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active Template  IN1 - Insurance

Id 2.16.840.1.113883.3.1937.777.10.13.56
ref
ad4bbr-
Ingangsdatum 2013‑02‑10
Status active Actief Versielabel
Naam IN1_segment Weergavenaam IN1 - Insurance
Classificatie HL7v2 segment level template
Open/gesloten Open (ook andere dan gedefinieerde elementen zijn toegestaan)
Gebruikt door / Gebruikt
Gebruikt door 0 transacties en 0 templates, Gebruikt 16 templates
Gebruikt als Naam Versie
2.16.840.1.113883.3.1937.777.10.15.88 Containment active SI - Sequence ID DYNAMISCH
2.16.840.1.113883.3.1937.777.10.15.5 Containment active CE - Coded element DYNAMISCH
2.16.840.1.113883.3.1937.777.10.15.12 Containment active CX - Extended composite ID with check digit DYNAMISCH
2.16.840.1.113883.3.1937.777.10.15.75 Containment active XON - Extended composite name and ID number for organizations DYNAMISCH
2.16.840.1.113883.3.1937.777.10.15.73 Containment active XAD - Extended address DYNAMISCH
2.16.840.1.113883.3.1937.777.10.15.76 Containment active XPN - Extended person name DYNAMISCH
2.16.840.1.113883.3.1937.777.10.15.77 Containment active XTN - Extended telecommunications number DYNAMISCH
2.16.840.1.113883.3.1937.777.10.15.89 Containment active ST - String DYNAMISCH
2.16.840.1.113883.3.1937.777.10.15.80 Containment active DT - Date DYNAMISCH
2.16.840.1.113883.3.1937.777.10.15.2 Containment active AUI - Authorization information DYNAMISCH
2.16.840.1.113883.3.1937.777.10.15.84 Containment active IS - Coded value for user-defined tables DYNAMISCH
2.16.840.1.113883.3.1937.777.10.15.64 Containment active TS - Time stamp DYNAMISCH
2.16.840.1.113883.3.1937.777.10.15.83 Containment active ID - Coded value for HL7 defined tables DYNAMISCH
2.16.840.1.113883.3.1937.777.10.15.74 Containment active XCN - Extended composite ID number and name for persons DYNAMISCH
2.16.840.1.113883.3.1937.777.10.15.86 Containment active NM - Numeric DYNAMISCH
2.16.840.1.113883.3.1937.777.10.15.8 Containment active CP - Composite price DYNAMISCH
Item DT Card Conf Omschrijving Label
hl7v2:IN1.1
SI 1 … 1 en-US Set ID - IN1
Bevat 2.16.840.1.113883.3.1937.777.10.15.88 SI - Sequence ID (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 426
@Type
0 … 1 F SI
@LongName
0 … 1 F Set ID - IN1
hl7v2:IN1.2
CE 1 … 1 en-US Insurance Plan ID
Bevat 2.16.840.1.113883.3.1937.777.10.15.5 CE - Coded element (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 368
@Type
0 … 1 F CE
@Table
0 … 1 F HL70072
@LongName
0 … 1 F Insurance Plan ID
hl7v2:IN1.3
CX 1 … * en-US Insurance Company ID
Bevat 2.16.840.1.113883.3.1937.777.10.15.12 CX - Extended composite ID with check digit (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 428
@Type
0 … 1 F CX
@LongName
0 … 1 F Insurance Company ID
hl7v2:IN1.4
XON 0 … * en-US Insurance Company Name
Bevat 2.16.840.1.113883.3.1937.777.10.15.75 XON - Extended composite name and ID number for organizations (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 429
@Type
0 … 1 F XON
@LongName
0 … 1 F Insurance Company Name
hl7v2:IN1.5
XAD 0 … * en-US Insurance Company Address
Bevat 2.16.840.1.113883.3.1937.777.10.15.73 XAD - Extended address (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 430
@Type
0 … 1 F XAD
@LongName
0 … 1 F Insurance Company Address
hl7v2:IN1.6
XPN 0 … * en-US Insurance Co Contact Person
Bevat 2.16.840.1.113883.3.1937.777.10.15.76 XPN - Extended person name (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 431
@Type
0 … 1 F XPN
@LongName
0 … 1 F Insurance Co Contact Person
hl7v2:IN1.7
XTN 0 … * en-US Insurance Co Phone Number
Bevat 2.16.840.1.113883.3.1937.777.10.15.77 XTN - Extended telecommunications number (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 432
@Type
0 … 1 F XTN
@LongName
0 … 1 F Insurance Co Phone Number
hl7v2:IN1.8
ST 0 … 1 en-US Group Number
Bevat 2.16.840.1.113883.3.1937.777.10.15.89 ST - String (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 433
@Type
0 … 1 F ST
@LongName
0 … 1 F Group Number
hl7v2:IN1.9
XON 0 … * en-US Group Name
Bevat 2.16.840.1.113883.3.1937.777.10.15.75 XON - Extended composite name and ID number for organizations (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 434
@Type
0 … 1 F XON
@LongName
0 … 1 F Group Name
hl7v2:IN1.10
CX 0 … * en-US Insured's Group Emp ID
Bevat 2.16.840.1.113883.3.1937.777.10.15.12 CX - Extended composite ID with check digit (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 435
@Type
0 … 1 F CX
@LongName
0 … 1 F Insured's Group Emp ID
hl7v2:IN1.11
XON 0 … * en-US Insured's Group Emp Name
Bevat 2.16.840.1.113883.3.1937.777.10.15.75 XON - Extended composite name and ID number for organizations (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 436
@Type
0 … 1 F XON
@LongName
0 … 1 F Insured's Group Emp Name
hl7v2:IN1.12
DT 0 … 1 en-US Plan Effective Date
Bevat 2.16.840.1.113883.3.1937.777.10.15.80 DT - Date (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 437
@Type
0 … 1 F DT
@LongName
0 … 1 F Plan Effective Date
hl7v2:IN1.13
DT 0 … 1 en-US Plan Expiration Date
Bevat 2.16.840.1.113883.3.1937.777.10.15.80 DT - Date (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 438
@Type
0 … 1 F DT
@LongName
0 … 1 F Plan Expiration Date
hl7v2:IN1.14
AUI 0 … 1 en-US Authorization Information
Bevat 2.16.840.1.113883.3.1937.777.10.15.2 AUI - Authorization information (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 439
@Type
0 … 1 F AUI
@LongName
0 … 1 F Authorization Information
hl7v2:IN1.15
IS 0 … 1 en-US Plan Type
Bevat 2.16.840.1.113883.3.1937.777.10.15.84 IS - Coded value for user-defined tables (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 440
@Type
0 … 1 F IS
@Table
0 … 1 F HL70086
@LongName
0 … 1 F Plan Type
hl7v2:IN1.16
XPN 0 … * en-US Name Of Insured
Bevat 2.16.840.1.113883.3.1937.777.10.15.76 XPN - Extended person name (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 441
@Type
0 … 1 F XPN
@LongName
0 … 1 F Name Of Insured
hl7v2:IN1.17
CE 0 … 1 en-US Insured's Relationship To Patient
Bevat 2.16.840.1.113883.3.1937.777.10.15.5 CE - Coded element (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 442
@Type
0 … 1 F CE
@Table
0 … 1 F HL70063
@LongName
0 … 1 F Insured's Relationship To Patient
hl7v2:IN1.18
TS 0 … 1 en-US Insured's Date Of Birth
Bevat 2.16.840.1.113883.3.1937.777.10.15.64 TS - Time stamp (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 443
@Type
0 … 1 F TS
@LongName
0 … 1 F Insured's Date Of Birth
hl7v2:IN1.19
XAD 0 … * en-US Insured's Address
Bevat 2.16.840.1.113883.3.1937.777.10.15.73 XAD - Extended address (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 444
@Type
0 … 1 F XAD
@LongName
0 … 1 F Insured's Address
hl7v2:IN1.20
IS 0 … 1 en-US Assignment Of Benefits
Bevat 2.16.840.1.113883.3.1937.777.10.15.84 IS - Coded value for user-defined tables (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 445
@Type
0 … 1 F IS
@Table
0 … 1 F HL70135
@LongName
0 … 1 F Assignment Of Benefits
hl7v2:IN1.21
IS 0 … 1 en-US Coordination Of Benefits
Bevat 2.16.840.1.113883.3.1937.777.10.15.84 IS - Coded value for user-defined tables (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 446
@Type
0 … 1 F IS
@Table
0 … 1 F HL70173
@LongName
0 … 1 F Coordination Of Benefits
hl7v2:IN1.22
ST 0 … 1 en-US Coord Of Ben. Priority
Bevat 2.16.840.1.113883.3.1937.777.10.15.89 ST - String (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 447
@Type
0 … 1 F ST
@LongName
0 … 1 F Coord Of Ben. Priority
hl7v2:IN1.23
ID 0 … 1 en-US Notice Of Admission Flag
Bevat 2.16.840.1.113883.3.1937.777.10.15.83 ID - Coded value for HL7 defined tables (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 448
@Type
0 … 1 F ID
@Table
0 … 1 F HL70136
@LongName
0 … 1 F Notice Of Admission Flag
hl7v2:IN1.24
DT 0 … 1 en-US Notice Of Admission Date
Bevat 2.16.840.1.113883.3.1937.777.10.15.80 DT - Date (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 449
@Type
0 … 1 F DT
@LongName
0 … 1 F Notice Of Admission Date
hl7v2:IN1.25
ID 0 … 1 en-US Report Of Eligibility Flag
Bevat 2.16.840.1.113883.3.1937.777.10.15.83 ID - Coded value for HL7 defined tables (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 450
@Type
0 … 1 F ID
@Table
0 … 1 F HL70136
@LongName
0 … 1 F Report Of Eligibility Flag
hl7v2:IN1.26
DT 0 … 1 en-US Report Of Eligibility Date
Bevat 2.16.840.1.113883.3.1937.777.10.15.80 DT - Date (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 451
@Type
0 … 1 F DT
@LongName
0 … 1 F Report Of Eligibility Date
hl7v2:IN1.27
IS 0 … 1 en-US Release Information Code
Bevat 2.16.840.1.113883.3.1937.777.10.15.84 IS - Coded value for user-defined tables (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 452
@Type
0 … 1 F IS
@Table
0 … 1 F HL70093
@LongName
0 … 1 F Release Information Code
hl7v2:IN1.28
ST 0 … 1 en-US Pre-Admit Cert (PAC)
Bevat 2.16.840.1.113883.3.1937.777.10.15.89 ST - String (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 453
@Type
0 … 1 F ST
@LongName
0 … 1 F Pre-Admit Cert (PAC)
hl7v2:IN1.29
TS 0 … 1 en-US Verification Date/Time
Bevat 2.16.840.1.113883.3.1937.777.10.15.64 TS - Time stamp (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 454
@Type
0 … 1 F TS
@LongName
0 … 1 F Verification Date/Time
hl7v2:IN1.30
XCN 0 … * en-US Verification By
Bevat 2.16.840.1.113883.3.1937.777.10.15.74 XCN - Extended composite ID number and name for persons (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 455
@Type
0 … 1 F XCN
@LongName
0 … 1 F Verification By
hl7v2:IN1.31
IS 0 … 1 en-US Type Of Agreement Code
Bevat 2.16.840.1.113883.3.1937.777.10.15.84 IS - Coded value for user-defined tables (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 456
@Type
0 … 1 F IS
@Table
0 … 1 F HL70098
@LongName
0 … 1 F Type Of Agreement Code
hl7v2:IN1.32
IS 0 … 1 en-US Billing Status
Bevat 2.16.840.1.113883.3.1937.777.10.15.84 IS - Coded value for user-defined tables (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 457
@Type
0 … 1 F IS
@Table
0 … 1 F HL70022
@LongName
0 … 1 F Billing Status
hl7v2:IN1.33
NM 0 … 1 en-US Lifetime Reserve Days
Bevat 2.16.840.1.113883.3.1937.777.10.15.86 NM - Numeric (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 458
@Type
0 … 1 F NM
@LongName
0 … 1 F Lifetime Reserve Days
hl7v2:IN1.34
NM 0 … 1 en-US Delay Before L.R. Day
Bevat 2.16.840.1.113883.3.1937.777.10.15.86 NM - Numeric (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 459
@Type
0 … 1 F NM
@LongName
0 … 1 F Delay Before L.R. Day
hl7v2:IN1.35
IS 0 … 1 en-US Company Plan Code
Bevat 2.16.840.1.113883.3.1937.777.10.15.84 IS - Coded value for user-defined tables (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 460
@Type
0 … 1 F IS
@Table
0 … 1 F HL70042
@LongName
0 … 1 F Company Plan Code
hl7v2:IN1.36
ST 0 … 1 en-US Policy Number
Bevat 2.16.840.1.113883.3.1937.777.10.15.89 ST - String (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 461
@Type
0 … 1 F ST
@LongName
0 … 1 F Policy Number
hl7v2:IN1.37
CP 0 … 1 en-US Policy Deductible
Bevat 2.16.840.1.113883.3.1937.777.10.15.8 CP - Composite price (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 462
@Type
0 … 1 F CP
@LongName
0 … 1 F Policy Deductible
hl7v2:IN1.38
CP 0 … 1 en-US Policy Limit - Amount
Bevat 2.16.840.1.113883.3.1937.777.10.15.8 CP - Composite price (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 463
@Type
0 … 1 F CP
@LongName
0 … 1 F Policy Limit - Amount
hl7v2:IN1.39
NM 0 … 1 en-US Policy Limit - Days
Bevat 2.16.840.1.113883.3.1937.777.10.15.86 NM - Numeric (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 464
@Type
0 … 1 F NM
@LongName
0 … 1 F Policy Limit - Days
hl7v2:IN1.40
CP 0 … 1 en-US Room Rate - Semi-Private
Bevat 2.16.840.1.113883.3.1937.777.10.15.8 CP - Composite price (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 465
@Type
0 … 1 F CP
@LongName
0 … 1 F Room Rate - Semi-Private
hl7v2:IN1.41
CP 0 … 1 en-US Room Rate - Private
Bevat 2.16.840.1.113883.3.1937.777.10.15.8 CP - Composite price (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 466
@Type
0 … 1 F CP
@LongName
0 … 1 F Room Rate - Private
hl7v2:IN1.42
CE 0 … 1 en-US Insured's Employment Status
Bevat 2.16.840.1.113883.3.1937.777.10.15.5 CE - Coded element (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 467
@Type
0 … 1 F CE
@Table
0 … 1 F HL70066
@LongName
0 … 1 F Insured's Employment Status
hl7v2:IN1.43
IS 0 … 1 en-US Insured's Administrative Sex
Bevat 2.16.840.1.113883.3.1937.777.10.15.84 IS - Coded value for user-defined tables (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 468
@Type
0 … 1 F IS
@Table
0 … 1 F HL70001
@LongName
0 … 1 F Insured's Administrative Sex
hl7v2:IN1.44
XAD 0 … * en-US Insured's Employer's Address
Bevat 2.16.840.1.113883.3.1937.777.10.15.73 XAD - Extended address (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 469
@Type
0 … 1 F XAD
@LongName
0 … 1 F Insured's Employer's Address
hl7v2:IN1.45
ST 0 … 1 en-US Verification Status
Bevat 2.16.840.1.113883.3.1937.777.10.15.89 ST - String (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 470
@Type
0 … 1 F ST
@LongName
0 … 1 F Verification Status
hl7v2:IN1.46
IS 0 … 1 en-US Prior Insurance Plan ID
Bevat 2.16.840.1.113883.3.1937.777.10.15.84 IS - Coded value for user-defined tables (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 471
@Type
0 … 1 F IS
@Table
0 … 1 F HL70072
@LongName
0 … 1 F Prior Insurance Plan ID
hl7v2:IN1.47
IS 0 … 1 en-US Coverage Type
Bevat 2.16.840.1.113883.3.1937.777.10.15.84 IS - Coded value for user-defined tables (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 1227
@Type
0 … 1 F IS
@Table
0 … 1 F HL70309
@LongName
0 … 1 F Coverage Type
hl7v2:IN1.48
IS 0 … 1 en-US Handicap
Bevat 2.16.840.1.113883.3.1937.777.10.15.84 IS - Coded value for user-defined tables (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 753
@Type
0 … 1 F IS
@Table
0 … 1 F HL70295
@LongName
0 … 1 F Handicap
hl7v2:IN1.49
CX 0 … * en-US Insured's ID Number
Bevat 2.16.840.1.113883.3.1937.777.10.15.12 CX - Extended composite ID with check digit (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 1230
@Type
0 … 1 F CX
@LongName
0 … 1 F Insured's ID Number
hl7v2:IN1.50
IS 0 … 1 en-US Signature Code
Bevat 2.16.840.1.113883.3.1937.777.10.15.84 IS - Coded value for user-defined tables (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 1854
@Type
0 … 1 F IS
@Table
0 … 1 F HL70535
@LongName
0 … 1 F Signature Code
hl7v2:IN1.51
DT 0 … 1 en-US Signature Code Date
Bevat 2.16.840.1.113883.3.1937.777.10.15.80 DT - Date (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 1855
@Type
0 … 1 F DT
@LongName
0 … 1 F Signature Code Date
hl7v2:IN1.52
ST 0 … 1 en-US Insured_s Birth Place
Bevat 2.16.840.1.113883.3.1937.777.10.15.89 ST - String (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 1899
@Type
0 … 1 F ST
@LongName
0 … 1 F Insured_s Birth Place
hl7v2:IN1.53
IS 0 … 1 en-US VIP Indicator
Bevat 2.16.840.1.113883.3.1937.777.10.15.84 IS - Coded value for user-defined tables (DYNAMISCH)
(IN1dotsent)
@Item
0 … 1 F 1852
@Type
0 … 1 F IS
@Table
0 … 1 F HL70099
@LongName
0 … 1 F VIP Indicator