| Global Profile (Differential) | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Seq# | Data Element | Description | Flags | Implement | Vocabulary | |||||
 AUT | ||||||||||
  | 2 | 01147 | Authorizing Payor, Company ID | SHALL | InsuranceCompanyIdCodes (CD) | |||||
| 13 | 03413 | Authorization Referral Type | SHALL | AuthorizationReferralType (CD) | |||||
| Global Profile (Snapshot) | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Seq# | Data Element | Description | Flags | Implement | Cardinality | Vocabulary | Data Type | |||
| AUT | ||||||||||
| 1 | 01146 | Authorizing Payor, Plan ID | MAY | [0..1] | InsurancePlanId (CD) | CWE Coded with Exceptions | |||
| 2 | 01147 | Authorizing Payor, Company ID | SHALL | [1..1] | InsuranceCompanyIdCodes (CD) | CWE Coded with Exceptions | |||
| 3 | 01148 | Authorizing Payor, Company Name | = Truncation allowed. | MAY | [0..1] | ST String Data | |||
| 4 | 01149 | Authorization Effective Date | MAY | [0..1] | DTM Date/Time | ||||
| 5 | 01150 | Authorization Expiration Date | MAY | [0..1] | DTM Date/Time | ||||
 | 6 | 01151 | Authorization Identifier | C Condition defined for this element | MAY | [0..1] | EI Entity Identifier | |||
| 7 | 01152 | Reimbursement Limit | MAY | [0..1] | CP Composite Price | ||||
| 8 | 01153 | Requested Number of Treatments | MAY | [0..1] | CQ Composite Quantity with Units | ||||
| 9 | 01154 | Authorized Number of Treatments | MAY | [0..1] | CQ Composite Quantity with Units | ||||
| 10 | 01145 | Process Date | MAY | [0..1] | DTM Date/Time | ||||
| 11 | 02375 | Requested Discipline(s) | MAY | [0..*] | RequestedDiscipline(s) (CD) | CWE Coded with Exceptions | |||
| 12 | 02376 | Authorized Discipline(s) | MAY | [0..*] | AuthorizedDiscipline(s) (CD) | CWE Coded with Exceptions | |||
| 13 | 03413 | Authorization Referral Type | SHALL | [1..1] | AuthorizationReferralType (CD) | CWE Coded with Exceptions | |||
| 14 | 03414 | Approval Status | MAY | [0..1] | ApprovalStatus (CD) | CWE Coded with Exceptions | |||
| 15 | 03415 | Planned Treatment Stop Date | MAY | [0..1] | DTM Date/Time | ||||
| 16 | 03416 | Clinical Service | MAY | [0..1] | ClinicalService (CD) | CWE Coded with Exceptions | |||
| 17 | 03417 | Reason Text | MAY | [0..1] | ST String Data | ||||
| 18 | 03418 | Number of Authorized Treatments/Units | MAY | [0..1] | CQ Composite Quantity with Units | ||||
| 19 | 03419 | Number of Used Treatments/Units | MAY | [0..1] | CQ Composite Quantity with Units | ||||
| 20 | 03420 | Number of Schedule Treatments/Units | MAY | [0..1] | CQ Composite Quantity with Units | ||||
| 21 | 03421 | Encounter Type | MAY | [0..1] | EncounterType (CD) | CWE Coded with Exceptions | |||
| 22 | 03422 | Remaining Benefit Amount | MAY | [0..1] | MO Money | ||||
| 23 | 03423 | Authorized Provider | MAY | [0..1] | XON Extended Composite Name and Identification Number for Organizations | ||||
| 24 | 03424 | Authorized Health Professional | MAY | [0..1] | XCN Extended Composite ID Number and Name for Persons | ||||
| 25 | 03425 | Source Text | MAY | [0..1] | ST String Data | ||||
| 26 | 03426 | Source Date | MAY | [0..1] | DTM Date/Time | ||||
| 27 | 03427 | Source Phone | MAY | [0..1] | XTN Extended Telecommunication Number | ||||
| 28 | 03428 | Comment | MAY | [0..1] | ST String Data | ||||
 | 29 | 03429 | Action Code | MAY | [0..1] | univ: SegmentActionCode (CD) hl7VS-segmentActionCode (VS) segmentAction (CS) | ID Coded Value for HL7 Defined Tables | |||
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