field_separator
|
|
|
|
encoding_characters
^~\&
^
\&
\
\&
sending_application
Test Application
Test Application
Test Application
Test Application
sending_facility
Test Facility
Test Facility
Test Facility
Test Facility
receiving_application
MLLP_SERVER
MLLP_SERVER
MLLP_SERVER
MLLP_SERVER
receiving_facility
DESISIV
DESISIV
DESISIV
DESISIV
message_datetime
20260420030655
20260420030655
20260420030655
20260420030655
msh_8
message_type
DFT^P03
DFT
DFT
P03
P03
DFT^P03
message_control_id
c0019de1-e5d
c0019de1-e5d
c0019de1-e5d
c0019de1-e5d
processing_id
P
P
P
P
version_id
2.5.1
2.5.1
2.5.1
2.5.1
header
header
MSH|^~\&|Test Application|Test Facility|MLLP_SERVER|DESISIV|20260420030655||DFT^P03|c0019de1-e5d|P|2.5.1
MSH
evn_1
P03
P03
P03
P03
evn_2
20260420030655
20260420030655
20260420030655
20260420030655
header
header
EVN|P03|20260420030655
EVN
set_id
1
1
1
1
pid_2
CX
patient_identifier_list
TESTPAT017^^^TEST^MR~ALTTESTPAT017^^^TESTFAC^AN
id_number
TESTPAT017
TESTPAT017
check_digit
check_digit_scheme
assigning_authority
TEST
TEST
identifier_type_code
MR
MR
TESTPAT017^^^TEST^MR
id_number
ALTTESTPAT017
ALTTESTPAT017
check_digit
check_digit_scheme
assigning_authority
TESTFAC
TESTFAC
identifier_type_code
AN
AN
ALTTESTPAT017^^^TESTFAC^AN
pid_4
XPN
patient_name
DOE^JANE^A^JR
family_name
DOE
DOE
given_name
JANE
JANE
second_and_further_given_names_or_initials_thereof
A
A
suffix
JR
JR
DOE^JANE^A^JR
pid_6
date_time_of_birth
19800101
19800101
19800101
19800101
administrative_sex
F
F
F
F
pid_9
pid_10
2106-3
2106-3
2106-3
2106-3
pid_11
123 MAIN ST^^RALEIGH^NC^27601^USA
123 MAIN ST
123 MAIN ST
RALEIGH
RALEIGH
NC
NC
27601
27601
USA
USA
123 MAIN ST^^RALEIGH^NC^27601^USA
pid_12
XTN
phone_number_home
555-1234^PRN^PH~jane.doe@example.com^NET^Internet
telephone_number
555-1234
555-1234
telecommunication_use_code
PRN
PRN
telecommunication_equipment_type
PH
PH
555-1234^PRN^PH
telephone_number
jane.doe@example.com
jane.doe@example.com
telecommunication_use_code
NET
NET
telecommunication_equipment_type
Internet
Internet
jane.doe@example.com^NET^Internet
XTN
phone_number_business
555-5678^WPN^PH
telephone_number
555-5678
555-5678
telecommunication_use_code
WPN
WPN
telecommunication_equipment_type
PH
PH
555-5678^WPN^PH
pid_15
pid_16
ENG
ENG
ENG
ENG
pid_17
M
M
M
M
pid_18
CHR
CHR
CHR
CHR
pid_19
999-99-1234
999-99-1234
999-99-1234
999-99-1234
patient
patient
PID|1||TESTPAT017^^^TEST^MR~ALTTESTPAT017^^^TESTFAC^AN||DOE^JANE^A^JR||19800101|F||2106-3|123 MAIN ST^^RALEIGH^NC^27601^USA||555-1234^PRN^PH~jane.doe@example.com^NET^Internet|555-5678^WPN^PH||ENG|M|CHR|999-99-1234
PID
set_id
1
1
1
1
patient_class
O
O
O
O
PL
assigned_patient_location
CLINIC1^ROOM12^BEDA^TESTFAC^A^OP
point_of_care
CLINIC1
CLINIC1
room
ROOM12
ROOM12
bed
BEDA
BEDA
facility
TESTFAC
TESTFAC
location_status
A
A
person_location_type
OP
OP
CLINIC1^ROOM12^BEDA^TESTFAC^A^OP
pv1_4
pv1_5
pv1_6
XCN
attending_doctor
1234^PROVIDER^TEST^A^MD
id_number
1234
1234
family_name
PROVIDER
PROVIDER
given_name
TEST
TEST
second_and_further_given_names_or_initials_thereof
A
A
suffix
MD
MD
1234^PROVIDER^TEST^A^MD
pv1_8
2345^REFERRAL^SAM^B^MD
2345
2345
REFERRAL
REFERRAL
SAM
SAM
B
B
MD
MD
2345^REFERRAL^SAM^B^MD
pv1_9
pv1_10
pv1_11
pv1_12
pv1_13
pv1_14
MED
MED
MED
MED
pv1_15
pv1_16
pv1_17
pv1_18
ACCT017
ACCT017
ACCT017
ACCT017
CX
visit_number
id_number
pv1_20
pv1_21
pv1_22
pv1_23
pv1_24
pv1_25
pv1_26
pv1_27
pv1_28
pv1_29
pv1_30
pv1_31
pv1_32
pv1_33
pv1_34
pv1_35
pv1_36
pv1_37
pv1_38
pv1_39
pv1_40
pv1_41
pv1_42
20260420030655
20260420030655
20260420030655
20260420030655
visit
visit
PV1|1|O|CLINIC1^ROOM12^BEDA^TESTFAC^A^OP||||1234^PROVIDER^TEST^A^MD|2345^REFERRAL^SAM^B^MD||||||MED||||ACCT017||||||||||||||||||||||||20260420030655
PV1
set_id
1
1
1
1
transaction_id
TXNACCT017
TXNACCT017
TXNACCT017
TXNACCT017
transaction_batch_id
ACCT017
ACCT017
ACCT017
ACCT017
transaction_date
20260420030655
20260420030655
20260420030655
20260420030655
transaction_posting_date
20260420030655
20260420030655
20260420030655
20260420030655
transaction_type
CG
CG
CG
CG
CE
transaction_code
71020^CHEST XRAY^CPT
identifier
71020
71020
text
CHEST XRAY
CHEST XRAY
name_of_coding_system
CPT
CPT
71020^CHEST XRAY^CPT
transaction_description
Chest radiology study
Chest radiology study
Chest radiology study
Chest radiology study
ft1_9
transaction_amount_extended
125.00
125.00
125.00
125.00
transaction_quantity
1
1
1
1
ft1_12
EA
EA
EA
EA
ft1_13
125.00
125.00
125.00
125.00
ft1_14
ft1_15
PL
assigned_patient_location
CLINIC1^ROOM12^BEDA^TESTFAC^A^OP
point_of_care
CLINIC1
CLINIC1
room
ROOM12
ROOM12
bed
BEDA
BEDA
facility
TESTFAC
TESTFAC
location_status
A
A
person_location_type
OP
OP
CLINIC1^ROOM12^BEDA^TESTFAC^A^OP
ft1_17
ft1_18
CE
diagnosis_code_ft1
R509^COUGH
identifier
R509
R509
text
COUGH
COUGH
R509^COUGH
XCN
performed_by_code
1234^PROVIDER^TEST^A^MD
id_number
1234
1234
family_name
PROVIDER
PROVIDER
given_name
TEST
TEST
second_and_further_given_names_or_initials_thereof
A
A
suffix
MD
MD
1234^PROVIDER^TEST^A^MD
financial_transaction
financial_transaction_groups[1]
FT1|1|TXNACCT017|ACCT017|20260420030655|20260420030655|CG|71020^CHEST XRAY^CPT|Chest radiology study||125.00|1|EA|125.00|||CLINIC1^ROOM12^BEDA^TESTFAC^A^OP|||R509^COUGH|1234^PROVIDER^TEST^A^MD
FT1
set_id
1
1
1
1
dg1_2
CE
diagnosis_code
R509^Cough^ICD10
identifier
R509
R509
text
Cough
Cough
name_of_coding_system
ICD10
ICD10
R509^Cough^ICD10
dg1_4
dg1_5
diagnosis_type
W
W
W
W
financial_transaction
financial_transaction_groups[1]
DG1|1||R509^Cough^ICD10|||W
DG1
set_id
1
1
1
1
value_type
TX
TX
TX
TX
CE
observation_identifier
NOTE^Visit Note
identifier
NOTE
NOTE
text
Visit Note
Visit Note
NOTE^Visit Note
obx_4
observation_value
Patient TESTPAT017 completed outpatient chest imaging follow-up
Patient TESTPAT017 completed outpatient chest imaging follow-up
Patient TESTPAT017 completed outpatient chest imaging follow-up
Patient TESTPAT017 completed outpatient chest imaging follow-up
obx_6
obx_7
obx_8
N
N
N
N
obx_9
obx_10
observation_result_status
F
F
F
F
obx_12
obx_13
date_time_of_the_observation
20260420030655
20260420030655
20260420030655
20260420030655
financial_transaction
financial_transaction_groups[1]
OBX|1|TX|NOTE^Visit Note||Patient TESTPAT017 completed outpatient chest imaging follow-up|||N|||F|||20260420030655
OBX
DG1|1||R509^Cough^ICD10|||W
DG1
EVN|P03|20260420030655
EVN
FT1|1|TXNACCT017|ACCT017|20260420030655|20260420030655|CG|71020^CHEST XRAY^CPT|Chest radiology study||125.00|1|EA|125.00|||CLINIC1^ROOM12^BEDA^TESTFAC^A^OP|||R509^COUGH|1234^PROVIDER^TEST^A^MD
FT1
MSH|^~\&|Test Application|Test Facility|MLLP_SERVER|DESISIV|20260420030655||DFT^P03|c0019de1-e5d|P|2.5.1
MSH
OBX|1|TX|NOTE^Visit Note||Patient TESTPAT017 completed outpatient chest imaging follow-up|||N|||F|||20260420030655
OBX
PID|1||TESTPAT017^^^TEST^MR~ALTTESTPAT017^^^TESTFAC^AN||DOE^JANE^A^JR||19800101|F||2106-3|123 MAIN ST^^RALEIGH^NC^27601^USA||555-1234^PRN^PH~jane.doe@example.com^NET^Internet|555-5678^WPN^PH||ENG|M|CHR|999-99-1234
PID
PV1|1|O|CLINIC1^ROOM12^BEDA^TESTFAC^A^OP||||1234^PROVIDER^TEST^A^MD|2345^REFERRAL^SAM^B^MD||||||MED||||ACCT017||||||||||||||||||||||||20260420030655
PV1