DRA Drug Authorization

Opt
GT 1

To specify a drug for which authorization is being requested

Elements

PositionElementNameTypeMin/MaxRepeat
1
352
DescriptionMandatoryAlphanumeric1/80AtMax 2
2
1322
Certification Type CodeMandatoryID1/1AtMax 1
C003Composite Medical Procedure IdentifierOpt
AtMax 2
4
355
Unit or Basis for Measurement CodeRelID2/2AtMax 1
5
380
QuantityRelDecimal1/15AtMax 1
6
933
Free-form Message TextOptAlphanumeric1/264AtMax 1
7
1073
Yes/No Condition or Response CodeOptID1/1AtMax 1
8
1073
Yes/No Condition or Response CodeRelID1/1AtMax 1
9
374
Date/Time QualifierRelID3/3AtMax 1
10
373
DateRelDate8/8AtMax 1
11
933
Free-form Message TextOptAlphanumeric1/264AtMax 999
12
380
QuantityOptDecimal1/15AtMax 1
C060Question and AnswerOpt
AtMax 999
14
1330
Dosage Form CodeOptID2/2AtMax 1
15
933
Free-form Message TextOptAlphanumeric1/264AtMax 999

Element Details

ID352
NameDescription
LengthMin 1 / Max 80
Position1
RequirementMandatory