| # | Name | Location | Type | Details | Index | Description |
|---|---|---|---|---|---|---|
| .01 | sequence number(+) | 0;1 | NUMERIC | The record number for this extract entry. | ||
| 1 | year month | 0;2 | FREE TEXT | A six character string representing the year and the month for which this extract was performed. | ||
| 2 | extract number | 0;3 | POINTER | 727 | AC | The corresponding entry in the DSS EXTRACT LOG file (#727) for this extract. |
| 3 | facility | 0;4 | POINTER | 40.8 | This is the medical center division where the extract was performed. | |
| 4 | patient no. - dfn | 0;5 | POINTER | 2 | An identifying number for the patient at the local site. | |
| 5 | ssn | 0;6 | FREE TEXT | The patient's social security number. | ||
| 6 | name | 0;7 | FREE TEXT | The first four characters of the patient's last name. | ||
| 7 | in out patient indicator | 0;8 | SET OF CODES | I:INPATIENT O:OUTPATIENT | Indicates whether the patient was an inpatient or an outpatient for this extract. | |
| 8 | day | 0;9 | FREE TEXT | This 8-character string represents the date on which the admission occurred. | ||
| 9 | primary care team | 0;10 | FREE TEXT | The primary care team assigned to this patient. | ||
| 10 | sex | 0;11 | SET OF CODES | M:MALE F:FEMALE | Data is M if this patient is a male, or F if female. | |
| 11 | date of birth | 0;12 | FREE TEXT | Patient's date of birth. | ||
| 12 | religion | 0;13 | POINTER | 13 | The current religious preference of this patient. | |
| 13 | employment status | 0;14 | SET OF CODES | 1:EMPLOYED FULL TIME 2:EMPLOYED PART TIME 3:NOT EMPLOYED 4:SELF EMPLOYED 5:RETIRED 6:ACTIVE DUTY MILITARY 9:UNKNOWN | The patient's current employment status. | |
| 14 | health insurance | 0;15 | SET OF CODES | 1:INSURED 0:UNINSURED | Identifies if patient is covered by health insurance. | |
| 15 | state | 0;16 | FREE TEXT | The state in which the patient resides. | ||
| 16 | county | 0;17 | FREE TEXT | County in which the patient resides. | ||
| 17 | zip+4 | 0;18 | FREE TEXT | The zip code for where the patient resides. The 5-character zip code is provided if zip+4 is not available. | ||
| 18 | eligibility | 0;19 | FREE TEXT | Appropriate eligibility code based on veteran or non-veteran status. | ||
| 19 | veteran | 0;20 | BOOLEAN | Y:YES N:NO | Patient's Veteran status. | |
| 20 | vietnam | 0;21 | SET OF CODES | Y:YES N:NO U:UNKNOWN | Indicates if patient is a Vietnam era veteran. | |
| 21 | agent orange status | 0;22 | SET OF CODES | Y:YES N:NO U:UNKNOWN | Indicates whether patient was exposed to Agent Orange. | |
| 22 | radiation status | 0;23 | SET OF CODES | Y:YES N:NO U:UNKNOWN | Indicates if the patient claims exposure to ionizing radiation. | |
| 23 | pow status | 0;24 | SET OF CODES | Y:YES N:NO U:UNKNOWN | Indicates if patient was confined as a Prisoner of War. | |
| 24 | period of service | 0;25 | FREE TEXT | The period of service which best classifies this patient based on eligibility code. | ||
| 25 | means test | 0;26 | SET OF CODES | A:CATEGORY A B:CATEGORY B C:CATEGORY C P:PENDING ADJUDICATION R:REQUIRES MEANS TEST N:MEANS TEST NOT REQUIRED E:EXEMPT I:INCOMPLETE L:NO LONGER APPLICABLE M:NON-EXEMPT | The current means test category for this patient. | |
| 26 | marital status | 0;27 | POINTER | 11 | Current marital status for this patient. | |
| 27 | ward | 0;28 | POINTER | 44 | Current ward for this patient. | |
| 28 | treating specialty | 0;29 | FREE TEXT | The PTF CODE of the treating specialty associated with this extract record. | ||
| 29 | attending physician | 0;30 | FREE TEXT | The attending physician assigned to this patient at the time of admission. | ||
| 30 | movement file # | 0;31 | POINTER | 405 | Current movement number for this patient. | |
| 31 | drg | 0;32 | POINTER | 80.2 | The Diagnostic Related Group (DRG) for this admission. | |
| 32 | principal diagnosis | 0;33 | FREE TEXT | Principal ICD diagnosis for this patient. | ||
| 33 | time | 0;34 | FREE TEXT | A 6-character numeric string which represents the time of day at which the admission occurred. | ||
| 34 | primary care provider | 0;35 | FREE TEXT | The primary care provider assigned to this patient. | ||
| 35 | race | 0;36 | FREE TEXT | Race ABBREVIATION for this patient. | ||
| 36 | primary ward provider | 0;37 | FREE TEXT | The provider assigned to the ward where the patient is located at the time of admission. | ||
| 37 | master patient index | 1;1 | FREE TEXT | Unique national VA patient identifier. | ||
| 38 | dss dept. | 1;2 | FREE TEXT | The DSS Department code for the ward. Must contain at least four characters to be a valid code. | ||
| 39 | placeholder | 1;3 | FREE TEXT | Currently NULL. | ||
| 40 | placeholder | 1;4 | FREE TEXT | Currently NULL. | ||
| 41 | placeholder | 1;5 | FREE TEXT | Currently NULL. | ||
| 42 | admission eligibility | 1;6 | FREE TEXT | The eligibility of the patient for this specific admission. | ||
| 43 | mst status | 1;7 | SET OF CODES | Y:Yes, screened reports MST N:Screened, does not report MST D:Screened, declines to answer U:Unknown, not screened | The MST Status of the patient on the date of the patient's admission. | |
| 44 | shad status | 1;8 | SET OF CODES | Y:YES N:NO U:UNKNOWN | Indicates whether patient meets requirements for Shipboard Hazard and Defense (SHAD) status. | |
| 45 | sharing agreement payor | 1;9 | FREE TEXT | An indicator used for patients participating in sharing agreements. | ||
| 46 | sharing agreement insurance | 1;10 | FREE TEXT | Used to indicate insurer, if patient participates in a sharing agreement. | ||
| 47 | enrollment location | 1;11 | FREE TEXT | The facility that the patient chooses to designate as his preferred location for care. | ||
| 48 | pc provider person class | 1;12 | FREE TEXT | The VA Code of the Person Class of the Primary Care Provider as of the date of this extract record. | ||
| 49 | associate pc provider | 1;13 | FREE TEXT | The Associate Primary Care Provider assigned to this patient through the Primary Care Management Module (PCMM) application. | ||
| 50 | assoc. pc prov. person class | 1;14 | FREE TEXT | VA Code of the Person Class of the patient's Associate Primary Care Provider. | ||
| 51 | placeholder | 1;15 | FREE TEXT | Currently NULL. | ||
| 52 | dom, prrtp and saartp | 1;16 | SET OF CODES | P:GEN. PRRTP T:PTSD PRRTP S:DOM. PRRTP H:HOMELESS CWT/TR A:SA CWT/TR D:DOMICILIARY B:PTSD CWT/TR C:GEN. CET/TR | Indicates if the patient is admitted to either a RRTP, PRRTP, or SARRTP at the time care is provided. | |
| 53 | enrollment category | 1;17 | FREE TEXT | Patient's enrollment category. | ||
| 54 | enrollment status | 1;18 | FREE TEXT | Patient's enrollment status. | ||
| 55 | encounter shad | 1;19 | BOOLEAN | Y:YES N:NO | Indicates if treatment provided during the patient's admission is related to the Shipboard Hazard And Defense (SHAD) condition. | |
| 56 | purple heart indicator | 1;20 | BOOLEAN | Y:YES N:NO | Indicates whether or not a patient is a Purple Heart recipient. | |
| 57 | observation patient indicator | 1;21 | SET OF CODES | NO:NO YES:YES | Indicates if patient is considered to be an observation patient. | |
| 58 | encounter number | 1;22 | FREE TEXT | The unique number assigned for DSS. | ||
| 59 | agent orange location | 1;23 | FREE TEXT | Indicates the location where the patient was exposed to Agent Orange. | ||
| 60 | production division code | 1;24 | FREE TEXT | Identifies the division/facility where the work was performed. | ||
| 61 | pow location | 1;25 | POINTER | 22 | If POW status is indicated, then this is the POW confinement location/period. 1 WORLD WAR I 2 WORLD WAR II - EUROPE 3 WORLD WAR II - PACIFIC 4 KOREAN 5 VIETNAM 6 OTHER | |
| 62 | source of admission | 1;26 | SET OF CODES | 1:HOSPITAL 2:NHCU 3:DOMICILIARY 4:MILITARY HOSPITAL 5:CNH | Indicates where the admission took place. | |
| 63 | head & neck cancer indicator | 1;27 | BOOLEAN | Y:YES N:NO | Identifies whether patient has head and/or neck cancer. | |
| 64 | ethnicity | 1;28 | FREE TEXT | The patient's PTF ethnicity code. | ||
| 65 | race 1 | 1;29 | FREE TEXT | Self-reported by patient as recorded in VistA patient file. | ||
| 66 | enrollment priority | 1;30 | FREE TEXT | This field contains the enrollment priority group and the enrollment priority subgroup. | ||
| 67 | user enrollee | 1;31 | SET OF CODES | U:USER ENROLLED | Indicates whether a Veteran has User Enrollee status for the current or future fiscal year. | |
| 68 | patient type | 1;32 | SET OF CODES | AC:ACTIVE DUTY AL:ALLIED VETERAN CO:COLLATERAL EM:EMPLOYEE IN:INELIGIBLE MI:MILITARY RETIREE NO:NON-VETERAN (OTHER) NS:NSC VETERAN SC:SC VETERAN TR:TRICARE | Refers to the various types of patient which may be seen at a VA facility. Every patient in the system must have a TYPE specified. | |
| 69 | cv status eligibility | 1;33 | SET OF CODES | Y:YES E:ELIGIBILITY EXPIRED | Records if veteran served on active duty in a theater of combat operations during a period of war after the Persian Gulf War or in combat against a hostile force during a period of hostilities after November 11, 1998. | |
| 70 | cv eligibility end date | 1;34 | FREE TEXT | Records the Combat Veteran eligibility expiration date of the veteran who served on active duty in a theater of combat operations during a period of war after the Persian Gulf War or in combat against a hostile force during a period of hostilities after November 11, 1998. | ||
| 71 | encounter cv | 1;35 | BOOLEAN | Y:YES | Records if a veteran served on active duty in a theater of combat operations during a period of war after the Persian Gulf War or in combat against a hostile force during a period of hostilities after November 11, 1998. | |
| 72 | national patient record flag | 1;36 | BOOLEAN | Y:YES | This field records whether the patient's record contains 1 or more active category 1 (National) Patient Record Flags. | |
| 73 | attending physician pc | 1;37 | FREE TEXT | The VA Code of the Person Class of the Attending Physician associated with this record. | ||
| 74 | primary ward provider pc | 1;38 | FREE TEXT | The VA Code of the Person Class of the Primary Ward Provider associated with this record. | ||
| 75 | sw asia conditions | 1;39 | SET OF CODES | Y:YES N:NO U:UNKNOWN | This field is used to indicate if this patient claims exposure to Southwest Asia Conditions. | |
| 76 | eri | 1;40 | FREE TEXT | This field identifies patients from impacted zip code areas designated by the Federal Emergency Management Agency (FEMA). | ||
| 77 | agent orange enc indicator | 1;41 | BOOLEAN | Y:YES N:NO | Indicates whether service provided during this patient encounter is related to exposure to Agent Orange. | |
| 78 | encounter swac | 1;42 | FREE TEXT | Indicates the appropriate response for exposure to Southwest Asia conditions as related to this patient's episode of care: Y = Yes N = No Null | ||
| 79 | enc head/neck ca | 1;43 | FREE TEXT | Indicates the appropriate response for head/neck cancer as related to this patient's episode of care: Y = Yes N = No Null | ||
| 80 | encounter mst | 1;44 | FREE TEXT | Indicates the appropriate response for military sexual trauma as related to this patient's episode of care: Y = Yes N = No Null | ||
| 81 | radiation encounter indicator | 1;45 | FREE TEXT | Indicates the appropriate response for ionizing radiation exposure as related to this patient's episode of care: Y = Yes N = No Null | ||
| 82 | oef/oif | 2;1 | FREE TEXT | The Military Operation in which the patient was in combat during the specified time period. This field is a length of nine characters and reflects the OEF or OIF where this patient was in combat. | ||
| 83 | oef/oif return date | 2;2 | FREE TEXT | The date the patient left the OEF/OIF area, if known. Otherwise, it is the end date of military pay for this OEF/OIF deployment. | ||
| 84 | associate pc provider npi | 2;3 | FREE TEXT | Standard unique life-long identifier of the associate primary care provider. This field has a length of fifteen characters. | ||
| 85 | attending physician npi | 2;4 | FREE TEXT | Standard unique life-long identifier of the attending physician. This field has a length of fifteen characters. | ||
| 86 | primary care provider npi | 2;5 | FREE TEXT | A standard unique life-long identifier of the primary care provider. This field has a length of fifteen characters. | ||
| 87 | primary ward provider npi | 2;6 | FREE TEXT | A standard unique life-long identifier of the primary ward provider. This field has a length of fifteen characters. | ||
| 88 | admit outpatient tx flag | 2;7 | BOOLEAN | Y:YES | This field contains the patient's source of admission flag. YES, if admit outpatient treatment ('1P'). | |
| 89 | country code | 2;8 | FREE TEXT | This is the code for the country associated with the address. | ||
| 90 | patcat | 2;9 | SET OF CODES | AD:Active Duty ADD:Active Duty Dependent FNRS:Former Non-Remarried Spouse RET:Retired RETD:Retiree Dependent RES:Reservist REC:Recruit TDRL:Temporary Disability TFL:TRICARE for Life | This is the Patient's category which will be used for FHCC (Federal Health Care Center) Reconciliation. DSS must capture and report DoD patients so that the FHCC reconciliation process can function as designed. "Reconciliation" is the process used within the new FHCC to determine which patients DoD pays for and which VA pays for. | |
| 91 | admit source | 2;10 | FREE TEXT | This field contains the source of admission for the PTF entry. This is a two character code in the format of 1 numeric and 1 alphanumeric. | ||
| 92 | ed disposition code | 2;11 | SET OF CODES | A:ADMIT D:DECEASED E:ERROR L:LEFT R:REFERRED T:TRANSFERRED U:UNKNOWN N:NONE | Disposition code associated with the patient's emergency room visit. | |
| 93 | primary icd-10 code | 2;12 | FREE TEXT | The primary ICD-10 diagnosis code for this admission. | ||
| 94 | camp lejeune status | 2;13 | BOOLEAN | Y:YES N:NO | Indicates if patient was exposed to contaminated water while stationed at Camp Lejeune, NC between January 1, 1957 and December 31, 1987. | |
| 95 | encounter camp lejeune | 2;14 | BOOLEAN | Y:YES N:NO | Indicates if episode of care is related to exposure to contaminated water while stationed at Camp Lejeune, NC between January 1, 1957 and December 31, 1987. | |
| 96 | encounter sc | 2;15 | BOOLEAN | Y:YES N:NO | Indicates if treatment provided during this patient encounter is Service Connected. | |
| 97 | combat veteran indicator | 2;16 | BOOLEAN | Y:YES N:NO | Identifies if the patient served in a combat zone. | |
| 98 | combat veteran location | 2;17 | FREE TEXT | Identifies the war in which the combat service was incurred. |
Not Referenced