| # | Name | Location | Type | Details | Index | Description |
|---|---|---|---|---|---|---|
| .01 | date | 0;1 | DATE-TIME | B | Enter the date the prescription was written. | |
| 2 | expiration date | 0;3 | DATE-TIME | AE | Enter the date that this prescription expires. | |
| 3 | description | 1;0 | WORD-PROCESSING | Enter prescription information. | ||
| 4 | a&b letters sent | 0;5 | FREE TEXT | This field is set by the program. When an A or a B type letter is sent the letter type is stored here. | ||
| 30 | primary icd diagnosis code | BA1;1 | POINTER | 80 | Primary ICD from the consult. Associated with the prescription. | |
| 30.1 | primary agent orange | BA1;2 | BOOLEAN | 0:NO 1:YES | Primary diagnosis is related to Agent Orange exposure. | |
| 30.2 | primary ionized radiation | BA1;3 | BOOLEAN | 0:NO 1:YES | Primary diagnosis is related to Ionized Radiation exposure. | |
| 30.3 | primary service connected | BA1;4 | BOOLEAN | 0:NO 1:YES | Primary diagnosis is related to a Service Connected condition. | |
| 30.4 | primary environmental cont. | BA1;5 | BOOLEAN | 0:NO 1:YES | Primary diagnosis is related to Environmental Contaminants exposure. | |
| 30.5 | primary mst | BA1;6 | BOOLEAN | 0:NO 1:YES | Primary diagnosis is related to Military Sexual Trauma. | |
| 30.6 | primary head/neck cancer | BA1;7 | BOOLEAN | 0:NO 1:YES | Primary diagnosis is related to Head/Neck Cancer. | |
| 30.7 | primary combat vet | BA1;8 | BOOLEAN | 0:NO 1:YES | Primary diagnosis is related to Combat. | |
| 31 | secondary icd diagnosis code 1 | BA2;1 | POINTER | 80 | A Secondary ICD from the consult. Associated with the prescription. | |
| 31.1 | secondary agent orange 1 | BA2;2 | BOOLEAN | 0:NO 1:YES | A secondary agent orange from the consult. | |
| 31.2 | secondary ionized radiation 1 | BA2;3 | BOOLEAN | 0:NO 1:YES | Secondary diagnosis 1 is related to Ionized Radiation exposure. | |
| 31.3 | secondary service connected 1 | BA2;4 | BOOLEAN | 0:NO 1:YES | Secondary diagnosis 1 is related to a Service Connected condition. | |
| 31.4 | secondary environmental cont 1 | BA2;5 | BOOLEAN | 0:NO 1:YES | Secondary diagnosis 1 is related to Environmental Contaminants exposure. | |
| 31.5 | secondary mst 1 | BA2;6 | BOOLEAN | 0:NO 1:YES | Secondary diagnosis 1 is related to Military Sexual Trauma. | |
| 31.6 | secondary head/neck cancer 1 | BA2;7 | BOOLEAN | 0:NO 1:YES | Secondary diagnosis 1 is related to Head/Neck Cancer. | |
| 31.7 | secondary combat vet 1 | BA2;8 | BOOLEAN | 0:NO 1:YES | Secondary diagnosis 1 is related to Combat. | |
| 32 | secondary icd diagnosis code 2 | BA3;1 | POINTER | 80 | A Secondary ICD from the consult. Associated with the prescription. | |
| 32.1 | secondary agent orange 2 | BA3;2 | BOOLEAN | 0:NO 1:YES | Secondary diagnosis 2 is related to Agent Orange exposure. | |
| 32.2 | secondary ionized radiation 2 | BA3;3 | BOOLEAN | 0:NO 1:YES | Secondary diagnosis 2 is related to Ionized Radiation exposure. | |
| 32.3 | secondary service connected 2 | BA3;4 | BOOLEAN | 0:NO 1:YES | Secondary diagnosis 2 is related to a Service Connected condition. | |
| 32.4 | secondary environmental cont 2 | BA3;5 | BOOLEAN | 0:NO 1:YES | Secondary diagnosis 2 is related to Environmental Contaminants exposure. | |
| 32.5 | secondary mst 2 | BA3;6 | BOOLEAN | 0:NO 1:YES | Secondary diagnosis 2 is related to Military Sexual Trauma. | |
| 32.6 | secondary head/neck cancer 2 | BA3;7 | BOOLEAN | 0:NO 1:YES | Secondary diagnosis 2 is related to Head/Neck Cancer. | |
| 32.7 | secondary combat vet 2 | BA3;8 | BOOLEAN | 0:NO 1:YES | Secondary diagnosis 2 is related to Combat. | |
| 33 | secondary icd diagnosis code 3 | BA4;1 | POINTER | 80 | A Secondary ICD from the consult. Associated with the prescription. | |
| 33.1 | secondary agent orange 3 | BA4;2 | BOOLEAN | 0:NO 1:YES | Secondary diagnosis 3 is related to Agent Orange exposure. | |
| 33.2 | secondary ionized radiation 3 | BA4;3 | BOOLEAN | 0:NO 1:YES | Secondary diagnosis 3 is related to Ionized Radiation exposure. | |
| 33.3 | secondary service connected 3 | BA4;4 | BOOLEAN | 0:NO 1:YES | Secondary diagnosis 3 is related to a Service Connected condition. | |
| 33.4 | secondary environmental cont 3 | BA4;5 | BOOLEAN | 0:NO 1:YES | Secondary diagnosis 3 is related to Environmental Contaminants exposure. | |
| 33.5 | secondary mst 3 | BA4;6 | BOOLEAN | 0:NO 1:YES | Secondary diagnosis 3 is related to Military Sexual Trauma. | |
| 33.6 | secondary head/neck cancer 3 | BA4;7 | BOOLEAN | 0:NO 1:YES | Secondary diagnosis 3 is related to Head/Neck Cancer. | |
| 33.7 | secondary combat vet 3 | BA4;8 | BOOLEAN | 0:NO 1:YES | Secondary diagnosis 3 is related to Combat. | |
| 100 | pfss new prescription flag | PFSS;1 | SET OF CODES | 1:READY TO PROCESS | APNEW | This flag indicates that a new Home Oxygen prescription has been entered and that pre-certification processing for this patient should begin. |
| 101 | requestor | PFSS;2 | POINTER | 200 | Person that performed the initial consult request. Pointer to file #200. Associated with the prescription. |
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