Segment
X12 EDI Release 00402
To supply demographic information
Elements
Code indicating the date format, time format, or date and time format
Codes (39)- CCFirst Two Digits of Year Expressed in Format CCYY
- CDMonth and Year Expressed in Format MMMYYYY
- CMDate in Format CCYYMM
- CQDate in Format CCYYQ
- CYYear Expressed in Format CCYY
- D6Date Expressed in Format YYMMDD
- D8Date Expression in Format CCYYMMDD
- DARange of Dates within a Single Month Expressed in Format DD-DD
- DBDate Expressed in Format MMDDCCYY
- DDDay of Month in Numeric Format
- DTDate and Time Expressed in Format CCYYMMDDHHMM
- EHLast Digit of Year and Julian Date Expressed in Format YDDD
- KADate Expressed in Format YYMMMDD
- MDMonth of Year and Day of Month Expressed in Format MMDD
- MMMonth of Year in Numeric Format
- RDRange of Dates Expressed in Format MMDDCCYY-MMDDCCYY
- TCJulian Date Expressed in Format DDD
- TMTime Expressed in Format HHMM
- TQDate Expressed in Format MMYY
- TRDate and Time Expressed in Format DDMMYYHHMM
- TSTime Expressed in Format HHMMSS
- TTDate Expressed in Format MMDDYY
- TUDate Expressed in Format YYDDD
- UNUnstructured
- YMYear and Month Expressed in Format YYMM
- YYLast Two Digits of Year Expressed in Format CCYY
- DTSRange of Date and Time Expressed in Format CCYYMMDDHHMMSS-CCYYMMDDHHMMSS
- RD2Range of Years Expressed in Format YY-YY
- RD4Range of Years Expressed in Format CCYY-CCYY
- RD5Range of Years and Months Expressed in Format CCYYMM-CCYYMM
- RD6Range of Dates Expressed in Format YYMMDD-YYMMDD
- RD8Range of Dates Expressed in Format CCYYMMDD-CCYYMMDD
- RDMRange of Dates Expressed in Format YYMMDD-MMDD
- RDTRange of Date and Time, Expressed in Format CCYYMMDDHHMM-CCYYMMDDHHMM
- RMDRange of Months and Days Expressed in Format MMDD-MMDD
- RMYRange of Years and Months Expressed in Format YYMM-YYMM
- RTMRange of Time Expressed in Format HHMM-HHMM
- RTSDate and Time Expressed in Format CCYYMMDDHHMMSS
- YMMRange of Year and Months, Expressed in CCYYMMM-MMM Format
Code indicating the racial or ethnic background of a person; it is normally self-reported; Under certain circumstances this information is collected for United States Government statistical purposes
Codes (16)- 7Not Provided
- 8Not Applicable
- AAsian or Pacific Islander
- BBlack
- CCaucasian
- DSubcontinent Asian American
- EOther Race or Ethnicity
- FAsian Pacific American
- GNative American
- HHispanic
- IAmerican Indian or Alaskan Native
- JNative Hawaiian
- NBlack (Non-Hispanic)
- OWhite (Non-Hispanic)
- PPacific Islander
- ZMutually Defined
Code indicating citizenship status
Codes (18)- 1U.S. Citizen
- 2Non-Resident Alien
- 3Resident Alien
- 4Illegal Alien
- 5Alien
- 6U.S. Citizen - Non-Resident
- 7U.S. Citizen - Resident
- 8Citizen
- 9Non-citizen with Student Authorization
- ANon-permanent Resident Alien
- BPermanent Visa
- CTemporary Visa
- DWork Permit
- ENordic Citizen
- FNon-Nordic Citizen
- GNaturalized Citizen
- HEligible Non-citizen
- IIneligible Non-citizen
Code indicating the basis of verification
Codes (11)- 1Birth Certificate
- 2Passport
- 3Hospital Certificate
- 4Affidavit
- 5Immigration Document
- 6Baptismal or Church Certificate
- 7Physician's Certificate
- 8Undocumented
- 9Driver's License
- APhoto ID
- BSocial Insurance Certificate