Sequence
Element
Name
Type
Requirement
Min
Max
Repeat
01
Reference Identification Qualifier
Identifier (ID)
Mandatory
2
3
1
Code identifying the Reference Identification
02
Reference Identification
String (AN)
Mandatory
1
80
1
Reference information as defined for a particular Transaction Set or as
specified by the Reference Identification Qualifier
03
Date
Date (DT)
Optional
8
8
1
Date expressed as CCYYMMDD where CC represents the first two digits of the
calendar year