To specify a drug for which authorization is being requested
| Position | Element | Name | Type | Min/Max | Repeat | ||
|---|---|---|---|---|---|---|---|
| 1 | 352 | Description | Mandatory | Alphanumeric | 1/80 | 2 | |
| 2 | 1322 | Certification Type Code | Mandatory | ID | 1/1 | 1 | |
2 | |||||||
| 4 | 355 | Unit or Basis for Measurement Code | Rel | ID | 2/2 | 1 | |
| 5 | 380 | Quantity | Rel | Decimal | 1/15 | 1 | |
| 6 | 933 | Free-form Message Text | Opt | Alphanumeric | 1/264 | 1 | |
| 7 | 1073 | Yes/No Condition or Response Code | Opt | ID | 1/1 | 1 | |
| 8 | 1073 | Yes/No Condition or Response Code | Rel | ID | 1/1 | 1 | |
| 9 | 374 | Date/Time Qualifier | Rel | ID | 3/3 | 1 | |
| 10 | 373 | Date | Rel | Date | 8/8 | 1 | |
| 11 | 933 | Free-form Message Text | Opt | Alphanumeric | 1/264 | 999 | |
| 12 | 380 | Quantity | Opt | Decimal | 1/15 | 1 | |
999 | |||||||
| 14 | 1330 | Dosage Form Code | Opt | ID | 2/2 | 1 | |
| 15 | 933 | Free-form Message Text | Opt | Alphanumeric | 1/264 | 999 | |