UNH M 1 MESSAGE HEADER

  • Mandatory
  • Max repeat: 1
A service segment starting and uniquely identifying a message. The message type code for the Medical resource usage and cost message is MEDRUC.
0062
MESSAGE REFERENCE NUMBER
  • Mandatory
  • Type: an
  • Length: 0..14
Unique message reference assigned by the sender.
S009
MESSAGE IDENTIFIER
  • Mandatory
Identification of the type, version, etc. of the message being interchanged.
0065
Message type
  • Mandatory
  • Type: an
  • Length: 0..6
Code identifying a type of message and assigned by its controlling agency.
0052
Message version number
  • Mandatory
  • Type: an
  • Length: 0..3
Version number of a message type.
0054
Message release number
  • Mandatory
  • Type: an
  • Length: 0..3
Release number within the current message version number.
0051
Controlling agency, coded
  • Mandatory
  • Type: an
  • Length: 0..3
Code identifying a controlling agency.
0057
Association assigned code
  • Conditional
  • Type: an
  • Length: 0..6
Code, assigned by the association responsible for the design and maintenance of the message type concerned, which further identifies the message.
0110
Code list directory version number
  • Conditional
  • Type: an
  • Length: 0..6
Version number of the code list directory.
0113
Message type sub-function identification
  • Conditional
  • Type: an
  • Length: 0..6
Code identifying a sub-function of a message type.
0068
COMMON ACCESS REFERENCE
  • Conditional
  • Type: an
  • Length: 0..35
Reference serving as a key to relate all subsequent transfers of data to the same business case or file.
S010
STATUS OF THE TRANSFER
  • Conditional
Statement that the message is one in a sequence of transfers relating to the same topic.
0070
Sequence of transfers
  • Mandatory
  • Type: n
  • Length: 0..2
Number assigned by the sender indicating the transfer sequence of a message related to the same topic. The message could be an addition or a change to an earlier transfer related to the same topic.
0073
First and last transfer
  • Conditional
  • Type: a
  • Length: 1
Indication used for the first and last message in a sequence of messages related to the same topic.
S016
MESSAGE SUBSET IDENTIFICATION
  • Conditional
Identification of a message subset by its identifier, version, release and source.
0115
Message subset identification
  • Mandatory
  • Type: an
  • Length: 0..14
Coded identification of a message subset, assigned by its controlling agency.
0116
Message subset version number
  • Conditional
  • Type: an
  • Length: 0..3
Version number of the message subset.
0118
Message subset release number
  • Conditional
  • Type: an
  • Length: 0..3
Release number within the message subset version number.
0051
Controlling agency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Code identifying a controlling agency.
S017
MESSAGE IMPLEMENTATION GUIDELINE IDENTIFICATION
  • Conditional
Identification of a message implementation guideline by its identifier, version, release and source.
0121
Message implementation guideline identification
  • Mandatory
  • Type: an
  • Length: 0..14
Coded identification of the message implementation guideline, assigned by its controlling agency.
0122
Message implementation guideline version number
  • Conditional
  • Type: an
  • Length: 0..3
Version number of the message implementation guideline.
0124
Message implementation guideline release number
  • Conditional
  • Type: an
  • Length: 0..3
Release number within the message implementation guideline version number.
0051
Controlling agency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Code identifying a controlling agency.
S018
SCENARIO IDENTIFICATION
  • Conditional
Identification of a scenario.
0127
Scenario identification
  • Mandatory
  • Type: an
  • Length: 0..14
Code identifying scenario.
0128
Scenario version number
  • Conditional
  • Type: an
  • Length: 0..3
Version number of a scenario.
0130
Scenario release number
  • Conditional
  • Type: an
  • Length: 0..3
Release number within the scenario version number.
0051
Controlling agency, coded
  • Conditional
  • Type: an
  • Length: 0..3
Code identifying a controlling agency.

BGM M 1 BEGINNING OF MESSAGE

  • Mandatory
  • Max repeat: 1
A segment for unique identification of the message and specification of its function.
C002
DOCUMENT/MESSAGE NAME
  • Conditional
Identification of a type of document/message by code or name. Code preferred.
1001
Document name code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the document name.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
1000
Document name
  • Conditional
  • Type: an
  • Length: 0..35
Name of a document.
C106
DOCUMENT/MESSAGE IDENTIFICATION
  • Conditional
Identification of a document/message by its number and eventually its version or revision.
1004
Document identifier
  • Conditional
  • Type: an
  • Length: 0..35
To identify a document.
1056
Version identifier
  • Conditional
  • Type: an
  • Length: 0..9
To identify a version.
1060
Revision identifier
  • Conditional
  • Type: an
  • Length: 0..6
To identify a revision.
1225
MESSAGE FUNCTION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code indicating the function of the message.
4343
RESPONSE TYPE CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the type of acknowledgment required or transmitted.

DTM C 9 DATE/TIME/PERIOD

  • Conditional
  • Max repeat: 9
A segment identifying the date/time of message generation and/or other date/times concerning the whole message.
C507
DATE/TIME/PERIOD
  • Mandatory
Date and/or time, or period relevant to the specified date/time/period type.
2005
Date or time or period function code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the function of a date, time or period.
2380
Date or time or period text
  • Conditional
  • Type: an
  • Length: 0..35
The value of a date, a date and time, a time or of a period in a specified representation.
2379
Date or time or period format code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the representation of a date, time or period.

RFF C 9 REFERENCE

  • Conditional
  • Max repeat: 9
A segment specifying references to other related message(s) or batch(es), e.g. a previous message.
C506
REFERENCE
  • Mandatory
Identification of a reference.
1153
Reference code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying a reference.
1154
Reference identifier
  • Conditional
  • Type: an
  • Length: 0..70
Identifies a reference.
1156
Document line identifier
  • Conditional
  • Type: an
  • Length: 0..6
To identify a line of a document.
4000
Reference version identifier
  • Conditional
  • Type: an
  • Length: 0..35
To identify the version of a reference.
1060
Revision identifier
  • Conditional
  • Type: an
  • Length: 0..6
To identify a revision.

FTX C 9 FREE TEXT

  • Conditional
  • Max repeat: 9
A segment giving free text information, in coded or clear form, for specifying information about the whole message.
4451
TEXT SUBJECT CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the subject of the text.
4453
FREE TEXT FUNCTION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the function of free text.
C107
TEXT REFERENCE
  • Conditional
Coded reference to a standard text and its source.
4441
Free text description code
  • Mandatory
  • Type: an
  • Length: 0..17
Code specifying free form text.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
C108
TEXT LITERAL
  • Conditional
Free text; one to five lines.
4440
Free text
  • Mandatory
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
3453
LANGUAGE NAME CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the language name.
4447
FREE TEXT FORMAT CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the format of free text.

CUX C 1 CURRENCIES

  • Conditional
  • Max repeat: 1
A segment specifying the currency in which all the monetary amounts are expressed in the message.
C504
CURRENCY DETAILS
  • Conditional
The usage to which a currency relates.
6347
Currency usage code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the usage of a currency.
6345
Currency identification code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a monetary unit.
6343
Currency type code qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Code qualifying the type of currency.
6348
Currency rate
  • Conditional
  • Type: n
  • Length: 0..4
To specify the value of the multiplication factor used in expressing currency units.
C504
CURRENCY DETAILS
  • Conditional
The usage to which a currency relates.
6347
Currency usage code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the usage of a currency.
6345
Currency identification code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a monetary unit.
6343
Currency type code qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Code qualifying the type of currency.
6348
Currency rate
  • Conditional
  • Type: n
  • Length: 0..4
To specify the value of the multiplication factor used in expressing currency units.
5402
CURRENCY EXCHANGE RATE
  • Conditional
  • Type: n
  • Length: 0..12
To specify the rate at which one specified currency is expressed in another specified currency.
6341
EXCHANGE RATE CURRENCY MARKET IDENTIFIER
  • Conditional
  • Type: an
  • Length: 0..3
To identify an exchange rate currency market.

CNT C 9 CONTROL TOTAL

  • Conditional
  • Max repeat: 9
A segment specifying aggregate information concerning the whole message, e.g. number of claims, number of parties, number of patients, etc.
C270
CONTROL
  • Mandatory
Control total for checking integrity of a message or part of a message.
6069
Control total type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of control of hash total.
6066
Control total quantity
  • Mandatory
  • Type: n
  • Length: 0..18
To specify the value of a control quantity.
6411
Measurement unit code
  • Conditional
  • Type: an
  • Length: 0..8
Code specifying the unit of measurement.

GRP1 C 9 MOA TAX

  • Conditional
  • Max repeat: 9
A group of segments giving total amounts for the whole reimbursement message, and the relevant tax information if any.

MOA M 1 MONETARY AMOUNT

  • Mandatory
  • Max repeat: 1
A segment specifying total amounts for the whole reimbursement message.
C516
MONETARY AMOUNT
  • Mandatory
Amount of goods or services stated as a monetary amount in a specified currency.
5025
Monetary amount type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of monetary amount.
5004
Monetary amount
  • Conditional
  • Type: n
  • Length: 0..35
To specify a monetary amount.
6345
Currency identification code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a monetary unit.
6343
Currency type code qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Code qualifying the type of currency.
4405
Status description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a status.

TAX C 1 DUTY/TAX/FEE DETAILS

  • Conditional
  • Max repeat: 1
A segment specifying the tax type if relevant.
5283
DUTY OR TAX OR FEE FUNCTION CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the function of a duty or tax or fee.
C241
DUTY/TAX/FEE TYPE
  • Conditional
Code and/or name identifying duty, tax or fee.
5153
Duty or tax or fee type name code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a type of duty, tax or fee.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
5152
Duty or tax or fee type name
  • Conditional
  • Type: an
  • Length: 0..35
Name of a type of duty, tax or fee.
C533
DUTY/TAX/FEE ACCOUNT DETAIL
  • Conditional
Indication of account reference for duties, taxes and/or fees.
5289
Duty or tax or fee account code
  • Mandatory
  • Type: an
  • Length: 0..6
Code specifying a duty or tax or fee account.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
5286
DUTY OR TAX OR FEE ASSESSMENT BASIS QUANTITY
  • Conditional
  • Type: an
  • Length: 0..15
To specify the basis on which a duty or tax or fee will be assessed.
C243
DUTY/TAX/FEE DETAIL
  • Conditional
Rate of duty/tax/fee applicable to commodities or of tax applicable to services.
5279
Duty or tax or fee rate code
  • Conditional
  • Type: an
  • Length: 0..7
Code specifying a rate of a duty or tax or fee.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
5278
Duty or tax or fee rate
  • Conditional
  • Type: an
  • Length: 0..17
Rate of a duty or tax or fee.
5273
Duty or tax or fee rate basis code
  • Conditional
  • Type: an
  • Length: 0..12
Code specifying the basis for a duty or tax or fee rate.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
5305
DUTY OR TAX OR FEE CATEGORY CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a duty or tax or fee category.
3446
PARTY TAX IDENTIFIER
  • Conditional
  • Type: an
  • Length: 0..20
To identify a number assigned to a party by a tax authority.
1227
CALCULATION SEQUENCE CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a calculation sequence.

GRP2 C 999 PNA SEQ ADR CTA COM RFF REL NAT LAN SPR EMP QUA DTM STS RCS PDI FII

  • Conditional
  • Max repeat: 999
Parties Segment Group. A group of segments giving information about involved financial, administrative and medical parties such as requester, payee, insurance organisations, insured family and service providers, or their representatives.

PNA M 1 PARTY IDENTIFICATION

  • Mandatory
  • Max repeat: 1
A segment specifying the identity number and name of a party.
3035
PARTY FUNCTION CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code giving specific meaning to a party.
C206
IDENTIFICATION NUMBER
  • Conditional
The identification of an object.
7402
Object identifier
  • Mandatory
  • Type: an
  • Length: 0..35
Code specifying the unique identity of an object.
7405
Object identification code qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Code qualifying the identification of an object.
4405
Status description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a status.
C082
PARTY IDENTIFICATION DETAILS
  • Conditional
Identification of a transaction party by code.
3039
Party identifier
  • Mandatory
  • Type: an
  • Length: 0..35
Code specifying the identity of a party.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
3403
NAME TYPE CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the type of name.
3397
NAME STATUS CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the status of a name.
C816
NAME COMPONENT DETAILS
  • Conditional
To specify a name component.
3405
Name component type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of a name component.
3398
Name component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of a name component.
3401
Name component usage code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the usage of a name component.
3295
Name original alphabet code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the alphabet originally used to represent a name.
C816
NAME COMPONENT DETAILS
  • Conditional
To specify a name component.
3405
Name component type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of a name component.
3398
Name component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of a name component.
3401
Name component usage code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the usage of a name component.
3295
Name original alphabet code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the alphabet originally used to represent a name.
C816
NAME COMPONENT DETAILS
  • Conditional
To specify a name component.
3405
Name component type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of a name component.
3398
Name component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of a name component.
3401
Name component usage code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the usage of a name component.
3295
Name original alphabet code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the alphabet originally used to represent a name.
C816
NAME COMPONENT DETAILS
  • Conditional
To specify a name component.
3405
Name component type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of a name component.
3398
Name component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of a name component.
3401
Name component usage code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the usage of a name component.
3295
Name original alphabet code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the alphabet originally used to represent a name.
C816
NAME COMPONENT DETAILS
  • Conditional
To specify a name component.
3405
Name component type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of a name component.
3398
Name component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of a name component.
3401
Name component usage code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the usage of a name component.
3295
Name original alphabet code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the alphabet originally used to represent a name.
1229
ACTION REQUEST/NOTIFICATION DESCRIPTION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the action to be taken or already taken.

SEQ C 1 SEQUENCE DETAILS

  • Conditional
  • Max repeat: 1
A segment allocating a sequence number to the individual party allowing each party to be referenced from within the message.
1229
ACTION REQUEST/NOTIFICATION DESCRIPTION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the action to be taken or already taken.
C286
SEQUENCE INFORMATION
  • Conditional
Identification of a sequence and source for sequencing.
1050
Sequence position identifier
  • Mandatory
  • Type: an
  • Length: 0..10
To identify a position in a sequence.
1159
Sequence identifier source code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the source of a sequence identifier.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.

ADR C 9 ADDRESS

  • Conditional
  • Max repeat: 9
A segment specifying address(es) of the party.
C817
ADDRESS USAGE
  • Conditional
To describe the usage of an address.
3299
Address purpose code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the purpose of an address.
3131
Address type code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the type of an address.
3475
Address status code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the status of an address.
C090
ADDRESS DETAILS
  • Conditional
To specify the details of an address.
3477
Address format code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying the format of an address.
3286
Address component description
  • Mandatory
  • Type: an
  • Length: 0..70
Free form description of the component of an address.
3286
Address component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of the component of an address.
3286
Address component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of the component of an address.
3286
Address component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of the component of an address.
3286
Address component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of the component of an address.
3164
CITY NAME
  • Conditional
  • Type: an
  • Length: 0..35
Name of a city.
3251
POSTAL IDENTIFICATION CODE
  • Conditional
  • Type: an
  • Length: 0..17
Code specifying the postal zone or address.
3207
COUNTRY NAME CODE
  • Conditional
  • Type: an
  • Length: 0..3
Identification of the name of the country or other geographical entity as defined in ISO 3166-1.
C819
COUNTRY SUB-ENTITY DETAILS
  • Conditional
To specify a part of a country (eg county or part of a city).
3229
Country sub-entity name code
  • Conditional
  • Type: an
  • Length: 0..9
Code specifying the name of a country sub-entity.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
3228
Country sub-entity name
  • Conditional
  • Type: an
  • Length: 0..70
Name of a country sub-entity.
C517
LOCATION IDENTIFICATION
  • Conditional
Identification of a location by code or name.
3225
Location name code
  • Conditional
  • Type: an
  • Length: 0..35
Code specifying the name of the location.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
3224
Location name
  • Conditional
  • Type: an
  • Length: 0..256
Name of the location.

CTA C 9 CONTACT INFORMATION

  • Conditional
  • Max repeat: 9
A segment identifying a person or department to whom contacts should be directed and their function.
3139
CONTACT FUNCTION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the function of a contact (e.g. department or person).
C056
DEPARTMENT OR EMPLOYEE DETAILS
  • Conditional
Code and/or name of a department or employee. Code preferred.
3413
Department or employee name code
  • Conditional
  • Type: an
  • Length: 0..17
Code specifying the name of a department or employee.
3412
Department or employee name
  • Conditional
  • Type: an
  • Length: 0..35
Name of a department or employee.

COM C 9 COMMUNICATION CONTACT

  • Conditional
  • Max repeat: 9
A segment giving communication type and number of the party.
C076
COMMUNICATION CONTACT
  • Mandatory
Communication number of a department or employee in a specified channel.
3148
Communication address identifier
  • Mandatory
  • Type: an
  • Length: 0..512
To identify a communication address.
3155
Communication address code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the communication address.

RFF C 99 REFERENCE

  • Conditional
  • Max repeat: 99
A segment specifying alternative identification numbers of the party. This segment also facilitates reference to another party if the current party is related to another party such as a department in a hospital, a physician in a department, etc.
C506
REFERENCE
  • Mandatory
Identification of a reference.
1153
Reference code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying a reference.
1154
Reference identifier
  • Conditional
  • Type: an
  • Length: 0..70
Identifies a reference.
1156
Document line identifier
  • Conditional
  • Type: an
  • Length: 0..6
To identify a line of a document.
4000
Reference version identifier
  • Conditional
  • Type: an
  • Length: 0..35
To identify the version of a reference.
1060
Revision identifier
  • Conditional
  • Type: an
  • Length: 0..6
To identify a revision.

REL C 9 RELATIONSHIP

  • Conditional
  • Max repeat: 9
A segment specifying the relationship with another party.
9141
RELATIONSHIP TYPE CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying a type of relationship.
C941
RELATIONSHIP
  • Conditional
Identification and/or description of a relationship.
9143
Relationship description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a relationship.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
9142
Relationship description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of a relationship.

NAT C 9 NATIONALITY

  • Conditional
  • Max repeat: 9
A segment specifying the nationalities of the party.
3493
NATIONALITY CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying a nationality.
C042
NATIONALITY DETAILS
  • Conditional
To specify a nationality.
3293
Nationality name code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the name of a nationality.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
3292
Nationality name
  • Conditional
  • Type: a
  • Length: 0..35
Name of a nationality.

LAN C 9 LANGUAGE

  • Conditional
  • Max repeat: 9
A segment specifying the language used by the party.
3455
LANGUAGE CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying a language.
C508
LANGUAGE DETAILS
  • Conditional
To identify a language.
3453
Language name code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the language name.
3452
Language name
  • Conditional
  • Type: an
  • Length: 0..35
Name of language.

SPR C 1 ORGANISATION CLASSIFICATION DETAILS

  • Conditional
  • Max repeat: 1
A segment specifying the type and (medical) speciality of an organisation.
7293
SECTOR AREA IDENTIFICATION CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying identification of a subject area.
3079
ORGANISATION CLASSIFICATION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the classification of an organisation.
C844
ORGANISATION CLASSIFICATION DETAIL
  • Conditional
To specify details regarding the class of an organisation.
3083
Organisational class name code
  • Conditional
  • Type: an
  • Length: 0..17
Code specifying a class of organisation.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
3082
Organisational class name
  • Conditional
  • Type: an
  • Length: 0..70
Name of a class of organisation.

EMP C 9 EMPLOYMENT DETAILS

  • Conditional
  • Max repeat: 9
A segment specifying the type and (medical) speciality of a person as well as his/her position within an organisation.
9003
EMPLOYMENT DETAILS CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the employment details.
C948
EMPLOYMENT CATEGORY
  • Conditional
Code and/or description of an employment category.
9005
Employment category description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the employment category.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
9004
Employment category description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of the employment category.
C951
OCCUPATION
  • Conditional
Description of an occupation.
9009
Occupation description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying an occupation.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
9008
Occupation description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of an occupation.
9008
Occupation description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of an occupation.
C950
QUALIFICATION CLASSIFICATION
  • Conditional
Qualification classification description and/or code. This specifies the trade, skill, professional or similar qualification category.
9007
Qualification classification description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a qualification classification.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
9006
Qualification classification description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of a qualification classification.
9006
Qualification classification description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of a qualification classification.
3494
JOB TITLE DESCRIPTION
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of a job title.
9035
QUALIFICATION APPLICATION AREA CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the application area of a qualification.

QUA C 9 QUALIFICATION

  • Conditional
  • Max repeat: 9
A segment specifying the professional (medical) qualifications of the party.
9037
QUALIFICATION TYPE CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying a type of qualification.
C950
QUALIFICATION CLASSIFICATION
  • Conditional
Qualification classification description and/or code. This specifies the trade, skill, professional or similar qualification category.
9007
Qualification classification description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a qualification classification.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
9006
Qualification classification description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of a qualification classification.
9006
Qualification classification description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of a qualification classification.

DTM C 99 DATE/TIME/PERIOD

  • Conditional
  • Max repeat: 99
A segment specifying validity dates or any other date related to the party.
C507
DATE/TIME/PERIOD
  • Mandatory
Date and/or time, or period relevant to the specified date/time/period type.
2005
Date or time or period function code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the function of a date, time or period.
2380
Date or time or period text
  • Conditional
  • Type: an
  • Length: 0..35
The value of a date, a date and time, a time or of a period in a specified representation.
2379
Date or time or period format code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the representation of a date, time or period.

STS C 1 STATUS

  • Conditional
  • Max repeat: 1
A segment specifying the status of involvement for the party (former, previous, current, next).
C601
STATUS CATEGORY
  • Conditional
To specify the category of the status.
9015
Status category code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying the category of a status.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
C555
STATUS
  • Conditional
To specify a status.
4405
Status description code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying a status.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
4404
Status description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of a status.
C556
STATUS REASON
  • Conditional
To specify the reason for a status.
9013
Status reason description code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying the reason for a status.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
9012
Status reason description
  • Conditional
  • Type: an
  • Length: 0..256
Free form description of the status reason.
C556
STATUS REASON
  • Conditional
To specify the reason for a status.
9013
Status reason description code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying the reason for a status.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
9012
Status reason description
  • Conditional
  • Type: an
  • Length: 0..256
Free form description of the status reason.
C556
STATUS REASON
  • Conditional
To specify the reason for a status.
9013
Status reason description code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying the reason for a status.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
9012
Status reason description
  • Conditional
  • Type: an
  • Length: 0..256
Free form description of the status reason.
C556
STATUS REASON
  • Conditional
To specify the reason for a status.
9013
Status reason description code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying the reason for a status.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
9012
Status reason description
  • Conditional
  • Type: an
  • Length: 0..256
Free form description of the status reason.
C556
STATUS REASON
  • Conditional
To specify the reason for a status.
9013
Status reason description code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying the reason for a status.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
9012
Status reason description
  • Conditional
  • Type: an
  • Length: 0..256
Free form description of the status reason.

RCS C 99 REQUIREMENTS AND CONDITIONS

  • Conditional
  • Max repeat: 99
A segment specifying administrative conditions of a party, such as the type of location from which a healthcare professional operates, (e.g. town, countryside, mountain area), identifier for agreement on reimbursement mode and tariff, or other statutory information.
7293
SECTOR AREA IDENTIFICATION CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying identification of a subject area.
C550
REQUIREMENT/CONDITION IDENTIFICATION
  • Conditional
To identify the specific rule/condition requirement.
7295
Requirement or condition description identifier
  • Mandatory
  • Type: an
  • Length: 0..17
Code specifying a requirement or condition.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
7294
Requirement or condition description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of a requirement or condition.
1229
ACTION REQUEST/NOTIFICATION DESCRIPTION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the action to be taken or already taken.
3207
COUNTRY NAME CODE
  • Conditional
  • Type: an
  • Length: 0..3
Identification of the name of the country or other geographical entity as defined in ISO 3166-1.

PDI C 1 PERSON DEMOGRAPHIC INFORMATION

  • Conditional
  • Max repeat: 1
A segment specifying demographic information such as sex, marital status, and other demographic information.
3499
GENDER CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code giving the gender of a person, animal or plant.
C085
MARITAL STATUS DETAILS
  • Conditional
To specify the marital status of a person.
3479
Marital status description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the marital status of a person.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
3478
Marital status description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of the marital status of a person.
C101
RELIGION DETAILS
  • Conditional
To specify the religion of a person.
3483
Religion name code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the name of a religion.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
3482
Religion name
  • Conditional
  • Type: an
  • Length: 0..35
Name of a religion.

FII C 9 FINANCIAL INSTITUTION INFORMATION

  • Conditional
  • Max repeat: 9
A segment identifying an account number and a financial institution related to the party.
3035
PARTY FUNCTION CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code giving specific meaning to a party.
C078
ACCOUNT HOLDER IDENTIFICATION
  • Conditional
Identification of an account holder by account number and/or account holder name in one or two lines. Number preferred.
3194
Account holder identifier
  • Conditional
  • Type: an
  • Length: 0..35
To identify the holder of an account.
3192
Account holder name
  • Conditional
  • Type: an
  • Length: 0..35
Name of the holder of an account.
3192
Account holder name
  • Conditional
  • Type: an
  • Length: 0..35
Name of the holder of an account.
6345
Currency identification code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a monetary unit.
C088
INSTITUTION IDENTIFICATION
  • Conditional
Identification of a financial institution by code branch number, or name and name of place. Code or branch number preferred.
3433
Institution name code
  • Conditional
  • Type: an
  • Length: 0..11
Code specifying the name of an institution.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
3434
Institution branch identifier
  • Conditional
  • Type: an
  • Length: 0..17
To identify a branch of an institution.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
3432
Institution name
  • Conditional
  • Type: an
  • Length: 0..70
Name of an institution.
3436
Institution branch location name
  • Conditional
  • Type: an
  • Length: 0..70
Name of the location of a branch of an institution.
3207
COUNTRY NAME CODE
  • Conditional
  • Type: an
  • Length: 0..3
Identification of the name of the country or other geographical entity as defined in ISO 3166-1.

GRP3 C 999 AGR SEQ RFF DTM GRP4

  • Conditional
  • Max repeat: 999
Contracts Segment Group. A group of segments related to the whole message, specifying contracts between insured parties or between patients and insurance institutions, and detailing insurance coverage.

AGR M 1 AGREEMENT IDENTIFICATION

  • Mandatory
  • Max repeat: 1
A segment identifying the type of the insurance contract.
C543
AGREEMENT TYPE IDENTIFICATION
  • Conditional
Identification of specific agreement type by code or name.
7431
Agreement type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of agreement.
7433
Agreement type description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the type of agreement.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
7434
Agreement type description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of the type of agreement.
9419
SERVICE LAYER CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a service layer.

SEQ C 1 SEQUENCE DETAILS

  • Conditional
  • Max repeat: 1
A segment allocating a sequence number to the individual contract allowing each contract to be referenced from within the message.
1229
ACTION REQUEST/NOTIFICATION DESCRIPTION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the action to be taken or already taken.
C286
SEQUENCE INFORMATION
  • Conditional
Identification of a sequence and source for sequencing.
1050
Sequence position identifier
  • Mandatory
  • Type: an
  • Length: 0..10
To identify a position in a sequence.
1159
Sequence identifier source code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the source of a sequence identifier.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.

RFF C 99 REFERENCE

  • Conditional
  • Max repeat: 99
A segment specifying certificate numbers and other references related to the contract. This segment is also used to hold a reference to administrative parties in the Parties Segment Group where the related insurance organisation or institution is identified.
C506
REFERENCE
  • Mandatory
Identification of a reference.
1153
Reference code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying a reference.
1154
Reference identifier
  • Conditional
  • Type: an
  • Length: 0..70
Identifies a reference.
1156
Document line identifier
  • Conditional
  • Type: an
  • Length: 0..6
To identify a line of a document.
4000
Reference version identifier
  • Conditional
  • Type: an
  • Length: 0..35
To identify the version of a reference.
1060
Revision identifier
  • Conditional
  • Type: an
  • Length: 0..6
To identify a revision.

DTM C 99 DATE/TIME/PERIOD

  • Conditional
  • Max repeat: 99
A segment specifying dates, times and periods related to the contract such as period of validity and period of specific coverage.
C507
DATE/TIME/PERIOD
  • Mandatory
Date and/or time, or period relevant to the specified date/time/period type.
2005
Date or time or period function code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the function of a date, time or period.
2380
Date or time or period text
  • Conditional
  • Type: an
  • Length: 0..35
The value of a date, a date and time, a time or of a period in a specified representation.
2379
Date or time or period format code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the representation of a date, time or period.

GRP4 C 99 ICD FTX

  • Conditional
  • Max repeat: 99
A group of segments specifying detailed information about rights and insurance coverage.

ICD M 1 INSURANCE COVER DESCRIPTION

  • Mandatory
  • Max repeat: 1
A segment identifying the insurance scheme or product covering the patient.
C330
INSURANCE COVER TYPE
  • Mandatory
To provide the insurance cover type.
4497
Insurance cover type code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying the meaning of the insurance cover.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
C331
INSURANCE COVER DETAILS
  • Mandatory
To provide the insurance cover details.
4495
Insurance cover description code
  • Conditional
  • Type: an
  • Length: 0..17
Code specifying the insurance cover.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
4494
Insurance cover description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of the insurance cover.
4494
Insurance cover description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of the insurance cover.

FTX C 9 FREE TEXT

  • Conditional
  • Max repeat: 9
A segment with free text information, in coded or clear form, illustrating or justifying a particular term of the insurance scheme or product, specified in the ICD segment.
4451
TEXT SUBJECT CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the subject of the text.
4453
FREE TEXT FUNCTION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the function of free text.
C107
TEXT REFERENCE
  • Conditional
Coded reference to a standard text and its source.
4441
Free text description code
  • Mandatory
  • Type: an
  • Length: 0..17
Code specifying free form text.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
C108
TEXT LITERAL
  • Conditional
Free text; one to five lines.
4440
Free text
  • Mandatory
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
3453
LANGUAGE NAME CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the language name.
4447
FREE TEXT FORMAT CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the format of free text.

GRP5 C 99 DOC DTM GRP6

  • Conditional
  • Max repeat: 99
External documents Segment Group. A group of segments giving the identification of external documents the message is referring to (e.g. forms, regulation texts, etc.).

DOC M 1 DOCUMENT/MESSAGE DETAILS

  • Mandatory
  • Max repeat: 1
A segment specifying the type and the name of a document.
C002
DOCUMENT/MESSAGE NAME
  • Mandatory
Identification of a type of document/message by code or name. Code preferred.
1001
Document name code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the document name.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
1000
Document name
  • Conditional
  • Type: an
  • Length: 0..35
Name of a document.
C503
DOCUMENT/MESSAGE DETAILS
  • Conditional
Identification of document/message by number, status, source and/or language.
1004
Document identifier
  • Conditional
  • Type: an
  • Length: 0..35
To identify a document.
1373
Document status code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the status of a document.
1366
Document source description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of the source of a document.
3453
Language name code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the language name.
1056
Version identifier
  • Conditional
  • Type: an
  • Length: 0..9
To identify a version.
1060
Revision identifier
  • Conditional
  • Type: an
  • Length: 0..6
To identify a revision.
3153
COMMUNICATION MEDIUM TYPE CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the type of communication medium.
1220
DOCUMENT COPIES REQUIRED QUANTITY
  • Conditional
  • Type: n
  • Length: 0..2
Quantity of document copies required.
1218
DOCUMENT ORIGINALS REQUIRED QUANTITY
  • Conditional
  • Type: n
  • Length: 0..2
Quantity of document originals required.

DTM C 9 DATE/TIME/PERIOD

  • Conditional
  • Max repeat: 9
A segment specifying dates related to the document. (e.g. issuing date, validity date, etc.).
C507
DATE/TIME/PERIOD
  • Mandatory
Date and/or time, or period relevant to the specified date/time/period type.
2005
Date or time or period function code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the function of a date, time or period.
2380
Date or time or period text
  • Conditional
  • Type: an
  • Length: 0..35
The value of a date, a date and time, a time or of a period in a specified representation.
2379
Date or time or period format code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the representation of a date, time or period.

GRP6 C 9 PNA ADR STS RCS

  • Conditional
  • Max repeat: 9
A group of segments providing information about parties related to the document, such as signatories, sender and receivers.

PNA M 1 PARTY IDENTIFICATION

  • Mandatory
  • Max repeat: 1
A segment identifying the party.
3035
PARTY FUNCTION CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code giving specific meaning to a party.
C206
IDENTIFICATION NUMBER
  • Conditional
The identification of an object.
7402
Object identifier
  • Mandatory
  • Type: an
  • Length: 0..35
Code specifying the unique identity of an object.
7405
Object identification code qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Code qualifying the identification of an object.
4405
Status description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a status.
C082
PARTY IDENTIFICATION DETAILS
  • Conditional
Identification of a transaction party by code.
3039
Party identifier
  • Mandatory
  • Type: an
  • Length: 0..35
Code specifying the identity of a party.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
3403
NAME TYPE CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the type of name.
3397
NAME STATUS CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the status of a name.
C816
NAME COMPONENT DETAILS
  • Conditional
To specify a name component.
3405
Name component type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of a name component.
3398
Name component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of a name component.
3401
Name component usage code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the usage of a name component.
3295
Name original alphabet code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the alphabet originally used to represent a name.
C816
NAME COMPONENT DETAILS
  • Conditional
To specify a name component.
3405
Name component type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of a name component.
3398
Name component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of a name component.
3401
Name component usage code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the usage of a name component.
3295
Name original alphabet code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the alphabet originally used to represent a name.
C816
NAME COMPONENT DETAILS
  • Conditional
To specify a name component.
3405
Name component type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of a name component.
3398
Name component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of a name component.
3401
Name component usage code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the usage of a name component.
3295
Name original alphabet code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the alphabet originally used to represent a name.
C816
NAME COMPONENT DETAILS
  • Conditional
To specify a name component.
3405
Name component type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of a name component.
3398
Name component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of a name component.
3401
Name component usage code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the usage of a name component.
3295
Name original alphabet code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the alphabet originally used to represent a name.
C816
NAME COMPONENT DETAILS
  • Conditional
To specify a name component.
3405
Name component type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of a name component.
3398
Name component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of a name component.
3401
Name component usage code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the usage of a name component.
3295
Name original alphabet code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the alphabet originally used to represent a name.
1229
ACTION REQUEST/NOTIFICATION DESCRIPTION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the action to be taken or already taken.

ADR C 9 ADDRESS

  • Conditional
  • Max repeat: 9
A segment specifying the address of the party.
C817
ADDRESS USAGE
  • Conditional
To describe the usage of an address.
3299
Address purpose code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the purpose of an address.
3131
Address type code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the type of an address.
3475
Address status code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the status of an address.
C090
ADDRESS DETAILS
  • Conditional
To specify the details of an address.
3477
Address format code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying the format of an address.
3286
Address component description
  • Mandatory
  • Type: an
  • Length: 0..70
Free form description of the component of an address.
3286
Address component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of the component of an address.
3286
Address component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of the component of an address.
3286
Address component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of the component of an address.
3286
Address component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of the component of an address.
3164
CITY NAME
  • Conditional
  • Type: an
  • Length: 0..35
Name of a city.
3251
POSTAL IDENTIFICATION CODE
  • Conditional
  • Type: an
  • Length: 0..17
Code specifying the postal zone or address.
3207
COUNTRY NAME CODE
  • Conditional
  • Type: an
  • Length: 0..3
Identification of the name of the country or other geographical entity as defined in ISO 3166-1.
C819
COUNTRY SUB-ENTITY DETAILS
  • Conditional
To specify a part of a country (eg county or part of a city).
3229
Country sub-entity name code
  • Conditional
  • Type: an
  • Length: 0..9
Code specifying the name of a country sub-entity.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
3228
Country sub-entity name
  • Conditional
  • Type: an
  • Length: 0..70
Name of a country sub-entity.
C517
LOCATION IDENTIFICATION
  • Conditional
Identification of a location by code or name.
3225
Location name code
  • Conditional
  • Type: an
  • Length: 0..35
Code specifying the name of the location.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
3224
Location name
  • Conditional
  • Type: an
  • Length: 0..256
Name of the location.

STS C 1 STATUS

  • Conditional
  • Max repeat: 1
A segment specifying the involvement status of the party (former, previous, current, next).
C601
STATUS CATEGORY
  • Conditional
To specify the category of the status.
9015
Status category code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying the category of a status.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
C555
STATUS
  • Conditional
To specify a status.
4405
Status description code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying a status.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
4404
Status description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of a status.
C556
STATUS REASON
  • Conditional
To specify the reason for a status.
9013
Status reason description code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying the reason for a status.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
9012
Status reason description
  • Conditional
  • Type: an
  • Length: 0..256
Free form description of the status reason.
C556
STATUS REASON
  • Conditional
To specify the reason for a status.
9013
Status reason description code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying the reason for a status.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
9012
Status reason description
  • Conditional
  • Type: an
  • Length: 0..256
Free form description of the status reason.
C556
STATUS REASON
  • Conditional
To specify the reason for a status.
9013
Status reason description code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying the reason for a status.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
9012
Status reason description
  • Conditional
  • Type: an
  • Length: 0..256
Free form description of the status reason.
C556
STATUS REASON
  • Conditional
To specify the reason for a status.
9013
Status reason description code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying the reason for a status.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
9012
Status reason description
  • Conditional
  • Type: an
  • Length: 0..256
Free form description of the status reason.
C556
STATUS REASON
  • Conditional
To specify the reason for a status.
9013
Status reason description code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying the reason for a status.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
9012
Status reason description
  • Conditional
  • Type: an
  • Length: 0..256
Free form description of the status reason.

RCS C 9 REQUIREMENTS AND CONDITIONS

  • Conditional
  • Max repeat: 9
A segment specifying administrative conditions of a party such as the social sector it belongs to.
7293
SECTOR AREA IDENTIFICATION CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying identification of a subject area.
C550
REQUIREMENT/CONDITION IDENTIFICATION
  • Conditional
To identify the specific rule/condition requirement.
7295
Requirement or condition description identifier
  • Mandatory
  • Type: an
  • Length: 0..17
Code specifying a requirement or condition.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
7294
Requirement or condition description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of a requirement or condition.
1229
ACTION REQUEST/NOTIFICATION DESCRIPTION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the action to be taken or already taken.
3207
COUNTRY NAME CODE
  • Conditional
  • Type: an
  • Length: 0..3
Identification of the name of the country or other geographical entity as defined in ISO 3166-1.

GRP7 C 999 FCA GEI RFF DTM FTX AGR DOC GRP8 GRP9 GRP10 GRP11

  • Conditional
  • Max repeat: 999
This segment group provides information about a reimbursement claim: identification of patient(s), and the healthcare services provided to the patient(s). The reimbursement claim specified in this segment group may be related to any party specified in the Parties Segment Group, any insurance coverage as specified in the Contracts Segment Group or any transport activity as specified in the Transports Segment Group.

FCA M 1 FINANCIAL CHARGES ALLOCATION

  • Mandatory
  • Max repeat: 1
A segment specifying whether reimbursement is due to the patient, to the healthcare service provider, or to a combination of both.
4471
SETTLEMENT MEANS CODE
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying the means of settlement.
C878
CHARGE/ALLOWANCE ACCOUNT
  • Conditional
Identification of the account for charge or allowance.
3434
Institution branch identifier
  • Mandatory
  • Type: an
  • Length: 0..17
To identify a branch of an institution.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
3194
Account holder identifier
  • Conditional
  • Type: an
  • Length: 0..35
To identify the holder of an account.
6345
Currency identification code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a monetary unit.

GEI C 9 PROCESSING INFORMATION

  • Conditional
  • Max repeat: 9
A segment specifying the service type of the actual reimbursement claim, i.e. whether this is a new reimbursement claim, modification of a previous reimbursement claim, cancellation of a previous reimbursement claim or a complete replacement of a previous reimbursement claim.
9649
PROCESSING INFORMATION CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the processing information.
C012
PROCESSING INDICATOR
  • Conditional
Identification of the processing indicator.
7365
Processing indicator description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a processing indicator.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
7364
Processing indicator description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of a processing indicator.
7187
PROCESS TYPE DESCRIPTION CODE
  • Conditional
  • Type: an
  • Length: 0..17
Code specifying a type of process.

RFF C 99 REFERENCE

  • Conditional
  • Max repeat: 99
A segment specifying certificate numbers and other references related to the reimbursement claim. This segment may also be used to hold the reference to administrative, financial, and medical parties of the Parties Segment Group, insurance contracts of the Contract Segment Group and transport activities of the Transports Segment Group.
C506
REFERENCE
  • Mandatory
Identification of a reference.
1153
Reference code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying a reference.
1154
Reference identifier
  • Conditional
  • Type: an
  • Length: 0..70
Identifies a reference.
1156
Document line identifier
  • Conditional
  • Type: an
  • Length: 0..6
To identify a line of a document.
4000
Reference version identifier
  • Conditional
  • Type: an
  • Length: 0..35
To identify the version of a reference.
1060
Revision identifier
  • Conditional
  • Type: an
  • Length: 0..6
To identify a revision.

DTM C 99 DATE/TIME/PERIOD

  • Conditional
  • Max repeat: 99
A segment specifying dates, times and periods related to the reimbursement claim.
C507
DATE/TIME/PERIOD
  • Mandatory
Date and/or time, or period relevant to the specified date/time/period type.
2005
Date or time or period function code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the function of a date, time or period.
2380
Date or time or period text
  • Conditional
  • Type: an
  • Length: 0..35
The value of a date, a date and time, a time or of a period in a specified representation.
2379
Date or time or period format code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the representation of a date, time or period.

FTX C 99 FREE TEXT

  • Conditional
  • Max repeat: 99
A segment with free text information, in coded or clear form, for specifying information about the reimbursement claim.
4451
TEXT SUBJECT CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the subject of the text.
4453
FREE TEXT FUNCTION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the function of free text.
C107
TEXT REFERENCE
  • Conditional
Coded reference to a standard text and its source.
4441
Free text description code
  • Mandatory
  • Type: an
  • Length: 0..17
Code specifying free form text.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
C108
TEXT LITERAL
  • Conditional
Free text; one to five lines.
4440
Free text
  • Mandatory
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
3453
LANGUAGE NAME CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the language name.
4447
FREE TEXT FORMAT CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the format of free text.

AGR C 99 AGREEMENT IDENTIFICATION

  • Conditional
  • Max repeat: 99
A segment identifying the type of the insurance contract related to the reimbursement claim.
C543
AGREEMENT TYPE IDENTIFICATION
  • Conditional
Identification of specific agreement type by code or name.
7431
Agreement type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of agreement.
7433
Agreement type description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the type of agreement.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
7434
Agreement type description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of the type of agreement.
9419
SERVICE LAYER CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a service layer.

DOC C 9 DOCUMENT/MESSAGE DETAILS

  • Conditional
  • Max repeat: 9
A segment specifying documents the reimbursement claim is referring to. This segment may also be used to hold a document reference of the external documents Segment Group.
C002
DOCUMENT/MESSAGE NAME
  • Mandatory
Identification of a type of document/message by code or name. Code preferred.
1001
Document name code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the document name.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
1000
Document name
  • Conditional
  • Type: an
  • Length: 0..35
Name of a document.
C503
DOCUMENT/MESSAGE DETAILS
  • Conditional
Identification of document/message by number, status, source and/or language.
1004
Document identifier
  • Conditional
  • Type: an
  • Length: 0..35
To identify a document.
1373
Document status code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the status of a document.
1366
Document source description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of the source of a document.
3453
Language name code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the language name.
1056
Version identifier
  • Conditional
  • Type: an
  • Length: 0..9
To identify a version.
1060
Revision identifier
  • Conditional
  • Type: an
  • Length: 0..6
To identify a revision.
3153
COMMUNICATION MEDIUM TYPE CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the type of communication medium.
1220
DOCUMENT COPIES REQUIRED QUANTITY
  • Conditional
  • Type: n
  • Length: 0..2
Quantity of document copies required.
1218
DOCUMENT ORIGINALS REQUIRED QUANTITY
  • Conditional
  • Type: n
  • Length: 0..2
Quantity of document originals required.

GRP8 C 99 MOA TAX

  • Conditional
  • Max repeat: 99
To specify total amounts, and the relevant duty/tax/fee information about the current reimbursement claim.

MOA M 1 MONETARY AMOUNT

  • Mandatory
  • Max repeat: 1
A segment specifying total amounts such as total amount to pay.
C516
MONETARY AMOUNT
  • Mandatory
Amount of goods or services stated as a monetary amount in a specified currency.
5025
Monetary amount type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of monetary amount.
5004
Monetary amount
  • Conditional
  • Type: n
  • Length: 0..35
To specify a monetary amount.
6345
Currency identification code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a monetary unit.
6343
Currency type code qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Code qualifying the type of currency.
4405
Status description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a status.

TAX C 1 DUTY/TAX/FEE DETAILS

  • Conditional
  • Max repeat: 1
A segment specifying relevant tax information.
5283
DUTY OR TAX OR FEE FUNCTION CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the function of a duty or tax or fee.
C241
DUTY/TAX/FEE TYPE
  • Conditional
Code and/or name identifying duty, tax or fee.
5153
Duty or tax or fee type name code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a type of duty, tax or fee.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
5152
Duty or tax or fee type name
  • Conditional
  • Type: an
  • Length: 0..35
Name of a type of duty, tax or fee.
C533
DUTY/TAX/FEE ACCOUNT DETAIL
  • Conditional
Indication of account reference for duties, taxes and/or fees.
5289
Duty or tax or fee account code
  • Mandatory
  • Type: an
  • Length: 0..6
Code specifying a duty or tax or fee account.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
5286
DUTY OR TAX OR FEE ASSESSMENT BASIS QUANTITY
  • Conditional
  • Type: an
  • Length: 0..15
To specify the basis on which a duty or tax or fee will be assessed.
C243
DUTY/TAX/FEE DETAIL
  • Conditional
Rate of duty/tax/fee applicable to commodities or of tax applicable to services.
5279
Duty or tax or fee rate code
  • Conditional
  • Type: an
  • Length: 0..7
Code specifying a rate of a duty or tax or fee.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
5278
Duty or tax or fee rate
  • Conditional
  • Type: an
  • Length: 0..17
Rate of a duty or tax or fee.
5273
Duty or tax or fee rate basis code
  • Conditional
  • Type: an
  • Length: 0..12
Code specifying the basis for a duty or tax or fee rate.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
5305
DUTY OR TAX OR FEE CATEGORY CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a duty or tax or fee category.
3446
PARTY TAX IDENTIFIER
  • Conditional
  • Type: an
  • Length: 0..20
To identify a number assigned to a party by a tax authority.
1227
CALCULATION SEQUENCE CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a calculation sequence.

GRP9 C 99 RCS FTX

  • Conditional
  • Max repeat: 99
This segment group provides information about required administrative conditions concerning the reimbursement claim, such as risk identification (e.g. illness, maternity, accident, industrial accident).

RCS M 1 REQUIREMENTS AND CONDITIONS

  • Mandatory
  • Max repeat: 1
A segment specifying requirements and conditions concerning the reimbursement claim.
7293
SECTOR AREA IDENTIFICATION CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying identification of a subject area.
C550
REQUIREMENT/CONDITION IDENTIFICATION
  • Conditional
To identify the specific rule/condition requirement.
7295
Requirement or condition description identifier
  • Mandatory
  • Type: an
  • Length: 0..17
Code specifying a requirement or condition.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
7294
Requirement or condition description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of a requirement or condition.
1229
ACTION REQUEST/NOTIFICATION DESCRIPTION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the action to be taken or already taken.
3207
COUNTRY NAME CODE
  • Conditional
  • Type: an
  • Length: 0..3
Identification of the name of the country or other geographical entity as defined in ISO 3166-1.

FTX C 9 FREE TEXT

  • Conditional
  • Max repeat: 9
A segment with free text information, in coded or clear form, illustrating or justifying a particular condition specified in the RCS segment.
4451
TEXT SUBJECT CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the subject of the text.
4453
FREE TEXT FUNCTION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the function of free text.
C107
TEXT REFERENCE
  • Conditional
Coded reference to a standard text and its source.
4441
Free text description code
  • Mandatory
  • Type: an
  • Length: 0..17
Code specifying free form text.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
C108
TEXT LITERAL
  • Conditional
Free text; one to five lines.
4440
Free text
  • Mandatory
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
3453
LANGUAGE NAME CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the language name.
4447
FREE TEXT FORMAT CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the format of free text.

GRP10 C 999 PNA RFF ADR COM DTM PDI RSL NAT LAN HAN REL

  • Conditional
  • Max repeat: 999
This segment group identifies the patient(s) to whom the medical services of this actual reimbursement claim have been provided and information about any related person, or other name or identity of the patient. This segment group may also be used to specify name and identity of any other party related to the actual reimbursement claim, and involved in the medical or administrative process provided to the patient(s). In this case, only the PNA segment is used.

PNA M 1 PARTY IDENTIFICATION

  • Mandatory
  • Max repeat: 1
A segment identifying the patient, related person, or party identity number and name.
3035
PARTY FUNCTION CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code giving specific meaning to a party.
C206
IDENTIFICATION NUMBER
  • Conditional
The identification of an object.
7402
Object identifier
  • Mandatory
  • Type: an
  • Length: 0..35
Code specifying the unique identity of an object.
7405
Object identification code qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Code qualifying the identification of an object.
4405
Status description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a status.
C082
PARTY IDENTIFICATION DETAILS
  • Conditional
Identification of a transaction party by code.
3039
Party identifier
  • Mandatory
  • Type: an
  • Length: 0..35
Code specifying the identity of a party.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
3403
NAME TYPE CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the type of name.
3397
NAME STATUS CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the status of a name.
C816
NAME COMPONENT DETAILS
  • Conditional
To specify a name component.
3405
Name component type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of a name component.
3398
Name component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of a name component.
3401
Name component usage code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the usage of a name component.
3295
Name original alphabet code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the alphabet originally used to represent a name.
C816
NAME COMPONENT DETAILS
  • Conditional
To specify a name component.
3405
Name component type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of a name component.
3398
Name component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of a name component.
3401
Name component usage code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the usage of a name component.
3295
Name original alphabet code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the alphabet originally used to represent a name.
C816
NAME COMPONENT DETAILS
  • Conditional
To specify a name component.
3405
Name component type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of a name component.
3398
Name component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of a name component.
3401
Name component usage code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the usage of a name component.
3295
Name original alphabet code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the alphabet originally used to represent a name.
C816
NAME COMPONENT DETAILS
  • Conditional
To specify a name component.
3405
Name component type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of a name component.
3398
Name component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of a name component.
3401
Name component usage code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the usage of a name component.
3295
Name original alphabet code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the alphabet originally used to represent a name.
C816
NAME COMPONENT DETAILS
  • Conditional
To specify a name component.
3405
Name component type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of a name component.
3398
Name component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of a name component.
3401
Name component usage code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the usage of a name component.
3295
Name original alphabet code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the alphabet originally used to represent a name.
1229
ACTION REQUEST/NOTIFICATION DESCRIPTION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the action to be taken or already taken.

RFF C 99 REFERENCE

  • Conditional
  • Max repeat: 99
A segment specifying the identification numbers of the person or other identification references such as card number. This segment may also be used to keep the reference to administrative, financial, and medical parties of the Parties Segment Group, and insurance contracts of the Contracts Segment Group.
C506
REFERENCE
  • Mandatory
Identification of a reference.
1153
Reference code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying a reference.
1154
Reference identifier
  • Conditional
  • Type: an
  • Length: 0..70
Identifies a reference.
1156
Document line identifier
  • Conditional
  • Type: an
  • Length: 0..6
To identify a line of a document.
4000
Reference version identifier
  • Conditional
  • Type: an
  • Length: 0..35
To identify the version of a reference.
1060
Revision identifier
  • Conditional
  • Type: an
  • Length: 0..6
To identify a revision.

ADR C 9 ADDRESS

  • Conditional
  • Max repeat: 9
A segment specifying the details of the patient and related person(s) place of residence, or any other address or location related to the person, such as place of birth.
C817
ADDRESS USAGE
  • Conditional
To describe the usage of an address.
3299
Address purpose code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the purpose of an address.
3131
Address type code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the type of an address.
3475
Address status code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the status of an address.
C090
ADDRESS DETAILS
  • Conditional
To specify the details of an address.
3477
Address format code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying the format of an address.
3286
Address component description
  • Mandatory
  • Type: an
  • Length: 0..70
Free form description of the component of an address.
3286
Address component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of the component of an address.
3286
Address component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of the component of an address.
3286
Address component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of the component of an address.
3286
Address component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of the component of an address.
3164
CITY NAME
  • Conditional
  • Type: an
  • Length: 0..35
Name of a city.
3251
POSTAL IDENTIFICATION CODE
  • Conditional
  • Type: an
  • Length: 0..17
Code specifying the postal zone or address.
3207
COUNTRY NAME CODE
  • Conditional
  • Type: an
  • Length: 0..3
Identification of the name of the country or other geographical entity as defined in ISO 3166-1.
C819
COUNTRY SUB-ENTITY DETAILS
  • Conditional
To specify a part of a country (eg county or part of a city).
3229
Country sub-entity name code
  • Conditional
  • Type: an
  • Length: 0..9
Code specifying the name of a country sub-entity.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
3228
Country sub-entity name
  • Conditional
  • Type: an
  • Length: 0..70
Name of a country sub-entity.
C517
LOCATION IDENTIFICATION
  • Conditional
Identification of a location by code or name.
3225
Location name code
  • Conditional
  • Type: an
  • Length: 0..35
Code specifying the name of the location.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
3224
Location name
  • Conditional
  • Type: an
  • Length: 0..256
Name of the location.

COM C 9 COMMUNICATION CONTACT

  • Conditional
  • Max repeat: 9
A segment providing a telecommunication number for the person.
C076
COMMUNICATION CONTACT
  • Mandatory
Communication number of a department or employee in a specified channel.
3148
Communication address identifier
  • Mandatory
  • Type: an
  • Length: 0..512
To identify a communication address.
3155
Communication address code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the communication address.

DTM C 99 DATE/TIME/PERIOD

  • Conditional
  • Max repeat: 99
A segment specifying relevant dates/times for the person such as date of birth, date of death or date identification card was issued.
C507
DATE/TIME/PERIOD
  • Mandatory
Date and/or time, or period relevant to the specified date/time/period type.
2005
Date or time or period function code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the function of a date, time or period.
2380
Date or time or period text
  • Conditional
  • Type: an
  • Length: 0..35
The value of a date, a date and time, a time or of a period in a specified representation.
2379
Date or time or period format code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the representation of a date, time or period.

PDI C 1 PERSON DEMOGRAPHIC INFORMATION

  • Conditional
  • Max repeat: 1
A segment specifying demographic information such as sex, marital status, and other demographic information.
3499
GENDER CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code giving the gender of a person, animal or plant.
C085
MARITAL STATUS DETAILS
  • Conditional
To specify the marital status of a person.
3479
Marital status description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the marital status of a person.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
3478
Marital status description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of the marital status of a person.
C101
RELIGION DETAILS
  • Conditional
To specify the religion of a person.
3483
Religion name code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the name of a religion.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
3482
Religion name
  • Conditional
  • Type: an
  • Length: 0..35
Name of a religion.

RSL C 9 RESULT

  • Conditional
  • Max repeat: 9
A segment specifying the result of a clinical examination, such as the height or weight of the patient.
6087
RESULT VALUE TYPE CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of a result value.
6077
RESULT REPRESENTATION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the representation of a result.
C831
RESULT DETAILS
  • Conditional
To specify a value.
6314
Measure
  • Conditional
  • Type: an
  • Length: 0..18
To specify the value of a measurement.
6321
Measurement significance code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the significance of a measurement.
6155
Non-discrete measurement name code
  • Conditional
  • Type: an
  • Length: 0..17
Code specifying the name of a non-discrete measurement.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
6154
Non-discrete measurement name
  • Conditional
  • Type: an
  • Length: 0..70
Name of a non-discrete measurement.
C831
RESULT DETAILS
  • Conditional
To specify a value.
6314
Measure
  • Conditional
  • Type: an
  • Length: 0..18
To specify the value of a measurement.
6321
Measurement significance code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the significance of a measurement.
6155
Non-discrete measurement name code
  • Conditional
  • Type: an
  • Length: 0..17
Code specifying the name of a non-discrete measurement.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
6154
Non-discrete measurement name
  • Conditional
  • Type: an
  • Length: 0..70
Name of a non-discrete measurement.
C848
MEASUREMENT UNIT DETAILS
  • Conditional
To specify a measurement unit.
6411
Measurement unit code
  • Conditional
  • Type: an
  • Length: 0..8
Code specifying the unit of measurement.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
6410
Measurement unit name
  • Conditional
  • Type: an
  • Length: 0..35
Name of a measurement unit.
6079
RESULT NORMALCY CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the degree of conformance to a standard.

NAT C 9 NATIONALITY

  • Conditional
  • Max repeat: 9
A segment specifying the nationality of a person.
3493
NATIONALITY CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying a nationality.
C042
NATIONALITY DETAILS
  • Conditional
To specify a nationality.
3293
Nationality name code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the name of a nationality.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
3292
Nationality name
  • Conditional
  • Type: a
  • Length: 0..35
Name of a nationality.

LAN C 9 LANGUAGE

  • Conditional
  • Max repeat: 9
A segment specifying the language used by the person.
3455
LANGUAGE CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying a language.
C508
LANGUAGE DETAILS
  • Conditional
To identify a language.
3453
Language name code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the language name.
3452
Language name
  • Conditional
  • Type: an
  • Length: 0..35
Name of language.

HAN C 9 HANDLING INSTRUCTIONS

  • Conditional
  • Max repeat: 9
A segment specifying confidentiality constraints on person data.
C524
HANDLING INSTRUCTIONS
  • Conditional
Instruction for the handling of goods, products or articles in shipment, storage etc.
4079
Handling instruction description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a handling instruction.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
4078
Handling instruction description
  • Conditional
  • Type: an
  • Length: 0..512
Free form description of a handling instruction.
C218
HAZARDOUS MATERIAL
  • Conditional
To specify a hazardous material.
7419
Hazardous material category name code
  • Conditional
  • Type: an
  • Length: 0..7
Code specifying a kind of hazard for a material.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
7418
Hazardous material category name
  • Conditional
  • Type: an
  • Length: 0..35
Name of a kind of hazard for a material.

REL C 1 RELATIONSHIP

  • Conditional
  • Max repeat: 1
A segment specifying the relationship between a related person and the patient. This relation can be an organ donor-receiver relationship, a mother-child relationship or any other family relationship.
9141
RELATIONSHIP TYPE CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying a type of relationship.
C941
RELATIONSHIP
  • Conditional
Identification and/or description of a relationship.
9143
Relationship description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a relationship.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
9142
Relationship description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of a relationship.

GRP11 C 999 PRC GEI STS IMD CIN PNA DTM RFF FTX QTY PCD GRP12 GRP13 GRP14 GRP15

  • Conditional
  • Max repeat: 999
A group of segments describing a medical activity. A medical activity can be a collection of several detailed medical activities which are all related to the same medical treatment. The medical activity specified in this segment group may also be related to any party specified in the Parties Segment Group, any insurance coverage description as specified in the Contracts Segment Group or to any transport activity as specified in the Transports Segment Group.

PRC M 1 PROCESS IDENTIFICATION

  • Mandatory
  • Max repeat: 1
A segment specifying the type of medical activity provided such as hospitalisation or outpatient treatment.
C242
PROCESS TYPE AND DESCRIPTION
  • Conditional
Identification of process type and description.
7187
Process type description code
  • Mandatory
  • Type: an
  • Length: 0..17
Code specifying a type of process.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
7186
Process type description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of a type of process.
7186
Process type description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of a type of process.
C830
PROCESS IDENTIFICATION DETAILS
  • Conditional
To identify the details of a specific process.
7191
Process description code
  • Conditional
  • Type: an
  • Length: 0..17
Code specifying a process.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
7190
Process description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of a process.

GEI C 1 PROCESSING INFORMATION

  • Conditional
  • Max repeat: 1
A segment specifying the service type for the medical activity: new activity, modification of a previous activity, cancellation of a previous activity or replacement of a previous activity.
9649
PROCESSING INFORMATION CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the processing information.
C012
PROCESSING INDICATOR
  • Conditional
Identification of the processing indicator.
7365
Processing indicator description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a processing indicator.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
7364
Processing indicator description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of a processing indicator.
7187
PROCESS TYPE DESCRIPTION CODE
  • Conditional
  • Type: an
  • Length: 0..17
Code specifying a type of process.

STS C 9 STATUS

  • Conditional
  • Max repeat: 9
A segment specifying the activity status regarding its achievement (e.g. started, in progress, terminated) and/or payment (e.g. received, granted, paid).
C601
STATUS CATEGORY
  • Conditional
To specify the category of the status.
9015
Status category code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying the category of a status.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
C555
STATUS
  • Conditional
To specify a status.
4405
Status description code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying a status.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
4404
Status description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of a status.
C556
STATUS REASON
  • Conditional
To specify the reason for a status.
9013
Status reason description code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying the reason for a status.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
9012
Status reason description
  • Conditional
  • Type: an
  • Length: 0..256
Free form description of the status reason.
C556
STATUS REASON
  • Conditional
To specify the reason for a status.
9013
Status reason description code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying the reason for a status.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
9012
Status reason description
  • Conditional
  • Type: an
  • Length: 0..256
Free form description of the status reason.
C556
STATUS REASON
  • Conditional
To specify the reason for a status.
9013
Status reason description code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying the reason for a status.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
9012
Status reason description
  • Conditional
  • Type: an
  • Length: 0..256
Free form description of the status reason.
C556
STATUS REASON
  • Conditional
To specify the reason for a status.
9013
Status reason description code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying the reason for a status.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
9012
Status reason description
  • Conditional
  • Type: an
  • Length: 0..256
Free form description of the status reason.
C556
STATUS REASON
  • Conditional
To specify the reason for a status.
9013
Status reason description code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying the reason for a status.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
9012
Status reason description
  • Conditional
  • Type: an
  • Length: 0..256
Free form description of the status reason.

IMD C 9 ITEM DESCRIPTION

  • Conditional
  • Max repeat: 9
A segment identifying the actual medical activity, and allowing several alternative coding schemes depending on separately agreed criteria.
7077
DESCRIPTION FORMAT CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the format of a description.
C272
ITEM CHARACTERISTIC
  • Conditional
To provide the characteristic of the item being described.
7081
Item characteristic code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the characteristic of an item.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
C273
ITEM DESCRIPTION
  • Conditional
Description of an item.
7009
Item description code
  • Conditional
  • Type: an
  • Length: 0..17
Code specifying an item.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
7008
Item description
  • Conditional
  • Type: an
  • Length: 0..256
Free form description of an item.
7008
Item description
  • Conditional
  • Type: an
  • Length: 0..256
Free form description of an item.
3453
Language name code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the language name.
7383
SURFACE OR LAYER CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the surface or layer of an object.

CIN C 99 CLINICAL INFORMATION

  • Conditional
  • Max repeat: 99
A segment justifying the medical activity provided in terms of diagnosis or clinical observation.
6415
CLINICAL INFORMATION TYPE CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of clinical information.
C836
CLINICAL INFORMATION DETAILS
  • Conditional
To specify an item of clinical information.
6413
Clinical information description identifier
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying an item of clinical information.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
6412
Clinical information description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of an item of clinical information.
C837
CERTAINTY DETAILS
  • Conditional
To specify the certainty.
4049
Certainty description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a certainty.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
4048
Certainty description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of a certainty.

PNA C 99 PARTY IDENTIFICATION

  • Conditional
  • Max repeat: 99
A segment specifying the identity number and name of any medical or administrative party related to the current activity, such as treatment provider or prescriber, diagnosis originator, etc.
3035
PARTY FUNCTION CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code giving specific meaning to a party.
C206
IDENTIFICATION NUMBER
  • Conditional
The identification of an object.
7402
Object identifier
  • Mandatory
  • Type: an
  • Length: 0..35
Code specifying the unique identity of an object.
7405
Object identification code qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Code qualifying the identification of an object.
4405
Status description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a status.
C082
PARTY IDENTIFICATION DETAILS
  • Conditional
Identification of a transaction party by code.
3039
Party identifier
  • Mandatory
  • Type: an
  • Length: 0..35
Code specifying the identity of a party.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
3403
NAME TYPE CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the type of name.
3397
NAME STATUS CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the status of a name.
C816
NAME COMPONENT DETAILS
  • Conditional
To specify a name component.
3405
Name component type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of a name component.
3398
Name component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of a name component.
3401
Name component usage code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the usage of a name component.
3295
Name original alphabet code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the alphabet originally used to represent a name.
C816
NAME COMPONENT DETAILS
  • Conditional
To specify a name component.
3405
Name component type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of a name component.
3398
Name component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of a name component.
3401
Name component usage code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the usage of a name component.
3295
Name original alphabet code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the alphabet originally used to represent a name.
C816
NAME COMPONENT DETAILS
  • Conditional
To specify a name component.
3405
Name component type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of a name component.
3398
Name component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of a name component.
3401
Name component usage code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the usage of a name component.
3295
Name original alphabet code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the alphabet originally used to represent a name.
C816
NAME COMPONENT DETAILS
  • Conditional
To specify a name component.
3405
Name component type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of a name component.
3398
Name component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of a name component.
3401
Name component usage code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the usage of a name component.
3295
Name original alphabet code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the alphabet originally used to represent a name.
C816
NAME COMPONENT DETAILS
  • Conditional
To specify a name component.
3405
Name component type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of a name component.
3398
Name component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of a name component.
3401
Name component usage code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the usage of a name component.
3295
Name original alphabet code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the alphabet originally used to represent a name.
1229
ACTION REQUEST/NOTIFICATION DESCRIPTION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the action to be taken or already taken.

DTM C 99 DATE/TIME/PERIOD

  • Conditional
  • Max repeat: 99
A segment specifying dates, times and periods related to the current medical activity such as date performed, date of prescription, date of sickness and date of medical authorisation.
C507
DATE/TIME/PERIOD
  • Mandatory
Date and/or time, or period relevant to the specified date/time/period type.
2005
Date or time or period function code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the function of a date, time or period.
2380
Date or time or period text
  • Conditional
  • Type: an
  • Length: 0..35
The value of a date, a date and time, a time or of a period in a specified representation.
2379
Date or time or period format code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the representation of a date, time or period.

RFF C 99 REFERENCE

  • Conditional
  • Max repeat: 99
To specify a reference related to a treatment such as identification number of prescription or medical authorisation number. This segment may also be used to hold the reference to administrative, financial, and medical parties of the Parties Segment Group, insurance contracts of the Contracts Segment Group and transports of the Transports Segment Group.
C506
REFERENCE
  • Mandatory
Identification of a reference.
1153
Reference code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying a reference.
1154
Reference identifier
  • Conditional
  • Type: an
  • Length: 0..70
Identifies a reference.
1156
Document line identifier
  • Conditional
  • Type: an
  • Length: 0..6
To identify a line of a document.
4000
Reference version identifier
  • Conditional
  • Type: an
  • Length: 0..35
To identify the version of a reference.
1060
Revision identifier
  • Conditional
  • Type: an
  • Length: 0..6
To identify a revision.

FTX C 99 FREE TEXT

  • Conditional
  • Max repeat: 99
A segment with free text information, in coded or clear form, specifying information about the current medical activity.
4451
TEXT SUBJECT CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the subject of the text.
4453
FREE TEXT FUNCTION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the function of free text.
C107
TEXT REFERENCE
  • Conditional
Coded reference to a standard text and its source.
4441
Free text description code
  • Mandatory
  • Type: an
  • Length: 0..17
Code specifying free form text.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
C108
TEXT LITERAL
  • Conditional
Free text; one to five lines.
4440
Free text
  • Mandatory
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
3453
LANGUAGE NAME CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the language name.
4447
FREE TEXT FORMAT CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the format of free text.

QTY C 99 QUANTITY

  • Conditional
  • Max repeat: 99
A segment providing quantities related to the medical activity such as number of units of service as identified in the IMD segment. If the service type of this medical activity is a modification then variations from the original quantities are given here.
C186
QUANTITY DETAILS
  • Mandatory
Quantity information in a transaction, qualified when relevant.
6063
Quantity type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of quantity.
6060
Quantity
  • Mandatory
  • Type: an
  • Length: 0..35
Alphanumeric representation of a quantity.
6411
Measurement unit code
  • Conditional
  • Type: an
  • Length: 0..8
Code specifying the unit of measurement.

PCD C 99 PERCENTAGE DETAILS

  • Conditional
  • Max repeat: 99
A segment specifying percentage used to calculate a share of a reimbursement. This information is useful when a party has already paid a certain amount, or more generally when several recipients are identified in the business scenario (e.g. 75% of a visit will be paid to the general practitioner and 25% to the patient).
C501
PERCENTAGE DETAILS
  • Mandatory
Percentage relating to a specified basis.
5245
Percentage type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of percentage.
5482
Percentage
  • Conditional
  • Type: n
  • Length: 0..10
To specify a percentage.
5249
Percentage basis identification code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the basis on which a percentage is calculated.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
4405
STATUS DESCRIPTION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a status.

GRP12 C 99 PAS LOC DTM RFF

  • Conditional
  • Max repeat: 99
A group of segments specifying healthcare administrative information about the patient.

PAS M 1 ATTENDANCE

  • Mandatory
  • Max repeat: 1
A segment specifying patient administrative information such as administrative status concerning current hospital stay or outpatient visit or ward stay related to the patient.
9443
ATTENDANCE TYPE CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying a type of attendance.
C839
ATTENDEE CATEGORY
  • Conditional
To specify the category of the attendee.
7459
Attendee category description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a category of attendee.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
7458
Attendee category description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of a category attendee.
C840
ATTENDANCE ADMISSION DETAILS
  • Conditional
To specify type of admission.
9445
Admission type description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the type of admission.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
9444
Admission type description
  • Conditional
  • Type: an
  • Length: 0..35
Free form of the type of admission.
C841
ATTENDANCE DISCHARGE DETAILS
  • Conditional
To specify type of discharge.
9447
Discharge type description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the type of discharge.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
9446
Discharge type description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of the type of discharge.

LOC C 9 PLACE/LOCATION IDENTIFICATION

  • Conditional
  • Max repeat: 9
A segment specifying the physical location of patient care in terms of ward, room, bed, etc.
3227
LOCATION FUNCTION CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code identifying the function of a location.
C517
LOCATION IDENTIFICATION
  • Conditional
Identification of a location by code or name.
3225
Location name code
  • Conditional
  • Type: an
  • Length: 0..35
Code specifying the name of the location.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
3224
Location name
  • Conditional
  • Type: an
  • Length: 0..256
Name of the location.
C519
RELATED LOCATION ONE IDENTIFICATION
  • Conditional
Identification the first related location by code or name.
3223
First related location name code
  • Conditional
  • Type: an
  • Length: 0..25
Code specifying first related location.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
3222
First related location name
  • Conditional
  • Type: an
  • Length: 0..70
Name of first related location.
C553
RELATED LOCATION TWO IDENTIFICATION
  • Conditional
Identification of second related location by code or name.
3233
Second related location name code
  • Conditional
  • Type: an
  • Length: 0..25
Code specifying the second related location.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
3232
Second related location name
  • Conditional
  • Type: an
  • Length: 0..70
Name of the second related location.
5479
RELATION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a relation.

DTM C 9 DATE/TIME/PERIOD

  • Conditional
  • Max repeat: 9
A segment specifying admission and/or discharge date and time or start and/or end date and time of a ward stay.
C507
DATE/TIME/PERIOD
  • Mandatory
Date and/or time, or period relevant to the specified date/time/period type.
2005
Date or time or period function code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the function of a date, time or period.
2380
Date or time or period text
  • Conditional
  • Type: an
  • Length: 0..35
The value of a date, a date and time, a time or of a period in a specified representation.
2379
Date or time or period format code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the representation of a date, time or period.

RFF C 9 REFERENCE

  • Conditional
  • Max repeat: 9
This segment holds the reference of a healthcare party for specifying healthcare administrative information such as hospital, department, etc. where patient is admitted, located, etc.
C506
REFERENCE
  • Mandatory
Identification of a reference.
1153
Reference code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying a reference.
1154
Reference identifier
  • Conditional
  • Type: an
  • Length: 0..70
Identifies a reference.
1156
Document line identifier
  • Conditional
  • Type: an
  • Length: 0..6
To identify a line of a document.
4000
Reference version identifier
  • Conditional
  • Type: an
  • Length: 0..35
To identify the version of a reference.
1060
Revision identifier
  • Conditional
  • Type: an
  • Length: 0..6
To identify a revision.

GRP13 C 99 MOA TAX

  • Conditional
  • Max repeat: 99
To specify total amounts, and the relevant duty/tax/fee information about the current medical activity.

MOA M 1 MONETARY AMOUNT

  • Mandatory
  • Max repeat: 1
A segment specifying total amounts such as amount of fees.
C516
MONETARY AMOUNT
  • Mandatory
Amount of goods or services stated as a monetary amount in a specified currency.
5025
Monetary amount type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of monetary amount.
5004
Monetary amount
  • Conditional
  • Type: n
  • Length: 0..35
To specify a monetary amount.
6345
Currency identification code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a monetary unit.
6343
Currency type code qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Code qualifying the type of currency.
4405
Status description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a status.

TAX C 1 DUTY/TAX/FEE DETAILS

  • Conditional
  • Max repeat: 1
A segment specifying relevant tax information.
5283
DUTY OR TAX OR FEE FUNCTION CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the function of a duty or tax or fee.
C241
DUTY/TAX/FEE TYPE
  • Conditional
Code and/or name identifying duty, tax or fee.
5153
Duty or tax or fee type name code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a type of duty, tax or fee.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
5152
Duty or tax or fee type name
  • Conditional
  • Type: an
  • Length: 0..35
Name of a type of duty, tax or fee.
C533
DUTY/TAX/FEE ACCOUNT DETAIL
  • Conditional
Indication of account reference for duties, taxes and/or fees.
5289
Duty or tax or fee account code
  • Mandatory
  • Type: an
  • Length: 0..6
Code specifying a duty or tax or fee account.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
5286
DUTY OR TAX OR FEE ASSESSMENT BASIS QUANTITY
  • Conditional
  • Type: an
  • Length: 0..15
To specify the basis on which a duty or tax or fee will be assessed.
C243
DUTY/TAX/FEE DETAIL
  • Conditional
Rate of duty/tax/fee applicable to commodities or of tax applicable to services.
5279
Duty or tax or fee rate code
  • Conditional
  • Type: an
  • Length: 0..7
Code specifying a rate of a duty or tax or fee.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
5278
Duty or tax or fee rate
  • Conditional
  • Type: an
  • Length: 0..17
Rate of a duty or tax or fee.
5273
Duty or tax or fee rate basis code
  • Conditional
  • Type: an
  • Length: 0..12
Code specifying the basis for a duty or tax or fee rate.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
5305
DUTY OR TAX OR FEE CATEGORY CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a duty or tax or fee category.
3446
PARTY TAX IDENTIFIER
  • Conditional
  • Type: an
  • Length: 0..20
To identify a number assigned to a party by a tax authority.
1227
CALCULATION SEQUENCE CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a calculation sequence.

GRP14 C 99 RCS FTX

  • Conditional
  • Max repeat: 99
This segment group provides information about required medical and administrative conditions concerning the current medical activity.

RCS M 1 REQUIREMENTS AND CONDITIONS

  • Mandatory
  • Max repeat: 1
A segment specifying requirements and conditions about the current medical activity.
7293
SECTOR AREA IDENTIFICATION CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying identification of a subject area.
C550
REQUIREMENT/CONDITION IDENTIFICATION
  • Conditional
To identify the specific rule/condition requirement.
7295
Requirement or condition description identifier
  • Mandatory
  • Type: an
  • Length: 0..17
Code specifying a requirement or condition.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
7294
Requirement or condition description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of a requirement or condition.
1229
ACTION REQUEST/NOTIFICATION DESCRIPTION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the action to be taken or already taken.
3207
COUNTRY NAME CODE
  • Conditional
  • Type: an
  • Length: 0..3
Identification of the name of the country or other geographical entity as defined in ISO 3166-1.

FTX C 9 FREE TEXT

  • Conditional
  • Max repeat: 9
A segment with free text information, in coded or clear form, illustrating or justifying a particular condition specified in the RCS segment.
4451
TEXT SUBJECT CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the subject of the text.
4453
FREE TEXT FUNCTION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the function of free text.
C107
TEXT REFERENCE
  • Conditional
Coded reference to a standard text and its source.
4441
Free text description code
  • Mandatory
  • Type: an
  • Length: 0..17
Code specifying free form text.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
C108
TEXT LITERAL
  • Conditional
Free text; one to five lines.
4440
Free text
  • Mandatory
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
3453
LANGUAGE NAME CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the language name.
4447
FREE TEXT FORMAT CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the format of free text.

GRP15 C 999 CLI GEI IMD CIN PNA DTM RFF FTX QTY PCD PAC GRP16 GRP17 GRP18

  • Conditional
  • Max repeat: 999
A group of segments describing a detailed medical activity. The detailed medical activity specified in this segment group may also be related to any party specified in the Parties Segment Group, any insurance coverage description as specified in the Contracts Segment Group or to any transport activity as specified in the Transports Segment Group.

CLI M 1 CLINICAL INTERVENTION

  • Mandatory
  • Max repeat: 1
A segment specifying a clinical intervention.
9441
CLINICAL INTERVENTION TYPE CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying a type of clinical intervention.
C828
CLINICAL INTERVENTION DETAILS
  • Conditional
To specify a clinical intervention.
9437
Clinical intervention description code
  • Conditional
  • Type: an
  • Length: 0..17
Code specifying a clinical intervention.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
9436
Clinical intervention description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of a clinical intervention.

GEI C 1 PROCESSING INFORMATION

  • Conditional
  • Max repeat: 1
A segment specifying the service type of the current detailed medical activity, i.e. whether this is a new detailed medical activity, modification of a previous detailed medical activity, cancellation of a previous detailed medical activity or a complete replacement of a previous detailed medical activity.
9649
PROCESSING INFORMATION CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the processing information.
C012
PROCESSING INDICATOR
  • Conditional
Identification of the processing indicator.
7365
Processing indicator description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a processing indicator.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
7364
Processing indicator description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of a processing indicator.
7187
PROCESS TYPE DESCRIPTION CODE
  • Conditional
  • Type: an
  • Length: 0..17
Code specifying a type of process.

IMD C 9 ITEM DESCRIPTION

  • Conditional
  • Max repeat: 9
A segment identifying the current detailed medical activity and allowing several alternative coding schemes depending on separately agreed criteria.
7077
DESCRIPTION FORMAT CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the format of a description.
C272
ITEM CHARACTERISTIC
  • Conditional
To provide the characteristic of the item being described.
7081
Item characteristic code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the characteristic of an item.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
C273
ITEM DESCRIPTION
  • Conditional
Description of an item.
7009
Item description code
  • Conditional
  • Type: an
  • Length: 0..17
Code specifying an item.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
7008
Item description
  • Conditional
  • Type: an
  • Length: 0..256
Free form description of an item.
7008
Item description
  • Conditional
  • Type: an
  • Length: 0..256
Free form description of an item.
3453
Language name code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the language name.
7383
SURFACE OR LAYER CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the surface or layer of an object.

CIN C 99 CLINICAL INFORMATION

  • Conditional
  • Max repeat: 99
A segment specifying the reason for applying the current detailed medical activity in terms of diagnosis or clinical observation.
6415
CLINICAL INFORMATION TYPE CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of clinical information.
C836
CLINICAL INFORMATION DETAILS
  • Conditional
To specify an item of clinical information.
6413
Clinical information description identifier
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying an item of clinical information.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
6412
Clinical information description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of an item of clinical information.
C837
CERTAINTY DETAILS
  • Conditional
To specify the certainty.
4049
Certainty description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a certainty.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
4048
Certainty description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of a certainty.

PNA C 99 PARTY IDENTIFICATION

  • Conditional
  • Max repeat: 99
A segment specifying the identity number and name of any medical or administrative party related to the current activity, such as activity provider or prescriber, diagnosis originator, etc.
3035
PARTY FUNCTION CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code giving specific meaning to a party.
C206
IDENTIFICATION NUMBER
  • Conditional
The identification of an object.
7402
Object identifier
  • Mandatory
  • Type: an
  • Length: 0..35
Code specifying the unique identity of an object.
7405
Object identification code qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Code qualifying the identification of an object.
4405
Status description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a status.
C082
PARTY IDENTIFICATION DETAILS
  • Conditional
Identification of a transaction party by code.
3039
Party identifier
  • Mandatory
  • Type: an
  • Length: 0..35
Code specifying the identity of a party.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
3403
NAME TYPE CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the type of name.
3397
NAME STATUS CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the status of a name.
C816
NAME COMPONENT DETAILS
  • Conditional
To specify a name component.
3405
Name component type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of a name component.
3398
Name component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of a name component.
3401
Name component usage code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the usage of a name component.
3295
Name original alphabet code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the alphabet originally used to represent a name.
C816
NAME COMPONENT DETAILS
  • Conditional
To specify a name component.
3405
Name component type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of a name component.
3398
Name component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of a name component.
3401
Name component usage code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the usage of a name component.
3295
Name original alphabet code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the alphabet originally used to represent a name.
C816
NAME COMPONENT DETAILS
  • Conditional
To specify a name component.
3405
Name component type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of a name component.
3398
Name component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of a name component.
3401
Name component usage code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the usage of a name component.
3295
Name original alphabet code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the alphabet originally used to represent a name.
C816
NAME COMPONENT DETAILS
  • Conditional
To specify a name component.
3405
Name component type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of a name component.
3398
Name component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of a name component.
3401
Name component usage code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the usage of a name component.
3295
Name original alphabet code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the alphabet originally used to represent a name.
C816
NAME COMPONENT DETAILS
  • Conditional
To specify a name component.
3405
Name component type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of a name component.
3398
Name component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of a name component.
3401
Name component usage code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the usage of a name component.
3295
Name original alphabet code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the alphabet originally used to represent a name.
1229
ACTION REQUEST/NOTIFICATION DESCRIPTION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the action to be taken or already taken.

DTM C 99 DATE/TIME/PERIOD

  • Conditional
  • Max repeat: 99
A segment specifying dates, times and periods related to the current medical activity such as date performed, date of prescription, date of sickness and date of medical authorisation.
C507
DATE/TIME/PERIOD
  • Mandatory
Date and/or time, or period relevant to the specified date/time/period type.
2005
Date or time or period function code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the function of a date, time or period.
2380
Date or time or period text
  • Conditional
  • Type: an
  • Length: 0..35
The value of a date, a date and time, a time or of a period in a specified representation.
2379
Date or time or period format code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the representation of a date, time or period.

RFF C 99 REFERENCE

  • Conditional
  • Max repeat: 99
To specify the reference related to a detailed medical activity such as identification number of prescription and medical authorisation number. This segment may also be used to hold the reference to administrative, financial, and medical parties of the Parties Segment Group, insurance contracts of the Contracts Segment Group, and transports of the Transports Segment Group.
C506
REFERENCE
  • Mandatory
Identification of a reference.
1153
Reference code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying a reference.
1154
Reference identifier
  • Conditional
  • Type: an
  • Length: 0..70
Identifies a reference.
1156
Document line identifier
  • Conditional
  • Type: an
  • Length: 0..6
To identify a line of a document.
4000
Reference version identifier
  • Conditional
  • Type: an
  • Length: 0..35
To identify the version of a reference.
1060
Revision identifier
  • Conditional
  • Type: an
  • Length: 0..6
To identify a revision.

FTX C 99 FREE TEXT

  • Conditional
  • Max repeat: 99
A segment with free text information, in coded or clear form, specifying information about the current detailed medical activity.
4451
TEXT SUBJECT CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the subject of the text.
4453
FREE TEXT FUNCTION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the function of free text.
C107
TEXT REFERENCE
  • Conditional
Coded reference to a standard text and its source.
4441
Free text description code
  • Mandatory
  • Type: an
  • Length: 0..17
Code specifying free form text.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
C108
TEXT LITERAL
  • Conditional
Free text; one to five lines.
4440
Free text
  • Mandatory
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
3453
LANGUAGE NAME CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the language name.
4447
FREE TEXT FORMAT CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the format of free text.

QTY C 99 QUANTITY

  • Conditional
  • Max repeat: 99
A segment specifying quantities related to the detailed medical activity such as number of units of service as identified in the IMD segment. If the service type of this detailed medical activity is a modification then variations from the original quantities are given here.
C186
QUANTITY DETAILS
  • Mandatory
Quantity information in a transaction, qualified when relevant.
6063
Quantity type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of quantity.
6060
Quantity
  • Mandatory
  • Type: an
  • Length: 0..35
Alphanumeric representation of a quantity.
6411
Measurement unit code
  • Conditional
  • Type: an
  • Length: 0..8
Code specifying the unit of measurement.

PCD C 99 PERCENTAGE DETAILS

  • Conditional
  • Max repeat: 99
A segment specifying percentage used to calculate a share of a reimbursement. This information is useful when a party has already paid a certain amount, or more generally when several recipients are identified in the business scenario (e.g. 75% of a visit will be paid to the general practitioner and 25% to the patient).
C501
PERCENTAGE DETAILS
  • Mandatory
Percentage relating to a specified basis.
5245
Percentage type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of percentage.
5482
Percentage
  • Conditional
  • Type: n
  • Length: 0..10
To specify a percentage.
5249
Percentage basis identification code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the basis on which a percentage is calculated.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
4405
STATUS DESCRIPTION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a status.

PAC C 9 PACKAGE

  • Conditional
  • Max repeat: 9
A segment specifying package and number of physical units for drugs or any other materials.
7224
PACKAGE QUANTITY
  • Conditional
  • Type: n
  • Length: 0..8
To specify the number of packages.
C531
PACKAGING DETAILS
  • Conditional
Packaging level and details, terms and conditions.
7075
Packaging level code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a level of packaging.
7233
Packaging related description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying information related to packaging.
7073
Packaging terms and conditions code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the packaging terms and conditions.
C202
PACKAGE TYPE
  • Conditional
Type of package by name or by code from a specified source.
7065
Package type description code
  • Conditional
  • Type: an
  • Length: 0..17
Code specifying the type of package.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
7064
Type of packages
  • Conditional
  • Type: an
  • Length: 0..35
Description of the form in which goods are presented.
C402
PACKAGE TYPE IDENTIFICATION
  • Conditional
Identification of the form in which goods are described.
7077
Description format code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying the format of a description.
7064
Type of packages
  • Mandatory
  • Type: an
  • Length: 0..35
Description of the form in which goods are presented.
7143
Item type identification code
  • Conditional
  • Type: an
  • Length: 0..3
Coded identification of an item type.
7064
Type of packages
  • Conditional
  • Type: an
  • Length: 0..35
Description of the form in which goods are presented.
7143
Item type identification code
  • Conditional
  • Type: an
  • Length: 0..3
Coded identification of an item type.
C532
RETURNABLE PACKAGE DETAILS
  • Conditional
Indication of responsibility for payment and load contents of returnable packages.
8395
Returnable package freight payment responsibility code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the responsibility for the freight payment for a returnable package.
8393
Returnable package load contents code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the load contents for a returnable package.

GRP16 C 99 MOA TAX

  • Conditional
  • Max repeat: 99
To specify total amounts, and the relevant duty/tax/fee information about the detailed medical activity.

MOA M 1 MONETARY AMOUNT

  • Mandatory
  • Max repeat: 1
A segment specifying total amounts such as amount of fees.
C516
MONETARY AMOUNT
  • Mandatory
Amount of goods or services stated as a monetary amount in a specified currency.
5025
Monetary amount type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of monetary amount.
5004
Monetary amount
  • Conditional
  • Type: n
  • Length: 0..35
To specify a monetary amount.
6345
Currency identification code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a monetary unit.
6343
Currency type code qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Code qualifying the type of currency.
4405
Status description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a status.

TAX C 1 DUTY/TAX/FEE DETAILS

  • Conditional
  • Max repeat: 1
A segment specifying relevant tax information.
5283
DUTY OR TAX OR FEE FUNCTION CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the function of a duty or tax or fee.
C241
DUTY/TAX/FEE TYPE
  • Conditional
Code and/or name identifying duty, tax or fee.
5153
Duty or tax or fee type name code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a type of duty, tax or fee.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
5152
Duty or tax or fee type name
  • Conditional
  • Type: an
  • Length: 0..35
Name of a type of duty, tax or fee.
C533
DUTY/TAX/FEE ACCOUNT DETAIL
  • Conditional
Indication of account reference for duties, taxes and/or fees.
5289
Duty or tax or fee account code
  • Mandatory
  • Type: an
  • Length: 0..6
Code specifying a duty or tax or fee account.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
5286
DUTY OR TAX OR FEE ASSESSMENT BASIS QUANTITY
  • Conditional
  • Type: an
  • Length: 0..15
To specify the basis on which a duty or tax or fee will be assessed.
C243
DUTY/TAX/FEE DETAIL
  • Conditional
Rate of duty/tax/fee applicable to commodities or of tax applicable to services.
5279
Duty or tax or fee rate code
  • Conditional
  • Type: an
  • Length: 0..7
Code specifying a rate of a duty or tax or fee.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
5278
Duty or tax or fee rate
  • Conditional
  • Type: an
  • Length: 0..17
Rate of a duty or tax or fee.
5273
Duty or tax or fee rate basis code
  • Conditional
  • Type: an
  • Length: 0..12
Code specifying the basis for a duty or tax or fee rate.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
5305
DUTY OR TAX OR FEE CATEGORY CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a duty or tax or fee category.
3446
PARTY TAX IDENTIFIER
  • Conditional
  • Type: an
  • Length: 0..20
To identify a number assigned to a party by a tax authority.
1227
CALCULATION SEQUENCE CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a calculation sequence.

GRP17 C 99 RCS FTX

  • Conditional
  • Max repeat: 99
This segment group provides information about required administrative conditions about the reimbursement claim, such as risk identification (e.g. illness, maternity, accident, industrial accident).

RCS M 1 REQUIREMENTS AND CONDITIONS

  • Mandatory
  • Max repeat: 1
A segment specifying requirements and conditions concerning the current detailed medical activity.
7293
SECTOR AREA IDENTIFICATION CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying identification of a subject area.
C550
REQUIREMENT/CONDITION IDENTIFICATION
  • Conditional
To identify the specific rule/condition requirement.
7295
Requirement or condition description identifier
  • Mandatory
  • Type: an
  • Length: 0..17
Code specifying a requirement or condition.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
7294
Requirement or condition description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of a requirement or condition.
1229
ACTION REQUEST/NOTIFICATION DESCRIPTION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the action to be taken or already taken.
3207
COUNTRY NAME CODE
  • Conditional
  • Type: an
  • Length: 0..3
Identification of the name of the country or other geographical entity as defined in ISO 3166-1.

FTX C 9 FREE TEXT

  • Conditional
  • Max repeat: 9
A segment with free text information, in coded or clear form, illustrating or justifying a particular condition specified in the RCS segment.
4451
TEXT SUBJECT CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the subject of the text.
4453
FREE TEXT FUNCTION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the function of free text.
C107
TEXT REFERENCE
  • Conditional
Coded reference to a standard text and its source.
4441
Free text description code
  • Mandatory
  • Type: an
  • Length: 0..17
Code specifying free form text.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
C108
TEXT LITERAL
  • Conditional
Free text; one to five lines.
4440
Free text
  • Mandatory
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
3453
LANGUAGE NAME CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the language name.
4447
FREE TEXT FORMAT CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the format of free text.

GRP18 C 99 EQD SEQ

  • Conditional
  • Max repeat: 99
A group of segments providing information about the equipment used to provide the current detailed medical activity.

EQD M 1 EQUIPMENT DETAILS

  • Mandatory
  • Max repeat: 1
A segment identifying the equipment used.
8053
EQUIPMENT TYPE CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying a type of equipment.
C237
EQUIPMENT IDENTIFICATION
  • Conditional
Marks (letters/numbers) identifying equipment.
8260
Equipment identifier
  • Conditional
  • Type: an
  • Length: 0..17
To identify equipment.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
3207
Country name code
  • Conditional
  • Type: an
  • Length: 0..3
Identification of the name of the country or other geographical entity as defined in ISO 3166-1.
C224
EQUIPMENT SIZE AND TYPE
  • Conditional
Code and or name identifying size and type of equipment. Code preferred.
8155
Equipment size and type description code
  • Conditional
  • Type: an
  • Length: 0..10
Code specifying the size and type of equipment.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
8154
Equipment size and type description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of the size and type of equipment.
8077
EQUIPMENT SUPPLIER CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the party that is the supplier of the equipment.
8249
EQUIPMENT STATUS CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the status of equipment.
8169
FULL OR EMPTY INDICATOR CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code indicating whether an object is full or empty.

SEQ C 1 SEQUENCE DETAILS

  • Conditional
  • Max repeat: 1
A segment specifying the sequential number of the activity performed on the equipment.
1229
ACTION REQUEST/NOTIFICATION DESCRIPTION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the action to be taken or already taken.
C286
SEQUENCE INFORMATION
  • Conditional
Identification of a sequence and source for sequencing.
1050
Sequence position identifier
  • Mandatory
  • Type: an
  • Length: 0..10
To identify a position in a sequence.
1159
Sequence identifier source code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the source of a sequence identifier.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.

GRP19 C 999 TMD SEQ GEI FTX GRP20

  • Conditional
  • Max repeat: 999
Transports Segment Group. A group of segments specifying a transport activity related to the provision of a medical service. A transport activity comprises of several transport phases, each transport phase can be made up of several detailed transport activities.

TMD M 1 TRANSPORT MOVEMENT DETAILS

  • Mandatory
  • Max repeat: 1
A segment specifying journey trip such as a journey from a hospital to a patient home.
C219
MOVEMENT TYPE
  • Conditional
Description of type of service for movement of cargo.
8335
Movement type description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a type of movement.
8334
Movement type description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of a type of movement.
8332
EQUIPMENT PLAN DESCRIPTION
  • Conditional
  • Type: an
  • Length: 0..26
Free form description of the equipment plan.
8341
HAULAGE ARRANGEMENTS CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the arrangement for the haulage of goods.

SEQ C 1 SEQUENCE DETAILS

  • Conditional
  • Max repeat: 1
A segment allocating a sequence number to the transport activity, allowing each transport activity to be referenced from within the message.
1229
ACTION REQUEST/NOTIFICATION DESCRIPTION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the action to be taken or already taken.
C286
SEQUENCE INFORMATION
  • Conditional
Identification of a sequence and source for sequencing.
1050
Sequence position identifier
  • Mandatory
  • Type: an
  • Length: 0..10
To identify a position in a sequence.
1159
Sequence identifier source code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the source of a sequence identifier.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.

GEI C 1 PROCESSING INFORMATION

  • Conditional
  • Max repeat: 1
A segment specifying the service type of the transport activity: new transport activity, modification of a previous transport activity, cancellation of a previous transport activity or replacement for a previous transport activity.
9649
PROCESSING INFORMATION CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the processing information.
C012
PROCESSING INDICATOR
  • Conditional
Identification of the processing indicator.
7365
Processing indicator description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a processing indicator.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
7364
Processing indicator description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of a processing indicator.
7187
PROCESS TYPE DESCRIPTION CODE
  • Conditional
  • Type: an
  • Length: 0..17
Code specifying a type of process.

FTX C 99 FREE TEXT

  • Conditional
  • Max repeat: 99
A segment with free text information, in coded or clear form, specifying information about the whole transport activity.
4451
TEXT SUBJECT CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the subject of the text.
4453
FREE TEXT FUNCTION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the function of free text.
C107
TEXT REFERENCE
  • Conditional
Coded reference to a standard text and its source.
4441
Free text description code
  • Mandatory
  • Type: an
  • Length: 0..17
Code specifying free form text.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
C108
TEXT LITERAL
  • Conditional
Free text; one to five lines.
4440
Free text
  • Mandatory
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
3453
LANGUAGE NAME CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the language name.
4447
FREE TEXT FORMAT CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the format of free text.

GRP20 C 999 TDT GEI IMD PNA RFF FTX CIN QTY GRP21 GRP22 GRP23

  • Conditional
  • Max repeat: 999
A group of segments specifying one transport phase. A new phase can result from vehicle changes, crew changes, different stages, different numbers of people transported, different rates, etc. The transport activity specified in this segment group may also be related to any party specified in the Parties Segment Group such as transport service provider.

TDT M 1 TRANSPORT INFORMATION

  • Mandatory
  • Max repeat: 1
A segment identifying the transport service provider, the kind of transportation used, and the vehicle.
8051
TRANSPORT STAGE CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying a specific stage of transport.
8028
MEANS OF TRANSPORT JOURNEY IDENTIFIER
  • Conditional
  • Type: an
  • Length: 0..17
To identify a journey of a means of transport.
C220
MODE OF TRANSPORT
  • Conditional
Method of transport code or name. Code preferred.
8067
Transport mode name code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the name of a mode of transport.
8066
Transport mode name
  • Conditional
  • Type: an
  • Length: 0..17
Name of a mode of transport.
C001
TRANSPORT MEANS
  • Conditional
Code and/or name identifying the type of means of transport.
8179
Transport means description code
  • Conditional
  • Type: an
  • Length: 0..8
Code specifying the means of transport.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
8178
Transport means description
  • Conditional
  • Type: an
  • Length: 0..17
Free form description of the means of transport.
C040
CARRIER
  • Conditional
Identification of a carrier by code and/or by name. Code preferred.
3127
Carrier identifier
  • Conditional
  • Type: an
  • Length: 0..17
To identify a carrier.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
3128
Carrier name
  • Conditional
  • Type: an
  • Length: 0..35
Name of a carrier.
8101
TRANSIT DIRECTION INDICATOR CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the direction of transport.
C401
EXCESS TRANSPORTATION INFORMATION
  • Conditional
To provide details of reason for, and responsibility for, use of transportation other than normally utilized.
8457
Excess transportation reason code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying the reason for excess transportation.
8459
Excess transportation responsibility code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying the responsibility for excess transportation.
7130
Customer shipment authorisation identifier
  • Conditional
  • Type: an
  • Length: 0..17
To identify the authorisation to ship issued by the customer.
C222
TRANSPORT IDENTIFICATION
  • Conditional
Code and/or name identifying the means of transport.
8213
Transport means identification name identifier
  • Conditional
  • Type: an
  • Length: 0..35
Identifies the name of the transport means.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
8212
Transport means identification name
  • Conditional
  • Type: an
  • Length: 0..70
Name identifying a means of transport.
8453
Transport means nationality code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the nationality of a means of transport.
8281
TRANSPORT MEANS OWNERSHIP INDICATOR CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code indicating the ownership of a means of transport.

GEI C 1 PROCESSING INFORMATION

  • Conditional
  • Max repeat: 1
A segment specifying the service type of the actual transport phase: new transport phase, modification of a previous reported transport phase, cancellation of a previous reported transport phase and replacement for a previous reported transport phase.
9649
PROCESSING INFORMATION CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the processing information.
C012
PROCESSING INDICATOR
  • Conditional
Identification of the processing indicator.
7365
Processing indicator description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a processing indicator.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
7364
Processing indicator description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of a processing indicator.
7187
PROCESS TYPE DESCRIPTION CODE
  • Conditional
  • Type: an
  • Length: 0..17
Code specifying a type of process.

IMD C 9 ITEM DESCRIPTION

  • Conditional
  • Max repeat: 9
A segment identifying the current transport activity and allowing several alternative coding schemes depending on separately agreed criteria.
7077
DESCRIPTION FORMAT CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the format of a description.
C272
ITEM CHARACTERISTIC
  • Conditional
To provide the characteristic of the item being described.
7081
Item characteristic code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the characteristic of an item.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
C273
ITEM DESCRIPTION
  • Conditional
Description of an item.
7009
Item description code
  • Conditional
  • Type: an
  • Length: 0..17
Code specifying an item.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
7008
Item description
  • Conditional
  • Type: an
  • Length: 0..256
Free form description of an item.
7008
Item description
  • Conditional
  • Type: an
  • Length: 0..256
Free form description of an item.
3453
Language name code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the language name.
7383
SURFACE OR LAYER CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the surface or layer of an object.

PNA C 99 PARTY IDENTIFICATION

  • Conditional
  • Max repeat: 99
A segment identifying the party transported and the transport service provider, such as a driver.
3035
PARTY FUNCTION CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code giving specific meaning to a party.
C206
IDENTIFICATION NUMBER
  • Conditional
The identification of an object.
7402
Object identifier
  • Mandatory
  • Type: an
  • Length: 0..35
Code specifying the unique identity of an object.
7405
Object identification code qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Code qualifying the identification of an object.
4405
Status description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a status.
C082
PARTY IDENTIFICATION DETAILS
  • Conditional
Identification of a transaction party by code.
3039
Party identifier
  • Mandatory
  • Type: an
  • Length: 0..35
Code specifying the identity of a party.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
3403
NAME TYPE CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the type of name.
3397
NAME STATUS CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the status of a name.
C816
NAME COMPONENT DETAILS
  • Conditional
To specify a name component.
3405
Name component type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of a name component.
3398
Name component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of a name component.
3401
Name component usage code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the usage of a name component.
3295
Name original alphabet code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the alphabet originally used to represent a name.
C816
NAME COMPONENT DETAILS
  • Conditional
To specify a name component.
3405
Name component type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of a name component.
3398
Name component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of a name component.
3401
Name component usage code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the usage of a name component.
3295
Name original alphabet code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the alphabet originally used to represent a name.
C816
NAME COMPONENT DETAILS
  • Conditional
To specify a name component.
3405
Name component type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of a name component.
3398
Name component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of a name component.
3401
Name component usage code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the usage of a name component.
3295
Name original alphabet code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the alphabet originally used to represent a name.
C816
NAME COMPONENT DETAILS
  • Conditional
To specify a name component.
3405
Name component type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of a name component.
3398
Name component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of a name component.
3401
Name component usage code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the usage of a name component.
3295
Name original alphabet code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the alphabet originally used to represent a name.
C816
NAME COMPONENT DETAILS
  • Conditional
To specify a name component.
3405
Name component type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of a name component.
3398
Name component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of a name component.
3401
Name component usage code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the usage of a name component.
3295
Name original alphabet code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the alphabet originally used to represent a name.
1229
ACTION REQUEST/NOTIFICATION DESCRIPTION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the action to be taken or already taken.

RFF C 99 REFERENCE

  • Conditional
  • Max repeat: 99
A segment specifying references concerning the actual transport phase such as authorisation number. This segment may also be used to hold the reference to administrative, financial, and medical parties of the Parties Segment Group, and insurance contracts of Contracts Segment Group.
C506
REFERENCE
  • Mandatory
Identification of a reference.
1153
Reference code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying a reference.
1154
Reference identifier
  • Conditional
  • Type: an
  • Length: 0..70
Identifies a reference.
1156
Document line identifier
  • Conditional
  • Type: an
  • Length: 0..6
To identify a line of a document.
4000
Reference version identifier
  • Conditional
  • Type: an
  • Length: 0..35
To identify the version of a reference.
1060
Revision identifier
  • Conditional
  • Type: an
  • Length: 0..6
To identify a revision.

FTX C 99 FREE TEXT

  • Conditional
  • Max repeat: 99
A segment with free text information, in coded or clear form, specifying information about the current transport phase.
4451
TEXT SUBJECT CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the subject of the text.
4453
FREE TEXT FUNCTION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the function of free text.
C107
TEXT REFERENCE
  • Conditional
Coded reference to a standard text and its source.
4441
Free text description code
  • Mandatory
  • Type: an
  • Length: 0..17
Code specifying free form text.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
C108
TEXT LITERAL
  • Conditional
Free text; one to five lines.
4440
Free text
  • Mandatory
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
3453
LANGUAGE NAME CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the language name.
4447
FREE TEXT FORMAT CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the format of free text.

CIN C 99 CLINICAL INFORMATION

  • Conditional
  • Max repeat: 99
A segment specifying the reason for the current transport phase in terms of diagnosis or clinical observation.
6415
CLINICAL INFORMATION TYPE CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of clinical information.
C836
CLINICAL INFORMATION DETAILS
  • Conditional
To specify an item of clinical information.
6413
Clinical information description identifier
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying an item of clinical information.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
6412
Clinical information description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of an item of clinical information.
C837
CERTAINTY DETAILS
  • Conditional
To specify the certainty.
4049
Certainty description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a certainty.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
4048
Certainty description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of a certainty.

QTY C 99 QUANTITY

  • Conditional
  • Max repeat: 99
A segment specifying quantities related to the transport phase, such as number of people transported.
C186
QUANTITY DETAILS
  • Mandatory
Quantity information in a transaction, qualified when relevant.
6063
Quantity type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of quantity.
6060
Quantity
  • Mandatory
  • Type: an
  • Length: 0..35
Alphanumeric representation of a quantity.
6411
Measurement unit code
  • Conditional
  • Type: an
  • Length: 0..8
Code specifying the unit of measurement.

GRP21 C 99 ADR DTM

  • Conditional
  • Max repeat: 99
A group of segments specifying the transport legs and relevant dates and times.

ADR M 1 ADDRESS

  • Mandatory
  • Max repeat: 1
A segment specifying the address details of the transport phase such as location of departure and arrival.
C817
ADDRESS USAGE
  • Conditional
To describe the usage of an address.
3299
Address purpose code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the purpose of an address.
3131
Address type code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the type of an address.
3475
Address status code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the status of an address.
C090
ADDRESS DETAILS
  • Conditional
To specify the details of an address.
3477
Address format code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying the format of an address.
3286
Address component description
  • Mandatory
  • Type: an
  • Length: 0..70
Free form description of the component of an address.
3286
Address component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of the component of an address.
3286
Address component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of the component of an address.
3286
Address component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of the component of an address.
3286
Address component description
  • Conditional
  • Type: an
  • Length: 0..70
Free form description of the component of an address.
3164
CITY NAME
  • Conditional
  • Type: an
  • Length: 0..35
Name of a city.
3251
POSTAL IDENTIFICATION CODE
  • Conditional
  • Type: an
  • Length: 0..17
Code specifying the postal zone or address.
3207
COUNTRY NAME CODE
  • Conditional
  • Type: an
  • Length: 0..3
Identification of the name of the country or other geographical entity as defined in ISO 3166-1.
C819
COUNTRY SUB-ENTITY DETAILS
  • Conditional
To specify a part of a country (eg county or part of a city).
3229
Country sub-entity name code
  • Conditional
  • Type: an
  • Length: 0..9
Code specifying the name of a country sub-entity.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
3228
Country sub-entity name
  • Conditional
  • Type: an
  • Length: 0..70
Name of a country sub-entity.
C517
LOCATION IDENTIFICATION
  • Conditional
Identification of a location by code or name.
3225
Location name code
  • Conditional
  • Type: an
  • Length: 0..35
Code specifying the name of the location.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
3224
Location name
  • Conditional
  • Type: an
  • Length: 0..256
Name of the location.

DTM C 9 DATE/TIME/PERIOD

  • Conditional
  • Max repeat: 9
A segment specifying relevant dates and times for the transport phase such as date/time of departure, arrival and elapsed time.
C507
DATE/TIME/PERIOD
  • Mandatory
Date and/or time, or period relevant to the specified date/time/period type.
2005
Date or time or period function code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the function of a date, time or period.
2380
Date or time or period text
  • Conditional
  • Type: an
  • Length: 0..35
The value of a date, a date and time, a time or of a period in a specified representation.
2379
Date or time or period format code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the representation of a date, time or period.

GRP22 C 99 TSR FTX

  • Conditional
  • Max repeat: 99
This segment group provides information about special circumstances affecting the transport phase.

TSR M 1 TRANSPORT SERVICE REQUIREMENTS

  • Mandatory
  • Max repeat: 1
A segment specifying special circumstances affecting the current transport phase.
C536
CONTRACT AND CARRIAGE CONDITION
  • Conditional
To identify a contract and carriage condition.
4065
Contract and carriage condition code
  • Mandatory
  • Type: an
  • Length: 0..3
Code to identify the conditions of contract and carriage.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
C233
SERVICE
  • Conditional
To identify a service (which may constitute an additional component to a basic contract).
7273
Service requirement code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying a service requirement.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
7273
Service requirement code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a service requirement.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
C537
TRANSPORT PRIORITY
  • Conditional
To indicate the priority of requested transport service.
4219
Transport service priority code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying the priority of a transport service.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
C703
NATURE OF CARGO
  • Conditional
Rough classification of a type of cargo.
7085
Cargo type classification code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying the classification of a type of cargo.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.

FTX C 9 FREE TEXT

  • Conditional
  • Max repeat: 9
A segment with free text information, in coded or clear form, illustrating or justifying a particular circumstance specified in the TSR segment.
4451
TEXT SUBJECT CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the subject of the text.
4453
FREE TEXT FUNCTION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the function of free text.
C107
TEXT REFERENCE
  • Conditional
Coded reference to a standard text and its source.
4441
Free text description code
  • Mandatory
  • Type: an
  • Length: 0..17
Code specifying free form text.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
C108
TEXT LITERAL
  • Conditional
Free text; one to five lines.
4440
Free text
  • Mandatory
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
3453
LANGUAGE NAME CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the language name.
4447
FREE TEXT FORMAT CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the format of free text.

GRP23 C 999 TCC GEI IMD DTM RFF FTX QTY PCD GRP24 GRP25

  • Conditional
  • Max repeat: 999
A group of segments providing information about each transport phase specifying the transport components to be used for financial calculation.

TCC M 1 CHARGE/RATE CALCULATIONS

  • Mandatory
  • Max repeat: 1
A segment specifying charges for a transport component.
C200
CHARGE
  • Conditional
Identification of a charge by code and/or by name.
8023
Freight and other charges description identifier
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying freight and other charges.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
8022
Freight and other charges description
  • Conditional
  • Type: an
  • Length: 0..26
Free form description of freight and other charges.
4237
Payment arrangement code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the arrangements for a payment.
7140
Item identifier
  • Conditional
  • Type: an
  • Length: 0..35
To identify an item.
C203
RATE/TARIFF CLASS
  • Conditional
Identification of the applicable rate/tariff class.
5243
Rate or tariff class description code
  • Mandatory
  • Type: an
  • Length: 0..9
Code specifying an applicable rate or tariff class.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
5242
Rate or tariff class description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of an applicable rate or tariff class.
5275
Supplementary rate or tariff code
  • Conditional
  • Type: an
  • Length: 0..6
Code specifying a supplementary rate or tariff.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
5275
Supplementary rate or tariff code
  • Conditional
  • Type: an
  • Length: 0..6
Code specifying a supplementary rate or tariff.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
C528
COMMODITY/RATE DETAIL
  • Conditional
Identification of commodity/rates.
7357
Commodity identification code
  • Conditional
  • Type: an
  • Length: 0..18
Code identifying a commodity for Customs, transport or statistical purposes (generic term).
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
C554
RATE/TARIFF CLASS DETAIL
  • Conditional
Identification of the applicable rate/tariff class.
5243
Rate or tariff class description code
  • Conditional
  • Type: an
  • Length: 0..9
Code specifying an applicable rate or tariff class.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.

GEI C 1 PROCESSING INFORMATION

  • Conditional
  • Max repeat: 1
A segment specifying the service type of the actual transport component, i.e. whether this is a new transport component, modification of a previous transport component, cancellation of a previous transport component or a complete replacement of a previous transport component.
9649
PROCESSING INFORMATION CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the processing information.
C012
PROCESSING INDICATOR
  • Conditional
Identification of the processing indicator.
7365
Processing indicator description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a processing indicator.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
7364
Processing indicator description
  • Conditional
  • Type: an
  • Length: 0..35
Free form description of a processing indicator.
7187
PROCESS TYPE DESCRIPTION CODE
  • Conditional
  • Type: an
  • Length: 0..17
Code specifying a type of process.

IMD C 9 ITEM DESCRIPTION

  • Conditional
  • Max repeat: 9
A segment identifying the current transport component such as night trip, day trip, toll gate and highway.
7077
DESCRIPTION FORMAT CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the format of a description.
C272
ITEM CHARACTERISTIC
  • Conditional
To provide the characteristic of the item being described.
7081
Item characteristic code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the characteristic of an item.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
C273
ITEM DESCRIPTION
  • Conditional
Description of an item.
7009
Item description code
  • Conditional
  • Type: an
  • Length: 0..17
Code specifying an item.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
7008
Item description
  • Conditional
  • Type: an
  • Length: 0..256
Free form description of an item.
7008
Item description
  • Conditional
  • Type: an
  • Length: 0..256
Free form description of an item.
3453
Language name code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the language name.
7383
SURFACE OR LAYER CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the surface or layer of an object.

DTM C 99 DATE/TIME/PERIOD

  • Conditional
  • Max repeat: 99
A segment specifying dates and times concerning the current transport component.
C507
DATE/TIME/PERIOD
  • Mandatory
Date and/or time, or period relevant to the specified date/time/period type.
2005
Date or time or period function code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the function of a date, time or period.
2380
Date or time or period text
  • Conditional
  • Type: an
  • Length: 0..35
The value of a date, a date and time, a time or of a period in a specified representation.
2379
Date or time or period format code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the representation of a date, time or period.

RFF C 99 REFERENCE

  • Conditional
  • Max repeat: 99
To specify references of a transport component.
C506
REFERENCE
  • Mandatory
Identification of a reference.
1153
Reference code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying a reference.
1154
Reference identifier
  • Conditional
  • Type: an
  • Length: 0..70
Identifies a reference.
1156
Document line identifier
  • Conditional
  • Type: an
  • Length: 0..6
To identify a line of a document.
4000
Reference version identifier
  • Conditional
  • Type: an
  • Length: 0..35
To identify the version of a reference.
1060
Revision identifier
  • Conditional
  • Type: an
  • Length: 0..6
To identify a revision.

FTX C 99 FREE TEXT

  • Conditional
  • Max repeat: 99
A segment with free text information, in coded or clear form, illustrating or justifying the current transport component.
4451
TEXT SUBJECT CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the subject of the text.
4453
FREE TEXT FUNCTION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the function of free text.
C107
TEXT REFERENCE
  • Conditional
Coded reference to a standard text and its source.
4441
Free text description code
  • Mandatory
  • Type: an
  • Length: 0..17
Code specifying free form text.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
C108
TEXT LITERAL
  • Conditional
Free text; one to five lines.
4440
Free text
  • Mandatory
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
3453
LANGUAGE NAME CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the language name.
4447
FREE TEXT FORMAT CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the format of free text.

QTY C 99 QUANTITY

  • Conditional
  • Max repeat: 99
A segment specifying quantities related to the transport component such as number of km.
C186
QUANTITY DETAILS
  • Mandatory
Quantity information in a transaction, qualified when relevant.
6063
Quantity type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of quantity.
6060
Quantity
  • Mandatory
  • Type: an
  • Length: 0..35
Alphanumeric representation of a quantity.
6411
Measurement unit code
  • Conditional
  • Type: an
  • Length: 0..8
Code specifying the unit of measurement.

PCD C 99 PERCENTAGE DETAILS

  • Conditional
  • Max repeat: 99
A segment specifying percentage used to calculate a share of a reimbursement. This information is useful when a party has already paid a certain amount, or more generally when several recipients are identified in the business scenario (e.g. 75% of a transport will be paid to the transport service provider and 25% to the patient).
C501
PERCENTAGE DETAILS
  • Mandatory
Percentage relating to a specified basis.
5245
Percentage type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of percentage.
5482
Percentage
  • Conditional
  • Type: n
  • Length: 0..10
To specify a percentage.
5249
Percentage basis identification code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the basis on which a percentage is calculated.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
4405
STATUS DESCRIPTION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a status.

GRP24 C 99 MOA TAX

  • Conditional
  • Max repeat: 99
To specify total amounts and the relevant duty/tax/fee information.

MOA M 1 MONETARY AMOUNT

  • Mandatory
  • Max repeat: 1
A segment specifying total amounts such as amount of fees.
C516
MONETARY AMOUNT
  • Mandatory
Amount of goods or services stated as a monetary amount in a specified currency.
5025
Monetary amount type code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the type of monetary amount.
5004
Monetary amount
  • Conditional
  • Type: n
  • Length: 0..35
To specify a monetary amount.
6345
Currency identification code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a monetary unit.
6343
Currency type code qualifier
  • Conditional
  • Type: an
  • Length: 0..3
Code qualifying the type of currency.
4405
Status description code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a status.

TAX C 1 DUTY/TAX/FEE DETAILS

  • Conditional
  • Max repeat: 1
A segment specifying relevant tax information.
5283
DUTY OR TAX OR FEE FUNCTION CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the function of a duty or tax or fee.
C241
DUTY/TAX/FEE TYPE
  • Conditional
Code and/or name identifying duty, tax or fee.
5153
Duty or tax or fee type name code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a type of duty, tax or fee.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
5152
Duty or tax or fee type name
  • Conditional
  • Type: an
  • Length: 0..35
Name of a type of duty, tax or fee.
C533
DUTY/TAX/FEE ACCOUNT DETAIL
  • Conditional
Indication of account reference for duties, taxes and/or fees.
5289
Duty or tax or fee account code
  • Mandatory
  • Type: an
  • Length: 0..6
Code specifying a duty or tax or fee account.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
5286
DUTY OR TAX OR FEE ASSESSMENT BASIS QUANTITY
  • Conditional
  • Type: an
  • Length: 0..15
To specify the basis on which a duty or tax or fee will be assessed.
C243
DUTY/TAX/FEE DETAIL
  • Conditional
Rate of duty/tax/fee applicable to commodities or of tax applicable to services.
5279
Duty or tax or fee rate code
  • Conditional
  • Type: an
  • Length: 0..7
Code specifying a rate of a duty or tax or fee.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
5278
Duty or tax or fee rate
  • Conditional
  • Type: an
  • Length: 0..17
Rate of a duty or tax or fee.
5273
Duty or tax or fee rate basis code
  • Conditional
  • Type: an
  • Length: 0..12
Code specifying the basis for a duty or tax or fee rate.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
5305
DUTY OR TAX OR FEE CATEGORY CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a duty or tax or fee category.
3446
PARTY TAX IDENTIFIER
  • Conditional
  • Type: an
  • Length: 0..20
To identify a number assigned to a party by a tax authority.
1227
CALCULATION SEQUENCE CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a calculation sequence.

GRP25 C 99 TSR FTX

  • Conditional
  • Max repeat: 99
This segment group provides information about special circumstances affecting the current transport component.

TSR M 1 TRANSPORT SERVICE REQUIREMENTS

  • Mandatory
  • Max repeat: 1
A segment specifying special circumstances affecting the current transport component.
C536
CONTRACT AND CARRIAGE CONDITION
  • Conditional
To identify a contract and carriage condition.
4065
Contract and carriage condition code
  • Mandatory
  • Type: an
  • Length: 0..3
Code to identify the conditions of contract and carriage.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
C233
SERVICE
  • Conditional
To identify a service (which may constitute an additional component to a basic contract).
7273
Service requirement code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying a service requirement.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
7273
Service requirement code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying a service requirement.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
C537
TRANSPORT PRIORITY
  • Conditional
To indicate the priority of requested transport service.
4219
Transport service priority code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying the priority of a transport service.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
C703
NATURE OF CARGO
  • Conditional
Rough classification of a type of cargo.
7085
Cargo type classification code
  • Mandatory
  • Type: an
  • Length: 0..3
Code specifying the classification of a type of cargo.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.

FTX C 9 FREE TEXT

  • Conditional
  • Max repeat: 9
A segment with free text information, in coded or clear form, illustrating or justifying a particular circumstance specified in the TSR segment.
4451
TEXT SUBJECT CODE QUALIFIER
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the subject of the text.
4453
FREE TEXT FUNCTION CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the function of free text.
C107
TEXT REFERENCE
  • Conditional
Coded reference to a standard text and its source.
4441
Free text description code
  • Mandatory
  • Type: an
  • Length: 0..17
Code specifying free form text.
1131
Code list identification code
  • Conditional
  • Type: an
  • Length: 0..17
Code identifying a user or association maintained code list.
3055
Code list responsible agency code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the agency responsible for a code list.
C108
TEXT LITERAL
  • Conditional
Free text; one to five lines.
4440
Free text
  • Mandatory
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
4440
Free text
  • Conditional
  • Type: an
  • Length: 0..512
Free form text.
3453
LANGUAGE NAME CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the language name.
4447
FREE TEXT FORMAT CODE
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the format of free text.

GRP26 C 9 AUT DTM

  • Conditional
  • Max repeat: 9
A group of segments providing an authentication result for the message. This segment group can also be used for authentication results of message sender or receiver.

AUT M 1 AUTHENTICATION RESULT

  • Mandatory
  • Max repeat: 1
A segment specifying the result of an authentication procedure.
9280
VALIDATION RESULT TEXT
  • Mandatory
  • Type: an
  • Length: 0..35
To specify the value of a validation result.
9282
VALIDATION KEY IDENTIFIER
  • Conditional
  • Type: an
  • Length: 0..35
To identify the cryptographic key used for the calculation of the validation.

DTM C 9 DATE/TIME/PERIOD

  • Conditional
  • Max repeat: 9
A segment specifying dates and times of an authentication result.
C507
DATE/TIME/PERIOD
  • Mandatory
Date and/or time, or period relevant to the specified date/time/period type.
2005
Date or time or period function code qualifier
  • Mandatory
  • Type: an
  • Length: 0..3
Code qualifying the function of a date, time or period.
2380
Date or time or period text
  • Conditional
  • Type: an
  • Length: 0..35
The value of a date, a date and time, a time or of a period in a specified representation.
2379
Date or time or period format code
  • Conditional
  • Type: an
  • Length: 0..3
Code specifying the representation of a date, time or period.

UNT M 1 MESSAGE TRAILER

  • Mandatory
  • Max repeat: 1
A service segment ending a message, giving the total number of segments in the message (including the UNH & UNT) and the control reference number of the message.
0074
NUMBER OF SEGMENTS IN A MESSAGE
  • Mandatory
  • Type: n
  • Length: 0..10
The number of segments in a message body, plus the message header segment and message trailer segment.
0062
MESSAGE REFERENCE NUMBER
  • Mandatory
  • Type: an
  • Length: 0..14
Unique message reference assigned by the sender.