Draft| Used by 0 transactions and 4 templates, Uses 4 templates | ||||||||||||||||||||||||||||||||||||||||
|
| Item | DT | Card | Conf | Description | Label |
|---|---|---|---|---|---|
| hl7v2:AUT.1 | CE | 0 … 1 | Authorizing Payor, Plan ID Contains 2.16.840.1.113883.3.1937.99.60.4.15.5 (DYNAMIC) | AUT_ ment | |
| @Item | 0 … 1 | F | 1146 | ||
| @Type | 0 … 1 | F | CE | ||
| @Table | 0 … 1 | F | HL70072 | ||
| @LongName | 0 … 1 | F | Authorizing Payor, Plan ID | ||
| hl7v2:AUT.2 | CE | 1 … 1 | Authorizing Payor, Company ID Contains 2.16.840.1.113883.3.1937.99.60.4.15.5 (DYNAMIC) | AUT_ment | |
| @Item | 0 … 1 | F | 1147 | ||
| @Type | 0 … 1 | F | CE | ||
| @Table | 0 … 1 | F | HL70285 | ||
| @LongName | 0 … 1 | F | Authorizing Payor, Company ID | ||
| hl7v2:AUT.3 | ST | 0 … 1 | Authorizing Payor, Company Name | AUT_ment | |
| @Item | 0 … 1 | F | 1148 | ||
| @Type | 0 … 1 | F | ST | ||
| @LongName | 0 … 1 | F | Authorizing Payor, Company Name | ||
| hl7v2:AUT.4 | TS | 0 … 1 | Authorization Effective Date Contains 2.16.840.1.113883.3.1937.99.60.4.15.64 (DYNAMIC) | AUT_ment | |
| @Item | 0 … 1 | F | 1149 | ||
| @Type | 0 … 1 | F | TS | ||
| @LongName | 0 … 1 | F | Authorization Effective Date | ||
| hl7v2:AUT.5 | TS | 0 … 1 | Authorization Expiration Date Contains 2.16.840.1.113883.3.1937.99.60.4.15.64 (DYNAMIC) | AUT_ment | |
| @Item | 0 … 1 | F | 1150 | ||
| @Type | 0 … 1 | F | TS | ||
| @LongName | 0 … 1 | F | Authorization Expiration Date | ||
| hl7v2:AUT.6 | EI | 0 … 1 | Authorization Identifier Contains 2.16.840.1.113883.3.1937.99.60.4.15.21 (DYNAMIC) | AUT_ment | |
| @Item | 0 … 1 | F | 1151 | ||
| @Type | 0 … 1 | F | EI | ||
| @LongName | 0 … 1 | F | Authorization Identifier | ||
| hl7v2:AUT.7 | CP | 0 … 1 | Reimbursement Limit Contains 2.16.840.1.113883.3.1937.99.60.4.15.8 (DYNAMIC) | AUT_ment | |
| @Item | 0 … 1 | F | 1152 | ||
| @Type | 0 … 1 | F | CP | ||
| @LongName | 0 … 1 | F | Reimbursement Limit | ||
| hl7v2:AUT.8 | NM | 0 … 1 | Requested Number of Treatments | AUT_ment | |
| @Item | 0 … 1 | F | 1153 | ||
| @Type | 0 … 1 | F | NM | ||
| @LongName | 0 … 1 | F | Requested Number of Treatments | ||
| hl7v2:AUT.9 | NM | 0 … 1 | Authorized Number of Treatments | AUT_ment | |
| @Item | 0 … 1 | F | 1154 | ||
| @Type | 0 … 1 | F | NM | ||
| @LongName | 0 … 1 | F | Authorized Number of Treatments | ||
| hl7v2:AUT.10 | TS | 0 … 1 | Process Date Contains 2.16.840.1.113883.3.1937.99.60.4.15.64 (DYNAMIC) | AUT_ment | |
| @Item | 0 … 1 | F | 1145 | ||
| @Type | 0 … 1 | F | TS | ||
| @LongName | 0 … 1 | F | Process Date | ||