`IN1` - Insurance (HL7 v2.4)

Versions: v2.3 v2.3.1 v2.4 v2.5.1 v2.6 v2.7.1

The IN1 segment (Insurance) has 49 fields in HL7 v2.4. Fields are addressed as IN1-n; composite fields break into components IN1-n.m. Paste a message into the parser to see every field annotated with this table.

#	Name	Type	Len	Opt	Repeats	Table
1	Set ID - IN1	`SI`	4	Required	No
2	Insurance Plan ID	`CE`	250	Required	No	0072
3	Insurance Company ID	`CX`	250	Required	Yes
4	Insurance Company Name	`XON`	250	Optional	Yes
5	Insurance Company Address	`XAD`	250	Optional	Yes
6	Insurance Co Contact Person	`XPN`	250	Optional	Yes
7	Insurance Co Phone Number	`XTN`	250	Optional	Yes
8	Group Number	`ST`	12	Optional	No
9	Group Name	`XON`	250	Optional	Yes
10	Insured's Group Emp ID	`CX`	250	Optional	Yes
11	Insured's Group Emp Name	`XON`	250	Optional	Yes
12	Plan Effective Date	`DT`	8	Optional	No
13	Plan Expiration Date	`DT`	8	Optional	No
14	Authorization Information	`AUI`	250	Optional	No
15	Plan Type	`IS`	3	Optional	No	0086
16	Name Of Insured	`XPN`	250	Optional	Yes
17	Insured's Relationship To Patient	`CE`	250	Optional	No	0063
18	Insured's Date Of Birth	`TS`	26	Optional	No
19	Insured's Address	`XAD`	250	Optional	Yes
20	Assignment Of Benefits	`IS`	2	Optional	No	0135
21	Coordination Of Benefits	`IS`	2	Optional	No	0173
22	Coord Of Ben. Priority	`ST`	2	Optional	No
23	Notice Of Admission Flag	`ID`	1	Optional	No	0136
24	Notice Of Admission Date	`DT`	8	Optional	No
25	Report Of Eligibility Flag	`ID`	1	Optional	No	0136
26	Report Of Eligibility Date	`DT`	8	Optional	No
27	Release Information Code	`IS`	2	Optional	No	0093
28	Pre-Admit Cert	`ST`	15	Optional	No
29	Verification Date/Time	`TS`	26	Optional	No
30	Verification By	`XCN`	250	Optional	Yes
31	Type Of Agreement Code	`IS`	2	Optional	No	0098
32	Billing Status	`IS`	2	Optional	No	0022
33	Lifetime Reserve Days	`NM`	4	Optional	No
34	Delay Before L.R. Day	`NM`	4	Optional	No
35	Company Plan Code	`IS`	8	Optional	No	0042
36	Policy Number	`ST`	15	Optional	No
37	Policy Deductible	`CP`	12	Optional	No
38	Policy Limit - Amount	`CP`	12	Optional	No
39	Policy Limit - Days	`NM`	4	Optional	No
40	Room Rate - Semi-Private	`CP`	12	Optional	No
41	Room Rate - Private	`CP`	12	Optional	No
42	Insured's Employment Status	`CE`	250	Optional	No	0066
43	Insured's Administrative Sex	`IS`	1	Optional	No	0001
44	Insured's Employer's Address	`XAD`	250	Optional	Yes
45	Verification Status	`ST`	2	Optional	No
46	Prior Insurance Plan ID	`IS`	8	Optional	No	0072
47	Coverage Type	`IS`	3	Optional	No	0309
48	Handicap	`IS`	2	Optional	No	0295
49	Insured's ID Number	`CX`	250	Optional	Yes

Synthetic example

IN1|1|MC^Medicare^HL70072|AUSHIC^Medicare Australia

Open in parser

IN1 - Insurance (HL7 v2.4)

Synthetic example

`IN1` - Insurance (HL7 v2.4)