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This section describes how the HL7 MSH segment is mapped into the Medicalis databases. We use a table to describe the relationship between the HL7 Element and the database column. It is assumed that this description can be used to encode mappings from HL7 to SQL and from SQL to HL7.

HL7 Element HL7 Element Name Database.Table.Column

MSH-1.1.1 Field Separator

MSH-2.1.1 Encoding Characters

MSH-4.1.1 Sending Facility.Namespace ID MSH-5.1.1 Receiving Application.Namespace ID MSH-6.1.1 Receiving Facility.Namespace ID MSH-7.1.1 Date/Time of Message.Time MSG-9.1.1 Message Type.Message Code Id MSH-9.2.1 Message Type.Trigger Event MSH-10.1.1 Message Control Id MSH-11.1.1 Processing ID.Processing ID MSH-12.1.1 Version ID.Version ID

5.2 EVN Segment

HL7 Element

HL7 Element Name Database.Table.Column Length Notes

EVN-1.1.1 Event Type Code <<event type code>> (only in ADT

messages) EVENT_PATIENT_REGISTRATION = "PRG"; EVENT_PATIENT_UPDATE = "PUP"; EVENT_PATIENT_LINK = "PLK"; EVENT_PATIENT_MERGE = "PMG"; EVENT_ALTERNATE_ID_ADD = "AAD"; EVENT_ALTERNATE_ID_REMOVE = "ARM"; EVENT_GUARANTOR_UPDATE = "GUP"; EVENT_GUARANTOR_REMOVE = "GRM"; EVENT_INSURANCE_UPDATE = "IUP"; EVENT_INSURANCE_REMOVE = "IRM"; EVENT_PROVIDER_UPDATE = "RUP"; EVENT_PROVIDER_REMOVE = "RRM"; EVENT_ALLERGY_UPDATE = "LUP"; EVENT_ALLERGY_REMOVE = "LRM"; EVENT_VISIT_STATUS = "VUP";

EVN-2.1.1 Recorded Date/Time <<event generated timestamp>>

EVN-3.1.1 Date/Time Planned Event EVN-4.1.1 Event Reason Code

EVN-5.1.1 Operator ID- ID Number MSystem.MtfUserCredential.userId 45 EVN-5.2.1 Operator ID- Family Name MSystem.MtfUser.Contact.familyName 50

EVN-5.3.1 Operator ID- Given Name MSystem.MtfUser.Contact.givenName 50 EVN-5.4.1 Operator ID- Second and Further Given

Names or Initials Thereof

MSystem.MtfUser.Contact.middleName 50

EVN-5.5.1 Operator ID- Suffix MSystem.MtfUser.Contact.suffix 50 EVN-5.6.1 Operator ID- Prefix MSystem.MtfUser.Contact.title 50 EVN-5.7.1 Operator ID- Degree MSystem.MtfUser.Contact.degreeCd 10 EVN-6.1.1 Event Occurred

EVN-7.1.1 Event Facility- Namespace ID MClinical.Location.Issuer.issuerId (OMI, ORU, MDM)

45

EVN-7.2.1 Event Facility- Universal ID MClinical.Location.locationId (OMI, ORU, MDM)

45

5.3 PID

The PID segment is used by all applications as the primary means of communicating patient identification information. This segment contains permanent patient identifying and demographic information that, for the most part, is not likely to change frequently. The CDR stores one (1) patient record for each repeated patient identifier/issuer (PID-3). Patient records contain all of the demographic data transmitted in a message. When multiple identifiers are provided, a patient record is created for each identifier. All new records initially contain copies of the same

demographic information. When updates are received, the update will be applied to all records where the identifier for the record is present in the message (PID-3 list). This allows patient records to be synchronized, managed in groups, or managed individually by Assigning Authority (a.k.a Issuer).

PATIENT LINKING: All patient records present in the same message (PID-3 list) are considered to be the same “person”. Therefore, in this case, patient records are automatically linked. A Person record is simply a linking mechanism and does not sore any human readable information about the patient. A patient record cannot be linked to more than 1 person at a time. So if a patient record with ID “123” is linked to other patient records (forming person A), and ID “123” is sent in the PID-3 list containing IDs for a different person, the “123” patient record will be unlinked form Person A, and linked to Person B. The first sequence in PID-3 is considered the “Primary Patient Identifier”. This essentially dictates the “link to” record. All other IDs are secondary and will be linked to the person that the Primary Patient Identifier is linked to.

HL7 Element

HL7 Element Name Database.Table.Column Length Notes Usage

PID-3.1.1 Patient ID.ID Number MClinical.Patient.patientId 45 R

PID-3.4.1 Patient ID.Assigning Authority.Namespace ID

MClinical.Issuer.issuerId 45 R

PID-4.1.1 Alternate Patient ID List.ID Number MClinical.AlternatePatientId.patientId 45 PID-4.4.1 Alternate Patient ID List.Assigning

Authority.Namespace ID

MClinical.Issuer.issuerId 45

PID-5.1.1 Patient Name.Family Name.Surname MClinical.Patient.Contact.familyName 50 R PID-5.2.1 Patient Name.Given Name MClinical.Patient.Contact.givenName 50

PID-5.3.1 Patient Name.Second and Further Given Names or Initials Thereof

MClinical.Patient.Contact.middleName 50

PID-5.4.1 Patient Name.Suffix MClinical.Patient.Contact.suffix 50 PID-5.5.1 Patient Name.Prefix MClinical.Patient.Contact.title 50 PID-5.6.1 Patient Name.Degree MClinical.Patient.Contact.degreeCd 10 PID-5.7.1 Name Type Code MClinical.mapPatientContact

.patientContactUseCd

16

PID-6.1.1 Mother's Maiden Name.Family Name.Surname

MClinical.Patient.mothersMaidenName 60

PID-7.1.1 Date/Time of Birth.Time MClinical.Patient.patientBirthDateTime DATETIME

PID-8.1.1 Administrative Sex MClinical.Patient.individualSexCd 10 Dictionary: Individual_Sex

PID-10.1.1 Race MClinical.Patient.patientRaceCd 10

PID-11.1.1 Patient Address.Street Address.Street or Mailing Address

MClinical.Patient.Contact.Address.addr ess1

199

PID-11.3.1 Patient Address.City MClinical.Patient.Contact.Address.city 199 PID-11.4.1 Patient Address.State or Province MClinical.Patient.Contact.Address

.provinceStateCd

10 Dictionary: Province/State

PID-11.5.1 Patient Address.Zip or Postal Code MClinical.Patient.Contact.Address.posta lZipCd

199

PID-11.6.1 Patient Address.Country MClinical.Patient.Contact.Address.count ryCd

3 Dictionary: Country

PID-11.7.1 Patient Address.Address Type MClinical.Patient.Contact.Address .addressType

3 Dictionary: Address_Type

PID-11.8.1 Other Geographic Designation MClinical.Patient.Contact.Address .otherGeographicDesignation

199

PID-13.1.1 Phone Number – Home MClinical.Patient.Contact.PhoneNumber .phoneNumber

60

PID-13.2.1 Telecommunication Use Code MClinical.Patient.Contact.PhoneNumber .contactPhoneNumberUseCd

MClinical.Patient.Contact.EmailAddress .contactEmailAddressUseCd

3 Defaults to 'HP' (Home Phone) for phone numbers or 'P' (Personal) for email addresses PID-13.4.1 Email Address MClinical.Patient.Contact.EmailAddress

PID-14.1.1 Phone Number – Business MClinical.Patient.Contact.PhoneNumber .phoneNumber

60

PID-14.2.1 Telecommunication Use Code MClinical.Patient.Contact.PhoneNumbe r

.contactPhoneNumberUseCd

MClinical.Patient.Contact.EmailAddress .contactEmailAddressUseCd

3 Defaults to 'WP' (Work Phone) for phone numbers or 'O' (Office) for email addresses PID-14.4.1 Email Address MClinical.Patient.Contact.EmailAddress

PID-15.1.1 Primary Language MClinical.Patient.languageCd 3

PID-16.1.1 Marital Status MClinical.Patient.maritalStatusCd 10

PID-17.1.1 Religion MClinical.Patient.patientReligionCd 10

PID-18.1.1 Patient Account Number MClinical.Patient.patientAccountNumber 255 PID-19.1.1 SSN Number – Patient.ID Number MClinical.Patient.ssn 50 PID-20.1.1 Driver's License Number MClinical.Patient.driversLicense 199 PID-25.1.1 Birth Order MClinical.Patient.birthOrderIdentifier TINYINT

PID-29.1.1 Patient Death Date/Time MClinical.Patient.patientDeathDateTime DATETIME PID-31.1.1 Identity Unknown Indicator MClinical.Patient.identityUnknown FLAG PID-32.1.1 Identity Reliability Codde MClinical.Patient..identityReliabilityCd 10 PID-34.1.1 Event Facility- Namespace ID MClinical.Location.Issuer.issuerId 45

PID-34.2.1 Event Facility- Universal ID MClinical.Location.locationId 45

5.4 PD1

HL7 Element

HL7 Element Name Database.Table.Column Length Notes

patientProviderUseCd = 'PP'

(Primary Care Provider) PD1-4.1.1 Patient Primary Care Provider & ID No.ID

Number

MClinical.Patient.Provider.providerId 45

PD1-4.2.1 Patient Primary Care Provider & ID No.Family Name.Surname

MClinical.Patient.Provider.Contact.familyName 50

PD1-4.3.1 Patient Primary Care Provider & ID No.Given Name

MClinical.Patient.Provider.Contact.givenName 50

PD1-4.4.1 Patient Primary Care Provider & ID No.Second

and Further Given Names or Initials Thereof

MClinical.Patient.Provider.Contact.middleName 50

PD1-4.5.1 Patient Primary Care Provider & ID No.Suffix

MClinical.Patient.Provider.Contact.suffix 50

PD1-4.6.1 Patient Primary Care Provider & ID No.Prefix

MClinical.Patient.Provider.Contact.title 50

PD1-4.7.1 Patient Primary Care Provider & ID No.Degree

MClinical.Patient.Provider.Contact.degreeCd 10

PD1-4.9.1 Patient Primary Care Provider & ID No.Assigning Authority.Namespace ID

MClinical.Patient.Provider.Issuer.issuerId 45

PD1-4.22.1 Patient Primary Care Provider NPI MClinical.Patient.Provider.NPI 50 PD1-4.22.4 Patient Primary Care Provider UPIN MClinical.Patient.Provider.UPIN 50 PD1-12.1.1 Protection Indicator (ID) MClinical.Patient.confidentialityConstraint FLAG PD1-13.1.1 Identifier Type Code MClinical.Patient.Provider.providerUseCd 16

PD1-22.1.1 Phone Number - Cell <<Use PID-13>>

PD1-23.1.1 Email Address – Personal <<Use PID-13>>

PD1-24.1.1 Email Address – Business <<Use PID-14>>

The LAN segment adds detailed language information to the patient identified by the PID segment. HL7

Element

HL7 Element Name Database.Table.Column Length Notes

LAN-1.1.1 Set ID

LAN-2.1.1 Language Code EN (English) is the only value supported

LAN-3.1.1 Language Ability Code LAN-4.1.1 Language Proficiency

Code

MClinical.Patient.translationServiceRequired FLAG 1,2,3 = false (no translation service required)

4,5,6 = true (translation service required) 1 Excellent

2 Good 3 Fair 4 Poor

5 Some (level unknown) 6 None

5.6 ROL

The ROL segment contains the data about record persons involved, as well as their functional involvement with the activity being transmitted.

HL7 Element Designator HL7 Element Name Database.Table.Column Length

ROL-1.1.1 Role Instance ID

ROL-2.1.1 Action Code

ROL-3.1.1 Role MClinical.Patient.Provider.providerUseCd 16

ROL-4.1.1 Role Person ID Number MClinical.Patient.Provider.providerId 45

ROL-4.2.1 Role Person Family Name MClinical.Patient.Provider.Contact.familyName 50

ROL-4.3.1 Role Person Given Name MClinical.Patient.Provider.Contact.givenName 50

ROL-4.4.1 Role Person Second and Further Given Names MClinical.Patient.Provider.Contact.middleName 50

ROL-4.5.1 Role Person Suffix MClinical.Patient.Provider.Contact.suffix 50

ROL-4.6.1 Role Person Prefix MClinical.Patient.Provider.Contact.title 50

ROL-4.7.1 Role Person Degree MClinical.Patient.Provider.Contact.degreeCd 10

ROL-4.9.1 Role Person Assigning Authority MClinical.Patient.Provider.Issuer.issuerId 45 ROL-4.15.1 Role Person Name Representation Code

ROL-4.22.1 Patient Primary Care Provider NPI MClinical.Patient.Provider.NPI 50

5.7 NK1

The NK1 segment contains information about the patient’s other related parties. Any associated parties may be identified. HL7

Element

HL7 Element Name Database.Table.Column Length Notes

NK1-1.1.1 Set ID

NK1-2.1.1 Family Name MClinical.Patient.Contact.familyName 50

NK1-2.2.1 Given Name MClinical.Patient.Contact.givenName 50

NK1-2.3.1 Second and Further Given Names or Initials Thereof

MClinical.Patient.Contact.middleName 50

NK1-2.4.1 Suffix MClinical.Patient.Contact.suffix 50

NK1-2.5.1 Prefix MClinical.Patient.Contact.title 50

NK1-2.6.1 Degree MClinical.Patient.Contact.degreeCd 10

NK1-2.7.1 Name Type Code MClinical.mapPatientContact.patientContactUseCd 10

NK1-3.1.1 Relationship MClinical.mapPatientContact.relationTypeCd 10

NK1-4.1.1 Patient Address.Street

Address.Street or Mailing Address

MClinical.Patient.Contact.Address.address1 199

NK1-4.3.1 Patient Address.City MClinical.Patient.Contact.Address.city 199

NK1-4.4.1 Patient Address.State or Province MClinical.Patient.Contact.Address.provinceStateCd 10 Dictionary: Province/State

NK1-4.5.1 Patient Address.Zip or Postal Code MClinical.Patient.Contact.Address.postalZipCd 199

NK1-4.6.1 Patient Address.Country MClinical.Patient.Contact.Address.countryCd 3 Dictionary: Country

NK1-4.7.1 Patient Address.Address Type MClinical.Patient.Contact.Address.addressType 3 Dictionary: Address_Type

NK1-4.8.1 Other Geographic Designation MClinical.Patient.Contact.Address.otherGeographicDesignation 199 NK1-5.1.1 Phone Number MClinical.Patient.Contact.PhoneNumber.phoneNumber 60 NK1-5.2.1 Telecommunication Use Code MClinical.mapContactPhoneNumber.contactPhoneNumberUseCd 3 NK1-6.1.1 Business Phone Number MClinical.Patient.Contact.PhoneNumber.phoneNumber 60 NK1-6.2.1 Business Telecommunication Use

Code

MClinical.mapContactPhoneNumber.contactPhoneNumberUseCd 3

NK1-7.1.1 Contact Role MClinical.mapPatientContact.patientContactUseCd 10

5.8 PV1

We only create a visit if there is an Admission Number PV1-19 (i.e. Visit Number). HL7

Element

HL7 Element Name Database.Table.Column Length Notes

PV1-2.1.1 Patient Class MClinical.Visit.patientClassCd 3 Dictionary:

PV1-3.1.1 + '^' + PV1-3.2.1 + '^' + PV1-3.3.1 + '^' + PV1-3.4.1

Assigned Patient Location.Point of Care + Assigned Patient Location.Room + Assigned Patient Location.Bed + Assigned Patient Location.Facility.Namespace ID MClinical.Visit.Location.locationName 255 PV1-3.4.1 Assigned Patient Location.Facility.Namespace ID MClinical.Visit.Location.locationName 255

PV1-3.4.2 Assigned Patient Location.Facility.Universal Id

MSystem.Node.nodeId 45

PV1-3.9.1 Assigned Patient Location.Location Description

MClinical.Visit.Location.description 1024

PV1-3.10.1 Assigned Patient Location.Comprehensive Location Identifier.Entity Identifier

MClinical.Visit.Location.locationId 45

PV1-3.10.2 Assigned Patient Location.Comprehensive Location Identifier.Namespace ID

MClinical.Visit.Location.Issuer.issuerId 45

PV1-3.11.1 Assigned Patient Location. Assigning Authority.Namespace ID

MClinical.Visit.Location.assigningAuthorityCd 10

PV1-4.1.1 Admission Type MClinical.Visist.addmissionTypeCd 3

visitProviderUseCd = 'ATN'

PV1-7.1.1 Attending Doctor ID Number MClinical.Visit.Provider.providerId 45 PV1-7.2.1 Attending Doctor Family Name MClinical.Visit.Provider.Contact.familyName 50 PV1-7.3.1 Attending Doctor Given Name MClinical.Visit.Provider.Contact.givenName 50 PV1-7.4.1 Attending Doctor Second

and Further Given Names

MClinical.Visit.Provider.Contact.middleName 50

PV1-7.5.1 Attending Doctor Suffix MClinical.Visit.Provider.Contact.suffix 50 PV1-7.6.1 Attending Doctor Prefix MClinical.Visit.Provider.Contact.title 50 PV1-7.7.1 Attending Doctor Degree MClinical.Visit.Provider.Contact.degreeCd 10 PV1-7.9.1 Attending Doctor Assigning Authority MClinical.Visit.Provider.Issuer.issuerId 45 PV1-7.13.1 Attending Doctor Identifier Type Code MClinical.Visit.Provider.providerUseCd 16

PV1-7.22.1 Attending Doctor NPI MClinical.Visit.Provider.NPI 50

PV1-7.22.4 Attending Doctor UPIN MClinical.Visit.Provider.UPIN 50

visitProviderUseCd = 'REF'

PV1-8.1.1 Referring Doctor.ID Number MClinical.Visit.Provider.providerId 45 PV1-8.2.1 Referring Doctor.Family Name.Surname MClinical.Visit.Provider.Contact.familyName 50 PV1-8.3.1 Referring Doctor.Given Name MClinical.Visit.Provider.Contact.givenName 50

PV1-8.4.1 Referring Doctor.Second and

Further Given Names or Initials Thereof

MClinical.Visit.Provider.Contact.middleName 50

PV1-8.5.1 Referring Doctor.Suffix MClinical.Visit.Provider.Contact.suffix 50 PV1-8.6.1 Referring Doctor.Prefix MClinical.Visit.Provider.Contact.title 50 PV1-8.7.1 Referring Doctor.Degree MClinical.Visit.Provider.Contact.degreeCd 10 PV1-8.9.1 Referring Doctor.

Assigning Authority.Namespace ID

MClinical.Visit.Provider.Issuer.issuerId 45

PV1-8.13.1 Referring Doctor Identifier Type Code MClinical.Visit.Provider.providerUseCd 16

PV1-8.22.1 Referring Doctor NPI MClinical.Visit.Provider.NPI 50

PV1-8.22.4 Referring Doctor UPIN MClinical.Visit.Provider.UPIN 50

visitProviderUseCd = 'CON'

PV1-9.1.1 Consulting Doctor ID Number MClinical.Visit.Provider.providerId 45 PV1-9.2.1 Consulting Doctor Family Name MClinical.Visit.Provider.Contact.familyName 50 PV1-9.3.1 Consulting Doctor Given Name MClinical.Visit.Provider.Contact.givenName 50 PV1-9.4.1 Consulting Doctor Second

and Further Given Names

MClinical.Visit.Provider.Contact.middleName 50

PV1-9.5.1 Consulting Doctor Suffix MClinical.Visit.Provider.Contact.suffix 50 PV1-9.6.1 Consulting Doctor Prefix MClinical.Visit.Provider.Contact.title 50 PV1-9.7.1 Consulting Doctor Degree MClinical.Visit.Provider.Contact.degreeCd 10 PV1-9.9.1 Consulting Doctor Assigning Authority MClinical.Visit.Provider.Issuer.issuerId 45 PV1-9.13.1 Consulting Doctor Identifier Type Code MClinical.Visit.Provider.providerUseCd 16

PV1-9.22.1 Consulting Doctor NPI MClinical.Visit.Provider.NPI 50

PV1-9.22.4 Consulting Doctor UPIN MClinical.Visit.Provider.UPIN 50

Hospital Service MClinical.Visit.hospitalServiceCd 10

PV1-14.1.1 Admit Source MClinical.Visit.admitSourceCd 3

PV1.15.1.1 Ambulatory Status MClinical.Visit.ambulatoryStatusCd 9 Dictionary:

Ambulatory_Status

PV1.16.1.1 VIP indicator MClinical.Patient.vipStatusCd Support coming in

future release visitProviderUseCd = 'ADM'

PV1-17.1.1 Admitting Doctor.ID Number MClinical.Visit.Provider.providerId 45 PV1-17.2.1 Admitting Doctor.Family Name.Surname MClinical.Visit.Provider.Contact.familyName 50 PV1-17.3.1 Admitting Doctor.Given Name MClinical.Visit.Provider.Contact.givenName 50 PV1-17.4.1 Admitting Doctor.Second and

Further Given Names or Initials Thereof

MClinical.Visit.Provider.Contact.middleName 50

PV1-17.5.1 Admitting Doctor.Suffix MClinical.Visit.Provider.Contact.suffix 50 PV1-17.6.1 Admitting Doctor.Prefix MClinical.Visit.Provider.Contact.title 50

PV1-17.7.1 Admitting Doctor.Degree MClinical.Visit.Provider.Contact.degreeCd 10 PV1-17.9.1 Admitting Doctor.

Assigning Authority.Namespace ID

MClinical.Issuer.issuerId 45

PV1-17.13.1 Admitting Doctor Identifier Type Code MClinical.Visit.Provider.providerUseCd 16

PV1-17.22.1 Admitting Doctor NPI MClinical.Visit.Provider.NPI 50

PV1-17.22.4 Admitting Doctor UPIN MClinical.Visit.Provider.UPIN 50

PV1-19.1.1 Visit Number.ID Number MClinical.Visit.admissionNum 64

PV1-19.4.1 Visit Number.Assigning Authority.Namespace ID

MClinical.Visit.Issuer.issuerId 45

PV1-44.1.1 Admit Date/Time.Time MClinical.Visit.admittingDateTime DATETIME

PV1-50.1.1 Visit Indicator MClinical.Visit.visitIndicatorCd 3

5.9 PV2

HL7 Element HL7 Element Name Database.Table.Column Length

PV2-7 Visit User Code MClinical.Visit.visitStatusCd 3

PV2-12.1.1 Visit Description MClinical.Visit.description 2048

5.10 AL1

We assume all allergy information for a specific source system(s) is provided in the segment. We clear all allergy information for the source system(s) before inserting to eliminate duplicates.

HL7 Element

HL7 Element Name Database.Table.Column Length Usage Notes

AL1-1.1.1 Set ID – AL1

AL1-2.1.1 Allergen Type Code MClinical.Allergy.allergenTypeCd 10 R Dictionary:

Allergen_Type

AL1-3.2.1 Allergen

Code/Mnemonic/Description

MClinical.Allergy.allergyComment max

AL1-4.1.1 Allergy Severity Code MClinical.Allergy.allergySeverityCd 10 R Dictionary: Allergy_Severity

AL1-5.1.1 Allergy Reaction Code MClinical.Allergy.allergyReaction 12 AL1-6.1.1 Identification Date MClinical.Allergy.identificationDate DATETIME

AL1-7.1.1 Allergy Reliability Code MClinical.Allergy.allergyReliabilityCd 10 Dictionary: Allergy_Reliability

AL1-8.1.1 Allergy Clinical Status Code MClinical.Allergy.allergyClinicalStatusCd 10 Dictionary:

Allergy_Clinical_Status

AL1-9.1.1 Entered By MClinical.Allergy.enteredBy 255

AL1-10.1.1 Source System Identifier MClinical.Allergy.sourceSystemKey/MSystem.Node.nodeId 45 R

HL7 Element

HL7 Element Name Database.Table.Column Length Notes

GT1-1.1.1 Set ID - GT1

GT1-2.1.1 Guarantor Number MClinical.Guarantor.guarantorNumber 45

guarantorContactUseCd = P

GT1-3.1.1 Guarantor Name Family Name

MClinical.Guarantor.Contact.familyName 50

GT1-3.2.1 Guarantor Name Given Name

MClinical.Guarantor.Contact.givenName 50

GT1-3.3.1 Guarantor Name Second and Further Given Names

MClinical.Guarantor.Contact.middleName 50

GT1-3.4.1 Guarantor Name Suffix MClinical.Guarantor.Contact.suffix 50 GT1-3.5.1 Guarantor Name Prefix MClinical.Guarantor.Contact.title 50 GT1-3.6.1 Guarantor Name Degree MClinical.Guarantor.Contact.degreeCd 10 GT1-5.1.1 Guarantor Address Street

Address

MClinical.Guarantor.Contact.Address.address1 199

GT1-5.3.1 Guarantor Address City MClinical.Guarantor.Contact.Address.city 199 GT1-5.4.1 Guarantor Address State or

Province

MClinical.Guarantor.Contact.Address.provinceStateCd 10 Dictionary: Province/State

GT1-5.5.1 Guarantor Address Zip or Postal Code

MClinical.Guarantor.Contact.Address.postalZipCd 199

GT1-5.6.1 Guarantor Address Country MClinical.Guarantor.Contact.Address.countryCd 3 Dictionary: Country

GT1-5.7.1 Guarantor Address Type MClinical.Guarantor.Contact.Address.addressType 3 Dictionary: Address_Type GT1-5.8.1 Guarantor Address Other Geographic Designation MClinical.Guarantor.Contact. Address.otherGeographicDesignation 199

GT1-6.1.1 Guarantor Phone Number Home

MClinical.Guarantor.Contact.PhoneNumber.phoneNumber 60

GT1-6.2.1 Guarantor Phone Number Home Telecommunication Use Code MClinical.Guarantor.Contact. PhoneNumber.contactPhoneNumberUseCd 3

GT1-7.1.1 Guarantor Phone Number Business

MClinical.Guarantor.Contact.PhoneNumber.phoneNumber 60

GT1-7.2.1 Guarantor Phone Number Business Telecommunication Use Code MClinical.Guarantor.Contact. PhoneNumber.contactPhoneNumberUseCd 3

GT1-8.1.1 Guarantor Date/Time of Birth MClinical.Guarantor.guarantorBirthDateTime DATETIME

GT1-9.1.1 Guarantor Administrative Sex MClinical.Guarantor.individualSexCd 10 Dictionary: Individual_Sex

GT1-12.1.1 Guarantor SSN MClinical.Guarantor.ssn 50 GT1-13.1.1 Guarantor Date - Begin MClinical.Guarantor.guarantorStartDate DATETIME GT1-14.1.1 Guarantor Date - End MClinical.Guarantor.guarantorEndDate DATETIME

guarantorContactUseCd = E

GT1-16.1.1 Guarantor Employer Name Family Name

MClinical.Guarantor.Contact.familyName 50

GT1-16.2.1 Guarantor Employer Name Given Name

MClinical.Guarantor.Contact.givenName 50

GT1-16.3.1 Guarantor Employer Name Second

and Further Given Names

MClinical.Guarantor.Contact.middleName 50

GT1-16.4.1 Guarantor Employer Name Suffix

MClinical.Guarantor.Contact.suffix 50

GT1-16.5.1 Guarantor Employer Name Prefix

MClinical.Guarantor.Contact.title 50

GT1-16.6.1 Guarantor Employer Name Degree

MClinical.Guarantor.Contact.degreeCd 10

GT1-17.1.1 Guarantor Employer Address Street Address

MClinical.Guarantor.Contact.Address.address1 199

GT1-17.3.1 Guarantor Employer Address City

MClinical.Guarantor.Contact.Address.city 199

GT1-17.4.1 Guarantor Employer Address State or Province

MClinical.Guarantor.Contact.Address.provinceStateCd 10 Dictionary: Province/State

GT1-17.5.1 Guarantor Employer Address Zip or Postal Code

MClinical.Guarantor.Contact.Address.postalZipCd 199

GT1-17.6.1 Guarantor Employer Address Country

MClinical.Guarantor.Contact.Address.countryCd 3 Dictionary: Country

GT1-17.7.1 Guarantor Employer Address Type

MClinical.Guarantor.Contact.Address.addressType 3 Dictionary: Address_Type

GT1-17.8.1 Guarantor Employer Address Other Geographic

Designation

MClinical.Guarantor.Contact. Address.otherGeographicDesignation

199

GT1-18.1.1 Guarantor Employer Phone Number MClinical.Guarantor.Contact.PhoneNumber.phoneNumber 60 GT1-18.2.1 Guarantor Employer Telecommunication Use Code MClinical.Guarantor.Contact. PhoneNumber.contactPhoneNumberUseCd 3 GT1-19.1.1 Guarantor Employee ID Number MClinical.Guarantor.employeeId 255 GT1-20.1.1 Guarantor Employment Status MClinical.Guarantor.employmentStatusCd 10 guarantorContactUseCd = O

GT1-45.1.1 Contact Person's Name Family Name

MClinical.Guarantor.Contact.familyName 50

GT1-45.2.1 Contact Person's Name Given Name

Guarantor.Contact.givenName

MClinical. 50

GT1-45.3.1 Contact Person's Name Second

and Further Given Names

Guarantor.Contact.middleName

MClinical. 50

GT1-45.4.1 Contact Person's Name Suffix

Guarantor.Contact.suffix

MClinical. 50

GT1-45.5.1 Contact Person's Name Prefix

Guarantor.Contact.title

MClinical. 50

GT1-45.6.1 Contact Person's Name Degree

Guarantor.Contact.degreeCd

MClinical. 10

GT1-46.1.1 Contact Person's Telephone Number MClinical.Guarantor.Contact.PhoneNumber.phoneNumber 60 GT1-46.2.1 Contact Person's Telecommunication Use Code MClinical.Guarantor.Contact. PhoneNumber.contactPhoneNumberUseCd 3

5.12 IN1

HL7 Element

HL7 Element Name Database.Table.Column Length Notes

IN1-1.1.1 Set ID - IN1

IN1-2.1.1 Insurance Plan ID InsurancePlan.insurancePlanId 15

IN1-2.2.1 Insurance Plan Text InsurancePlan.planDescription 255

IN1-3.1.1 Insurance Company ID InsuranceCompany.insuranceCompanyId 50

IN1-3.4.1 Insurance Company Assigning Authority InsuranceCompany.Issuer.issuerId 45 IN1-3.6.1 Insurance Company Assigning Facility InsuranceOffice.emdeonId 50 IN1-4.1.1 Insurance Company Name InsuranceCompany.insuranceCompanyName

InsuranceOffice.officeName (if IN1-5.2.1 is empty)

255

IN1-5.1.1 Insurance Company Address InsuranceOffice.Address.address1 199

IN1-5.2.1 Insurance Company Other Designation InsuranceOffice.officeName 255

IN1-5.3.1 Insurance Company City InsuranceOffice.Address.city 199

IN1-5.4.1 Insurance Company State or Province InsuranceOffice.Address.provinceStateCd 10 Dictionary: Province/State

IN1-5.5.1 Insurance Company Zip or Postal Code InsuranceOffice.Address.postalZipCd 199

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