| Pos |
Segment |
M/C |
Repeat |
Repr. |
Notes |
| 010 |
|
E029 |
DIAGNOSIS |
C |
1 |
|
|
|
|
7135 |
Product identifier |
M |
|
an..35 |
|
|
|
9623 |
Diagnosis type code |
C |
|
an..3 |
|
|
|
1131 |
Code list identification code |
C |
|
an..17 |
|
| 020 |
|
E021 |
SERVICE |
C |
1 |
|
|
|
|
7135 |
Product identifier |
M |
|
an..35 |
|
|
|
1131 |
Code list identification code |
C |
|
an..17 |
|
|
|
9629 |
Procedure modification code |
C |
|
an..3 |
|
|
|
9629 |
Procedure modification code |
C |
|
an..3 |
|
|
|
9629 |
Procedure modification code |
C |
|
an..3 |
|
|
|
9629 |
Procedure modification code |
C |
|
an..3 |
|
| 030 |
|
E083 |
DELIVERY PATTERN |
C |
1 |
|
|
|
|
6063 |
Quantity type code qualifier |
M |
|
an..3 |
|
|
|
6060 |
Quantity |
C |
|
an..35 |
|
|
|
6411 |
Measurement unit code |
C |
|
an..8 |
|
|
|
6060 |
Quantity |
C |
|
an..35 |
|
|
|
2151 |
Period type code |
C |
|
an..3 |
|
|
|
2152 |
Period count quantity |
C |
|
n..3 |
|
|
|
2015 |
Despatch pattern code |
C |
|
an..3 |
|
|
|
2017 |
Despatch pattern timing code |
C |
|
an..3 |
|