "8\n", "\n- \n\n
\n", "12\n", "ST\n", "NOT REQUIRED\n", ""], ["GROUP NAME", "", "", "", "00249\n", "", "", "", "MRG\n", "", "9\n", "\n- \n\n
\n", "35\n", "ST\n", "NOT REQUIRED\n", ""], ["INSURED'S GROUP EMP. ID", "", "", "", "00250\n", "", "", "", "MRG\n", "", "10\n", "\n- \n\n
\n", "12\n", "ST\n", "NOT REQUIRED\n", ""], ["DATE OF BIRTH", "", "AUGUST 9, 1927\n", "19270809 (YYYYMMDD)\n", "00043\n", "", "", "\nThe patient's date of birth (as found in the .03 field of the PATIENT file)\nwill be returned in this field.\n
\n\n", "PID\n", "", "7\n", "\n- \n\n
\n", "8\n", "DT\n", "NOT REQUIRED\n", ""], ["INSURED'S GROUP EMP. NAME", "", "", "", "00251\n", "", "", "", "MRG\n", "", "11\n", "\n- \n\n
\n", "45\n", "ST\n", "NOT REQUIRED\n", ""], ["PLAN EFFECTIVE DATE", "", "", "", "00252\n", "", "", "", "MRG\n", "", "12\n", "\n- \n\n
\n", "8\n", "DT\n", "NOT REQUIRED\n", ""], ["PLAN EXPIRATION DATE", "", "", "", "00253\n", "", "", "", "MRG\n", "", "13\n", "\n- \n\n
\n", "8\n", "DT\n", "NOT REQUIRED\n", ""], ["AUTHORIZATION INFORMATION", "", "", "", "00254\n", "", "", "", "MRG\n", "", "14\n", "\n- \n\n
\n", "55\n", "ST\n", "NOT REQUIRED\n", ""], ["PLAN TYPE", "0086\n", "", "", "00260\n", "", "", "", "MRG\n", "", "15\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["NAME OF INSURED", "", "", "", "00261\n", "", "", "", "MRG\n", "", "16\n", "\n- \n\n
\n", "48\n", "PN\n", "NOT REQUIRED\n", ""], ["INSURED'S RELATIONSHIP TO PATIENT", "0063\n", "", "", "00262\n", "", "", "", "MRG\n", "", "17\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["INSURED'S DATE OF BIRTH", "", "", "", "00708\n", "", "", "", "MRG\n", "", "18\n", "\n- \n\n
\n", "8\n", "DT\n", "NOT REQUIRED\n", ""], ["INSURED'S ADDRESS", "", "", "", "00709\n", "", "", "", "MRG\n", "", "19\n", "\n- \n\n
\n", "106\n", "AD\n", "NOT REQUIRED\n", ""], ["ASSIGNMENT OF BENEFITS", "", "", "", "00263\n", "", "", "", "MRG\n", "", "20\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["TEXT MESSAGE", "", "", "", "00004\n", "", "", "", "MSA\n", "", "3\n", "\n- \n\n
\n", "80\n", "ST\n", "NOT REQUIRED\n", ""], ["SEX", "0001\n", "MALE\n", "M\n", "00042\n", "", "", "\nThis field will contain the patient's sex (as found in the .02 field of the \n U Unknown\nPATIENT file). It will be returned as defined by HL7 Table 0001. DHCP \nwill never return the code O (Other). The code U (Unknown) will be used\nif no data exists in the DHCP field. The codes (as found in HL7 Table 0001-\nSEX) are:\n VALUE DESCRIPTION\n F Female\n M Male\n O Other (Note: Not used in DHCP)\n
\n\n", "PID\n", "", "8\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["COORDINATION OF BENEFITS", "", "", "", "00264\n", "", "", "", "MRG\n", "", "21\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["COORD OF BEN. PRIORITY", "", "", "", "00265\n", "", "", "", "MRG\n", "", "22\n", "\n- \n\n
\n", "2\n", "ST\n", "NOT REQUIRED\n", ""], ["NOTICE OF ADMISSION CODE", "0081\n", "", "", "00266\n", "", "", "", "MRG\n", "", "23\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["NOTICE OF ADMISSION DATE", "", "", "", "00267\n", "", "", "", "MRG\n", "", "24\n", "\n- \n\n
\n", "8\n", "DT\n", "NOT REQUIRED\n", ""], ["RPT OF ELIGIBILITY CODE", "0094\n", "", "", "00268\n", "", "", "", "MRG\n", "", "25\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["RPT OF ELIGIBILITY DATE", "", "", "", "00269\n", "", "", "", "MRG\n", "", "26\n", "\n- \n\n
\n", "8\n", "DT\n", "NOT REQUIRED\n", ""], ["RELEASE INFORMATION CODE", "0093\n", "", "", "00270\n", "", "", "", "MRG\n", "", "27\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["PRE-ADMIT CERT. (PAC)", "", "", "", "00271\n", "", "", "", "MRG\n", "", "28\n", "\n- \n\n
\n", "15\n", "ST\n", "NOT REQUIRED\n", ""], ["VERIFICATION DATE", "", "", "", "00272\n", "", "", "", "MRG\n", "", "29\n", "\n- \n\n
\n", "8\n", "DT\n", "NOT REQUIRED\n", ""], ["VERIFICATION BY", "", "", "", "00273\n", "", "", "", "MRG\n", "", "30\n", "\n- \n\n
\n", "60\n", "CM\n", "NOT REQUIRED\n", ""], ["SSN NUMBER - PATIENT", "", "", "", "00457\n", "", "", "\nThe patient's social security number (as found in the .09 field of the\nPATIENT file) will be returned in this field. The SSN NUMBER will be in \nthe internal (9 digit or digits followed by a P) format.\n
\n\n", "PID\n", "", "19\n", "\n- \n\n
\n", "16\n", "ST\n", "NOT REQUIRED\n", ""], ["TYPE OF AGREEMENT CODE", "0098\n", "", "", "00277\n", "", "", "", "MRG\n", "", "31\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["BILLING STATUS", "0022\n", "", "", "00278\n", "", "", "", "MRG\n", "", "32\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["LIFETIME RESERVE DAYS", "", "", "", "00280\n", "", "", "", "MRG\n", "", "33\n", "\n- \n\n
\n", "4\n", "NM\n", "NOT REQUIRED\n", ""], ["DELAY BEFORE L. R. DAY", "", "", "", "00281\n", "", "", "", "MRG\n", "", "34\n", "\n- \n\n
\n", "4\n", "NM\n", "NOT REQUIRED\n", ""], ["COMPANY PLAN CODE", "0042\n", "", "", "00282\n", "", "", "", "MRG\n", "", "35\n", "\n- \n\n
\n", "8\n", "ST\n", "NOT REQUIRED\n", ""], ["POLICY NUMBER", "", "", "", "00283\n", "", "", "", "MRG\n", "", "36\n", "\n- \n\n
\n", "15\n", "ST\n", "NOT REQUIRED\n", ""], ["POLICY DEDUCTIBLE", "", "", "", "00284\n", "", "", "", "MRG\n", "", "37\n", "\n- \n\n
\n", "12\n", "NM\n", "NOT REQUIRED\n", ""], ["POLICY LIMIT - AMOUNT", "", "", "", "00285\n", "", "", "", "MRG\n", "", "38\n", "\n- \n\n
\n", "12\n", "NM\n", "NOT REQUIRED\n", ""], ["POLICY LIMIT - DAYS", "", "", "", "00286\n", "", "", "", "MRG\n", "", "39\n", "\n- \n\n
\n", "4\n", "NM\n", "NOT REQUIRED\n", ""], ["ROOM RATE - SEMI-PRIVATE", "", "", "", "00287\n", "", "", "", "MRG\n", "", "40\n", "\n- \n\n
\n", "12\n", "NM\n", "NOT REQUIRED\n", ""], ["QUERY DATE/TIME", "", "", "", "00156\n", "", "", "", "QRD\n", "", "1\n", "\n- \n\n
\n", "19\n", "TS\n", "REQUIRED\n", ""], ["ROOM RATE - PRIVATE", "", "", "", "00288\n", "", "", "", "MRG\n", "", "41\n", "\n- \n\n
\n", "12\n", "NM\n", "NOT REQUIRED\n", ""], ["INSURED'S EMPLOYMENT STATUS", "0066\n", "", "", "00710\n", "", "", "", "MRG\n", "", "42\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["INSURED'S SEX", "0001\n", "", "", "00711\n", "", "", "", "MRG\n", "", "43\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["INSURED'S EMPLOYER ADDRESS", "", "", "", "00713\n", "", "", "", "MRG\n", "", "44\n", "\n- \n\n
\n", "106\n", "AD\n", "NOT REQUIRED\n", ""], ["NEXT OF KIN - PHONE NUMBER", "", "", "", "00230\n", "", "", "", "NPU\n", "", "5\n", "\n- \n\n
\n", "40\n", "TN\n", "NOT REQUIRED\n", "100\n"], ["SET ID - PROCEDURE", "", "", "", "00304\n", "", "", "", "PV1\n", "", "1\n", "\n- \n\n
\n", "4\n", "SI\n", "REQUIRED\n", "100\n"], ["PROCEDURE CODING METHOD", "0089\n", "", "", "00393\n", "", "", "", "PV1\n", "", "2\n", "\n- \n\n
\n", "2\n", "ID\n", "REQUIRED\n", "100\n"], ["PROCEDURE CODE", "0088\n", "", "", "00305\n", "", "", "", "PV1\n", "", "3\n", "\n- \n\n
\n", "10\n", "ID\n", "REQUIRED\n", "100\n"], ["PROCEDURE DESCRIPTION", "", "", "", "00306\n", "", "", "", "PV1\n", "", "4\n", "\n- \n\n
\n", "40\n", "ST\n", "NOT REQUIRED\n", "100\n"], ["PROCEDURE DATE/TIME", "", "", "", "00307\n", "", "", "", "PV1\n", "", "5\n", "\n- \n\n
\n", "19\n", "TS\n", "REQUIRED\n", ""], ["QUERY FORMAT CODE", "0106\n", "", "", "00158\n", "", "", "", "QRD\n", "", "2\n", "\n- \n\n
\n", "1\n", "ID\n", "REQUIRED\n", ""], ["PROCEDURE TYPE", "0090\n", "", "", "00309\n", "", "", "", "PV1\n", "", "6\n", "\n- \n\n
\n", "2\n", "ID\n", "REQUIRED\n", ""], ["PROCEDURE MINUTES", "", "", "", "00310\n", "", "", "", "PV1\n", "", "7\n", "\n- \n\n
\n", "4\n", "NM\n", "NOT REQUIRED\n", ""], ["ANESTHESIOLOGIST", "0010\n", "", "", "00311\n", "", "", "", "PV1\n", "", "8\n", "\n- \n\n
\n", "60\n", "CN\n", "NOT REQUIRED\n", ""], ["ANESTHESIA CODE", "0019\n", "", "", "00313\n", "", "", "", "PV1\n", "", "9\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["ANESTHESIA MINUTES", "", "", "", "00314\n", "", "", "", "PV1\n", "", "10\n", "\n- \n\n
\n", "4\n", "NM\n", "NOT REQUIRED\n", ""], ["SURGEON", "0010\n", "", "", "00315\n", "", "", "", "PV1\n", "", "11\n", "\n- \n\n
\n", "60\n", "CN\n", "NOT REQUIRED\n", ""], ["RESIDENT CODE", "0010\n", "", "", "00318\n", "", "", "", "PV1\n", "", "12\n", "\n- \n\n
\n", "60\n", "CN\n", "NOT REQUIRED\n", ""], ["CONSENT CODE", "0059\n", "", "", "00317\n", "", "", "", "PV1\n", "", "13\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["SET ID - UB82", "", "", "", "00459\n", "", "", "", "URD\n", "", "1\n", "\n- \n\n
\n", "4\n", "SI\n", "NOT REQUIRED\n", ""], ["BLOOD DEDUCTIBLE", "", "", "", "00279\n", "", "", "", "URD\n", "", "2\n", "\n- \n\n
\n", "1\n", "ST\n", "NOT REQUIRED\n", ""], ["QUERY PRIORITY", "0091\n", "", "", "00159\n", "", "", "", "QRD\n", "", "3\n", "\n- \n\n
\n", "1\n", "ID\n", "REQUIRED\n", ""], ["BLOOD FURN.-PINTS OF (40)", "", "", "", "00396\n", "", "", "", "URD\n", "", "3\n", "\n- \n\n
\n", "2\n", "ST\n", "NOT REQUIRED\n", ""], ["BLOOD REPLACED-PINTS (41)", "", "", "", "00397\n", "", "", "", "URD\n", "", "4\n", "\n- \n\n
\n", "2\n", "ST\n", "NOT REQUIRED\n", ""], ["BLOOD NOT RPLCD-PINTS(42)", "", "", "", "00398\n", "", "", "", "URD\n", "", "5\n", "\n- \n\n
\n", "2\n", "ST\n", "NOT REQUIRED\n", ""], ["CO-INSURANCE DAYS (25)", "", "", "", "00399\n", "", "", "", "URD\n", "", "6\n", "\n- \n\n
\n", "2\n", "ST\n", "NOT REQUIRED\n", ""], ["CONDITION CODE", "0043\n", "", "", "00400\n", "", "", "", "URD\n", "", "7\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", "5\n"], ["COVERED DAYS - (23)", "", "", "", "00405\n", "", "", "", "URD\n", "", "8\n", "\n- \n\n
\n", "3\n", "ST\n", "NOT REQUIRED\n", ""], ["NON COVERED DAYS - (24)", "", "", "", "00406\n", "", "", "", "URD\n", "", "9\n", "\n- \n\n
\n", "3\n", "ST\n", "NOT REQUIRED\n", ""], ["VALUE AMOUNT & CODE", "", "", "", "00407\n", "", "", "", "URD\n", "", "10\n", "\n- \n\n
\n", "12\n", "CM\n", "NOT REQUIRED\n", "8\n"], ["NUMBER OF GRACE DAYS (90)", "", "", "", "00424\n", "", "", "", "URD\n", "", "11\n", "\n- \n\n
\n", "2\n", "ST\n", "NOT REQUIRED\n", ""], ["SPEC. PROG. INDICATOR(44)", "", "", "", "00425\n", "", "", "", "URD\n", "", "12\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["QUERY ID", "", "", "", "00160\n", "", "", "", "QRD\n", "", "4\n", "\n- \n\n
\n", "10\n", "ST\n", "REQUIRED\n", ""], ["PSRO/UR APPROVAL IND. (87)", "", "", "", "00426\n", "", "", "", "URD\n", "", "13\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["PSRO/UR APRVD STAY-FM(88)", "", "", "", "00427\n", "", "", "", "URD\n", "", "14\n", "\n- \n\n
\n", "8\n", "DT\n", "NOT REQUIRED\n", ""], ["PSRO/UR APRVD STAY-TO(89)", "", "", "", "00428\n", "", "", "", "URD\n", "", "15\n", "\n- \n\n
\n", "8\n", "DT\n", "NOT REQUIRED\n", ""], ["OCCURRENCE (28-32)", "", "", "", "00429\n", "", "", "", "URD\n", "", "16\n", "\n- \n\n
\n", "20\n", "ID\n", "NOT REQUIRED\n", "5\n"], ["OCCURRENCE SPAN (33)", "", "", "", "00435\n", "", "", "", "URD\n", "", "17\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["OCCURRENCE SPAN START DATE(33)", "", "", "", "00446\n", "", "", "", "URD\n", "", "18\n", "\n- \n\n
\n", "8\n", "DT\n", "NOT REQUIRED\n", ""], ["OCCUR. SPAN END DATE (33)", "", "", "", "00447\n", "", "", "", "URD\n", "", "19\n", "\n- \n\n
\n", "8\n", "DT\n", "NOT REQUIRED\n", ""], ["UB-82 LOCATOR 2", "", "", "", "00448\n", "", "", "", "URD\n", "", "20\n", "\n- \n\n
\n", "30\n", "ST\n", "NOT REQUIRED\n", ""], ["UB-82 LOCATOR 9", "", "", "", "00449\n", "", "", "", "URD\n", "", "21\n", "\n- \n\n
\n", "7\n", "ST\n", "NOT REQUIRED\n", ""], ["UB-82 LOCATOR 27", "", "", "", "00450\n", "", "", "", "URD\n", "", "22\n", "\n- \n\n
\n", "8\n", "ST\n", "NOT REQUIRED\n", ""], ["QUANTITY LIMITED REQUEST", "0126\n", "", "", "00164\n", "", "", "", "QRD\n", "", "7\n", "\n- \n\n
\n", "5\n", "CQ\n", "REQUIRED\n", ""], ["UB-82 LOCATOR 45", "", "", "", "00451\n", "", "", "", "URD\n", "", "23\n", "\n- \n\n
\n", "17\n", "ST\n", "NOT REQUIRED\n", ""], ["SET ID - OBSERVATION REQUEST", "", "", "", "00520\n", "", "", "", "OBR\n", "", "1\n", "\n- \n\n
\n", "4\n", "SI\n", "NOT REQUIRED\n", ""], ["PLACERS ORDER #", "", "", "", "00732\n", "", "", "", "OBR\n", "", "2\n", "\n- \n\n
\n", "75\n", "CM\n", "NOT REQUIRED\n", ""], ["FILLERS ORDER #", "", "", "", "00733\n", "", "", "", "OBR\n", "", "3\n", "\n- \n\n
\n", "75\n", "CM\n", "NOT REQUIRED\n", ""], ["PRIORITY", "", "", "", "00524\n", "", "", "", "OBR\n", "", "5\n", "\n- \n\n
\n", "2\n", "ST\n", "NOT REQUIRED\n", ""], ["REQUESTED DATE-TIME", "", "", "", "00529\n", "", "", "", "OBR\n", "", "6\n", "\n- \n\n
\n", "19\n", "TS\n", "NOT REQUIRED\n", ""], ["COLLECTOR IDENTIFIER", "", "", "", "00533\n", "", "", "", "OBR\n", "", "10\n", "\n- \n\n
\n", "60\n", "CN\n", "NOT REQUIRED\n", "100\n"], ["SPECIMEN ACTION CODE", "0065\n", "", "", "00534\n", "", "", "", "OBR\n", "", "11\n", "\n- \n\n
\n", "1\n", "ST\n", "NOT REQUIRED\n", ""], ["DANGER CODE", "0047\n", "", "", "00535\n", "", "", "", "OBR\n", "", "12\n", "\n- \n\n
\n", "60\n", "CM\n", "NOT REQUIRED\n", ""], ["WHO SUBJECT FILTER", "", "", "", "00168\n", "", "", "", "QRD\n", "", "8\n", "\n- \n\n
\n", "20\n", "ST\n", "REQUIRED\n", "100\n"], ["RELEVANT CLINICAL INFO.", "", "", "", "00536\n", "", "", "", "OBR\n", "", "13\n", "\n- \n\n
\n", "300\n", "ST\n", "NOT REQUIRED\n", ""], ["SPECIMEN SOURCE", "0070\n", "", "", "00538\n", "", "", "", "OBR\n", "", "15\n", "\n- \n\n
\n", "300\n", "CM\n", "NOT REQUIRED\n", ""], ["ORDER CALL-BACK PHONE NUM", "", "", "", "00540\n", "", "", "", "OBR\n", "", "17\n", "\n- \n\n
\n", "40\n", "TN\n", "NOT REQUIRED\n", "2\n"], ["PLACERS FIELD #2", "", "", "", "00542\n", "", "", "", "OBR\n", "", "19\n", "\n- \n\n
\n", "60\n", "ST\n", "NOT REQUIRED\n", ""], ["FILLERS FIELD #2", "", "", "", "00544\n", "", "", "", "OBR\n", "", "21\n", "\n- \n\n
\n", "60\n", "ST\n", "NOT REQUIRED\n", ""], ["CHARGE TO PRACTICE", "", "", "", "00547\n", "", "", "", "OBR\n", "", "23\n", "\n- \n\n
\n", "40\n", "CM\n", "NOT REQUIRED\n", ""], ["DIAGNOSTIC SERV SECT ID", "0074\n", "", "", "00548\n", "", "", "", "OBR\n", "", "24\n", "\n- \n\n
\n", "10\n", "ID\n", "NOT REQUIRED\n", ""], ["RESULT STATUS", "0123\n", "", "", "00734\n", "", "", "", "OBR\n", "", "25\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["LINKED RESULTS", "", "", "", "00550\n", "", "", "", "OBR\n", "", "26\n", "\n- \n\n
\n", "200\n", "CE\n", "NOT REQUIRED\n", ""], ["WHAT SUBJECT FILTER", "0048\n", "", "", "00169\n", "", "", "", "QRD\n", "", "9\n", "\n- \n\n
\n", "3\n", "ID\n", "REQUIRED\n", "100\n"], ["QUANTITY/TIMING", "", "", "", "00735\n", "", "", "", "OBR\n", "", "27\n", "\n- \n\n
\n", "200\n", "CM\n", "NOT REQUIRED\n", "100\n"], ["RESULT COPIES TO", "", "", "", "00551\n", "", "", "", "OBR\n", "", "28\n", "\n- \n\n
\n", "80\n", "CN\n", "NOT REQUIRED\n", "5\n"], ["PARENT ACCESSION #", "", "", "", "00737\n", "", "", "", "OBR\n", "", "29\n", "\n- \n\n
\n", "150\n", "CM\n", "NOT REQUIRED\n", ""], ["TRANSPORTATION MODE", "0124\n", "", "", "00625\n", "", "", "", "OBR\n", "", "30\n", "\n- \n\n
\n", "20\n", "ID\n", "NOT REQUIRED\n", ""], ["REASON FOR STUDY", "", "", "", "00626\n", "", "", "", "OBR\n", "", "31\n", "\n- \n\n
\n", "300\n", "CE\n", "NOT REQUIRED\n", "100\n"], ["PRINCIPAL RESULT INTERPRETER", "", "", "", "00627\n", "", "", "", "OBR\n", "", "32\n", "\n- \n\n
\n", "60\n", "CN\n", "NOT REQUIRED\n", ""], ["ASSISTANT RESULT INTERPRETER", "", "", "", "00628\n", "", "", "", "OBR\n", "", "33\n", "\n- \n\n
\n", "60\n", "CN\n", "NOT REQUIRED\n", ""], ["TECHNICIAN", "", "", "", "00630\n", "", "", "", "OBR\n", "", "34\n", "\n- \n\n
\n", "60\n", "CN\n", "NOT REQUIRED\n", ""], ["TRANSCRIPTIONIST", "", "", "", "00629\n", "", "", "", "OBR\n", "", "35\n", "\n- \n\n
\n", "60\n", "CN\n", "NOT REQUIRED\n", ""], ["SCHEDULED - DATE/TIME", "", "", "", "00736\n", "", "", "", "OBR\n", "", "36\n", "\n- \n\n
\n", "19\n", "TS\n", "NOT REQUIRED\n", ""], ["WHAT DEPARTMENT DATA CODE", "", "", "", "00170\n", "", "", "", "QRD\n", "", "10\n", "\n- \n\n
\n", "20\n", "ST\n", "REQUIRED\n", "100\n"], ["SET ID - OBSERVATION SIMPLE", "", "", "", "00559\n", "", "", "", "OBX\n", "", "1\n", "\n- \n\n
\n", "4\n", "SI\n", "NOT REQUIRED\n", ""], ["OBSERVATION SUB-ID", "", "", "", "00769\n", "", "", "", "OBX\n", "", "4\n", "\n- \n\n
\n", "20\n", "ST\n", "NOT REQUIRED\n", ""], ["UNITS", "", "", "", "00562\n", "", "", "", "OBX\n", "", "6\n", "\n- \n\n
\n", "20\n", "ST\n", "NOT REQUIRED\n", ""], ["REFERENCE RANGE", "", "", "", "00563\n", "", "", "", "OBX\n", "", "7\n", "\n- \n\n
\n", "60\n", "ST\n", "NOT REQUIRED\n", ""], ["ABNORMAL FLAGS", "0078\n", "", "", "00564\n", "", "", "", "OBX\n", "", "8\n", "\n- \n\n
\n", "10\n", "ST\n", "NOT REQUIRED\n", "5\n"], ["PROBABILITY", "", "", "", "00639\n", "", "", "", "OBX\n", "", "9\n", "\n- \n\n
\n", "5\n", "NM\n", "NOT REQUIRED\n", ""], ["NATURE OF ABNORMAL TEST", "0080\n", "", "", "00565\n", "", "", "", "OBX\n", "", "10\n", "\n- \n\n
\n", "5\n", "ID\n", "NOT REQUIRED\n", ""], ["OBSERVATION RESULT STATUS", "0085\n", "", "", "00566\n", "", "", "", "OBX\n", "", "11\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["DATE LAST OBS NORMAL VALUES", "", "", "", "00567\n", "", "", "", "OBX\n", "", "12\n", "\n- \n\n
\n", "19\n", "TS\n", "NOT REQUIRED\n", ""], ["SYSTEM DATE/TIME", "", "", "", "00742\n", "", "", "", "NK1\n", "", "1\n", "\n- \n\n
\n", "19\n", "TS\n", "REQUIRED\n", ""], ["FIELD SEPARATOR", "", "", "", "00005\n", "", "", "", "MSH\n", "", "1\n", "\n- \n\n
\n", "1\n", "ST\n", "REQUIRED\n", ""], ["PLACERS FIELD #1", "", "", "", "00541\n", "", "", "", "OBR\n", "", "18\n", "\n- \n\n
\n", "60\n", "ST\n", "NOT REQUIRED\n", ""], ["STATISTICS AVAILABLE", "", "", "", "00743\n", "", "", "", "NTE\n", "", "1\n", "\n- \n\n
\n", "1\n", "ID\n", "REQUIRED\n", ""], ["SOURCE IDENTIFIER", "", "", "", "00744\n", "", "", "", "NTE\n", "", "2\n", "\n- \n\n
\n", "30\n", "ST\n", "NOT REQUIRED\n", ""], ["SOURCE TYPE", "", "", "", "00745\n", "", "", "", "NTE\n", "", "3\n", "\n- \n\n
\n", "3\n", "ID\n", "NOT REQUIRED\n", ""], ["STATISTICS START", "", "", "", "00746\n", "", "", "", "NTE\n", "", "4\n", "\n- \n\n
\n", "19\n", "TS\n", "NOT REQUIRED\n", ""], ["STATISTICS END", "", "", "", "00747\n", "", "", "", "NTE\n", "", "5\n", "\n- \n\n
\n", "19\n", "TS\n", "NOT REQUIRED\n", ""], ["RECEIVE CHARACTER COUNT", "", "", "", "00748\n", "", "", "", "NTE\n", "", "6\n", "\n- \n\n
\n", "10\n", "NM\n", "NOT REQUIRED\n", ""], ["SEND CHARACTER COUNT", "", "", "", "00749\n", "", "", "", "NTE\n", "", "7\n", "\n- \n\n
\n", "10\n", "NM\n", "NOT REQUIRED\n", ""], ["MESSAGES RECEIVED", "", "", "", "00750\n", "", "", "", "NTE\n", "", "8\n", "\n- \n\n
\n", "10\n", "NM\n", "NOT REQUIRED\n", ""], ["MESSAGES SENT", "", "", "", "00751\n", "", "", "", "NTE\n", "", "9\n", "\n- \n\n
\n", "10\n", "NM\n", "NOT REQUIRED\n", ""], ["CHECKSUM ERRORS RECEIVED", "", "", "", "00752\n", "", "", "", "NTE\n", "", "10\n", "\n- \n\n
\n", "10\n", "NM\n", "NOT REQUIRED\n", ""], ["ORDER CONTROL", "0119\n", "", "", "00714\n", "", "", "", "ORC\n", "", "1\n", "\n- \n\n
\n", "2\n", "ST\n", "REQUIRED\n", ""], ["LENGTH ERRORS RECEIVED", "", "", "", "00753\n", "", "", "", "NTE\n", "", "11\n", "\n- \n\n
\n", "10\n", "NM\n", "NOT REQUIRED\n", ""], ["OTHER ERRORS RECEIVED", "", "", "", "00754\n", "", "", "", "NTE\n", "", "12\n", "\n- \n\n
\n", "10\n", "NM\n", "NOT REQUIRED\n", ""], ["CONNECT TIMEOUTS", "", "", "", "00755\n", "", "", "", "NTE\n", "", "13\n", "\n- \n\n
\n", "10\n", "NM\n", "NOT REQUIRED\n", ""], ["RECEIVE TIMEOUTS", "", "", "", "00756\n", "", "", "", "NTE\n", "", "14\n", "\n- \n\n
\n", "10\n", "NM\n", "NOT REQUIRED\n", ""], ["NETWORK ERRORS", "", "", "", "00757\n", "", "", "", "NTE\n", "", "15\n", "\n- \n\n
\n", "10\n", "NM\n", "NOT REQUIRED\n", ""], ["NETWORK CHANGE TYPE", "", "", "", "00758\n", "", "", "", "NST\n", "", "1\n", "\n- \n\n
\n", "4\n", "ID\n", "REQUIRED\n", ""], ["CURRENT CPU", "", "", "", "00759\n", "", "", "", "NST\n", "", "2\n", "\n- \n\n
\n", "30\n", "ST\n", "NOT REQUIRED\n", ""], ["CURRENT FILESERVER", "", "", "", "00760\n", "", "", "", "NST\n", "", "3\n", "\n- \n\n
\n", "30\n", "ST\n", "NOT REQUIRED\n", ""], ["CURRENT APPLICATION", "", "", "", "00761\n", "", "", "", "NST\n", "", "4\n", "\n- \n\n
\n", "30\n", "ST\n", "NOT REQUIRED\n", ""], ["CURRENT FACILITY", "", "", "", "00762\n", "", "", "", "NST\n", "", "5\n", "\n- \n\n
\n", "30\n", "ST\n", "NOT REQUIRED\n", ""], ["ORDER STATUS", "0038\n", "", "", "00718\n", "", "", "", "ORC\n", "", "5\n", "\n- \n\n
\n", "2\n", "ST\n", "NOT REQUIRED\n", ""], ["NEW CPU", "", "", "", "00763\n", "", "", "", "NST\n", "", "6\n", "\n- \n\n
\n", "30\n", "ST\n", "NOT REQUIRED\n", ""], ["NEW FILESERVER", "", "", "", "00764\n", "", "", "", "NST\n", "", "7\n", "\n- \n\n
\n", "30\n", "ST\n", "NOT REQUIRED\n", ""], ["NEW APPLICATION", "", "", "", "00765\n", "", "", "", "NST\n", "", "8\n", "\n- \n\n
\n", "30\n", "ST\n", "NOT REQUIRED\n", ""], ["NEW FACILITY", "", "", "", "00766\n", "", "", "", "NST\n", "", "9\n", "\n- \n\n
\n", "30\n", "ST\n", "NOT REQUIRED\n", ""], ["LANGUAGE - PATIENT", "", "", "", "00464\n", "", "", "\nThere is no corresponding DHCP field at this time.\n
\n\n", "PID\n", "", "15\n", "\n- \n\n
\n", "25\n", "ST\n", "NOT REQUIRED\n", ""], ["SET ID - CONTACT", "", "N/A\n", "", "", "", "", "\nThis field is passed to the segment and is used as an identifier. It will\nbe set to 1 if it is not passed in. This field is numeric with a maximum\nlength of 4 digits.\n
\n\n", "ZDP\n", "", "1\n", "\n- \n\n
\n", "4\n", "SI\n", "REQUIRED\n", ""], ["CONTACT TYPE", "", "N/A\n", "", "", "", "", "\nThis field will be passed to the segment and is used to return various\n 3 = Emergency Contact .33\n 4 = Second Emergency Contact .331\n 5 = Designee .34\nPATIENT file nodes based on the CONTACT TYPE. Table (A) below identifies\nthe various CONTACT TYPES and the corresponding DHCP PATIENT file node.\n \n TABLE A\n \n CONTACT TYPE DHCP PATIENT FILE NODE\n 1 = Next of Kin .21\n 2 = Second Next of Kin .211\n
\n\n", "ZDP\n", "", "2\n", "\n- \n\n
\n", "1\n", "ID\n", "REQUIRED\n", ""], ["CONTACT NAME", "", "SMITH,JOHN\n", "SMITH,JOHN\n", "", "", "", "\nThis field returns the name of the contact person from the first piece of\nthe corresponding PATIENT file node based on CONTACT TYPE. Please refer\nto Table (A) in the CONTACT TYPE field.\n
\n\n", "ZDP\n", "", "3\n", "\n- \n\n
\n", "35\n", "ST\n", "NOT REQUIRED\n", ""], ["CONTACT RELATIONSHIP", "", "SPOUSE\n", "SPOUSE\n", "", "", "", "\nThis field returns the relationship of the contact to the patient from the\nsecond piece of the corresponding PATIENT file node and is dependent on\nthe CONTACT TYPE field. Please refer to Table (A) in the CONTACT TYPE\nfield.\n
\n\n", "ZDP\n", "", "4\n", "\n- \n\n
\n", "30\n", "ST\n", "NOT REQUIRED\n", ""], ["CONTACT ADDRESS", "", "123 Park Avenue^Apt. 4^Suite 301^Albany^NY^12234-2311\n", "123 Park Avenue~Apt. 4 Suite 301~Albany~NY~12234-2311\n", "", "", "", "\nThis field will return the address of the contact from pieces 3 through 8\nslightly longer.\nof the corresponding PATIENT file node based on the CONTACT TYPE field.\nPlease refer to Table (A) in the CONTACT TYPE field. This field will be\nreturned in standard HL7 AD (address) format. This includes the contact's\nstreet address, city, state and zip code fields. HL7 allows for only 2\nlines of street address. If 3 lines are specified in the contact's address,\nthe second and third lines will be put into the second HL7 component and\nwill be separated by a space. Further, HL7 allows 106 characters for all\nAD data types, but it is possible that the DHCP address field could be\n
\n\n", "ZDP\n", "", "5\n", "\n- \n\n
\n", "106\n", "AD\n", "NOT REQUIRED\n", ""], ["DATE/TIME OF TRANSACTION", "", "", "", "00722\n", "", "", "", "ORC\n", "", "9\n", "\n- \n\n
\n", "19\n", "TS\n", "NOT REQUIRED\n", ""], ["CONTACT PHONE NUMBER", "", "", "(518)555-7689\n", "", "", "", "\nThis field returns the contact telephone number from the ninth piece of\nthe corresponding PATIENT file node and is dependent on the CONTACT TYPE\nfield. Please refer to Table (A) in the CONTACT TYPE field. The data\nwill be returned in HL7 TN (Telephone Number) format as follows\n[(999)999-9999X888]. The optional 'X' portion gives an extension.\n
\n\n", "ZDP\n", "", "6\n", "\n- \n\n
\n", "40\n", "TN\n", "NOT REQUIRED\n", ""], ["CONTACT WORK PHONE NUMBER", "", "", "(518)555-2125\n", "", "", "", "\nThis field returns the work telephone number of the contact from the\neleventh piece of the corresponding PATIENT file node and is dependent\non CONTACT TYPE field. Please refer to Table (A) in the CONTACT TYPE\nfield. The data will be returned in HL7 TN (Telephone Number) format as\nfollows [(999)999-9999X888]. The optional 'X' portion gives an extension.\n
\n\n", "ZDP\n", "", "7\n", "\n- \n\n
\n", "40\n", "TN\n", "NOT REQUIRED\n", ""], ["CONTACT ADDRESS SAME AS NOK?", "", "Y\n", "", "", "", "", "\nThis field will contain the result to the question "Is the address of\neither the primary Next of Kin (NOK) or secondary NOK the same as the\npatient?". This data is found in the tenth piece of the corresponding\nPATIENT file node and is dependent on the CONTACT TYPE field. Please\nrefer to Table (A) in the CONTACT TYPE field. This question pertains only\nto the Next of Kin and secondary Next of Kin types.\n DHCP VALUE CORRESPONDING HL7 VALUE\n Y 1\n N 0\n
\n\n", "ZDP\n", "", "8\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["CONTACT PERSON SAME AS NOK?", "", "N\n", "", "", "", "", "\nThis field will contain the result to the question "Is the Emergency\nContact or Designee the same person as the one listed in the Next of Kin\nfield?". The data returned is found in the tenth piece of the\ncorresponding PATIENT file node and is dependent on the CONTACT TYPE\nfield. Please refer to Table (A) in the CONTACT TYPE field.\nThis question pertains only to the Emergency Contact and Designee types.\n DHCP VALUE CORRESPONDING HL7 VALUE\n Y 1\n N 0\n
\n\n", "ZDP\n", "", "9\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["SET ID - ELIGIBILITY", "", "N/A\n", "", "", "", "", "\nThis field is passed to the segment and is used as an identifier. If the\nnumber 1 is passed in, the primary eligibility segment which includes the\neligibility code, long ID, short ID and all other fields of the segment\nwill be returned. If the number passed in is 2 or greater, the primary\neligibility segment will be returned and each additional eligibility code\npertaining to the patient will be returned in a segment containing the\neligibility code, long ID, and short ID fields only. This field will be\nset to 1 if it is not passed.\n
\n\n", "ZEM\n", "", "1\n", "\n- \n\n
\n", "4\n", "SI\n", "REQUIRED\n", ""], ["ELIGIBILITY CODE", "", "", "", "", "", "", "\nThe code describing the patient's eligibility as found in the MAS\n EMPLOYEE 14\n HOUSEBOUND 15\n HUMANITARIAN EMERGENCY 8\n AID & ATTENDANCE 2\n MEXICAN BORDER WAR 16\n NSC 5\n NSC, VA PENSION 4\n OTHER FEDERAL AGENCY 6\n PRISONER OF WAR 18\n REIMBURSABLE INSURANCE 10\nELIGIBILITY CODE file (#8.1) will be returned in this field. Table (A)\n SC LESS THAN 50% 3\n SERVICE CONNECTED 50-100% 1\n SHARING AGREEMENT 9\n WORLD WAR I 17\nbelow identifies all DHCP eligibility codes and their descriptions.\n TABLE A\n DESCRIPTION ELIGIBILITY CODE\n ALLIED VETERAN 7\n CHAMPVA 12\n COLLATERAL OF VET. 13\n DOM. PATIENT 11\n
\n\n", "ZEM\n", "", "2\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["LONG ID", "", "123-45-6789\n", "123-45-6789~1~M11\n", "", "", "", "\nThis field returns the Long ID field of the patient from the Patient\nEligibilities multiple (as found in the .03 field of the .0361 multiple\nof the PATIENT file). For most eligibilities, this will be the patient's\nsocial security number formatted with dashes. However, for patients\nseen under joint sharing agreements or seen at DoD facilities, this field\nmay differ. This field is returned in HL7 CK (M11 check digit) format.\nIt may exceed the 16 character maximum length specified in the HL7\ndefinition.\n
\n\n", "ZEM\n", "", "3\n", "\n- \n\n
\n", "16\n", "CK\n", "NOT REQUIRED\n", ""], ["SHORT ID", "", "", "", "", "", "", "\nThis field returns the Short ID field of the patient from the Patient\nEligibilities multiple (as found in the .04 field of the .0361 multiple\nfield of the Patient file). For most eligibilities, this will be the last\n4 digits in the patient's social security number. However, for patients\nseen under joint sharing agreements or seen at DoD facilities, this field\nmay differ.\n
\n\n", "ZEM\n", "", "4\n", "\n- \n\n
\n", "12\n", "ST\n", "NOT REQUIRED\n", ""], ["DISABILITY RETIREMENT FROM MIL.", "", "", "", "", "", "", "\nThis field returns whether the patient was retired from the military as a\n 2 YES, Receiving Military Retirement in lieu of VA Compensation\n 3 UNKNOWN\nresult of a disability (as found in the .362 field of the PATIENT file).\nThis field is represented in DHCP as a coded value. The table describes \nthe list of DHCP coded values and their descriptions. This field will be\nreturned with the primary eligibility segment (SET ID=1) only. The codes\n(as found in the .362 field of the PATIENT file) are:\n VALUE DESCRIPTION\n 0 NO\n 1 YES, Receiving Military Retirement\n
\n\n", "ZEM\n", "", "5\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["ELIGIBILITY STATUS", "", "P\n", "P\n", "", "", "", "\nThis field returns the status of the patient's eligibility (as found in\nthe .3611 field of the PATIENT file). This status will be one of three\ncodes: P for Pending Verification, R for Pending Re-Verification, and\nV for Verified. This field will be returned with the primary eligibility\nsegment (SET ID=1) only.\n
\n\n", "ZEM\n", "", "10\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["ORDERING PROVIDER", "", "", "", "00725\n", "", "", "", "ORC\n", "", "12\n", "\n- \n\n
\n", "80\n", "CN\n", "NOT REQUIRED\n", ""], ["CLAIM FOLDER NUMBER", "", "", "", "", "", "", "\nThis field returns the patient's Claim Folder Number (as found in the .313\nfield of the PATIENT file). This field will be returned with the primary\neligibility segment (SET ID=1) only.\n
\n\n", "ZEM\n", "", "6\n", "\n- \n\n
\n", "8\n", "NM\n", "NOT REQUIRED\n", ""], ["CLAIM FOLDER LOCATION", "", "ALBANY\n", "ALBANY\n", "", "", "", "\nThis field returns the location of the patient's claim folder (as found in \nthe .312 field of the PATIENT file). This field will be returned with the \nprimary eligibility segment (SET ID=1) only.\n
\n\n", "ZEM\n", "", "7\n", "\n- \n\n
\n", "40\n", "ST\n", "NOT REQUIRED\n", ""], ["VETERAN?", "", "Y\n", "", "", "", "", "\nThis field will contain the result of the question, "Is the patient \nrequesting care as a veteran of the U.S. Armed Forces?" (as found in\nthe field #1901 of the PATIENT file). This field will be returned with\nthe primary eligibility segment (SET ID=1) only.\n DHCP VALUE CORRESPONDING HL7 VALUE\n Y 1\n N O\n
\n\n", "ZEM\n", "", "8\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["TYPE OF PATIENT", "", "NSC VETERAN\n", "NSC VETERAN\n", "", "", "", "\nThis field returns the type classification of the patient (as found in the\n.01 field of the TYPE OF PATIENT file #391). A list of distributed patient\ntypes from this file includes: NSC VETERAN, SC VETERAN, ACTIVE DUTY,\nALLIED VETERAN, COLLATERAL, EMPLOYEE, MILITARY RETIREE, and NON-VETERAN\n(OTHER). (The site may also have locally defined patient types.) This\nfield will be returned with the primary eligibility segment (SET ID=1)\nonly.\n
\n\n", "ZEM\n", "", "9\n", "\n- \n\n
\n", "30\n", "ST\n", "NOT REQUIRED\n", ""], ["ELIGIBILITY STATUS DATE", "", "April 30, 1993\n", "", "", "", "", "\nThis field returns the date that the current eligibility status was\ndetermined (as found in the .3612 field of the PATIENT file). This field\nwill be returned for the primary eligibility segment (SET ID=1) only.\n
\n\n", "ZEM\n", "", "11\n", "\n- \n\n
\n", "8\n", "DT\n", "NOT REQUIRED\n", ""], ["ELIGIBILITY INTERIM RESPONSE", "", "March 1, 1993\n", "19930301 (YYYYMMDD)\n", "", "", "", "\nThis field returns the interim response date concerning the patient's\ncurrent eligibility status (as found in the .3614 field of the PATIENT\nfile). This field will be returned for the primary eligibility segment\n(SET ID=1) only.\n
\n\n", "ZEM\n", "", "12\n", "\n- \n\n
\n", "8\n", "DT\n", "NOT REQUIRED\n", ""], ["ELIGIBILITY VERIFICATION METHOD", "", "HINQ\n", "HINQ\n", "", "", "", "\nThis field returns the method by which the patient's eligibility was\nverified (as found in the .3615 field of the PATIENT file). This field\nwill be returned for the primary eligibility segment (SET ID=1) only.\n
\n\n", "ZEM\n", "", "13\n", "\n- \n\n
\n", "50\n", "ST\n", "NOT REQUIRED\n", ""], ["SET ID - EMPLOYMENT", "", "N/A\n", "", "", "", "", "\nFor those messages that permit multiple patients to be transmitted, this\nfield will contain a sequential number to identify the repetitions.\n
\n\n", "ZGD\n", "", "1\n", "\n- \n\n
\n", "4\n", "SI\n", "REQUIRED\n", ""], ["EMPLOYMENT PERSON", "", "N/A\n", "", "", "", "", "\nThis field will contain a 1 if the data returned in the segment pertains\nto the patient's employer. A 2 will be returned if the data in the \nsegment pertains to the spouse. When calling the utility which produces \nthis segment, the calling program may pass the value of 1 or 2 to\ndetermine what data will be returned. If a value is not specified by\nthe calling application, the patient employer data will be returned.\n
\n\n", "ZGD\n", "", "2\n", "\n- \n\n
\n", "1\n", "ID\n", "REQUIRED\n", ""], ["EMPLOYMENT STATUS", "", "", "", "", "", "", "\nThis field returns the current employment status of the veteran or the\n 4 Self Employed\n 5 Retired\n 6 Active Military Duty\n 9 Unknown\nveteran's spouse and is dependent on the EMPLOYMENT PERSON field. If\nEMPLOYMENT PERSON is 1, the EMPLOYMENT STATUS (.31115) field of the\nPATIENT file will be returned. If EMPLOYMENT PERSON is 2, the SPOUSE'S\nEMPLOYMENT STATUS (.2515) field of the PATIENT file will be returned.\n DHCP VALUE EMPLOYMENT STATUS\n 1 Employed Full Time\n 2 Employed Part Time\n 3 Not Employed\n
\n\n", "ZGD\n", "", "3\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["CALL BACK PHONE NUMBER", "", "", "", "00727\n", "", "", "", "ORC\n", "", "14\n", "\n- \n\n
\n", "40\n", "TN\n", "NOT REQUIRED\n", "2\n"], ["EMPLOYER NAME", "", "SMITH CONTRACTORS\n", "SMITH CONTRACTORS\n", "", "", "", "\nThis field returns the name of the patient's employer or the spouse's\nemployer and is dependent on the EMPLOYMENT PERSON field. If the\nEMPLOYMENT PERSON is 1, the EMPLOYER (.3111) field of the PATIENT file\nwill be returned. If EMPLOYMENT PERSON is 2, the SPOUSE'S EMPLOYER \n(.251) field of the PATIENT file will be returned.\n
\n\n", "ZGD\n", "", "4\n", "\n- \n\n
\n", "30\n", "ST\n", "NOT REQUIRED\n", ""], ["OCCUPATION", "", "FOREMAN\n", "FOREMAN\n", "", "", "", "\nThis field contains the patient's or the spouse's occupation and is\ndependent on the EMPLOYMENT PERSON field. If EMPLOYMENT PERSON is 1,\nthe OCCUPATION (.07) field of the PATIENT file will be returned. If the\nEMPLOYMENT PERSON is 2, the SPOUSE'S OCCUPATION (.2514) field of the\nPATIENT file will be returned.\n
\n\n", "ZGD\n", "", "5\n", "\n- \n\n
\n", "30\n", "ST\n", "NOT REQUIRED\n", ""], ["EMPLOYER ADDRESS", "", "18 Main Street^Apt 5B^Albany^NY^12345-1234\n", "18 Main Street~Apt 5B~Albany~NY~12345-1234\n", "", "", "", "\nThis field returns the mailing address of the patient's employer or the\nput into the 2nd HL7 component (other designation) and will be separated\nby a space. Further, HL7 allows 106 characters for all AD data types,\nbut it is possible that the DHCP address field could be slightly longer.\nspouse's employer and is dependent on the EMPLOYMENT PERSON field. If\nEMPLOYMENT PERSON is 1, the veteran's address (.3113-.3118) fields of\nthe PATIENT file will be returned. If EMPLOYMENT PERSON is 2, the\nspouse's address (.252-.257) fields of the PATIENT file will be returned.\nThe address will be returned in standard HL7 AD (Address) format. The \nstreet address, other designation, city, state, and zip code will be\nreturned. HL7 allows for only 2 lines of the street address. If 3 lines\nare specified in the patient address, the second and third lines will be\n
\n\n", "ZGD\n", "", "6\n", "\n- \n\n
\n", "106\n", "AD\n", "NOT REQUIRED\n", ""], ["EMPLOYER PHONE NUMBER", "", "", "(212)555-2344\n", "", "", "", "\nThis field contains the phone number of the patient's employer or the\nspouse's employer and is depent on the EMPLOYMENT PERSON field. If\nthe EMPLOYMENT PERSON is 1, the EMPLOYER PHONE (.3119) field of the\nPATIENT file will be returned. If the EMPLOYMENT PERSON is 2, the\nSPOUSE'S EMPLOYMENT PHONE (.258) field of the PATIENT file will be\nreturned. The data will be returned in HL7 TN (Telephone Number) format\nas follows [(999)999-9999X888]. The optional 'X' portion gives an\nextension.\n
\n\n", "ZGD\n", "", "7\n", "\n- \n\n
\n", "40\n", "TN\n", "NOT REQUIRED\n", ""], ["GOVERNMENT AGENCY", "", "Y\n", "", "", "", "", "\nIf the EMPLOYMENT PERSON field is 1, the GOVERNMENT AGENCY (.3112) field\n(as found in the .3112 field of the PATIENT file) will be returned. This\nfield is only returned if the EMPLOYMENT PERSON field contains a value of 1.\n DHCP VALUE CORRESPONDING HL7 VALUE\n Y 1\n N 0\n
\n\n", "ZGD\n", "", "8\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["SET ID - GUARDIAN", "", "N/A\n", "", "", "", "", "\nFor those messages that permit multiple patients to be transmitted, this\nfield will contain a sequential number to identify the repetitions.\n
\n\n", "ZIC\n", "", "1\n", "\n- \n\n
\n", "4\n", "SI\n", "REQUIRED\n", ""], ["GUARDIAN TYPE", "", "N/A\n", "", "", "", "", "\nThis field will be passed to the segment and is used to return various\nPATIENT file nodes based on the GUARDIAN TYPE field. Table (A) identifies\nthe various GUARDIAN TYPES and the corresponding DHCP PATIENT file nodes.\n \n TABLE A\n GUARDIAN TYPE DHCP PATIENT FILE NODE\n 1 = VA Guardian .29\n 2 = Civil Guardian .291\n
\n\n", "ZIC\n", "", "2\n", "\n- \n\n
\n", "2\n", "ID\n", "REQUIRED\n", ""], ["GUARDIAN NAME", "", "JONES,TOM\n", "JONES,TOM\n", "", "", "", "\nThis field returns the name of the patient's guardian and is dependent on\nthe GUARDIAN TYPE field. If GUARDIAN TYPE is 1, the GUARDIAN (VA) (.2912)\nfield of the PATIENT file will be returned. If GUARDIAN TYPE is 2, the\nGUARDIAN (CIVIL) (.2922) field of the PATIENT file will be returned.\n
\n\n", "ZIC\n", "", "3\n", "\n- \n\n
\n", "35\n", "ST\n", "NOT REQUIRED\n", ""], ["GUARDIAN INSTITUTION", "", "FIRST NATIONAL BANK\n", "FIRST NATIONAL BANK\n", "", "", "", "\nThis field returns the institution responsible for handling funds on the\npatient's behalf and is dependent on the GUARDIAN TYPE field. If GUARDIAN\nTYPE is 1, the INSTITUTION (VA) (.2911) field of the PATIENT file will be\nreturned. If GUARDIAN TYPE is 2, the INSTITUTION (CIVIL) (.2921) field\nof the PATIENT file will be returned.\n
\n\n", "ZIC\n", "", "4\n", "\n- \n\n
\n", "30\n", "ST\n", "NOT REQUIRED\n", ""], ["GUARDIAN RELATIONSHIP", "", "BROTHER\n", "BROTHER\n", "", "", "", "\nThis field returns the relationship of the guardian to the patient and is\ndependent upon the GUARDIAN TYPE field. If GUARDIAN TYPE is 1, the\nRELATIONSHIP (VA) (.2913) field of the PATIENT file will be returned. If\nGUARDIAN TYPE is 2, the RELATIONSHIP (CIVIL) (.2923) field of the PATIENT\nfile will be returned.\n
\n\n", "ZIC\n", "", "5\n", "\n- \n\n
\n", "30\n", "ST\n", "NOT REQUIRED\n", ""], ["GUARDIAN ADDRESS", "", "18 Main Street^Apt 5B^Albany^NY^12345-1234\n", "18 Main Street~Apt 5B~Albany~NY~12345-1234\n", "", "", "", "\nThis field returns the mailing address of the patient's guardian and is\nHL7 allows 106 characters for all AD data types, but it is possible that\nthe DHCP address field could be slightly longer.\ndependent on the GUARDIAN TYPE field. If GUARDIAN TYPE is 1, fields\n(.2914-.2918) of the PATIENT file will be returned. If GUARDIAN TYPE is\n2, fields (.2924-.2928) of the PATIENT file will be returned. The address\nwill be returned in standard HL7 AD (Address) format. The street address,\nother designation city, state, and zip code will be returned. HL7 allows\nfor only 2 lines of the street address. If 3 lines are specified in the\npatient address, the second and third lines will be put into the 2nd HL7\ncomponent (other designation) and will be separated by a space. Further,\n
\n\n", "ZIC\n", "", "6\n", "\n- \n\n
\n", "106\n", "AD\n", "NOT REQUIRED\n", ""], ["GUARDIAN PHONE NUMBER", "", "", "(212)555-1234\n", "", "", "", "\nThis field returns the phone number of the patient's guardian and is\ndependent on the GUARDIAN TYPE field. If GUARDIAN TYPE is 1, field\n(.2919) of the PATIENT file will be returned. If GUARDIAN TYPE is 2, \nfield (.2929) of the PATIENT file will be returned. The data will be\nreturned in HL7 TN (Telephone number) format as follows [(999)999-9999X888].\nThe optional 'X' portion gives an extension.\n
\n\n", "ZIC\n", "", "7\n", "\n- \n\n
\n", "40\n", "TN\n", "NOT REQUIRED\n", ""], ["DATE RULED INCOMPETENT", "", "August 9, 1927\n", "19270809 (YYYYMMDD)\n", "", "", "", "\nThis field returns the date that the patient was ruled incompetent to \nhandle his/her funds and is dependent upon the GUARDIAN TYPE field. If\nGUARDIAN TYPE is 1, field (.291) of the PATIENT file will be returned.\nIf GUARDIAN TYPE is 2, field (.292) of the PATIENT file will be returned.\n
\n\n", "ZIC\n", "", "8\n", "\n- \n\n
\n", "8\n", "DT\n", "NOT REQUIRED\n", ""], ["SET ID - PATIENT", "", "N/A\n", "", "", "", "", "\nFor those messages that permit multiple patients to be transmitted, this\nfield will contain a sequential number to identify the repetitions.\n
\n\n", "ZPD\n", "", "1\n", "\n- \n\n
\n", "4\n", "SI\n", "REQUIRED\n", ""], ["REMARKS", "", "HEART CONDITION\n", "HEART CONDITION\n", "", "", "", "\nThis field returns general remarks concerning the patient (as found in the\n.091 field of the PATIENT file).\n
\n\n", "ZPD\n", "", "2\n", "\n- \n\n
\n", "60\n", "ST\n", "NOT REQUIRED\n", ""], ["PLACE OF BIRTH CITY", "", "ALBANY\n", "ALBANY\n", "", "", "", "\nThis field returns the patient's city of birth (as found in the .092\nfield of the PATIENT file).\n
\n\n", "ZPD\n", "", "3\n", "\n- \n\n
\n", "20\n", "ST\n", "NOT REQUIRED\n", ""], ["PLACE OF BIRTH STATE", "", "NEW YORK\n", "NY\n", "", "", "", "\nThis field returns the patient's state abbreviation for place of birth\n(as found in the #1 field of the STATE file via pointer from the .093 field\nof the PATIENT file).\n
\n\n", "ZPD\n", "", "4\n", "\n- \n\n
\n", "2\n", "ST\n", "NOT REQUIRED\n", ""], ["CURRENT MEANS TEST STATUS", "", "M\n", "M\n", "", "", "", "\nThis field returns the patient's current means test status (as found in the\n.03 field of the MEANS TEST STATUS file via pointer from the .14 field\nof the PATIENT file). The DHCP codes (as found in the .03 field of the MEANS\nTEST STATUS file) are:\n VALUE DESCRIPTION\n D Discretionary\n M Mandatory\n N Not Applicable\n
\n\n", "ZPD\n", "", "5\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["FATHER'S NAME", "", "JOHN J. SMITH\n", "JOHN J. SMITH\n", "", "", "", "\nThis field returns the patient's father's name (as found in the .2401\nfield of the PATIENT file).\n
\n\n", "ZPD\n", "", "6\n", "\n- \n\n
\n", "35\n", "ST\n", "NOT REQUIRED\n", ""], ["MOTHER'S NAME", "", "JEAN SMITH\n", "JEAN SMITH\n", "", "", "", "\nThis field returns the patient's mother's name (as found in the .2402 \nfield of the PATIENT file).\n
\n\n", "ZPD\n", "", "7\n", "\n- \n\n
\n", "35\n", "ST\n", "NOT REQUIRED\n", ""], ["ADDENDUM CONTINUATION POINTER", "", "", "", "00641\n", "", "", "", "BHS\n", "", "1\n", "\n- \n\n
\n", "60\n", "ST\n", "NOT REQUIRED\n", ""], ["RATED INCOMPETENT", "", "", "", "", "", "", "\nThis field returns whether the patient was rated incompetent by the VA\n(as found in the .293 field of the PATIENT file). The DHCP codes (as found\nin the .293 field of the PATIENT file) are:\n VALUE DESCRIPTION\n 0 No\n 1 Yes\n
\n\n", "ZPD\n", "", "8\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["DATE OF DEATH", "", "9/26/88@1306\n", "198809261306 (YYYYMMDDHHMM)\n", "", "", "", "\nThis field returns the patient's date and time of death (as found in the\n.351 field of the PATIENT file).\n
\n\n", "ZPD\n", "", "9\n", "\n- \n\n
\n", "19\n", "TS\n", "NOT REQUIRED\n", ""], ["COLLATERAL SPONSOR", "", "SMITH,JOHN JR.\n", "SMITH~JOHN~JR.\n", "", "", "", "\nIf the patient is a collateral responsible for picking up medications or\ninformation regarding another patient, this field will return that\npatient's name (as found in the .3601 field of the PATIENT file). The HL7 \ndata type that will be returned for the COLLATERAL SPONSOR field is PN\n(Person Name). The format for this HL7 field is family name (last name),\ngiven name (first name), middle initial or name, and suffix (JR or II).\n
\n\n", "ZPD\n", "", "10\n", "\n- \n\n
\n", "48\n", "PN\n", "NOT REQUIRED\n", ""], ["ACTIVE HEALTH INSURANCE", "", "", "", "", "", "", "\nThis computed field contains whether or not the patient has active\ninsurance. The DHCP codes for this computed field are:\n DHCP VALUE DESCRIPTION\n 0 No\n 1 Yes\n
\n\n", "ZPD\n", "", "11\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["COVERED BY MEDICAID", "", "", "", "", "", "", "\nThis field contains whether the patient is eligible to receive Medicaid \ncoverage (as found in the .381 field of the PATIENT file). The DHCP codes\n(as found in the .381 field of the PATIENT file) are:\n DHCP VALUE DESCRIPTION\n 0 No\n 1 Yes\n
\n\n", "ZPD\n", "", "12\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["DATE MEDICAID LAST ASKED", "", "9/26/88@1306\n", "198809261306 (YYYYMMDDHHMM)\n", "", "", "", "\nThis field contains the date and time that the "ELIGIBLE FOR MEDICAID"\nquestion was last asked of the patient (as found in the .382 field of the\nPATIENT file).\n
\n\n", "ZPD\n", "", "13\n", "\n- \n\n
\n", "19\n", "TS\n", "NOT REQUIRED\n", ""], ["RACE", "", "", "", "", "", "", "\nThis field contains the patient's race abbreviation (as found in field #2\n 6 White, not of Hispanic origin\n 7 Unknown\nof the RACE file, via pointer from the .06 field of the PATIENT file).\nThe DHCP codes (as found in the #3 field of the RACE file) are:\n DHCP VALUE DESCRIPTION\n 1 White Hispanic\n 2 Black Hispanic\n 3 American Indian or Alaska Native\n 4 Black, not of Hispanic origin\n 5 Asian or Pacific Islander\n
\n\n", "ZPD\n", "", "14\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["RELIGION", "", "", "", "", "", "", "\nThis field contains the patient's religious preference (as contained in\n 4 Methodist\n 5 Lutheran\n 6 Presbyterian\n 7 United Church of Christ\n 8 Episcopalian\n 9 Adventist\n 10 Assembly of God\n 11 Brethren\n 12 Christian Scientist\n 13 Church of Christ\nfield #3 of the RELIGION file, via pointer from the .08 field of the\n 14 Church of God\n 15 Disciples of Christ\n 16 Evangelical Covenant\n 17 Friends\n 18 Jehovah's Witness\n 19 Latter-Day Saints\n 20 Islam\n 21 Nazarene\n 22 Other\n 23 Pentecostal\nPATIENT file). The DHCP codes (as found in the #3 field of the RELIGION\n 24 Protestant, Other\n 25 Protestant, No Preference\n 26 Reformed\n 27 Salvation Army\n 28 Unitarian; Universalist\n 29 Unknown/No Preference\nfile) are:\n DHCP VALUE DESCRIPTION\n 0 Catholic\n 1 Jewish\n 2 Eastern Orthodox\n 3 Baptist\n
\n\n", "ZPD\n", "", "15\n", "\n- \n\n
\n", "3\n", "ID\n", "NOT REQUIRED\n", ""], ["SET ID - TEMPORARY ADDRESS", "", "N/A\n", "", "", "", "", "\nThis field is passed to the segment and is used as an identifier. It\nwill be set to 1 if it is not passed in.\n
\n\n", "ZTA\n", "", "1\n", "\n- \n\n
\n", "4\n", "SI\n", "REQUIRED\n", ""], ["TEMPORARY ADDRESS?", "", "Y\n", "", "", "", "", "\nThis field will return the result to the question "Want to enter/edit\ntemporary address data?" as found in the .12105 field of the PATIENT\nfile.\n DHCP VALUE CORRESPONDING HL7 VALUE\n Y 1\n N 0\n
\n\n", "ZTA\n", "", "2\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["BATCH FIELD SEPARATOR", "", "", "", "00685\n", "", "", "", "BLG\n", "", "1\n", "\n- \n\n
\n", "1\n", "ST\n", "REQUIRED\n", ""], ["TEMPORARY ADDRESS START", "", "June 1, 1993\n", "19930601 (YYYYMMDD)\n", "", "", "", "\nThis field will return the date on which the patient will first be found\nat the temporary address (as found in the .1217 field of the PATIENT\nfile).\n
\n\n", "ZTA\n", "", "3\n", "\n- \n\n
\n", "8\n", "DT\n", "NOT REQUIRED\n", ""], ["TEMPORARY ADDRESS END", "", "September 30, 1993\n", "19930930 (YYYYMMDD)\n", "", "", "", "\nThis field will return the date on which the patient will no longer be\nfound at the temporary address (as found in the .1218 field of the\nPATIENT file).\n
\n\n", "ZTA\n", "", "4\n", "\n- \n\n
\n", "8\n", "DT\n", "NOT REQUIRED\n", ""], ["TEMPORARY ADDRESS", "", "123 Park Avenue^Apt. 4^Suite 301^Albany^NY^12234-2311\n", "123 Park Avenue~Apt. 4 Suite 301~Albany~NY~12234-2311\n", "", "", "", "\nThe temporary address of the patient (fields .1211-.1216 of the PATIENT\nfile) will be returned in standard HL7 AD(Address) format. This includes\nthe temporary street address, temporary city, temporary state, and\ntemporary zip code fields. HL7 allows 2 lines of street address only.\nIf 3 lines are specified in the temporary address, the second & third lines\nwill be separated by a space. Further, HL7 allows 106 characters for all\nAD data types, but it is possible that the DHCP address field could be\nslightly longer.\n
\n\n", "ZTA\n", "", "5\n", "\n- \n\n
\n", "106\n", "AD\n", "NOT REQUIRED\n", ""], ["TEMPORARY ADDRESS COUNTY", "", "011\n", "011\n", "", "", "", "\nThe temporary address county code (as found in the .12111 field of the\nPATIENT file) will be returned in this field. The format will be the\n3 digit VA COUNTY CODE field as found in the COUNTY multiple of the \nSTATE file.\n
\n\n", "ZTA\n", "", "6\n", "\n- \n\n
\n", "4\n", "ID\n", "NOT REQUIRED\n", ""], ["TEMPORARY ADDRESS PHONE", "", "", "(518)555-3456\n", "", "", "", "\nThe temporary address phone number (as found in the .1219 field of the\nPATIENT file) will be returned to this field.\n
\n\n", "ZTA\n", "", "7\n", "\n- \n\n
\n", "40\n", "TN\n", "NOT REQUIRED\n", ""], ["BED STATUS", "0116\n", "", "", "00617\n", "", "", "", "QRF\n", "", "40\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["ACCOUNT STATUS", "0117\n", "", "", "00703\n", "", "", "", "QRF\n", "", "41\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["PENDING LOCATION", "0079\n", "", "", "00704\n", "", "", "", "QRF\n", "", "42\n", "\n- \n\n
\n", "12\n", "ID\n", "NOT REQUIRED\n", ""], ["PRIOR TEMPORARY LOCATION", "0079\n", "", "", "00705\n", "", "", "", "QRF\n", "", "43\n", "\n- \n\n
\n", "12\n", "ID\n", "NOT REQUIRED\n", ""], ["ADMIT DATE/TIME", "", "", "", "00775\n", "", "", "", "QRF\n", "", "44\n", "\n- \n\n
\n", "19\n", "TS\n", "NOT REQUIRED\n", ""], ["BATCH ENCODING CHARACTERS", "", "", "", "00686\n", "", "", "", "BLG\n", "", "2\n", "\n- \n\n
\n", "3\n", "ST\n", "REQUIRED\n", ""], ["DISCHARGE DATE/TIME", "", "", "", "00776\n", "", "", "", "QRF\n", "", "45\n", "\n- \n\n
\n", "19\n", "TS\n", "NOT REQUIRED\n", ""], ["CURRENT PATIENT BALANCE", "", "", "", "00777\n", "", "", "", "QRF\n", "", "46\n", "\n- \n\n
\n", "12\n", "NM\n", "NOT REQUIRED\n", ""], ["TOTAL CHARGES", "", "", "", "00778\n", "", "", "", "QRF\n", "", "47\n", "\n- \n\n
\n", "12\n", "NM\n", "NOT REQUIRED\n", ""], ["TOTAL ADJUSTMENTS", "", "", "", "00779\n", "", "", "", "QRF\n", "", "48\n", "\n- \n\n
\n", "12\n", "NM\n", "NOT REQUIRED\n", ""], ["TOTAL PAYMENTS", "", "", "", "00780\n", "", "", "", "QRF\n", "", "49\n", "\n- \n\n
\n", "12\n", "NM\n", "NOT REQUIRED\n", ""], ["SET ID - DEPENDENT", "", "N/A\n", "", "", "", "", "\nThis field is passed to the segment as an identifier. It will be set to 1\nif it is not passed in. This field is numeric with a maximum length of 4\ndigits.\n
\n\n", "ZEL\n", "", "1\n", "\n- \n\n
\n", "4\n", "SI\n", "REQUIRED\n", ""], ["SET ID - INCOME", "", "N/A\n", "", "", "", "", "\nFor those messages that permit multiple income segments to be transmitted,\nthis field will contain a sequential number to identify the repetitions.\n
\n\n", "ZIV\n", "", "1\n", "\n- \n\n
\n", "4\n", "SI\n", "REQUIRED\n", ""], ["SET ID - MEANS TEST", "", "N/A\n", "", "", "", "", "\nThis field is passed to the segment and is used as an identifier. This\nfield will be set to 1 if it is not passed. This is a numeric field with\na maximum length of 4 digits.\n
\n\n", "ZMT\n", "", "1\n", "\n- \n\n
\n", "4\n", "SI\n", "REQUIRED\n", ""], ["NAME", "", "SMITH,JOHN JR.\n", "SMITH~JOHN~JR\n", "", "", "", "\nThis field returns the name of the veteran's dependent (as found in the\n.01 field of the INCOME PERSON file or the .01 field of the PATIENT file).\nThe name should be in the format: LASTNAME,FIRSTNAME,MIDDLENAME.\n
\n\n", "ZEL\n", "", "2\n", "\n- \n\n
\n", "48\n", "PN\n", "REQUIRED\n", ""], ["SEX", "0001\n", "MALE\n", "M\n", "", "", "", "\nThis field returns the sex of the veteran's relative (as found in the .02\nfield of the INCOME PERSON file or the .02 field of the PATIENT file).\nIt will be returned as defined by the HL7 Table 0001. DHCP will never\nreturn the code O (Other). The code U (Unknown) will be used if no\ndata exists in the DHCP field.\n
\n\n", "ZEL\n", "", "3\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["ENCODING CHARACTERS", "", "", "", "00509\n", "", "", "", "MSH\n", "", "2\n", "\n- \n\n
\n", "4\n", "ST\n", "REQUIRED\n", ""], ["BATCH SENDING APPLICATION", "", "", "", "00687\n", "", "", "", "BLG\n", "", "3\n", "\n- \n\n
\n", "15\n", "ST\n", "NOT REQUIRED\n", ""], ["DATE OF BIRTH", "", "AUGUST 9, 1927\n", "19270809 (YYYYMMDD)\n", "", "", "", "\nThis field returns the date of birth of the veteran's dependent. The\nDHCP field that will be returned is the .03 field of the PATIENT file\nif the relation is a veteran and the .03 field of the INCOME PERSON\nfile if the relation is not a veteran.\n
\n\n", "ZEL\n", "", "4\n", "\n- \n\n
\n", "8\n", "DT\n", "NOT REQUIRED\n", ""], ["SOCIAL SECURITY NUMBER", "", "", "", "", "", "", "\nThis field returns the social security number of the veteran's dependent.\nThe DHCP field that will be returned is the .09 field of the PATIENT\nfile if the relation is a veteran and the .09 field of the INCOME\nPERSON file if the relation is not a veteran.\n
\n\n", "ZEL\n", "", "5\n", "\n- \n\n
\n", "16\n", "ST\n", "NOT REQUIRED\n", ""], ["RELATIONSHIP TO PATIENT", "", "", "", "", "", "", "\nThis field returns the dependent's relationship to the veteran as found \nin the .02 field of the PATIENT RELATION file (this will be the internal\nvalue).\n
\n\n", "ZEL\n", "", "6\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["INTERNAL ENTRY NUMBER", "", "", "", "", "", "", "\nThis field returns the internal entry number of the dependent (as found\nin the PATIENT RELATION file).\n
\n\n", "ZEL\n", "", "7\n", "\n- \n\n
\n", "10\n", "NM\n", "NOT REQUIRED\n", ""], ["INCOME YEAR", "", "", "19930000 (YYYYMMDD)\n", "", "", "", "\nThis field will contain the year the income is being collected as found\nin the .01 field of the Individual Annual Income file (#408.21). The\nmonth and day will be 0.\n
\n\n", "ZIV\n", "", "2\n", "\n- \n\n
\n", "8\n", "DT\n", "NOT REQUIRED\n", ""], ["SOCIAL SECURITY", "", "", "", "", "", "", "\nThis field will return the annual Social Security amount (not SSI)\nreceived (as found in the .08 field of the INDIVIDUAL ANNUAL INCOME file).\n
\n\n", "ZIV\n", "", "3\n", "\n- \n\n
\n", "8\n", "NM\n", "NOT REQUIRED\n", ""], ["U.S. CIVIL SERVICE", "", "", "", "", "", "", "\nThis field will return the annual U.S. Civil Service amount received (as\nfound in the .09 field of the INDIVIDUAL ANNUAL INCOME file).\n
\n\n", "ZIV\n", "", "4\n", "\n- \n\n
\n", "8\n", "NM\n", "NOT REQUIRED\n", ""], ["U.S. RAILROAD RETIREMENT", "", "", "", "", "", "", "\nThis field will return the annual U.S. Railroad Retirement amount received\n(as found in the .1 field of the INDIVIDUAL ANNUAL INCOME file).\n
\n\n", "ZIV\n", "", "5\n", "\n- \n\n
\n", "8\n", "NM\n", "NOT REQUIRED\n", ""], ["MILITARY RETIREMENT", "", "", "", "", "", "", "\nThis field will return the annual Military Retirement amount received (as\nfound in the .11 field of the INDIVIDUAL ANNUAL INCOME file).\n
\n\n", "ZIV\n", "", "6\n", "\n- \n\n
\n", "8\n", "NM\n", "NOT REQUIRED\n", ""], ["UNEMPLOYMENT COMPENSATION", "", "", "", "", "", "", "\nThis field will return the annual Unemployment Compensation amount\nreceived (as found in the .12 field of the INDIVIDUAL ANNUAL INCOME file).\n
\n\n", "ZIV\n", "", "7\n", "\n- \n\n
\n", "8\n", "NM\n", "NOT REQUIRED\n", ""], ["BATCH SENDING FACILITY", "", "", "", "00688\n", "", "", "", "BLG\n", "", "4\n", "\n- \n\n
\n", "20\n", "ST\n", "NOT REQUIRED\n", ""], ["OTHER RETIREMENT", "", "", "", "", "", "", "\nThis field will return the annual Other Retirement amount received (as\nfound in the .13 field of the INDIVIDUAL ANNUAL INCOME file).\n
\n\n", "ZIV\n", "", "8\n", "\n- \n\n
\n", "8\n", "NM\n", "NOT REQUIRED\n", ""], ["EMPLOYMENT INCOME", "", "", "", "", "", "", "\nThis field will return the annual total income from employment received\n(as found in the .14 field of the INDIVIDUAL ANNUAL INCOME file).\n
\n\n", "ZIV\n", "", "9\n", "\n- \n\n
\n", "9\n", "NM\n", "NOT REQUIRED\n", ""], ["INTEREST,DIVIDEND,ANNUITY", "", "", "", "", "", "", "\nThis field will return the annual interest, dividend, or annuity income\nreceived (as found in the .15 field of the INDIVIDUAL ANNUAL INCOME file).\n
\n\n", "ZIV\n", "", "10\n", "\n- \n\n
\n", "8\n", "NM\n", "NOT REQUIRED\n", ""], ["WORKERS COMP/BLACK LUNG", "", "", "", "", "", "", "\nThis field will return the annual amount of Workers Compensation or\nBlack Lung benefits received (as found in the .16 field of the INDIVIDUAL\nANNUAL INCOME file).\n
\n\n", "ZIV\n", "", "11\n", "\n- \n\n
\n", "8\n", "NM\n", "NOT REQUIRED\n", ""], ["OTHER INCOME", "", "", "", "", "", "", "\nThis field will return the annual amount of all other income received\n(as found in the .17 field of the INDIVIDUAL ANNUAL INCOME file).\n
\n\n", "ZIV\n", "", "12\n", "\n- \n\n
\n", "9\n", "NM\n", "NOT REQUIRED\n", ""], ["MEDICAL EXPENSES", "", "", "", "", "", "", "\nThis field will return the annual amount of all unreimbursed medical\nexpenses paid by the veteran (as found in the 1.01 field of the \nINDIVIDUAL ANNUAL INCOME file).\n
\n\n", "ZIV\n", "", "13\n", "\n- \n\n
\n", "8\n", "NM\n", "NOT REQUIRED\n", ""], ["FUNERAL AND BURIAL EXPENSES", "", "", "", "", "", "", "\nThis field will return the annual amount of funeral and burial expenses\npaid by the veteran for the veteran's spouse or children (as found in\nthe 1.02 field of the INDIVIDUAL ANNUAL INCOME file).\n
\n\n", "ZIV\n", "", "14\n", "\n- \n\n
\n", "8\n", "NM\n", "NOT REQUIRED\n", ""], ["EDUCATIONAL EXPENSES", "", "", "", "", "", "", "\nThis field will return the annual amount of educational expenses paid by\nthe veteran (as found in the 1.03 field of the INDIVIDUAL ANNUAL INCOME\nfile).\n
\n\n", "ZIV\n", "", "15\n", "\n- \n\n
\n", "8\n", "NM\n", "NOT REQUIRED\n", ""], ["CASH,AMOUNTS IN BANK ACCOUNTS", "", "", "", "", "", "", "\nThis field will return the amount of cash and amounts in bank accounts\n(as found in the 2.01 field of the INDIVIDUAL ANNUAL INCOME file).\n
\n\n", "ZIV\n", "", "16\n", "\n- \n\n
\n", "9\n", "NM\n", "NOT REQUIRED\n", ""], ["STOCKS AND BONDS", "", "", "", "", "", "", "\nThis field will return the amount of stocks, bonds, and similar assets\n(as found in the 2.02 field of the INDIVIDUAL ANNUAL INCOME file).\n
\n\n", "ZIV\n", "", "17\n", "\n- \n\n
\n", "9\n", "NM\n", "NOT REQUIRED\n", ""], ["BATCH RECEIVING APPLICATION", "", "", "", "00689\n", "", "", "", "BLG\n", "", "5\n", "\n- \n\n
\n", "15\n", "ST\n", "NOT REQUIRED\n", ""], ["REAL PROPERTY", "", "", "", "", "", "", "\nThis field will return the amount of any property owned (as found in the\n2.03 field of the INDIVIDUAL ANNUAL INCOME file).\n
\n\n", "ZIV\n", "", "18\n", "\n- \n\n
\n", "9\n", "NM\n", "NOT REQUIRED\n", ""], ["OTHER PROPERTY OR ASSETS", "", "", "", "", "", "", "\nThis field will return the current market value of other property or \nassets owned (as found in the 2.04 field of the INDIVIDUAL ANNUAL INCOME\nfile).\n
\n\n", "ZIV\n", "", "19\n", "\n- \n\n
\n", "9\n", "NM\n", "NOT REQUIRED\n", ""], ["DEBTS", "", "", "", "", "", "", "\nThis field will return the amount of debts that will reduce the value of\nthe property listed in the Other Property or Assets field (as found in\nthe 2.05 field of the INDIVIDUAL ANNUAL INCOME file).\n
\n\n", "ZIV\n", "", "20\n", "\n- \n\n
\n", "9\n", "NM\n", "NOT REQUIRED\n", ""], ["MEANS TEST DATE", "", "AUGUST 5, 1993\n", "19930805 (YYYYMMDD)\n", "", "", "", "\nThis field returns the date of the patient's annual means test (as\nfound in the .01 field of the ANNUAL MEANS TEST file).\n
\n\n", "ZMT\n", "", "2\n", "\n- \n\n
\n", "8\n", "DT\n", "NOT REQUIRED\n", ""], ["MEANS TEST STATUS", "", "", "A\n", "", "", "", "\nThis field returns the patient's means test status (as found in the .03\n No Longer Required (N) 3\n Category A (A) 4\n Category B (B) 5\n Category C (C) 6\n Exempt (E) 7\n Non-Exempt (M) 8\n Pending Adjudication (P) 9\n Incomplete (I) 10\n No Longer Applicable (L) 11\nfield of the ANNUAL MEANS TEST file) translated to the code found in the\n.02 field of the Means Test Status file.\n \nThe DHCP codes (as found in the .02 field of the MEANS TEST STATUS file)\nare:\n DHCP DESCRIPTION DHCP CODE\n Required (R) 1\n Pending Adjudication (P) 2\n
\n\n", "ZMT\n", "", "3\n", "\n- \n\n
\n", "2\n", "ID\n", "NOT REQUIRED\n", ""], ["INCOME", "", "", "", "", "", "", "\nThis field returns the summation of each applicable family member's \nincome in the INDIVIDUAL ANNUAL INCOME file (#408.21) for the previous\ncalendar year from the date of the means test. This field is found in\nthe .04 field of the ANNUAL MEANS TEST file.\n
\n\n", "ZMT\n", "", "4\n", "\n- \n\n
\n", "10\n", "NM\n", "NOT REQUIRED\n", ""], ["NET WORTH", "", "", "", "", "", "", "\nThis field returns the summation of the veteran and spouse (if applicable)\nnet worth minus any debts in the INDIVIDUAL ANNUAL INCOME file (#408.21)\nfor the previous calendar year from the date of the means test. This\nfield is computed by the system and is found in the .05 field of the\nANNUAL MEANS TEST file.\n
\n\n", "ZMT\n", "", "5\n", "\n- \n\n
\n", "10\n", "NM\n", "NOT REQUIRED\n", ""], ["DATE/TIME ADJUDICATION", "", "9/26/93@1306\n", "199309261306 (YYYYMMDDHHMM)\n", "", "", "", "\nThis field returns the date/time that the means test was adjudicated (as\nfound in the .1 field of the ANNUAL MEANS TEST file).\n
\n\n", "ZMT\n", "", "6\n", "\n- \n\n
\n", "19\n", "TS\n", "NOT REQUIRED\n", ""], ["AGREED TO PAY DEDUCTIBLE", "", "", "", "", "", "", "\nThis field returns whether the veteran agrees to pay the deductible. The\nveteran must also sign the 1010f form agreeing to pay the deductible. \nThis field is found in the .11 field of the ANNUAL MEANS TEST file.\n \nThe DHCP codes (as found in the .11 field of the ANNUAL MEANS TEST file)\nare:\n DHCP VALUE DESCRIPTION\n 0 No\n 1 Yes\n
\n\n", "ZMT\n", "", "7\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["THRESHOLD A", "", "", "", "", "", "", "\nThis field returns the income threshold A as determined by the system for\nthe veteran. The threshold is determined by the system in the following\nmanner: Category A Veteran Income + Category A First Dependent +\n(Category A Per Dependent * (Number of Dependents - First Dependent)).\nThis field is found in the .12 field of the ANNUAL MEANS TEST file.\n
\n\n", "ZMT\n", "", "8\n", "\n- \n\n
\n", "8\n", "NM\n", "NOT REQUIRED\n", ""], ["BATCH RECEIVING FACILITY", "", "", "", "00690\n", "", "", "", "BLG\n", "", "6\n", "\n- \n\n
\n", "20\n", "ST\n", "NOT REQUIRED\n", ""], ["DEDUCTIBLE EXPENSES", "", "", "", "", "", "", "\nThis field returns the summation of the veteran's deductible expenses in\nthe INDIVIDUAL ANNUAL INCOME (#408.21) file. This field is computed by\nthe system and is found in the .15 field of the ANNUAL MEANS TEST\n(#408.31) file.\n
\n\n", "ZMT\n", "", "9\n", "\n- \n\n
\n", "10\n", "NM\n", "NOT REQUIRED\n", ""], ["BATCH CREATION DATE/TIME", "", "", "", "00655\n", "", "", "", "BLG\n", "", "7\n", "\n- \n\n
\n", "19\n", "TS\n", "NOT REQUIRED\n", ""], ["BATCH SECURITY", "", "", "", "00691\n", "", "", "", "BLG\n", "", "8\n", "\n- \n\n
\n", "40\n", "ST\n", "NOT REQUIRED\n", ""], ["BATCH NAME/ID/TYPE", "", "", "", "00656\n", "", "", "", "BLG\n", "", "9\n", "\n- \n\n
\n", "20\n", "ST\n", "NOT REQUIRED\n", ""], ["BATCH COMMENT", "", "", "", "00657\n", "", "", "", "BLG\n", "", "10\n", "\n- \n\n
\n", "80\n", "ST\n", "NOT REQUIRED\n", ""], ["BATCH CONTROL ID", "", "", "", "00658\n", "", "", "", "BLG\n", "", "11\n", "\n- \n\n
\n", "20\n", "ST\n", "NOT REQUIRED\n", ""], ["REFERENCE BATCH CONTROL ID", "", "", "", "00659\n", "", "", "", "BLG\n", "", "12\n", "\n- \n\n
\n", "20\n", "ST\n", "NOT REQUIRED\n", ""], ["SENDING APPLICATION", "", "", "", "00006\n", "", "", "", "MSH\n", "", "3\n", "\n- \n\n
\n", "15\n", "ST\n", "NOT REQUIRED\n", ""], ["BATCH MESSAGE COUNT", "", "", "", "00664\n", "", "", "", "DG1\n", "", "1\n", "\n- \n\n
\n", "10\n", "ST\n", "NOT REQUIRED\n", ""], ["BATCH TOTALS", "", "", "", "00666\n", "", "", "", "DG1\n", "", "3\n", "\n- \n\n
\n", "100\n", "CM\n", "NOT REQUIRED\n", ""], ["ERROR CODE AND LOCATION", "0060\n", "", "", "00080\n", "", "", "", "EVN\n", "", "1\n", "\n- \n\n
\n", "80\n", "ID\n", "REQUIRED\n", "100\n"], ["FILE FIELD SEPARATOR", "", "", "", "00692\n", "", "", "", "FT1\n", "", "1\n", "\n- \n\n
\n", "1\n", "ST\n", "REQUIRED\n", ""], ["FILE ENCODING CHARACTERS", "", "", "", "00693\n", "", "", "", "FT1\n", "", "2\n", "\n- \n\n
\n", "4\n", "ST\n", "REQUIRED\n", ""], ["FILE SENDING APPLICATION", "", "", "", "00694\n", "", "", "", "FT1\n", "", "3\n", "\n- \n\n
\n", "15\n", "ST\n", "NOT REQUIRED\n", ""], ["FILE SENDING FACILITY", "", "", "", "00695\n", "", "", "", "FT1\n", "", "4\n", "\n- \n\n
\n", "20\n", "ST\n", "NOT REQUIRED\n", ""], ["FILE RECEIVING APPLICATION", "", "", "", "00696\n", "", "", "", "FT1\n", "", "5\n", "\n- \n\n
\n", "15\n", "ST\n", "NOT REQUIRED\n", ""], ["FILE RECEIVING FACILITY", "", "", "", "00697\n", "", "", "", "FT1\n", "", "6\n", "\n- \n\n
\n", "20\n", "ST\n", "NOT REQUIRED\n", ""], ["DATE/TIME OF FILE CREATION", "", "", "", "00660\n", "", "", "", "FT1\n", "", "7\n", "\n- \n\n
\n", "19\n", "TS\n", "NOT REQUIRED\n", ""], ["SENDING FACILITY", "", "", "", "00512\n", "", "", "", "MSH\n", "", "4\n", "\n- \n\n
\n", "20\n", "ST\n", "NOT REQUIRED\n", ""], ["FILE SECURITY", "", "", "", "00698\n", "", "", "", "FT1\n", "", "8\n", "\n- \n\n
\n", "40\n", "ST\n", "NOT REQUIRED\n", ""], ["FILE NAME/ID", "", "", "", "00661\n", "", "", "", "FT1\n", "", "9\n", "\n- \n\n
\n", "20\n", "ST\n", "NOT REQUIRED\n", ""], ["FILE HEADER COMMENT", "", "", "", "00662\n", "", "", "", "FT1\n", "", "10\n", "\n- \n\n
\n", "80\n", "ST\n", "NOT REQUIRED\n", ""], ["FILE CONTROL ID", "", "", "", "00663\n", "", "", "", "FT1\n", "", "11\n", "\n- \n\n
\n", "20\n", "ST\n", "NOT REQUIRED\n", ""], ["REFERENCE FILE CONTROL ID", "", "", "", "00768\n", "", "", "", "FT1\n", "", "12\n", "\n- \n\n
\n", "20\n", "ST\n", "NOT REQUIRED\n", ""], ["FILE BATCH COUNT", "", "", "", "00667\n", "", "", "", "GT1\n", "", "1\n", "\n- \n\n
\n", "10\n", "ST\n", "NOT REQUIRED\n", ""], ["FILE TRAILER COMMENT", "", "", "", "00668\n", "", "", "", "GT1\n", "", "2\n", "\n- \n\n
\n", "80\n", "ST\n", "NOT REQUIRED\n", ""], ["EXPECTED SEQUENCE NUMBER", "", "", "", "00598\n", "", "", "", "MSA\n", "", "4\n", "\n- \n\n
\n", "15\n", "NM\n", "NOT REQUIRED\n", ""], ["DELAYED ACKNOWLEDGMENT TYPE", "0102\n", "", "", "00632\n", "", "", "", "MSA\n", "", "5\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["RECEIVING APPLICATION", "", "", "", "00009\n", "", "", "", "MSH\n", "", "5\n", "\n- \n\n
\n", "15\n", "ST\n", "NOT REQUIRED\n", ""], ["SEQUENCE NUMBER", "", "", "", "00633\n", "", "", "", "MSH\n", "", "13\n", "\n- \n\n
\n", "15\n", "NM\n", "NOT REQUIRED\n", ""], ["CONTINUATION POINTER", "", "", "", "00699\n", "", "", "", "MSH\n", "", "14\n", "\n- \n\n
\n", "180\n", "ST\n", "NOT REQUIRED\n", ""], ["SET ID - NOTES AND COMMENTS", "", "", "", "00573\n", "", "", "", "ORO\n", "", "1\n", "\n- \n\n
\n", "4\n", "SI\n", "NOT REQUIRED\n", ""], ["SOURCE OF COMMENT", "0105\n", "", "", "00574\n", "", "", "", "ORO\n", "", "2\n", "\n- \n\n
\n", "8\n", "ID\n", "NOT REQUIRED\n", ""], ["COMMENT", "", "", "", "00575\n", "", "", "", "ORO\n", "", "3\n", "\n- \n\n
\n", "120\n", "TX\n", "REQUIRED\n", "100\n"], ["EVENT TYPE CODE", "0003\n", "", "", "00029\n", "", "", "", "AIG\n", "", "1\n", "\n- \n\n
\n", "3\n", "ID\n", "REQUIRED\n", ""], ["DATE/TIME OF EVENT", "", "", "", "00030\n", "", "", "", "AIG\n", "", "2\n", "\n- \n\n
\n", "19\n", "TS\n", "REQUIRED\n", ""], ["DATE/TIME PLANNED EVENT", "", "", "", "00032\n", "", "", "", "AIG\n", "", "3\n", "\n- \n\n
\n", "19\n", "TS\n", "NOT REQUIRED\n", ""], ["EVENT REASON CODE", "0062\n", "", "", "00369\n", "", "", "", "AIG\n", "", "4\n", "\n- \n\n
\n", "3\n", "ID\n", "NOT REQUIRED\n", ""], ["PRIOR PATIENT ID - INTERNAL", "0061\n", "", "", "00576\n", "", "", "", "NCK\n", "", "1\n", "\n- \n\n
\n", "16\n", "CK\n", "REQUIRED\n", ""], ["RECEIVING FACILITY", "", "", "", "00513\n", "", "", "", "MSH\n", "", "6\n", "\n- \n\n
\n", "30\n", "ST\n", "NOT REQUIRED\n", ""], ["PRIOR ALTERNATE PATIENT ID", "0061\n", "", "", "00577\n", "", "", "", "NCK\n", "", "2\n", "\n- \n\n
\n", "16\n", "CK\n", "NOT REQUIRED\n", ""], ["PRIOR PATIENT ACCOUNT NUMBER", "0061\n", "", "", "00578\n", "", "", "", "NCK\n", "", "3\n", "\n- \n\n
\n", "20\n", "CK\n", "NOT REQUIRED\n", ""], ["SET ID - PATIENT ID", "", "", "", "00572\n", "", "", "\nFOR THOSE MESSAGES THAT PERMIT MULTIPLE PATIENTS TO BE TRANSMITTED, THIS\nFIELD WILL CONTAIN A SEQUENTIAL NUMBER TO IDENTIFY THE REPETITIONS.\n
\n\n", "PID\n", "", "1\n", "\n- \n\n
\n", "4\n", "SI\n", "NOT REQUIRED\n", ""], ["PATIENT ID (EXTERNAL ID)", "0061\n", "", "123-45-6789~1~M11\n", "00581\n", "", "", "\nThis field will contain the patient's primary long ID as defined by the\nvariable VA("PID") which is returned from VADPT or as found\nin field .363 (the PRIMARY LONG ID) in the PATIENT file. In most cases,\nthis will be the patient's social security number formatted with dashes.\nHowever, for patients seen under joint sharing agreements or seen at\nDoD facilities, this field may differ.\n\n\n", "PID\n", "", "2\n", "\n- \n\n
\n", "16\n", "CK\n", "NOT REQUIRED\n", ""], ["ALTERNATE PATIENT ID", "", "", "", "00038\n", "", "", "\nThis field will contain the patient's primary short ID as defined by the\nvariable VA("BID") which is returned from VADPT or as found in the \nPRIMARY SHORT ID field (.364) in the PATIENT file. In most cases, this\nwill be the last 4 digits of the patient's social security number. \nHowever, for patients seen under joint sharing agreements or seen at DoD\nfacilities, this field may differ. The format of the returned data will\nbe identical to the way it is found in the VA("BID") variable or the .364\nfield of the PATIENT file.\n\n\n", "PID\n", "", "4\n", "\n- \n\n
\n", "12\n", "ST\n", "NOT REQUIRED\n", ""], ["MOTHER'S MAIDEN NAME", "", "JONES,MARY\n", "JONES,MARY\n", "00582\n", "", "", "\nThis field will return the maiden name of the patient's mother (as found\nin the .2403 field of the PATIENT file). The data type returned in this\nfield will be HL7 ST (String) which means that it will appear identically\nas it is found in DHCP. Although HL7 allows only 30 characters for this\nfield, DHCP allows 35 characters.\n
\n\n", "PID\n", "", "6\n", "\n- \n\n
\n", "30\n", "ST\n", "NOT REQUIRED\n", ""], ["PATIENT ALIAS", "", "", "", "00597\n", "", "", "\nThis field is not used at this time.\n
\n\n", "PID\n", "", "9\n", "\n- \n\n
\n", "48\n", "PN\n", "NOT REQUIRED\n", "100\n"], ["ETHNIC GROUP", "0005\n", "", "", "00044\n", "", "", "\nDue to the variations between the HL7 table for ethnic group (Table 0005)\nand the DHCP RACE file, this HL7 field will not be used. The DHCP RACE\nfield will be transmitted with the ZPD segment.\n
\n\n", "PID\n", "", "10\n", "\n- \n\n
\n", "1\n", "ID\n", "NOT REQUIRED\n", ""], ["PATIENT ADDRESS", "", "18 Main Street^Apt 4B^Albany^NY^12234-2311\n", "18 Main Street~Apt4B~Albany~NY~12234-2311\n", "00020\n", "", "", "\nThe mailing address of the patient (as found in fields .111-.116 of the\nPATIENT file) will be returned in this field. The address will be\nreturned in standard HL7 AD (Address) format. The street address, other\ndesignation, city, state, and zip code will be returned. HL7 allows for\nonly 2 lines of the street address. If 3 lines are specified in the\npatient address, the second and third lines will be put into the 2nd HL7\ncomponent (other designation) and will be separated by a space. Further,\nHL7 allows 106 characters for all AD data types, but it is possible that\nthe DHCP address field could be slightly longer.\n
\n\n", "PID\n", "", "11\n", "\n- \n\n
\n", "106\n", "AD\n", "NOT REQUIRED\n", ""], ["COUNTY CODE", "", "ALBANY\n", "001\n", "00026\n", "", "", "\nThe COUNTY CODE (as found in the .117 field of the PATIENT file) will be\nreturned in this field. The format will be the three digit VA COUNTY\nCode field as found in the COUNTY multiple of the STATE file.\n
\n\n", "PID\n", "", "12\n", "\n- \n\n
\n", "4\n", "ID\n", "NOT REQUIRED\n", ""]]}