R509
ICD10
Cough
W
1
1
1
set_id
1
1
1
1
dg1_2
identifier
R509
R509
text
Cough
Cough
name_of_coding_system
ICD10
ICD10
R509
ICD10
R509^Cough^ICD10
Cough
diagnosis_code
R509^Cough^ICD10
identifier
R509
R509
text
Cough
Cough
name_of_coding_system
ICD10
ICD10
R509
ICD10
R509^Cough^ICD10
Cough
dg1_4
dg1_5
W
W
W
diagnosis_type
W
W
W
W
DG1|1||R509^Cough^ICD10|||W
DG1
1
BEDA
TESTFAC
A
OP
CLINIC1
ROOM12
R509
COUGH
1
1
1
set_id
1
1
1
1
TXNACCT018
TXNACCT018
TXNACCT018
transaction_id
TXNACCT018
TXNACCT018
TXNACCT018
TXNACCT018
ACCT018
ACCT018
ACCT018
transaction_batch_id
ACCT018
ACCT018
ACCT018
ACCT018
20260413191601
20260413191601
20260413191601
transaction_date
20260413191601
20260413191601
20260413191601
20260413191601
20260413191601
20260413191601
20260413191601
transaction_posting_date
20260413191601
20260413191601
20260413191601
20260413191601
CG
CG
CG
transaction_type
CG
CG
CG
CG
identifier
71020
71020
text
CHEST XRAY
CHEST XRAY
name_of_coding_system
CPT
CPT
71020
CPT
71020^CHEST XRAY^CPT
CHEST XRAY
transaction_code
71020^CHEST XRAY^CPT
identifier
71020
71020
text
CHEST XRAY
CHEST XRAY
name_of_coding_system
CPT
CPT
71020
CPT
71020^CHEST XRAY^CPT
CHEST XRAY
Chest radiology study
Chest radiology study
Chest radiology study
transaction_description
Chest radiology study
Chest radiology study
Chest radiology study
Chest radiology study
ft1_9
125.00
125.00
125.00
transaction_amount_extended
125.00
125.00
125.00
125.00
1
1
1
transaction_quantity
1
1
1
1
EA
EA
EA
ft1_12
EA
EA
EA
EA
125.00
125.00
125.00
ft1_13
125.00
125.00
125.00
125.00
ft1_14
ft1_15
BEDA
point_of_care
CLINIC1
CLINIC1
room
ROOM12
ROOM12
bed
BEDA
BEDA
facility
TESTFAC
TESTFAC
location_status
A
A
person_location_type
OP
OP
TESTFAC
A
OP
CLINIC1
CLINIC1^ROOM12^BEDA^TESTFAC^A^OP
ROOM12
assigned_patient_location
CLINIC1^ROOM12^BEDA^TESTFAC^A^OP
BEDA
point_of_care
CLINIC1
CLINIC1
room
ROOM12
ROOM12
bed
BEDA
BEDA
facility
TESTFAC
TESTFAC
location_status
A
A
person_location_type
OP
OP
TESTFAC
A
OP
CLINIC1
CLINIC1^ROOM12^BEDA^TESTFAC^A^OP
ROOM12
ft1_17
ft1_18
identifier
R509
R509
text
COUGH
COUGH
R509
R509^COUGH
COUGH
diagnosis_code_ft1
R509^COUGH
identifier
R509
R509
text
COUGH
COUGH
R509
R509^COUGH
COUGH
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
PROVIDER
TEST
1234
1234^PROVIDER^TEST^A^MD
A
MD
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
PROVIDER
TEST
1234
1234^PROVIDER^TEST^A^MD
A
MD
EA
125.00
PROVIDER
TEST
1234
A
MD
FT1|1|TXNACCT018|ACCT018|20260413191601|20260413191601|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
1
125.00
ACCT018
71020
CPT
CHEST XRAY
20260413191601
Chest radiology study
TXNACCT018
20260413191601
1
CG
20260413191601
1
1
1
set_id
1
1
1
1
TX
TX
TX
value_type
TX
TX
TX
TX
identifier
NOTE
NOTE
text
Visit Note
Visit Note
NOTE
NOTE^Visit Note
Visit Note
observation_identifier
NOTE^Visit Note
identifier
NOTE
NOTE
text
Visit Note
Visit Note
NOTE
NOTE^Visit Note
Visit Note
obx_4
Patient TESTPAT018 completed outpatient chest imaging follow-up
Patient TESTPAT018 completed outpatient chest imaging follow-up
Patient TESTPAT018 completed outpatient chest imaging follow-up
observation_value
Patient TESTPAT018 completed outpatient chest imaging follow-up
Patient TESTPAT018 completed outpatient chest imaging follow-up
Patient TESTPAT018 completed outpatient chest imaging follow-up
Patient TESTPAT018 completed outpatient chest imaging follow-up
obx_6
obx_7
N
N
N
obx_8
N
N
N
N
obx_9
obx_10
F
F
F
observation_result_status
F
F
F
F
obx_12
obx_13
20260413191601
20260413191601
20260413191601
date_time_of_the_observation
20260413191601
20260413191601
20260413191601
20260413191601
NOTE
Visit Note
F
Patient TESTPAT018 completed outpatient chest imaging follow-up
N
OBX|1|TX|NOTE^Visit Note||Patient TESTPAT018 completed outpatient chest imaging follow-up|||N|||F|||20260413191601
OBX
1
TX
BEDA
TESTFAC
A
OP
CLINIC1
ROOM12
R509
COUGH
1
1
1
set_id
1
1
1
1
TXNACCT018
TXNACCT018
TXNACCT018
transaction_id
TXNACCT018
TXNACCT018
TXNACCT018
TXNACCT018
ACCT018
ACCT018
ACCT018
transaction_batch_id
ACCT018
ACCT018
ACCT018
ACCT018
20260413191601
20260413191601
20260413191601
transaction_date
20260413191601
20260413191601
20260413191601
20260413191601
20260413191601
20260413191601
20260413191601
transaction_posting_date
20260413191601
20260413191601
20260413191601
20260413191601
CG
CG
CG
transaction_type
CG
CG
CG
CG
identifier
71020
71020
text
CHEST XRAY
CHEST XRAY
name_of_coding_system
CPT
CPT
71020
CPT
71020^CHEST XRAY^CPT
CHEST XRAY
transaction_code
71020^CHEST XRAY^CPT
identifier
71020
71020
text
CHEST XRAY
CHEST XRAY
name_of_coding_system
CPT
CPT
71020
CPT
71020^CHEST XRAY^CPT
CHEST XRAY
Chest radiology study
Chest radiology study
Chest radiology study
transaction_description
Chest radiology study
Chest radiology study
Chest radiology study
Chest radiology study
ft1_9
125.00
125.00
125.00
transaction_amount_extended
125.00
125.00
125.00
125.00
1
1
1
transaction_quantity
1
1
1
1
EA
EA
EA
ft1_12
EA
EA
EA
EA
125.00
125.00
125.00
ft1_13
125.00
125.00
125.00
125.00
ft1_14
ft1_15
BEDA
point_of_care
CLINIC1
CLINIC1
room
ROOM12
ROOM12
bed
BEDA
BEDA
facility
TESTFAC
TESTFAC
location_status
A
A
person_location_type
OP
OP
TESTFAC
A
OP
CLINIC1
CLINIC1^ROOM12^BEDA^TESTFAC^A^OP
ROOM12
assigned_patient_location
CLINIC1^ROOM12^BEDA^TESTFAC^A^OP
BEDA
point_of_care
CLINIC1
CLINIC1
room
ROOM12
ROOM12
bed
BEDA
BEDA
facility
TESTFAC
TESTFAC
location_status
A
A
person_location_type
OP
OP
TESTFAC
A
OP
CLINIC1
CLINIC1^ROOM12^BEDA^TESTFAC^A^OP
ROOM12
ft1_17
ft1_18
identifier
R509
R509
text
COUGH
COUGH
R509
R509^COUGH
COUGH
diagnosis_code_ft1
R509^COUGH
identifier
R509
R509
text
COUGH
COUGH
R509
R509^COUGH
COUGH
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
PROVIDER
TEST
1234
1234^PROVIDER^TEST^A^MD
A
MD
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
PROVIDER
TEST
1234
1234^PROVIDER^TEST^A^MD
A
MD
EA
125.00
PROVIDER
TEST
1234
A
MD
FT1|1|TXNACCT018|ACCT018|20260413191601|20260413191601|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
1
125.00
ACCT018
71020
CPT
CHEST XRAY
20260413191601
Chest radiology study
TXNACCT018
20260413191601
1
CG
R509
ICD10
Cough
W
1
1
1
set_id
1
1
1
1
dg1_2
identifier
R509
R509
text
Cough
Cough
name_of_coding_system
ICD10
ICD10
R509
ICD10
R509^Cough^ICD10
Cough
diagnosis_code
R509^Cough^ICD10
identifier
R509
R509
text
Cough
Cough
name_of_coding_system
ICD10
ICD10
R509
ICD10
R509^Cough^ICD10
Cough
dg1_4
dg1_5
W
W
W
diagnosis_type
W
W
W
W
DG1|1||R509^Cough^ICD10|||W
DG1
1
20260413191601
1
1
1
set_id
1
1
1
1
TX
TX
TX
value_type
TX
TX
TX
TX
identifier
NOTE
NOTE
text
Visit Note
Visit Note
NOTE
NOTE^Visit Note
Visit Note
observation_identifier
NOTE^Visit Note
identifier
NOTE
NOTE
text
Visit Note
Visit Note
NOTE
NOTE^Visit Note
Visit Note
obx_4
Patient TESTPAT018 completed outpatient chest imaging follow-up
Patient TESTPAT018 completed outpatient chest imaging follow-up
Patient TESTPAT018 completed outpatient chest imaging follow-up
observation_value
Patient TESTPAT018 completed outpatient chest imaging follow-up
Patient TESTPAT018 completed outpatient chest imaging follow-up
Patient TESTPAT018 completed outpatient chest imaging follow-up
Patient TESTPAT018 completed outpatient chest imaging follow-up
obx_6
obx_7
N
N
N
obx_8
N
N
N
N
obx_9
obx_10
F
F
F
observation_result_status
F
F
F
F
obx_12
obx_13
20260413191601
20260413191601
20260413191601
date_time_of_the_observation
20260413191601
20260413191601
20260413191601
20260413191601
NOTE
Visit Note
F
Patient TESTPAT018 completed outpatient chest imaging follow-up
N
OBX|1|TX|NOTE^Visit Note||Patient TESTPAT018 completed outpatient chest imaging follow-up|||N|||F|||20260413191601
OBX
1
TX
P03
20260413191601
P03
P03
P03
evn_1
P03
P03
P03
P03
20260413191601
20260413191601
20260413191601
evn_2
20260413191601
20260413191601
20260413191601
20260413191601
EVN|P03|20260413191601
EVN
^ \&
|
|
|
|
field_separator
|
|
|
|
^
encoding_characters
^~\&
^
\&
\
\&
Test Application
Test Application
Test Application
sending_application
Test Application
Test Application
Test Application
Test Application
Test Facility
Test Facility
Test Facility
sending_facility
Test Facility
Test Facility
Test Facility
Test Facility
MLLP_SERVER
MLLP_SERVER
MLLP_SERVER
receiving_application
MLLP_SERVER
MLLP_SERVER
MLLP_SERVER
MLLP_SERVER
DESISIV
DESISIV
DESISIV
receiving_facility
DESISIV
DESISIV
DESISIV
DESISIV
20260413191601
20260413191601
20260413191601
message_datetime
20260413191601
20260413191601
20260413191601
20260413191601
msh_8
DFT
DFT
P03
P03
DFT^P03
message_type
DFT^P03
DFT
DFT
P03
P03
DFT^P03
3ed16e9d-987
3ed16e9d-987
3ed16e9d-987
message_control_id
3ed16e9d-987
3ed16e9d-987
3ed16e9d-987
3ed16e9d-987
P
P
P
processing_id
P
P
P
P
2.5.1
2.5.1
2.5.1
version_id
2.5.1
2.5.1
2.5.1
2.5.1
3ed16e9d-987
20260413191601
DFT^P03
P
MSH|^~\&|Test Application|Test Facility|MLLP_SERVER|DESISIV|20260413191601||DFT^P03|3ed16e9d-987|P|2.5.1
MLLP_SERVER
DESISIV
MSH
Test Application
Test Facility
2.5.1
^ \&
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|
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field_separator
|
|
|
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^
encoding_characters
^~\&
^
\&
\
\&
Test Application
Test Application
Test Application
sending_application
Test Application
Test Application
Test Application
Test Application
Test Facility
Test Facility
Test Facility
sending_facility
Test Facility
Test Facility
Test Facility
Test Facility
MLLP_SERVER
MLLP_SERVER
MLLP_SERVER
receiving_application
MLLP_SERVER
MLLP_SERVER
MLLP_SERVER
MLLP_SERVER
DESISIV
DESISIV
DESISIV
receiving_facility
DESISIV
DESISIV
DESISIV
DESISIV
20260413191601
20260413191601
20260413191601
message_datetime
20260413191601
20260413191601
20260413191601
20260413191601
msh_8
DFT
DFT
P03
P03
DFT^P03
message_type
DFT^P03
DFT
DFT
P03
P03
DFT^P03
3ed16e9d-987
3ed16e9d-987
3ed16e9d-987
message_control_id
3ed16e9d-987
3ed16e9d-987
3ed16e9d-987
3ed16e9d-987
P
P
P
processing_id
P
P
P
P
2.5.1
2.5.1
2.5.1
version_id
2.5.1
2.5.1
2.5.1
2.5.1
3ed16e9d-987
20260413191601
DFT^P03
P
MSH|^~\&|Test Application|Test Facility|MLLP_SERVER|DESISIV|20260413191601||DFT^P03|3ed16e9d-987|P|2.5.1
MLLP_SERVER
DESISIV
MSH
Test Application
Test Facility
2.5.1
P03
20260413191601
P03
P03
P03
evn_1
P03
P03
P03
P03
20260413191601
20260413191601
20260413191601
evn_2
20260413191601
20260413191601
20260413191601
20260413191601
EVN|P03|20260413191601
EVN
F
19800101
1
1
1
set_id
1
1
1
1
pid_2
TEST
id_number
TESTPAT018
TESTPAT018
check_digit
check_digit_scheme
assigning_authority
TEST
TEST
identifier_type_code
MR
MR
TESTPAT018
MR
TESTPAT018^^^TEST^MR
patient_identifier_list
TESTPAT018^^^TEST^MR~ALTTESTPAT018^^^TESTFAC^AN
TEST
id_number
TESTPAT018
TESTPAT018
check_digit
check_digit_scheme
assigning_authority
TEST
TEST
identifier_type_code
MR
MR
TESTPAT018
MR
TESTPAT018^^^TEST^MR
TESTFAC
id_number
ALTTESTPAT018
ALTTESTPAT018
check_digit
check_digit_scheme
assigning_authority
TESTFAC
TESTFAC
identifier_type_code
AN
AN
ALTTESTPAT018
AN
ALTTESTPAT018^^^TESTFAC^AN
pid_4
family_name
DOE
DOE
given_name
JANE
JANE
second_and_further_given_names_or_initials_thereof
A
A
suffix
JR
JR
DOE
JANE
DOE^JANE^A^JR
A
JR
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
DOE^JANE^A^JR
A
JR
pid_6
19800101
19800101
19800101
date_time_of_birth
19800101
19800101
19800101
19800101
F
F
F
administrative_sex
F
F
F
F
pid_9
2106-3
2106-3
2106-3
pid_10
2106-3
2106-3
2106-3
2106-3
123 MAIN ST
123 MAIN ST
RALEIGH
RALEIGH
NC
NC
27601
27601
USA
USA
123 MAIN ST^^RALEIGH^NC^27601^USA
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
555-1234
555-1234
PRN
PRN
PH
PH
555-1234^PRN^PH
pid_13
555-1234^PRN^PH~jane.doe@example.com^NET^Internet
555-1234
555-1234
PRN
PRN
PH
PH
555-1234^PRN^PH
jane.doe@example.com
jane.doe@example.com
NET
NET
Internet
Internet
jane.doe@example.com^NET^Internet
555-5678
555-5678
WPN
WPN
PH
PH
555-5678^WPN^PH
pid_14
555-5678^WPN^PH
555-5678
555-5678
WPN
WPN
PH
PH
555-5678^WPN^PH
pid_15
ENG
ENG
ENG
pid_16
ENG
ENG
ENG
ENG
M
M
M
pid_17
M
M
M
M
CHR
CHR
CHR
pid_18
CHR
CHR
CHR
CHR
999-99-1234
999-99-1234
999-99-1234
pid_19
999-99-1234
999-99-1234
999-99-1234
999-99-1234
TEST
TESTPAT018
MR
TESTFAC
ALTTESTPAT018
AN
DOE
JANE
A
JR
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|1||TESTPAT018^^^TEST^MR~ALTTESTPAT018^^^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
1
F
19800101
1
1
1
set_id
1
1
1
1
pid_2
TEST
id_number
TESTPAT018
TESTPAT018
check_digit
check_digit_scheme
assigning_authority
TEST
TEST
identifier_type_code
MR
MR
TESTPAT018
MR
TESTPAT018^^^TEST^MR
patient_identifier_list
TESTPAT018^^^TEST^MR~ALTTESTPAT018^^^TESTFAC^AN
TEST
id_number
TESTPAT018
TESTPAT018
check_digit
check_digit_scheme
assigning_authority
TEST
TEST
identifier_type_code
MR
MR
TESTPAT018
MR
TESTPAT018^^^TEST^MR
TESTFAC
id_number
ALTTESTPAT018
ALTTESTPAT018
check_digit
check_digit_scheme
assigning_authority
TESTFAC
TESTFAC
identifier_type_code
AN
AN
ALTTESTPAT018
AN
ALTTESTPAT018^^^TESTFAC^AN
pid_4
family_name
DOE
DOE
given_name
JANE
JANE
second_and_further_given_names_or_initials_thereof
A
A
suffix
JR
JR
DOE
JANE
DOE^JANE^A^JR
A
JR
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
DOE^JANE^A^JR
A
JR
pid_6
19800101
19800101
19800101
date_time_of_birth
19800101
19800101
19800101
19800101
F
F
F
administrative_sex
F
F
F
F
pid_9
2106-3
2106-3
2106-3
pid_10
2106-3
2106-3
2106-3
2106-3
123 MAIN ST
123 MAIN ST
RALEIGH
RALEIGH
NC
NC
27601
27601
USA
USA
123 MAIN ST^^RALEIGH^NC^27601^USA
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
555-1234
555-1234
PRN
PRN
PH
PH
555-1234^PRN^PH
pid_13
555-1234^PRN^PH~jane.doe@example.com^NET^Internet
555-1234
555-1234
PRN
PRN
PH
PH
555-1234^PRN^PH
jane.doe@example.com
jane.doe@example.com
NET
NET
Internet
Internet
jane.doe@example.com^NET^Internet
555-5678
555-5678
WPN
WPN
PH
PH
555-5678^WPN^PH
pid_14
555-5678^WPN^PH
555-5678
555-5678
WPN
WPN
PH
PH
555-5678^WPN^PH
pid_15
ENG
ENG
ENG
pid_16
ENG
ENG
ENG
ENG
M
M
M
pid_17
M
M
M
M
CHR
CHR
CHR
pid_18
CHR
CHR
CHR
CHR
999-99-1234
999-99-1234
999-99-1234
pid_19
999-99-1234
999-99-1234
999-99-1234
999-99-1234
TEST
TESTPAT018
MR
TESTFAC
ALTTESTPAT018
AN
DOE
JANE
A
JR
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|1||TESTPAT018^^^TEST^MR~ALTTESTPAT018^^^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
1
^ \&
|
|
|
|
field_separator
|
|
|
|
^
encoding_characters
^~\&
^
\&
\
\&
Test Application
Test Application
Test Application
sending_application
Test Application
Test Application
Test Application
Test Application
Test Facility
Test Facility
Test Facility
sending_facility
Test Facility
Test Facility
Test Facility
Test Facility
MLLP_SERVER
MLLP_SERVER
MLLP_SERVER
receiving_application
MLLP_SERVER
MLLP_SERVER
MLLP_SERVER
MLLP_SERVER
DESISIV
DESISIV
DESISIV
receiving_facility
DESISIV
DESISIV
DESISIV
DESISIV
20260413191601
20260413191601
20260413191601
message_datetime
20260413191601
20260413191601
20260413191601
20260413191601
msh_8
DFT
DFT
P03
P03
DFT^P03
message_type
DFT^P03
DFT
DFT
P03
P03
DFT^P03
3ed16e9d-987
3ed16e9d-987
3ed16e9d-987
message_control_id
3ed16e9d-987
3ed16e9d-987
3ed16e9d-987
3ed16e9d-987
P
P
P
processing_id
P
P
P
P
2.5.1
2.5.1
2.5.1
version_id
2.5.1
2.5.1
2.5.1
2.5.1
3ed16e9d-987
20260413191601
DFT^P03
P
MSH|^~\&|Test Application|Test Facility|MLLP_SERVER|DESISIV|20260413191601||DFT^P03|3ed16e9d-987|P|2.5.1
MLLP_SERVER
DESISIV
MSH
Test Application
Test Facility
2.5.1
P03
20260413191601
P03
P03
P03
evn_1
P03
P03
P03
P03
20260413191601
20260413191601
20260413191601
evn_2
20260413191601
20260413191601
20260413191601
20260413191601
EVN|P03|20260413191601
EVN
F
19800101
1
1
1
set_id
1
1
1
1
pid_2
TEST
id_number
TESTPAT018
TESTPAT018
check_digit
check_digit_scheme
assigning_authority
TEST
TEST
identifier_type_code
MR
MR
TESTPAT018
MR
TESTPAT018^^^TEST^MR
patient_identifier_list
TESTPAT018^^^TEST^MR~ALTTESTPAT018^^^TESTFAC^AN
TEST
id_number
TESTPAT018
TESTPAT018
check_digit
check_digit_scheme
assigning_authority
TEST
TEST
identifier_type_code
MR
MR
TESTPAT018
MR
TESTPAT018^^^TEST^MR
TESTFAC
id_number
ALTTESTPAT018
ALTTESTPAT018
check_digit
check_digit_scheme
assigning_authority
TESTFAC
TESTFAC
identifier_type_code
AN
AN
ALTTESTPAT018
AN
ALTTESTPAT018^^^TESTFAC^AN
pid_4
family_name
DOE
DOE
given_name
JANE
JANE
second_and_further_given_names_or_initials_thereof
A
A
suffix
JR
JR
DOE
JANE
DOE^JANE^A^JR
A
JR
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
DOE^JANE^A^JR
A
JR
pid_6
19800101
19800101
19800101
date_time_of_birth
19800101
19800101
19800101
19800101
F
F
F
administrative_sex
F
F
F
F
pid_9
2106-3
2106-3
2106-3
pid_10
2106-3
2106-3
2106-3
2106-3
123 MAIN ST
123 MAIN ST
RALEIGH
RALEIGH
NC
NC
27601
27601
USA
USA
123 MAIN ST^^RALEIGH^NC^27601^USA
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
555-1234
555-1234
PRN
PRN
PH
PH
555-1234^PRN^PH
pid_13
555-1234^PRN^PH~jane.doe@example.com^NET^Internet
555-1234
555-1234
PRN
PRN
PH
PH
555-1234^PRN^PH
jane.doe@example.com
jane.doe@example.com
NET
NET
Internet
Internet
jane.doe@example.com^NET^Internet
555-5678
555-5678
WPN
WPN
PH
PH
555-5678^WPN^PH
pid_14
555-5678^WPN^PH
555-5678
555-5678
WPN
WPN
PH
PH
555-5678^WPN^PH
pid_15
ENG
ENG
ENG
pid_16
ENG
ENG
ENG
ENG
M
M
M
pid_17
M
M
M
M
CHR
CHR
CHR
pid_18
CHR
CHR
CHR
CHR
999-99-1234
999-99-1234
999-99-1234
pid_19
999-99-1234
999-99-1234
999-99-1234
999-99-1234
TEST
TESTPAT018
MR
TESTFAC
ALTTESTPAT018
AN
DOE
JANE
A
JR
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|1||TESTPAT018^^^TEST^MR~ALTTESTPAT018^^^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
1
BEDA
TESTFAC
A
OP
CLINIC1
ROOM12
PROVIDER
TEST
1234
A
MD
1
1
1
set_id
1
1
1
1
O
O
O
patient_class
O
O
O
O
BEDA
point_of_care
CLINIC1
CLINIC1
room
ROOM12
ROOM12
bed
BEDA
BEDA
facility
TESTFAC
TESTFAC
location_status
A
A
person_location_type
OP
OP
TESTFAC
A
OP
CLINIC1
CLINIC1^ROOM12^BEDA^TESTFAC^A^OP
ROOM12
assigned_patient_location
CLINIC1^ROOM12^BEDA^TESTFAC^A^OP
BEDA
point_of_care
CLINIC1
CLINIC1
room
ROOM12
ROOM12
bed
BEDA
BEDA
facility
TESTFAC
TESTFAC
location_status
A
A
person_location_type
OP
OP
TESTFAC
A
OP
CLINIC1
CLINIC1^ROOM12^BEDA^TESTFAC^A^OP
ROOM12
pv1_4
pv1_5
pv1_6
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
PROVIDER
TEST
1234
1234^PROVIDER^TEST^A^MD
A
MD
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
PROVIDER
TEST
1234
1234^PROVIDER^TEST^A^MD
A
MD
2345
2345
REFERRAL
REFERRAL
SAM
SAM
B
B
MD
MD
2345^REFERRAL^SAM^B^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
MED
MED
MED
pv1_14
MED
MED
MED
MED
pv1_15
pv1_16
pv1_17
ACCT018
ACCT018
ACCT018
pv1_18
ACCT018
ACCT018
ACCT018
ACCT018
id_number
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
20260413191601
20260413191601
20260413191601
pv1_42
20260413191601
20260413191601
20260413191601
20260413191601
O
MED
ACCT018
20260413191601
2345^REFERRAL^SAM^B^MD
PV1|1|O|CLINIC1^ROOM12^BEDA^TESTFAC^A^OP||||1234^PROVIDER^TEST^A^MD|2345^REFERRAL^SAM^B^MD||||||MED||||ACCT018||||||||||||||||||||||||20260413191601
PV1
1
BEDA
TESTFAC
A
OP
CLINIC1
ROOM12
R509
COUGH
1
1
1
set_id
1
1
1
1
TXNACCT018
TXNACCT018
TXNACCT018
transaction_id
TXNACCT018
TXNACCT018
TXNACCT018
TXNACCT018
ACCT018
ACCT018
ACCT018
transaction_batch_id
ACCT018
ACCT018
ACCT018
ACCT018
20260413191601
20260413191601
20260413191601
transaction_date
20260413191601
20260413191601
20260413191601
20260413191601
20260413191601
20260413191601
20260413191601
transaction_posting_date
20260413191601
20260413191601
20260413191601
20260413191601
CG
CG
CG
transaction_type
CG
CG
CG
CG
identifier
71020
71020
text
CHEST XRAY
CHEST XRAY
name_of_coding_system
CPT
CPT
71020
CPT
71020^CHEST XRAY^CPT
CHEST XRAY
transaction_code
71020^CHEST XRAY^CPT
identifier
71020
71020
text
CHEST XRAY
CHEST XRAY
name_of_coding_system
CPT
CPT
71020
CPT
71020^CHEST XRAY^CPT
CHEST XRAY
Chest radiology study
Chest radiology study
Chest radiology study
transaction_description
Chest radiology study
Chest radiology study
Chest radiology study
Chest radiology study
ft1_9
125.00
125.00
125.00
transaction_amount_extended
125.00
125.00
125.00
125.00
1
1
1
transaction_quantity
1
1
1
1
EA
EA
EA
ft1_12
EA
EA
EA
EA
125.00
125.00
125.00
ft1_13
125.00
125.00
125.00
125.00
ft1_14
ft1_15
BEDA
point_of_care
CLINIC1
CLINIC1
room
ROOM12
ROOM12
bed
BEDA
BEDA
facility
TESTFAC
TESTFAC
location_status
A
A
person_location_type
OP
OP
TESTFAC
A
OP
CLINIC1
CLINIC1^ROOM12^BEDA^TESTFAC^A^OP
ROOM12
assigned_patient_location
CLINIC1^ROOM12^BEDA^TESTFAC^A^OP
BEDA
point_of_care
CLINIC1
CLINIC1
room
ROOM12
ROOM12
bed
BEDA
BEDA
facility
TESTFAC
TESTFAC
location_status
A
A
person_location_type
OP
OP
TESTFAC
A
OP
CLINIC1
CLINIC1^ROOM12^BEDA^TESTFAC^A^OP
ROOM12
ft1_17
ft1_18
identifier
R509
R509
text
COUGH
COUGH
R509
R509^COUGH
COUGH
diagnosis_code_ft1
R509^COUGH
identifier
R509
R509
text
COUGH
COUGH
R509
R509^COUGH
COUGH
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
PROVIDER
TEST
1234
1234^PROVIDER^TEST^A^MD
A
MD
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
PROVIDER
TEST
1234
1234^PROVIDER^TEST^A^MD
A
MD
EA
125.00
PROVIDER
TEST
1234
A
MD
FT1|1|TXNACCT018|ACCT018|20260413191601|20260413191601|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
1
125.00
ACCT018
71020
CPT
CHEST XRAY
20260413191601
Chest radiology study
TXNACCT018
20260413191601
1
CG
R509
ICD10
Cough
W
1
1
1
set_id
1
1
1
1
dg1_2
identifier
R509
R509
text
Cough
Cough
name_of_coding_system
ICD10
ICD10
R509
ICD10
R509^Cough^ICD10
Cough
diagnosis_code
R509^Cough^ICD10
identifier
R509
R509
text
Cough
Cough
name_of_coding_system
ICD10
ICD10
R509
ICD10
R509^Cough^ICD10
Cough
dg1_4
dg1_5
W
W
W
diagnosis_type
W
W
W
W
DG1|1||R509^Cough^ICD10|||W
DG1
1
20260413191601
1
1
1
set_id
1
1
1
1
TX
TX
TX
value_type
TX
TX
TX
TX
identifier
NOTE
NOTE
text
Visit Note
Visit Note
NOTE
NOTE^Visit Note
Visit Note
observation_identifier
NOTE^Visit Note
identifier
NOTE
NOTE
text
Visit Note
Visit Note
NOTE
NOTE^Visit Note
Visit Note
obx_4
Patient TESTPAT018 completed outpatient chest imaging follow-up
Patient TESTPAT018 completed outpatient chest imaging follow-up
Patient TESTPAT018 completed outpatient chest imaging follow-up
observation_value
Patient TESTPAT018 completed outpatient chest imaging follow-up
Patient TESTPAT018 completed outpatient chest imaging follow-up
Patient TESTPAT018 completed outpatient chest imaging follow-up
Patient TESTPAT018 completed outpatient chest imaging follow-up
obx_6
obx_7
N
N
N
obx_8
N
N
N
N
obx_9
obx_10
F
F
F
observation_result_status
F
F
F
F
obx_12
obx_13
20260413191601
20260413191601
20260413191601
date_time_of_the_observation
20260413191601
20260413191601
20260413191601
20260413191601
NOTE
Visit Note
F
Patient TESTPAT018 completed outpatient chest imaging follow-up
N
OBX|1|TX|NOTE^Visit Note||Patient TESTPAT018 completed outpatient chest imaging follow-up|||N|||F|||20260413191601
OBX
1
TX
BEDA
TESTFAC
A
OP
CLINIC1
ROOM12
PROVIDER
TEST
1234
A
MD
1
1
1
set_id
1
1
1
1
O
O
O
patient_class
O
O
O
O
BEDA
point_of_care
CLINIC1
CLINIC1
room
ROOM12
ROOM12
bed
BEDA
BEDA
facility
TESTFAC
TESTFAC
location_status
A
A
person_location_type
OP
OP
TESTFAC
A
OP
CLINIC1
CLINIC1^ROOM12^BEDA^TESTFAC^A^OP
ROOM12
assigned_patient_location
CLINIC1^ROOM12^BEDA^TESTFAC^A^OP
BEDA
point_of_care
CLINIC1
CLINIC1
room
ROOM12
ROOM12
bed
BEDA
BEDA
facility
TESTFAC
TESTFAC
location_status
A
A
person_location_type
OP
OP
TESTFAC
A
OP
CLINIC1
CLINIC1^ROOM12^BEDA^TESTFAC^A^OP
ROOM12
pv1_4
pv1_5
pv1_6
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
PROVIDER
TEST
1234
1234^PROVIDER^TEST^A^MD
A
MD
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
PROVIDER
TEST
1234
1234^PROVIDER^TEST^A^MD
A
MD
2345
2345
REFERRAL
REFERRAL
SAM
SAM
B
B
MD
MD
2345^REFERRAL^SAM^B^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
MED
MED
MED
pv1_14
MED
MED
MED
MED
pv1_15
pv1_16
pv1_17
ACCT018
ACCT018
ACCT018
pv1_18
ACCT018
ACCT018
ACCT018
ACCT018
id_number
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
20260413191601
20260413191601
20260413191601
pv1_42
20260413191601
20260413191601
20260413191601
20260413191601
O
MED
ACCT018
20260413191601
2345^REFERRAL^SAM^B^MD
PV1|1|O|CLINIC1^ROOM12^BEDA^TESTFAC^A^OP||||1234^PROVIDER^TEST^A^MD|2345^REFERRAL^SAM^B^MD||||||MED||||ACCT018||||||||||||||||||||||||20260413191601
PV1
1
BEDA
TESTFAC
A
OP
CLINIC1
ROOM12
PROVIDER
TEST
1234
A
MD
1
1
1
set_id
1
1
1
1
O
O
O
patient_class
O
O
O
O
BEDA
point_of_care
CLINIC1
CLINIC1
room
ROOM12
ROOM12
bed
BEDA
BEDA
facility
TESTFAC
TESTFAC
location_status
A
A
person_location_type
OP
OP
TESTFAC
A
OP
CLINIC1
CLINIC1^ROOM12^BEDA^TESTFAC^A^OP
ROOM12
assigned_patient_location
CLINIC1^ROOM12^BEDA^TESTFAC^A^OP
BEDA
point_of_care
CLINIC1
CLINIC1
room
ROOM12
ROOM12
bed
BEDA
BEDA
facility
TESTFAC
TESTFAC
location_status
A
A
person_location_type
OP
OP
TESTFAC
A
OP
CLINIC1
CLINIC1^ROOM12^BEDA^TESTFAC^A^OP
ROOM12
pv1_4
pv1_5
pv1_6
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
PROVIDER
TEST
1234
1234^PROVIDER^TEST^A^MD
A
MD
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
PROVIDER
TEST
1234
1234^PROVIDER^TEST^A^MD
A
MD
2345
2345
REFERRAL
REFERRAL
SAM
SAM
B
B
MD
MD
2345^REFERRAL^SAM^B^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
MED
MED
MED
pv1_14
MED
MED
MED
MED
pv1_15
pv1_16
pv1_17
ACCT018
ACCT018
ACCT018
pv1_18
ACCT018
ACCT018
ACCT018
ACCT018
id_number
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
20260413191601
20260413191601
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pv1_42
20260413191601
20260413191601
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20260413191601
O
MED
ACCT018
20260413191601
2345^REFERRAL^SAM^B^MD
PV1|1|O|CLINIC1^ROOM12^BEDA^TESTFAC^A^OP||||1234^PROVIDER^TEST^A^MD|2345^REFERRAL^SAM^B^MD||||||MED||||ACCT018||||||||||||||||||||||||20260413191601
PV1
1
DG1|1||R509^Cough^ICD10|||W
EVN|P03|20260413191601
FT1|1|TXNACCT018|ACCT018|20260413191601|20260413191601|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
MSH|^~\&|Test Application|Test Facility|MLLP_SERVER|DESISIV|20260413191601||DFT^P03|3ed16e9d-987|P|2.5.1
OBX|1|TX|NOTE^Visit Note||Patient TESTPAT018 completed outpatient chest imaging follow-up|||N|||F|||20260413191601
PID|1||TESTPAT018^^^TEST^MR~ALTTESTPAT018^^^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
PV1|1|O|CLINIC1^ROOM12^BEDA^TESTFAC^A^OP||||1234^PROVIDER^TEST^A^MD|2345^REFERRAL^SAM^B^MD||||||MED||||ACCT018||||||||||||||||||||||||20260413191601