# | 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 | This is the facility/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 entry. | |
8 | day | 0;9 | FREE TEXT | This 8-character string represents the date on which the Prescription fill/refill was released. | ||
9 | division | 0;10 | POINTER | 59 | The outpatient pharmacy site for this extract entry. | |
10 | provider | 0;11 | FREE TEXT | The provider who wrote the new, refill, or partial refill prescription for this patient. | ||
11 | va drug classification | 0;12 | FREE TEXT | The VA Drug Classification for the drug/supply item in this prescription. | ||
12 | 0;13 | SET OF CODES | 1:MAIL 2:CMOP | Identifies if prescription was mailed. | ||
13 | provider person class | 0;14 | FREE TEXT | The VA code associate with the active Person Class of the provider. | ||
14 | new | 0;15 | FREE TEXT | Data will be 1 if this is a new prescription. | ||
15 | shad status | 0;16 | SET OF CODES | Y:YES N:NO U:UNKNOWN | Indicates whether patient meets requirements for Shipboard Hazard and Defense (SHAD). | |
16 | quantity | 0;17 | NUMERIC | Drug quantity dispensed in the unit of issue for that drug. Unit of issue may vary from product to product and site to site. | ||
17 | cost | 0;18 | NUMERIC | VA pharmacy supply cost of drug dispensed. | ||
18 | encounter shad | 0;19 | BOOLEAN | Y:YES N:NO | Indicates if treatment provided during the patient's encounter is related to the Shipboard Hazard And Defense (SHAD) condition. | |
19 | movement file # | 0;20 | POINTER | 405 | Current patient movement record associated with this extract record. | |
20 | treating specialty | 0;21 | FREE TEXT | The treating specialty PTF CODE assigned to this patient when the prescription was issued, if the patient was an inpatient at that time. | ||
21 | placeholder4 | 0;22 | FREE TEXT | This field marked as a placeholder for future use. | ||
22 | unit of issue | 0;23 | FREE TEXT | This units in which this item was dispensed. | ||
23 | date of birth | 0;24 | FREE TEXT | Patient's date of birth. | ||
24 | eligibility(+) | 0;25 | FREE TEXT | Appropriate eligibility code based on veteran or non-veteran status. | ||
25 | veteran | 0;26 | BOOLEAN | Y:YES N:NO | Patient's Veteran status. | |
26 | copay(+) | 0;27 | BOOLEAN | 1:YES 0:NO | This field indicates whether this prescription was billed for copay. | |
27 | feeder key(+) | 0;28 | FREE TEXT | Code that uniquely identifies a DSS drug/supply product. | ||
28 | dea, special hdlg | 0;29 | SET OF CODES | I:INVESTIGATIONAL 1:SCHEDULE 1 ITEM 2:SCHEDULE 2 ITEM 3:SCHEDULE 3 ITEM 4:SCHEDULE 4 ITEM 5:SCHEDULE 5 ITEM | Indicates if the drug in this record is Investigational, or Schedule 1-5. | |
29 | days supply | 0;30 | NUMERIC | The number of days covered by this prescription. | ||
30 | primary care team | 0;31 | POINTER | 404.51 | The primary care team assigned to this patient in the PCMM module. | |
31 | primary care provider | 0;32 | FREE TEXT | The primary care provider assigned to this patient through the PCMM module. | ||
32 | time | 0;33 | FREE TEXT | Time of day when the prescription fill/refill was released. | ||
33 | race | 0;34 | FREE TEXT | Race ABBREVIATION for this patient. | ||
34 | master patient index | 1;1 | FREE TEXT | Unique national VA patient identifier. | ||
35 | dss product department | 1;2 | FREE TEXT | The nationally defined DSS Intermediate Department Number designated to the Pharmacy care product. | ||
36 | sex | 1;3 | SET OF CODES | M:MALE F:FEMALE | Patient's gender. | |
37 | zip+4 | 1;4 | FREE TEXT | The ZIP code for where the patient resides. The 5-character ZIP code is provided if ZIP+4 is not available. | ||
38 | placeholder | 1;5 | FREE TEXT | Currently NULL. | ||
39 | placeholder | 1;6 | FREE TEXT | Currently NULL. | ||
40 | state | 1;7 | FREE TEXT | The state in which the patient resides. | ||
41 | county | 1;8 | FREE TEXT | The county in which the patient resides. | ||
42 | pc provider person class | 1;9 | FREE TEXT | The VA Code of the Person Class of the Primary Care Provider as of the date of this extract record. | ||
43 | pow status | 1;10 | SET OF CODES | Y:YES N:NO U:UNKNOWN | Indicates if patient was confined as a Prisoner of War. | |
44 | pow location | 1;11 | 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 | |
45 | radiation status | 1;12 | SET OF CODES | Y:YES N:NO U:UNKNOWN | Indicates if patient claims exposure to ionizing radiation. | |
46 | agent orange status | 1;13 | SET OF CODES | Y:YES N:NO U:UNKNOWN | Indicates whether patient was exposed to Agent Orange. | |
47 | sharing agreement payor | 1;14 | FREE TEXT | An indicator used for patients participating in sharing agreements. | ||
48 | sharing agreement insurance | 1;15 | POINTER | 36 | Indicates the first insurer for patients who participate in sharing agreements. | |
49 | mst status | 1;16 | SET OF CODES | Y:Yes, screened reports MST N:Screened, does not report MST D:Screened, declines to answer U:Unknown, not screened | Military Sexual Trauma (MST) status of a patient on the date of the encounter. | |
50 | enrollment location | 1;17 | FREE TEXT | The facility that the patient chooses to designate as his preferred location for care. | ||
51 | associate pc provider | 1;18 | FREE TEXT | The associate primary care provider assigned to this patient through the Primary Care Management Module (PCMM) application. | ||
52 | assoc. pc prov. person class | 1;19 | FREE TEXT | The VA code of the Person Class of the Associate Primary Care Provider as of the date of this extract record. | ||
53 | placeholder | 1;20 | FREE TEXT | Currently NULL. | ||
54 | dom,prrtp and saartp indicator | 1;21 | 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. | |
55 | purple heart indicator | 1;22 | BOOLEAN | Y:YES N:NO | Indicates whether or not a patient is a Purple Heart recipient. | |
56 | enrollment category | 1;23 | FREE TEXT | Patient's enrollment category. | ||
57 | enrollment status | 1;24 | POINTER | 27.15 | Patient's enrollment status. | |
58 | placeholder | 1;25 | FREE TEXT | |||
59 | cnhu status | 1;26 | BOOLEAN | Y:YES N:NO | Identifies if patient resides in a contract nursing home. | |
60 | period of service | 1;27 | FREE TEXT | The period of service that best classifies the patient based on eligibility code. | ||
61 | observation patient indicator | 1;28 | SET OF CODES | NO:NO YES:YES | Indicates if patient is considered to be an observation patient. | |
62 | encounter number | 1;29 | FREE TEXT | The unique number assigned to each encounter within DSS. | ||
63 | agent orange location | 1;30 | SET OF CODES | K:KOREAN DMZ V:VIETNAM O:OTHER | Indicates the location where the patient was exposed to Agent Orange. | |
64 | ordering physician | 1;31 | FREE TEXT | For future development; currently set to null. | ||
65 | ordering stop code | 1;32 | FREE TEXT | This field contains the stop code associated with the order. | ||
66 | ordering date | 1;33 | FREE TEXT | Date provider ordered the prescription. | ||
67 | cnh status | 1;34 | SET OF CODES | YES:YES NO:NO | This field is used to indicate whether a patient is currently in a contract nursing home. | |
68 | production division code | 1;35 | FREE TEXT | Identifies the division/facility where the work was performed. | ||
69 | means test | 1;36 | 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. | |
70 | head & neck cancer indicator | 1;37 | BOOLEAN | Y:YES N:NO | Identifies whether treatment was for head and/or neck cancer. | |
71 | ethnicity | 1;38 | FREE TEXT | The patient's PTF Ethnicity code. | ||
72 | race 1 | 1;39 | FREE TEXT | Self-reported by patient as recorded in VistA patient file. | ||
73 | dss ip # | 1;40 | NUMERIC | The nationally defined DSS Intermediate Product Number designated to the patient care product. | ||
74 | enrollment priority | 1;41 | FREE TEXT | This field contains the enrollment priority group and the enrollment priority subgroup. | ||
75 | user enrollee | 1;42 | FREE TEXT | User enrollee is determined by checking the Patient Enrollment file 27.11, when a user has a current or future fiscal year in the VistA User Enrollee Status field set value to 'U' and Null if no date or a past year's value is contained. | ||
76 | patient type | 2;1 | FREE TEXT | PATIENT TYPE refers to the various types of patient which might be seen at a VA facility. It is determined by the TYPE field of the PATIENT File #2 which points to the TYPE OF PATIENT entries in File #391. | ||
77 | cv status eligibility | 2;2 | 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. | |
78 | cv eligibility end date | 2;3 | FREE TEXT | Records the Combat Veteran eligibility expiration date or 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. | ||
79 | encounter cv | 2;4 | 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. | |
80 | national patient record flag | 2;5 | BOOLEAN | Y:YES | This field records whether the patient's record contains 1 or more active category 1 (National) Patient Record Flags. | |
81 | rx patient status | 2;6 | SET OF CODES | SC:SERVICE CONNECTED AA:A&A OTH:OTHER INP:INPATIENT NON:NON-VA | Indicates the status of the patient at the time the medication was filled. | |
82 | non va prescriber | 2;7 | SET OF CODES | Y:YES 0:NO | Indicates the provider prescribing the prescription is not a VA employee. | |
83 | rx order number | 2;8 | NUMERIC | This field contains the prescription number which shall be a whole number between 1 and 999999999. | ||
84 | eri | 2;9 | FREE TEXT | This field identifies patients from impacted zip code areas designated by the Federal Emergency Management Agency (FEMA). | ||
85 | agent orange enc indicator | 2;10 | BOOLEAN | Y:YES N:NO | Indicates whether service provided during this patient encounter is related to exposure to Agent Orange. | |
86 | encounter swac | 2;11 | BOOLEAN | Y:YES N:NO | Indicates the appropriate response for Southwest Asia conditions as related to this patient's episode of care. | |
87 | enc head/neck ca | 2;12 | BOOLEAN | Y:YES N:NO | Indicates whether service provided during this patient encounter is related to head and/or neck cancer. | |
88 | encounter mst | 2;13 | BOOLEAN | N:NO Y:YES | Indicates whether service provided during this patient encounter is related to military sexual trauma. | |
89 | sw asia conditions | 2;14 | SET OF CODES | Y:YES N:NO U:UNKNOWN | This field is used to indicate if this visit represents treatment of a VA patient claiming exposure to Southwest Asia Conditions. | |
90 | radiation encounter indicator | 2;15 | BOOLEAN | Y:YES N:NO | Indicates whether service provided during this patient encounter is related to exposure to ionizing radiation. | |
91 | service connected rx | 2;16 | BOOLEAN | Y:YES N:NO | This field will indicate whether this prescription is for a service connected condition. | |
92 | oef/oif | 2;17 | 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. | ||
93 | oef/oif return date | 2;18 | 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. This date field has a format equal to YYYYMMDD. | ||
94 | associate pc provider npi | 2;19 | FREE TEXT | A standard unique life-long identifier of the associate primary care provider. This field has a length of fifteen characters. | ||
95 | primary care provider npi | 2;20 | FREE TEXT | A standard unique life-long identifier of the primary care provider. This field has a length of fifteen characters. | ||
96 | provider npi | 2;21 | FREE TEXT | A standard unique life-long identifier of the individuals providing health care services. This field has a length of fifteen characters. | ||
97 | country code | 2;22 | FREE TEXT | The code for the country associated with the address. | ||
98 | patcat | 2;23 | 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. | |
99 | encounter sc | 2;24 | BOOLEAN | Y:YES N:NO | Indicates if treatment provided during this patient encounter is Service Connected. | |
100 | vietnam | 2;25 | SET OF CODES | Y:YES N:NO U:UNKNOWN | Indicates if patient is a Vietnam era veteran. | |
101 | camp lejeune status | 2;26 | 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. | |
102 | encounter camp lejeune | 2;27 | 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. | |
103 | combat veteran indicator | 2;28 | BOOLEAN | Y:YES N:NO | Identifies if the patient served in a combat zone. | |
104 | combat veteran location | 2;29 | FREE TEXT | Identifies the war in which the combat service was incurred. | ||
105 | remarks | 2;30 | SET OF CODES | C:CHOICE | This field is set based on whether the prescription is being filled by the VA as part of the Veteran's Choice program. |
Not Referenced