| 1 | set_id_rxv | SI | Optional | No | - |
| 2 | bolus_type | ID | Required | No | HL70917 |
| 3 | bolus_dose_amount | NM | Optional | No | - |
| 4 | ▶bolus_dose_amount_units | CWE | Optional | No | HL70767 |
| 4.1 | ├.identifier | ST | Optional | No | - |
| 4.2 | ├.text | ST | Optional | No | - |
| 4.3 | ├.name_of_coding_system | ID | Optional | No | - |
| 4.4 | ├.alternate_identifier | ST | Optional | No | - |
| 4.5 | ├.alternate_text | ST | Optional | No | - |
| 4.6 | ├.name_of_alternate_coding_system | ID | Optional | No | - |
| 4.7 | ├.coding_system_version_id | ST | Optional | No | - |
| 4.8 | ├.alternate_coding_system_version_id | ST | Optional | No | - |
| 4.9 | ├.original_text | ST | Optional | No | - |
| 4.10 | ├.second_alternate_identifier | ST | Optional | No | - |
| 4.11 | ├.second_alternate_text | ST | Optional | No | - |
| 4.12 | ├.name_of_second_alternate_coding_system | ID | Optional | No | - |
| 4.13 | ├.second_alternate_coding_system_version_id | ST | Optional | No | - |
| 4.14 | ├.coding_system_oid | ST | Optional | No | - |
| 4.15 | ├.value_set_oid | ST | Optional | No | - |
| 4.16 | ├.value_set_version_id | DTM | Optional | No | - |
| 4.17 | ├.alternate_coding_system_oid | ST | Optional | No | - |
| 4.18 | ├.alternate_value_set_oid | ST | Optional | No | - |
| 4.19 | ├.alternate_value_set_version_id | DTM | Optional | No | - |
| 4.20 | ├.second_alternate_coding_system_oid | ST | Optional | No | - |
| 4.21 | ├.second_alternate_value_set_oid | ST | Optional | No | - |
| 4.22 | └.second_alternate_value_set_version_id | DTM | Optional | No | - |
| 5 | bolus_dose_volume | NM | Optional | No | - |
| 6 | ▶bolus_dose_volume_units | CWE | Optional | No | HL70768 |
| 6.1 | ├.identifier | ST | Optional | No | - |
| 6.2 | ├.text | ST | Optional | No | - |
| 6.3 | ├.name_of_coding_system | ID | Optional | No | - |
| 6.4 | ├.alternate_identifier | ST | Optional | No | - |
| 6.5 | ├.alternate_text | ST | Optional | No | - |
| 6.6 | ├.name_of_alternate_coding_system | ID | Optional | No | - |
| 6.7 | ├.coding_system_version_id | ST | Optional | No | - |
| 6.8 | ├.alternate_coding_system_version_id | ST | Optional | No | - |
| 6.9 | ├.original_text | ST | Optional | No | - |
| 6.10 | ├.second_alternate_identifier | ST | Optional | No | - |
| 6.11 | ├.second_alternate_text | ST | Optional | No | - |
| 6.12 | ├.name_of_second_alternate_coding_system | ID | Optional | No | - |
| 6.13 | ├.second_alternate_coding_system_version_id | ST | Optional | No | - |
| 6.14 | ├.coding_system_oid | ST | Optional | No | - |
| 6.15 | ├.value_set_oid | ST | Optional | No | - |
| 6.16 | ├.value_set_version_id | DTM | Optional | No | - |
| 6.17 | ├.alternate_coding_system_oid | ST | Optional | No | - |
| 6.18 | ├.alternate_value_set_oid | ST | Optional | No | - |
| 6.19 | ├.alternate_value_set_version_id | DTM | Optional | No | - |
| 6.20 | ├.second_alternate_coding_system_oid | ST | Optional | No | - |
| 6.21 | ├.second_alternate_value_set_oid | ST | Optional | No | - |
| 6.22 | └.second_alternate_value_set_version_id | DTM | Optional | No | - |
| 7 | pca_type | ID | Required | No | HL70918 |
| 8 | pca_dose_amount | NM | Optional | No | - |
| 9 | ▶pca_dose_amount_units | CWE | Optional | No | HL70769 |
| 9.1 | ├.identifier | ST | Optional | No | - |
| 9.2 | ├.text | ST | Optional | No | - |
| 9.3 | ├.name_of_coding_system | ID | Optional | No | - |
| 9.4 | ├.alternate_identifier | ST | Optional | No | - |
| 9.5 | ├.alternate_text | ST | Optional | No | - |
| 9.6 | ├.name_of_alternate_coding_system | ID | Optional | No | - |
| 9.7 | ├.coding_system_version_id | ST | Optional | No | - |
| 9.8 | ├.alternate_coding_system_version_id | ST | Optional | No | - |
| 9.9 | ├.original_text | ST | Optional | No | - |
| 9.10 | ├.second_alternate_identifier | ST | Optional | No | - |
| 9.11 | ├.second_alternate_text | ST | Optional | No | - |
| 9.12 | ├.name_of_second_alternate_coding_system | ID | Optional | No | - |
| 9.13 | ├.second_alternate_coding_system_version_id | ST | Optional | No | - |
| 9.14 | ├.coding_system_oid | ST | Optional | No | - |
| 9.15 | ├.value_set_oid | ST | Optional | No | - |
| 9.16 | ├.value_set_version_id | DTM | Optional | No | - |
| 9.17 | ├.alternate_coding_system_oid | ST | Optional | No | - |
| 9.18 | ├.alternate_value_set_oid | ST | Optional | No | - |
| 9.19 | ├.alternate_value_set_version_id | DTM | Optional | No | - |
| 9.20 | ├.second_alternate_coding_system_oid | ST | Optional | No | - |
| 9.21 | ├.second_alternate_value_set_oid | ST | Optional | No | - |
| 9.22 | └.second_alternate_value_set_version_id | DTM | Optional | No | - |
| 10 | pca_dose_amount_volume | NM | Optional | No | - |
| 11 | ▶pca_dose_amount_volume_units | CWE | Optional | No | HL70770 |
| 11.1 | ├.identifier | ST | Optional | No | - |
| 11.2 | ├.text | ST | Optional | No | - |
| 11.3 | ├.name_of_coding_system | ID | Optional | No | - |
| 11.4 | ├.alternate_identifier | ST | Optional | No | - |
| 11.5 | ├.alternate_text | ST | Optional | No | - |
| 11.6 | ├.name_of_alternate_coding_system | ID | Optional | No | - |
| 11.7 | ├.coding_system_version_id | ST | Optional | No | - |
| 11.8 | ├.alternate_coding_system_version_id | ST | Optional | No | - |
| 11.9 | ├.original_text | ST | Optional | No | - |
| 11.10 | ├.second_alternate_identifier | ST | Optional | No | - |
| 11.11 | ├.second_alternate_text | ST | Optional | No | - |
| 11.12 | ├.name_of_second_alternate_coding_system | ID | Optional | No | - |
| 11.13 | ├.second_alternate_coding_system_version_id | ST | Optional | No | - |
| 11.14 | ├.coding_system_oid | ST | Optional | No | - |
| 11.15 | ├.value_set_oid | ST | Optional | No | - |
| 11.16 | ├.value_set_version_id | DTM | Optional | No | - |
| 11.17 | ├.alternate_coding_system_oid | ST | Optional | No | - |
| 11.18 | ├.alternate_value_set_oid | ST | Optional | No | - |
| 11.19 | ├.alternate_value_set_version_id | DTM | Optional | No | - |
| 11.20 | ├.second_alternate_coding_system_oid | ST | Optional | No | - |
| 11.21 | ├.second_alternate_value_set_oid | ST | Optional | No | - |
| 11.22 | └.second_alternate_value_set_version_id | DTM | Optional | No | - |
| 12 | max_dose_amount | NM | Optional | No | - |
| 13 | ▶max_dose_amount_units | CWE | Optional | No | HL70772 |
| 13.1 | ├.identifier | ST | Optional | No | - |
| 13.2 | ├.text | ST | Optional | No | - |
| 13.3 | ├.name_of_coding_system | ID | Optional | No | - |
| 13.4 | ├.alternate_identifier | ST | Optional | No | - |
| 13.5 | ├.alternate_text | ST | Optional | No | - |
| 13.6 | ├.name_of_alternate_coding_system | ID | Optional | No | - |
| 13.7 | ├.coding_system_version_id | ST | Optional | No | - |
| 13.8 | ├.alternate_coding_system_version_id | ST | Optional | No | - |
| 13.9 | ├.original_text | ST | Optional | No | - |
| 13.10 | ├.second_alternate_identifier | ST | Optional | No | - |
| 13.11 | ├.second_alternate_text | ST | Optional | No | - |
| 13.12 | ├.name_of_second_alternate_coding_system | ID | Optional | No | - |
| 13.13 | ├.second_alternate_coding_system_version_id | ST | Optional | No | - |
| 13.14 | ├.coding_system_oid | ST | Optional | No | - |
| 13.15 | ├.value_set_oid | ST | Optional | No | - |
| 13.16 | ├.value_set_version_id | DTM | Optional | No | - |
| 13.17 | ├.alternate_coding_system_oid | ST | Optional | No | - |
| 13.18 | ├.alternate_value_set_oid | ST | Optional | No | - |
| 13.19 | ├.alternate_value_set_version_id | DTM | Optional | No | - |
| 13.20 | ├.second_alternate_coding_system_oid | ST | Optional | No | - |
| 13.21 | ├.second_alternate_value_set_oid | ST | Optional | No | - |
| 13.22 | └.second_alternate_value_set_version_id | DTM | Optional | No | - |
| 14 | max_dose_amount_volume | NM | Optional | No | - |
| 15 | ▶max_dose_amount_volume_units | CWE | Optional | No | HL70773 |
| 15.1 | ├.identifier | ST | Optional | No | - |
| 15.2 | ├.text | ST | Optional | No | - |
| 15.3 | ├.name_of_coding_system | ID | Optional | No | - |
| 15.4 | ├.alternate_identifier | ST | Optional | No | - |
| 15.5 | ├.alternate_text | ST | Optional | No | - |
| 15.6 | ├.name_of_alternate_coding_system | ID | Optional | No | - |
| 15.7 | ├.coding_system_version_id | ST | Optional | No | - |
| 15.8 | ├.alternate_coding_system_version_id | ST | Optional | No | - |
| 15.9 | ├.original_text | ST | Optional | No | - |
| 15.10 | ├.second_alternate_identifier | ST | Optional | No | - |
| 15.11 | ├.second_alternate_text | ST | Optional | No | - |
| 15.12 | ├.name_of_second_alternate_coding_system | ID | Optional | No | - |
| 15.13 | ├.second_alternate_coding_system_version_id | ST | Optional | No | - |
| 15.14 | ├.coding_system_oid | ST | Optional | No | - |
| 15.15 | ├.value_set_oid | ST | Optional | No | - |
| 15.16 | ├.value_set_version_id | DTM | Optional | No | - |
| 15.17 | ├.alternate_coding_system_oid | ST | Optional | No | - |
| 15.18 | ├.alternate_value_set_oid | ST | Optional | No | - |
| 15.19 | ├.alternate_value_set_version_id | DTM | Optional | No | - |
| 15.20 | ├.second_alternate_coding_system_oid | ST | Optional | No | - |
| 15.21 | ├.second_alternate_value_set_oid | ST | Optional | No | - |
| 15.22 | └.second_alternate_value_set_version_id | DTM | Optional | No | - |
| 16 | ▶max_dose_per_time | CQ | Required | No | - |
| 16.1 | ├.quantity | NM | Optional | No | - |
| 16.2 | └.units | CWE | Optional | No | - |
| 17 | ▶lockout_interval | CQ | Optional | No | - |
| 17.1 | ├.quantity | NM | Optional | No | - |
| 17.2 | └.units | CWE | Optional | No | - |
| 18 | ▶syringe_manufacturer | CWE | Optional | No | - |
| 18.1 | ├.identifier | ST | Optional | No | - |
| 18.2 | ├.text | ST | Optional | No | - |
| 18.3 | ├.name_of_coding_system | ID | Optional | No | - |
| 18.4 | ├.alternate_identifier | ST | Optional | No | - |
| 18.5 | ├.alternate_text | ST | Optional | No | - |
| 18.6 | ├.name_of_alternate_coding_system | ID | Optional | No | - |
| 18.7 | ├.coding_system_version_id | ST | Optional | No | - |
| 18.8 | ├.alternate_coding_system_version_id | ST | Optional | No | - |
| 18.9 | ├.original_text | ST | Optional | No | - |
| 18.10 | ├.second_alternate_identifier | ST | Optional | No | - |
| 18.11 | ├.second_alternate_text | ST | Optional | No | - |
| 18.12 | ├.name_of_second_alternate_coding_system | ID | Optional | No | - |
| 18.13 | ├.second_alternate_coding_system_version_id | ST | Optional | No | - |
| 18.14 | ├.coding_system_oid | ST | Optional | No | - |
| 18.15 | ├.value_set_oid | ST | Optional | No | - |
| 18.16 | ├.value_set_version_id | DTM | Optional | No | - |
| 18.17 | ├.alternate_coding_system_oid | ST | Optional | No | - |
| 18.18 | ├.alternate_value_set_oid | ST | Optional | No | - |
| 18.19 | ├.alternate_value_set_version_id | DTM | Optional | No | - |
| 18.20 | ├.second_alternate_coding_system_oid | ST | Optional | No | - |
| 18.21 | ├.second_alternate_value_set_oid | ST | Optional | No | - |
| 18.22 | └.second_alternate_value_set_version_id | DTM | Optional | No | - |
| 19 | ▶syringe_model_number | CWE | Optional | No | - |
| 19.1 | ├.identifier | ST | Optional | No | - |
| 19.2 | ├.text | ST | Optional | No | - |
| 19.3 | ├.name_of_coding_system | ID | Optional | No | - |
| 19.4 | ├.alternate_identifier | ST | Optional | No | - |
| 19.5 | ├.alternate_text | ST | Optional | No | - |
| 19.6 | ├.name_of_alternate_coding_system | ID | Optional | No | - |
| 19.7 | ├.coding_system_version_id | ST | Optional | No | - |
| 19.8 | ├.alternate_coding_system_version_id | ST | Optional | No | - |
| 19.9 | ├.original_text | ST | Optional | No | - |
| 19.10 | ├.second_alternate_identifier | ST | Optional | No | - |
| 19.11 | ├.second_alternate_text | ST | Optional | No | - |
| 19.12 | ├.name_of_second_alternate_coding_system | ID | Optional | No | - |
| 19.13 | ├.second_alternate_coding_system_version_id | ST | Optional | No | - |
| 19.14 | ├.coding_system_oid | ST | Optional | No | - |
| 19.15 | ├.value_set_oid | ST | Optional | No | - |
| 19.16 | ├.value_set_version_id | DTM | Optional | No | - |
| 19.17 | ├.alternate_coding_system_oid | ST | Optional | No | - |
| 19.18 | ├.alternate_value_set_oid | ST | Optional | No | - |
| 19.19 | ├.alternate_value_set_version_id | DTM | Optional | No | - |
| 19.20 | ├.second_alternate_coding_system_oid | ST | Optional | No | - |
| 19.21 | ├.second_alternate_value_set_oid | ST | Optional | No | - |
| 19.22 | └.second_alternate_value_set_version_id | DTM | Optional | No | - |
| 20 | syringe_size | NM | Optional | No | - |
| 21 | ▶syringe_size_units | CWE | Optional | No | - |
| 21.1 | ├.identifier | ST | Optional | No | - |
| 21.2 | ├.text | ST | Optional | No | - |
| 21.3 | ├.name_of_coding_system | ID | Optional | No | - |
| 21.4 | ├.alternate_identifier | ST | Optional | No | - |
| 21.5 | ├.alternate_text | ST | Optional | No | - |
| 21.6 | ├.name_of_alternate_coding_system | ID | Optional | No | - |
| 21.7 | ├.coding_system_version_id | ST | Optional | No | - |
| 21.8 | ├.alternate_coding_system_version_id | ST | Optional | No | - |
| 21.9 | ├.original_text | ST | Optional | No | - |
| 21.10 | ├.second_alternate_identifier | ST | Optional | No | - |
| 21.11 | ├.second_alternate_text | ST | Optional | No | - |
| 21.12 | ├.name_of_second_alternate_coding_system | ID | Optional | No | - |
| 21.13 | ├.second_alternate_coding_system_version_id | ST | Optional | No | - |
| 21.14 | ├.coding_system_oid | ST | Optional | No | - |
| 21.15 | ├.value_set_oid | ST | Optional | No | - |
| 21.16 | ├.value_set_version_id | DTM | Optional | No | - |
| 21.17 | ├.alternate_coding_system_oid | ST | Optional | No | - |
| 21.18 | ├.alternate_value_set_oid | ST | Optional | No | - |
| 21.19 | ├.alternate_value_set_version_id | DTM | Optional | No | - |
| 21.20 | ├.second_alternate_coding_system_oid | ST | Optional | No | - |
| 21.21 | ├.second_alternate_value_set_oid | ST | Optional | No | - |
| 21.22 | └.second_alternate_value_set_version_id | DTM | Optional | No | - |
| 22 | action_code | ID | Optional | No | - |