|   |
  |
  |
  |
  |
  |
  |
  |
  |
  |
  |
|   |
_Ref_ |
Id |
_________Element Name__________ |
Req |
Type |
Min/Max |
  |
  |
|   |
HI01 |
C022 |
Health Care Code Information |
M |
Comp |
  |
  |
  |
|   |
  |
  |
Description: To send health care codes and their associated dates, amounts and quantities |
|   |
  |
1270 |
Code List Qualifier Code |
M |
ID |
1/3 |
  |
  |
|   |
  |
  |
Description: Code identifying a specific industry code list |
|   |
  |
  |
  |
Code |
Name_______________________________ |
|   |
  |
  |
|
BO |
Health Care Financing Administration Common Procedural Coding System |
|   |
  |
  |
|
BQ |
International Classification of Diseases Clinical Modification (ICD-9-CM) Procedure |
|   |
  |
  |
|
JP |
National Standard Tooth Numbering System |
|   |
  |
  |
|
ZZ |
Mutually Defined |
|   |
  |
  |
|
NDC |
National Drug Code (NDC) |
|   |
  |
1271 |
Industry Code |
M |
AN |
1/30 |
  |
  |
|   |
  |
  |
Description: Code indicating a code from a specific industry code list |
|   |
  |
1250 |
Date Time Period Format Qualifier |
C |
ID |
2/3 |
  |
  |
|   |
  |
  |
Description: Code indicating the date format, time format, or date and time format |
|   |
  |
  |
  |
Code |
Name_______________________________ |
|   |
  |
  |
|
D8 |
Date Expressed in Format CCYYMMDD |
|   |
  |
  |
|
RD8 |
Range of Dates Expressed in Format CCYYMMDD-CCYYMMDD |
|   |
  |
  |
  |
  |
Description: A range of dates expressed in the format CCYYMMDD-CCYYMMDD where CCYY is the numerical expression of the century CC and year YY, MM is the numerical expression of the month within the year, and DD is the numerical expression of the day within the year; the first occurrence of CCYYMMDD is the beginning date and the second occurrence is the ending date |
|   |
  |
1251 |
Date Time Period |
C |
AN |
1/35 |
  |
  |
|   |
  |
  |
Description: Expression of a date, a time, or range of dates, times or dates and times |
|   |
  |
380 |
Quantity |
O |
R |
1/15 |
  |
  |
|   |
  |
  |
Description: Numeric value of quantity |
|   |
  |
799 |
Version Identifier |
O |
AN |
1/30 |
  |
  |
|   |
  |
  |
Description: Revision level of a particular format, program, technique or algorithm |
|   |
HI02 |
C022 |
Health Care Code Information |
O |
Comp |
  |
  |
  |
|   |
  |
  |
Description: To send health care codes and their associated dates, amounts and quantities |
|   |
  |
1270 |
Code List Qualifier Code |
M |
ID |
1/3 |
  |
  |
|   |
  |
  |
Description: Code identifying a specific industry code list |
|   |
  |
  |
  |
Code |
Name_______________________________ |
|   |
  |
  |
|
BO |
Health Care Financing Administration Common Procedural Coding System |
|   |
  |
  |
|
BQ |
International Classification of Diseases Clinical Modification (ICD-9-CM) Procedure |
|   |
  |
  |
|
JP |
National Standard Tooth Numbering System |
|   |
  |
  |
|
ZZ |
Mutually Defined |
|   |
  |
  |
|
NDC |
National Drug Code (NDC) |
|   |
  |
1271 |
Industry Code |
M |
AN |
1/30 |
  |
  |
|   |
  |
  |
Description: Code indicating a code from a specific industry code list |
|   |
  |
1250 |
Date Time Period Format Qualifier |
C |
ID |
2/3 |
  |
  |
|   |
  |
  |
Description: Code indicating the date format, time format, or date and time format |
|   |
  |
  |
  |
Code |
Name_______________________________ |
|   |
  |
  |
|
D8 |
Date Expressed in Format CCYYMMDD |
|   |
  |
  |
|
RD8 |
Range of Dates Expressed in Format CCYYMMDD-CCYYMMDD |
|   |
  |
  |
  |
  |
Description: A range of dates expressed in the format CCYYMMDD-CCYYMMDD where CCYY is the numerical expression of the century CC and year YY, MM is the numerical expression of the month within the year, and DD is the numerical expression of the day within the year; the first occurrence of CCYYMMDD is the beginning date and the second occurrence is the ending date |
|   |
  |
1251 |
Date Time Period |
C |
AN |
1/35 |
  |
  |
|   |
  |
  |
Description: Expression of a date, a time, or range of dates, times or dates and times |
|   |
  |
380 |
Quantity |
O |
R |
1/15 |
  |
  |
|   |
  |
  |
Description: Numeric value of quantity |
|   |
  |
799 |
Version Identifier |
O |
AN |
1/30 |
  |
  |
|   |
  |
  |
Description: Revision level of a particular format, program, technique or algorithm |
|   |
HI03 |
C022 |
Health Care Code Information |
O |
Comp |
  |
  |
  |
|   |
  |
  |
Description: To send health care codes and their associated dates, amounts and quantities |
|   |
  |
1270 |
Code List Qualifier Code |
M |
ID |
1/3 |
  |
  |
|   |
  |
  |
Description: Code identifying a specific industry code list |
|   |
  |
  |
  |
Code |
Name_______________________________ |
|   |
  |
  |
|
BO |
Health Care Financing Administration Common Procedural Coding System |
|   |
  |
  |
|
BQ |
International Classification of Diseases Clinical Modification (ICD-9-CM) Procedure |
|   |
  |
  |
|
JP |
National Standard Tooth Numbering System |
|   |
  |
  |
|
ZZ |
Mutually Defined |
|   |
  |
  |
|
NDC |
National Drug Code (NDC) |
|   |
  |
1271 |
Industry Code |
M |
AN |
1/30 |
  |
  |
|   |
  |
  |
Description: Code indicating a code from a specific industry code list |
|   |
  |
1250 |
Date Time Period Format Qualifier |
C |
ID |
2/3 |
  |
  |
|   |
  |
  |
Description: Code indicating the date format, time format, or date and time format |
|   |
  |
  |
  |
Code |
Name_______________________________ |
|   |
  |
  |
|
D8 |
Date Expressed in Format CCYYMMDD |
|   |
  |
  |
|
RD8 |
Range of Dates Expressed in Format CCYYMMDD-CCYYMMDD |
|   |
  |
  |
  |
  |
Description: A range of dates expressed in the format CCYYMMDD-CCYYMMDD where CCYY is the numerical expression of the century CC and year YY, MM is the numerical expression of the month within the year, and DD is the numerical expression of the day within the year; the first occurrence of CCYYMMDD is the beginning date and the second occurrence is the ending date |
|   |
  |
1251 |
Date Time Period |
C |
AN |
1/35 |
  |
  |
|   |
  |
  |
Description: Expression of a date, a time, or range of dates, times or dates and times |
|   |
  |
380 |
Quantity |
O |
R |
1/15 |
  |
  |
|   |
  |
  |
Description: Numeric value of quantity |
|   |
  |
799 |
Version Identifier |
O |
AN |
1/30 |
  |
  |
|   |
  |
  |
Description: Revision level of a particular format, program, technique or algorithm |
|   |
HI04 |
C022 |
Health Care Code Information |
O |
Comp |
  |
  |
  |
|   |
  |
  |
Description: To send health care codes and their associated dates, amounts and quantities |
|   |
  |
1270 |
Code List Qualifier Code |
M |
ID |
1/3 |
  |
  |
|   |
  |
  |
Description: Code identifying a specific industry code list |
|   |
  |
  |
  |
Code |
Name_______________________________ |
|   |
  |
  |
|
BO |
Health Care Financing Administration Common Procedural Coding System |
|   |
  |
  |
|
BQ |
International Classification of Diseases Clinical Modification (ICD-9-CM) Procedure |
|   |
  |
  |
|
JP |
National Standard Tooth Numbering System |
|   |
  |
  |
|
ZZ |
Mutually Defined |
|   |
  |
  |
|
NDC |
National Drug Code (NDC) |
|   |
  |
1271 |
Industry Code |
M |
AN |
1/30 |
  |
  |
|   |
  |
  |
Description: Code indicating a code from a specific industry code list |
|   |
  |
1250 |
Date Time Period Format Qualifier |
C |
ID |
2/3 |
  |
  |
|   |
  |
  |
Description: Code indicating the date format, time format, or date and time format |
|   |
  |
  |
  |
Code |
Name_______________________________ |
|   |
  |
  |
|
D8 |
Date Expressed in Format CCYYMMDD |
|   |
  |
  |
|
RD8 |
Range of Dates Expressed in Format CCYYMMDD-CCYYMMDD |
|   |
  |
  |
  |
  |
Description: A range of dates expressed in the format CCYYMMDD-CCYYMMDD where CCYY is the numerical expression of the century CC and year YY, MM is the numerical expression of the month within the year, and DD is the numerical expression of the day within the year; the first occurrence of CCYYMMDD is the beginning date and the second occurrence is the ending date |
|   |
  |
1251 |
Date Time Period |
C |
AN |
1/35 |
  |
  |
|   |
  |
  |
Description: Expression of a date, a time, or range of dates, times or dates and times |
|   |
  |
380 |
Quantity |
O |
R |
1/15 |
  |
  |
|   |
  |
  |
Description: Numeric value of quantity |
|   |
  |
799 |
Version Identifier |
O |
AN |
1/30 |
  |
  |
|   |
  |
  |
Description: Revision level of a particular format, program, technique or algorithm |
|   |
HI05 |
C022 |
Health Care Code Information |
O |
Comp |
  |
  |
  |
|   |
  |
  |
Description: To send health care codes and their associated dates, amounts and quantities |
|   |
  |
1270 |
Code List Qualifier Code |
M |
ID |
1/3 |
  |
  |
|   |
  |
  |
Description: Code identifying a specific industry code list |
|   |
  |
  |
  |
Code |
Name_______________________________ |
|   |
  |
  |
|
BO |
Health Care Financing Administration Common Procedural Coding System |
|   |
  |
  |
|
BQ |
International Classification of Diseases Clinical Modification (ICD-9-CM) Procedure |
|   |
  |
  |
|
JP |
National Standard Tooth Numbering System |
|   |
  |
  |
|
ZZ |
Mutually Defined |
|   |
  |
  |
|
NDC |
National Drug Code (NDC) |
|   |
  |
1271 |
Industry Code |
M |
AN |
1/30 |
  |
  |
|   |
  |
  |
Description: Code indicating a code from a specific industry code list |
|   |
  |
1250 |
Date Time Period Format Qualifier |
C |
ID |
2/3 |
  |
  |
|   |
  |
  |
Description: Code indicating the date format, time format, or date and time format |
|   |
  |
  |
  |
Code |
Name_______________________________ |
|   |
  |
  |
|
D8 |
Date Expressed in Format CCYYMMDD |
|   |
  |
  |
|
RD8 |
Range of Dates Expressed in Format CCYYMMDD-CCYYMMDD |
|   |
  |
  |
  |
  |
Description: A range of dates expressed in the format CCYYMMDD-CCYYMMDD where CCYY is the numerical expression of the century CC and year YY, MM is the numerical expression of the month within the year, and DD is the numerical expression of the day within the year; the first occurrence of CCYYMMDD is the beginning date and the second occurrence is the ending date |
|   |
  |
1251 |
Date Time Period |
C |
AN |
1/35 |
  |
  |
|   |
  |
  |
Description: Expression of a date, a time, or range of dates, times or dates and times |
|   |
  |
380 |
Quantity |
O |
R |
1/15 |
  |
  |
|   |
  |
  |
Description: Numeric value of quantity |
|   |
  |
799 |
Version Identifier |
O |
AN |
1/30 |
  |
  |
|   |
  |
  |
Description: Revision level of a particular format, program, technique or algorithm |
|   |
HI06 |
C022 |
Health Care Code Information |
O |
Comp |
  |
  |
  |
|   |
  |
  |
Description: To send health care codes and their associated dates, amounts and quantities |
|   |
  |
1270 |
Code List Qualifier Code |
M |
ID |
1/3 |
  |
  |
|   |
  |
  |
Description: Code identifying a specific industry code list |
|   |
  |
  |
  |
Code |
Name_______________________________ |
|   |
  |
  |
|
BO |
Health Care Financing Administration Common Procedural Coding System |
|   |
  |
  |
|
BQ |
International Classification of Diseases Clinical Modification (ICD-9-CM) Procedure |
|   |
  |
  |
|
JP |
National Standard Tooth Numbering System |
|   |
  |
  |
|
ZZ |
Mutually Defined |
|   |
  |
  |
|
NDC |
National Drug Code (NDC) |
|   |
  |
1271 |
Industry Code |
M |
AN |
1/30 |
  |
  |
|   |
  |
  |
Description: Code indicating a code from a specific industry code list |
|   |
  |
1250 |
Date Time Period Format Qualifier |
C |
ID |
2/3 |
  |
  |
|   |
  |
  |
Description: Code indicating the date format, time format, or date and time format |
|   |
  |
  |
  |
Code |
Name_______________________________ |
|   |
  |
  |
|
D8 |
Date Expressed in Format CCYYMMDD |
|   |
  |
  |
|
RD8 |
Range of Dates Expressed in Format CCYYMMDD-CCYYMMDD |
|   |
  |
  |
  |
  |
Description: A range of dates expressed in the format CCYYMMDD-CCYYMMDD where CCYY is the numerical expression of the century CC and year YY, MM is the numerical expression of the month within the year, and DD is the numerical expression of the day within the year; the first occurrence of CCYYMMDD is the beginning date and the second occurrence is the ending date |
|   |
  |
1251 |
Date Time Period |
C |
AN |
1/35 |
  |
  |
|   |
  |
  |
Description: Expression of a date, a time, or range of dates, times or dates and times |
|   |
  |
380 |
Quantity |
O |
R |
1/15 |
  |
  |
|   |
  |
  |
Description: Numeric value of quantity |
|   |
  |
799 |
Version Identifier |
O |
AN |
1/30 |
  |
  |
|   |
  |
  |
Description: Revision level of a particular format, program, technique or algorithm |
|   |
HI07 |
C022 |
Health Care Code Information |
O |
Comp |
  |
  |
  |
|   |
  |
  |
Description: To send health care codes and their associated dates, amounts and quantities |
|   |
  |
1270 |
Code List Qualifier Code |
M |
ID |
1/3 |
  |
  |
|   |
  |
  |
Description: Code identifying a specific industry code list |
|   |
  |
  |
  |
Code |
Name_______________________________ |
|   |
  |
  |
|
BO |
Health Care Financing Administration Common Procedural Coding System |
|   |
  |
  |
|
BQ |
International Classification of Diseases Clinical Modification (ICD-9-CM) Procedure |
|   |
  |
  |
|
JP |
National Standard Tooth Numbering System |
|   |
  |
  |
|
ZZ |
Mutually Defined |
|   |
  |
  |
|
NDC |
National Drug Code (NDC) |
|   |
  |
1271 |
Industry Code |
M |
AN |
1/30 |
  |
  |
|   |
  |
  |
Description: Code indicating a code from a specific industry code list |
|   |
  |
1250 |
Date Time Period Format Qualifier |
C |
ID |
2/3 |
  |
  |
|   |
  |
  |
Description: Code indicating the date format, time format, or date and time format |
|   |
  |
  |
  |
Code |
Name_______________________________ |
|   |
  |
  |
|
D8 |
Date Expressed in Format CCYYMMDD |
|   |
  |
  |
|
RD8 |
Range of Dates Expressed in Format CCYYMMDD-CCYYMMDD |
|   |
  |
  |
  |
  |
Description: A range of dates expressed in the format CCYYMMDD-CCYYMMDD where CCYY is the numerical expression of the century CC and year YY, MM is the numerical expression of the month within the year, and DD is the numerical expression of the day within the year; the first occurrence of CCYYMMDD is the beginning date and the second occurrence is the ending date |
|   |
  |
1251 |
Date Time Period |
C |
AN |
1/35 |
  |
  |
|   |
  |
  |
Description: Expression of a date, a time, or range of dates, times or dates and times |
|   |
  |
380 |
Quantity |
O |
R |
1/15 |
  |
  |
|   |
  |
  |
Description: Numeric value of quantity |
|   |
  |
799 |
Version Identifier |
O |
AN |
1/30 |
  |
  |
|   |
  |
  |
Description: Revision level of a particular format, program, technique or algorithm |
|   |
HI08 |
C022 |
Health Care Code Information |
O |
Comp |
  |
  |
  |
|   |
  |
  |
Description: To send health care codes and their associated dates, amounts and quantities |
|   |
  |
1270 |
Code List Qualifier Code |
M |
ID |
1/3 |
  |
  |
|   |
  |
  |
Description: Code identifying a specific industry code list |
|   |
  |
  |
  |
Code |
Name_______________________________ |
|   |
  |
  |
|
BO |
Health Care Financing Administration Common Procedural Coding System |
|   |
  |
  |
|
BQ |
International Classification of Diseases Clinical Modification (ICD-9-CM) Procedure |
|   |
  |
  |
|
JP |
National Standard Tooth Numbering System |
|   |
  |
  |
|
ZZ |
Mutually Defined |
|   |
  |
  |
|
NDC |
National Drug Code (NDC) |
|   |
  |
1271 |
Industry Code |
M |
AN |
1/30 |
  |
  |
|   |
  |
  |
Description: Code indicating a code from a specific industry code list |
|   |
  |
1250 |
Date Time Period Format Qualifier |
C |
ID |
2/3 |
  |
  |
|   |
  |
  |
Description: Code indicating the date format, time format, or date and time format |
|   |
  |
  |
  |
Code |
Name_______________________________ |
|   |
  |
  |
|
D8 |
Date Expressed in Format CCYYMMDD |
|   |
  |
  |
|
RD8 |
Range of Dates Expressed in Format CCYYMMDD-CCYYMMDD |
|   |
  |
  |
  |
  |
Description: A range of dates expressed in the format CCYYMMDD-CCYYMMDD where CCYY is the numerical expression of the century CC and year YY, MM is the numerical expression of the month within the year, and DD is the numerical expression of the day within the year; the first occurrence of CCYYMMDD is the beginning date and the second occurrence is the ending date |
|   |
  |
1251 |
Date Time Period |
C |
AN |
1/35 |
  |
  |
|   |
  |
  |
Description: Expression of a date, a time, or range of dates, times or dates and times |
|   |
  |
380 |
Quantity |
O |
R |
1/15 |
  |
  |
|   |
  |
  |
Description: Numeric value of quantity |
|   |
  |
799 |
Version Identifier |
O |
AN |
1/30 |
  |
  |
|   |
  |
  |
Description: Revision level of a particular format, program, technique or algorithm |
|   |
HI09 |
C022 |
Health Care Code Information |
O |
Comp |
  |
  |
  |
|   |
  |
  |
Description: To send health care codes and their associated dates, amounts and quantities |
|   |
  |
1270 |
Code List Qualifier Code |
M |
ID |
1/3 |
  |
  |
|   |
  |
  |
Description: Code identifying a specific industry code list |
|   |
  |
  |
  |
Code |
Name_______________________________ |
|   |
  |
  |
|
BO |
Health Care Financing Administration Common Procedural Coding System |
|   |
  |
  |
|
BQ |
International Classification of Diseases Clinical Modification (ICD-9-CM) Procedure |
|   |
  |
  |
|
JP |
National Standard Tooth Numbering System |
|   |
  |
  |
|
ZZ |
Mutually Defined |
|   |
  |
  |
|
NDC |
National Drug Code (NDC) |
|   |
  |
1271 |
Industry Code |
M |
AN |
1/30 |
  |
  |
|   |
  |
  |
Description: Code indicating a code from a specific industry code list |
|   |
  |
1250 |
Date Time Period Format Qualifier |
C |
ID |
2/3 |
  |
  |
|   |
  |
  |
Description: Code indicating the date format, time format, or date and time format |
|   |
  |
  |
  |
Code |
Name_______________________________ |
|   |
  |
  |
|
D8 |
Date Expressed in Format CCYYMMDD |
|   |
  |
  |
|
RD8 |
Range of Dates Expressed in Format CCYYMMDD-CCYYMMDD |
|   |
  |
  |
  |
  |
Description: A range of dates expressed in the format CCYYMMDD-CCYYMMDD where CCYY is the numerical expression of the century CC and year YY, MM is the numerical expression of the month within the year, and DD is the numerical expression of the day within the year; the first occurrence of CCYYMMDD is the beginning date and the second occurrence is the ending date |
|   |
  |
1251 |
Date Time Period |
C |
AN |
1/35 |
  |
  |
|   |
  |
  |
Description: Expression of a date, a time, or range of dates, times or dates and times |
|   |
  |
380 |
Quantity |
O |
R |
1/15 |
  |
  |
|   |
  |
  |
Description: Numeric value of quantity |
|   |
  |
799 |
Version Identifier |
O |
AN |
1/30 |
  |
  |
|   |
  |
  |
Description: Revision level of a particular format, program, technique or algorithm |
|   |
HI10 |
C022 |
Health Care Code Information |
O |
Comp |
  |
  |
  |
|   |
  |
  |
Description: To send health care codes and their associated dates, amounts and quantities |
|   |
  |
1270 |
Code List Qualifier Code |
M |
ID |
1/3 |
  |
  |
|   |
  |
  |
Description: Code identifying a specific industry code list |
|   |
  |
  |
  |
Code |
Name_______________________________ |
|   |
  |
  |
|
BO |
Health Care Financing Administration Common Procedural Coding System |
|   |
  |
  |
|
BQ |
International Classification of Diseases Clinical Modification (ICD-9-CM) Procedure |
|   |
  |
  |
|
JP |
National Standard Tooth Numbering System |
|   |
  |
  |
|
ZZ |
Mutually Defined |
|   |
  |
  |
|
NDC |
National Drug Code (NDC) |
|   |
  |
1271 |
Industry Code |
M |
AN |
1/30 |
  |
  |
|   |
  |
  |
Description: Code indicating a code from a specific industry code list |
|   |
  |
1250 |
Date Time Period Format Qualifier |
C |
ID |
2/3 |
  |
  |
|   |
  |
  |
Description: Code indicating the date format, time format, or date and time format |
|   |
  |
  |
  |
Code |
Name_______________________________ |
|   |
  |
  |
|
D8 |
Date Expressed in Format CCYYMMDD |
|   |
  |
  |
|
RD8 |
Range of Dates Expressed in Format CCYYMMDD-CCYYMMDD |
|   |
  |
  |
  |
  |
Description: A range of dates expressed in the format CCYYMMDD-CCYYMMDD where CCYY is the numerical expression of the century CC and year YY, MM is the numerical expression of the month within the year, and DD is the numerical expression of the day within the year; the first occurrence of CCYYMMDD is the beginning date and the second occurrence is the ending date |
|   |
  |
1251 |
Date Time Period |
C |
AN |
1/35 |
  |
  |
|   |
  |
  |
Description: Expression of a date, a time, or range of dates, times or dates and times |
|   |
  |
380 |
Quantity |
O |
R |
1/15 |
  |
  |
|   |
  |
  |
Description: Numeric value of quantity |
|   |
  |
799 |
Version Identifier |
O |
AN |
1/30 |
  |
  |
|   |
  |
  |
Description: Revision level of a particular format, program, technique or algorithm |
|   |
HI11 |
C022 |
Health Care Code Information |
O |
Comp |
  |
  |
  |
|   |
  |
  |
Description: To send health care codes and their associated dates, amounts and quantities |
|   |
  |
1270 |
Code List Qualifier Code |
M |
ID |
1/3 |
  |
  |
|   |
  |
  |
Description: Code identifying a specific industry code list |
|   |
  |
  |
  |
Code |
Name_______________________________ |
|   |
  |
  |
|
BO |
Health Care Financing Administration Common Procedural Coding System |
|   |
  |
  |
|
BQ |
International Classification of Diseases Clinical Modification (ICD-9-CM) Procedure |
|   |
  |
  |
|
JP |
National Standard Tooth Numbering System |
|   |
  |
  |
|
ZZ |
Mutually Defined |
|   |
  |
  |
|
NDC |
National Drug Code (NDC) |
|   |
  |
1271 |
Industry Code |
M |
AN |
1/30 |
  |
  |
|   |
  |
  |
Description: Code indicating a code from a specific industry code list |
|   |
  |
1250 |
Date Time Period Format Qualifier |
C |
ID |
2/3 |
  |
  |
|   |
  |
  |
Description: Code indicating the date format, time format, or date and time format |
|   |
  |
  |
  |
Code |
Name_______________________________ |
|   |
  |
  |
|
D8 |
Date Expressed in Format CCYYMMDD |
|   |
  |
  |
|
RD8 |
Range of Dates Expressed in Format CCYYMMDD-CCYYMMDD |
|   |
  |
  |
  |
  |
Description: A range of dates expressed in the format CCYYMMDD-CCYYMMDD where CCYY is the numerical expression of the century CC and year YY, MM is the numerical expression of the month within the year, and DD is the numerical expression of the day within the year; the first occurrence of CCYYMMDD is the beginning date and the second occurrence is the ending date |
|   |
  |
1251 |
Date Time Period |
C |
AN |
1/35 |
  |
  |
|   |
  |
  |
Description: Expression of a date, a time, or range of dates, times or dates and times |
|   |
  |
380 |
Quantity |
O |
R |
1/15 |
  |
  |
|   |
  |
  |
Description: Numeric value of quantity |
|   |
  |
799 |
Version Identifier |
O |
AN |
1/30 |
  |
  |
|   |
  |
  |
Description: Revision level of a particular format, program, technique or algorithm |
|   |
HI12 |
C022 |
Health Care Code Information |
O |
Comp |
  |
  |
  |
|   |
  |
  |
Description: To send health care codes and their associated dates, amounts and quantities |
|   |
  |
1270 |
Code List Qualifier Code |
M |
ID |
1/3 |
  |
  |
|   |
  |
  |
Description: Code identifying a specific industry code list |
|   |
  |
  |
  |
Code |
Name_______________________________ |
|   |
  |
  |
|
BO |
Health Care Financing Administration Common Procedural Coding System |
|   |
  |
  |
|
BQ |
International Classification of Diseases Clinical Modification (ICD-9-CM) Procedure |
|   |
  |
  |
|
JP |
National Standard Tooth Numbering System |
|   |
  |
  |
|
ZZ |
Mutually Defined |
|   |
  |
  |
|
NDC |
National Drug Code (NDC) |
|   |
  |
1271 |
Industry Code |
M |
AN |
1/30 |
  |
  |
|   |
  |
  |
Description: Code indicating a code from a specific industry code list |
|   |
  |
1250 |
Date Time Period Format Qualifier |
C |
ID |
2/3 |
  |
  |
|   |
  |
  |
Description: Code indicating the date format, time format, or date and time format |
|   |
  |
  |
  |
Code |
Name_______________________________ |
|   |
  |
  |
|
D8 |
Date Expressed in Format CCYYMMDD |
|   |
  |
  |
|
RD8 |
Range of Dates Expressed in Format CCYYMMDD-CCYYMMDD |
|   |
  |
  |
  |
  |
Description: A range of dates expressed in the format CCYYMMDD-CCYYMMDD where CCYY is the numerical expression of the century CC and year YY, MM is the numerical expression of the month within the year, and DD is the numerical expression of the day within the year; the first occurrence of CCYYMMDD is the beginning date and the second occurrence is the ending date |
|   |
  |
1251 |
Date Time Period |
C |
AN |
1/35 |
  |
  |
|   |
  |
  |
Description: Expression of a date, a time, or range of dates, times or dates and times |
|   |
  |
380 |
Quantity |
O |
R |
1/15 |
  |
  |
|   |
  |
  |
Description: Numeric value of quantity |
|   |
  |
799 |
Version Identifier |
O |
AN |
1/30 |
  |
  |
|   |
  |
  |
Description: Revision level of a particular format, program, technique or algorithm |