| # | 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 | FREE TEXT | Identifies the facility for this extract record. | ||
| 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. Any patient with an SSN beginning with "00000" is considered a "test patient" and will not be included in the extract. | ||
| 6 | name | 0;7 | FREE TEXT | The first four characters of the patient's last name. | ||
| 7 | in out patient indicator | 0;8 | FREE TEXT | Indicates whether the patient was an inpatient or an outpatient for this extract entry. | ||
| 8 | day | 0;9 | FREE TEXT | This 8-character string represents the date on which the clinic appointment was scheduled to occur. | ||
| 9 | placeholder1 | 0;10 | FREE TEXT | A placeholder for future use. | ||
| 10 | movement file # | 0;11 | POINTER | 405 | Current patient movement record associated with this extract record. | |
| 12 | treating specialty | 0;12 | POINTER | 42.4 | Enter the name of the treating specialty associated with this extract record. | |
| 13 | date of birth | 0;13 | FREE TEXT | The patient's date of birth between December 31,1870 and today's date. | ||
| 14 | eligibility | 0;14 | FREE TEXT | Appropriate eligibility code based on veteran or non-veteran status. | ||
| 15 | veteran | 0;15 | BOOLEAN | Y:YES N:NO | Data is Y if the patient is a veteran, N if not. | |
| 16 | time | 0;16 | FREE TEXT | A 6-character data element which represents the time for which the appointment was scheduled. | ||
| 17 | primary care team | 0;17 | FREE TEXT | The primary care team assigned to this patient. | ||
| 18 | primary care provider | 0;18 | FREE TEXT | The primary care provider assigned to this patient. | ||
| 19 | provider | 0;19 | FREE TEXT | The provider assigned to this patient. | ||
| 20 | race | 0;20 | FREE TEXT | Race ABBREVIATION for this patient. | ||
| 21 | dss identifier | 0;21 | FREE TEXT | The DSS Identifier consists of the primary and secondary stop codes associated with this clinic. It is exactly 6 numeric characters in length. | ||
| 22 | master patient index | 1;1 | FREE TEXT | A national VA system identifier which uniquely identifies a patient. | ||
| 23 | dss dept. | 1;2 | FREE TEXT | The DSS Department Code for the clinic product. | ||
| 24 | pc provider npi | 1;3 | FREE TEXT | The Primary Care Provider's National Provider Identifier code. | ||
| 25 | provider npi | 1;4 | FREE TEXT | The Provider's National Provider Identifier code. | ||
| 26 | pc provider person class | 1;5 | FREE TEXT | The VA Code of the Person Class of the Primary Care Provider associated with this record. | ||
| 27 | provider person class | 1;6 | FREE TEXT | The VA code associated with the active Person Class of the provider. | ||
| 28 | pow status | 1;7 | SET OF CODES | Y:YES N:NO U:UNKNOWN | The patient's POW status. May be set to Y(es), N(o), or U(nknown). | |
| 29 | pow location | 1;8 | 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 | |
| 30 | radiation status | 1;9 | SET OF CODES | Y:YES N:NO U:UNKNOWN | The patient's Ionizing Radiation status. (Y/N/U) | |
| 31 | agent orange status | 1;10 | SET OF CODES | Y:YES N:NO U:UNKNOWN | The patient's Agent Orange status. | |
| 32 | sharing agreement payor | 1;11 | FREE TEXT | An indicator used for patients participating in sharing agreements. | ||
| 33 | sharing agreement insurance | 1;12 | FREE TEXT | Used to indicate insurer, if patient participates in a sharing agreement. | ||
| 34 | mst status | 1;13 | SET OF CODES | Y:Yes, screened reports MST N:Screened, does not report MST D:Screened, declines to answer | The MST Status of the patient on the date of the outpatient encounter. Possible status values are: Y = Yes, screened reports MST N = Screened, does not report MST D = Screened, declines to answer | |
| 35 | enrollment location | 1;14 | FREE TEXT | The facility that the patient chooses to designate as his preferred location for care. | ||
| 36 | state | 1;15 | FREE TEXT | The state in which the patient resides. | ||
| 37 | county | 1;16 | FREE TEXT | The county in which the patient resides. | ||
| 38 | zip+4 | 1;17 | FREE TEXT | The patient's Zipcode with optional 4-digit extension. For example: 11223-1234 | ||
| 39 | sex(+) | 1;18 | SET OF CODES | M:MALE F:FEMALE | Data is M if this patient is a male, or F if female. | |
| 40 | associate pc provider | 1;19 | FREE TEXT | This is a reference to the NEW PERSON file (#200) for the provider who is the patients Associate Provider for Primary Care as assigned with the PCMM application. The IEN to file #200 is prefixed with the character 2. | ||
| 41 | assoc. pc prov. person class | 1;20 | FREE TEXT | The field will hold the VA Code associated with the active Person Class of the Associate Primary Care Provider as assigned by through the PCMM appilcation. The VA Code is always of the form "V"_six numeric digits; exactly 7 characters in length. | ||
| 42 | associate pc provider npi | 1;21 | FREE TEXT | The Associate Primary Care Provider's National Provider Identifier code. | ||
| 43 | dom,prrtp and saartp indicator | 1;22 | FREE TEXT | DOM, PRRTP and SAARTP Indicator indicates if the patient is admitted to either a DOM, PRRTP or SAARTP at the time hospital service is provided. Domiciliary (DOM) Psychiatric Residential Rehabilitation Treatment Program (PRRTP) Substance Abuse Residential Rehabiltation Treatment Program (SARRTP) | ||
| 44 | enrollment category | 1;23 | FREE TEXT | Derived from the Patient Enrollment File #27.11 | ||
| 45 | enrollment status | 1;24 | FREE TEXT | Derived from the Patient Enrollment File #27.11 | ||
| 46 | enrollment priority | 1;25 | FREE TEXT | Derived from the Patient Enrollment File #27.11 | ||
| 47 | period of service | 1;26 | FREE TEXT | The period of service that best classifies the patient based on eligibility code. | ||
| 48 | observation patient indicator | 1;27 | FREE TEXT | This field is derived from the inpatient/outpatient status, treating specialty, and DSS Identifier or feeder key values in the record. | ||
| 49 | encounter number | 1;28 | FREE TEXT | This field is derived from the inpatient/outpatient status, SSN, admit/visit date, treating specialty, observation patient indicator, and DSS Identifier or feeder key values in the record. | ||
| 50 | agent orange location | 1;29 | FREE TEXT | This field contains the Agent Orange exposure location. | ||
| 51 | purple heart indicator | 1;30 | BOOLEAN | Y:YES N:NO | This field indicates whether or not the patient is a Purple Heart recipient. | |
| 52 | clinic name | 1;31 | POINTER | 44 | This field contains the six-character name of the clinic. | |
| 53 | production division code | 1;32 | FREE TEXT | Data represents the medical center division the work was performed in. This field corresponds to an entry in the INSTITUTION file (#4). | ||
| 54 | head & neck cancer indicator | 1;33 | BOOLEAN | Y:YES N:NO | Identifies whether treatment was for head and/or neck cancer. | |
| 55 | ethnicity | 1;34 | FREE TEXT | The patient's PTF Ethnicity code. | ||
| 56 | race 1 | 1;35 | FREE TEXT | The patient's PTF Race code(s). |
Not Referenced