| # | Name | Location | Type | Details | Index | Description |
|---|---|---|---|---|---|---|
| .01 | suspected agent | 0;1 | FREE TEXT | B | This field indicates one of the suspected agents for this observed reaction. | |
| 1 | daily dose | 0;2 | FREE TEXT | This field contains the daily dosage for this suspected agent. | ||
| 1.5 | sig | 1;5 | FREE TEXT | This file contains the SIG code that indicates how this drug is to be given. | ||
| 2 | route of administration | 0;3 | FREE TEXT | This is the route of administration for this suspected agent. | ||
| 3 | indications for use | 0;4 | FREE TEXT | This field indicates the reasoning for a particular agent. | ||
| 4 | start date of administration | 1;1 | DATE-TIME | This field contains the date a patient was first given the suspected agent. | ||
| 5 | stop date of administration | 1;2 | DATE-TIME | This field contains the stop date for a suspected agent. | ||
| 6 | duration of administration | COMPUTED | This field contains the total time the suspected agent was given to a patient. | |||
| 7 | manufacturer | 0;7 | FREE TEXT | This field contains the name of the manufacturer of the suspected agent. | ||
| 8 | lot # | 0;8 | FREE TEXT | This field contains the lot # for a suspected agent. | ||
| 9 | number of previous doses | 0;9 | NUMERIC | This field contains the total number of doses of this suspected agent that were given to the patient prior to the reaction. | ||
| 10 | last fill dt | 0;10 | DATE-TIME | This field is the date that this agent was last filled. | ||
| 10.1 | expiration date | 1;3 | DATE-TIME | This is the date that the suspected agent is to expire. | ||
| 10.2 | ndc # | 1;4 | FREE TEXT | This is the NDC (National Drug Code) of this agent. | ||
| 11 | like question #1 | LIKE;1 | BOOLEAN | y:YES n:NO | This question determines whether this reaction normally occurs with this reactant. reactant. | |
| 12 | like question #2 | LIKE;2 | BOOLEAN | y:YES n:NO | This question determines whether administration of the reactant was stopped. | |
| 13 | like question #3 | LIKE;3 | BOOLEAN | y:YES n:NO | This question determines if the reaction stopped when the administration of the reactant was terminated. the reactant was terminated. | |
| 14 | like question #4 | LIKE;4 | BOOLEAN | y:YES n:NO | This question determines whether the reactant was readministered. | |
| 15 | like question #5 | LIKE;5 | BOOLEAN | y:YES n:NO | This question determines whether the reaction could be due to the patient current clinical condition. | |
| 16 | like question #6 | LIKE;6 | BOOLEAN | y:YES n:NO | This question determines if the reaction reappeared after the reactant was readministered. was readministered. | |
| 17 | likelihood | LIKE;7 | SET OF CODES | 1:REMOTE 2:POSSIBLE 3:PROBABLE 4:HIGHLY PROBABLE | If this is an observed drug allergy/adverse reaction, then this is the likelihood that this is an adverse reaction. The data for this field is based on an algorithm used by the FDA. |
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