Sequential Number: 1
Description: Referral Status
Data Type: CWE
Item ID: 1137
Table: 0283
Sequential Number: 2
Description: Referral Priority
Data Type: CWE
Item ID: 1138
Table: 0280
Sequential Number: 3
Description: Referral Type
Data Type: CWE
Item ID: 1139
Table: 0281
RF1.4_Referral_DispositionSequential Number: 4
Description: Referral Disposition
Data Type: CWE
Item ID: 1140
Table: 0282
Sequential Number: 5
Description: Referral Category
Data Type: CWE
Item ID: 1141
Table: 0284
RF1.6_Originating_Referral_IdentifierSequential Number: 6
Description: Originating Referral Identifier
Data Type: EI
Item ID: 1142
Sequential Number: 7
Description: Effective Date
Data Type: DTM
Item ID: 1143
Sequential Number: 8
Description: Expiration Date
Data Type: DTM
Item ID: 1144
Sequential Number: 9
Description: Process Date
Data Type: DTM
Item ID: 1145
RF1.10_Referral_ReasonSequential Number: 10
Description: Referral Reason
Data Type: CWE
Item ID: 1228
Table: 0336
RF1.11_External_Referral_IdentifierSequential Number: 11
Description: External Referral Identifier
Data Type: EI
Item ID: 1300
Sequential Number: 12
Description: Referral Documentation Completion Status
Data Type: CWE
Item ID: 2262
Table: 0865
RF1.13_Planned_Treatment_Stop_DateSequential Number: 13
Description: Planned Treatment Stop Date
Data Type: DTM
Item ID: 3400
RF1.14_Referral_Reason_TextSequential Number: 14
Description: Referral Reason Text
Data Type: ST
Item ID: 3401
RF1.15_Number_of_Authorized_Treatments_UnitsSequential Number: 15
Description: Number of Authorized Treatments/Units
Data Type: CQ
Item ID: 3402
RF1.16_Number_of_Used_Treatments_UnitsSequential Number: 16
Description: Number of Used Treatments/Units
Data Type: CQ
Item ID: 3403
RF1.17_Number_of_Schedule_Treatments_UnitsSequential Number: 17
Description: Number of Schedule Treatments/Units
Data Type: CQ
Item ID: 3404
RF1.18_Remaining_Benefit_AmountSequential Number: 18
Description: Remaining Benefit Amount
Data Type: MO
Item ID: 3405
RF1.19_Authorized_ProviderSequential Number: 19
Description: Authorized Provider
Data Type: XON
Item ID: 3406
RF1.20_Authorized_Health_ProfessionalSequential Number: 20
Description: Authorized Health Professional
Data Type: XCN
Item ID: 3407
RF1.21_Source_TextSequential Number: 21
Description: Source Text
Data Type: ST
Item ID: 3408
RF1.22_Source_DateSequential Number: 22
Description: Source Date
Data Type: DTM
Item ID: 3409
RF1.23_Source_PhoneSequential Number: 23
Description: Source Phone
Data Type: XTN
Item ID: 3410
RF1.24_CommentSequential Number: 24
Description: Comment
Data Type: ST
Item ID: 3411
RF1.25_Action_CodeSequential Number: 25
Description: Action Code
Data Type: ID
Item ID: 3412
Table: 0206
any