Active| Used by 0 transactions and 12 templates, Uses 14 templates | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Item | DT | Card | Conf | Description | Label |
|---|---|---|---|---|---|
| hl7v2:FT1.1 | SI | 0 … 1 | Set ID - FT1 Contains 2.16.840.1.113883.3.1937.777.10.15.88 SI - Sequence ID (DYNAMIC) | FT1_ ment | |
| @Item | 0 … 1 | F | 355 | ||
| @Type | 0 … 1 | F | SI | ||
| @LongName | 0 … 1 | F | Set ID - FT1 | ||
| hl7v2:FT1.2 | ST | 0 … 1 | Transaction ID Contains 2.16.840.1.113883.3.1937.777.10.15.89 ST - String (DYNAMIC) | FT1_ment | |
| @Item | 0 … 1 | F | 356 | ||
| @Type | 0 … 1 | F | ST | ||
| @LongName | 0 … 1 | F | Transaction ID | ||
| hl7v2:FT1.3 | ST | 0 … 1 | Transaction Batch ID Contains 2.16.840.1.113883.3.1937.777.10.15.89 ST - String (DYNAMIC) | FT1_ment | |
| @Item | 0 … 1 | F | 357 | ||
| @Type | 0 … 1 | F | ST | ||
| @LongName | 0 … 1 | F | Transaction Batch ID | ||
| hl7v2:FT1.4 | DR | 1 … 1 | Transaction Date Contains 2.16.840.1.113883.3.1937.777.10.15.18 DR - Date/time range (DYNAMIC) | FT1_ment | |
| @Item | 0 … 1 | F | 358 | ||
| @Type | 0 … 1 | F | DR | ||
| @LongName | 0 … 1 | F | Transaction Date | ||
| hl7v2:FT1.5 | TS | 0 … 1 | Transaction Posting Date Contains 2.16.840.1.113883.3.1937.777.10.15.64 TS - Time stamp (DYNAMIC) | FT1_ment | |
| @Item | 0 … 1 | F | 359 | ||
| @Type | 0 … 1 | F | TS | ||
| @LongName | 0 … 1 | F | Transaction Posting Date | ||
| hl7v2:FT1.6 | IS | 1 … 1 | Transaction Type Contains 2.16.840.1.113883.3.1937.777.10.15.84 IS - Coded value for user-defined tables (DYNAMIC) | FT1_ment | |
| @Item | 0 … 1 | F | 360 | ||
| @Type | 0 … 1 | F | IS | ||
| @Table | 0 … 1 | F | HL70017 | ||
| @LongName | 0 … 1 | F | Transaction Type | ||
| hl7v2:FT1.7 | CE | 1 … 1 | Transaction Code Contains 2.16.840.1.113883.3.1937.777.10.15.5 CE - Coded element (DYNAMIC) | FT1_ment | |
| @Item | 0 … 1 | F | 361 | ||
| @Type | 0 … 1 | F | CE | ||
| @Table | 0 … 1 | F | HL70132 | ||
| @LongName | 0 … 1 | F | Transaction Code | ||
| hl7v2:FT1.8 | ST | 0 … 1 | Transaction Description Contains 2.16.840.1.113883.3.1937.777.10.15.89 ST - String (DYNAMIC) | FT1_ment | |
| @Item | 0 … 1 | F | 362 | ||
| @Type | 0 … 1 | F | ST | ||
| @LongName | 0 … 1 | F | Transaction Description | ||
| hl7v2:FT1.9 | ST | 0 … 1 | Transaction Description - Alt Contains 2.16.840.1.113883.3.1937.777.10.15.89 ST - String (DYNAMIC) | FT1_ment | |
| @Item | 0 … 1 | F | 363 | ||
| @Type | 0 … 1 | F | ST | ||
| @LongName | 0 … 1 | F | Transaction Description - Alt | ||
| hl7v2:FT1.10 | NM | 0 … 1 | Transaction Quantity Contains 2.16.840.1.113883.3.1937.777.10.15.86 NM - Numeric (DYNAMIC) | FT1_ment | |
| @Item | 0 … 1 | F | 364 | ||
| @Type | 0 … 1 | F | NM | ||
| @LongName | 0 … 1 | F | Transaction Quantity | ||
| hl7v2:FT1.11 | CP | 0 … 1 | Transaction Amount - Extended Contains 2.16.840.1.113883.3.1937.777.10.15.8 CP - Composite price (DYNAMIC) | FT1_ment | |
| @Item | 0 … 1 | F | 365 | ||
| @Type | 0 … 1 | F | CP | ||
| @LongName | 0 … 1 | F | Transaction Amount - Extended | ||
| hl7v2:FT1.12 | CP | 0 … 1 | Transaction Amount - Unit Contains 2.16.840.1.113883.3.1937.777.10.15.8 CP - Composite price (DYNAMIC) | FT1_ment | |
| @Item | 0 … 1 | F | 366 | ||
| @Type | 0 … 1 | F | CP | ||
| @LongName | 0 … 1 | F | Transaction Amount - Unit | ||
| hl7v2:FT1.13 | CE | 0 … 1 | Department Code Contains 2.16.840.1.113883.3.1937.777.10.15.5 CE - Coded element (DYNAMIC) | FT1_ment | |
| @Item | 0 … 1 | F | 367 | ||
| @Type | 0 … 1 | F | CE | ||
| @Table | 0 … 1 | F | HL70049 | ||
| @LongName | 0 … 1 | F | Department Code | ||
| hl7v2:FT1.14 | CE | 0 … 1 | Insurance Plan ID Contains 2.16.840.1.113883.3.1937.777.10.15.5 CE - Coded element (DYNAMIC) | FT1_ment | |
| @Item | 0 … 1 | F | 368 | ||
| @Type | 0 … 1 | F | CE | ||
| @Table | 0 … 1 | F | HL70072 | ||
| @LongName | 0 … 1 | F | Insurance Plan ID | ||
| hl7v2:FT1.15 | CP | 0 … 1 | Insurance Amount Contains 2.16.840.1.113883.3.1937.777.10.15.8 CP - Composite price (DYNAMIC) | FT1_ment | |
| @Item | 0 … 1 | F | 369 | ||
| @Type | 0 … 1 | F | CP | ||
| @LongName | 0 … 1 | F | Insurance Amount | ||
| hl7v2:FT1.16 | PL | 0 … 1 | Assigned Patient Location Contains 2.16.840.1.113883.3.1937.777.10.15.44 PL - Person location (DYNAMIC) | FT1_ment | |
| @Item | 0 … 1 | F | 133 | ||
| @Type | 0 … 1 | F | PL | ||
| @LongName | 0 … 1 | F | Assigned Patient Location | ||
| hl7v2:FT1.17 | IS | 0 … 1 | Fee Schedule Contains 2.16.840.1.113883.3.1937.777.10.15.84 IS - Coded value for user-defined tables (DYNAMIC) | FT1_ment | |
| @Item | 0 … 1 | F | 370 | ||
| @Type | 0 … 1 | F | IS | ||
| @Table | 0 … 1 | F | HL70024 | ||
| @LongName | 0 … 1 | F | Fee Schedule | ||
| hl7v2:FT1.18 | IS | 0 … 1 | Patient Type Contains 2.16.840.1.113883.3.1937.777.10.15.84 IS - Coded value for user-defined tables (DYNAMIC) | FT1_ment | |
| @Item | 0 … 1 | F | 148 | ||
| @Type | 0 … 1 | F | IS | ||
| @Table | 0 … 1 | F | HL70018 | ||
| @LongName | 0 … 1 | F | Patient Type | ||
| hl7v2:FT1.19 | CE | 0 … * | Diagnosis Code - FT1 Contains 2.16.840.1.113883.3.1937.777.10.15.5 CE - Coded element (DYNAMIC) | FT1_ment | |
| @Item | 0 … 1 | F | 371 | ||
| @Type | 0 … 1 | F | CE | ||
| @Table | 0 … 1 | F | HL70051 | ||
| @LongName | 0 … 1 | F | Diagnosis Code - FT1 | ||
| hl7v2:FT1.20 | XCN | 0 … * | Performed By Code Contains 2.16.840.1.113883.3.1937.777.10.15.74 XCN - Extended composite ID number and name for persons (DYNAMIC) | FT1_ment | |
| @Item | 0 … 1 | F | 372 | ||
| @Type | 0 … 1 | F | XCN | ||
| @Table | 0 … 1 | F | HL70084 | ||
| @LongName | 0 … 1 | F | Performed By Code | ||
| hl7v2:FT1.21 | XCN | 0 … * | Ordered By Code Contains 2.16.840.1.113883.3.1937.777.10.15.74 XCN - Extended composite ID number and name for persons (DYNAMIC) | FT1_ment | |
| @Item | 0 … 1 | F | 373 | ||
| @Type | 0 … 1 | F | XCN | ||
| @LongName | 0 … 1 | F | Ordered By Code | ||
| hl7v2:FT1.22 | CP | 0 … 1 | Unit Cost Contains 2.16.840.1.113883.3.1937.777.10.15.8 CP - Composite price (DYNAMIC) | FT1_ment | |
| @Item | 0 … 1 | F | 374 | ||
| @Type | 0 … 1 | F | CP | ||
| @LongName | 0 … 1 | F | Unit Cost | ||
| hl7v2:FT1.23 | EI | 0 … 1 | Filler Order Number Contains 2.16.840.1.113883.3.1937.777.10.15.21 EI - Entity identifier (DYNAMIC) | FT1_ment | |
| @Item | 0 … 1 | F | 217 | ||
| @Type | 0 … 1 | F | EI | ||
| @LongName | 0 … 1 | F | Filler Order Number | ||
| hl7v2:FT1.24 | XCN | 0 … * | Entered By Code Contains 2.16.840.1.113883.3.1937.777.10.15.74 XCN - Extended composite ID number and name for persons (DYNAMIC) | FT1_ment | |
| @Item | 0 … 1 | F | 765 | ||
| @Type | 0 … 1 | F | XCN | ||
| @LongName | 0 … 1 | F | Entered By Code | ||
| hl7v2:FT1.25 | CE | 0 … 1 | Procedure Code Contains 2.16.840.1.113883.3.1937.777.10.15.5 CE - Coded element (DYNAMIC) | FT1_ment | |
| @Item | 0 … 1 | F | 393 | ||
| @Type | 0 … 1 | F | CE | ||
| @Table | 0 … 1 | F | HL70088 | ||
| @LongName | 0 … 1 | F | Procedure Code | ||
| hl7v2:FT1.26 | CE | 0 … * | Procedure Code Modifier Contains 2.16.840.1.113883.3.1937.777.10.15.5 CE - Coded element (DYNAMIC) | FT1_ment | |
| @Item | 0 … 1 | F | 1316 | ||
| @Type | 0 … 1 | F | CE | ||
| @Table | 0 … 1 | F | HL70340 | ||
| @LongName | 0 … 1 | F | Procedure Code Modifier | ||
| hl7v2:FT1.27 | CE | 0 … 1 | Advanced Beneficiary Notice Code Contains 2.16.840.1.113883.3.1937.777.10.15.5 CE - Coded element (DYNAMIC) | FT1_ment | |
| @Item | 0 … 1 | F | 1310 | ||
| @Type | 0 … 1 | F | CE | ||
| @Table | 0 … 1 | F | HL70339 | ||
| @LongName | 0 … 1 | F | Advanced Beneficiary Notice Code | ||
| hl7v2:FT1.28 | CWE | 0 … 1 | Medically Necessary Duplicate Procedure Reason. Contains 2.16.840.1.113883.3.1937.777.10.15.11 CWE - Coded with exceptions (DYNAMIC) | FT1_ment | |
| @Item | 0 … 1 | F | 1646 | ||
| @Type | 0 … 1 | F | CWE | ||
| @Table | 0 … 1 | F | HL70476 | ||
| @LongName | 0 … 1 | F | Medically Necessary Duplicate Procedure Reason. | ||
| hl7v2:FT1.29 | CNE | 0 … 1 | NDC Code Contains 2.16.840.1.113883.3.1937.777.10.15.6 CNE - Coded with no exceptions (DYNAMIC) | FT1_ment | |
| @Item | 0 … 1 | F | 1845 | ||
| @Type | 0 … 1 | F | CNE | ||
| @Table | 0 … 1 | F | HL70549 | ||
| @LongName | 0 … 1 | F | NDC Code | ||
| hl7v2:FT1.30 | CX | 0 … 1 | Payment Reference ID Contains 2.16.840.1.113883.3.1937.777.10.15.12 CX - Extended composite ID with check digit (DYNAMIC) | FT1_ment | |
| @Item | 0 … 1 | F | 1846 | ||
| @Type | 0 … 1 | F | CX | ||
| @LongName | 0 … 1 | F | Payment Reference ID | ||
| hl7v2:FT1.31 | SI | 0 … * | Transaction Reference Key Contains 2.16.840.1.113883.3.1937.777.10.15.88 SI - Sequence ID (DYNAMIC) | FT1_ment | |
| @Item | 0 … 1 | F | 1847 | ||
| @Type | 0 … 1 | F | SI | ||
| @LongName | 0 … 1 | F | Transaction Reference Key | ||