| # | 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 | 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 | Internal entry number of the PATIENT file (#2) record identifying the patient associated with the clinic visit information. | |
| 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 on the date in the DAY field (#8) for this extract record. | ||
| 8 | day(+) | 0;9 | FREE TEXT | Date in format YYYYMMDD; date with which the clinic visit extract data is associated. | ||
| 9 | primary stop code(+) | 0;10 | FREE TEXT | Primary Stop Code is a fixed length field of 3 numeric characters. The ACTION TO SEND field (#5) of the CLINIC AND STOP CODES file (#728.44) for the clinic determines the how the data is derived. | ||
| 10 | master patient index | 0;11 | FREE TEXT | A national VA system identifier which uniquely identifies a patient. | ||
| 11 | sex(+) | 0;12 | SET OF CODES | M:MALE F:FEMALE | Data is M if this patient is a male, or F if female. | |
| 12 | date of birth(+) | 0;13 | FREE TEXT | The patient's date of birth between December 31,1870 and today's date represented by an 8-character numeric string. | ||
| 13 | eligibility(+) | 0;14 | FREE TEXT | Appropriate eligibility code based on veteran or non-veteran status. | ||
| 14 | veteran(+) | 0;15 | BOOLEAN | Y:YES N:NO | Data is Y if this patient is a veteran, N if not. | |
| 15 | race(+) | 0;16 | FREE TEXT | Race ABBREVIATION for this patient. | ||
| 16 | pow status | 0;17 | 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). | |
| 17 | pow location | 0;18 | 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 | |
| 18 | radiation status | 0;19 | SET OF CODES | Y:YES N:NO U:UNKNOWN | The patient's Ionizing Radiation status. (Y/N/U) | |
| 19 | agent orange status | 0;20 | SET OF CODES | Y:YES N:NO U:UNKNOWN | The patient's Agent Orange status. | |
| 20 | mst status | 0;21 | 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 | |
| 21 | state(+) | 0;22 | FREE TEXT | The state in which the patient resides. | ||
| 22 | county(+) | 0;23 | FREE TEXT | The county in which the patient resides. | ||
| 23 | zip+4(+) | 0;24 | FREE TEXT | The patient's zipcode with optional 4-digit extension. | ||
| 24 | enrollment location | 0;25 | FREE TEXT | The facility that the patient chooses to designate as his preferred location for care. | ||
| 25 | placeholder1 | 0;26 | FREE TEXT | The primary care team assigned to this patient. Placeholder for future use. | ||
| 26 | provider | 0;27 | FREE TEXT | The provider primarily responsible for services to the patient during the clinic visit. | ||
| 27 | provider person class | 0;28 | FREE TEXT | The VA Code of the Person Class of the primary Provider of services during the clinic visit. | ||
| 28 | provider npi | 0;29 | FREE TEXT | The Provider's National Provider Identifier code. | ||
| 29 | sharing agreement payor | 0;30 | FREE TEXT | An indicator used for patients participating in sharing agreements. | ||
| 30 | sharing agreement insurance | 0;31 | FREE TEXT | Used to indicate insurer, if patient participates in a sharing agreement. | ||
| 31 | radiation encounter indicator | 0;32 | BOOLEAN | Y:YES N:NO | Indicates whether treatment provided during this encounter was related to the patient's ionizing radiation exposure. | |
| 32 | ao encounter indicator | 0;33 | BOOLEAN | Y:YES N:NO | Indicates whether treatment provided during this encounter was related to the patient's Agent Orange exposure. | |
| 33 | mst encounter indicator | 0;34 | BOOLEAN | Y:YES N:NO | Indicates whether treatment provided during this encounter was related to the patient's military sexual trauma. | |
| 34 | dss dept. | 0;35 | FREE TEXT | The DSS Department Code for the clinic product. | ||
| 35 | icd-9 codes(+) | 1;1 | FREE TEXT | The primary ICD-9 code followed by upto eight secondary IDC-9 codes concatenated together in a string. Only the primary IDC-9 code is required. Each ICD-9 code is composed of exactly 7 characters, padded on the right with space characters as needed. |
Not Referenced