4. Order Entry


Contents



4 A. Order Entry: Pharmacy/Treatment, Vaccination

Chapter Chair:

Hans Buitendijk Siemens Medical Solutions Health Services

Chapter Chair:

Gunther Schadow Regenstrief Institute for Health Care

Chapter Chair:

Patrick Loyd Gordon Point Informatics Ltd

Editor

Greg Thomas Kaiser Permanente

Sponsoring Committee:

Orders & Observations

List Server:

ord@lists.hl7.org

4.A CHAPTER 4A CONTENTS

PURPOSE

This extension of chapter 4 was created because as of version 2.6 it had become too large to edit without great difficulty. Thus, the sections specific to pharmacy and vaccines were excised from that chapter and now comprise the content of this chapter.

4.A.1 Preface (organization of this chapter)

This chapter is organized into two major sections, Pharmacy, and Vaccine. Each section contains the trigger events, message definitions, segments and examples for the specific type of order messages. Each section about a type of order is organized into background and overview, message structure, and message segments (that are specific to the order class in question). Special discussions of the use of fields, segments or messages, and examples are included. Segments are introduced in order of occurrence in a message. A list of allowable values for a field is included in the body of the text, along with the field definition for easier reference.

Section 4A.3 to 4A.6 Covers pharmacy/treatment trigger events & messages, pharmacy/treatment segments, pharmacy/treatment message examples and pharmacy/treatment message flow diagrams.

Sections 4A.7 to 4A.6 Covers vaccine trigger events & message definitions, vaccine segments and vaccine message examples.

4.A PHARMACY/TREATMENT TRIGGER EVENTS & MESSAGES

4.A.1 Usage notes for pharmacy/treatment messages

For the RDS (pharmacy/treatment dispense), RGV (pharmacy/treatment give) and RAS (pharmacy/treatment administration) messages, the placer and filler order numbers are those of the parent RDE (pharmacy/treatment encoded order) message. In these messages, the filler order number does not provide a unique identification of the instance of the pharmacy/treatment action (dispense, give or administer). To correct this problem, each of the defining segments (RXD, RXG, and RXA) has an appropriately named sub-ID field (dispense sub-ID counter, give sub-ID counter, and administration sub-ID counter). The combination of the filler order number (including its application ID component) and the appropriate sub-ID counter uniquely identifies the instance of the pharmacy/treatment action(s) present in these messages.

Although the default order control code for the RDE, RDS, RGV and RAS messages is "RE," there are cases in which the pharmacy or treatment system and the receiving system must communicate changes in state. Depending on whether the pharmacy or treatment supplier's relationship to the receiving system is that of placer or filler, the appropriate order control code may be substituted for the default value of RE. The receiving system can also use an appropriate order control code to report status back to the pharmacy or treatment system.

For example, suppose that a pharmacy or treatment system is sending RGV messages to a nursing system which will administer the medication and that the pharmacy or treatment system needs to request that several instances of a give order be discontinued. To implement this request, the RGV message may be sent with a "DC" order control code (discontinue request), and the appropriate RXG segments whose give sub-ID fields identify the instances to be discontinued. If a notification back to the pharmacy or treatment supplier is needed, the nursing system can initiate an RGV message with a "DR" order control code (discontinue as requested), and containing RXG segments whose give sub-ID fields identify the discontinued instances.

4.A.2 IV solution groups

An order for a group of IV solutions to be given sequentially can be supported in two similar ways: Parent/Child and Separate Orders. This HL7 Standard supports both methods of ordering. The method used at a particular site must be negotiated between the site institution and the various application vendors. See Chapter 2, section 2.A.53 OSD Order Sequence Definition, "Use Case 1 Cyclic placer order groups," for further details.

4.A.3 OMP - Pharmacy/Treatment Order Message (Event O09)

OMP^O09^OMP_O09: Pharmacy/treatment Order Message


MSH Message Header
2 DB
[ { SFT } ] Software
2 DB
[ UAC ] User Authentication Credential
2 DB
[ { NTE } ] Notes and Comments (for Header)
2 DB
[ --- PATIENT begin


PID Patient Identification
3 DB
[ --- ADDITIONAL_DEMOGRAPHICS begin


PD1 Additional Demographics
3 DB
[ { PRT } ] Participation (for Additional Demographics)
7 DB
] --- ADDITIONAL_DEMOGRAPHICS end


[ { NTE } ] Notes and Comments (for Patient ID)
2 DB
[ --- PATIENT_VISIT begin


PV1 Patient Visit
3 DB
[ PV2 ] Patient Visit - Additional Info
3 DB
[ { PRT } ] Participation (for Patient Visit)
7 DB
] --- PATIENT_VISIT end


[{ --- INSURANCE begin


IN1 Insurance
6 DB
[ IN2 ] Insurance Additional Information
6 DB
[ IN3 ] Insurance Additional Information, Certification
6 DB
}] --- INSURANCE end


[ GT1 ] Guarantor
6 DB
[ { AL1 } ] Allergy Information
3 DB
] --- PATIENT end


{ --- ORDER begin


ORC Common Order
4 DB
[{ --- TIMING begin


TQ1 Timing/Quantity
4 DB
[ { TQ2 } ] Timing/Quantity Order Sequence
4 DB
}] --- TIMING end


RXO Pharmacy/Treatment Order
4 DB
[ { PRT } ] Participation (for Order)
7 DB
[ { NTE } ] Notes and Comments (for RXO)
2 DB
{ RXR } Pharmacy/Treatment Route
4 DB
[{ --- COMPONENT begin


RXC Pharmacy/Treatment Component
4 DB
[ { NTE } ] Notes and Comments (for each RXC)
2 DB
}] --- COMPONENT end


[{ --- OBSERVATION begin


OBX Observation/Result
7 DB
[ { PRT } ] Participation (for Observation)
7 DB
[ { NTE } ] Notes and Comments (for OBX)
2 DB
}] --- OBSERVATION end


[ { FT1 } ] Financial Transaction
6 DB
[ BLG ] Billing Segment
6 DB
} --- ORDER end


4.A.4 ORP - Pharmacy/Treatment Order Acknowledgment (Event O10)

ORP^O10^ORP_O10: Description


MSH Message Header
2 DB
MSA Message Acknowledgment
2 DB
[ { ERR } ] Error
2 DB
[ { SFT } ] Software
2 DB
[ UAC ] User Authentication Credential
2 DB
[ { NTE } ] Notes and Comments (for Response Header)
2 DB
[ --- RESPONSE begin


[ --- PATIENT begin


PID Patient Identification
3 DB
[ { NTE } ] Notes and Comments (for Patient ID)
2 DB
] --- PATIENT end


{ --- ORDER begin


ORC Common Order
4 DB
[ { PRT } ] Participation (for ORC)
7 DB
[{ --- TIMING begin


TQ1 Timing/Quantity
4 DB
[ { TQ2 } ] Timing/Quantity Order Sequence
4 DB
}] --- TIMING end


[ --- ORDER_DETAIL begin


RXO Pharmacy/Treatment Order
4 DB
[ { PRT } ] Participation (for RXO)
7 DB
[ { NTE } ] Notes and Comments (for RXO)
2 DB
{ RXR } Pharmacy/Treatment Route
4 DB
[{ --- COMPONENT begin


RXC Pharmacy/Treatment Component
4 DB
[ { NTE } ] Notes and Comments (for each RXC)
2 DB
}] --- COMPONENT end


] --- ORDER_DETAIL end


} --- ORDER end


] --- RESPONSE end


4.A.5 RDE - Pharmacy/Treatment Encoded Order Message (Event O11)

This message communicates the pharmacy or treatment application's encoding of the pharmacy/treatment order ,OMP, message. It may be sent as an unsolicited message to report on either a single order or multiple pharmacy/treatment orders for a patient.

The RDE/RRE message pair can also be used to communicate a refill authorization request; however, a specific trigger event has been assigned. See section 4A.3.13 "RDE - Pharmacy/Treatment Refill Authorization Request Message (Event O25)." As a site-specific variant, the original order segments (RXO, RXRs, associated RXCs, and any NTEs) may be sent optionally (for comparison).

RDE^O11^RDE_O11: Pharmacy/Treatment Encoded Order Message


MSH Message Header
2 DB
[ { SFT } ] Software
2 DB
[ UAC ] User Authentication Credential
2 DB
[ { NTE } ] Notes and Comments (for Header)
2 DB
[ --- PATIENT begin


PID Patient Identification
3 DB
[ PD1 ] Additional Demographics
3 DB
[ { PRT } ] Participation (for Patient)
7 DB
[ { NTE } ] Notes and Comments (for Patient ID)
2 DB
[ --- PATIENT_VISIT begin


PV1 Patient Visit
3 DB
[ PV2 ] Patient Visit - Additional Info
3 DB
[ { PRT } ] Participation (for Patient Visit)
7 DB
] --- PATIENT_VISIT end


[{ --- INSURANCE begin


IN1 Insurance

DB
[ IN2 ] Insurance Additional Information
6 DB
[ IN3 ] Insurance Additional Information, Certification
6 DB
}] --- INSURANCE end


[ GT1 ] Guarantor
6 DB
[ { AL1 } ] Allergy Information
3 DB
] --- PATIENT end


{ --- ORDER begin


ORC Common Order
4 DB
[{ --- TIMING begin


TQ1 Timing/Quantity
4 DB
[ { TQ2 } ] Timing/Quantity Order Sequence
4 DB
}] --- TIMING end


[ --- ORDER_DETAIL begin


RXO Pharmacy/Treatment Prescription Order
4 DB
[ { NTE } ] Notes and Comments (for RXO)
2 DB
{ RXR } Pharmacy/Treatment Route
4 DB
[{ --- COMPONENT begin


RXC Pharmacy/Treatment Component (for RXO)
4 DB
[ { NTE } ] Notes and Comments (for each RXC)
2 DB
}] --- COMPONENT end


] --- ORDER_DETAIL end


[ { PRT } ] Participation (for Order)
7 DB
RXE Pharmacy/Treatment Encoded Order
4 DB
[ { PRT } ] Participation (for Encoded Order)
7 DB
[ { NTE } ] Notes and Comments (for RXE)
2 DB
{ --- TIMING_ENCODED begin


TQ1 Timing/Quantity
4 DB
[ { TQ2 } ] Timing/Quantity Order Sequence
4 DB
} --- TIMING_ENCODED end


{ RXR } Pharmacy/Treatment Route
4 DB
[ { RXC } ] Pharmacy/Treatment Component (for RXE)
4 DB
[{ --- OBSERVATION begin


OBX Results
7 DB
[ { PRT } ] Participation (for Observation)
7 DB
[ { NTE } ] Notes and Comments (for OBX)
2 DB
}] --- OBSERVATION end


[ { FT1 } ] Financial Detail
6 DB
[ BLG ] Billing Segment
4 DB
[ { CTI } ] Clinical Trial Identification
7 DB
} --- ORDER end


Note: The RXCs which follow the RXO may not be fully encoded, but those that follow the RXE must be fully encoded.

The NTE segment(s) following the PD1 segment are intended to communicate notes and comments relative to the patient.

The NTE segment(s) following the RXO segment are intended to communicate notes and comments relative to the pharmacy/treatment order.

The NTE segment(s) following the RXE segment are intended to communicate notes and comments relative to the encoded order.

The NTE segment(s) following the RXC segment are intended to communicate notes and comments relative to the component(s).

The NTE segment following the OBX segment is intended to communicate notes and comments relative to the results.

4.A.6 RRE - Pharmacy/Treatment Encoded Order Acknowledgment (Event O12)

RRE^O12^RRE_O12: Pharmacy/Treatment Encoded Order Acknowledgment Message


MSH Message Header
2 DB
MSA Message Acknowledgment
2 DB
[ { ERR } ] Error
2 DB
[ { SFT } ] Software
2 DB
[ UAC ] User Authentication Credential
2 DB
[ { NTE } ] Notes and Comments (for Header)
2 DB
[ --- RESPONSE begin


[ --- PATIENT begin


PID Patient Identification
3 DB
[ { NTE } ] Notes and Comments (for PID)
2 DB
] --- PATIENT end


{ --- ORDER begin


ORC Common Order
4 DB
[{ --- TIMING begin


TQ1 Timing/Quantity
4 DB
[ { TQ2 } ] Timing/Quantity Order Sequence
4 DB
}] --- TIMING end


[ --- ENCODING begin


RXE Pharmacy/Treatment Encoded Order
4 DB
[ { NTE } ] Notes and Comments (for RXE)
2 DB
{ --- TIMING_ENCODED begin


TQ1 Timing/Quantity
4 DB
[ { TQ2 } ] Timing/Quantity Order Sequence
4 DB
} --- TIMING_ENCODED end


{ RXR } Pharmacy/Treatment Route
4 DB
[ { RXC } ] Pharmacy/Treatment Component
4 DB
] --- ENCODING end


[ { PRT } ] Participation (for Order)
7 DB
} --- ORDER end


] --- RESPONSE end


Note: The use of RDE with the trigger of O01 and RRE with the trigger O02 is maintained for backward compatibility as of v2.4 and is withdrawn as of v2.7.

4.A.7 RDS - Pharmacy/Treatment Dispense Message (Event O13)

The RDS message may be created by the pharmacy/treatment application for each instance of dispensing a drug or treatment to fill an existing order or orders. In the most common case, the RDS messages would be routed to a Nursing application or to some clinical application, which needs the data about drugs dispensed or treatments given. As a site-specific variant, the original order segments (RXO, RXE and their associated RXR/RXCs) may be sent optionally (for comparison).

The ORC must have the filler order number and the order control code RE. The RXE and associated RXCs may be present if the receiving application needs any of their data. The RXD carries the dispense data for a given issuance of medication: thus it may describe a single dose, a half-day dose, a daily dose, a refill of a prescription, etc. The RXD is not a complete record of an order. Use the RXO and RXE segments if a complete order is needed. It is a record from the pharmacy or treatment supplier to the Nursing application (or other) with drug/treatment dispense and administration instructions.

The FT1 segment is optional and repeating in order to accommodate multiple charge, benefit and pricing situations. Example use cases demonstrating zero, one and two FT1 segments follow:

In the case where the RDS message represents a dispense event that is in process (i.e., has not been received by the patient), the financial transactions associated with the dispense do not yet exist. Until the financial transactions associated with the dispense event have been completed, no FT1 segment may exist in the message.

In the case where the RDS message represents a dispense event that has been received by the patient, and thus all financial transactions have been completed, the RDS message may contain one or more FT1 segments. Examples of single and multiple FT1 segments follow.

Payment for the dispense event completed by a single payor:

MSH|^&~\|Pharm|GenHosp|CIS|GenHosp|2006082911150700||RDS^O13^RDS_O13|...<cr>

PID|...<cr>

ORC|RE|...<cr>

RXD|1|00310-0131-10^LISINOPRIL 10MG TABLET^NDC|200607150830|100|TAB|...<cr>

FT1|1|||200607151035||PY|00310-0131-10^LISINOPRIL 10MG TABLET^NDC|||100|125.43&USD|...<cr>

Payment for the dispense event involves multiple payment sources:

MSH|^&~\|Pharm|GenHosp|CIS|GenHosp|2006082213000700||RDS^O13^RDS_O13|...<cr>

PID|...<cr>

ORC|RE|...<cr>

RXD|1|00340-0241-10^VERAPAMIL 120MG TABLET^NDC|200607200940|100|TAB|...<cr>

FT1|1|||200607211055||CD|00340024110^VERAPAMIL 120MG TABLET ^NDC|||100|55.43&USD|...<cr> (amount paid by insurance)

FT1|2|||200607211055||CP|00340024110^VERAPAMIL 120MG TABLET ^NDC|||100|5.00&USD|...<cr> (copay paid by patient)

The use of RDS with the trigger of O01 and RRD with the trigger O02 is maintained for backward compatibility as of v2.4 and is withdrawn as of v2.7.

RDS^O13^RDS_O13: Pharmacy/Treatment Dispense Message


MSH Message Header
2 DB
[ { SFT } ] Software
2 DB
[ UAC ] User Authentication Credential
2 DB
[ { NTE } ] Notes and Comments (for Header)
2 DB
[ --- PATIENT begin


PID Patient Identification
3 DB
[ --- ADDITIONAL_DEMOGRAPHICS begin


PD1 Additional Demographics
3 DB
[ { PRT } ] Participation (for Additional Demographics)
7 DB
] --- ADDITIONAL_DEMOGRAPHICS end


[ { NTE } ] Notes and Comments (for PID)
2 DB
[ { AL1 } ] Allergy Information
2 DB
[ --- PATIENT_VISIT begin


PV1 Patient Visit
3 DB
[ PV2 ] Patient Visit - Additional Info
3 DB
[ { PRT } ] Participation (for Patient Visit)
7 DB
] --- PATIENT_VISIT end


] --- PATIENT end


{ --- ORDER begin


ORC Common Order
4 DB
[{ --- TIMING begin


TQ1 Timing/Quantity
4 DB
[ { TQ2 } ] Timing/Quantity Order Sequence
4 DB
}] --- TIMING end


[ --- ORDER_DETAIL begin


RXO Pharmacy /Treatment Order
4 DB
[ --- ORDER_DETAIL_SUPPLEMENT begin


{ NTE } Notes and Comments (for RXO)
2 DB
{ RXR } Pharmacy/Treatment Route
4 DB
[{ --- COMPONENT begin


RXC Pharmacy/Treatment Component
4 DB
[ { NTE } ] Notes and Comments (for each RXC)
2 DB
}] --- COMPONENT end


] --- ORDER_DETAIL_SUPPLEMENT end


] --- ORDER_DETAIL end


[ { PRT } ] Participation (for Order)
7 DB
[ --- ENCODING begin


RXE Pharmacy/Treatment Encoded Order
4 DB
[ { PRT } ] Participation (for Order Encoding)
7 DB
[ { NTE } ] Notes and Comments (for RXE)
2 DB
{ --- TIMING_ENCODED begin


TQ1 Timing/Quantity
4 DB
[ { TQ2 } ] Timing/Quantity Order Sequence
4 DB
} --- TIMING_ENCODED end


{ RXR } Pharmacy/Treatment Route
4 DB
[ { RXC } ] Pharmacy/Treatment Component
4 DB
] --- ENCODING end


RXD Pharmacy/Treatment Dispense
4 DB
[ { PRT } ] Participation (for Treatment Dispense)
7 DB
[ { NTE } ] Notes and Comments (for RXD)
2 DB
{ RXR } Pharmacy/Treatment Route
4 DB
[ { RXC } ] Pharmacy/Treatment Component
4 DB
[{ --- OBSERVATION begin


OBX Results
7 DB
[ { PRT } ] Participation (for Observation)
7 DB
[ { NTE } ] Notes and Comments (for OBX)
2 DB
}] --- OBSERVATION end


[ { FT1 } ] Financial Transaction segment
6 DB
} --- ORDER end


Note: The NTE segment(s) following the PD1 segment are intended to communicate notes and comments relative to the patient.

The NTE segment(s) following the RXO segment are intended to communicate notes and comments relative to the pharmacy/treatment order.

The NTE segment(s) following the RXE segment are intended to communicate notes and comments relative to the encoded order.

The NTE segment(s) following the RXD segment are intended to communicate notes and comments relative to the dispense event.

The NTE segment(s) following the RXC segment are intended to communicate notes and comments relative to the component(s).

The NTE segment following the OBX segment is intended to communicate notes and comments relative to the results.

4.A.8 RRD - Pharmacy/Treatment Dispense Acknowledgement Message (Event O14)

RRD^O14^RRD_O14: Pharmacy/Treatment Dispense Acknowledgment Message


MSH Message Header
2 DB
MSA Message Acknowledgment
2 DB
[ { ERR } ] Error
2 DB
[ { SFT } ] Software
2 DB
[ UAC ] User Authentication Credential
2 DB
[ { NTE } ] Notes and Comments (for Header)
2 DB
[ --- RESPONSE begin


[ --- PATIENT begin


PID Patient Identification
3 DB
[ { NTE } ] Notes and Comments (for Patient ID)
2 DB
] --- PATIENT end


{ --- ORDER begin


ORC Common Order
4 DB
[{ --- TIMING begin


TQ1 Timing/Quantity
4 DB
[ { TQ2 } ] Timing/Quantity Order Sequence
4 DB
}] --- TIMING end


[ --- DISPENSE begin


RXD Pharmacy/Treatment Dispense
4 DB
[ { NTE } ] Notes and Comments (for RXD)
2 DB
{ RXR } Pharmacy/Treatment Route
4 DB
[ { RXC } ] Pharmacy/Treatment Component
4 DB
] --- DISPENSE end


[ { PRT } ] Participation (for Order)
7 DB
} --- ORDER end


] --- RESPONSE end


4.A.9 RGV - Pharmacy/Treatment Give Message (Event O15)

The RDS message's RXD segment carries the dispense data for a given issuance of medication: thus it may describe a single dose, a half-day dose, a daily dose, a refill of a prescription, etc. It does not contain the given instructions or scheduling information. When this "give" (i.e., administration) information needs to be transmitted from the pharmacy or treatment application to another application, it is done with the RGV message.

The RGV message uses the RXG segment to record drug or treatment administration instructions. It may carry information about a single scheduled administration on a drug or treatment, or it may carry information about multiple administrations. If the pharmacy or treatment application (or some other application) needs to create an unambiguous MAR report where each administration is matched to a particular give date/time instruction, it may use the RGV message as described in the following way:

For each scheduled administration of the medication, the pharmacy/treatment issues either a single RGV message or a single RGV message with multiple RXG segments, one for each scheduled administration. The actual administrations (transmitted by one or more RAS messages) are matched against the scheduled ones by recording in each RXA segment the Give Sub-ID of the corresponding RXG segment. If more than one administration needs to be matched (as in the case of recording a change or rate of an IV solution) the administering application issues additional RXA segment(s) (corresponding to the same RXG segment). If no matching is needed, the Give Sub-ID of the RXA segments has the value zero (0).

The ORC must have the filler order number and the order control code RE. The RXE and associated RXCs may be present if the receiving application needs any of their data. The RXG carries the scheduled administration data for either a single "give instruction" (single dose) of medication or for multiple "give instructions." The RXG is not a complete record of an order. Use the RXO and RXE segments if a complete order is needed. It is a record from the pharmacy or treatment application to the Nursing application (or other) with drug/treatment administration instructions.

RGV^O15^RGV_O15: Pharmacy/Treatment Give


MSH Message Header
2 DB
[ { SFT } ] Software
2 DB
[ UAC ] User Authentication Credential
2 DB
[ { NTE } ] Notes and Comments (for Header)
2 DB
[ --- PATIENT begin


PID Patient Identification
3 DB
[ { NTE } ] Notes and Comments (for PID)
2 DB
[ { AL1 } ] Allergy Information
2 DB
[ --- PATIENT_VISIT begin


PV1 Patient Visit
3 DB
[ PV2 ] Patient Visit - Additional Info
3 DB
[ { PRT } ] Participation (for Patient Visit)
7 DB
] --- PATIENT_VISIT end


] --- PATIENT end


{ --- ORDER begin


ORC Common Order
4 DB
[{ --- TIMING begin


TQ1 Timing/Quantity
4 DB
[ { TQ2 } ] Timing/Quantity Order Sequence
4 DB
}] --- TIMING end


[ --- ORDER_DETAIL begin


RXO Pharmacy /Treatment Order
4 DB
[ --- ORDER_DETAIL_SUPPLEMENT begin


{ NTE } Notes and Comments (for RXO)
2 DB
{ RXR } Pharmacy/Treatment Route
4 DB
[{ --- COMPONENTS begin


RXC Pharmacy/Treatment Component
4 DB
[ { NTE } ] Notes and Comments (for each RXC)
2 DB
}] --- COMPONENTS end


] --- ORDER_DETAIL_SUPPLEMENT end


] --- ORDER_DETAIL end


[ { PRT } ] Participation (for Order)
7 DB
[ --- ENCODING begin


RXE Pharmacy/Treatment Encoded Order
4 DB
[ { PRT } ] Participation (for Encoded Order)
7 DB
[ { NTE } ] Notes and Comments (for RXE)
2 DB
{ --- TIMING_ENCODED begin


TQ1 Timing/Quantity
4 DB
[ { TQ2 } ] Timing/Quantity Order Sequence
4 DB
} --- TIMING_ENCODED end


{ RXR } Pharmacy/Treatment Route
4 DB
[ { RXC } ] Pharmacy/Treatment Component
4 DB
] --- ENCODING end


{ --- GIVE begin


RXG Pharmacy/Treatment Give
4 DB
{ --- TIMING_GIVE begin


TQ1 Timing/Quantity
4 DB
[ { TQ2 } ] Timing/Quantity Order Sequence
4 DB
} --- TIMING_GIVE end


{ RXR } Pharmacy/Treatment Route
4 DB
[ { RXC } ] Pharmacy/Treatment Component
4 DB
[{ --- OBSERVATION begin


OBX Observation/Results
7 DB
[ { PRT } ] Participation (for Observation)
7 DB
[ { NTE } ] Notes and Comments (for OBX)
2 DB
}] --- OBSERVATION end


} --- GIVE end


} --- ORDER end


4.A.10 RRG - Pharmacy/Treatment Give Acknowledgment Message (Event O16)

RRG^O16^RRG_O16: Pharmacy/Treatment Give Acknowledgment Message


MSH Message Header
2 DB
MSA Message Acknowledgment
2 DB
[ { ERR } ] Error
2 DB
[ { SFT } ] Software
2 DB
[ UAC ] User Authentication Credential
2 DB
[ { NTE } ] Notes and Comments (for Header)
2 DB
[ --- RESPONSE begin


[ --- PATIENT begin


PID Patient Identification
3 DB
[ { NTE } ] Notes and Comments (for PID)
2 DB
] --- PATIENT end


{ --- ORDER begin


ORC Common Order
4 DB
[ { PRT } ] Participation (for Order)
7 DB
[{ --- TIMING begin


TQ1 Timing/Quantity
4 DB
[ { TQ2 } ] Timing/Quantity Order Sequence
4 DB
}] --- TIMING end


[ --- GIVE begin


RXG Pharmacy/Treatment Give
4 DB
{ --- TIMING_GIVE begin


TQ1 Timing/Quantity
4 DB
[ { TQ2 } ] Timing/Quantity Order Sequence
4 DB
} --- TIMING_GIVE end


{ RXR } Pharmacy/Treatment Route
4 DB
[ { RXC } ] Pharmacy/Treatment Component
4 DB
] --- GIVE end


} --- ORDER end


] --- RESPONSE end


Note: The use of RGV with the trigger of O01 and RRG with the trigger O02 is maintained for backward compatibility as of v2.4 and is withdrawn as of v2.7.

4.A.11 RAS - Pharmacy/Treatment Administration Message (Event O17)

The RAS message may be created by the administering application (e.g., nursing application) for each instance of administration for an existing order. If the administering application wants to report several administrations of medication/treatment for a given order with a single RAS message, each instance is reported by a separate (repeating) RXA segment. In addition, the administration records for a group of orders may be sent in a single message by creating repeating groups of segments at the ORC level.

In the most common case, the RAS messages would be sent from a nursing application to the pharmacy or treatment application (or to the ordering application or another clinical application), which could use the data to generate the medication administration reports. Multiple RXA segments, each corresponding to a separate administration instance for a given order, may be sent with a single ORC.

RAS^O17^RAS_O17: Pharmacy/Treatment Administration


MSH Message Header
2 DB
[ { SFT } ] Software
2 DB
[ UAC ] User Authentication Credential
2 DB
[ { NTE } ] Notes and Comments (for Header)
2 DB
[ --- PATIENT begin


PID Patient Identification
3 DB
[ --- ADDITIONAL_DEMOGRAPHICS begin


PD1 Additional Demographics
3 DB
[ { PRT } ] Participation (for Additional Demographics)
7 DB
] --- ADDITIONAL_DEMOGRAPHICS end


[ { NTE } ] Notes and Comments (for PID)
2 DB
[ { AL1 } ] Allergy Information
2 DB
[ --- PATIENT_VISIT begin


PV1 Patient Visit
3 DB
[ PV2 ] Patient Visit - Additional Info
3 DB
[ { PRT } ] Participation (for Patient Visit)
7 DB
] --- PATIENT_VISIT end


] --- PATIENT end


{ --- ORDER begin


ORC Common Order
4 DB
[{ --- TIMING begin


TQ1 Timing/Quantity
4 DB
[ { TQ2 } ] Timing/Quantity Order Sequence
4 DB
}] --- TIMING end


[ --- ORDER_DETAIL begin


RXO Pharmacy /Treatment Order
4 DB
[ --- ORDER_DETAIL_SUPPLEMENT begin


{ NTE } Notes and Comments (for RXO)
2 DB
{ RXR } Pharmacy/Treatment Route
4 DB
[{ --- COMPONENTS begin


RXC Pharmacy/Treatment Component
4 DB
[ { NTE } ] Notes and Comments (for each RXC)
2 DB
}] --- COMPONENTS end


] --- ORDER_DETAIL_SUPPLEMENT end


] --- ORDER_DETAIL end


[ { PRT } ] Participation (for Order)
7 DB
[ --- ENCODING begin


RXE Pharmacy/Treatment Encoded Order
4 DB
[ { PRT } ] Participation (for Encoded Order)
7 DB
[ { NTE } ] Notes and Comments (for RXE)
2 DB
{ --- TIMING_ENCODED begin


TQ1 Timing/Quantity
4 DB
[ { TQ2 } ] Timing/Quantity Order Sequence
4 DB
} --- TIMING_ENCODED end


{ RXR } Pharmacy/Treatment Route
4 DB
[ { RXC } ] Pharmacy/Treatment Component
4 DB
] --- ENCODING end


{ --- ADMINISTRATION begin


{ RXA } Pharmacy/Treatment Administration
4 DB
[ { PRT } ] Participation (for Administration)
7 DB
RXR Pharmacy/Treatment Route
4 DB
[{ --- OBSERVATION begin


OBX Observation/Result
7 DB
[ { PRT } ] Participation (for Observation)
7 DB
[ { NTE } ] Notes and Comments (for OBX)
2 DB
}] --- OBSERVATION end


} --- ADMINISTRATION end


[ { CTI } ] Clinical Trial Identification
7 DB
} --- ORDER end


4.A.12 RRA - Pharmacy/Treatment Administration Acknowledgment Message (Event O18)

RRA^O18^RRA_O18: Pharmacy/Treatment Administration Acknowledgment Message


MSH Message Header
2 DB
MSA Message Acknowledgment
2 DB
[ { ERR } ] Error
2 DB
[ { SFT } ] Software
2 DB
[ UAC ] User Authentication Credential
2 DB
[ { NTE } ] Notes and Comments (for Header)
2 DB
[ --- RESPONSE begin


[ --- PATIENT begin


PID Patient Identification
3 DB
[ { NTE } ] Notes and Comments (for PID)
2 DB
] --- PATIENT end


{ --- ORDER begin


ORC Common Order
4 DB
[ { PRT } ] Participation (for ORC)
7 DB
[{ --- TIMING begin


TQ1 Timing/Quantity
4 DB
[ { TQ2 } ] Timing/Quantity Order Sequence
4 DB
}] --- TIMING end


[ --- ADMINISTRATION begin


{ --- TREATMENT begin
4
RXA Pharmacy/Treatment Administration
4 DB
[ { PRT } ] Participation (for Administration)
7 DB
} --- TREATMENT end
4
RXR Pharmacy/Treatment Route
4 DB
] --- ADMINISTRATION end


} --- ORDER end


] --- RESPONSE end


Note: The use of RAS with the trigger of O01 and RRA with the trigger O02 is maintained for backward compatibility as of v2.4 and is withdrawn as of v2.7.

4.A.13 RDE - Pharmacy/Treatment Refill Authorization Request Message (Event O25)

The RDE/RRE is used to communicate a refill authorization request originating with the pharmacy. This message replicates the standard RDE message with a different trigger event code to indicate the specific use case of a refill authorization request.

RDE^O25^RDE_O11: Pharmacy/Treatment Refill Authorization Request


MSH Message Header
2 DB
[ { SFT } ] Software
2 DB
[ UAC ] User Authentication Credential
2 DB
[ { NTE } ] Notes and Comments (for Header)
2 DB
[ --- PATIENT begin


PID Patient Identification
3 DB
[ PD1 ] Additional Demographics
3 DB
[ { PRT } ] Participation (for Additional Demographics)
7 DB
[ { NTE } ] Notes and Comments (for Patient ID)
2 DB
[ --- PATIENT_VISIT begin


PV1 Patient Visit
3 DB
[ PV2 ] Patient Visit - Additional Info
3 DB
[ { PRT } ] Participation (for Patient Visit)
7 DB
] --- PATIENT_VISIT end


[{ --- INSURANCE begin


IN1 Insurance

DB
[ IN2 ] Insurance Additional Information
6 DB
[ IN3 ] Insurance Additional Information, Certification
6 DB
}] --- INSURANCE end


[ GT1 ] Guarantor
6 DB
[ { AL1 } ] Allergy Information
3 DB
] --- PATIENT end


{ --- ORDER begin


ORC Common Order
4 DB
[{ --- TIMING begin


TQ1 Timing/Quantity
4 DB
[ { TQ2 } ] Timing/Quantity Order Sequence
4 DB
}] --- TIMING end


[ --- ORDER_DETAIL begin


RXO Pharmacy/Treatment Prescription Order
4 DB
[ { NTE } ] Notes and Comments (for RXO)
2 DB
{ RXR } Pharmacy/Treatment Route
4 DB
[{ --- COMPONENTS begin


RXC Pharmacy/Treatment Component (for RXO)
4 DB
[ { NTE } ] Notes and Comments (for each RXC)
2 DB
}] --- COMPONENTS end


] --- ORDER_DETAIL end


[ { PRT } ] Participation (for Order)
7 DB
RXE Pharmacy/Treatment Encoded Order
4 DB
[ { PRT } ] Participation (for Encoded Order)
7 DB
[ { NTE } ] Notes and Comments (for Encoded Order)
2 DB
{ --- TIMING_ENCODED begin


TQ1 Timing/Quantity
4 DB
[ { TQ2 } ] Timing/Quantity Order Sequence
4 DB
} --- TIMING_ENCODED end


{ RXR } Pharmacy/Treatment Route
4 DB
[ { RXC } ] Pharmacy/Treatment Component (for RXE)
4 DB
[{ --- OBSERVATION begin


OBX Results
7 DB
[ { PRT } ] Participation (for Observation)
7 DB
[ { NTE } ] Notes and Comments (for OBX)
2 DB
}] --- OBSERVATION end


[ { FT1 } ] Financial Detail
6 DB
[ BLG ] Billing Segment
4 DB
[ { CTI } ] Clinical Trial Identification
7 DB
} --- ORDER end


4.A.14 RRE - Pharmacy/Treatment Refill Authorization Request Acknowledgment (Event O26)

RRE^O26^RRE_O12: Pharmacy/Treatment Refill Authorization Request Acknowledgment Message


MSH Message Header
2 DB
MSA Message Acknowledgment
2 DB
[ { ERR } ] Error
2 DB
[ { SFT } ] Software
2 DB
[ UAC ] User Authentication Credential
2 DB
[ { NTE } ] Notes and Comments (for Header)
2 DB
[ --- RESPONSE begin


[ --- PATIENT begin


PID Patient Identification
3 DB
[ { NTE } ] Notes and Comments (for PID)
2 DB
] --- PATIENT end


{ --- ORDER begin


ORC Common Order
4 DB
[{ --- TIMING begin


TQ1 Timing/Quantity
4 DB
[ { TQ2 } ] Timing/Quantity Order Sequence
4 DB
}] --- TIMING end


[ --- ENCODING begin


RXE Pharmacy/Treatment Encoded Order
4 DB
[ { NTE } ] Notes and Comments (for RXE)
2 DB
{ --- TIMING_ENCODED begin


TQ1 Timing/Quantity
4 DB
[ { TQ2 } ] Timing/Quantity Order Sequence
4 DB
} --- TIMING_ENCODED end


{ RXR } Pharmacy/Treatment Route
4 DB
[ { RXC } ] Pharmacy/Treatment Component
4 DB
] --- ENCODING end


[ { PRT } ] Participation (for Order)
7 DB
} --- ORDER end


] --- RESPONSE end


4.A.15 ROR - Pharmacy/Treatment Order Response

Attention: This query/response pair was retained for backward compatibility only as of v2.4 and withdrawn as of v2.7. Please refer to Chapter 5 for detailed coverage of query/response methodology to be employed in Versions 2.4 and later.

4.A.16 RAR - Pharmacy/Treatment Administration Information

Attention:This query/response pair was retained for backward compatibility only as of v2.4 and withdrawn as of v2.7. Please refer to Chapter 5 for detailed coverage of query/response methodology to be employed in Versions 2.4 and later.

4.A.17 RDR - Pharmacy/Treatment Dispense Information

Attention: This query/response pair was retained for backward compatibility only as of v2.4 and withdrawn as of v2.7. Please refer to Chapter 5 for detailed coverage of query/response methodology to be employed in Versions 2.4 and later.

4.A.18 RER - Pharmacy/Treatment Encoded Order

Attention: This query/response pair was retained for backward compatibility only as of v2.4 and withdrawn as of v2.7. Please refer to Chapter 5 for detailed coverage of query/response methodology to be employed in Versions 2.4 and later.

4.A.19 RGR - Pharmacy/Treatment Dose Information

Attention: This query/response pair was retained for backward compatibility only as of v2.4 and withdrawn as of v2.7. Please refer to Chapter 5 for detailed coverage of query/response methodology to be employed in Versions 2.4 and later.

4.A.20 Pharmacy Query/Response Message Pair

Conformance Statement

Query ID Q31
Query Type Query
Query Name Dispense History
Query Trigger QBP^Q31^QBP_Q11
Both
Response Trigger RSP^K31^RSP_K31
Query Characteristics May specify patient, medication, a date range, and how the response is to be sorted.
Query Purpose To retrieve patient pharmacy dispense history information from the Server.
Response Characteristics Sorted by Medication Dispensed unless otherwise specified in SortControl.
Query Trigger QBP^Q31^QBP_Q11

QBP^Q31^QBP_Q11: Query Grammar: QBP Message


MSH Message Header Segment
2.15.9 DB
[ { SFT } ] Software
2.15.12 DB
[ UAC ] User Authentication Credential
2 DB
QPD Query Parameter Definition
5.5.3 DB
RCP Response Control Parameter
5.5.6 DB
[ DSC ] Continuation Pointer
2.15.4 DB

RSP^K31^RSP_K31: Response Grammar: Pharmacy Dispense Message


MSH Message Header
2.15.9 DB
MSA Message Acknowledgement
2.15.8 DB
[ { ERR } ] Error
2.15.5 DB
[ { SFT } ] Software
2.15.12 DB
[ UAC ] User Authentication Credential
2 DB
QAK Query Acknowledgement
5.5.2 DB
QPD Query Parameter Definition
5.5.3 DB
RCP Response Control Parameter
5.5.6 DB
{ --- RESPONSE begin


[ --- PATIENT begin


PID Patient Identification
3.3.2 DB
[ --- ADDITIONAL_DEMOGRAPHICS begin


PD1 Additional Demographics
3 DB
[ { PRT } ] Participation (for Additional Demographics)
7 DB
] --- ADDITIONAL_DEMOGRAPHICS end


[ { NTE } ] Notes and Comments (for PID)
2.15.10 DB
[ { AL1 } ] Allergy Information
3.3.6 DB
[ --- PATIENT_VISIT begin


PV1 Patient Visit
3.3.3 DB
[ PV2 ] Patient Visit - Additional Info
3.3.4 DB
[ { PRT } ] Participation (for Patient Visit)
7 DB
] --- PATIENT_VISIT end


] --- PATIENT end


{ --- ORDER begin


ORC Common Order
4.5.1 DB
[{ --- TIMING begin


TQ1 Timing/Quantity
4.5.4 DB
[ { TQ2 } ] Timing/Quantity Order Sequence
4.5.5 DB
}] --- TIMING end


[ --- ORDER_DETAIL begin


RXO Pharmacy/Treatment Order
4.14.1 DB
[ { NTE } ] Notes and Comments (for RXO)
2.15.10 DB
{ RXR } Pharmacy/Treatment Route
4.14.2 DB
[{ --- COMPONENTS begin


RXC Pharmacy/Treatment Component
4.14.3 DB
[ { NTE } ] Notes and Comments (for each RXC)
2.15.10 DB
}] --- COMPONENTS end


] --- ORDER_DETAIL end


[ --- ENCODING begin


RXE Pharmacy/Treatment Encoded Order
4.14.4 DB
[ { NTE } ] Notes and Comments (for RXE)
2 DB
{ --- TIMING_ENCODED begin


TQ1 Timing/Quantity
4.5.4 DB
[ { TQ2 } ] Timing/Quantity Order Sequence
4.5.5 DB
} --- TIMING_ENCODED end


{ RXR } Pharmacy/Treatment Route
4.14.2 DB
[ { RXC } ] Pharmacy/Treatment Component
4.14.3 DB
] --- ENCODING end


RXD Pharmacy/Treatment Dispense
4.14.5 DB
[ { PRT } ] Participation (for Order)
7 DB
{ RXR } Pharmacy/Treatment Route
4.14.2 DB
[ { RXC } ] Pharmacy/Treatment Component
4.14.3 DB
[{ --- OBSERVATION begin


OBX Results
7.14.2 DB
[ { PRT } ] Participation (for Observation)
7 DB
[ { NTE } ] Notes and Comments (for OBX)
2.15.10 DB
}] --- OBSERVATION end


} --- ORDER end


} --- RESPONSE end


[ DSC ] Continuation Pointer
2.15.4 DB

Field Seq (Query ID=Q31) Name Key/

Search

Sort LEN TYPE Opt Rep Match Op TBL Segment Field Name Service Identifier Code Element Name
1 MessageQueryName

60 CWE R





2 QueryTag

32 ST R






PatientList S Y 20 CX O


PID.3
PID-3: Patient Identifier List

MedicationDispensed S Y 100 CWE O
=
RXD.2
RXD-2: Dispense/Give Code

DispenseDate.LL S Y 24 DTM O
> =
RXD.3
RXD-3: Date/Time Dispensed

DispenseDate.UL S Y 24 DTM O
< =
RXD.3
RXD-3: Date/Time Dispensed

Input Parameter (Query ID=Q31) Comp. Name DT Description
MessageQueryName
CWE Must be valued Q31^Dispense History^HL7nnnn.
QueryTag
ST Unique to each query message instance.
PatientList
CX The combination of values for PatientList.ID, and PatientList.AssigningAuthority, are intended to identify a unique entry on the PATIENT_MASTER table. The PatientList.IdentifierTypeCode is useful for further filtering or to supply uniqueness in the event that the assigning authority may have more than one coding system. (The PATIENT_MASTER table contains a constraint that prevents multiple patients from being identified by the same combination of field values.) This PATIENT_MASTER entry will be searched against on the PHARMACY_DISPENSE_TRANSACTION table to retrieve the rows fulfilling the query conditions. If this field is not valued, all values for this field are considered to be a match. If one PID.3 is specified, only 1 segment pattern will be returned.

ID ID If this field, PID.3.1, is not valued, all values for this field are considered to be a match.

Assigning Authority HD If this field, PID.3.4, is not valued, all values for this field are considered to be a match.

Identifier type code IS If this field, PID.3.5, is not valued, all values for this field are considered to be a match.
MedicationDispensed
CWE If this field is not valued, all values for this field are considered to be a match.
DispenseDate.LL
DTM This is the earliest value to be returned for Date/Time Dispensed. If this field is not valued, all values for this field are considered to be a match.
DispenseDate.UL
DTM This is the latest value to be returned for Date/Time Dispensed. If this field is not valued, all values for this field are considered to be a match.

4.A.20.0 Example

Example: The user wishes to know all the medications dispensed for the patient whose medical record number is "555444222111" for the period beginning 5/31/2005 and ending 5/31/2006. The following QBP message is generated.

MSH|^&~\|PCR|Gen Hosp|Pharm||200611201400-0800||QBP^Q31^QBP_Q11|ACK9901|P|2.6|

QPD|Q31^Dispense History^HL70471|Q001|555444222111^^^MPI^MR||20050531|20060531|

RCP|I|999^RD|

The pharmacy system identifies medical record number "555444222111" as belonging to Adam Everyman and locates 4 prescription dispenses for the period beginning 5/31/2005 and ending 5/31/2006 and returns the following RSP message:

MSH|^&~\|Pharm|Gen hosp|PCR||200611201400-0800||RSP^K31^RSP_K31|8858|P|2.6|

MSA|AA|ACK9901|

QAK|Q001|OK|Q31^Dispense History^HL70471|4|

QPD|Q31^Dispense History^HL70471|Q001|444-33-3333^^^MPI^MR||20050531|20060531|

PID|||444-33-3333^^^MPI^MR||Everyman^Adam||19600614|M||C|2222 Home Street ^^Anytown^US^12345||^^^^^555^5552004|

ORC|RE||89968665||||||200505121345-0700|||444-44-4444^HIPPOCRATES^HAROLD^^^^MD||^^^^^555^5551003|

RXE|1^BID^^20050529|00378112001^Verapamil Hydrochloride 120 mg TAB^NDC |120||mgm|

RXD|1|00378112001^Verapamil Hydrochloride 120 mg TAB^NDC |200505291115-0700|100|||1331665|3|

RXR|PO|

ORC|RE||89968665||||||200505291030-0700|||444-44-4444^HIPPOCRATES^HAROLD^^^^MD||^^^^^555^5551003|

RXE|1^^D100^^20070731^^^TAKE 1 TABLET DAILY --GENERIC FOR CALAN SR|00182196901^VERAPAMIL HCL ER TAB 180MG ER^NDC |100||180MG|TABLET SA|||G|||0|BC3126631^CHU^Y^L||213220929|0|0|19980821|

RXD|1|00182196901^VERAPAMIL HCL ER TAB 180MG ER^NDC |20050821|100|||213220929|0|TAKE 1 TABLET DAILY --GENERIC FOR CALAN SR|

RXR|PO|

ORC|RE||235134037||||||200509221330-0700|||444-44-4444^HIPPOCRATES^HAROLD^^^^MD||^^^^^555^5551003|

RXD|1|00172409660^BACLOFEN 10MG TABS^NDC|200509221415-0700|10|||235134037|5|AS DIRECTED|

RXR|PO|

ORC|RE||235134030||||||200510121030-0700|||222-33-4444^PUMP^PATRICK^^^^MD ||^^^^^555^5551027|

RXD|1|00054384163^THEOPHYLLINE 80MG/15ML SOLN^NDC|200510121145-0700|10|||235134030|5|AS DIRECTED|

RXR|PO|

4.A PHARMACY/TREATMENT SEGMENTS

4.A.1 RXO - Pharmacy/Treatment Order Segment

This is the "master" pharmacy/treatment order segment. It contains order data not specific to components or additives. Unlike the OBR, it does not contain status fields or other data that are results-only.

It can be used for any type of pharmacy order, including inpatient (unit dose and compound unit dose), outpatient, IVs, and hyperalimentation IVs (nutritional IVs), as well as other non-pharmacy treatments, e.g., respiratory therapy, oxygen, and many nursing treatments.

In addition to the pharmaceutical/treatment information, this segment contains additional data such as provider and text comments.

A quantity/timing field is not needed in the RXO segment. The ORC segment contains the requested ORC-7-quantity/timing of the original order which does not change as the order is encoded, dispensed, or administered.

HL7 Attribute Table - RXO - Pharmacy/Treatment Order

SEQ LEN C.LEN DT OPT RP/# TBL# ITEM # ELEMENT NAME DB Ref.
1

CWE C
9999 00292 Requested Give Code DB
2

NM C

00293 Requested Give Amount - Minimum DB
3

NM O

00294 Requested Give Amount - Maximum DB
4

CWE C
9999 00295 Requested Give Units DB
5

CWE C
9999 00296 Requested Dosage Form DB
6

CWE O Y 9999 00297 Provider's Pharmacy/Treatment Instructions DB
7

CWE O Y 9999 00298 Provider's Administration Instructions DB
8

LA1 B

00299 Deliver-To Location DB
9 1..1
ID O
0161 00300 Allow Substitutions DB
10

CWE O
9999 00301 Requested Dispense Code DB
11

NM O

00302 Requested Dispense Amount DB
12

CWE O
9999 00303 Requested Dispense Units DB
13
3= NM O

00304 Number Of Refills DB
14

XCN B Y
00305 Ordering Provider's DEA Number DB
15

XCN C Y
00306 Pharmacist/Treatment Supplier's Verifier ID DB
16 1..1
ID O
0136 00307 Needs Human Review DB
17
20= ST C

00308 Requested Give Per (Time Unit) DB
18

NM O

01121 Requested Give Strength DB
19

CWE O
9999 01122 Requested Give Strength Units DB
20

CWE O Y 9999 01123 Indication DB
21
6= ST O

01218 Requested Give Rate Amount DB
22

CWE O
9999 01219 Requested Give Rate Units DB
23

CQ O

00329 Total Daily Dose DB
24

CWE O Y 9999 01476 Supplementary Code DB
25
5# NM O

01666 Requested Drug Strength Volume DB
26

CWE O
9999 01667 Requested Drug Strength Volume Units DB
27 1..1
ID O
0480 01668 Pharmacy Order Type DB
28

NM O

01669 Dispensing Interval DB
29

EI O

02149 Medication Instance Identifier DB
30

EI O

02150 Segment Instance Identifier DB
31

CNE C
0725 02151 Mood Code DB
32

CWE B
9999 01681 Dispensing Pharmacy DB
33

XAD B

01682 Dispensing Pharmacy Address DB
34

PL O

01683 Deliver-to Patient Location DB
35

XAD O

01684 Deliver-to Address DB
36

XTN O Y
2309 Pharmacy Phone Number DB

4.A.1.0 RXO-1 Requested Give Code (CWE) 00292

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field identifies the treatment product or treatment ordered to be given to the patient; it is analogous to OBR-4-universal service ID in function. Examples of treatments products include medications and certain devices or supplies, e.g., inhaler spacers, blood glucose monitors, syringes, infusion sets, which might require prescription.

Often the coded entry implies dosage form and a dosage form is required in addition to the product name. When the give code does not include the dosage form, use RXO-5-requested dosage form. When the give code does not include the strength, use RXO-18-requested give strength and the RXO-19-requested give units. Realize that strengths do not apply to some such orders.

The RXO-1, RXO-2 and RXO-4 are mandatory unless the prescription/treatment is transmitted as free text using RXO-6; then RXO-1, RXO-2, and RXO-4 may be blank and the first subcomponent of RXO-6 must be blank.

Use of the RXO-6.2 versus the RXO-1.2 for a free text order is dependent on whether or not the free text describes a product or if it is more commentary in nature.

Please refer to the request -to-dispense fields RXO-10, RXO-11, and RXO-12 for a discussion of the interrelationship with the request-to-give fields.

4.A.1.1 RXO-2 Requested Give Amount - Minimum (NM) 00293

Definition: This field is the ordered amount. In a variable dose order, this is the minimum ordered amount. In a non-varying dose order, this is the exact amount of the order.

The RXO-1, RXO-2 and RXO-4 are mandatory unless the prescription/treatment is transmitted as free text using RXO-6, then RXO-1, RXO-2, and RXO-4 may be blank and the first subcomponent of RXO-6 must be blank.

Note: This field is not a duplication of the first component of the quantity/timing field, since in non-pharmacy/treatment orders, that component can be used to specify multiples of an ordered amount. Another way to say this is that, for pharmacy/treatment orders, the quantity component of the quantity/timing field refers to what is to be given out at each service interval; thus, in terms of the RX order, that first component always defaults to 1. Hence, in the actual execution of the order, the value of 1 in the first component of the quantity/timing field always refers to one administration of the amount specified in this field (the Requested Give Amount field).

4.A.1.2 RXO-3 Requested Give Amount - Maximum (NM) 00294

Definition: In a variable dose order, this is the maximum ordered amount. In a non-varying dose order, this field is not used.

4.A.1.3 RXO-4 Requested Give Units (CWE) 00295

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field indicates the units for the give amount.

The RXO-1, RXO-2 and RXO-4 are mandatory unless the prescription is transmitted as free text using RXO-6, then RXO-1, RXO-2, and RXO-4 may be blank and the first subcomponent of RXO-6 must be blank.

Note: These units can be a "compound quantity"; i.e., the units may contain the word "per." For example, micrograms per KG (micg/kg) is an acceptable value, which means that the units are micrograms per KG (of body weight). See Chapter 7 for full definition of ISO+ units.

A table of standard units is needed to define standard abbreviations for compound units. Until such a table is agreed on, a user-defined table is needed for each site. If the interpretation of a compound unit requires knowledge of some observation results (such as body weight or height), these results can be sent in the same order message using the optional OBX segments.

4.A.1.4 RXO-5 Requested Dosage Form (CWE) 00296

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field indicates the manner in which the treatment is aggregated for dispensing, e.g., tablets, capsules suppositories. In some cases, this information is implied by the dispense/give code in RXO-1-requested give code or RXO-10-Requested dispense code. Required when both RXO-1-Requested give code and RXO-10-Requested dispense code do not specify the drug/treatment form; optionally included otherwise.

4.A.1.5 RXO-6 Provider's Pharmacy/Treatment Instructions (CWE) 00297

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field identifies the ordering provider's instructions to the pharmacy or the non-pharmacy treatment provider (e.g., respiratory therapy). If coded, a user-defined table must be used. If transmitted as a free text field, place a null in the first component and the text in the second, e.g., |^this is a free text treatment instruction|.

If the prescription is transmitted as free text using RXO-6, then RXO-1, RXO-2, and RXO-4 may be blank and the first subcomponent of RXO-6 must be blank. Otherwise, RXO-1, RXO-2 and RXO-4 are mandatory.

4.A.1.6 RXO-7 Provider's Administration Instructions (CWE) 00298

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field identifies the ordering provider's instructions to the patient or to the provider administering the drug or treatment. If coded, a user-defined table must be used. If transmitted as free text, place a null in the first component and the text in the second, e.g., |^this is a free text administration instruction|.

4.A.1.7 RXO-8 Deliver-to Location (LA1) 00299

Components: <Point of Care (IS)> ^ <Room (IS)> ^ <Bed (IS)> ^ <Facility (HD)> ^ <Location Status (IS)> ^ <Patient Location Type (IS)> ^ <Building (IS)> ^ <Floor (IS)> ^ <Address (AD)>

Subcomponents for Facility (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Address (AD): <Street Address (ST)> & <Other Designation (ST)> & <City (ST)> & <State or Province (ST)> & <Zip or Postal Code (ST)> & <Country (ID)> & <Address Type (ID)> & <Other Geographic Designation (ST)>

Definition: This field is retained for backward compatibility only as of v 2.6. The reader is referred to RXO-32, RXO-33, RXO-34 and RXO-35. The first components contain the inpatient or outpatient location to which the pharmacy provider or treatment supplier is to deliver the drug or treatment device (if applicable). The default (null) value is the current census location for the patient. The last component can be used to specify an address. This could be used to fill mail orders to a patient or provider, or to account for home health care.

4.A.1.8 RXO-9 Allow Substitutions (ID) 00300

Definition: Following are the values:

HL7 Table 0161 - Allow Substitution

Value Description Comment
N Substitutions are NOT authorized. (This is the default - null.)
G Allow generic substitutions.
T Allow therapeutic substitutions

4.A.1.9 RXO-10 Requested Dispense Code (CWE) 00301

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field indicates what is to be/was dispensed; it is analogous to OBR-4-universal service ID in function. It may be present in the order or not, depending on the application. If not present, and values are given for RXO-11-requested dispense amount and RXO-12-requested dispense units, the RXO-1-requested give code is assumed. If the requested dispense code does not include the dosage form, then RXO-5-requested dosage form is required

Note on request-to-dispense fields:

Sometimes an order will be written in which the total amount of the drug or treatment requested to be dispensed has no direct relationship with the give amounts and schedule. For example, an outpatient pharmacy/treatment order might be take four tablets a day of <drug name, value>, Q6H (every 6 hours) -- dispense 30 tablets. An inpatient order might be NS/D5W (normal saline with 5% dextrose) at 1000cc/hour-dispense 3 1-liter bottles of NSD5W solution. The request-to-dispense fields support this common style of ordering.

4.A.1.10 RXO-11 Requested Dispense Amount (NM) 00302

Definition: This field specifies the amount to be dispensed. See above note.

4.A.1.11 RXO-12 Requested Dispense Units (CWE) 00303

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field identifies the units for the dispense amount. This must be in simple units that reflect the actual quantity of the substance to be dispensed. It does not include compound units. See above note.

4.A.1.12 RXO-13 Number of Refills (NM) 00304

Definition: This field defines the number of times the requested dispense amount can be given to the patient, subject to local regulation. Refers to outpatient only.

4.A.1.13 RXO-14 Ordering Provider's DEA Number (XCN) 00305

Components: <Person Identifier (ST)> ^ <Family Name (FN)> ^ <Given Name (ST)> ^ <Second and Further Given Names or Initials Thereof (ST)> ^ <Suffix (e.g., JR or III) (ST)> ^ <Prefix (e.g., DR) (ST)> ^ <WITHDRAWN Constituent> ^ <DEPRECATED-Source Table (CWE)> ^ <Assigning Authority (HD)> ^ <Name Type Code (ID)> ^ <Identifier Check Digit (ST)> ^ <Check Digit Scheme (ID)> ^ <Identifier Type Code (ID)> ^ <Assigning Facility (HD)> ^ <Name Representation Code (ID)> ^ <Name Context (CWE)> ^ <WITHDRAWN Constituent> ^ <Name Assembly Order (ID)> ^ <Effective Date (DTM)> ^ <Expiration Date (DTM)> ^ <Professional Suffix (ST)> ^ <Assigning Jurisdiction (CWE)> ^ <Assigning Agency or Department (CWE)> ^ <Security Check (ST)> ^ <Security Check Scheme (ID)>

Subcomponents for Family Name (FN): <Surname (ST)> & <Own Surname Prefix (ST)> & <Own Surname (ST)> & <Surname Prefix from Partner/Spouse (ST)> & <Surname from Partner/Spouse (ST)>

Subcomponents for Source Table (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Assigning Authority (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Assigning Facility (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Name Context (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Assigning Jurisdiction (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Assigning Agency or Department (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Definition: This field is retained for backward compatibility only as of v27. The reader is referred to the PRT segment described in chapter 7.

This field identifies the provider's controlled substance number, if required, by site. It is defined as conditional because it is required when the substance being requested is a controlled substance (e.g., a narcotic). If the person referenced in this field is also referenced in PRT segment, they must contain the same information. However, if there is a difference, then PRT segment takes precedence.

4.A.1.14 RXO-15 Pharmacist/Treatment Supplier's Verifier ID (XCN) 00306

Components: <Person Identifier (ST)> ^ <Family Name (FN)> ^ <Given Name (ST)> ^ <Second and Further Given Names or Initials Thereof (ST)> ^ <Suffix (e.g., JR or III) (ST)> ^ <Prefix (e.g., DR) (ST)> ^ <WITHDRAWN Constituent> ^ <DEPRECATED-Source Table (CWE)> ^ <Assigning Authority (HD)> ^ <Name Type Code (ID)> ^ <Identifier Check Digit (ST)> ^ <Check Digit Scheme (ID)> ^ <Identifier Type Code (ID)> ^ <Assigning Facility (HD)> ^ <Name Representation Code (ID)> ^ <Name Context (CWE)> ^ <WITHDRAWN Constituent> ^ <Name Assembly Order (ID)> ^ <Effective Date (DTM)> ^ <Expiration Date (DTM)> ^ <Professional Suffix (ST)> ^ <Assigning Jurisdiction (CWE)> ^ <Assigning Agency or Department (CWE)> ^ <Security Check (ST)> ^ <Security Check Scheme (ID)>

Subcomponents for Family Name (FN): <Surname (ST)> & <Own Surname Prefix (ST)> & <Own Surname (ST)> & <Surname Prefix from Partner/Spouse (ST)> & <Surname from Partner/Spouse (ST)>

Subcomponents for Source Table (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Assigning Authority (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Assigning Facility (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Name Context (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Assigning Jurisdiction (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Assigning Agency or Department (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Definition: This field is the provider ID of the pharmacist/treatment supplier verifier. Use if required by the pharmacy or treatment application or site on orders (or some subgroup of orders), in addition to ORC-11-verified by.

Example:

The site requires a "verified by" provider (such as a nurse) and a "verifying pharmacist/treatment supplier" on the order. In this case the first field, ORC-11-verified by, is already present; but the second field, RXO-15-pharmacist/treatment supplier's verifier ID, is needed.

4.A.1.15 RXO-16 Needs Human Review (ID) 00307

Definition: This field uses HL7 Table 0136 - Yes/No Indicator. The values have the following meaning for this field:

Y Yes - Indicates that the pharmacist or non-pharmacist treatment supplier filling the order needs to pay special attention to the text in the RXO-6-provider's pharmacy/treatment instructions. A warning is present.

N No - No warning is present. This is the equivalent default (null) value.

An example of the use of this field is given by the following case:

A smart Order Entry application knows of a possible drug or treatment interaction on a certain order, but the provider issuing the order wants to override the condition. In this case, the pharmacy or treatment application receiving the order will want to have a staff pharmacist or non-pharmacist treatment supplier review the interaction and contact the ordering physician.

4.A.1.16 RXO-17 Requested Give Per (Time Unit) (ST) 00308

Definition: This field identifies the time unit to use to calculate the rate at which the pharmaceutical is to be administered.

Format:

S = seconds
M = minutes
H = hours
D = days
W = weeks
L = months

Note: This is the same as the format specified for the DURATION component of the quantity/timing field, excluding the "X" specification.

This field is defined as conditional because it is required when the ordered substance is to be administered continuously at a prescribed rate (e.g., certain IVs). For example, if the "give amount/units" are 300 ml and the "give per" time unit is H1, the rate is 300ml/hr and the duration of this dose is 1 hour. Thus the give amount and give per time unit define the duration of the service.

This field is distinct from the "interval" component of the quantity/timing field, but it could be used in conjunction with it, as in give 300ml of NS per hr for 1 hour, repeat twice a day.

4.A.1.17 RXO-18 Requested Give Strength (NM) 01121

Definition: Required when RXO-1-requested give code does not specify the strength; optionally included otherwise. This is the numeric part of the strength, used in combination with RXO-19-requested give strength units.

The need for strength and strength unit fields in addition to the amount and amount units fields included in various RX_ segments requires explanation. Physicians can write a prescription for a drug such as Ampicillin in two ways. One way would be: "Ampicillin 250 mg capsules, 2 capsules four times a day." In this case the give amount would be 2, the give units would be capsules, the strength would be 250 and the strength units would milligrams.

However, the provider could also write the pharmaceutical treatment as "Ampicillin 500 mg four times a day." In this case the give amount would be 500 and the give units would be milligrams. The strength would not be reported in the RXO segment because it is not specified; the drug could be given in two 250 mg caps or one 500 mg cap. But the pharmacist would dispense a specific capsule size and would record the strength in the RXE segment as 250 or 500, depending upon which capsule size was dispensed.

Some coding systems imply the strength, units, route of administration, and manufacturer of substances within a single instructional code. NDC codes, for example, usually imply not only the medical substance, but also the strength, the units, and the form, e.g., 0047-0402-30^Ampicillin 250 MG CAPS^NDC. So all of this information can also be completely specified in RXO-1-requested give code and in the analogous CE fields in other pharmacy/treatment segments. In this case, it is not necessary to use the strength and strength units fields to specify this information.

4.A.1.18 RXO-19 Requested Give Strength Units (CWE) 01122

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: Required when both RXO-1-requested give code and RXO-10-requested dispense code do not specify the strength; optionally included otherwise. This is the unit of the strength, used in combination with RXO-18-requested give strength.

Note: These units can be a "compound quantity;" i.e., the units may express a quantity per unit of time. For example, micrograms per hour (micg/h) is an acceptable value. These compound units are contained in the ISO+ table. See Chapter 7 for full definition of ISO+ units.

4.A.1.19 RXO-20 Indication (CWE) 01123

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field identifies the condition or problem for which the drug/treatment was prescribed. May repeat if multiple indications are relevant.

4.A.1.20 RXO-21 Requested Give Rate Amount (ST) 01218

Definition: This field contains the rate at which to administer a treatment, e.g., 150 ml/hr (for an IV) or 4 liters/min for nasal oxygen.

4.A.1.21 RXO-22 Requested Give Rate Units (CWE) 01219

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field contains the units in which RXO-21-requested give rate amount is denominated.

4.A.1.22 RXO-23 Total Daily Dose (CQ) 00329

Components: <Quantity (NM)> ^ <Units (CWE)>

Subcomponents for Units (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Definition: This field contains the total daily dose for this particular pharmaceutical as expressed in terms of actual dispense units.

4.A.1.23 RXO-24 Supplementary Code (CWE) 01476

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

This field accommodates the identification of any codes that might be associated with the pharmaceutical substance. Common codes include: the Generic Product Identifier (GPI), Generic Code Number_Sequence Number (GCN_SEQNO), National Drug Code (NDC).

4.A.1.24 RXO-25 Requested Drug Strength Volume (NM) 01666

Description: This numeric field defines the volume measurement in which the drug strength concentration is contained. For example, Acetaminophen 120 MG/5ML Elixir means that 120 MG of the drug is in a solution with a volume of 5 ML, which would be encoded in RXO-18, RXO-19, RXO-25 and RXO-26 as:

RXO||||||||||||||||||120|mg^^ISO||||||5|ml^^ISO ...<cr>

4.A.1.25 RXO-26 Requested Drug Strength Volume Units (CWE) 01667

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Description: This field indicates the volumetric unit associated with RXO-25 Requested Drug Strength Volume. See example in RXO-25.

4.A.1.26 RXO-27 Pharmacy Order Type (ID) 01668

Definition: The Pharmacy Order Type field defines the general category of pharmacy order which may be used to determine the processing path the order will take. Refer to HL7 Table 0480 - Pharmacy Order Types for valid values.

This field may also be used for grouping of related orders for processing and/or reports. For example, Medication Administration Records (MARs) often group large volume solutions, medications and small volume solutions differently based upon site-specific workflow.

Usage Rule: This field is optional for all Pharmacy transactions. When not populated, a default value of "M" is assumed.

HL7 Table 0480 - Pharmacy Order Types

Value Description Comment
M Medication Default value. Includes, but is not limited to, tables, capsules, powders, puffs, and other non-injected/non-infused products.
S IV Large Volume Solutions Includes, but is not limited to, TPNs, admixtures, solutions and drips.
O Other solution as medication orders Includes, but is not limited to, piggybacks and syringes

4.A.1.27 RXO-28 Dispensing Interval (NM) 01669

Definition: This field specifies the minimum number of days that must occur between dispensing events

4.A.1.28 RXO-29 Medication Instance Identifier (EI) 02149

Components: <Entity Identifier (ST)> ^ <Namespace ID (IS)> ^ <Universal ID (ST)> ^ <Universal ID Type (ID)>

Definition: This field contains a value that uniquely identifies the medication associated with this segment. Rather than identifying the product to be given, as in RXO-1 Requested Give Code, this field serves to identify the medication in association with the order represented by the segment instance. This identifier is persistent within and across message instances.

Note: RXO-39 Medication Instance Identifier was introduced in v2.6 to support Patient Care messaging concepts and constructs. At this time, there are no documented use cases for this field in the context of a pharmacy/treatment orders as described in this chapter. This statement does not preclude the use of RXO-29 in pharmacy messages, but implementers should exercise caution in using this field outside of the Patient Care context until the pharmacy/treatment use cases are established.

4.A.1.29 RXO-30 Segment Instance Identifier (EI) 02150

Components: <Entity Identifier (ST)> ^ <Namespace ID (IS)> ^ <Universal ID (ST)> ^ <Universal ID Type (ID)>

Definition: This field contains a value that uniquely identifies this segment across time and messages. This is not intended as a "Set ID", but as a unique identifier allowing references not only to segments of the same message, but also to segments of other messages and indirectly to the entities described in those segments if the necessary persistence was manageable by the applications. This identifier is persistent within and across message instances.

Note: RXO-30 Segment Instance Identifier was introduced in v2.6 to support Patient Care messaging concepts and constructs. At this time, there are no documented use cases for this field in the context of a pharmacy/treatment orders as described in this chapter. This statement does not preclude the use of RXO-30 in pharmacy messages, but implementers should exercise caution in using this field outside of the Patient Care context until the pharmacy/treatment use cases are established.

4.A.1.30 RXO-31 Mood Code (CNE) 02151

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field represents the functional state of the order represented by this segment instance. Refer to HL7 Table 0725 - Mood Codes for valid values. This field may only be used with new trigger events and new messages from v2.6 onward. When this field is not valued in a message that qualifies, then the value is assumed to be 'EVN'.

There may appear to be overlap between this field and ORC-5 Order Status. However, the intent of Mood Code is to support the description and documentation of historical events. In this context, Mood codes may clash with Order Status codes, a Mood code may apply for different Order Status values, or this segment may be being used outside of the order paradigm (e.g., in a patient care plan). Moods are meant to change the semantics of clinical data in a message when it is not inferable from the trigger event: when the data can represent a past medication, a future medication (e.g., in a patient care plan), or in a request (e.g., as a reason for referral). The reader is referred to Chapter 12, Patient Care, for further discussion of patient care plans and referrals.

Note: RXO-31 Mood Code was introduced in v2.6 to support Patient Care messaging concepts and constructs. At this time, there are no documented use cases for this field in the context of a pharmacy/treatment orders as described in this chapter. This statement does not preclude the use of RXO-31 in pharmacy messages, but implementers should exercise caution in using this field outside of the Patient Care context until the pharmacy/treatment use cases are established. While a similar note exists for RXO-29 Medication Instance Identifier and RXO-30 Segment Instance Identifier, particular care should be taken with RXO-31 as this could modify the intent of the segment/message and create backward compatibility problems.

HL7 Table 0725 - Mood Codes

Value Description Comment
INT Intent Plan to perform a service
APT Appointment Planned act for specific time and place
ARQ Appointment Request Request for Booking of an Appointment
PRMS Promise An intent to perform a service
PRP Proposal Non-mandated intent to perform an act
RQO Request-Order Request or Order for a service
EVN Event Service actually happens or happened or is ongoing.
EVN.CRT Event Criterion

Criterion applying to Events for another Service to be applied.

This is an Act Mood Predicate

Similar uses of above moods may be defined.

Eg Use in Care Plans,
EXP Expectation Expecting that something will occur independently of deliberate intent. Eg expect a patient will discard medications.

4.A.1.31 RXO-32 Dispensing Pharmacy (CWE) 01681

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field is retained for backward compatibility only as of v27. The information formerly communicated using this field should now be communicated using the PRT segment. The reader is referred to chapter 7 for a description of that segment.

This field specifies the pharmacy that will dispense or has dispensed the prescription. In the context of an order/request (i.e., in an RXO segment) this field represents the requested dispensing pharmacy. In the context of a registered order (i.e., in an RXE segment) this field represents the intended dispensing pharmacy, the pharmacy that is expected to dispense the prescription.

4.A.1.32 RXO-33 Dispensing Pharmacy Address (XAD) 01682

Components: <Street Address (SAD)> ^ <Other Designation (ST)> ^ <City (ST)> ^ <State or Province (ST)> ^ <Zip or Postal Code (ST)> ^ <Country (ID)> ^ <Address Type (ID)> ^ <Other Geographic Designation (ST)> ^ <County/Parish Code (CWE)> ^ <Census Tract (CWE)> ^ <Address Representation Code (ID)> ^ <WITHDRAWN Constituent> ^ <Effective Date (DTM)> ^ <Expiration Date (DTM)> ^ <Expiration Reason (CWE)> ^ <Temporary Indicator (ID)> ^ <Bad Address Indicator (ID)> ^ <Address Usage (ID)> ^ <Addressee (ST)> ^ <Comment (ST)> ^ <Preference Order (NM)> ^ <Protection Code (CWE)> ^ <Address Identifier (EI)>

Subcomponents for Street Address (SAD): <Street or Mailing Address (ST)> & <Street Name (ST)> & <Dwelling Number (ST)>

Subcomponents for County/Parish Code (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Census Tract (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Expiration Reason (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Protection Code (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Address Identifier (EI): <Entity Identifier (ST)> & <Namespace ID (IS)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Definition: This field is retained for backward compatibility only as of v27. The information formerly communicated using this field should now be communicated using the PRT segment. The reader is referred to chapter 7 for a description of that segment.

This field specifies the address of the dispensing facility.

4.A.1.33 RXO-34 Deliver-to Patient Location (PL) 01683

Components: <Point of Care (HD)> ^ <Room (HD)> ^ <Bed (HD)> ^ <Facility (HD)> ^ <Location Status (IS)> ^ <Person Location Type (IS)> ^ <Building (HD)> ^ <Floor (HD)> ^ <Location Description (ST)> ^ <Comprehensive Location Identifier (EI)> ^ <Assigning Authority for Location (HD)>

Subcomponents for Point of Care (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Room (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Bed (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Facility (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Building (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Floor (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Comprehensive Location Identifier (EI): <Entity Identifier (ST)> & <Namespace ID (IS)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Assigning Authority for Location (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Definition: This field specifies the location of the patient to whom the pharmaceutical substance is to be delivered.

4.A.1.34 RXO-35 Deliver-to Address (XAD) 01684

Components: <Street Address (SAD)> ^ <Other Designation (ST)> ^ <City (ST)> ^ <State or Province (ST)> ^ <Zip or Postal Code (ST)> ^ <Country (ID)> ^ <Address Type (ID)> ^ <Other Geographic Designation (ST)> ^ <County/Parish Code (CWE)> ^ <Census Tract (CWE)> ^ <Address Representation Code (ID)> ^ <WITHDRAWN Constituent> ^ <Effective Date (DTM)> ^ <Expiration Date (DTM)> ^ <Expiration Reason (CWE)> ^ <Temporary Indicator (ID)> ^ <Bad Address Indicator (ID)> ^ <Address Usage (ID)> ^ <Addressee (ST)> ^ <Comment (ST)> ^ <Preference Order (NM)> ^ <Protection Code (CWE)> ^ <Address Identifier (EI)>

Subcomponents for Street Address (SAD): <Street or Mailing Address (ST)> & <Street Name (ST)> & <Dwelling Number (ST)>

Subcomponents for County/Parish Code (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Census Tract (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Expiration Reason (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Protection Code (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Address Identifier (EI): <Entity Identifier (ST)> & <Namespace ID (IS)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Definition: This field specifies the address, either mailing or physical, to which the prescription should be mailed or delivered.

4.A.1.35 RXO-36 Pharmacy Phone Number (XTN) 02309

Components: <WITHDRAWN Constituent> ^ <Telecommunication Use Code (ID)> ^ <Telecommunication Equipment Type (ID)> ^ <Communication Address (ST)> ^ <Country Code (SNM)> ^ <Area/City Code (SNM)> ^ <Local Number (SNM)> ^ <Extension (SNM)> ^ <Any Text (ST)> ^ <Extension Prefix (ST)> ^ <Speed Dial Code (ST)> ^ <Unformatted Telephone number (ST)> ^ <Effective Start Date (DTM)> ^ <Expiration Date (DTM)> ^ <Expiration Reason (CWE)> ^ <Protection Code (CWE)> ^ <Shared Telecommunication Identifier (EI)> ^ <Preference Order (NM)>

Subcomponents for Expiration Reason (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Protection Code (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Shared Telecommunication Identifier (EI): <Entity Identifier (ST)> & <Namespace ID (IS)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Definition: This field contains the telecommunication contact information for the pharmacy. Repetitions may be supplied for various device types or use codes, or multiple instances of the same type or use. This concept also exists as RXE-45 and RXD-34 to support pharmacy contact information in the context of the order, the encoded order and the dispense.

4.A.2 RXR - Pharmacy/Treatment Route Segment

The Pharmacy/Treatment Route segment contains the alternative combination of route, site, administration device, and administration method that are prescribed as they apply to a particular order. The pharmacy, treatment staff and/or nursing staff has a choice between the routes based on either their professional judgment or administration instructions provided by the physician.

HL7 Attribute Table - RXR - Pharmacy/Treatment Route

SEQ LEN C.LEN DT OPT RP/# TBL# ITEM # ELEMENT NAME DB Ref.
1

CWE R
0162 00309 Route DB
2

CWE O
0550 00310 Administration Site DB
3

CWE O
0164 00311 Administration Device DB
4

CWE O
0165 00312 Administration Method DB
5

CWE O
9999 01315 Routing Instruction DB
6

CWE O
0495 01670 Administration Site Modifier DB

4.A.2.0 RXR-1 Route (CWE) 00309

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field is the route of administration.

Some current "route codes," such as some of the NDC-derived codes include the site already. In such cases, the entire code can be included in this field as a "locally-defined code" for the CE data type. Refer to User-Defined Table 0162 - Route of Administration for valid values.

User-defined Table 0162 - Route of Administration

Value Description Comment
AP Apply Externally
B Buccal
DT Dental
EP Epidural
ET Endotrachial Tube* used primarily for respiratory therapy and anesthesia delivery
GTT Gastrostomy Tube
GU GU Irrigant
IMR Immerse (Soak) Body Part
IA Intra-arterial
IB Intrabursal
IC Intracardiac
ICV Intracervical (uterus)
ID Intradermal
IH Inhalation
IHA Intrahepatic Artery
IM Intramuscular
IN Intranasal
IO Intraocular
IP Intraperitoneal
IS Intrasynovial
IT Intrathecal
IU Intrauterine
IV Intravenous
MTH Mouth/Throat
MM Mucous Membrane
NS Nasal
NG Nasogastric
NP Nasal Prongs* used primarily for respiratory therapy and anesthesia delivery
NT Nasotrachial Tube
OP Ophthalmic
OT Otic
OTH Other/Miscellaneous
PF Perfusion
PO Oral
PR Rectal
RM Rebreather Mask* used primarily for respiratory therapy and anesthesia delivery
SD Soaked Dressing
SC Subcutaneous
SL Sublingual
TP Topical
TRA Tracheostomy* used primarily for respiratory therapy and anesthesia delivery
TD Transdermal
TL Translingual
UR Urethral
VG Vaginal
VM Ventimask
WND Wound

4.A.2.1 RXR-2 Administration Site (CWE) 00310

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field contains the site of the administration route. When using a post-coordinated code table in this field, RXR-6 Administration Site may be used to modify the meaning of this field.

Refer to HL7 Table 0550 - Body Parts for valid values. Other appropriate external code sets (e.g., SNOMED) may also be employed.

4.A.2.2 RXR-3 Administration Device (CWE) 00311

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field contains the mechanical device used to aid in the administration of the drug or other treatment. Common examples are IV-sets of different types. Refer to User-defined Table 0164 - Administration device for valid entries.

User-defined Table 0164 - Administration Device

Value Description Comment
AP Applicator
BT Buretrol
HL Heparin Lock
IPPB IPPB
IVP IV Pump
IVS IV Soluset
MI Metered Inhaler
NEB Nebulizer
PCA PCA Pump

4.A.2.3 RXR-4 Administration Method (CWE) 00312

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field identifies the specific method requested for the administration of the drug or treatment to the patient. Refer To User-defined Table 0165 - Administration Method for valid values.

User-defined Table 0165 - Administration Method

Value Description Comment
CH Chew
DI Dissolve
DU Dust
IF Infiltrate
IS Insert
IR Irrigate
IVPB IV Piggyback
IVP IV Push
NB Nebulized
PT Paint
PF Perfuse
SH Shampoo
SO Soak
WA Wash
WI Wipe

4.A.2.4 RXR-5 Routing Instruction (CWE) 01315

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field provides instruction on administration routing, especially in cases where more than one route of administration is possible. A typical case would be designating which IV line should be used when more than one IV line is a possible route for injection.

4.A.2.5 RXR-6 Administration Site Modifier (CWE) 01670

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field contains a modifier which modifies the meaning of RXR-2 Administration Site.

The code table used in this field is dependent upon the code table used in RXR-2 Administration site. If RXR-2 employs HL7 Table 0550 - Body Parts, then this field may only be populated with values from HL7 Table 0495 - Body Parts Modifier. In the case of other code sets (e.g., SNOMED) in RXR-2, RXR-6 may only be populated if modifiers are defined within, or related to, that code set.

Condition Rule: This field may only be populated if RXR-2 Administration Site is populated. This field is not required if RXR-2 is populated.

4.A.3 RXC - Pharmacy/Treatment Component Order Segment

If the drug or treatment ordered with the RXO segment is a compound drug OR an IV solution, AND there is not a coded value for OBR-4-universal service ID, which specifies the components (base and all additives), then the components (the base and additives) are specified by two or more RXC segments. The policy of the pharmacy or treatment application on substitutions at the RXC level is identical to that for the RXO level.

HL7 Attribute Table - RXC - Pharmacy/Treatment Component Order

SEQ LEN C.LEN DT OPT RP/# TBL# ITEM # ELEMENT NAME DB Ref.
1 1..1
ID R
0166 00313 RX Component Type DB
2

CWE R
9999 00314 Component Code DB
3

NM R

00315 Component Amount DB
4

CWE R
9999 00316 Component Units DB
5

NM O

01124 Component Strength DB
6

CWE O
9999 01125 Component Strength Units DB
7

CWE O Y 9999 01476 Supplementary Code DB
8
5# NM O

01671 Component Drug Strength Volume DB
9

CWE O
9999 01672 Component Drug Strength Volume Units DB

4.A.3.0 RXC-1 RX Component Type (ID) 00313

Definition: Following are the values for this field:

HL7 Table 0166 - RX Component Type

Value Description Comment
B Base
A Additive

For the non-IV case, the "B" value may still apply. For example, if a custom dermatologic salve is being prepared, the "B" item might be a standard base ointment into which other components are mixed.

The amount of the "base" specified in the "B" segment(s) is defined to be the quantity into which amounts specified in the "A" components are mixed. Thus the RXC segments as a group define the "recipe" for a particular amount (defined by the base segment(s)). The give amount, as defined in the RXO, does not need to correspond to this base amount. For example, the RXC segments may specify a recipe for a liter of a standard type of saline with 1 gram of a particular antimicrobial, while the give amount (from the RXO) may specify the administration of 2 liters of this IV-solution every 24 hours.

The amount specified in each "A" segment is defined to be the quantity to be added to the amount of the base as specified in its RXC segment.

If any "base" components are present then these should be transmitted first. The first "base" component in the transmission should be considered the "primary base" if such a distinction is necessary. Similarly, the first "additive" in the transmission should be considered the "primary additive" if such a distinction is necessary.

4.A.3.1 RXC-2 Component Code (CWE) 00314

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field is equivalent to OBR-4-universal service ID. It defines the base or component in the same manner as the give and dispense codes. As with the give and dispense codes, it may contain text only, code only, text + code, or text + code + units (implied or explicit). As with the give and dispense codes, if RXC-4-component units is present, this overrides the units implied by the code. If only text is present, the pharmacy or treatment application must include a manual review or reentering of the component drug or treatment.

4.A.3.2 RXC-3 Component Amount (NM) 00315

Definition: This field identifies the amount of this component to be added to the specified amount of the base.

4.A.3.3 RXC-4 Component Units (CWE) 00316

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field identifies the units for the component amount. If present, this overrides the units implied by RXC-2-component code. This must be in simple units that reflect the actual quantity of the component being added. It does not include compound units.

4.A.3.4 RXC-5 Component Strength (NM) 01124

Definition: Use when RXC-2-component code does not specify the strength. This is the numeric part of the strength, used in combination with RXC-6-component strength units.

4.A.3.5 RXC-6 Component Strength Units (CWE) 01125

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: Use when RXC-2-component code does not specify the strength. This is the unit of the strength, used in combination with RXC-5-component strength.

Note: These units can be a "compound quantity;" i.e., the units may express a quantity per unit of time. For example, micrograms per hour (micg/h) is an acceptable value. These compound units are contained in the ISO+ table. See Chapter 7 for full definition of ISO+ units.

4.A.3.6 RXC-7 Supplementary Code (CWE) 01476

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

This field accommodates the identification of any codes that might be associated with the pharmaceutical or other treatment substance. Common codes include: the Generic Product Identifier (GPI), Generic Code Number_Sequence Number (GCN_SEQNO), National Drug Code (NDC).

4.A.3.7 RXC-8 Component Drug Strength Volume (NM) 01671

Description: This numeric field defines the volume measurement in which the drug strength concentration is contained. For example, Acetaminophen 120 MG/5ML Elixir means that 120 MG of the drug is in a solution with a volume of 5, which would be encoded in RXC-5, RXC-6, RXC-8 and RXC-9 as

RXC|||||120|mg^^ISO||5|ml^^ISO ...<cr>

4.A.3.8 RXC-9 Component Drug Strength Volume Units (CWE) 01672

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Description: This field indicates the volumetric unit associated with RXC-8 Component Drug Strength Volume. See example in RXC-8.

4.A.4 RXE - Pharmacy/Treatment Encoded Order Segment

The RXE segment details the pharmacy or treatment application's encoding of the order. It also contains several pharmacy-specific order status fields, such as RXE-16-number of refills remaining, RXE-17-number of refills/doses dispensed, RXE-18-D/T of most recent refill or dose dispensed, and RXE-19-total daily dose.

Note that ORC-7-quantity/timing has a different meaning from RXE-1-quantity/timing and RXG-3-quantity/timing. The pharmacy or treatment department has the "authority" (and/or necessity) to schedule dispense/give events. Hence, the pharmacy or treatment department has the responsibility to encode this scheduling information in RXE-1-quantity/timing and RXG-3-quantity/timing. ORC-7-quantity/timing does not change: it always specifies the requested give/dispense schedule of the original order.

HL7 Attribute Table - RXE - Pharmacy/Treatment Encoded Order

SEQ LEN C.LEN DT OPT RP/# TBL# ITEM # ELEMENT NAME DB Ref.
1


W

00221 Quantity/Timing DB
2

CWE R
0292/

0479

00317 Give Code DB
3

NM R

00318 Give Amount - Minimum DB
4

NM O

00319 Give Amount - Maximum DB
5

CWE R
9999 00320 Give Units DB
6

CWE O
9999 00321 Give Dosage Form DB
7

CWE O Y 9999 00298 Provider's Administration Instructions DB
8


W

00299 Deliver-to Location DB
9 1..1
ID O
0167 00322 Substitution Status DB
10

NM C

00323 Dispense Amount DB
11

CWE C
9999 00324 Dispense Units DB
12
3= NM O

00304 Number of Refills DB
13

XCN B Y
00305 Ordering Provider's DEA Number DB
14

XCN B Y
00306 Pharmacist/Treatment Supplier's Verifier ID DB
15
20= ST C

00325 Prescription Number DB
16

NM C

00326 Number of Refills Remaining DB
17

NM C

00327 Number of Refills/Doses Dispensed DB
18

DTM C

00328 D/T of Most Recent Refill or Dose Dispensed DB
19

CQ C

00329 Total Daily Dose DB
20 1..1
ID O
0136 00307 Needs Human Review DB
21

CWE O Y 9999 00330 Pharmacy/Treatment Supplier's Special Dispensing Instructions DB
22
20= ST C

00331 Give Per (Time Unit) DB
23
6= ST O

00332 Give Rate Amount DB
24

CWE O
9999 00333 Give Rate Units DB
25

NM O

01126 Give Strength DB
26

CWE O
9999 01127 Give Strength Units DB
27

CWE O Y 9999 01128 Give Indication DB
28

NM O

01220 Dispense Package Size DB
29

CWE O
9999 01221 Dispense Package Size Unit DB
30 1..2
ID O
0321 01222 Dispense Package Method DB
31

CWE O Y 9999 01476 Supplementary Code DB
32

DTM O

01673 Original Order Date/Time DB
33
5# NM O

01674 Give Drug Strength Volume DB
34

CWE O
9999 01675 Give Drug Strength Volume Units DB
35

CWE O
0477 01676 Controlled Substance Schedule DB
36 1..1
ID O
0478 01677 Formulary Status DB
37

CWE O Y 9999 01678 Pharmaceutical Substance Alternative DB
38

CWE O
9999 01679 Pharmacy of Most Recent Fill DB
39

NM O

01680 Initial Dispense Amount DB
40

CWE B
9999 01681 Dispensing Pharmacy DB
41

XAD B

01682 Dispensing Pharmacy Address DB
42

PL O

01683 Deliver-to Patient Location DB
43

XAD O

01684 Deliver-to Address DB
44 1..1
ID O
0480 01685 Pharmacy Order Type DB
45

XTN O Y
02310 Pharmacy Phone Number DB

4.A.4.0 RXE-1 Quantity/Timing

Attention: The RXE-1 field was retained for backward compatibilty only as of v2.5 and the detail was withdrawn and removed from the standard as of v2.7.

4.A.4.1 RXE-2 Give Code (CWE) 00317

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field identifies the medical substance or treatment that has been ordered to be given to the patient, as encoded by the pharmacy or treatment supplier; it is equivalent to OBR-4-universal service ID in function. In the RXE segment, this give code must be fully encoded. The dispense fields, which define the units and amount of what is to be issued to the patient (see RXE-10-dispense amount and RXE-11-dispense units below) do not necessarily correlate with the instructions of what amount is to be "given" or administered with each dose, and may or may not be specified with the order. For example, the "give" part of the order may convey the field-representation of give 250 mg of Ampicillin, while the request to dispense part of the order may convey issue 30 tablets of generic equivalent for this outpatient prescription.

The coding system used is conditional on both the nature of the medical substance or treatment ordered and site-specific implementation considerations. For vaccines, HL7 Table 0292 - Vaccines Administered is the preferred coding system. For non-vaccine products, the coding system may be a local implementation of User-defined Table 0479 - Pharmaceutical Substances or an external coding system. Examples of external coding systems include, but are not limited to, National Drug Codes (NDC), Medispan Generic Product Identifier (MGPI), Drug Descriptor Identifier (DDID), and other drug codes listed in HL7 Table 0396 - Coding Systems. The following examples illustrate some code tables other than User-defined Table 0479:

NDC: 0006915404^Norvasc 10mg Tabs^NDC

DDID: 015189^Norvasc 10mg Tabs^DDID

CVX (HL70292): 30^HBIG^CVX

User-defined Table 0479 - Pharmaceutical Substances

Value Description Comment

No suggested values

4.A.4.2 RXE-3 Give Amount - Minimum (NM) 00318

Definition: This field contains the ordered amount as encoded by the pharmacy or treatment supplier. In a variable dose order, this is the minimum ordered amount. In a non-varying dose order, this is the exact amount of the order.

Note: This field is not a duplication of the first component of the quantity/timing field, since in non-pharmacy/treatment orders, that component can be used to specify multiples of an ordered amount. Another way to say this is that, for pharmacy/treatment orders, the quantity component of the quantity/timing field refers to what is to be given out at each service interval; thus, in terms of the RX order, that first component always defaults to 1. Hence, in the actual execution of the order, the value of 1 in the first component of the quantity/timing field always refers to one administration of the amount specified in this field (the requested Give Amount field).

4.A.4.3 RXE-4 Give Amount - Maximum (NM) 00319

Definition: In a variable dose order, this is the maximum ordered amount. In a non-varying dose, this field is not used.

4.A.4.4 RXE-5 Give Units (CWE) 00320

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field contains the units for the give amount as encoded by the pharmacy or treatment (e.g., respiratory therapy) application.

Note: These units can be a "compound quantity"; i.e., the units may contain the word "per." For example, micrograms per KG (micg/kg) is an acceptable value, which means that the units are micrograms per KG (of body weight).

A table of standard units that contains compound units is needed. Until such a table is agreed on, a user-defined table is needed for each site.

4.A.4.5 RXE-6 Give Dosage Form (CWE) 00321

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: The dosage form indicates the manner in which the medication or treatment is aggregated for dispensing, e.g., tablets, capsules, suppositories. In some cases, this information is implied by the give code in RXE-2-Give Code. Use the RXE-6-Give Dosage Form when the give code does not specify the dosage form.

4.A.4.6 RXE-7 Provider's Administration Instructions (CWE) 00298

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field contains the ordering provider's instructions to the patient or the provider administering the drug or treatment. If coded, a user-defined table must be used; if free text (describing a custom IV, mixture, or salve, for example), place the text in the second component, e.g., |^this is a free text administration instruction|.

4.A.4.7 RXE-8 Deliver-to Location

Attention: The RXE-8 field was retained for backward compatibilty only as of v2.5 and the detail was withdrawn and removed from the standard as of v2.7.

4.A.4.8 RXE-9 Substitution Status (ID) 00322

Definition: Refer to HL7 Table 0167 - Substitution Status for valid values. If a substitution has been made, and a record of the original requested give code (RXO-1-requested give code) is needed, the optional RXO segment can be included in the RDE message.

HL7 Table 0167 - Substitution Status

Value Description Comment
N No substitute was dispensed. This is equivalent to the default (null) value.
G A generic substitution was dispensed.
T A therapeutic substitution was dispensed.
0 No product selection indicated
1 Substitution not allowed by prescriber
2 Substitution allowed - patient requested product dispensed
3 Substitution allowed - pharmacist selected product dispensed
4 Substitution allowed - generic drug not in stock
5 Substitution allowed - brand drug dispensed as a generic
7 Substitution not allowed - brand drug mandated by law
8 Substitution allowed - generic drug not available in marketplace

4.A.4.9 RXE-10 Dispense Amount (NM) 00323

Definition: This field contains the amount to be dispensed as encoded by the pharmacy or treatment supplier.

4.A.4.10 RXE-11 Dispense Units (CWE) 00324

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field contains the units for the dispense amount as encoded by the pharmacy or treatment supplier. This field is required if the units are not implied by the actual dispense code. This must be in simple units that reflect the actual quantity of the substance dispensed. It does not include compound units.

4.A.4.11 RXE-12 Number of Refills (NM) 00304

Definition: This field contains the total original number of refills. Outpatient only.

4.A.4.12 RXE-13 Ordering Provider's DEA Number (XCN) 00305

Components: <Person Identifier (ST)> ^ <Family Name (FN)> ^ <Given Name (ST)> ^ <Second and Further Given Names or Initials Thereof (ST)> ^ <Suffix (e.g., JR or III) (ST)> ^ <Prefix (e.g., DR) (ST)> ^ <WITHDRAWN Constituent> ^ <DEPRECATED-Source Table (CWE)> ^ <Assigning Authority (HD)> ^ <Name Type Code (ID)> ^ <Identifier Check Digit (ST)> ^ <Check Digit Scheme (ID)> ^ <Identifier Type Code (ID)> ^ <Assigning Facility (HD)> ^ <Name Representation Code (ID)> ^ <Name Context (CWE)> ^ <WITHDRAWN Constituent> ^ <Name Assembly Order (ID)> ^ <Effective Date (DTM)> ^ <Expiration Date (DTM)> ^ <Professional Suffix (ST)> ^ <Assigning Jurisdiction (CWE)> ^ <Assigning Agency or Department (CWE)> ^ <Security Check (ST)> ^ <Security Check Scheme (ID)>

Subcomponents for Family Name (FN): <Surname (ST)> & <Own Surname Prefix (ST)> & <Own Surname (ST)> & <Surname Prefix from Partner/Spouse (ST)> & <Surname from Partner/Spouse (ST)>

Subcomponents for Source Table (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Assigning Authority (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Assigning Facility (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Name Context (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Assigning Jurisdiction (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Assigning Agency or Department (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Definition: This field is retained for backward compatibility only as of v27. The reader is referred to the PRT segment described in chapter 7.

This field is defined as conditional because it is required when the substance requested is a controlled substance (e.g., a narcotic). If the person referenced in this field is also referenced in PRT segment, they must contain the same information. However, if there is a difference, then PRT segment takes precedence.

4.A.4.13 RXE-14 Pharmacist/Treatment Supplier's Verifier ID (XCN) 00306

Components: <Person Identifier (ST)> ^ <Family Name (FN)> ^ <Given Name (ST)> ^ <Second and Further Given Names or Initials Thereof (ST)> ^ <Suffix (e.g., JR or III) (ST)> ^ <Prefix (e.g., DR) (ST)> ^ <WITHDRAWN Constituent> ^ <DEPRECATED-Source Table (CWE)> ^ <Assigning Authority (HD)> ^ <Name Type Code (ID)> ^ <Identifier Check Digit (ST)> ^ <Check Digit Scheme (ID)> ^ <Identifier Type Code (ID)> ^ <Assigning Facility (HD)> ^ <Name Representation Code (ID)> ^ <Name Context (CWE)> ^ <WITHDRAWN Constituent> ^ <Name Assembly Order (ID)> ^ <Effective Date (DTM)> ^ <Expiration Date (DTM)> ^ <Professional Suffix (ST)> ^ <Assigning Jurisdiction (CWE)> ^ <Assigning Agency or Department (CWE)> ^ <Security Check (ST)> ^ <Security Check Scheme (ID)>

Subcomponents for Family Name (FN): <Surname (ST)> & <Own Surname Prefix (ST)> & <Own Surname (ST)> & <Surname Prefix from Partner/Spouse (ST)> & <Surname from Partner/Spouse (ST)>

Subcomponents for Source Table (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Assigning Authority (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Assigning Facility (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Name Context (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Assigning Jurisdiction (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Assigning Agency or Department (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Definition: This field is retained for backward compatibility only as of v27. The reader is referred to the PRT segment described in chapter 7.

This field contains the provider ID of Pharmacist/treatment supplier's verifier. Use if required by the pharmacy or treatment application or site on orders (or some subgroup of orders). If the person referenced in this field is also referenced in PRT segment, they must contain the same information. However, if there is a difference, then PRT segment takes precedence.

4.A.4.14 RXE-15 Prescription Number (ST) 00325

Definition: This field contains the prescription number as assigned by the pharmacy or treatment application. Equivalent in uniqueness to the pharmacy/treatment filler order number. At some sites, this may be the pharmacy or treatment system (internal) sequential form. At other sites, this may be an external form. This is a required field in RXE when used in pharmacy/treatment messages, but it is not required when used in product experience messages (see Chapter 7).

4.A.4.15 RXE-16 Number of Refills Remaining (NM) 00326

Definition: Number of refills remaining. This field is conditional because it is required when a prescription is dispensed to an outpatient. It is not relevant to inpatient treatment orders.

4.A.4.16 RXE-17 Number of Refills/Doses Dispensed (NM) 00327

Definition: Number of refills remaining. This field is conditional because it is required when a prescription is dispensed to an outpatient. It is not relevant to inpatient treatment orders.

4.A.4.17 RXE-18 D/T of Most Recent Refill or Dose Dispensed (DTM) 00328

Definition: Date/time of the most recent refill or dose dispensed.

4.A.4.18 RXE-19 Total Daily Dose (CQ) 00329

Components: <Quantity (NM)> ^ <Units (CWE)>

Subcomponents for Units (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Definition: This field contains the total daily dose for this particular pharmaceutical as expressed in terms of actual dispense units.

4.A.4.19 RXE-20 Needs Human Review (ID) 00307

Definition: This field uses HL7 Table 0136 - Yes/No Indicator. The values have the following meaning for this field:

Y Yes - Indicates that a warning is present. The application receiving the encoded order needs to warn the person administering the drug or treatment to pay attention to the text in RXE-21-pharmacy/treatment special dispensing instructions.

N No - Indicates no warning is present. This is the equivalent default (null) value.

4.A.4.20 RXE-21 Pharmacy/Treatment Supplier's Special Dispensing Instructions (CWE) 00330

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field contains the pharmacy or treatment supplier's provider-generated special instructions to the provider dispensing/administering the order.

4.A.4.21 RXE-22 Give Per (Time Unit) (ST) 00331

Definition: This field contains the time unit to use to calculate the rate at which the pharmaceutical is to be administered.

Format:

S = seconds
M = minutes
H = hours
D = days
W = weeks
L = months
T = at the interval and amount stated until a total of "DOSAGE" is accumulated. Units would be assumed to be the same as in the QUANTITY field.
INDEF = do indefinitely - also the default

This is the same as the format specified for the DURATION component of the quantity/timing field, excluding the "X" specification.

This field is defined as conditional because it is required when the ordered substance is to be administered continuously at a prescribed rate (e.g., certain IVs). For example, if the "give amount/units" were 300 ml and the "give per" time unit were H1 (equivalent to one hour), the rate is 300ml/hr.

4.A.4.22 RXE-23 Give Rate Amount (ST) 00332

Definition: This field contains the rate at which the substance should be administered.

4.A.4.23 RXE-24 Give Rate Units (CWE) 00333

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field contains the units for RXE-23-give rate amount. May be composite. The ratio of the RXE-23-give rate amount and RXE-24-give rate units defines the actual rate of administration. Thus, if RXE-23-give rate amount = 100 and RXE-24-give rate units = ml/hr, the requested rate of administration is 100 ml/hr. (See ISO+ figure 7-9 in Chapter 7 for possible compound units codes.)

4.A.4.24 RXE-25 Give Strength (NM) 01126

Definition: Use when RXE-2-give code does not specify the strength. This is the numeric part of the strength, used in combination with RXE-26-give strength units.

4.A.4.25 RXE-26 Give Strength Units (CWE) 01127

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: Use when RXE-2-Give Code does not specify the strength. This is the unit of the strength, used in combination with RXE-25-Give Strength.

Note: These units can be a "compound quantity"; i.e., the units may express a quantity per unit of time. For example, micrograms per hour (micg/h) is an acceptable value. These compound units are contained in the ISO+ table. See Chapter 7 for full definition of ISO+ units.

4.A.4.26 RXE-27 Give Indication (CWE) 01128

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field identifies the condition or problem for which the drug/treatment was prescribed. May repeat if multiple indications are relevant.

4.A.4.27 RXE-28 Dispense Package Size (NM) 01220

Definition: This field contains the size of package to be dispensed. Units are transmitted in RXE-29-dispense package size unit.

4.A.4.28 RXE-29 Dispense Package Size Unit (CWE) 01221

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field contains the units in which RXE-28-dispense package size is denominated.

4.A.4.29 RXE-30 Dispense Package Method (ID) 01222

Definition: This field contains the method by which treatment is dispensed. Refer to HL7 Table 0321 - Dispense Method for valid values.

HL7 Table 0321 - Dispense Method

Value Description Comment
TR Traditional
UD Unit Dose
F Floor Stock
AD Automatic Dispensing

4.A.4.30 RXE-31 Supplementary Code (CWE) 01476

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field accommodates the identification of any codes that might be associated with the pharmaceutical substance. Common codes include: the Generic Product Identifier (GPI), Generic Code Number_Sequence Number (GCN_SEQNO), National Drug Code (NDC).

4.A.4.31 RXE-32 Original Order Date/Time (DTM) 01673

Definition: This field contains the date/time of the original order (ORC-9) when a refill authorization is being requested. This was represented in the ORC-9 of the original order transaction.

4.A.4.32 RXE-33 Give Drug Strength Volume (NM) 01674

Description: This numeric field defines the volume measurement in which the drug strength concentration is contained. For example, Acetaminophen 120 MG/5ML Elixir means that 120 MG of the drug is in a solution with a volume of 5 ML, which would be encoded in RXE-25, RXE-26, RXE-33 and RXE-34 as:

RXE|||||||||||||||||||||||||120|mg^^ISO|||||||5|ml^^ISO ...<cr>

4.A.4.33 RXE-34 Give Drug Strength Volume Units (CWE) 01675

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Description: This field indicates the volumetric unit associated with RXE-33 Give Drug Strength Volume. See example in RXE-33.

4.A.4.34 RXE-35 Controlled Substance Schedule (CWE) 01676

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field specifies the class of the drug or other substance if its usage is controlled by legislation. In the USA, such legislation includes the federal Controlled Substance Act (CSA) or a State Uniform Controlled Substance Act. Refer to User-defined table 0477 - Controlled Substance Schedule for valid values for USA usage. Other countries should create their own versions of this table.

Because some jurisdictions may extend the list of drugs in a particular class and may create an additional schedule, table 0477 is user-defined.

User-defined Table 0477 - Controlled Substance Schedule*

Value Description Comment
I Schedule I Includes drugs that have a high potential for abuse, no currently accepted medical use in the United States and a lack of accepted safety for use under medical supervision.
II Schedule II Includes drugs having currently accepted medical use in the United States and a high abuse potential, with severe psychological or physical dependence liability.
III Schedule III Includes drugs having an abuse potential less than that of drugs listed in Schedules I and II. All CS III drugs have a currently accepted medical use in the United States.
IV Schedule IV Includes drugs having a lesser potential for abuse than those listed in Schedule III. CS IV drugs have a currently accepted medical use in the United States.
V Schedule V Includes drugs having low abuse potential and limited physical or psychological dependence relative to those listed in IV and have an accepted medical use in the United States.
VI Schedule VI State defined

*Pharmacy Law Digest July 1988

4.A.4.35 RXE-36 Formulary Status (ID) 01677

Definition: This field specifies whether or not the pharmaceutical substance is part of the local formulary. Refer to HL7 table 0478 - Formulary Status for valid values.

HL7 Table 0478 - Formulary Status

Value Description Comment
Y Pharmaceutical substance is in the formulary
N Pharmaceutical substance is NOT in the formulary
R Pharmaceutical substance is in the formulary, but restrictions apply
G Pharmaceutical substance is in the formulary, but guidelines apply

4.A.4.36 RXE-37 Pharmaceutical Substance Alternative (CWE) 01678

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field specifies a pharmaceutical substance that is in the formulary that could be prescribed in lieu of the substance being prescribed. In the case where the specified medication is non-formulary this field would contain therapeutic alternatives that are on the formulary.

4.A.4.37 RXE-38 Pharmacy of Most Recent Fill (CWE) 01679

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field specifies the pharmacy that last filled the prescription.

4.A.4.38 RXE-39 Initial Dispense Amount (NM) 01680

Definition: This field specifies the quantity dispensed on the original fill (first fill) of a prescription when that amount is not the same as the quantity to be used in refills. One use case is when a new medication is being prescribed and the prescriber wants to determine if the patient will tolerate the medication. The prescriber indicates that the medication should be filled for an initial amount of 30 tablets and, if tolerated, refilled using a quantity of 100 tablets. In this case, RXE-39 would contain 30 and RXE-10 would contain 100.

If this field is not populated, then the initial dispense amount is the same as RXE-10.

The units are identified in RXE-11.

4.A.4.39 RXE-40 Dispensing Pharmacy (CWE) 01681

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field is retained for backward compatibility only as of v27. The information formerly communicated using this field should now be communicated using the PRT segment. The reader is referred to chapter 7 for a description of that segment.

This field specifies the pharmacy that will dispense or has dispensed the prescription. In the context of an order/request (i.e., in an RXO segment) this field represents the requested dispensing pharmacy. In the context of a registered order (i.e., in an RXE segment) this field represents the intended dispensing pharmacy, the pharmacy that is expected to dispense the prescription.

4.A.4.40 RXE-41 Dispensing Pharmacy Address (XAD) 01682

Components: <Street Address (SAD)> ^ <Other Designation (ST)> ^ <City (ST)> ^ <State or Province (ST)> ^ <Zip or Postal Code (ST)> ^ <Country (ID)> ^ <Address Type (ID)> ^ <Other Geographic Designation (ST)> ^ <County/Parish Code (CWE)> ^ <Census Tract (CWE)> ^ <Address Representation Code (ID)> ^ <WITHDRAWN Constituent> ^ <Effective Date (DTM)> ^ <Expiration Date (DTM)> ^ <Expiration Reason (CWE)> ^ <Temporary Indicator (ID)> ^ <Bad Address Indicator (ID)> ^ <Address Usage (ID)> ^ <Addressee (ST)> ^ <Comment (ST)> ^ <Preference Order (NM)> ^ <Protection Code (CWE)> ^ <Address Identifier (EI)>

Subcomponents for Street Address (SAD): <Street or Mailing Address (ST)> & <Street Name (ST)> & <Dwelling Number (ST)>

Subcomponents for County/Parish Code (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Census Tract (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Expiration Reason (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Protection Code (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Address Identifier (EI): <Entity Identifier (ST)> & <Namespace ID (IS)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Definition: This field is retained for backward compatibility only as of v27. The information formerly communicated using this field should now be communicated using the PRT segment. The reader is referred to chapter 7 for a description of that segment.

This field specifies the address of the dispensing facility.

4.A.4.41 RXE-42 Deliver-To Patient Location (PL) 01683

Components: <Point of Care (HD)> ^ <Room (HD)> ^ <Bed (HD)> ^ <Facility (HD)> ^ <Location Status (IS)> ^ <Person Location Type (IS)> ^ <Building (HD)> ^ <Floor (HD)> ^ <Location Description (ST)> ^ <Comprehensive Location Identifier (EI)> ^ <Assigning Authority for Location (HD)>

Subcomponents for Point of Care (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Room (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Bed (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Facility (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Building (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Floor (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Comprehensive Location Identifier (EI): <Entity Identifier (ST)> & <Namespace ID (IS)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Assigning Authority for Location (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Definition: This field specifies the location of the patient to whom the pharmaceutical substance is to be delivered.

4.A.4.42 RXE-43 Deliver-to Address (XAD) 01684

Components: <Street Address (SAD)> ^ <Other Designation (ST)> ^ <City (ST)> ^ <State or Province (ST)> ^ <Zip or Postal Code (ST)> ^ <Country (ID)> ^ <Address Type (ID)> ^ <Other Geographic Designation (ST)> ^ <County/Parish Code (CWE)> ^ <Census Tract (CWE)> ^ <Address Representation Code (ID)> ^ <WITHDRAWN Constituent> ^ <Effective Date (DTM)> ^ <Expiration Date (DTM)> ^ <Expiration Reason (CWE)> ^ <Temporary Indicator (ID)> ^ <Bad Address Indicator (ID)> ^ <Address Usage (ID)> ^ <Addressee (ST)> ^ <Comment (ST)> ^ <Preference Order (NM)> ^ <Protection Code (CWE)> ^ <Address Identifier (EI)>

Subcomponents for Street Address (SAD): <Street or Mailing Address (ST)> & <Street Name (ST)> & <Dwelling Number (ST)>

Subcomponents for County/Parish Code (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Census Tract (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Expiration Reason (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Protection Code (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Address Identifier (EI): <Entity Identifier (ST)> & <Namespace ID (IS)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Definition: This field specifies the address, either mailing or physical, to which the prescription should be mailed or delivered.

4.A.4.43 RXE-44 Pharmacy Order Type (ID) 01685

Definition: The Pharmacy Order Type field defines the general category of pharmacy order which may be used to determine the processing path the order will take. Refer to HL7 Table 0480 Pharmacy Order Types for valid values.

This field may also be used for grouping of related orders for processing and/or reports. For example, Medication Administration Records (MARs) often group large volume solutions, medications and small volume solutions differently based upon site-specific workflow.

Usage Rule: This field is optional for all Pharmacy transactions. When not populated, a default value of "M" is assumed.

4.A.4.44 RXE-45 Pharmacy Phone Number (XTN) 02310

Components: <WITHDRAWN Constituent> ^ <Telecommunication Use Code (ID)> ^ <Telecommunication Equipment Type (ID)> ^ <Communication Address (ST)> ^ <Country Code (SNM)> ^ <Area/City Code (SNM)> ^ <Local Number (SNM)> ^ <Extension (SNM)> ^ <Any Text (ST)> ^ <Extension Prefix (ST)> ^ <Speed Dial Code (ST)> ^ <Unformatted Telephone number (ST)> ^ <Effective Start Date (DTM)> ^ <Expiration Date (DTM)> ^ <Expiration Reason (CWE)> ^ <Protection Code (CWE)> ^ <Shared Telecommunication Identifier (EI)> ^ <Preference Order (NM)>

Subcomponents for Expiration Reason (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Protection Code (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Shared Telecommunication Identifier (EI): <Entity Identifier (ST)> & <Namespace ID (IS)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Definition: This field contains the telecommunication contact information for the pharmacy. Repetitions may be supplied for various device types or use codes, or multiple instances of the same type or use. This concept also exists as RXO-36 and RXD-34 to support pharmacy contact information in the context of the order, the encoded order and the dispense.

4.A.5 RXD - Pharmacy/Treatment Dispense Segment

HL7 Attribute Table - RXD - Pharmacy/Treatment Dispense

SEQ LEN C.LEN DT OPT RP/# TBL# ITEM # ELEMENT NAME DB Ref.
1
4= NM R

00334 Dispense Sub-ID Counter DB
2

CWE R
0292 00335 Dispense/Give Code DB
3

DTM R

00336 Date/Time Dispensed DB
4

NM R

00337 Actual Dispense Amount DB
5

CWE C
9999 00338 Actual Dispense Units DB
6

CWE O
9999 00339 Actual Dosage Form DB
7
20= ST R

00325 Prescription Number DB
8

NM C

00326 Number of Refills Remaining DB
9
200= ST O Y
00340 Dispense Notes DB
10

XCN B Y
00341 Dispensing Provider DB
11 1..1
ID O
0167 00322 Substitution Status DB
12

CQ O

00329 Total Daily Dose DB
13

LA2 B

01303 Dispense-to Location DB
14 1..1
ID O
0136 00307 Needs Human Review DB
15

CWE O Y 9999 00330 Pharmacy/Treatment Supplier's Special Dispensing Instructions DB
16

NM O

01132 Actual Strength DB
17

CWE O
9999 01133 Actual Strength Unit DB
18
20= ST O Y
01129 Substance Lot Number DB
19

DTM O Y
01130 Substance Expiration Date DB
20

CWE O Y 0227 01131 Substance Manufacturer Name DB
21

CWE O Y 9999 01123 Indication DB
22

NM O

01220 Dispense Package Size DB
23

CWE O
9999 01221 Dispense Package Size Unit DB
24 1..2
ID O
0321 01222 Dispense Package Method DB
25

CWE O Y 9999 01476 Supplementary Code DB
26

CWE O
9999 01477 Initiating Location DB
27

CWE O
9999 01478 Packaging/Assembly Location DB
28
5= NM O

01686 Actual Drug Strength Volume DB
29

CWE O
9999 01687 Actual Drug Strength Volume Units DB
30

CWE B
9999 01688 Dispense to Pharmacy DB
31

XAD B

01689 Dispense to Pharmacy Address DB
32 1..1
ID O
0480 01690 Pharmacy Order Type DB
33

CWE O
0484 01691 Dispense Type DB
34

XTN O Y
02311 Pharmacy Phone Number DB

4.A.5.0 RXD-1 Dispense Sub-ID counter (NM) 00334

Definition: This field starts with 1 the first time that medication/treatment is delivered/dispensed for this order. Increments by one with each additional issuance.

4.A.5.1 RXD-2 Dispense/Give Code (CWE) 00335

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field identifies the medical substance or treatment ordered to be given to the patient; it is equivalent to OBR-4-Universal Service ID. See the RXE segment for a complete definition of the RXE-2-give code. If the substance dispensed is a vaccine, CVX codes may be used to code this field (see HL7 Table 0292 - Vaccines Administered).

Note: The contents of RXD-2-dispense/give code should be compatible with the comparable field in the RXE (RXE-2-give code). The RDS message refers ONLY to the dispensing of the drug or treatment by the pharmacy or treatment supplier.

4.A.5.2 RXD-3 Date/Time Dispensed (DTM) 00336

Definition: This field indicates when the pharmaceutical/treatment is dispensed from the pharmacy or treatment supplier. Use the time stamp format.

4.A.5.3 RXD-4 Actual Dispense Amount (NM) 00337

Definition: This field indicates the amount dispensed.

4.A.5.4 RXD-5 Actual Dispense Units (CWE) 00338

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field indicates the units dispensed. Site-defined table. This field is required if the units are not implied by the actual dispense code. If present, it overrides units implied by the actual dispense code. This must be in simple units that reflect the actual quantity of the substance dispensed. It does not include compound units.

4.A.5.5 RXD-6 Actual Dosage Form (CWE) 00339

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: The dosage form indicates the manner in which the medication/treatment is aggregated for dispensing, e.g., tablets, capsules, suppositories. In some cases, this information is implied by the dispense/give code in RXD-2-dispense/give code. Use this field when the give code and the dispense code do not specify the dosage form.

4.A.5.6 RXD-7 Prescription Number (ST) 00325

Definition: This field is equivalent in uniqueness to the pharmacy/treatment supplier filler order number. At some sites, this may be the pharmacy/treatment supplier (internal) sequential form. At other sites, this may be an external number.

4.A.5.7 RXD-8 Number of Refills Remaining (NM) 00326

Definition: This field is conditional because it is required when a prescription is dispensed to an outpatient. It is not relevant to inpatient treatment orders.

4.A.5.8 RXD-9 Dispense Notes (ST) 00340

Definition: This field contains free text notes to the person dispensing the medication/treatment (may include the ordering provider's original notes, as well as any notes from the formulary or the pharmacy or treatment supplier). This may contain free text describing a custom IV, mixture, or salve for example.

4.A.5.9 RXD-10 Dispensing Provider (XCN) 00341

Components: <Person Identifier (ST)> ^ <Family Name (FN)> ^ <Given Name (ST)> ^ <Second and Further Given Names or Initials Thereof (ST)> ^ <Suffix (e.g., JR or III) (ST)> ^ <Prefix (e.g., DR) (ST)> ^ <WITHDRAWN Constituent> ^ <DEPRECATED-Source Table (CWE)> ^ <Assigning Authority (HD)> ^ <Name Type Code (ID)> ^ <Identifier Check Digit (ST)> ^ <Check Digit Scheme (ID)> ^ <Identifier Type Code (ID)> ^ <Assigning Facility (HD)> ^ <Name Representation Code (ID)> ^ <Name Context (CWE)> ^ <WITHDRAWN Constituent> ^ <Name Assembly Order (ID)> ^ <Effective Date (DTM)> ^ <Expiration Date (DTM)> ^ <Professional Suffix (ST)> ^ <Assigning Jurisdiction (CWE)> ^ <Assigning Agency or Department (CWE)> ^ <Security Check (ST)> ^ <Security Check Scheme (ID)>

Subcomponents for Family Name (FN): <Surname (ST)> & <Own Surname Prefix (ST)> & <Own Surname (ST)> & <Surname Prefix from Partner/Spouse (ST)> & <Surname from Partner/Spouse (ST)>

Subcomponents for Source Table (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Assigning Authority (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Assigning Facility (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Name Context (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Assigning Jurisdiction (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Assigning Agency or Department (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Definition: This field is retained for backward compatibility only as of v27. The reader is referred to the PRT segment described in chapter.7.

This field contains the provider ID of the person dispensing the pharmaceutical. If the person referenced in this field is also referenced in PRT segment, they must contain the same information. However, if there is a difference, then PRT segment takes precedence.

4.A.5.10 RXD-11 Substitution Status (ID) 00322

Definition: Refer to HL7 Table 0167 - Substitution Status for suggested values.

4.A.5.11 RXD-12 Total Daily Dose (CQ) 00329

Components: <Quantity (NM)> ^ <Units (CWE)>

Subcomponents for Units (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Definition: This field contains the total daily dose being dispensed as expressed in terms of the actual dispense units.

Note: The next two fields are equivalent to the corresponding fields of the RXE segment. They are included (optionally) in the RXD so that it may "stand alone" as a dispense result instruction segment.

4.A.5.12 RXD-13 Dispense-to Location (LA2) 01303

Components: <Point of Care (IS)> ^ <Room (IS)> ^ <Bed (IS)> ^ <Facility (HD)> ^ <Location Status (IS)> ^ <Patient Location Type (IS)> ^ <Building (IS)> ^ <Floor (IS)> ^ <Street Address (ST)> ^ <Other Designation (ST)> ^ <City (ST)> ^ <State or Province (ST)> ^ <Zip or Postal Code (ST)> ^ <Country (ID)> ^ <Address Type (ID)> ^ <Other Geographic Designation (ST)>

Subcomponents for Facility (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Definition: This field is retained for backward compatibility only as of v 2.6. The reader is referred toRXD-30 and RXD-31. The first component (which is of PL data type with the component delimiters demoted to subcomponents) contains the inpatient or outpatient location where the drug or treatment was dispensed (if applicable). The default (null) value is the current census location for the patient. Site-specific table. The first eight components have the same form as the first eight components of PV1-3-Assigned Patient Location. The final eight components replace the ninth component of PV1-3-Assigned Patient Location and represent the full address specification.

4.A.5.13 RXD-14 Needs Human Review (ID) 00307

Definition: Refer to HL7 table 0136 - Yes/no indicator for valid values. The values have the following meaning for this field:

Y Yes - Indicates that a warning is present. The application receiving the dispense order needs to warn the person dispensing/administering the drug or treatment to pay attention to the text in RXD-15-pharmacy/treatment supplier's special dispensing instructions.

N No - Indicates no warning is present. This is the equivalent default (null) value.

4.A.5.14 RXD-15 Pharmacy/Treatment Supplier's Special Dispensing Instructions (CWE) 00330

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field contains pharmacy or treatment supplier-generated special instructions to the provider dispensing/administering the order.

4.A.5.15 RXD-16 Actual Strength (NM) 01132

Definition: Use when RXD-2-Dispense/Give Code does not specify the strength. This is the numeric part of the strength, of a single dosage unit of the dispensed product, used in combination with RXD-17-actual strength unit.

4.A.5.16 RXD-17 Actual Strength Unit (CWE) 01133

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: Use when RXD-2-Dispense/Give Code does not specify the strength. This is the unit of the strength, of a single dosage unit of the dispensed product, used in combination with RXD-16-actual strength.

Note: These units can be a "compound quantity;" i.e., the units may express a quantity per unit of time. For example, micrograms per hour (micg/h) is an acceptable value. These compound units are contained in the ISO+ table. See Chapter 7 for full definition of ISO+ units.

4.A.5.17 RXD-18 Substance Lot Number (ST) 01129

Definition: This field contains the lot number of the medical substance administered.

Note: The lot number is the number printed on the label attached to the container holding the substance and on the packaging which houses the container. If the substance is a vaccine, for example, and a diluent is required, a lot number may appear on the vial containing the diluent; however, any such identifier associated with a diluent is not the identifier of interest. The substance lot number should be reported, not that of the diluent.

4.A.5.18 RXD-19 Substance Expiration Date (DTM) 01130

Definition: This field contains the expiration date of the medical substance administered.

Note: Vaccine expiration date does not always have a "day" component; therefore, such a date may be transmitted as YYYYMM^L.

4.A.5.19 RXD-20 Substance Manufacturer Name (CWE) 01131

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field contains the manufacturer of the medical substance administered when it is a manufactured substance.

Note: For vaccines, code system MVX may be used to code this field. See Section 4A.7.1, "Vaccine administration data". This field may be used if the manufacturer of the substance is not identified by the code used in RXA-5-Administered code.

4.A.5.20 RXD-21 Indication (CWE) 01123

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field contains the identifier of the condition or problem for which the drug/treatment was prescribed. May repeat if multiple indications are relevant.

4.A.5.21 RXD-22 Dispense Package Size (NM) 01220

Definition: This field contains the size of package to be dispensed. Units are transmitted in RXD-23-dispense package size unit.

4.A.5.22 RXD-23 Dispense Package Size Unit (CWE) 01221

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field contains the units in which RXE-28-dispense package size is denominated. The advertised number of units in the manufacturer's package, i.e., the package as it comes from the supplier.

4.A.5.23 RXD-24 Dispense Package Method (ID) 01222

Definition: This field contains the method by which treatment is dispensed. Refer To HL7 Table 0321 - Dispense Method for valid values.

4.A.5.24 RXD-25 Supplementary code (CWE) 01476

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field accommodates the identification of any codes that might be associated with the pharmaceutical substance. Common codes include: the Generic Product Identifier (GPI), Generic Code Number_Sequence Number (GCN_SEQNO), National Drug Code (NDC).

4.A.5.25 RXD-26 Initiating Location (CWE) 01477

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field identifies the pharmacy or other treatment dispensing service (e.g., respiratory) that received the initial request.

Example: Pharmacy A (the Intake/Receiving) receives a phone call from the patient requesting a medication refill, but stipulates that the prescription will be picked up in pharmacy B. In accordance with the business process the prescription will be packaged/assembled in Pharmacy C.

4.A.5.26 RXD-27 Packaging/Assembly Location (CWE) 01478

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field identifies the pharmacy which packaged/assembled request.

4.A.5.27 RXD-28 Actual Drug Strength Volume (NM) 01686

Description: This numeric field defines the volume measurement in which the drug strength concentration is contained. For example, Acetaminophen 120 MG/5ML Elixir means that 120 MG of the drug is in a solution with a volume of 5 ML , which would be encoded in RXD-16, RXD-17, RXD-28 and RXD-29 as

RXD||||||||||||||||120|mg^^ISO|||||||||||5|ml^^ISO ...<cr>

4.A.5.28 RXD-29 Actual Drug Strength Volume Units (CWE) 01687

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Description: This field indicates the volumetric unit associated with RXD-28 Actual Drug Strength Volume. See example in RXD-28.

4.A.5.29 RXD-30 Dispense to Pharmacy (CWE) 01688

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field is retained for backward compatibility only as of v27. The information formerly communicated using this field should now be communicated using the PRT segment. The reader is referred to chapter 7 for a description of that segment.

This field specifies the pharmacy that will dispense or has dispensed the prescription. In the context of an order/request (i.e., in an RXO segment) this field represents the requested dispensing pharmacy. In the context of a registered order (i.e., in an RXE segment) this field represents the intended dispensing pharmacy, the pharmacy that is expected to dispense the prescription.

4.A.5.30 RXD-31 Dispense to Pharmacy Address (XAD) 01689

Components: <Street Address (SAD)> ^ <Other Designation (ST)> ^ <City (ST)> ^ <State or Province (ST)> ^ <Zip or Postal Code (ST)> ^ <Country (ID)> ^ <Address Type (ID)> ^ <Other Geographic Designation (ST)> ^ <County/Parish Code (CWE)> ^ <Census Tract (CWE)> ^ <Address Representation Code (ID)> ^ <WITHDRAWN Constituent> ^ <Effective Date (DTM)> ^ <Expiration Date (DTM)> ^ <Expiration Reason (CWE)> ^ <Temporary Indicator (ID)> ^ <Bad Address Indicator (ID)> ^ <Address Usage (ID)> ^ <Addressee (ST)> ^ <Comment (ST)> ^ <Preference Order (NM)> ^ <Protection Code (CWE)> ^ <Address Identifier (EI)>

Subcomponents for Street Address (SAD): <Street or Mailing Address (ST)> & <Street Name (ST)> & <Dwelling Number (ST)>

Subcomponents for County/Parish Code (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Census Tract (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Expiration Reason (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Protection Code (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Address Identifier (EI): <Entity Identifier (ST)> & <Namespace ID (IS)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Definition: This field is retained for backward compatibility only as of v27. The information formerly communicated using this field should now be communicated using the PRT segment. The reader is referred to chapter 7 for a description of that segment.

This field specifies the address of the dispensing facility or the patient's location where the dispensing will occur.

4.A.5.31 RXD-32 Pharmacy Order Type (ID) 01690

Definition: The Pharmacy Order Type field defines the general category of pharmacy order which may be used to determine the processing path the order will take. Refer to HL7 Table 0480 Pharmacy Order Types for valid values.

This field may also be used for grouping of related orders for processing and/or reports. For example, Medication Administration Records (MARs) often group large volume solutions, medications and small volume solutions differently based upon site-specific workflow.

Usage Rule: This field is optional for all Pharmacy transactions. When not populated, a default value of "M" is assumed.

4.A.5.32 RXD-33 Dispense Type (CWE) 01691

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This is the type of dispensing event that occurred. Refer to User-defined Table 0484 - Dispense Type for suggested values.

User-defined Table 0484 - Dispense Type

Value Description Comment
B Trial Quantity Balance
C Compassionate Fill
N New/Renew - Full Fill
P New/Renew - Part Fill
Q Refill - Part Fill
R Refill - Full Fill
S Manufacturer Sample
T Trial Quantity
Z Non-Prescription Fill

4.A.5.33 RXD-34 Pharmacy Phone Number (XTN) 02311

Components: <WITHDRAWN Constituent> ^ <Telecommunication Use Code (ID)> ^ <Telecommunication Equipment Type (ID)> ^ <Communication Address (ST)> ^ <Country Code (SNM)> ^ <Area/City Code (SNM)> ^ <Local Number (SNM)> ^ <Extension (SNM)> ^ <Any Text (ST)> ^ <Extension Prefix (ST)> ^ <Speed Dial Code (ST)> ^ <Unformatted Telephone number (ST)> ^ <Effective Start Date (DTM)> ^ <Expiration Date (DTM)> ^ <Expiration Reason (CWE)> ^ <Protection Code (CWE)> ^ <Shared Telecommunication Identifier (EI)> ^ <Preference Order (NM)>

Subcomponents for Expiration Reason (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Protection Code (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Shared Telecommunication Identifier (EI): <Entity Identifier (ST)> & <Namespace ID (IS)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Definition: This field contains the telecommunication contact information for the pharmacy. Repetitions may be supplied for various device types or use codes, or multiple instances of the same type or use. This concept also exists as RXO-36 and RXE-45 to support pharmacy contact information in the context of the order, the encoded order and the dispense.

4.A.6 RXG - Pharmacy/Treatment Give Segment

HL7 Attribute Table - RXG - Pharmacy/Treatment Give

SEQ LEN C.LEN DT OPT RP/# TBL# ITEM # ELEMENT NAME DB Ref.
1
4= NM R

00342 Give Sub-ID Counter DB
2
4= NM O

00334 Dispense Sub-ID Counter DB
3


W

00221 Quantity/Timing DB
4

CWE R
0292 00317 Give Code DB
5

NM R

00318 Give Amount - Minimum DB
6

NM O

00319 Give Amount - Maximum DB
7

CWE R
9999 00320 Give Units DB
8

CWE O
9999 00321 Give Dosage Form DB
9

CWE O Y 9999 00351 Administration Notes DB
10 1..1
ID O
0167 00322 Substitution Status DB
11

LA2 B

01303 Dispense-To Location DB
12 1..1
ID O
0136 00307 Needs Human Review DB
13 (1..250)
CWE O Y 9999 00343 Pharmacy/Treatment Supplier's Special Administration Instructions DB
14
20= ST C

00331 Give Per (Time Unit) DB
15
6= ST O

00332 Give Rate Amount DB
16

CWE O
9999 00333 Give Rate Units DB
17

NM O

01126 Give Strength DB
18

CWE O
9999 01127 Give Strength Units DB
19
20= ST O Y
01129 Substance Lot Number DB
20

DTM O Y
01130 Substance Expiration Date DB
21

CWE O Y 0227 01131 Substance Manufacturer Name DB
22

CWE O Y 9999 01123 Indication DB
23
5# NM O

01692 Give Drug Strength Volume DB
24

CWE O
9999 01693 Give Drug Strength Volume Units DB
25

CWE O
9999 01694 Give Barcode Identifier DB
26 1..1
ID O
0480 01695 Pharmacy Order Type DB
27

CWE B
9999 01688 Dispense to Pharmacy DB
28

XAD B

01689 Dispense to Pharmacy Address DB
29

PL O

01683 Deliver-to Patient Location DB
30

XAD O

01684 Deliver-to Address DB

4.A.6.0 RXG-1 Give Sub-ID Counter (NM) 00342

Definition: Use if this RXG segment carries information about a single administration. This field must contain a unique number for the placer order number. This field along with the placer order number provides a unique reference to the specific scheduled give date/time transmitted by the pharmacy/treatment supplier for this order.

If the RXG segment carries information about multiple administrations, this field's value is zero (0), since in this case a one-to-one matching with the RXA segment is ambiguous.

4.A.6.1 RXG-2 Dispense Sub-ID Counter (NM) 00334

Definition: This is the dispense sub-ID to which this give message is related.

4.A.6.2 RXG-3 Quantity/Timing

Attention: The RXG-3 field was retained for backward compatibilty only as of v2.5 and the detail was withdrawn and removed from the standard as of v2.7.

Note: The contents of fields 3-8 should be identical to the comparable fields in the RXE (RXE-2 thru 5).

4.A.6.3 RXG-4 Give Code (CWE) 00317

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field is the identifier of the medical substance/treatment ordered to be given to the patient; it is equivalent to OBR-4-Universal service ID in function. See the RXE segment for a complete definition of the RXE-2-Give code. If the substance given is a vaccine, CVX codes may be used to code this field (see HL7 Table 0292 - Vaccines administered).

4.A.6.4 RXG-5 Give Amount - Minimum (NM) 00318

Definition: This field contains the ordered amount as encoded by the pharmacy/treatment supplier. In a variable dose order, this is the minimum ordered amount. In a non-varying dose order, this is the exact amount of the order.

Note: This field is not a duplication of the first component of the quantity/timing field, since in non-pharmacy/treatment orders, that component can be used to specify multiples of an ordered amount.

Another way to say this is that, for pharmacy/treatment orders, the quantity component of the quantity/timing field refers to what is to be given out at each service interval; and thus, in terms of the RX order, that first component always defaults to 1. Hence, in the actual execution of the order, the value of 1 in the first component of the quantity/timing field always refers to one administration of the amount specified in this field (the requested Give Amount field).

4.A.6.5 RXG-6 Give Amount - Maximum (NM) 00319

Definition: In a variable dose order, this is the maximum ordered amount. In a non-varying dose order, this field is not used.

4.A.6.6 RXG-7 Give Units (CWE) 00320

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field contains the units for the give amount.

Note: These units can be a "compound quantity;" i.e., the units may contain the word "per." For example, micrograms per KG (micg/kg) is an acceptable value, which means that the units are micrograms per KG (of body weight).

A table of standard units that contains compound units is needed. Until such a table is agreed on, a user-defined table is needed for each site.

4.A.6.7 RXG-8 Give Dosage Form (CWE) 00321

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: The dosage form indicates the manner in which the medication/treatment is aggregated for dispensing, e.g., tablets, capsules, suppositories. In some cases, this information is implied by the give code in RXG-4-Give Code. Use this field when the give code does not specify the dosage form.

4.A.6.8 RXG-9 Administration Notes (CWE) 00351

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field contains notes to the person administering the medication/treatment (may include the ordering provider's original notes, as well as any notes from the formulary or the pharmacy or treatment supplier). If coded, a user-defined table must be used. If free text, place a null in the first component and the text in the second, e.g., |^this is a free text administration note|.

4.A.6.9 RXG-10 Substitution Status (ID) 00322

Definition: Refer to HL7 Table 0167 - Substitution Status for valid values.

Note: The next two fields are equivalent to the corresponding fields of the RXE segment. They are included (optionally) in the RXG so that it may "stand alone" as a "give" instruction segment.

4.A.6.10 RXG-11 Dispense-to Location (LA2) 01303

Components: <Point of Care (IS)> ^ <Room (IS)> ^ <Bed (IS)> ^ <Facility (HD)> ^ <Location Status (IS)> ^ <Patient Location Type (IS)> ^ <Building (IS)> ^ <Floor (IS)> ^ <Street Address (ST)> ^ <Other Designation (ST)> ^ <City (ST)> ^ <State or Province (ST)> ^ <Zip or Postal Code (ST)> ^ <Country (ID)> ^ <Address Type (ID)> ^ <Other Geographic Designation (ST)>

Subcomponents for Facility (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Definition: This field is retained for backward compatibility only as of v 2.6. The reader is referred to RXG-27 and RXG-28. The first component contains the inpatient or outpatient location where the drug or treatment was dispensed (if applicable). The default (null) value is the current census location for the patient. Site-specific table. The first eight components have the same form as the first eight components of PV1-3-assigned patient location. The final eight components replace the ninth component of PV1-3-assigned patient location and represent the full address specification.

4.A.6.11 RXG-12 Needs Human Review (ID) 00307

Definition: Refer to HL7 Table 0136 - Yes/No Indicator for valid values. The values have the following meaning for this field:

Y Yes - Indicates that a warning is present. The application receiving the dispense order needs to warn the person dispensing/administering the drug or treatment to pay attention to the text in RXG-13-pharmacy/treatment supplier's special administration instructions.

N No - Indicates no warning is present. This is the equivalent default (null) value.

4.A.6.12 RXG-13 Pharmacy/Treatment Supplier's Special Administration Instructions (CWE) 00343

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field contains pharmacy/treatment supplier-generated special instructions to the provider administering the order.

4.A.6.13 RXG-14 Give Per (Time Unit) (ST) 00331

Definition: This field contains the time unit to use to calculate the rate at which the pharmaceutical/treatment is to be administered.

Format:

S = seconds
M = minutes
H = hours
D = days
W = weeks
L = months
T = at the interval and amount stated until a total of "DOSAGE" is accumulated. Units would be assumed to be the same as in the QUANTITY field.
INDEF = do indefinitely - also the default

This is the same as the format specified for the DURATION component of the quantity/timing field, excluding the "X" specification.

Required when relevant (e.g., certain IVs). For example, if the "give amount/units" were 300 ml and the "give per" time unit were H1 (equivalent to one hour), the rate is 300ml/hr.

4.A.6.14 RXG-15 Give Rate Amount (ST) 00332

Definition: This field contains the amount (number) of substance/treatment to be administered.

4.A.6.15 RXG-16 Give Rate Units (CWE) 00333

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field contains the units for RXG-15-give rate amount. May be composite. The ratio of the RXG-15-give rate amount and RXG-16-give rate units fields define the actual rate of administration. Thus, if RXG-15-give rate amount = 100 and RXG-16-give rate units = ml/hr, the requested rate of administration is 100 ml/hr.

4.A.6.16 RXG-17 Give Strength (NM) 01126

Definition: Use when RXG-4-Give code does not specify the strength. This is the numeric part of the strength, used in combination with RXG-18-Give strength units.

4.A.6.17 RXG-18 Give Strength Units (CWE) 01127

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: Use when RXG-4-Give Code does not specify the strength. This is the unit of the strength, used in combination with RXG-17-Give Strength.

Note: These units can be a "compound quantity"; i.e., the units may express a quantity per unit of time. For example, micrograms per hour (micg/h) is an acceptable value. These compound units are contained in the ISO+ table. See Chapter 7 for full definition of ISO+ units.

4.A.6.18 RXG-19 Substance Lot Number (ST) 01129

Definition: This field contains the lot number of the medical substance administered.

Note: The lot number is the number printed on the label attached to the container holding the substance and on the packaging which houses the container. If the substance is a vaccine, for example, and a diluent is required, a lot number may appear on the vial containing the diluent; however, any such identifier associated with a diluent is not the identifier of interest. The substance lot number should be reported, not that of the diluent.

4.A.6.19 RXG-20 Substance Expiration Date (DTM) 01130

Definition: This field contains the expiration date of the medical substance administered.

Note: Vaccine expiration date does not always have a "day" component; therefore, such a date may be transmitted as YYYYMM.

4.A.6.20 RXG-21 Substance Manufacturer Name (CWE) 01131

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field contains the manufacturer of the medical substance administered.

Note: For vaccines, code system MVX may be used to code this field (see section 4A.7.1, "Vaccine administration data"). This field may be used if the manufacturer of the substance is not identified by the code used in RXA-5-administered code.

4.A.6.21 RXG-22 Indication (CWE) 01123

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field contains the identifier of the condition or problem for which the drug/treatment was prescribed. May repeat if multiple indications are relevant.

4.A.6.22 RXG-23 Give Drug Strength Volume (NM) 01692

Description: This numeric field defines the volume measurement in which the drug strength concentration is contained. For example, Acetaminophen 120 MG/5ML Elixir means that 120 MG of the drug is in a solution with a volume of 5 ML, which would be encoded in RXG-17, RXG-18, RXG-23 and RXG-24 as:

RXG|||||||||||||||||120|mg^^ISO|||||5|ml^^ISO ...<cr>

4.A.6.23 RXG-24 Give Drug Strength Volume Units (CWE) 01693

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Description: This field indicates the volumetric unit associated with RXG-23 Give Drug Strength Volume. See example in RXG-23.

4.A.6.24 RXG-25 Give Barcode Identifier (CWE) 01694

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field contains the pharmacy system's assigned barcode number for the give occurrence. For IV orders, many pharmacy systems generate a barcode number to identify a specific bag/bottle of the order. This number can be an instance identifier; unique for the patient, drug combination, and schedule instance or it may be just a drug identifier.

The composition and use of the barcode number is dependent on application negotiation. An example of this field follows: The barcode number is in the following format, 9XXXXXXX000. The number '9' is a constant, XXXXXXX is seven (7) characters for a unique identifier assigned or derived from the patient account and order ID and 000 is the zero-filled three (3) character IV bottle number.

The maximum length of the first component of this field is 40 characters to allow for the maximum existing barcode length in use today. The second component contains the description of the item being coded and the third component may define the barcode type.

12345678901^IV bottle^3X9

4.A.6.25 RXG-26 Pharmacy Order Type (ID) 01695

Definition: The Pharmacy Order Type field defines the general category of pharmacy order which may be used to determine the processing path the order will take. Refer to HL7 Table 0480 Pharmacy Order Types for valid values.

This field may also be used for grouping of related orders for processing and/or reports. For example, Medication Administration Records (MARs) often group large volume solutions, medications and small volume solutions differently based upon site-specific workflow.

Usage Rule: This field is optional for all Pharmacy transactions. When not populated, a default value of "M" is assumed.

4.A.6.26 RXG-27 Dispense to Pharmacy (CWE) 01688

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field is retained for backward compatibility only as of v27. The information formerly communicated using this field should now be communicated using the PRT segment. The reader is referred to chapter 7 for a description of that segment.

This field specifies the pharmacy that will dispense the prescription.

4.A.6.27 RXG-28 Dispense to Pharmacy Address (XAD) 01689

Components: <Street Address (SAD)> ^ <Other Designation (ST)> ^ <City (ST)> ^ <State or Province (ST)> ^ <Zip or Postal Code (ST)> ^ <Country (ID)> ^ <Address Type (ID)> ^ <Other Geographic Designation (ST)> ^ <County/Parish Code (CWE)> ^ <Census Tract (CWE)> ^ <Address Representation Code (ID)> ^ <WITHDRAWN Constituent> ^ <Effective Date (DTM)> ^ <Expiration Date (DTM)> ^ <Expiration Reason (CWE)> ^ <Temporary Indicator (ID)> ^ <Bad Address Indicator (ID)> ^ <Address Usage (ID)> ^ <Addressee (ST)> ^ <Comment (ST)> ^ <Preference Order (NM)> ^ <Protection Code (CWE)> ^ <Address Identifier (EI)>

Subcomponents for Street Address (SAD): <Street or Mailing Address (ST)> & <Street Name (ST)> & <Dwelling Number (ST)>

Subcomponents for County/Parish Code (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Census Tract (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Expiration Reason (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Protection Code (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Address Identifier (EI): <Entity Identifier (ST)> & <Namespace ID (IS)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Definition: This field is retained for backward compatibility only as of v27. The information formerly communicated using this field should now be communicated using the PRT segment. The reader is referred to chapter 7 for a description of that segment.

This field specifies the address of the dispensing facility or the patient's location where the dispensing will occur.

4.A.6.28 RXG-29 Deliver-to Patient Location (PL) 01683

Components: <Point of Care (HD)> ^ <Room (HD)> ^ <Bed (HD)> ^ <Facility (HD)> ^ <Location Status (IS)> ^ <Person Location Type (IS)> ^ <Building (HD)> ^ <Floor (HD)> ^ <Location Description (ST)> ^ <Comprehensive Location Identifier (EI)> ^ <Assigning Authority for Location (HD)>

Subcomponents for Point of Care (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Room (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Bed (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Facility (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Building (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Floor (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Comprehensive Location Identifier (EI): <Entity Identifier (ST)> & <Namespace ID (IS)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Assigning Authority for Location (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Definition: This field specifies the location of the patient to whom the pharmaceutical substance is to be delivered.

4.A.6.29 RXG-30 Deliver-to Address (XAD) 01684

Components: <Street Address (SAD)> ^ <Other Designation (ST)> ^ <City (ST)> ^ <State or Province (ST)> ^ <Zip or Postal Code (ST)> ^ <Country (ID)> ^ <Address Type (ID)> ^ <Other Geographic Designation (ST)> ^ <County/Parish Code (CWE)> ^ <Census Tract (CWE)> ^ <Address Representation Code (ID)> ^ <WITHDRAWN Constituent> ^ <Effective Date (DTM)> ^ <Expiration Date (DTM)> ^ <Expiration Reason (CWE)> ^ <Temporary Indicator (ID)> ^ <Bad Address Indicator (ID)> ^ <Address Usage (ID)> ^ <Addressee (ST)> ^ <Comment (ST)> ^ <Preference Order (NM)> ^ <Protection Code (CWE)> ^ <Address Identifier (EI)>

Subcomponents for Street Address (SAD): <Street or Mailing Address (ST)> & <Street Name (ST)> & <Dwelling Number (ST)>

Subcomponents for County/Parish Code (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Census Tract (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Expiration Reason (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Protection Code (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Address Identifier (EI): <Entity Identifier (ST)> & <Namespace ID (IS)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Definition: This field specifies the address, either mailing or physical, to which the prescription should be mailed or delivered.

4.A.7 RXA - Pharmacy/Treatment Administration Segment

The ORC must have the filler order number and the order control code RE. As a site-specific variant, the RXO and associated RXCs and/or the RXE (and associated RXCs) may be present if the receiving application needs any of their data. The RXA carries the administration data.

HL7 Attribute Table - RXA - Pharmacy/Treatment Administration

SEQ LEN C.LEN DT OPT RP/# TBL# ITEM # ELEMENT NAME DB Ref.
1
4= NM R

00342 Give Sub-ID Counter DB
2
4= NM R

00344 Administration Sub-ID Counter DB
3

DTM R

00345 Date/Time Start of Administration DB
4

DTM R

00346 Date/Time End of Administration DB
5

CWE R
0292 00347 Administered Code DB
6

NM R

00348 Administered Amount DB
7

CWE C
9999 00349 Administered Units DB
8

CWE O
9999 00350 Administered Dosage Form DB
9

CWE O Y 9999 00351 Administration Notes DB
10

XCN B Y
00352 Administering Provider DB
11

LA2 B

00353 Administered-at Location DB
12
20= ST C

00354 Administered Per (Time Unit) DB
13

NM O

01134 Administered Strength DB
14

CWE O
9999 01135 Administered Strength Units DB
15
20= ST O Y
01129 Substance Lot Number DB
16

DTM O Y
01130 Substance Expiration Date DB
17

CWE O Y 0227 01131 Substance Manufacturer Name DB
18

CWE O Y 9999 01136 Substance/Treatment Refusal Reason DB
19

CWE O Y 9999 01123 Indication DB
20 2..2
ID O
0322 01223 Completion Status DB
21 1..1
ID O
0206 01224 Action Code - RXA DB
22

DTM O

01225 System Entry Date/Time DB
23
5= NM O

01696 Administered Drug Strength Volume DB
24

CWE O
9999 01697 Administered Drug Strength Volume Units DB
25

CWE O
9999 01698 Administered Barcode Identifier DB
26 1..1
ID O
0480 01699 Pharmacy Order Type DB
27

PL O

02264 Administer-at DB
28

XAD O

02265 Administered-at Address DB

4.A.7.0 RXA-1 Give Sub-ID Counter (NM) 00342

Definition: Use this field if matching this RXA segment to its corresponding RXG segment. If the two applications are not matching RXG and RXA segments, this field's value is zero (0).

4.A.7.1 RXA-2 Administration Sub-ID Counter (NM) 00344

Definition: This field starts with 1 the first time that medication/treatment is administered for this order. Increments by one with each additional administration of the medication/treatment.

Note: More than one RXA segment can be "matched" to a single RXG segment, as is the case when recording a change of the rate of administration of an IV solution.

4.A.7.2 RXA-3 Date/Time Start of Administration (DTM) 00345

Definition: If the order is for a continuous administration (such as an IV), and the rate is changed at a certain time after the start, an RAS message can be issued to record the change. For such an RAS message, this field records the time the rate was changed to the new value recorded in the RXA-12-Administered Per (time unit) of the same message.

4.A.7.3 RXA-4 Date/Time End of Administration (DTM) 00346

Definition: If null, the date/time of RXA-3-Date/Time Start of Administration is assumed.

4.A.7.4 RXA-5 Administered Code (CWE) 00347

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field contains the identifier of the medical substance/treatment administered. It is equivalent to OBR-4-universal service ID in function. If the substance administered is a vaccine, CVX codes may be used to code this field (see HL7 Table 0292 - Vaccines Administered). If CVX code is used to identify vaccines, the coding system component (RXA-5.3) should be valued as "CVX", not as "HL70292."

4.A.7.5 RXA-6 Administered Amount (NM) 00348

Definition: This field contains the amount administered.

4.A.7.6 RXA-7 Administered units (CWE) 00349

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field is conditional because it is required if the administered amount code does not imply units. This field must be in simple units that reflect the actual quantity of the substance administered. It does not include compound units.

4.A.7.7 RXA-8 Administered Dosage Form (CWE) 00350

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: The dosage form indicates the manner in which the medication/treatment is aggregated for dispensing, e.g., tablets, capsules, suppositories. In some cases, this information is implied by the dispense/give code in RXA-5-Administered Code. Use this field when the administered code does not specify the dosage form.

4.A.7.8 RXA-9 Administration Notes (CWE) 00351

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field contains notes from the provider administering the medication/treatment. If coded, requires a user-defined table. If free text (describing a custom IV, mixture, or salve, for example) place a null in the first component and the text in the second, e.g., |^this is a free text administration note|.

4.A.7.9 RXA-10 Administering Provider (XCN) 00352

Components: <Person Identifier (ST)> ^ <Family Name (FN)> ^ <Given Name (ST)> ^ <Second and Further Given Names or Initials Thereof (ST)> ^ <Suffix (e.g., JR or III) (ST)> ^ <Prefix (e.g., DR) (ST)> ^ <WITHDRAWN Constituent> ^ <DEPRECATED-Source Table (CWE)> ^ <Assigning Authority (HD)> ^ <Name Type Code (ID)> ^ <Identifier Check Digit (ST)> ^ <Check Digit Scheme (ID)> ^ <Identifier Type Code (ID)> ^ <Assigning Facility (HD)> ^ <Name Representation Code (ID)> ^ <Name Context (CWE)> ^ <WITHDRAWN Constituent> ^ <Name Assembly Order (ID)> ^ <Effective Date (DTM)> ^ <Expiration Date (DTM)> ^ <Professional Suffix (ST)> ^ <Assigning Jurisdiction (CWE)> ^ <Assigning Agency or Department (CWE)> ^ <Security Check (ST)> ^ <Security Check Scheme (ID)>

Subcomponents for Family Name (FN): <Surname (ST)> & <Own Surname Prefix (ST)> & <Own Surname (ST)> & <Surname Prefix from Partner/Spouse (ST)> & <Surname from Partner/Spouse (ST)>

Subcomponents for Source Table (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Assigning Authority (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Assigning Facility (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Name Context (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Assigning Jurisdiction (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Assigning Agency or Department (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Definition: This field is retained for backward compatibility only as of v27. The reader is referred to the PRT segment described in chapter 7.

This field contains the provider ID of the person administering the pharmaceutical/treatment. If the person referenced in this field is also referenced in PRT segment, they must contain the same information. However, if there is a difference, then PRT segment takes precedence.

4.A.7.10 RXA-11 Administered-at Location (LA2) 00353

Components: <Point of Care (IS)> ^ <Room (IS)> ^ <Bed (IS)> ^ <Facility (HD)> ^ <Location Status (IS)> ^ <Patient Location Type (IS)> ^ <Building (IS)> ^ <Floor (IS)> ^ <Street Address (ST)> ^ <Other Designation (ST)> ^ <City (ST)> ^ <State or Province (ST)> ^ <Zip or Postal Code (ST)> ^ <Country (ID)> ^ <Address Type (ID)> ^ <Other Geographic Designation (ST)>

Subcomponents for Facility (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Definition: This field is retained for backward compatibility only as of v 2.6. The reader is referred to RXA-27 and RXA-28. The first component contains the inpatient or outpatient location at which the drug or treatment was administered (if applicable). The default (null) value is the current census location for the patient. Site-specific table. The first eight components have the same form as the first eight components of PV1-3-assigned patient location. The final eight components replace the ninth component of PV1-3-assigned patient location and represent the full address specification.

4.A.7.11 RXA-12 Administered Per (Time Unit) (ST) 00354

Definition: This field contains the rate at which this medication/treatment was administered as calculated by using RXA-6-administered amount and RXA-7-administered units. This field is conditional because it is required when a treatment is administered continuously at a prescribed rate, e.g., certain IV solutions.

4.A.7.12 RXA-13 Administered Strength (NM) 01134

Definition: Use when RXA-5-Administered Code does not specify the strength. This is the numeric part of the strength, used in combination with RXA-14-Administered Strength Units.

4.A.7.13 RXA-14 Administered Strength Units (CWE) 01135

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: Use when RXA-5-Administered Code does not specify the strength. This is the unit of the strength, used in combination with RXA-13-Administered Strength.

Note: These units can be a "compound quantity;" i.e., the units may express a quantity per unit of time. For example, micrograms per hour (micg/h) is an acceptable value. These compound units are contained in the ISO+ table. See Chapter 7 for full definition of ISO+ units.

4.A.7.14 RXA-15 Substance Lot Number (ST) 01129

Definition: This field contains the lot number of the medical substance administered.

Note: The lot number is the number printed on the label attached to the container holding the substance and on the packaging which houses the container. If the substance is a vaccine, for example, and a diluent is required, a lot number may appear on the vial containing the diluent; however, any such identifier associated with a diluent is not the identifier of interest. The substance lot number should be reported, not that of the diluent.

4.A.7.15 RXA-16 Substance Expiration Date (DTM) 01130

Definition: This field contains the expiration date of the medical substance administered.

Note: Vaccine expiration date does not always have a "day" component; therefore, such a date may be transmitted as YYYYMM.

4.A.7.16 RXA-17 Substance Manufacturer Name (CWE) 01131

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field contains the manufacturer of the medical substance administered.

Note: For vaccines, code system MVX may be used to code this field. See section 4A.7.1, "Vaccine administration data." This field may be used if the manufacturer of the substance is not identified by the code used in RXA-5- administered code. When using this code system to identify vaccines, the coding system component of the CE field should be valued as "MVX", not as "HL70227."

4.A.7.17 RXA-18 Substance/Treatment Refusal Reason (CWE) 01136

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field contains the reason the patient refused the medical substance/treatment. Any entry in the field indicates that the patient did not take the substance.

4.A.7.18 RXA-19 Indication (CWE) 01123

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field contains the identifier of the condition or problem for which the drug/treatment was prescribed. May repeat if multiple indications are relevant.

4.A.7.19 RXA-20 Completion Status (ID) 01223

Definition: Status of treatment administration event. Refer to HL7 Table 0322 - Completion Status for valid values.

HL7 Table 0322 - Completion Status

Value Description Comment
CP Complete
RE Refused
NA Not Administered
PA Partially Administered

4.A.7.20 RXA-21 Action Code - RXA (ID) 01224

Definition: Status of record. The information in this field enables the use of the RXA in the vaccine messages (see Section 4A.8, "Vaccine Segments"), where a method of correcting vaccination information transmitted with incorrect patient identifying information is needed. Refer To HL7 Table 0206 - Segment Action Code for valid values.

4.A.7.21 RXA-22 System Entry Date/Time (DTM) 01225

Definition: Date/time the administration information was entered into the source system. This field is used to detect instances where treatment administration information is inadvertently entered multiple times by providing a unique identification field. Under usual circumstances, this field would be provided automatically by the computer system rather than being entered by a person.

4.A.7.22 RXA-23 Administered Drug Strength Volume (NM) 01696

Description: This numeric field defines the volume measurement in which the drug strength concentration is contained. For example, Acetaminophen 120 MG/5ML Elixir means that 120 MG of the drug is in a solution with a volume of 5 ML , which would be encoded in RXA-13, RXA-14, RXA-23 and RXA-24 as:

RXA|||||||||||||120|mg^^ISO|||||||||5|ml^^ISO ...<cr>

4.A.7.23 RXA-24 Administered Drug Strength Volume Units (CWE) 01697

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Description: This field indicates the volumetric unit associated with RXA-23 Administered Drug Strength Volume. See example in RXA-23.

4.A.7.24 RXA-25 Administered Barcode Identifier (CWE) 01698

Components: <Identifier (ST)> ^ <Text (ST)> ^ <Name of Coding System (ID)> ^ <Alternate Identifier (ST)> ^ <Alternate Text (ST)> ^ <Name of Alternate Coding System (ID)> ^ <Coding System Version ID (ST)> ^ <Alternate Coding System Version ID (ST)> ^ <Original Text (ST)> ^ <Second Alternate Identifier (ST)> ^ <Second Alternate Text (ST)> ^ <Name of Second Alternate Coding System (ID)> ^ <Second Alternate Coding System Version ID (ST)> ^ <Coding System OID (ST)> ^ <Value Set OID (ST)> ^ <Value Set Version ID (DTM)> ^ <Alternate Coding System OID (ST)> ^ <Alternate Value Set OID (ST)> ^ <Alternate Value Set Version ID (DTM)> ^ <Second Alternate Coding System OID (ST)> ^ <Second Alternate Value Set OID (ST)> ^ <Second Alternate Value Set Version ID (DTM)>

Definition: This field contains the pharmacy system's assigned barcode number for the give occurrence. For IV orders, many pharmacy systems generate a barcode number to identify a specific bag/bottle of the order. This number can be an instance identifier; unique for the patient, drug combination, and schedule instance or it may be just a drug identifier.

The composition and use of the barcode number is dependent on application negotiation. An example of this field follows: The barcode number is in the following format, 9XXXXXXX000. The number '9' is a constant, XXXXXXX is seven (7) characters for a unique identifier assigned or derived from the patient account and order ID and 000 is the zero-filled three (3) character IV bottle number.

The maximum length of the first component of this field is 40 characters to allow for the maximum existing barcode length in use today. The second component contains the description of the item being coded and the third component may define the barcode type.

Example: 12345678901^IV bottle^3X9

4.A.7.25 RXA-26 Pharmacy Order Type (ID) 01699

Definition: The Pharmacy Order Type field defines the general category of pharmacy order which may be used to determine the processing path the order will take. Refer to HL7 Table 0480 - Pharmacy Order Types for valid values.

This field may also be used for grouping of related orders for processing and/or reports. For example, Medication Administration Records (MARs) often group large volume solutions, medications and small volume solutions differently based upon site-specific workflow.

Usage Rule: This field is optional for all Pharmacy transactions. When not populated, a default value of "M" is assumed.

4.A.7.26 RXA-27 Administered-At (PL) 02264

Components: <Point of Care (HD)> ^ <Room (HD)> ^ <Bed (HD)> ^ <Facility (HD)> ^ <Location Status (IS)> ^ <Person Location Type (IS)> ^ <Building (HD)> ^ <Floor (HD)> ^ <Location Description (ST)> ^ <Comprehensive Location Identifier (EI)> ^ <Assigning Authority for Location (HD)>

Subcomponents for Point of Care (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Room (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Bed (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Facility (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Building (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Floor (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Comprehensive Location Identifier (EI): <Entity Identifier (ST)> & <Namespace ID (IS)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Assigning Authority for Location (HD): <Namespace ID (CWE)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Subcomponents for Namespace ID (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Definition: This field specifies the location where the drug or treatment was administered.

4.A.7.27 RXA-28 Administered-at Address (XAD) 02265

Components: <Street Address (SAD)> ^ <Other Designation (ST)> ^ <City (ST)> ^ <State or Province (ST)> ^ <Zip or Postal Code (ST)> ^ <Country (ID)> ^ <Address Type (ID)> ^ <Other Geographic Designation (ST)> ^ <County/Parish Code (CWE)> ^ <Census Tract (CWE)> ^ <Address Representation Code (ID)> ^ <WITHDRAWN Constituent> ^ <Effective Date (DTM)> ^ <Expiration Date (DTM)> ^ <Expiration Reason (CWE)> ^ <Temporary Indicator (ID)> ^ <Bad Address Indicator (ID)> ^ <Address Usage (ID)> ^ <Addressee (ST)> ^ <Comment (ST)> ^ <Preference Order (NM)> ^ <Protection Code (CWE)> ^ <Address Identifier (EI)>

Subcomponents for Street Address (SAD): <Street or Mailing Address (ST)> & <Street Name (ST)> & <Dwelling Number (ST)>

Subcomponents for County/Parish Code (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Census Tract (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Expiration Reason (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Protection Code (CWE): <Identifier (ST)> & <Text (ST)> & <Name of Coding System (ID)> & <Alternate Identifier (ST)> & <Alternate Text (ST)> & <Name of Alternate Coding System (ID)> & <Coding System Version ID (ST)> & <Alternate Coding System Version ID (ST)> & <Original Text (ST)> & <Second Alternate Identifier (ST)> & <Second Alternate Text (ST)> & <Name of Second Alternate Coding System (ID)> & <Second Alternate Coding System Version ID (ST)> & <Coding System OID (ST)> & <Value Set OID (ST)> & <Value Set Version ID (DTM)> & <Alternate Coding System OID (ST)> & <Alternate Value Set OID (ST)> & <Alternate Value Set Version ID (DTM)> & <Second Alternate Coding System OID (ST)> & <Second Alternate Value Set OID (ST)> & <Second Alternate Value Set Version ID (DTM)>

Subcomponents for Address Identifier (EI): <Entity Identifier (ST)> & <Namespace ID (IS)> & <Universal ID (ST)> & <Universal ID Type (ID)>

Definition: This field specifies the address of the location where the drug or treatment was administered.

4.A PHARMACY/TREATMENT MESSAGE EXAMPLES

The purpose of this section is to show how certain specific situations would be handled using the pharmacy/treatment protocol. The ellipses represent uncompleted details. The symbol // precedes comments for clarification.

4.A.1 Example of various levels of coding in an order

The order "give 500 mg Ampicillin P.O. Q6H for 10 days for a total of 40 tablets" is sent to the RX application from the OE application. This order can be coded with various levels of precision by an ordering application:

  1. E-mail only version (uses only free text, RXO-6-provider's pharmacy/treatment instructions or RXO-7-provider's administration instructions only); fully encoded version must be re-entered or verified manually by the pharmacy or treatment application.

  2. With RXO-2-requested give amount-minimum, RXO-4-requested give units, and ORC-7-quantity/timing coded, and RXO-1-requested give code as free text.

  3. With RXO-1-requested give code, RXO-2-requested give amount-minimum, RXO-4-requested give units, and ORC-7-quantity/timing coded, but where RXO-1-requested give code does not include units.

  4. With RXO-1-requested give code, RXO-2-requested give amount-minimum, RXO-4-requested give units, and ORC-7-quantity/timing coded, and where RXO-1-requested give code does include units.

In this case, the units are optional. The rule for this case (on orders, dispense results, give results, and administration results) is as follows: if units are coded, they override or supersede the units value implied by the give code.

  1. The E-mail only version of the order: no coded fields exist in the RXO.

MSH|^&~\|Pharm|GenHosp|CIS|GenHosp|2006052911150700||OMP^O09^OMP_O09|...<cr>

PID|...<cr>

ORC|NW|1000^OE||||E|...<cr>

RXO||||||500 mg Polycillin Q6H for 10 days, dispense 40 Tablets|...<cr>

  1. A partially coded version of the order. This version has the RXO-2-requested give amount-minimum, RXO-4-requested give units, and ORC-7-quantity/timing coded, but the RXO-1-requested give code as free text.

MSH|^&~\|Pharm|GenHosp|CIS|GenHosp|2006052911150700||OMP^O09^OMP_O09|...<cr>

PID|...<cr>

ORC|NW|1000^OE||||E|^Q6H^D10^^^R|...<cr>

RXO|^Polycillin 500 mg TAB^|500||MG|||||Y||40|...<cr>

RXR|PO|...<cr>

  1. A more completely coded version of the order, with the RXO-1-requested give code, RXO-2-requested give amount-minimum, RXO-4-requested give units, and ORC-7-quantity/timing coded, but where RXO-1-requested give code does not imply units.

MSH|^&~\|Pharm|GenHosp|CIS|GenHosp|2006052911150700||OMP^O09^OMP_O09|...<cr>

PID|...<cr>

ORC|NW|1000^OE||||E|^Q6H^D10^^^R|...<cr>

RXO|RX1001^Polycillin^L|500||MG|||||Y||40|...<cr>

RXR|PO|...<cr>

  1. A completely encoded version, with the RXO-1-requested give code, RXO-2-requested give amount-minimum, RXO-4-requested give units, and ORC-7-quantity/timing coded, and where RXO-1-requested give code does imply units.

MSH|^&~\|Pharm|GenHosp|CIS|GenHosp|2006052911150700||OMP^O09^OMP_O09|...<cr>

PID|...<cr>

ORC|NW|1000^OE||||E|^Q6H^D10^^^R|...<cr>

RXO|RX1001^Polycillin 500 mg TAB^L|500||MG|||||G||40|...<cr>

RXR|PO|...<cr>

  1. Pharmacy or treatment supplier's encoded version (RDE message) sent to nursing application (a generic substitution).

MSH|^&~\|Pharm|GenHosp|CIS|GenHosp|2006052911150700||RDE^O11^RDE_O11|...<cr>

PID|...<cr>

ORC|RE|1000^OE|9999999^RX|||E|^Q6H^D10^^^R|...<cr>

RXE|^^^200612100600^^R|0047-0402-30^Ampicillin 250 MG

TAB^NDC|2||TAB|||||G|80||||123456|rx#1001|...<cr>

RXR|PO|...<cr>

  1. Pharmacy or treatment supplier's dispense results (RDS message).

MSH|...<cr>

PID|...<cr>

ORC|RE|1000^OE|9999999^RX|||E|^Q6H^D10^^^R|...<cr>

RXD|1|0047-0402-30^Ampicillin 250 MG TAB^NDC|199012100400|8|TAB||RX#1001|

123456|G|8|...<cr>

  1. Pharmacy or treatment supplier's give results (RGV message).

MSH|^&~\|Pharm|GenHosp|CIS|GenHosp|2006052911150700||RGV^O15^RGV_O15|...<cr>

PID|...<cr>

ORC|RE|1000^OE|9999999^RX|||E|^Q6H^D10^^^R|...<cr>

RXG|1|1|^^200612100600^^R|0047-0402-30^Ampicillin 250 MG TAB^NDC|500||MG|||G|...<cr>

RXR|PO|...<cr>

  1. Nursing application Medications Administration results to pharmacy, treatment, or Order Entry application.

MSH|^&~\|Pharm|GenHosp|CIS|GenHosp|2006052911150700||RAS^O17^RAS_O17|...<cr>

PID|...<cr>

ORC|RE|1000^OE|9999999^RX|||E|^Q6H^D10^^^R|...<cr>

RXA|1|1|200612100615||0047-0402-30^Ampicillin 250 MG TAB^NDC|2|TAB|...<cr>

RXR|PO|...<cr>

4.A.2 RXO segment field examples

4.A.2.0 RXO-1 Requested Give code example

RXO|58160040000110^Fluoxetine HCL 10mg Capsule^GPI^00777310402^Prozac 10 mg caps^NDC|...<cr>

4.A.2.1 RXO-18 and RXO-19 Requested Strength and Strength Unit examples

The need for strength and strength unit fields in addition to the amount and amount units fields included in various RX_ segments requires explanation. Physicians can write a prescription for a drug such as Ampicillin in two ways. One way would be: "Ampicillin 250 mg capsules, 2 capsules four times a day." In this case the give amount would be 2, the give units would be capsules, the strength would be 250 and the strength units would milligrams.

ORC|||||||1^QID|...<cr>

RXO|01200020200105^Ampicillin 250 mg capsule^GPI^00047040230^Ampicillin 250 mg caps^NDC|2||caps^capsule^FDB||||||||||||||250|mg|...<cr>

However, the provider could also write the prescription as "Ampicillin 500 mg four times a day." In this case the give amount would be 500 and the give units would be milligrams. The strength would not be reported in the RXO segment because it is not specified; the drug could be given in two 250 mg caps or one 500 mg cap. But the pharmacist would dispense a specific capsule size and would record the strength in the RXE segment as 250 or 500, depending upon which pill size was dispensed.

ORC|||||||1^QID|...<cr>

RXO|012000202001^Ampicillin capsule^GPI |500||mg^milligram^ISO||...<cr>

4.A.3 RXD segment field examples

4.A.3.0 RXD-4 and RXD-5 Dispense amount and Actual dispense units

The RXD-4 and RXD-5 together might say

100 tabs:

RXD||||100|TAB^tablet^FDB|...<cr>

Or, 100 each

RXD||||100|EA^each^FDB|...<cr>

Or, perhaps a volume, 3 liters

RXD||||3|L^liter^ISO|...<cr>

4.A.3.1 Actual dispense amount, Actual dispense units, Actual strength, Actual strength units

For example, the RXD-4, RXD-5, RXD-16 and RXD-17 together might say

100 tabs of 240 mg strength:

RXD||||100|tab^tablet^FDB|||||||||||240|mg|...<cr>

Or, 100 each of 60 units per cc

RXD||||100|EA||||||||||||60|iu/ml^^ISO+|...<cr>

Or, perhaps a volume, 3 liters with 60 grams per liter

RXD||||3|L^liter^ISO|||||||||||60|g/L^^ISO+|...<cr>

4.A.3.2 Valuing the Dispense Package Size Unit

If the package given to the patient is 2, 4 ounce bottles with a strength of 100/5ml, but the cough suppressant is stocked in 1 gallon bottles, then the field contains 1 gallon.

RXD||||8|ounce^^ISO|||||||||||20|mg/ml|||||1|gal^gallon^ISO|...<cr>

If one were to dispense Mevacor 100 tablets with a strength of 20 mg/tablet, and the package from the manufacturer is a 60 tablet package, then the fields reflect 60 tablets (the size of the package stocked by the pharmacy).

RXD||||100|tab^^FDB|||||||||||20|mg|||||60|tab|...<cr>

4.A.4 RDS with FT1 segments example

Example: Adam Everyman appears in the Pharmacy with a prescription for Veramil 120 mgm B.I.D. The prescription is filled and the $5 co-pay is collected. The following RDS message is generated:

MSH|^&~\|Pharm|GenHosp|IE||2006052911150700||RDS^O13^RDS_O13||...<cr>

PID|||444-33-3333^^^MPI&GenHosp&L^MR||Everyman^Adam||19600614|M||C|2222 Home St^^Anytown^US^12345||^^^^^555^5552004| ...<cr>

ORC|RE||89968665||||||2006052910300700|||444-44-4444^HIPPOCRATES^HAROLD^^^^MD||^^^^^555^ 5551004|...<cr>

RXE|1^BID^^20060529|^Verapamil|120||mg^milligram^FDB.MDDB||...<cr>

RXD|1|00378112001^Verapamil Hydrochloride 120 mg TAB^NDC |200605291115-0700|100|||1331665|3|...<cr>

RXR|PO|...<cr>

FT1|1|||200605291115-0700||CO^Co-Pay^HL70017 |00378112001^Verapamil Hydrochloride 120 mg TAB^NDC |||1|5&USD^TP|...<cr>

FT1|2|||200605291115-0700||PY^Payment^HL70017 |00378112001^Verapamil Hydrochloride 120 mg TAB^NDC |||1|5&USD|...<cr>

4.A.5 Alternating IV order messages

Encoding Note: For readability, these examples do not show encoding of the subcomponents of the Give Codes (CWE data type) in the RXC and RXO segments. In practice, the subcomponents should be encoded as described in the HL7 specification.

  1. Example #1

D5/0.45NaCl 1000mL with 20mEq KCl in every 3rd bottle. Start the KCl in the 3rd bottle of this order. Run in at a rate of 100mL/hr.

(Other message data: placer order #123, placer application ID=SMS, interval=continuous, start date/time=11/28/94 0900, no stop date/time, priority=Routine, order sequencing=Cyclical.)

This order may be expressed using a parent/child relationship. The parent order consists of an ORC (and a RXO, incompletely elaborated in this example) that contains order level information. The repeating bottle cycle of D5/0.45NaCl 1000mL followed by D5/0.45NaCl 1000mL followed by D5/0.45NaCl + 20mEq KCL 1000mL is represented by three child segments. The placer system may be treating this as a single order with two bottles, A (D5/0.45NaCl 1000mL @ 100mL/hr) and B (D5/0.45NaCl + 20mEq KCL 1000mL @ 100mL/hr), repeating in the cycle of A-A-B.

The parent:

ORC|NW|123^SMS|||||1^C^^200611280900^^R^^^^C|...<cr>

RXO|Cyclic IV|...<cr>

The first child:

ORC|CH|123A1^SMS|||||1^C^^^^^^^^C&123B&SMS&&&*ES+0M|123|...<cr>

RXO Segment, Requested Give Amount-Minimum: ...|100||ML|...

Requested Give Per (Time Unit): ...|H1|...<cr>

RXR|IV|...<cr>

RXC|B|D5/.45NACL|1000|ML|...<cr>

The second child:

ORC|CH|123A2^SMS|||||1^C^^^^^^^^C&123A1&SMS&&&ES+0M|123|...<cr>

RXO Segment, Requested Give Amount-Minimum: ...|100||ML|...

Requested Give Per (Time Unit): ...|H1|...<cr>

RXR|IV|...<cr>

RXC|B|D5/.45NACL|1000|ML|...<cr>

The third child:

ORC|CH|123B^SMS|||||1^C^^^^^^^^C&123A2&SMS&&&#ES+0M|123|...<cr>

RXO Segment, Requested Give Amount-Minimum: ...|100||ML|...

Requested Give Per (Time Unit): ...|H1|...<cr>

RXR|IV|...<cr>

RXC|B|D5/.45NACL|1000|ML|...<cr>

RXC|A|KCL|20|MEQ|...<cr>

Discussion points:

Placer Order Number - Three alternatives must be discussed for placer order number.

  1. Each child could have its own placer order number.

  2. Each child could have the order number of the parent plus some appended identifier (for examples, 123A or 123.A or 123.1 etc.) that labels each child or each unique combination of ingredients.

  3. In addition to the appended identifier discussed in 'B' above, a further suffix could be attached to uniquely identify each repetition of a particular member of the sequence. The example (a cycle of bottles 'A' and 'B' in the sequence A-A-B) identified the order numbers of the children as 123A1, 123A2, and 123B, thereby enabling the quantity/timing to be completely unambiguous. This could be expressed many other ways, such as 123A.1 or 123.A.1 or 123.A#1 etc. HL7 does not specify a format for the expression of order number suffixes, nor does it specify a delimiter to use for such a purpose.

Sequence Condition Value - In this example, the first child contains an asterisk (*) as the first character of the Sequence Condition Value and the third (last) child contains a pound sign (#).

The asterisk and pound sign are important for designating the first and last bottles especially when children are sent in separate messages, although this example is not constructed that way.

Note that computing the duration of the bottle is dependent upon the presence of all of the following fields:

For cyclic IV orders, these fields are all required in order to determine how long each occurrence of a child will last.

While HL7 allows either sending the parent and children in one message or sending the parent and children in separate messages, it appears simpler and therefore recommended to have the parent and all children included in a single message. The example is constructed that way.

  1. Example #2

D5W + 40mEq KCl 1000mL alternating with D5/LR + 20mEq KCl 1000mL at 125mL/hr

(Other message data: placer order #124, placer application ID=SMS, interval=continuous, start date/time=11/28/94 0900, no stop date/time, priority=Routine, order sequencing=Cyclical)

This example is a variation on the first example where two different base solutions are used. In this example, the placer system deals with this as one order with two alternating bottles, A (D5W + 40mEq KCl 1000mL @ 125mL/hr) and B (D5/LR + 20mEq KCl 1000mL @ 125mL/hr) in the cycle A-B. The principles discussed in Example #1 apply equally to this example.

The parent:

ORC|NW|124^SMS|||||1^C^^200611280900^^R^^^^C|...<cr>

RXO|Cyclic IV|...<cr>

The first child:

ORC|CH|124A^SMS|||||1^C^^^^^^^^C&124B&SMS&&&*ES+0M|124|...<cr>

RXO Segment, Requested Give Amount-Minimum: ...|125||ML|...

Requested Give Per (Time Unit): ...|H1|...<cr>

RXR|IV|...<cr>

RXC|B|D5W|1000|ML|...<cr>

RXC|A|KCL|40|MEQ|...<cr>

The second child:

ORC|CH|124B^SMS|||||1^C^^^^^^^^C&124A&SMS&&&#ES+0M|124|...<cr>

RXO Segment, Requested Give Amount-Minimum: ...|125||ML|...

Requested Give Per (Time Unit): ...|H1|...<cr>

RXR|IV|...<cr>

RXC|B|D5/LR|1000|ML|...<cr>

RXC|A|KCL|20|MEQ|...<cr>

  1. Example #3

D5/0.45NaCl 1000mL with 20mEq KCl in every 3rd bottle. Start the KCl in the 3rd bottle of this order. Add 10mL of multi-vitamins to the one bag daily. Run in at a rate of 100mL/hr.

(Other message data: placer order #134, placer application ID=SMS, interval=continuous, start date/time=11/28/94 0900, no stop date/time, priority=Routine, order sequencing=Cyclical. Note that the encoding of the multi-vitamins statement in the above order, adding multi-vitamins to one IV bag each day, may vary by institution to put it into the first or last bottle of the day.)

This order may be expressed using a parent/child relationship. The parent order consists of an ORC (and a RXO, although one is not completely elaborated in this example) that contains order level information. The repeating bottle cycle of D5/0.45NaCl 1000mL followed by D5/0.45NaCl 1000mL followed by D5/0.45NaCl + 20mEq KCL 1000mL is represented by three child segments. This order is complicated by the request to add one component into any one of the three repeating bottles, depending upon which of the bottles will occur first on any particular day. Further complicating this order is a rate of infusion (10 hours for a 1000mL bottle) which results in a fractional number of daily administrations. Most legacy systems have a great deal of trouble accommodating orders like this within their existing database structures; however there a few vendors who now are able to handle the situation. The placer system may be treating this as a single order with two bottles, A (D5/0.45NaCl 1000mL @ 100mL/hr) and B (D5/0.45NaCl + 20mEq KCL 1000mL @ 100mL/hr), repeating in the cycle of A-A-B with a cyclical component (multi-vitamins).

The parent:

ORC|NW|134^SMS|||||1^C^^200611280900^^R^^^^C|...<cr>

RXO|Cyclic IV|...<cr>

The first child:

ORC|CH|134A1^SMS|||||1^C^^^^^^^^C&134B&SMS&&&*ES+0M|134|...<cr>

RXO Segment, Requested Give Amount-Minimum: ...|100||ML|...

Requested Give Per (Time Unit): ...|H1|...<cr>

RXR|IV|...<cr>

RXC|B|D5/.45NACL|1000|ML|...<cr>

The second child:

ORC|CH|134A2^SMS|||||1^C^^^^^^^^C&134A1&SMS&&&ES+0M|134|...<cr>

RXO Segment, Requested Give Amount-Minimum: ...|100||ML|...

Requested Give Per (Time Unit): ...|H1|...<cr>

RXR|IV|...<cr>

RXC|B|D5/.45NACL|1000|ML|...<cr>

The third child:

ORC|CH|134B^SMS|||||1^C^^^^^^^^C&134A2&SMS&&&#ES+0M|134|...<cr>

RXO Segment, Requested Give Amount-Minimum: ...|100||ML|...

Requested Give Per (Time Unit): ...|H1|...<cr>

RXR|IV|...<cr>

RXC|B|D5/.45NACL|1000|ML|...<cr>

RXC|A|KCL|20|MEQ|...<cr>

The fourth child:

ORC|CH|134X^SMS|||||1^Q1D^^^^^^^^|134|...<cr>

RXO|MULTIVITAMINS|10||ML|INJECTABLE|...<cr>

Discussion points:

This method for accommodating the Multi-vitamins Daily scenario does not pretend to be the best or only way to express the message, but simply demonstrates adapting the current specification to a highly complex order without adding new components.

The Multi-vitamins component may be sent as a fourth child.

In this example, its ORC-7-quantity/timing includes an interval of "Q1D" (every 1 days).

Its order number consists of the placer's parent order number plus an appended identifier ('X' in the above example) that labels this child as a special case. This convention would need to be agreed upon by sending and receiving applications.

  1. Example #4

D5W + 40mEq KCl 1000mL alternating with D5/LR + 20mEq KCl 1000mL alternating with D5/0.45NaCl 1000mL. Infuse the D5W and D5/0.45 at 125mL/hr, and the D5/LR at 100mL/hr.

(Other message data: placer order #177, placer application ID=SMS, interval=continuous, start date/time=11/28/94 0900, no stop date/time, priority=Routine, order sequencing=Cyclical)

This example is another variation of Example 1 where the rate for each bottle is different, and this can be expressed within the RX segments of the children using current components. In this example, the placer system deals with this as one order with three alternating bottles, A (D5W + 40mEq KCl 1000mL @ 125mL/hr) , B (D5/LR + 20mEq KCl 1000mL @ 100mL/hr) , and C (D5/0.45NaCl 1000mL @ 125mL/hr) in the cycle A-B-C. The principles discussed in Example #1 apply equally to this example.

The parent:

ORC|NW|177^SMS|||||1^C^^200611280900^^R^^^^C|...<cr>

RXO|Cyclic IV|...<cr>

The first child:

ORC|CH|177A^SMS|||||1^C^^^^^^^^C&177C&SMS&&&*ES+0M|177|...<cr>

RXO Segment, Requested Give Amount-Minimum: ...|125||ML|...

Requested Give Per (Time Unit): ...|H1|...<cr>

RXR|IV|...<cr>

RXC|B|D5W|1000|ML|...<cr>

RXC|A|KCL|40|MEQ|...<cr>

The second child:

ORC|CH|177B^SMS|||||1^C^^^^^^^^C&177A&SMS&&&ES+0M|177|...<cr>

RXO Segment, Requested Give Amount-Minimum: ...|100||ML|...

Requested Give Per (Time Unit): ...|H1|...<cr>

RXR|IV|...<cr>

RXC|B|D5/LR|1000|ML|...<cr>

RXC|A|KCL|20|MEQ|...<cr>

The third child:

ORC|CH|177C^SMS|||||1^C^^^^^^^^C&177B&SMS&&&#ES+0M|177|...<cr>

RXO Segment, Requested Give Amount-Minimum: ...|125||ML|...

Requested Give Per (Time Unit): ...|H1|...<cr>

RXR|IV|...<cr>

RXC|B|D5/0.45NACL|1000|ML|...<cr>

4.A.6 Query examples

Attention: The original mode query, including QRD and QRF segments were retained for backward compatibility only as of v 2.4 and withdrawn as of v2.7. The reader is therefore referred to chapter 5, section 5.4, for the current query/response message structure.

4.A PHARMACY/TREATMENT TRANSACTION FLOW DIAGRAM

The following are possible routes at a generic site.

4.A.1 OMP:

The Ordering application generates a pharmacy/treatment OMP and sends it to the pharmacy or treatment application, Nursing application, and/or other applications as appropriate at the site.

4.A.2 RDE:

The pharmacy/treatment application may send the RDE, the Pharmacy/Treatment Encoded Order message, a fully encoded order to the Nursing application, Ordering application, and/or other system applications as appropriate at the site.

4.A.3 RDS:

The pharmacy/treatment application may send the RDS, the Pharmacy/Treatment Dispense message, to the Nursing application or other applications as appropriate at the site, each time a medication is dispensed for this order. This message may occur multiple times for each order.

4.A.4 RGV:

The pharmacy application may send the RGV, the Pharmacy/Treatment Give message, to the Nursing application or other applications as appropriate at the site, for each scheduled date/time of administration of a medication for a given order. This message may occur multiple times for each order.

4.A.5 RAS:

The Nursing application (and other applications) can generate the RAS, the pharmacy/treatment Administration Results message, whenever a medication is given to the patient. This message may occur multiple times for each order.

Note: Sites having a long term clinical data repository may wish to route data to the data repository from copies of all or any of the five messages.

4.A VACCINE TRIGGER EVENTS & MESSAGE DEFINITIONS

The message header segment will carry one of four event types at MSH-9-Message Type:

Event Description
V01 Query for Vaccination Record
V02 Response to Vaccination Query (V01) Returning Multiple PID Matches
V03 Response to Query (V01) Returning Vaccination Record
V04 Unsolicited Update to Vaccination Record

4.A.1 Vaccine administration data

Immunization registries that maintain vaccination records need to be able to transmit patient-specific records of vaccines administered to other registries to provide access to the record at the time healthcare is given and to allow tracking of progress in reaching age-appropriate immunization coverage. The transmissions will occur as the result of four activities: (1) a query from one system for a patient's vaccination record that is held in another system, (2) a response to a query containing multiple patient matches to the query, (3) a response to a query containing the vaccination record, and (4) an unsolicited update to an immunization registry

These messages permit the transmission of immunization records from care providers to immunization registries, queries of these registries for immunization records, and the return of these immunization records to care providers. Messages containing immunization records carry patient identifying information in the PID segment. They may also carry parent or guardian information in the NK1 segments to help identify a child. The RXA segment is used to report the details of the immunization event: the type of vaccine (e.g., DPT, polio, MMR), the date administered, the sequence (1st, 2nd, etc.), the amount (e.g., 0.5 ml), and location and provider of the immunization. In addition, the RXA provides a place to record the lot number, manufacturer and date of expiration of the immunization. The RXA can also be used to report the fact that a specified immunization was refused. This section includes two tables (0292 and 0227) maintained by the U.S. Centers for Disease Control and Prevention (CDC). These tables are recommended in the U.S. for identifying the immunization in field RXA-5-Administered Code and the vaccine manufacturer in field RXA-17-substance manufacturer name.

4.A.2 Queries for immunization records (QRF Segments)

Note: The original mode query, including QRD and QRF segments were retained for backward compatibility only as of v 2.4. The reader is therefore referred to chapter 5, section 5.4, for the current query/response message structure.

The VXQ, VXX, and VXR messages defined below incorporate the QRF segment defined at 5.10.5.4, "QRF - original style query filter segment." QRF-5-other query subject filter is a locally defined filter for use between two systems which mutually agree on a definition. For transferring vaccination administration data, QRF-5-other QRY subject filter should be structured as shown in Figure 4-7 to transmit up to fourteen (14) separate search "keys." These search keys are only used to identify one patient's immunization record. The message provides for a wide variety of "identifying" keys including mother's and/or father's name and other identifiers; in some cases such information will be needed to identify a specific patient in the immunization database.

The format of each of the possible "search keys" is given below, and listed in a more structured form in Figure 4-7. These keys are transmitted as strings separated by repeat delimiters. The position of the occurrences within QRF-5-other QRY subject filter is significant, since the position of an occurrence of this field defines the characteristic. Data will follow the order in Figure 4-7, below. If one of the fields is not valued, it is left empty in the repeating field, with a repeat delimiter holding its place.

Figure 4-7. QRF-5 usage in vaccination messages

Pos Component Data Type Description/Examples
1 Patient Social Security Number~ ST In U.S., use SSN, without hyphens between 3rd and 4th digits and 5th and 6th digits, e.g., 123456789. In other countries, universal patient ID such as National Health Service number may be used.
2 Patient Birth Date~ DT July 4, 1976 = 19760704
3 Patient Birth State~ ID In U.S., use 2-letter postal code, e.g., IN, NY, CA. In other countries, locally applicable postal table may be used.
4 Patient Birth Registration Number~ ST State birth certificate number
5 Patient Medicaid Number~ ST When relevant
6 Mother's Name Last^First^Middle~ XPN ^ ^ ^

^ ^ . E.g., Smith^Mary^Elizabeth

7 Mother's Maiden Name~ ST Family name of mother before marriage. E.g., Jones
8 Mother's Social Security Number~ ST In U.S., use SSN, without hyphens between 3rd and 4th digits and 5th and 6th digits, e.g., 123456789. In other countries, universal patient ID such as National Health Service number may be used.
9 Father's Name Last^First^Middle~ XPN ^ ^ ^

^ ^ . E.g.,Smith^Thomas^A^Jr

10 Father's Social Security Number ST In U.S., use SSN, without hyphens between 3rd and 4th digits and 5th and 6th digits, e.g., 123456789. In other countries, universal patient ID such as National Health Service number may be used.
11 Patient's Telephone Number XTN [NNN] [(999)]999-9999 [X99999] [B99999] [C any text] ^ ^ ^ ^ ^ ^ ^ ^
12 Additional Patient Telephone Number XTN [NNN] [(999)]999-9999 [X99999] [B99999] [C any text] ^ ^ ^ ^ ^ ^ ^ ^
13 Patient's Address XAD ^ ^ ^ ^ ^ ^ < address type (ID)> ^ ^ ^ ^

^

14 Additional Patient Address XAD ^ ^ ^ ^ ^ ^ < address type (ID)> ^ ^ ^ ^

^

For instance, if the requestor knew only the patient's Social Security number and birth date, this QRF-5-other QRY subject filter would be sent:

|908723461~19941005|

If, in addition, the patient's birth state and mother's current and maiden name were known, this QRF-5-other QRY subject filter would be sent:

|908723461~19941005~IN~~~HUTCHINS^KATHY^ANN~HARKNESS|

4.A.3 VXQ - Query for Vaccination Record (Event V01)

Attention: Retained for backwards compatibility only as of v2.4.and withdrawn as of v2.7. Refer to chapter 5, section 5.4, for the current query/response message structure.

4.A.4 VXX - RESPONSE TO VACCINATION QUERY RETURNING MULTIPLE PID MATCHES (EVENT V02)

Attention: Retained for backwards compatibility only as of v2.4.and withdrawn as of v2.7. Refer to chapter 5, section 5.4, for the current query/response message structure.

4.A.5 VXR - Vaccination Record Response (Event V03)

Attention: Retained for backwards compatibility only as of v2.4.and withdrawn as of v2.7. Refer to chapter 5, section 5.4, for the current query/response message structure.

4.A.6 VXU - Unsolicited Vaccination Record Update (Event V04)

Definition: When a provider wishes to update the patient's vaccination record being held in a registry, he will transmit an unsolicited update of the record (a V04 trigger event).

An unsolicited update will follow this format. The three-letter code in the leftmost column indicates the segment that is included; the column on the right specifies the chapter in which that segment is fully defined.

VXU^V04^VXU_V04: Unsolicited Vaccination Update


MSH Message Header Segment
2 DB
[ { SFT } ] Software
2 DB
[ UAC ] User Authentication Credential
2 DB
PID Patient Identification Segment
3 DB
[ PD1 ] Additional Demographics
3 DB
[ { NK1 } ] Next of Kin/Associated Parties
3 DB
[ --- PATIENT begin


PV1 Patient Visit
3 DB
[ PV2 ] Patient Visit - Additional Info
3 DB
] --- PATIENT end


[ { GT1 } ] Guarantor
6 DB
[{ --- INSURANCE begin


IN1 Insurance
6 DB
[ IN2 ] Insurance Additional Information
6 DB
[ IN3 ] Insurance Additional Information, Certification
6 DB
}] --- INSURANCE end


[{ --- ORDER begin


ORC Common Order
4 DB
[{ --- TIMING begin


TQ1 Timing/Quantity
4 DB
[ { TQ2 } ] Timing/Quantity Order Sequence
4 DB
}] --- TIMING end


RXA Pharmacy Administration Segment
4 DB
[ RXR ] Pharmacy Route
4 DB
[{ --- OBSERVATION begin


OBX Observation/Result
7 DB
[ { NTE } ] Notes (Regarding Immunization)
2 DB
}] --- OBSERVATION end


}] --- ORDER end


4.A VACCINE SEGMENTS

4.A.1 RXA - segment usage in vaccine messages

With the exception of RXA-5-Administered code and RXA-17-Substance manufacturer name, the structure for the RXA segment below is identical to that documented in section 4A.4.7, "RXA - Pharmacy/Treatment Administration Segment." When using the RXA segment for vaccine messages, HL7 Table 0292- Vaccines Administered, should be used for RXA-5- Administered code, as noted in Section 4A.8.1.1, "Using RXA-5 in vaccine messages." Imported Table 0227- Manufacturers of Vaccines, should be used for RXA-17- Substance manufacturer name, as noted in Section 4A.8.1.2, "Using RXA-17 in vaccine messages."

HL7 Attribute Table - RXA - Segment Uses in Vaccine Messages

SEQ LEN C.LEN DT OPT RP/# TBL# ITEM # ELEMENT NAME DB Ref.
1
4= NM R

00342 Give Sub-ID Counter DB
2
4= NM R

00344 Administration Sub-ID Counter DB
3

DTM R

00345 Date/Time Start of Administration DB
4

DTM R

00346 Date/Time End of Administration DB
5

CWE R
0292 00347 Administered Code DB
6

NM R

00348 Administered Amount DB
7

CWE C
9999 00349 Administered Units DB
8

CWE O
9999 00350 Administered Dosage Form DB
9

CWE O Y 9999 00351 Administration Notes DB
10

XCN O Y
00352 Administering Provider DB
11

LA2 B

00353 Administered-at Location DB
12
20= ST C

00354 Administered Per (Time Unit) DB
13

NM O

01134 Administered Strength DB
14

CWE O
9999 01135 Administered Strength Units DB
15
20= ST O Y
01129 Substance Lot Number DB
16

DTM O Y
01130 Substance Expiration Date DB
17

CWE O Y 0227 01131 Substance Manufacturer Name DB
18

CWE O Y 9999 01136 Substance/Treatment Refusal Reason DB
19

CWE O Y 9999 01123 Indication DB
20 2..2
ID O
0322 01223 Completion Status DB
21 1..1
ID O
0206 01224 Action Code - RXA DB
22

DTM O

01225 System Entry Date/Time DB
23
5= NM O

01696 Administered Drug Strength Volume DB
24

CWE O
9999 01697 Administered Drug Strength Volume Units DB
25

CWE O
9999 01698 Administered Barcode Identifier DB
26 1..1
ID O
0480 01699 Pharmacy Order Type DB
27

PL O

02264 Administer-at DB
28

XAD O

02265 Administered-at Address DB

4.A.1.0 Using RXA-5 in vaccine messages

Use in RXA-5- administered code to identify the particular vaccine administered. The codes listed are used by immunization by immunization registries in the U.S. Entries will be added as needed to accommodate international requirements. Refer to chapter 2C Imported Table 0292 - Vaccines administered for valid values. If CVX code is used to identify vaccines, the coding system component (RXA-5.3) should be valued as "CVX", not as "HL70292."

4.A.1.1 Using RXA-17 in vaccine messages

Use in RXA-17-substance manufacturer name to identify the manufacturer or distributor of the particular vaccine administered. The codes listed are used by immunization registries in the U.S. Entries will be added as needed to accommodate international requirements. Refer to chapter 2C Imported Table 0227 - manufacturers of Vaccines for valid values. If using an MVX, Manufacturer, code, the coding system component (RXA-17.3) should be valued as "MVX", not as "HL70227."

4.A VACCINATION MESSAGE EXAMPLES

Attention: The original mode query, including QRD and QRF segments were retained for backward compatibility only as of v 2.4 and withdrawn as of v2.7. The reader is therefore referred to chapter 5, section 5.4, for the current query/response message structure.