NEWRX:: Release 1 :: SCRIPT

The following message specification was auto-generated using the Messaging Workbench tool . This specification was auto-generated from a standard-based message profile. The comments and annotations included in this specification are those provided by the message profile authors as implementation notes and notes included in the associated Messaging Workbench file.

ER

For more information about the NCPDP SCRIPT,

refer to National Council for Prescription Drug Programs : www.ncpdp.org

Overview

The NCI Terminology is available at: http://evs.nci.nih.gov/ftp1/NCPDP/

This specification combines the information available in the SCRIPT Implementation Guide 10.6

  • 8. Transmission from sender to receiver structure
  • 9. Structure Quick Reference
  • 10. Specific segment discussion

This specification is also including an analysis of the changes introduced in version 10.11 of the SCRIPT implementation guide and compares the implementation guide guidance with the XML Schema Descriptions (XSD) provided for XML-encoded SCRIPT messages.

Notation

The following codes are used in this specification to refer to message element usage and table column names:

Usage CodesAbbreviations
RMandatory/Required elementReferenceReference for an element
RERequired but may be emptyTypeData Type (alphanumeric, numeric, date/time, composite)
CConditional - based on predicate evaluationLengthMax Length - for fields, components, and sub-components
CEConditional but may be emptyUsageElement Usage
XNot supportedCardinalityMinimum and Maximum number of occurrences

Summary

Specification Name SCRIPT
Organization NCPDP
SCRIPT Version 10.6
Specification Version 1
Application RoleSender
Conformance TypeImplementable
Encodings XML
  
Event DescriptionSCRIPT Version 10.6 Implementation Guide
Message TypeSCRIPT
Event TypeNEWRX
Message Profile Structure[REQ],[PVDP2],PVDPC,[PVDSU],[PVDSK],PTTNEWRX,{(MedicationPrescribed)DRU,[CPD],{SIG}}[OBS],[COO]

Message Structure

SegmentDescriptionUsageCardinality
REQRequest segment used for "NewRxRequestType" XML elementC[0..1]
PVDP2PVD-P2 Segment to specify the "Pharmacy" XML elementC[0..1]
PVDPCPVD-PC corresponding to the "Prescriber" XML elementR[1..1]
PVDSUPVD-SU segment corresponding to "Supervisor" XML elementC[0..1]
PVDSKPVD-SK segment corresponding to the "Facility" XML element.C[0..1]
PTTNEWRXPTT segment for "Patient" XML element in NEWRXR[1..1]
MedicationPrescribedMedicationPrescribedR[1..1]
...
SegmentDescriptionUsageCardinality
DRUDrug Segment for "MedicationPrescribed" XML elementR[1..1]
CPDCompound SegmentX[0..0]
SIG"StructuredSIG" XML element corresponds to SIG segmentR[0..*]
OBSObservation segment corresponding to the "Observation"XML elementC[0..1]
COOCoordination of Benefits segment corresponding to the "BenefitsCoordination" XML elementC[0..3]
  
Message Structure IdNEWRX

MedicationPrescribed : MedicationPrescribed

This grouping is represented by a single element in the XML structure that consists of looping group consisting of fields from the following {DRU, [CPD], {SIG}}

"DRU-P; One loop required for the drug prescribed. At least one loop must contain 85 = Date Issued (Written Date)". The XML representation limits this loop to a single occurrence.

Detail

MedicationPrescribed

Segment/ElementDescriptionUsageCardinality
DRUDrug Segment for "MedicationPrescribed" XML elementR[1..1]
CPDCompound SegmentX[0..0]
SIG"StructuredSIG" XML element corresponds to SIG segmentR[0..*]

REQ : Request segment used for "NewRxRequestType" XML element

This is the REQ segment definition constrained for NEWRX XML encoded. It supports a subset of fields.

Only required in a transaction when a return receipt is requested.

Request segment used for "NewRxRequestType" XML element Detail

ReferenceXML ReferenceIG ReferenceNotesTypeLengthUsageCardinalityValue SetValidation Pattern
REQ-010ChangeRequestTypeMessage Function, coded

Not supported according to the Implementation Guide but required according to the XSD.

C1 = Label Change (Any changes to the Drug, form, strength, dosage, or route) C2 = Frequency Change (Any change to the frequency or hours of   administration for the drug) C3 = Other

AN3C[ 0 .. 1 ] 4343C1|C2|C3





 
REQ-020ReturnReceiptCode List Qualifier

Used to request return receipt. If this field is submitted with 1 in the request, a Verify transaction is to be sent from the recipient at some time. 1 = Return Receipt Requested all other values = no return receipt requested

In XML, this valued Code List Qualifier is replaced by an element. This is a desirable simplification since the "1131 Code List Qualifier" is used in other contexts as specified by the External Code List specification.

Predicate:
Used if return receipt is needed, empty if return receipt is not needed..
AN3C[ 0 .. 1 ] 11311





 
REQ-030-1154RequestReferenceNumberReference Number

Transaction key. In some trading partner agreements utilizing a mailbox functionality, this field may contain the receiver's identification number for the transaction being returned.

Predicate:
This number does not appear to be relevant for NEWRX even though it is marked as "Conditional" - C.
AN35C[ 0 .. 1 ]  [ !-~]*





 

PVDP2 : PVD-P2 Segment to specify the "Pharmacy" XML element

Provider Segment used for Pharmacy. This is the PVD segment definition constrained for NEWRX XML encoded. When the recipient is a pharmacy, one loop is required for the pharmacy

This segment specialization appears in the XML structure as "Pharmacy"  XML element.

PVD-P2 Segment to specify the "Pharmacy" XML element Detail

ReferenceXML ReferenceIG ReferenceNotesTypeLengthUsageCardinalityValue SetValidation Pattern
PVD-020IdentificationReference number and Reference Qualifier

PVD-020 On the mandatory transactions: One occurrence is the prescriber number. One occurrence may be used to identify the clinic. One occurrence may be used to identify a supervisor. At least one occurrence of the PVD- 020-01 and _02 must contain HPI (NPI). Prescriber individual (not organizational) NPI Number is mandatory. This is mandatory for the PVD (PC), not the PVD (SU). For all transactions except RXHRES, if the prescriber has an NPI, one occurrence must contain the value HPI (NPI). For all transactions except RXHRES, if the prescriber has a DEA number, one occurrence must contain the value DH (DEA Number).

One occurrence may be the pharmacist number. NOTE: This element combines the reference number and qualifier but it does not exclude the identifiers types that are not applicable to prescribers.

ID_TYPE863R[ 1 .. 10 ]   
Choice for PVD-020NCPDPIDReference number and Reference Qualifier

Alphanumeric, D3

On the mandatory transactions: One occurrence must contain the value 'D3' (NCPDP Provider ID Number). One occurrence must contain the value 'HPI' (National Provider ID

AN35R[ 1 .. 1 ]  





 
Choice for PVD-020FileIDReference number and Reference Qualifier

Alphanumeric, 94

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020StateLicenseNumberReference number and Reference Qualifier

Alphanumeric, 0B

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020MedicareNumberReference number and Reference Qualifier

Alphanumeric, 1C

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020MedicaidNumberReference number and Reference Qualifier

Alphanumeric,1D

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020DentistLicenseNumberReference number and Reference Qualifier

Alphanumeric, 1E

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020UPINReference number and Reference Qualifier

Alphanumeric, 1G

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020FacilityIDReference number and Reference Qualifier

Alphanumeric, 1J

Choice

Predicate:
Not applicable
AN35C[ 0 .. 1 ]  





 
Choice for PVD-020PPONumberReference number and Reference Qualifier

Alphanumeric, 1M

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020PayerIDReference number and Reference Qualifier

Alphanumeric, 2U

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020ProcessorIdentificationNumberReference number and Reference Qualifier

Alphanumeric, ADI

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020BINLocationNumberReference number and Reference Qualifier

Alphanumeric, BO

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020CommercialReference number and Reference Qualifier

Alphanumeric, C1

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020MedicalRecordIdentificationNumberEHRReference number and Reference Qualifier

Alphanumeric, EA

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020PatientAccountNumberReference number and Reference Qualifier

Alphanumeric, EJ

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020DEANumberReference number and Reference Qualifier

Alphanumeric, DH

Choice

AN35R[ 1 .. 1 ]  





 
Choice for PVD-020HINReference number and Reference Qualifier

Alphanumeric, HI

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020IndividualPolicyNumberReference number and Reference Qualifier

Alphanumeric, IP

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020SecondaryCoverageReference number and Reference Qualifier

Alphanumeric, NC

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020NAICCodeReference number and Reference Qualifier

Alphanumeric, NF

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020PromotionNumberReference number and Reference Qualifier

Alphanumeric, PD

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020SocialSecurityReference number and Reference Qualifier

Alphanumeric, SY

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020NPIReference number and Reference Qualifier

Alphanumeric, HPI

One occurrence must contain the value 'HPI'  (National Provider ID) for mandatory occurences of this segment.   Choice

Predicate:
Applicable in this case
AN35C[ 0 .. 1 ]  





 
Choice for PVD-020PriorAuthorizationReference number and Reference Qualifier

Alphanumeric, G1

Choice

AN35C[ 0 .. 1 ]  





 
PVD-040SpecialtyAgency Qualifier, coded

The source of the code list for 040- I007-03-7990 Provider Specialty code. Required if Provider Specialty code (040-I007-03-7990) is used. Values: See External Code List

AN10C[ 0 .. 1 ]  [ !-~]*





 
PVD-050PharmacistName

Pharmacist's Name "The name of the prescriber or pharmacist or supervisor. This composite is broken into individual section for each part of the name."

NAME_TYPE129C[ 0 .. 1 ]   
PVD-050-1LastNameLast Name

Since this field is marked CM - this component is required. This assumption should apply to any mandatory composite field.

AN35R[ 1 .. 1 ]  [ !-~]*





 
PVD-050-2FirstNameFirst Name

First name required if the Phamacist's name is required.

AN35R[ 1 .. 1 ]  [ !-~]*





 
PVD-050-3MiddleNameMiddle Name

Alphanumeric

AN35C[ 0 .. 1 ]  [ !-~]*





 
PVD-050-3SuffixSuffix

Alphanumeric

AN10C[ 0 .. 1 ]  [ !-~]*





 
PVD-050-5PrefixPrefix

Alphanumeric

AN10C[ 0 .. 1 ]  [ !-~]*





 
PVD-070BusinessNameParty Name

The clinic or pharmacy name in one field.

AN35R[ 1 .. 1 ]  [ !-~]*





 
PVD-080AddressAddress

The composite for the prescriber or pharmacist or supervisor address. Further defined fields are used for specific section of the address.

ADDRESS_TYPE1120C[ 0 .. 1 ]   
PVD-080-1AddressLine1Street and Number/P.O. Box

Alphanumeric

AN35C[ 0 .. 1 ]  [ !-~]*





 
PVD-080-2AddressLine2Street and Number/P.O. Box

Alphanumeric

AN35C[ 0 .. 1 ]  [ !-~]*





 
PVD-080-3CityCity Name

Alphanumeric

AN35C[ 0 .. 1 ]  [ !-~]*





 
PVD-080-4StateCountry Sub-entity identification

United States and Canadian Province Postal Service Abbreviations. Values: See External Code List.

AN2C[ 0 .. 1 ]  AL|AK|AZ|AR|AS|CA|CO|CT|DE|DC|
|FM|FL|GA|GU|HI|ID|IL|IN|IA|KS
|KY|LA|ME|MH|MD|MA|MI|MN|MS|MO
|MT|NE|NV|NH|NJ|NM|NY|NC|ND|MP
|OH|OK|OR|PW|PA|PR|RI|SC|SD|TN
|TX|UT|VT|VA|VI|WA|WV|WI|WY|AB
|BC|MB|NB|NF|NS|NT|NU|ON|PE|QC
|SK|YT
PVD-080-5ZipCodePostcode Identification

ZIP code of the pharmacy or prescriber. Use the format 99999 or 999999999. Is not to include hyphen (-).

AN9C[ 0 .. 1 ]  (\d{5})|(\d{9})





 
PVD-080-6PlaceLocationQualifierPlace/Location Qualifier

Alphanumeric, free text. This field is locally defined "Agreement between trading partners if used." Should this be constrained and eliminated?

AN999C[ 0 .. 1 ]  [ !-~]*





 
PVD-090CommunicationNumbersCommunication Numbers

Provider contact number. Prescriber telephone number or other contact number. May occur multiple times when used with qualifier and repetition separator. Used with qualifiers in field 090-01 Code List qualifier.

COMM_TYPE83R[ 1 .. * ]   
PVD-090-1NumberCommunication Number

Telephone number, mandatory, max 80 length

AN80R[ 1 .. 1 ]  ([!-~]|[ ])*[!-~]([!-~]|[ ])*





 
PVD-090-2QualifierCode List Qualifier

Qualifies the Communication Number. X- 12 DE 365. When used, one occurrence is 'TE' (Telephone). Other occurrences are optional and would contain other values. Values: See External Code List

BN Beeper CP Cellular EM Electronic Mail FX Fax HP Home NP Night TE Telephone WP Work

AN2C[ 0 .. 1 ]  BN|CP|FX|HP|NP|TE|WP|EM





 

PVDPC : PVD-PC corresponding to the "Prescriber" XML element

This is the PVD segment definition constrained for NEWRX XML encoded. This segment specialization appears in the XML structure as "Prescriber" element.

NOTE: In the SCRIPT implementation guide this is the first PVD, in the XML XSD this information follows the "Pharmacy" PVD- P2 segment.

PVD-PC corresponding to the "Prescriber" XML element Detail

ReferenceXML ReferenceIG ReferenceNotesTypeLengthUsageCardinalityValue SetValidation Pattern
PVD-020IdentificationReference number and Reference Qualifier

PVD-020 On the mandatory transactions: One occurrence is the prescriber number. One occurrence may be used to identify the clinic. One occurrence may be used to identify a supervisor. At least one occurrence of the PVD- 020-01 and '02 must contain 'HPI' (NPI). Prescriber individual (not organizational) NPI Number is mandatory. This is mandatory for the PVD (PC), not the PVD (SU). For all transactions except RXHRES, if the prescriber has an NPI, one occurrence must contain the value 'HPI' (NPI). For all transactions except RXHRES, if the prescriber has a DEA number, one occurrence must contain the value 'DH' (DEA Number)

ERROR: The XML Schema does not allow repetitions. NOTE: This element combines the reference number and qualifier but it does not exclude the identifiers types that are not applicable to prescribers.

ID_TYPE863R[ 1 .. 10 ]   
Choice for PVD-020NCPDPIDReference number and Reference Qualifier

Alphanumeric, D3

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020FileIDReference number and Reference Qualifier

Alphanumeric, 94

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020StateLicenseNumberReference number and Reference Qualifier

Alphanumeric, 0B

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020MedicareNumberReference number and Reference Qualifier

Alphanumeric, 1C

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020MedicaidNumberReference number and Reference Qualifier

Alphanumeric,1D

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020DentistLicenseNumberReference number and Reference Qualifier

Alphanumeric, 1E

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020UPINReference number and Reference Qualifier

Alphanumeric, 1G

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020FacilityIDReference number and Reference Qualifier

Alphanumeric, 1J

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020PPONumberReference number and Reference Qualifier

Alphanumeric, 1M

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020PayerIDReference number and Reference Qualifier

Alphanumeric, 2U

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020ProcessorIdentificationNumberReference number and Reference Qualifier

Alphanumeric, ADI

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020BINLocationNumberReference number and Reference Qualifier

Alphanumeric, BO

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020CommercialReference number and Reference Qualifier

Alphanumeric, C1

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020MedicalRecordIdentificationNumberEHRReference number and Reference Qualifier

Alphanumeric, EA

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020PatientAccountNumberReference number and Reference Qualifier

Alphanumeric, EJ

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020DEANumberReference number and Reference Qualifier

Alphanumeric, DH

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020HINReference number and Reference Qualifier

Alphanumeric, HI

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020IndividualPolicyNumberReference number and Reference Qualifier

Alphanumeric, IP

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020SecondaryCoverageReference number and Reference Qualifier

Alphanumeric, NC

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020NAICCodeReference number and Reference Qualifier

Alphanumeric, NF

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020PromotionNumberReference number and Reference Qualifier

Alphanumeric, PD

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020SocialSecurityReference number and Reference Qualifier

Alphanumeric, SY

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020NPIReference number and Reference Qualifier

Alphanumeric, HPI

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020PriorAuthorizationReference number and Reference Qualifier

Alphanumeric, G1

Choice

AN35C[ 0 .. 1 ]  





 
PVD-040SpecialtyAgency Qualifier, coded

Required if 040-I007-01-4709 Agency Qualifier, coded is used. This attribute is encoded using an ASC X12 code. according to the External Code List reference it was modified as follows: "Deleted existing values (may be used in SCRIPT Standard Versions 5.0 - 10.4; added new value for use in SCRIPT Standard Version 10.5 or higher". The specification does not indicate what the values are or whether any specialty code specified by X12 is allowed.

040-I007-02-4707 is no longer supported.

AN10C[ 0 .. 1 ] 4709[ !-~]*





 
PVD-070CliniclNameParty Name

The clinic or pharmacy name in one field.

AN35C[ 0 .. 1 ]  [ !-~]*





 
PVD-050NameName

Prescriber's Name "The name of the prescriber or pharmacist or supervisor. This composite is broken into individual section for each part of the name."

NAME_TYPE129R[ 1 .. 1 ]   
PVD-050-1002-01LastNameLast Name

This field is marked as "conditional" but it should be mandatory in the context of the parent element (i.e. if the name appears, then the last name is required).

AN35C[ 0 .. 1 ]  [ !-~]*





 
PVD-050-1002-02FirstNameFist Name

Alphanumeric

AN35C[ 0 .. 1 ]  [ !-~]*





 
PVD-050-1002-03MiddleNameMiddle Name

Alphanumeric

AN35C[ 0 .. 1 ]  [ !-~]*





 
PVD-050-1002-04SuffixSuffix

Alphanumeric

AN10C[ 0 .. 1 ]  [ !-~]*





 
PVD-050-1002-05PrefixPrefix

Alphanumeric

AN10C[ 0 .. 1 ]  [ !-~]*





 
PVD-080AddersPrescriber's Address

The composite for the prescriber or pharmacist or supervisor address. Further defined fields are used for specific section of the address.

ADDRESS_TYPE1120R[ 1 .. 1 ]   
PVD-080-1AddressLine1Street and Number/P.O. Box

Alphanumeric

AN35R[ 1 .. 1 ]  [ !-~]*





 
PVD-080-2AddressLine2Street and Number/P.O. Box

Alphanumeric

AN35C[ 0 .. 1 ]  [ !-~]*





 
PVD-080-3CityCity Name

Alphanumeric

AN35C[ 0 .. 1 ]  [ !-~]*





 
PVD-080-4StateCountry Sub-entity identification

United States and Canadian Province Postal Service Abbreviations. Values: See External Code List.

AN2C[ 0 .. 1 ]  AL|AK|AZ|AR|AS|CA|CO|CT|DE|DC|
|FM|FL|GA|GU|HI|ID|IL|IN|IA|KS
|KY|LA|ME|MH|MD|MA|MI|MN|MS|MO
|MT|NE|NV|NH|NJ|NM|NY|NC|ND|MP
|OH|OK|OR|PW|PA|PR|RI|SC|SD|TN
|TX|UT|VT|VA|VI|WA|WV|WI|WY|AB
|BC|MB|NB|NF|NS|NT|NU|ON|PE|QC
|SK|YT
PVD-080-5ZipCodePostcode Identification

ZIP code of the pharmacy or prescriber. Use the format 99999 or 999999999. Is not to include hyphen (-).

AN9C[ 0 .. 1 ]  (\d{5})|(\d{9})





 
PVD-080-6PlaceLocationQualifierPlace/Location Qualifier

Alphanumeric, free text. This field is locally defined "Agreement between trading partners if used." Should this be constrained and eliminated?

AN999C[ 0 .. 1 ]  [ !-~]*





 
PVD-100PrescriberAgent 

This composite is used to identify the Designated Agent - use for transmitter/submitter name. If a supervising prescriber name or id is required, use another repetition of the PVD Segment placing the id in the reference number field. This composite is to be used in the 0PC0 PVD Segment loop only. Note: For NEWRX, REFRES, CANRX or CHGRES ' this field is mandatory if the sender of the message is not the actual prescriber referenced in PVD 020-01

NAME_TYPE129C[ 0 .. 1 ]   
PVD-100-1LastNameParty Name

Last name of the Designated Agent. This field is to be used in the 'PC' PVD Segment loop only.

This field should be marked as required in the XSD because it would be required if the name appears at all. Otherwise a name may appear with empty child elements.

AN35C[ 0 .. 1 ]  [ !-~]*





 
PVD-100-2FirstNameFirst Name

First name of the Designated Agent.

AN35C[ 0 .. 1 ]  [ !-~]*





 
PVD-100-3MiddleNameMiddle Name

Middle name of the Designated Agent..

AN35C[ 0 .. 1 ]  [ !-~]*





 
PVD-100-4SuffixSuffix

Alphanumeric

AN10C[ 0 .. 1 ]  [ !-~]*





 
PVD-100-5PrefixPrefix

Alphanumeric

AN10C[ 0 .. 1 ]  [ !-~]*





 
PVD-090CommunicationNumbersCommunication Numbers

Provider contact number. Prescriber telephone number or other contact number. May occur multiple times when used with qualifier and repetition separator. Used with qualifiers in

COMM_TYPE83R[ 1 .. * ]   
PVD-090-1NumberCommunication Number

Telephone number, mandatory, max 80 length

AN80R[ 1 .. 1 ]  ([!-~]|[ ])*[!-~]([!-~]|[ ])*





 
PVD-090-2QualifierCode List Qualifier

Qualifies the Communication Number. X- 12 DE 365. When used, one occurrence is TE (Telephone). Other occurrences are optional and would contain other values. Values: See External Code List

BN Beeper CP Cellular EM Electronic Mail FX Fax HP Home NP Night TE Telephone WP Work

AN2C[ 0 .. 1 ] X-12 DE 365BN|CP|FX|HP|NP|TE|WP|EM





 

PVDSU : PVD-SU segment corresponding to "Supervisor" XML element

This segment is used to specify the supervisor of the prescriber.

NOTE: Supervisor reference may be needed for DEA Schedule drugs.

PVD-SU segment corresponding to "Supervisor" XML element Detail

ReferenceXML ReferenceIG ReferenceNotesTypeLengthUsageCardinalityValue SetValidation Pattern
PVD-020IdentificationReference number and Reference Qualifier

This a choice of identifiers that combines the Reference Number and its Reference Qualifier.

NOTE: This element combines the reference number and qualifier but it does not exclude the identifiers types that are not applicable to prescribers.

ID_TYPE863R[ 1 .. 10 ]   
Choice for PVD-020NCPDPIDReference number and Reference Qualifier

Alphanumeric, D3

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020FileIDReference number and Reference Qualifier

Alphanumeric, 94

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020StateLicenseNumberReference number and Reference Qualifier

Alphanumeric, 0B

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020MedicareNumberReference number and Reference Qualifier

Alphanumeric, 1C

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020MedicaidNumberReference number and Reference Qualifier

Alphanumeric,1D

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020DentistLicenseNumberReference number and Reference Qualifier

Alphanumeric, 1E

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020UPINReference number and Reference Qualifier

Alphanumeric, 1G

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020FacilityIDReference number and Reference Qualifier

Alphanumeric, 1J

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020PPONumberReference number and Reference Qualifier

Alphanumeric, 1M

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020PayerIDReference number and Reference Qualifier

Alphanumeric, 2U

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020ProcessorIdentificationNumberReference number and Reference Qualifier

Alphanumeric, ADI

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020BINLocationNumberReference number and Reference Qualifier

Alphanumeric, BO

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020CommercialReference number and Reference Qualifier

Alphanumeric, C1

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020MedicalRecordIdentificationNumberEHRReference number and Reference Qualifier

Alphanumeric, EA

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020PatientAccountNumberReference number and Reference Qualifier

Alphanumeric, EJ

Choice

AN0X [ 0 .. 0 ]  





 
Choice for PVD-020DEANumberReference number and Reference Qualifier

Alphanumeric, DH

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020HINReference number and Reference Qualifier

Alphanumeric, HI

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020IndividualPolicyNumberReference number and Reference Qualifier

Alphanumeric, IP

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020SecondaryCoverageReference number and Reference Qualifier

Alphanumeric, NC

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020NAICCodeReference number and Reference Qualifier

Alphanumeric, NF

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020PromotionNumberReference number and Reference Qualifier

Alphanumeric, PD

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020SocialSecurityReference number and Reference Qualifier

Alphanumeric, SY

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020NPIReference number and Reference Qualifier

Alphanumeric, HPI

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020PriorAuthorizationReference number and Reference Qualifier

Alphanumeric, G1

Choice

AN35C[ 0 .. 1 ]  





 
 SpecialtyAgency Qualifier, coded

Required if 040-I007-01-4709 Agency Qualifier, coded is used. This attribute is encoded using an ASC X12 code. according to the External Code List reference it was modified as follows: "Deleted existing values (may be used in SCRIPT Standard Versions 5.0 - 10.4; added new value for use in SCRIPT Standard Version 10.5 or higher". The specification does not indicate what the values are or whether any specialty code specified by X12 is allowed.

AN10C[ 0 .. 1 ] 4709[ !-~]*





 
PVD-050NameName

The name of the prescriber or pharmacist or supervisor. This composite is broken into individual section for each part of the name.

NAME_TYPE129R[ 1 .. 1 ]   
PVD-050-1LastNameParty Name

Last name of the prescriber or pharmacist or supervisor.

AN35RE[ 0 .. 1 ]  [ !-~]*





 
PVD-050-2FirstNameFirst Name

First name of the prescriber or pharmacist or supervisor.

AN35R[ 1 .. 1 ]  [ !-~]*





 
PVD-050-3MiddleNameMiddle Name

Middle name of the prescriber or pharmacist or supervisor.

AN35C[ 0 .. 1 ]  [ !-~]*





 
PVD-050-4SuffixSuffix

Alphanumeric

AN10C[ 0 .. 1 ]  [ !-~]*





 
PVD-050-5PrefixPrefix

Alphanumeric

AN10C[ 0 .. 1 ]  [ !-~]*





 
 ClinicNameParty Name

The clinic or pharmacy name in one field.

AN35C[ 0 .. 1 ]  Choice





 
PVD-080Address 

The composite for the prescriber or pharmacist or supervisor address. Further defined fields are used for specific section of the address.

ADDRESS_TYPE1120R[ 1 .. 1 ]   
PVD-080-1AddressLine1Street and Number/P.O. Box

Alphanumeric

AN35C[ 0 .. 1 ]  [ !-~]*





 
PVD-080-1AddressLine2Street and Number/P.O. Box

Alphanumeric

AN35C[ 0 .. 1 ]  [ !-~]*





 
PVD-080-2CityCity Name

Alphanumeric

AN35C[ 0 .. 1 ]  [ !-~]*





 
PVD-080-3StateCountry Sub-entity identification

United States and Canadian Province Postal Service Abbreviations. Values: See External Code List.

AN2C[ 0 .. 1 ]  AL|AK|AZ|AR|AS|CA|CO|CT|DE|DC|
|FM|FL|GA|GU|HI|ID|IL|IN|IA|KS
|KY|LA|ME|MH|MD|MA|MI|MN|MS|MO
|MT|NE|NV|NH|NJ|NM|NY|NC|ND|MP
|OH|OK|OR|PW|PA|PR|RI|SC|SD|TN
|TX|UT|VT|VA|VI|WA|WV|WI|WY|AB
|BC|MB|NB|NF|NS|NT|NU|ON|PE|QC
|SK|YT
PVD-080-4ZipCodePostcode Identification

ZIP code of the pharmacy or prescriber. Use the format 99999 or 999999999. Is not to include hyphen (-).

AN9C[ 0 .. 1 ]  (\d{5})|(\d{9})





 
PVD-080-5PlaceLocationQualifierPlace/Location Qualifier

Alphanumeric, free text. This field is locally defined "Agreement between trading partners if used." Should this be constrained and eliminated?

AN999C[ 0 .. 1 ]  [ !-~]*





 
 CommunicationNumbers  COMM_TYPE999R[ 1 .. 2 ]   
PVD-090-1NumberCommunication Number

Telephone number, mandatory, max 80 length

AN80R[ 1 .. 1 ]  ([!-~]|[ ])*[!-~]([!-~]|[ ])*





 
PVD-090-2QualifierCode List Qualifier

Qualifies the Communication Number. X- 12 DE 365. When used, one occurrence is TE (Telephone). Other occurrences are optional and would contain other values. Values: See External Code List

BN: Beeper CP: Cellular EM: Electronic Mail FX: Fax HP: Home NP: Night TE: Telephone WP: Work

AN2C[ 0 .. 1 ] X-12 DE 365BN|CP|FX|HP|NP|TE|WP|EM





 

PVDSK : PVD-SK segment corresponding to the "Facility" XML element.

This segment is specified for long-term settings.

PVD-SK segment corresponding to the "Facility" XML element. Detail

ReferenceXML ReferenceIG ReferenceNotesTypeLengthUsageCardinalityValue SetValidation Pattern
PVD-020IdentificationReference number and Reference Qualifier

The actual identification for the facility. The qualifier was used to specify a choice of possible identifier listed here.

NOTE: This element combines the reference number and qualifier but it does not exclude the identifiers types that are not applicable to prescribers.

ID_TYPE863R[ 1 .. 1 ]   
Choice for PVD-020NCPDPIDReference number and Reference Qualifier

Alphanumeric, D3

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020FileIDReference number and Reference Qualifier

Alphanumeric, 94

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020StateLicenseNumberReference number and Reference Qualifier

Alphanumeric, 0B

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020MedicareNumberReference number and Reference Qualifier

Alphanumeric, 1C

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020MedicaidNumberReference number and Reference Qualifier

Alphanumeric,1D

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020DentistLicenseNumberReference number and Reference Qualifier

Alphanumeric, 1E

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020UPINReference number and Reference Qualifier

Alphanumeric, 1G

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020FacilityIDReference number and Reference Qualifier

Alphanumeric, 1J

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020PPONumberReference number and Reference Qualifier

Alphanumeric, 1M

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020PayerIDReference number and Reference Qualifier

Alphanumeric, 2U

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020ProcessorIdentificationNumberReference number and Reference Qualifier

Alphanumeric, ADI

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020BINLocationNumberReference number and Reference Qualifier

Alphanumeric, BO

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020CommercialReference number and Reference Qualifier

Alphanumeric, C1

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020MedicalRecordIdentificationNumberEHRReference number and Reference Qualifier

Alphanumeric, EA

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020PatientAccountNumberReference number and Reference Qualifier

Alphanumeric, EJ

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020DEANumberReference number and Reference Qualifier

Alphanumeric, DH

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020HINReference number and Reference Qualifier

Alphanumeric, HI

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020IndividualPolicyNumberReference number and Reference Qualifier

Alphanumeric, IP

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020SecondaryCoverageReference number and Reference Qualifier

Alphanumeric, NC

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020NAICCodeReference number and Reference Qualifier

Alphanumeric, NF

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020PromotionNumberReference number and Reference Qualifier

Alphanumeric, PD

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020SocialSecurityReference number and Reference Qualifier

Alphanumeric, SY

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020NPIReference number and Reference Qualifier

Alphanumeric, HPI

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PVD-020PriorAuthorizationReference number and Reference Qualifier

Alphanumeric, G1

Choice

AN35C[ 0 .. 1 ]  





 
PVD-070FacilityNameParty Name

"The clinic or pharmacy name in one field." - this duplicates one of the other segments' information.

AN35C[ 0 .. 1 ]  Choice





 
PVD-080AddressAddress

Facility Address

ADDRESS_TYPE1120C[ 0 .. 1 ]   
PVD-080-1AddressLine1Street and Number/P.O. Box

Alphanumeric

AN35C[ 0 .. 1 ]  [ !-~]*





 
PVD-080-1AddressLine2Street and Number/P.O. Box

Alphanumeric

AN35C[ 0 .. 1 ]  [ !-~]*





 
PVD-080-2CityCity Name

Alphanumeric

AN35C[ 0 .. 1 ]  [ !-~]*





 
PVD-080-3StateCountry Sub-entity identification

United States and Canadian Province Postal Service Abbreviations. Values: See External Code List.

AN2C[ 0 .. 1 ]  AL|AK|AZ|AR|AS|CA|CO|CT|DE|DC|
|FM|FL|GA|GU|HI|ID|IL|IN|IA|KS
|KY|LA|ME|MH|MD|MA|MI|MN|MS|MO
|MT|NE|NV|NH|NJ|NM|NY|NC|ND|MP
|OH|OK|OR|PW|PA|PR|RI|SC|SD|TN
|TX|UT|VT|VA|VI|WA|WV|WI|WY|AB
|BC|MB|NB|NF|NS|NT|NU|ON|PE|QC
|SK|YT
PVD-080-4ZipCodePostcode Identification

ZIP code of the pharmacy or prescriber. Use the format 99999 or 999999999. Is not to include hyphen (-).

AN9C[ 0 .. 1 ]  (\d{5})|(\d{9})





 
PVD-080-5PlaceLocationQualifierPlace/Location Qualifier

Alphanumeric, free text. This field is locally defined "Agreement between trading partners if used." Should this be constrained and eliminated?

AN999C[ 0 .. 1 ]  [ !-~]*





 
PVD-090CommunicationNumbers 

Facility contact number(s).

COMM_TYPE999C[ 0 .. 1 ]   
PVD-090-1NumberCommunication Number

Telephone number, mandatory, max 80 length

AN80R[ 1 .. 1 ]  ([!-~]|[ ])*[!-~]([!-~]|[ ])*





 
PVD-090-2QualifierCode List Qualifier

Qualifies the Communication Number. X- 12 DE 365. When used, one occurrence is  TE' (Telephone). Other occurrences are optional and would contain other values. Values: See External Code List

BN: Beeper CP: Cellular EM: Electronic Mail FX: Fax HP: Home NP: Night TE: Telephone WP: Work

AN2C[ 0 .. 1 ] X-12 DE 365BN|CP|FX|HP|NP|TE|WP|EM





 

PTTNEWRX : PTT segment for "Patient" XML element in NEWRX

PTT for NEWRX,  requires mandatory address.

Between SCRIPT 10.6 and 10.11 this segment underwent changes that are not backwards compatible - reordering and renaming of the XML elements.

PTT segment for "Patient" XML element in NEWRX Detail

ReferenceXML ReferenceIG ReferenceNotesTypeLengthUsageCardinalityValue SetValidation Pattern
PTT-010PatientRelationshipIndividual Relationship, coded

Defines the relationship of patient to cardholder.

1 (Cardholder), 2 (Spouse), 3 (Child), 4 (Other).

AN1C[ 0 .. 1 ] External Code List1|2|3|4





 
PTT-020DateOfBirth 

This is s choice in XML- either date or date/time may be specified.

DATE_TIME33R[ 1 .. 1 ]   
Choice for PTT-020Date 

Birth Date of patient. Format: CCYYMMDD Note: Whenever possible, Birth Date of patient should be sent.

DT8R[ 1 .. 1 ]  ^\d{4}((0\d)|(1[0-2]))((([0-2]
]\d)|(3[0-1])))?$





 
Choice for PTT-020Date/Time 

Date and Time

DTM24C[ 0 .. 1 ]  ^\d{4}(((0[1-9])|(1[0-2]))(((0
0[1-9])|([1-2]\d)|(3[0-1]))(((
[01]\d|2[0-3])([0-5]\d))(([0-5
]\d)((\.\d{1,4}))?)?)?)?)?([+-
](([0]\d|1[0-3])([0-5]\d)))?$


 
PT-030Name 

This composite is the name of the patient. Further defined fields separate the name into components.

NAME_TYPE129R[ 1 .. 1 ]   
PT-030-1LastName 

Last name of patient.

AN35R[ 1 .. 1 ]  [ !-~]*





 
PT-030-2FirstName 

First name of the patient.

AN35R[ 1 .. 1 ]  [ !-~]*





 
PT-030-3MiddleName 

Middlename should be specified if available.

AN35RE[ 0 .. 1 ]  [ !-~]*





 
PT-030-4Suffix 

Alphanumeric

AN10C[ 0 .. 1 ]  [ !-~]*





 
PT-030-5Prefix 

Alphanumeric

AN10C[ 0 .. 1 ]  [ !-~]*





 
PTT-040GenderGender, coded

Gender of the patient. X-12 DE 1069. Values: M = Male F = Female U = Unknown

AN1R[ 1 .. 1 ]  M|F|U





 
PTT-050IdentificationReference number and Reference Qualifier

Choice of relevant identifiers is not restricted to those relevant to Patient identification.

NOTE: This element combines the reference number and qualifier but it does not exclude the identifiers types that are not applicable to prescribers.

ID_TYPE863C[ 0 .. 2 ]   
Choice for PTT-050NCPDPIDReference number and Reference Qualifier

Alphanumeric, D3

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PTT-050FileIDReference number and Reference Qualifier

Alphanumeric, 94

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PTT-050StateLicenseNumberReference number and Reference Qualifier

Alphanumeric, 0B

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PTT-050MedicareNumberReference number and Reference Qualifier

Alphanumeric, 1C

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PTT-050MedicaidNumberReference number and Reference Qualifier

Alphanumeric,1D

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PTT-050DentistLicenseNumberReference number and Reference Qualifier

Alphanumeric, 1E

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PTT-050UPINReference number and Reference Qualifier

Alphanumeric, 1G

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PTT-050FacilityIDReference number and Reference Qualifier

Alphanumeric, 1J

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PTT-050PPONumberReference number and Reference Qualifier

Alphanumeric, 1M

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PTT-050PayerIDReference number and Reference Qualifier

Alphanumeric, 2U

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PTT-050ProcessorIdentificationNumberReference number and Reference Qualifier

Alphanumeric, ADI

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PTT-050BINLocationNumberReference number and Reference Qualifier

Alphanumeric, BO

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PTT-050CommercialReference number and Reference Qualifier

Alphanumeric, C1

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PTT-050MedicalRecordIdentificationNumberEHRReference number and Reference Qualifier

Alphanumeric, EA

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PTT-050PatientAccountNumberReference number and Reference Qualifier

Alphanumeric number, (Qualifier= 'EJ')

This is a possible choice for patient identifier types. Choice

AN35R[ 1 .. 1 ]  





 
Choice for PTT-050DEANumberReference number and Reference Qualifier

Alphanumeric, DH

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PTT-050HINReference number and Reference Qualifier

Alphanumeric, HI

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PTT-050IndividualPolicyNumberReference number and Reference Qualifier

Alphanumeric, IP

This is a possible choice for patient identifier types. Choice

AN35RE[ 0 .. 1 ]  





 
Choice for PTT-050SecondaryCoverageReference number and Reference Qualifier

Alphanumeric, NC

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PTT-050NAICCodeReference number and Reference Qualifier

Alphanumeric, NF

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PTT-050PromotionNumberReference number and Reference Qualifier

Alphanumeric, PD

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PTT-050SocialSecurityReference number and Reference Qualifier

Alphanumeric, SY

This is a possible choice for patient identifier types. Choice

AN35RE[ 0 .. 1 ]  





 
Choice for PTT-050NPIReference number and Reference Qualifier

Alphanumeric, HPI

Choice

AN35C[ 0 .. 1 ]  





 
Choice for PTT-050PriorAuthorizationReference number and Reference Qualifier

Alphanumeric, G1

Choice

AN35C[ 0 .. 1 ]  





 
PTT-060Address 

The composite for the patient address. Further defined fields are used for specific section of the address. Note: Whenever possible, the patient address fields should be sent.

If the address of the patient is unable to be obtained, the text 'UNKNOWN' should be put in the Street Address.

ADDRESS_TYPE1120R[ 1 .. 1 ]   
PTT-060-1AddressLine1Street and Number/P.O. Box

Street and Number/P.O. Box Note: Whenever possible, the patient address fields should be sent

If patient is homeless, the text 'HOMELESS' should be put in the Street Address.

AN35C[ 0 .. 1 ]  [ !-~]*





 
PTT-060-1AddressLine2Street and Number/P.O. Box

Street and Number/P.O. Box Note: Whenever possible, the patient address fields should be sent

AN35C[ 0 .. 1 ]  [ !-~]*





 
PTT-060-2CityCity Name

Alphanumeric

AN35C[ 0 .. 1 ]  [ !-~]*





 
PTT-060-3StateCountry Sub-entity identification

identification United States and Canadian Province Postal Service Abbreviations. Values: See External Code List.

AN2C[ 0 .. 1 ]  AL|AK|AZ|AR|AS|CA|CO|CT|DE|DC|
|FM|FL|GA|GU|HI|ID|IL|IN|IA|KS
|KY|LA|ME|MH|MD|MA|MI|MN|MS|MO
|MT|NE|NV|NH|NJ|NM|NY|NC|ND|MP
|OH|OK|OR|PW|PA|PR|RI|SC|SD|TN
|TX|UT|VT|VA|VI|WA|WV|WI|WY|AB
|BC|MB|NB|NF|NS|NT|NU|ON|PE|QC
|SK|YT
PTT-060-4ZipCodePostcode Identification

Postal Code ZIP code of the pharmacy or prescriber. Use the format 99999 or 999999999. Is not to include hyphen (-).

AN9C[ 0 .. 1 ]  (\d{5})|(\d{9})





 
PTT-060-5PlaceLocationQualifierPlace/Location Qualifier

Alphanumeric, free text. This field is locally defined "Agreement between trading partners if used." Should this be constrained and eliminated?

AN999C[ 0 .. 1 ]  [ !-~]*





 
PTT-070CommunicationNumbers 

Patient contact number. May occur multiple times when used with qualifier and repetition separator. Used with qualifiers in field 070-02 Code List qualifier.

COMM_TYPE83C[ 0 .. 1 ]   
PTT-070-1Number 

Telephone number, mandatory, max 80 length

AN80R[ 1 .. 1 ]  ([!-~]|[ ])*[!-~]([!-~]|[ ])*





 
PTT-070-1QualifierCode List Qualifier

Qualifies the Communication Number. X- 12 DE 365. When used, one occurrence is 'TE' (Telephone). Other occurrences are optional and would contain other values.

BN Beeper CP Cellular EM Electronic Mail FX Fax HP Home NP Night TE Telephone WP Work

AN2C[ 0 .. 1 ]  BN|CP|FX|HP|NP|TE|WP|EM





 
PTT-080PatientLocation 

Patient location elements order was changed for XML. Facility. --> Room --> Bed became Facility --> Bed --> Room.

LOCATION_TYPE57C[ 0 .. 1 ]   
PTT-080-1FacilityUnitFacility Unit

The unit of the patient.

AN35C[ 0 .. 1 ]  [ !-~]*





 
PTT-080-3BedBed

The bed of the patient.

AN10C[ 0 .. 1 ]  [ !-~]*





 
PTT-080-2RoomRoom

The room of the patient.

AN10C[ 0 .. 1 ]  ^\d{4}((0\d)|(1[0-2]))((([0-2]
]\d)|(3[0-1])))?$





 
PTT-090LanguageCodeLanguage Code

This element was added to 10.11 but it may be needed in earlier versions.

This field is required to support Meaningful Use Criteria .

AN3X [ 0 .. 0 ]  [ !-~]*





 

DRU : Drug Segment for "MedicationPrescribed" XML element

The fields of this segment are part of the "MedicationPrescribed" element. Item Description Identification "P" for "MedicationPrescribed" and "D" for "MedicationDispensed".

The "Item Description Identification" DRU- 010 is not included since the XML representation provide specializations for each ot fits values: P = Prescribed D = Dispensed R = Requested

Drug Segment for "MedicationPrescribed" XML element Detail

ReferenceXML ReferenceIG ReferenceNotesTypeLengthUsageCardinalityValue SetValidation Pattern
DRU-010-2 or DRU-10-12DrugDescriptionItem Description

There is a discrepancy in the field length: the implementation guide specifies only 35 "bytes" while the XSD specifies it can be maximum 105 characters. The implementation guide suggests that it's acceptable to abbreviate this field but since it is the only mandatory identifier for the drug it is necessary that this description be detailed and complete.

From the SCRIPT Implementation Guide the following is stated for the Item Description: 'Is the self-contained full drug name, strength, and form.'

AN105R[ 1 .. 1 ]  [ !-~]*





 
DRU-010-3 to 9DrugCodedItem Number

The "Drug number" refers ot the drug coded

DRUG_CODE5143C[ 0 .. 1 ]   
DRU-010-3ProductCodeDrug number

RxNorm preferred product code.

This element of the dataytype should be mandatory. Otherwise a XML message that contains a "DrugCoded" element that is empty would be acceptable though it does not make sense since "DrugCoded" is already optional.

AN35C[ 0 .. 1 ]  [ !-~]*





 
DRU-010-4ProductCodeQualifierCode List Responsibility Agency

Coded: the code list defining the Item Number. X-12 DE 235.

The allowed qualifiers were expanded for version 10.11 to "ND|MF|RT|UN|UP"

AN2C[ 0 .. 1 ] X-12 DE 235ND|MF|UP





 
DRU-010-6StrengthFree Text

Measurement Value - Drug strength. Changed from field 6314 to 4440 in Version 4.0. Field length expanded to an..70.

AN70C[ 0 .. 1 ]  [ !-~]*





 
DRU-010-8DrugDBCodeReference Number

GPI, GCN Seq #, GFC, DDID, SmartKey, GM, Multum MMDC, Multum Drug ID, etc

AN35C[ 0 .. 1 ]  [ !-~]*





 
DRU-010-9DrugDBCodeQualifierReference Qualifier

Code value to define the reference number.

AN2C[ 0 .. 1 ]  ND|MF|RT|UN|UP





 
DRU-010-13FormSourceCodeSource Code List

Code identifying the source organization. Required if Item Form Code (010-I013- 14-7992) used.

The XSD skips elements DRU-010-10 through DRU-010-12.

AN2C[ 0 .. 1 ] 7992AA





 
DRU-010-14FormCodeItem Form Code

Drug form, in a code. Dosage form code. Pharmaceutical Dosage Form. Qualified by Source Code List (7991). Values: See External Code List

AN15C[ 0 .. 1 ] 7991[ !-~]*





 
DRU-010-15StrengthSourceCodeSource Code List

Code identifying the source organization. Required if Item Strength Code (010- I013-16-7993) used. Values: See External Code List

AN2C[ 0 .. 1 ] 7993AB





 
DRU-010-16StrengthCodeItem Strength Code

Drug strength qualifier. Units of Presentation. Qualified by Source Code List (7991). Values: See External Code List

AN15C[ 0 .. 1 ] 7991[ !-~]*





 
DRU-010-17DEASchedule 

Code, the latest available at: http://evs.nci.nih.gov/ftp1/NCPDP/

This element is used to store the DEA Schedule code: C38046 Unspecified C48672 Schedule I Substance C48675 Schedule II C48676 Schedule III C48677 Schedule IV C48679 Schedule V

Predicate:
Required if the medication is categorized as a controlled substance by the Drug Enforcement Administration (DEA). The DEA Schedule would be populated by the system generating the message, and would utilize the Federal DEA Schedule classification code list, based on federal classification of the medication or the state reclassification of the medication.
AN15C[ 0 .. 1 ]  [ !-~]*





 
DRU-020QuantityQuantity Composite

This composite is for the count of tablets or number of grams.

QUANTITY1030R[ 1 .. 2 ]   
DRU-020-2ValueQuantity

This should be a numeric value but it is specified as a string. This element is required if the quantity is transmitted. "On NEWRX, when the DRU 020-I009- 03-1131 value 'QS' value is used, DRU 020-I009-05-7994 Potency Unit Code must equal 'C38046' (Unspecified). DRU 020-I009-02-6060 Quantity must equal '0'."

This element was corrected for 10.11 and became a numeric, mandatory, max 11 length (nM...11). Before that is was changed to (an...35) in version 4.0.

AN35R[ 1 .. 1 ]  [0-9]+(\.[0-9]+)?





 
DRU-020-3CodeListQualifierCode List Qualifier

Alphanumeric, coded using Uses X-12 DE 673 value set. Quantity Sufficient (QS) code usage: in care settings where there are established dispensing protocols between the prescriber and the pharmacy/pharmacist, dispensed quantities for certain medication orders are appropriately determined by the pharmacy'based on the prescriber's dosing directions as well as other factors. For example, in the Long Term Care setting, medication orders are typically open-ended. A medication is delivered to the resident's facility on a scheduled basis until the pharmacy is notified that the order has been discontinued by the prescriber. The delivery schedule is determined by each pharmacy based on a variety of factors'with deliveries occurring every 7 days, every 14 days, monthly, etc. Accordingly, the quantity to be dispensed for a given delivery must be determined by the pharmacy to match their particular delivery schedule. For use on the NEWRX message only, DRU 020-I009-03-1131 Code List Qualifier value of the 'QS' qualifier is limited to settings where dispensing protocols are in force between the physician and pharmacy/pharmacist, where such use is in accordance with federal and state regulations. Example settings include long term care, home health care, and outpatient clinics.

'QS' is not used in retail pharmacy NEWRX messages. If a NEWRX message is received by a retail pharmacy with the QS qualifier for a quantity of 0, then an ERROR response message must be returned. The ERROR message will contain a Status type, coded 010-9015 = '900' (Transaction Rejected). In addition, the Code List Qualifier STS-020-1131 (Reject Code) should indicate the rejection; for example, a Reject Code value of '134' to indicate 'DRU potency unit code is invalid.'

AN2R[ 1 .. 1 ] X-12 DE 67338|40|87|QS|CF





 
DRU-020-4UnitSourceCodeSource Code List

Alphanumeric, fixed in the XML "Code identifying the source organization. Required if Potency Unit Code (020-I009-05-7994) is used."

AN2C[ 0 .. 1 ]  AA|AB|AC





 
DRU-020-4PotencyUnitCodePotency Unit Code

Unit of measure. Potency Unit. Qualified by Source Code List (7991).

Uses NCPDP NCI subsets

Predicate:
020-I009-03-1131 value 'QS' value is used, DRU 020-I009-05-7994 Potency Unit Code must equal 'C38046' (Unspecified). DRU 020-I009-02-6060 Quantity must equal '0'.
AN15C[ 0 .. 1 ] 7991[ !-~]*





 
DRU-040DaySupplyDate

Note: It is strongly recommended that Days Supply (value 'ZDS' be supported.

Backwards compatibility note: The order was modified in version 10.11.

AN35C[ 0 .. 1 ]  [ !-~]*





 
DRU-030-2 and 3DirectionsDosage

SIG instructions. Dosage free text. Note: If Structured Sig Segment is used, see Note in Structured Sig Segment - Sig Free Text String Indicator (030-S024- 01-7902).

This element in the XML structure combines DRU-030-2 and 3.

AN140R[ 0 .. * ]  [ !-~]*





 
DRU-090NoteFree Text

Backwards compatibility: the order of the DRU segment was changed in 10.11 thus the later version is not  backwards compatible with 10.6.

AN210C[ 0 .. 1 ]  [ !-~]*





 
DRU-060-1Refills/QualifierQuantity Qualifier

This field does not appear in 10.11 because the qualifier is assumed to be "R" in all cases for NEWRX.

R = Number of Refills 'R' implies an Original Dispensing in addition to the Quantity specified in DRU 060-I009-02- 6060. Example: If DRU 060-I009-01- 6063 = 'R' and DRU 060-I009-02-6060 = 3, the prescriber is authorizing four dispensings. This value will appear in NEWRX messages and will not appear in REFRES messages. See Note 2. A = Additional Refills Authorized 'A' implies no Original Dispensing in addition to the quantity specified in DRU 060-I009--2-6060. Example: If DRU 060-I009-01-6063 = 'A' and DRU 060-I009-02-6060 = 3, the prescriber is authorizing three dispensings. This value will appear only in REFRES

AN3R[ 1 .. 2 ]  R|PRN





 
DRU-060-2Refills/ValueQuantity Value

This element specifies the number of refills allowed.

Renamed "NumberOfRefills" in version 10.11 and the type was change to numeric (n..2) and used without a qualifier - it is assumed to be"R".

AN35R[ 1 .. 2 ]  [ !-~]*





 
DRU-050SubstitutionsProduct/Service Substitution, coded

NCPDP value list. Value 0 = No Product Selection Indicated. This value should be used to designate that substitutions are allowed. When a prescriber wishes to allow substitutes for a NEWRX, this field should be ' to reflect that substitutions can be allowed. Values: See the NCPDP External Code List for definitions of values. 0 = No Product Selection Indicated 1 = Substitution Not Allowed by Prescriber 2 = Substitution Allowed - Patient Requested Product Dispensed 3 = Substitution Allowed - Pharmacist Selected Product Dispensed 4 = Substitution Allowed - Generic Drug Not in Stock 5 = Substitution Allowed - Brand Drug Dispensed as a Generic 7 = Substitution Not Allowed - Brand Drug Mandated by Law 8 = Substitution Allowed - Generic Drug Not Available in Marketplace (6 was intentionally left off)

AN1C[ 0 .. 1 ]  0|1|2|3|4|5|7|8





 
DRU-040-2 (85)WrittenDateDate/Time/Period

For Medication History Response (RXHRES): If the entity has fill history, Last Fill Date must be used. If the entity has prescribing data, date authorized (Date Written) must be used. For all transaction except VERIFY - At least one loop must contain 85 = Date Issued (Written Date) REFREQ ' At least one loop must contain LD ' (Last Fill). Value '06' (Sold Date) is only allowed to be used in Medication History Response, Fill Status Notification, and Refill Request transactions.

Qualifier - 85 is implied.

DATE_TIME33R[ 1 .. 1 ]   
Choice for DRU-040-2 (85)Date 

Date

DT8C[ 0 .. 1 ]  ^\d{4}((0\d)|(1[0-2]))((([0-2]
]\d)|(3[0-1])))?$





 
Choice for DRU-040-2 (85)Date/Time 

Date and Time

DTM24C[ 0 .. 1 ]  ^\d{4}(((0[1-9])|(1[0-2]))(((0
0[1-9])|([1-2]\d)|(3[0-1]))(((
[01]\d|2[0-3])([0-5]\d))(([0-5
]\d)((\.\d{1,4}))?)?)?)?)?([+-
](([0]\d|1[0-3])([0-5]\d)))?$


 
DRU-040 (LD)LastFillDateDate/Time/Period

For Medication History Response (RXHRES): If the entity has fill history, Last Fill Date must be used. If the entity has prescribing data, date authorized (Date Written) must be used. For all transaction except VERIFY - At least one loop must contain 85 = Date Issued (Written Date) REFREQ ' At least one loop must contain LD ' (Last Fill). Value '06' (Sold Date) is only allowed to be used in Medication History Response, Fill Status Notification, and Refill Request transactions.

Qualifier - LD is implied.

DATE_TIME33C[ 0 .. 1 ]   
Choice for DRU-040 (LD)Date 

Date

DT8C[ 0 .. 1 ]  ^\d{4}((0\d)|(1[0-2]))((([0-2]
]\d)|(3[0-1])))?$





 
Choice for DRU-040 (LD)Date/Time 

Date and Time

DTM24C[ 0 .. 1 ]  ^\d{4}(((0[1-9])|(1[0-2]))(((0
0[1-9])|([1-2]\d)|(3[0-1]))(((
[01]\d|2[0-3])([0-5]\d))(([0-5
]\d)((\.\d{1,4}))?)?)?)?)?([+-
](([0]\d|1[0-3])([0-5]\d)))?$


 
DRU-040 (36)ExpirationDateDate/Time/Period

Qualifier - 36 is implied

DATE_TIME33C[ 0 .. 1 ]   
Choice for DRU-040 (36)Date 

Date

DT8C[ 0 .. 1 ]  ^\d{4}((0\d)|(1[0-2]))((([0-2]
]\d)|(3[0-1])))?$





 
Choice for DRU-040 (36)Date/Time 

Date and Time

DTM24C[ 0 .. 1 ]  ^\d{4}(((0[1-9])|(1[0-2]))(((0
0[1-9])|([1-2]\d)|(3[0-1]))(((
[01]\d|2[0-3])([0-5]\d))(([0-5
]\d)((\.\d{1,4}))?)?)?)?)?([+-
](([0]\d|1[0-3])([0-5]\d)))?$


 
DRU-040 (07)EffectiveDateDate/Time/Period

Qualifier - 07 is implied

DATE_TIME33C[ 0 .. 1 ]   
Choice for DRU-040 (07)Date 

Date

DT8C[ 0 .. 1 ]  ^\d{4}((0\d)|(1[0-2]))((([0-2]
]\d)|(3[0-1])))?$





 
Choice for DRU-040 (07)Date/Time 

Date and Time

DTM24C[ 0 .. 1 ]  ^\d{4}(((0[1-9])|(1[0-2]))(((0
0[1-9])|([1-2]\d)|(3[0-1]))(((
[01]\d|2[0-3])([0-5]\d))(([0-5
]\d)((\.\d{1,4}))?)?)?)?)?([+-
](([0]\d|1[0-3])([0-5]\d)))?$


 
DRU-040 (PE)PeriodEndDate/Time/Period

Qualifier - PE is implied

DATE_TIME33C[ 0 .. 1 ]   
Choice for DRU-040 (PE)Date 

Date

DT8C[ 0 .. 1 ]  ^\d{4}((0\d)|(1[0-2]))((([0-2]
]\d)|(3[0-1])))?$





 
Choice for DRU-040 (PE)Date/Time 

Date and Time

DTM24C[ 0 .. 1 ]  ^\d{4}(((0[1-9])|(1[0-2]))(((0
0[1-9])|([1-2]\d)|(3[0-1]))(((
[01]\d|2[0-3])([0-5]\d))(([0-5
]\d)((\.\d{1,4}))?)?)?)?)?([+-
](([0]\d|1[0-3])([0-5]\d)))?$


 
DRU-040 (35)DeliveredOnDateDate/Time/Period

Qualifier - 35 is implied

DATE_TIME33C[ 0 .. 1 ]   
Choice for DRU-040 (35)Date 

Date

DT8C[ 0 .. 1 ]  ^\d{4}((0\d)|(1[0-2]))((([0-2]
]\d)|(3[0-1])))?$





 
Choice for DRU-040 (35)Date/Time 

Date and Time

DTM24C[ 0 .. 1 ]  ^\d{4}(((0[1-9])|(1[0-2]))(((0
0[1-9])|([1-2]\d)|(3[0-1]))(((
[01]\d|2[0-3])([0-5]\d))(([0-5
]\d)((\.\d{1,4}))?)?)?)?)?([+-
](([0]\d|1[0-3])([0-5]\d)))?$


 
DRU-040 (BE)DateValidatedDate/Time/Period

Qualifier - BE is implied

DATE_TIME33C[ 0 .. 1 ]   
Choice for DRU-040 (BE)Date 

Date

DT8C[ 0 .. 1 ]  ^\d{4}((0\d)|(1[0-2]))((([0-2]
]\d)|(3[0-1])))?$





 
Choice for DRU-040 (BE)Date/Time 

Date and Time

DTM24C[ 0 .. 1 ]  ^\d{4}(((0[1-9])|(1[0-2]))(((0
0[1-9])|([1-2]\d)|(3[0-1]))(((
[01]\d|2[0-3])([0-5]\d))(([0-5
]\d)((\.\d{1,4}))?)?)?)?)?([+-
](([0]\d|1[0-3])([0-5]\d)))?$


 
DRU-070Diagnosis 

This structure allows senders to specify two sets of primary and secondary diagnoses.

This repeated element allows for repeating groups of Primary and Secondary diagnoses.

DIAGNOSIS999C[ 0 .. 2 ]   
DRU-070-1ClinicalInformationQualifierClinical Information Qualifier

Qualifies the Clinical Information - primary field. Values: See External Code List

AN1R[ 1 .. 1 ]  1|2





 
DRU-070-2PrimaryDiagnosisClinical Information - primary DIAGNOSIS_TYPE21R[ 1 .. 1 ]   
DRU-070-4QualifierCode List Qualifier

E, F, and M are not supported. ABF International Classification of Diseases-10- Clinical Modifications (ICD- 10-CM) DX International Classification of Diseases-9- Clinical Modifications- Diagnosis (ICD-9-CM-Diagnosis E Micromedex/Medical F First DataBank M Medi-Span Product

ABF specifies ICD-10-CM DX specifies ICD-9-CM Diagnosis There is no support for SNOMED-CT.

AN3C[ 0 .. 1 ]  E|F|M|ABF|DX|ICD9|ICD10





 
DRU-070-5Value 

The prescriber supplied or pharmacy inferred code for the diagnosis, coded

AN17R[ 1 .. 1 ]  ([!-~]|[ ])*[!-~]([!-~]|[ ])*





 
DRU-070-4SecondaryDiagnosisClinical Information - secondary DIAGNOSIS_TYPE0X [ 0 .. 0 ]   
DRU-070-4QualifierCode List Qualifier

Alphanumeric ABF International Classification of Diseases-10- Clinical Modifications (ICD- 10-CM) DX International Classification of Diseases-9- Clinical Modifications- Diagnosis (ICD-9-CM-Diagnosis

ABF specifies ICD-10-CM DX specifies ICD-9-CM Diagnosis There is no support for SNOMED-CT and there is no support for Micromedex, Fist DataBank, or Medi-Span, unlike the Primary diagnosis.

AN3O[ 0 .. 1 ] X-12 DE 235E|F|M|ABF|DX|ICD9|ICD10





 
DRU-070-5Value 

The prescriber supplied or pharmacy inferred code for the secondary diagnosis., coded

AN17R[ 1 .. 1 ]  ([!-~]|[ ])*[!-~]([!-~]|[ ])*





 
DRU-080-2PriorAuthorizationReference Number AUTHORIZATION45C[ 0 .. 1 ]   
DRU-080-2QualifierReference Qualifier

Qualifier used to define the Reference Number. X-12 DE 128.   Alphanumeric, validation pattern G1|PD|D3|94|0B|1C|1D|1E|1G|1M|2U|BO|DH| HI|NC|NF|PD|SY|HPI|G1|ZZ

AN1C[ 0 .. 1 ]  G1|PD|D3|94|0B|1C|1D|1E|1G|1M|
|2U|BO|DH|HI|NC|NF|PD|SY|HPI|G
1|ZZ




 
DRU-080-1Value 

Alphanumeric, mandatory. This number is used to store the Prior Authorization or Sample Prescription number or the Prescriber Order Number, if used. Used in conjunction with 02-1153 qualifier field. The Prescriber Order Number resides in this field in a RXHRES transaction only. This field cannot be used for the prescriber order number in other transactions; these occur in the UIH Segment. For RXHRES in each loop of the medication - If the Prescriber Order Number is used, the qualifier of '94' (Pharmacy or Prescriber File ID) is required. The field is used to convey the prescriber order number in a Medication History response.

AN35R[ 1 .. 1 ]  [ !-~]*





 
DRU-100 CPD-030DrugUseEvaluation 

Conditional repeating composite for further explanation, conflict, or clarification of services related to drug use evaluation

DRUG_USE_EVAL112C[ 0 .. 5 ]   
DRU-100-1ServiceReasonCodeDUE Reason For Service Code

Code identifying the type of conflict detected. When this composite is used, DUE Reason For Service Code is mandatory. When the DUE Reason For Service Code is sent from the prescriber to the pharmacist, the DUE Result Of Service Code is mandatory. When the DUE Reason For Service Code is sent from the pharmacist to the prescriber, the DUE Result Of Service code is conditional. This field uses the appropriate values from the Reason For Service Code in NCPDP External Code List.

AN2R[ 1 .. 1 ]  AD|AN|AR|AT|CD|CH|CS|DA|DC|DD|
|DF|DI|DL|DM|DR|DS|ED|ER|EX|HD
|IC|ID|LD|LK|LR|MC|MN|MS|MX|NA
|NC|ND|NF|NN|NP|NR|NS|OH|PA|PC
|PG|PH|PN|PP|PR|PS|RE|RF|SC|SD
|SE|SF|SR|SX|TD|TN|TP|UD

 
DRU-100-2ProfessionalServiceCodeDUE Professional Service Code

Alphanumeric, pattern Code identifying intervention performed when a conflict has been detected. This field uses the appropriate values from the Professional Service Code in the NCPDP External Code List.

AN2C[ 0 .. 1 ]  00|AS|CC|DE|DP|FE|GP|MA|MB|MP|
|M0|MR|PA|PE|PH|PM|P0|PT|R0|RT
|SC|SW|TC|TH|ZZ




 
DRU-100-3ServiceResultCodeDUE Result Of Service Code

Alphanumeric, pattern Action taken in response to a conflict. This field uses the appropriate values from the Result of Service Code in the NCPDP External Code List.

AN2C[ 0 .. 1 ]  00|1A|1B|1C|1D|1E|1F|1G|1H|1J|
|1K|2A|2B|3A|3B|3C|3D|3E|3F|3G
|3H|3J|3K|3M|3N|4A




 
DRU-100-4 and DRU-100-5CoAgentDUE Co-Agent ID

Identifies the co-existing agent contributing to the DUR event (drug or disease) conflicting with the prescribed drug. When DUE Co-Agent ID is used, the DUE Co-Agent ID Qualifier must be present.

COAGENT0X [ 0 .. 0 ]   
DRU-100-5CoAgentIdentifierDUE Co-Agent ID Qualifier

Alphanumeric

AN19O[ 0 .. 1 ]  [ !-~]*





 
DRU-100-5CoAgentQualifierDUE Co-Agent ID Qualifier

Alphanumeric, see regex Code qualifying the value in DUE Co- Agent ID. When DUE Co-Agent ID Qualifier is sent, the DUE Co-Agent ID must be present. This field uses the appropriate values from the DUR Co-Agent Qualifier in the NCPDP External Code List.

AN2O[ 0 .. 1 ]  1|02|03|04|05|07|08|09|11|12|1
13|14|15|16|17|18|19|20|21|22|
23|24|25|26|27|28|29|30|31|32|
33|34|35|36|37|99



 
DRU-100-6ClinicalSignificanceCodeDUE Clinical Significance Code

Alphanumeric, pattern Code identifying the significance or severity level of a clinical event as contained in the originating database.

AN1C[ 0 .. 1 ]  1|2|3|9





 
DRU-100-07AcknowledgementReasonDUE Acknowledgement Reason

Additional textual information regarding intervention and/or acknowledgment associated with a DUE conflict. Mandatory if DUE Professional Service Code (100-S018-02-7881) = 'ZZ' (Other) to provide further explanation

AN100C[ 0 .. 1 ]  [ !-~]*





 
DRU-110DrugCoverageStatusDrug Coverage Status Code

Code identifying the coverage status of the prescribed drug.

Predicate:
This field should only be used for medication prescribed.
AN2C[ 0 .. 5 ]  PR|AP|PA|NF|NR|DC|UN|ST|SI





 
DRU-120PriorAuthorizationStatusPrior Authorization Status

The status of the prescription's prior authorization as known by the sender.

AN1C[ 0 .. 1 ]  A|D|R|N|F





 
DRU-130DoNotFill 

Used for medications ordered by a prescriber but not requiring dispensing at this time, but required for administration and available for drug-to-drug interactions.

The XSD pattern appears to have an error. This should be Y|N rather than Y|H ?

AN1C[ 0 .. 1 ]  Y|H





 
DRU-140NeededNoLaterThan 

Conditional composite for the facility to relay to the long term care pharmacy the timeframe when medication is needed for delivery. When a facility transmits either a new medication order (NEWRX) or request for the re-supply of a medication (RESUPP) to a pharmacy, it would optionally indicate the time by which the medication is needed. The facility could also provide a textual reason why the medication is needed by the time specified. The long term care pharmacy would then use this information to determine whether a special delivery is required, or whether the order could go out with the next scheduled delivery.

In the XSD this date/time is using UtcDatetype unlike other date/time values.

*12C[ 0 .. 1 ]  





 
DRU-150TimeZoneTime Zone

Composite for time zone for use with 140-I006; otherwise not used.

In the DRU Segment, Time Zone data elements are available for usage between the facility and the long term care pharmacy as part of the 'Needed No Later Than' information. In addition, Time Zone is available in the REQ segment for use when communicating drug administration events such as suspending medication administration, using the Drug Administration Notification (DRUADM) message. Events communicated in the CENSUS message may include time as well as date, and the Time Zone composite may be used to clarify those time values.

TIMEZONE10C[ 0 .. 1 ]   
DRU-150-01TimeZoneIdentifier 

Defines the time zone used by the sender. UN/EDIFACT element. Values: See External Code List For NEWRX or RESUPP in long term care setting, only value supported ' UT = Universal Time Coordinate Time zone difference quantity is mandatory if the composite is sent.

AN2R[ 1 .. 1 ]  UT





 
DRU-150-02TimeZoneDifferenceIdentifier 

Alphanumeric, pattern The time zone difference quantity is HHMM offset from the Coordinated Universal Time (UTC) (X12 Data Element 623, value UT (Universal Time Coordinate)).

AN7C[ 0 .. 1 ]  [\+\-]?[0-9][0-9]?[0-9]?[0-9]?
?





 
DRU-160NeededNoLaterThanReason 

Free text additional instructions.

AN70C[ 0 .. 1 ]  [ !-~]*





 
DRU-170OtherCompoundInformation 

NOT SUPPORTED IN 10.6 but added to 10.11

COMPOUND75X [ 0 .. 0 ]   
DRU-170-1CompoundCoded 

Alphanumeric, coded

AN1O[ 0 .. 1 ]  0|1|2





 
DRU-010-13, 170-02FormSourceCode 

Alphanumeric, fixed

AN2O[ 0 .. 1 ]  AA





 
DRU-170-03FinalCompoundPharmaceuticalDosageForm 

Alphanumeric

AN70O[ 0 .. 1 ]  [ !-~]*





 

CPD : Compound Segment

The fields of this segment are part of the "MedicationPrescribed" element.

Not supported in 10.6 but added in 10.11.

Compound Segment Detail

ReferenceXML ReferenceIG ReferenceNotesTypeLengthUsageCardinalityValue SetValidation Pattern
 Compound Content 

Not supported

SI4X [ 0 .. 0 ]  





 

SIG : "StructuredSIG" XML element corresponds to SIG segment

The fields of this segment are part of the "MedicationPrescribed" element.

Backwards compatibility note: the order of the SIG elements was changed in 10.11.

"StructuredSIG" XML element corresponds to SIG segment Detail

ReferenceXML ReferenceIG ReferenceNotesTypeLengthUsageCardinalityValue SetValidation Pattern
SIG-010RepeatingSIGREPEATING Sig

The Repeating Sig Composite is used to indicate if there is more than one Sig, such as for a tapered dose or sliding scale.

SIG_SEQUENCE7R[ 1 .. 1 ]   
SIG-010-1SigSequencePositionNumber 

A value of ' means that the Sig has no repeating elements. Values equal to or greater than 1 are used when the Sig has repeating elements to indicate the position within the string.

N2R[ 1 .. 1 ]  [0-9]+(\.[0-9]+)?





 
SIG-010-2MultipleModifier 

Alphanumeric, pattern AND|OR|THEN Used to express when there is more than one Sig as to whether all the Sigs must apply (AND) or if any of the Sigs can apply (OR) or if the Sigs are sequential (THEN), in the sequence defined by Sig SEQUENCE POSITION.

AN4C[ 0 .. 1 ]  AND|OR|THEN





 
SIG-020CodeSystemCODE SYSTEM

The Code System Composite of the Sig identifies which code system and version are used.

CODE_SYSTEM29R[ 1 .. 1 ]   
SIG-020-1SNOMEDVersion 

The version of The Systematized Nomenclature of Human and Veterinary Medicine (SNOMED) being used.

AN14C[ 0 .. 1 ]  [ !-~]*





 
SIG-020-2FMTVersion 

The version of Federal Medication Terminologies (FMT) being used.

AN14C[ 0 .. 1 ]  [ !-~]*





 
SIG-030FreeTextSig FREE TEXT STRING COMPOSITE

Used to reflect the text string express of the Sig. It should always be used, and in addition is the only composite to place a free text Sig from a generating system that CANNOT generate a structured Sig.

FREE_TEXT142R[ 1 .. 1 ]   
SIG-030-1SigFreeTextStringIndicatorSig Free Text String Indicator

Indicates the system capability of representing the instructions. Note: Value 1. Capture what the MD ordered. The Structured SIG Segment free text is used - free text is what the physician selected. DRU Dosage (030-I014-02 or 030-I014-03) Sig instructions must contain the same text. The Structured SIG Segment contains the codified SIG fields from the prescriber's order. Value 2. Reconstructed from structured Sig. The Structured SIG Segment free text used and it is a direct translation of codified SIG values and must not be structured English language or pharmacist/patient friendly. DRU Dosage (030-I014-02 or 030-I014-03) Sig instructions free text contains what the physician selected. Value 3. Pure free text. Value 3 is not used in the SCRIPT Standard. f the structured Sig cannot be generated, the segment is not used. The DRU Dosage (030-I014-02 or 030-I014-03) Sig instructions free text is used. DRU Dosage (030-I014-02 or 030-I014-03) Sig instructions free text contains what the physician selected.

AN1R[ 1 .. 1 ]  1|2|3





 
SIG-030-2SigFreeTextSig Free Text

Sig Free Text

AN140R[ 1 .. 1 ]  [ !-~]*





 
SIG-040DoseDOSE

The dose composite can define a fixed dose or can repeat to define a variable dose, dose range, or dose options.

DOSE230R[ 1 .. 1 ]   
SIG-040-1DoseCompositeIndicatorDose Composite Indicator

Alphanumeric, pattern 1|2|3|4 Indicates the action to be taken on the Dose Composite fields.

AN1C[ 0 .. 1 ]  1|2|3|4





 
SIG-040-2DoseDeliveryMethodTextDose Delivery Method Text

The textual representation of the Dose Delivery Method. This is the method in which the dose is delivered (describes how the dose is administered/consumed)

AN50C[ 0 .. 1 ]  [ !-~]*





 
SIG-040-3DoseDeliveryMethodCodeQualifierDose Delivery Method Code Qualifier

Alphanumeric, pattern 1|2 Qualifier to identify the code system being used

AN1C[ 0 .. 1 ]  1|2





 
SIG-040-4DoseDeliveryMethodCodeDose Delivery Method Code

The code representing the Dose Delivery Method Text.

AN15C[ 0 .. 1 ]  [ !-~]*





 
SIG-040-5DoseDeliveryMethodModifierTextDose Delivery Method Modifier Text

Modifies the method in which the dose is delivered (clarifies Dose Delivery Method Text).

AN50C[ 0 .. 1 ]  [ !-~]*





 
SIG-040-6DoseDeliveryMethodModifierCodeQualifierDose Delivery Method Modifier Code Qualifier

Qualifier to identify the code system being used. Values: See External Code List

AN1C[ 0 .. 1 ]  1|2





 
SIG-040-7DoseDeliveryMethodModifierCodeDose Delivery Method Modifier Code

The code representing the Dose Delivery Method Modifier Text.

AN15C[ 0 .. 1 ]  1|2





 
SIG-040-8DoseQuantityDose Quantity

The numeric expression of the dose.

N18C[ 0 .. 1 ]  [0-9]+(\.[0-9]+)?





 
SIG-040-9DoseFormTextDose Form Text

The textual representation of the Dose Form

AN50C[ 0 .. 1 ]  [ !-~]*





 
SIG-040-10DoseFormQualifierDose Form Code Qualifier

Qualifier to identify the code system being used. Values: See External Code List

AN0X [ 0 .. 0 ]  1|2





 
SIG-040-11DoseFormCodeDose Form Code

The code representing the Dose Form

AN15C[ 0 .. 1 ]  [ !-~]*





 
SIG-040-12DoseRangeModifierDose Range Modifier

Alphanumeric, pattern TO|OR Used to signify that the Sig contains more than one dose in a range or option. Values: See External Code List

AN3C[ 0 .. 1 ]  TO|OR





 
SIG-050DoseCalculationDOSE CALCULATION COMPOSITE

Used to calculate a dose where a body metric such as metric weight or surface area is used to calculate a dose for a patient.

DOSE_CALC198C[ 0 .. 1 ]   
SIG-050-1DosingBasisNumericValueDosing Basis Numeric Value

Expresses the numeric value of the dosing basis.

N18C[ 0 .. 1 ]  [0-9]+(\.[0-9]+)?





 
SIG-050-2DosisBasisUnitofMeasureTextDosing Basis Unit of Measure Text

The textual representation of the dosing basis unit of measure.

AN50C[ 0 .. 1 ]  [ !-~]*





 
SIG-050-3DosingBasisUnitofMeasureCodeQualifierDosing Basis Unit of Measure Code Qualifier

Alphanumeric, pattern 1|2 Qualifier to identify the code system being used.

AN1C[ 0 .. 1 ]  1|2





 
SIG-050-4DosingBasisUnitofMeasureCodeDosing Basis Unit of Measure Code

The code representing the dosing basis unit of measure

AN15C[ 0 .. 1 ]  [ !-~]*





 
SIG-050-5BodyMetricQualifierBody Metric Qualifier

Alphanumeric, pattern 1|2 Qualifier to identify the body metric being used (either weight or surface area). Values: See External Code List

AN0X [ 0 .. 0 ]  1|2





 
SIG-050-6BodyMetricValueBody Metric Value

Numeric Expresses the value of the body metric.

N18C[ 0 .. 1 ]  [0-9]+(\.[0-9]+)?





 
SIG-050-7CalculateDoseNumericCalculated Dose Numeric

Numeric Expresses the numeric value of the calculated dose

N18C[ 0 .. 1 ]  [0-9]+(\.[0-9]+)?





 
SIG-050-8CalculateDoseUnitofMeasureTextCalculated Dose Unit of Measure Text

The textual representation of the unit of measure of the calculated dose.

AN50C[ 0 .. 1 ]  [ !-~]*





 
SIG-050-9CalcuateDoseUnitofMeasureCodeQualifierCalculated Dose Unit of Measure Code Qualifier

Alphanumeric, pattern 1|2 Qualifier to identify the code system being used. Values: See External Code List

AN1C[ 0 .. 1 ]  1|2





 
SIG-050-10CalculateDoseUnitofMeasureCodeCalculated Dose Unit of Measure Code

Code representing the calculated dose unit of measure.

AN15C[ 0 .. 1 ]  [ !-~]*





 
SIG-050-11DosingBasisRangeModifierDosing Basis Range Modifier

Alphanumeric, pattern TO|OR Used to signify that the Sig contains more than one dose which represent a dose range (TO) or contains a dose option (OR). Values: See External Code List

AN2C[ 0 .. 1 ]  TO|PR





 
SIG-060VehicleVEHICLE COMPOSITE

Defines a vehicle specified for the delivery of the product.

VEHICLE160C[ 0 .. 1 ]   
SIG-060-1VehicleNameVehicle Name AN50C[ 0 .. 1 ]  [ !-~]*





 
SIG-050-2VehicleNameCodeQualifierVehicle Name Code Qualifier

Alphanumeric, pattern 1|2 Vehicle Name Code Qualifier

AN1C[ 0 .. 1 ]  1|2





 
SIG-060-3VehicleNameCodeVehicle Name Code

The code representing the Vehicle Name.

AN15C[ 0 .. 1 ]  [ !-~]*





 
SIG-060-4VehicleQuantityVehicle Quantity

A volume, expressed in a value.

N18C[ 0 .. 1 ]  [0-9]+(\.[0-9]+)?





 
SIG-060-5VehicleUnitOfMeasureTextVehicle Unit Of Measure Text

The textual representation of Vehicle Unit of Measure.

AN50C[ 0 .. 1 ]  [ !-~]*





 
SIG-060-6VehicleUnitOfMeasureCodeQualifierVehicle Unit Of Measure Code Qualifier

Alphanumeric, pattern 1|2 Qualifier to identify the code system being used. Values: See External Code List

AN1C[ 0 .. 1 ]  1|2





 
SIG-060-7VehicleUnitOfMeasureCodeVehicle Unit Of Measure Code

The code representing the Vehicle Unit of Measure

AN15C[ 0 .. 1 ]  [ !-~]*





 
SIG-050-8MultipleVehicleModifierMultiple Vehicle Modifier

Alphanumeric, pattern AND|OR Denotes if for an instance of more than one vehicle if all vehicles are used together (AND), or if each of the listed vehicles is an option (OR). Values: See External Code List

AN3C[ 0 .. 1 ]  AND|OR





 
SIG-070RouteofAdministrationROUTE OF ADMINISTRATION COMPOSITE

Defines the route of administration.

ROUTE72C[ 0 .. 1 ]   
SIG-070-1 DRU-180-1RouteofAdministrationTextRoute of Administration Text

Alphanumeric, free text, The textual representation of the Route of Administration

AN50C[ 0 .. 1 ]  [ !-~]*





 
SIG-070-2 DRU-180RouteofAdministrationCodeQualifierRoute of Administration Code Qualifier

Qualifier to identify the code system being used. Route of Administration Code Qualifier

AN1C[ 0 .. 1 ]  1|2





 
SIG-070-3 DRU-180-3RouteofAdministratoinCodeRoute of Administration Code

The code representing the Route of Administration

AN15C[ 0 .. 1 ]  [ !-~]*





 
SIG-070-4 DRU-180-4MultipleRouteofAdministrationModifierMultiple Route of Administration Modifier

Alphanumeric, AND/OR Used to express when there is more than one route as to whether the routes are all required to be used (AND) or if any of the routes can be used (OR). Values: See External Code List

AN3C[ 0 .. 1 ]  AND|OR





 
SIG-080SiteofAdministrationSITE OF ADMINISTRATION COMPOSITEPredicate:
Defines the site of administration.
SITE72C[ 0 .. 1 ]   
SIG-080-1SiteofAdministrationTextSite of Administration Text

The textual representation of Site Code. It is the site of administration.

AN50C[ 0 .. 1 ]  [ !-~]*





 
SIG-080-2SiteofAdministrationCodeQualifierSite of Administration Code Qualifier

Qualifier to identify the code system being used.

AN1C[ 0 .. 1 ]  1|2





 
SIG-080-3SiteofAdministrationCodeSite of Administration Code

The code representing the Site of Administration

AN15C[ 0 .. 1 ]  [ !-~]*





 
SIG-080-4MultipleAdministrationTimingModifierMultiple Site of Administration Timing Modifier

Alphanumeric, AND/OR/NOT Used to express when there is more than one site as to whether the sites are all required (AND) for use or excluded from use (NOT) or if any of the sites can be used (OR).

AN3C[ 0 .. 1 ]  AND|OR|NOT





 
SIG-090TimingSig TIMING COMPOSITE

This composite is used to provide instruction about the timing of the Sig - when/how often/frequently/at what rate - the medication is be taken. Defines a specific administration day, date or time

This composite in XML combines timing, frequency, and interval.

TIMING399C[ 0 .. 1 ]   
SIG-090-1AdministrationTimingTextAdministration Timing Text

The textual representation of Administration Timing.

AN50C[ 0 .. 1 ]  [ !-~]*





 
SIG-090-2AdministrationTimingCodeQualifierAdministration Timing Code Qualifier

Qualifier to identify the code system being used.

AN1C[ 0 .. 1 ]  1|2





 
SIG-090-3AdministrationTimingCodeAdministration Timing Code

The code representing the Administration Timing Text.

AN15C[ 0 .. 1 ]  [ !-~]*





 
SIG-090-4MultipleAdministrationTimingModifierMultiple Administration Timing Modifier

Alphanumeric, pattern AND|OR e ADMINISTRATION TIME as to whether the times are all required to be used (AND) or if any of the times can be used (OR). Values: See External Code List

AN3C[ 0 .. 1 ]  AND|OR





 
SIG-090-5RateofAdministrationRate of Administration

The amount of time for a {single} dose to be administered

AN11C[ 0 .. 1 ]  [ !-~]*





 
SIG-090-6RateUnitofMeasureTextRate Unit of Measure Text

The textual representation of Rate Unit of Measure for the period of time (seconds, minutes, hours, days) in which the dose is to be administered.

AN50C[ 0 .. 1 ]  [ !-~]*





 
SIG-090-7RateUnitofMeasureCodeQualifierRate Unit of Measure Code Qualifier

Alphanumeric, pattern 1|2 Qualifier to identify the code system being used.

AN1C[ 0 .. 1 ]  1|2





 
SIG-090-8RateUnitofMeasureCodeRate Unit of Measure Code

The code representing the Rate Unit Of Measure Text.

AN15C[ 0 .. 1 ]  [ !-~]*





 
SIG-090-9TimePeriodBasisTextTime Period Basis Text

Expresses the time unit of measure for the calculated dose.

AN50C[ 0 .. 1 ]  [ !-~]*





 
SIG-090-10TimePeriodBasisCodeQualifierTime Period Basis Code Qualifier

Alphanumeric, pattern 1|2 Qualifier to identify the code system being used.

AN1C[ 0 .. 1 ] External Code List1|2





 
SIG-090-11TimePeriodBasisCodeTime Period Basis Code

The code representing the time period basis.

AN15C[ 0 .. 1 ]  [ !-~]*





 
SIG-090-12FrequenceNumericValueFrequency Numeric Value

Defines a frequency of administration. Frequency is events per unit of time. The numeric interval for the event. Used to define a FREQUENCY of administration.

AN11C[ 0 .. 1 ]  [ !-~]*





 
SIG-090-13FrequencyUnitsTextFrequency Units Text

The textual representation of Frequency Units Code.

AN50C[ 0 .. 1 ]  [ !-~]*





 
SIG-090-14FrequencyUnitsCodeQualifierFrequency Units Code Qualifier

Alphanumeric, pattern 1|2 Qualifier to identify the code system being used.

AN1C[ 0 .. 1 ]  1|2





 
SIG-090-15FrequencyUnitsCodeFrequency Units Code

The code represented by Frequency Units Text.

AN15C[ 0 .. 1 ]  [ !-~]*





 
SIG-090-16VariableFrequencyModifierVariable Frequency Modifier

Alphanumeric, pattern AND|OR|TO Used to express when there is more than one FREQUENCY as to whether the frequencies are all required to be used (AND) or if any of the frequencies can be used (OR/TO).

AN3C[ 0 .. 1 ]  AND|OR|TO





 
SIG-090-17IntervalNumericValueInterval Numeric Value

Numeric Defines an interval of administration. Interval is the time between events.

N18C[ 0 .. 1 ]  [0-9]+(\.[0-9]+)?





 
SIG-090-18IntervalUnitsTextInterval Units Text

The textual representation of Interval Units Code.

AN50C[ 0 .. 1 ]  [ !-~]*





 
SIG-090-19IntervalUnitsCodeQualifierInterval Units Code Qualifier

Qualifier to identify the code system being used.

AN1C[ 0 .. 1 ]  1|2





 
SIG-090-20IntervalUnitsCodeInterval Units Code

The code representing the Interval Units Text.

AN15C[ 0 .. 1 ]  [ !-~]*





 
SIG-090-21VariableIntervalModifierVariable Interval Modifier

Alphanumeric, pattern AND|OR|TO Used to express when there is more than one INTERVAL as to whether the intervals are all required to be used (AND) or if any of the intervals can be used (OR/TO). Values: See External Code List

AN3C[ 0 .. 1 ]  AND|OR|TO





 
SIG-100DurationDURATION COMPOSITE

Defines a duration of use/therapy.

DURATION80C[ 0 .. 1 ]   
SIG-100-1DurationNumericValueDuration Numeric Value

Numeric The numeric duration units.

N11R[ 1 .. 1 ]  [0-9]+(\.[0-9]+)?





 
SIG-100-2DurationTextDuration Text

Alphanumeric The textual representation of Duration Units Code.

AN50R[ 1 .. 1 ]  [ !-~]*





 
SIG-100-3DurationTextCodeQualifierDuration Text Code Qualifier

Qualifier to identify the code system being used.

AN1R[ 1 .. 1 ]  1|2





 
SIG-100-4DurationTextCodeDuration Text Code

The code representing the Duration Units Text.

AN15R[ 1 .. 1 ]  [ !-~]*





 
SIG-110MaximumDoseRestrictionMAXIMUM DOSE RESTRICTION COMPOSITE

The dose restriction composite of the Sig which defines a maximum or dose limit, as specified by the prescriber.

MAX_DOSE179R[ 1 .. 1 ]   
 MaximumDoseRestrictionNumericValueMaximum Dose Restriction Numeric Value

Numeric Defines a MAXIMUM DOSE, so that the Sig can represent the concept, 'Not to exceed _____.' Expression of a DOSE MAXIMUM involves placing the core dose value in this field and the units and variables in the fields that follow.

N18R[ 1 .. 1 ]  [0-9]+(\.[0-9]+)?





 
SIG-110-2MaximumDoseRestrictionUnitsTextMaximum Dose Restriction Units Text

The textual representation of the Dose Maximum Units.

AN50R[ 1 .. 1 ]  [ !-~]*





 
SIG-110-3MaximumDoseRestrictionCodeQualifierMaximum Dose Restriction Code Qualifier

Qualifier 1, 2 Qualifier to identify the code system being used. Values: See External Code List

AN1R[ 1 .. 1 ]  1|2





 
SIG-110-4MaximumDoseRestrictionUnitsCodeMaximum Dose Restriction Units Code

The code representing the Dose Maximum Units Text.

AN15R[ 1 .. 1 ]  [ !-~]*





 
SIG-110-5MaximumDoseRestrictionVariableNumericValueMaximum Dose Restriction Variable Numeric Value

Numeric The numeric representation of the maximum dose calculations.

N18C[ 0 .. 1 ]  [0-9]+(\.[0-9]+)?





 
SIG-110-6MaximumDoseRestrictionVariableUnitsTextMaximum Dose Restriction Variable Units Text

The textual representation of the Dose Maximum Variable Units.

AN50C[ 0 .. 1 ]  [ !-~]*





 
SIG-110-7MaximumDoseRestrictionVariableUnitsCodeQualifierMaximum Dose Restriction Variable Units Code Qualifier

Qualifier 1, 2 Qualifier to identify the code system being used. Required when Maximum Dose Restriction Variable Units Code (110- S033-08-7974) is used. Values: See External Code List

AN1C[ 0 .. 1 ]  1|2





 
SIG-110-8MaximumDoseRestrictionVariableUnitsCodeMaximum Dose Restriction Variable Units Code

The code represented by the Dose Maximum Variable Units Text. Required when Maximum Dose Restriction Variable Units Code Qualifier (110-S033-07-7973) is used.

AN15C[ 0 .. 1 ]  [ !-~]*





 
SIG-110-9MaximumDoseRestrictionVariableDurationModifierMaximum Dose Restriction Variable Duration Modifier

AND, OR boolean operator Used to express when there is more than one DURATION as to whether the durations are all required to be used (AND) or if any of the durations can be used (OR). Values: See External Code List

AN3C[ 0 .. 1 ]  AND|OR





 
SIG-120IndicationINDICATION COMPOSITE

Defines the indication for use of the medication as meant to be conveyed to the patient.

INDICATION295R[ 1 .. 1 ]   
SIG-120-1IndicationPrecursorTextIndication Precursor Text

The textual representation of the indication precursor.

AN50C[ 0 .. 1 ]  [ !-~]*





 
SIG-120-3IndicationPrecursoCodeQualifierIndication Precursor Code Qualifier

Qualifier 1, 2 Qualifier to identify the code system being used. Values: See External Code List

AN1C[ 0 .. 1 ] External Code List1|2





 
SIG-120-3IndicationPrecursorCodeIndication Precursor Code

The code representing the indication precursor.

AN15R[ 1 .. 1 ]  [ !-~]*





 
SIG-120-4IndicationTextIndication Text

The textual representation of the Indication.

AN50C[ 0 .. 1 ]  [ !-~]*





 
SIG-120-5IndicationTextCodeQualifierIndication Text Code Qualifier

Qualifier 1,2 Qualifier to identify the code system being used. Values: See External Code List

AN1C[ 0 .. 1 ] External Code List1|2





 
SIG-120-6IndicationTextCodeIndication Text Code

The code representing the Indication Text.

AN15C[ 0 .. 1 ]  [ !-~]*





 
SIG-120-7IndicationValueTextIndication Value Text

The textual representation of when the indication value is applicable.

AN50C[ 0 .. 1 ]  [ !-~]*





 
SIG-120-8IndicatoinValueUnitIndication Value Unit

The numeric expression of a value when it applies to an Indication.

AN18C[ 0 .. 1 ]  [ !-~]*





 
SIG-120-9IndicationValueUnitofMeasureTextIndication Value Unit of Measure Text

The textual representation of the unit of measure of the indication value.

AN50C[ 0 .. 1 ]  [ !-~]*





 
SIG-120-10IndicationValueUnitsofMeasureCodeQualifierIndication Value Unit of Measure Code Qualifier

Qualifier 1, 2 Qualifier to identify the code system being used. Values: See External Code List

AN16C[ 0 .. 1 ] External Code List1|2





 
SIG-120-11IndicationValueUnitofMeasureCodeIndication Value Unit of Measure Code

The code representing the unit of measure.

AN15R[ 1 .. 1 ]  [ !-~]*





 
SIG-120-12IndicationVariableModifierIndication Variable Modifier

Logical boolean used to express when there is more than one INDICATION as to whether all the indications must apply (AND) or if any of the indications can apply (OR). Values: See External Code List Used to express a hard stop, such

"TO" is also supported in addition to boolean operators.

AN3C[ 0 .. 1 ] External Code ListAND|OR|TO





 
SIG-130StopStop Indicator

Defines if a stop is present.

Part of the STOP COMPOSITE, it corresponds to SIG-130-1.

AN1C[ 0 .. 1 ]  [ !-~]*





 

OBS : Observation segment corresponding to the "Observation"XML element

Observation segment

It used to specify height and weight.

Observation segment corresponding to the "Observation"XML element Detail

ReferenceXML ReferenceIG ReferenceNotesTypeLengthUsageCardinalityValue SetValidation Pattern
OBS-010MeasurementMeasurement Value

Repeated, limited to 10 occurrences.

MEASUREMENT74C[ 0 .. 10 ]   
OBS-010-1DimensionMeasurement Dimension, coded

Code Qualifies the Measurement value. Values: See External Code List

AN0X [ 0 .. 0 ]  HT|WG|ZZS|ZZD





 
OBS-010-2ValueMeasurement Value

Numeric

N18R[ 1 .. 1 ]  [0-9]+(\.[0-9]+)?





 
OBS-010-4ObservationDateDate/Time/Period

Choice date or date/time.

DATE_TIME33C[ 0 .. 1 ]   
ChoiceDateDate/Time/Period

Date

DT8C[ 0 .. 1 ]  ^\d{4}((0\d)|(1[0-2]))((([0-2]
]\d)|(3[0-1])))?$





 
ChoiceDate/TimeDate/Time/Period

Date and Time

DTM24C[ 0 .. 1 ]  ^\d{4}(((0[1-9])|(1[0-2]))(((0
0[1-9])|([1-2]\d)|(3[0-1]))(((
[01]\d|2[0-3])([0-5]\d))(([0-5
]\d)((\.\d{1,4}))?)?)?)?)?([+-
](([0]\d|1[0-3])([0-5]\d)))?$


 
OBS-010-6MeasurementDataQualifierMeasurement Data Qualifier

Qualifier 1, 2, 3, 4. Identifies code set of clinical physical findings.

AN1C[ 0 .. 1 ]  1|2|3|4





 
OBS-010-7MeasurementSourceCodeSource Code List

Code identifying the source organization. Required if Measurement Unit Code (010-S017-08-7995) is used.

AN2C[ 0 .. 1 ]  AA|AB|AC





 
OBS-010-8MeasurementUnitCodeMeasurement Unit Code

Basis for measurement code. Units of Presentation. Qualified by Source Code List (7991). Qualifies the Measurement Value (010-S017-02-6314). Values: See External Code List

AN15C[ 0 .. 1 ] 7991[ !-~]*





 
OBS-020ObservationNodesFree Text AN140C[ 0 .. 1 ]  [ !-~]*





 

COO : Coordination of Benefits segment corresponding to the "BenefitsCoordination" XML element

Coordination of Benefits Segment

Coordination of Benefits segment corresponding to the "BenefitsCoordination" XML element Detail

ReferenceXML ReferenceIG ReferenceNotesTypeLengthUsageCardinalityValue SetValidation Pattern
COO-010PayerIdentificationReference number and Reference Qualifier

Choice of relevant identifiers is not restricted to those relevant to Payer identification.

Within each COO Segment, the Reference Number (010-I001) repeats >1 times. For a given Primary Payer loop of the COO Segment, the Reference Number and Qualifier are used to denote identification of the payer, for example with a BIN Number and a Processor Control Number (if applicable). The Reference Number and Reference Qualifier will loop twice if there is a BIN Number (one loop of (010-I001)) and a Processor Control Number (second loop of (010-I001)) to report. If the payer does not use a Processor Control Number, the Reference Number (010- I001) would only loop once, containing the BIN Number.

ID_TYPE863C[ 0 .. 2 ]   
Choice for COO-010NCPDPIDReference number and Reference Qualifier

Alphanumeric, D3

Choice

AN35C[ 0 .. 1 ]  





 
Choice for COO-010FileIDReference number and Reference Qualifier

Alphanumeric, 94

Choice

AN35C[ 0 .. 1 ]  





 
Choice for COO-010StateLicenseNumberReference number and Reference Qualifier

Alphanumeric, 0B

Choice

AN35C[ 0 .. 1 ]  





 
Choice for COO-010MedicareNumberReference number and Reference Qualifier

Alphanumeric, 1C

Choice

AN35C[ 0 .. 1 ]  





 
Choice for COO-010MedicaidNumberReference number and Reference Qualifier

Alphanumeric,1D

Choice

AN35C[ 0 .. 1 ]  





 
Choice for COO-010DentistLicenseNumberReference number and Reference Qualifier

Alphanumeric, 1E

Choice

AN35C[ 0 .. 1 ]  





 
Choice for COO-010UPINReference number and Reference Qualifier

Alphanumeric, 1G

Choice

AN35C[ 0 .. 1 ]  





 
Choice for COO-010FacilityIDReference number and Reference Qualifier

Alphanumeric, 1J

Choice

AN35C[ 0 .. 1 ]  





 
Choice for COO-010PPONumberReference number and Reference Qualifier

Alphanumeric, 1M

Choice

AN35C[ 0 .. 1 ]  





 
Choice for COO-010PayerIDReference number and Reference Qualifier

Alphanumeric, 2U

Choice

AN35RE[ 0 .. 1 ]  





 
Choice for COO-010ProcessorIdentificationNumberReference number and Reference Qualifier

Alphanumeric, ADI

Choice

AN35C[ 0 .. 1 ]  





 
Choice for COO-010BINLocationNumberReference number and Reference Qualifier

Alphanumeric, BO

Choice

AN35RE[ 0 .. 1 ]  





 
Choice for COO-010CommercialReference number and Reference Qualifier

Alphanumeric, C1

Choice

AN35C[ 0 .. 1 ]  





 
Choice for COO-010MedicalRecordIdentificationNumberEHRReference number and Reference Qualifier

Alphanumeric, EA

Choice

AN35C[ 0 .. 1 ]  





 
Choice for COO-010PatientAccountNumberReference number and Reference Qualifier

Alphanumeric, EJ

Choice

AN35C[ 0 .. 1 ]  





 
Choice for COO-010DEANumberReference number and Reference Qualifier

Alphanumeric, DH

Choice

AN35C[ 0 .. 1 ]  





 
Choice for COO-010HINReference number and Reference Qualifier

Alphanumeric, HI

Choice

AN35C[ 0 .. 1 ]  





 
Choice for COO-010IndividualPolicyNumberReference number and Reference Qualifier

Alphanumeric, IP

Choice

AN35C[ 0 .. 1 ]  





 
Choice for COO-010SecondaryCoverageReference number and Reference Qualifier

Alphanumeric, NC

Choice

AN35C[ 0 .. 1 ]  





 
Choice for COO-010NAICCodeReference number and Reference Qualifier

Alphanumeric, NF

Choice

AN35C[ 0 .. 1 ]  





 
Choice for COO-010PromotionNumberReference number and Reference Qualifier

Alphanumeric, PD

Choice

AN35C[ 0 .. 1 ]  





 
Choice for COO-010SocialSecurityReference number and Reference Qualifier

Alphanumeric, SY

Choice

AN35C[ 0 .. 1 ]  





 
Choice for COO-010NPIReference number and Reference Qualifier

Alphanumeric, HPI

Choice

AN35C[ 0 .. 1 ]  





 
Choice for COO-010PriorAuthorizationReference number and Reference Qualifier

Alphanumeric, G1

Choice

AN35C[ 0 .. 1 ]  





 
COO-020PayerNameParty Name

Payer name CENSUS - if Private Pay ' This is the responsible Party Name.

AN35C[ 0 .. 1 ]  [ !-~]*





 
COO-040CardHolderIDReference Number

Cardholder ID

"CM" field but it is not a composite. This may be a "required but may be empty in some situations" field.

AN35RE[ 0 .. 1 ]  [ !-~]*





 
COO-050CardHolderNameParty Name

Cardholder name For CENSUS, Full Name of Responsible Party.

NAME_TYPE129C[ 0 .. 1 ]   
COO-050-1LastNameLast Name

Last name of the cardholder

AN35RE[ 0 .. 1 ]  [ !-~]*





 
COO-050-2FirstNameFirst Name

First name of the cardholder

AN35R[ 1 .. 1 ]  [ !-~]*





 
COO-050-3MiddleNameMiddle Name

Middlename of the cardholder

AN35C[ 0 .. 1 ]  [ !-~]*





 
COO-050-4SuffixSuffix

Suffix of the cardholder

AN10C[ 0 .. 1 ]  [ !-~]*





 
COO-050-5PrefixPrefix

Prefix of the cardholder

AN10C[ 0 .. 1 ]  [ !-~]*





 
COO-06-1154GroupIDReference Number AN35C[ 0 .. 1 ]  [ !-~]*





 
Created January 10, 2017, Updated March 01, 2017