| # | 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 IV room is located. | |
| 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 | An 8-character numeric string that represents the date on which the IV medication was dispensed. | ||
| 9 | va drug classification | 0;10 | FREE TEXT | The VA Drug Classification for the item in this order. | ||
| 10 | quantity | 0;11 | 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. | ||
| 11 | ward | 0;12 | POINTER | 44 | Current ward where the patient is located. | |
| 13 | cost | 0;13 | NUMERIC | VA pharmacy supply cost of drug dispensed. | ||
| 14 | movement file # | 0;14 | POINTER | 405 | Current patient movement record associated with this extract record. | |
| 15 | treating specialty | 0;15 | FREE TEXT | The PTF CODE of the treating specialty associated with this extract record. | ||
| 16 | ndc | 0;16 | FREE TEXT | This is the National Drug Code for the drug/supply item in this order. | ||
| 17 | dea, special hdlg | 0;17 | 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. | |
| 18 | pharmacy iv dispensing fee | 0;18 | SET OF CODES | A:ADMIXTURE P:PIGGYBACK H:HYPERAL S:SYRINGE C:CHEMOTHERAPY | The type of IV dispensed. | |
| 19 | new feeder key | 0;19 | FREE TEXT | Code that uniquely identifies a DSS drug/supply product. | ||
| 20 | total doses per day | 0;20 | FREE TEXT | The total doses per day including units. | ||
| 21 | primary care team | 0;21 | FREE TEXT | The primary care team assigned to this patient. | ||
| 22 | primary care provider | 0;22 | FREE TEXT | The primary care provider assigned to this patient through the PCMM module. | ||
| 23 | ivp time | 0;23 | FREE TEXT | The time of day when the IV medication was dispensed. | ||
| 24 | admission date | 0;24 | FREE TEXT | This 8-character numeric string represents the date on which the patient's admission occurred. | ||
| 25 | admission time | 0;25 | FREE TEXT | Time of day at which the patient admission occurred. | ||
| 26 | dss identifier for encounter | 0;26 | FREE TEXT | Primary and secondary stop codes associated with the clinic, if IV dispensed to outpatient. | ||
| 27 | master patient index | 1;1 | FREE TEXT | Unique national VA patient identifier. | ||
| 28 | dss product department | 1;2 | FREE TEXT | The nationally defined DSS Intermediate Department Number designated to the Pharmacy care product. | ||
| 29 | placeholder | 1;3 | FREE TEXT | Currently NULL. | ||
| 30 | pc provider person class | 1;4 | FREE TEXT | The VA Code of the Person Class of the Primary Care Provider as of the date of this extract record. | ||
| 31 | associate pc provider | 1;5 | FREE TEXT | The associate primary care provider assigned to this patient through the PCMM module. | ||
| 32 | assoc. pc prov. person class | 1;6 | FREE TEXT | The VA code of the Person Class of the Associate Primary Care Provider as of the date of this extract record. | ||
| 33 | placeholder | 1;7 | FREE TEXT | Currently NULL. | ||
| 34 | dom,prrtp and saartp indicator | 1;8 | 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. | |
| 35 | observation patient indicator | 1;9 | SET OF CODES | NO:NO YES:YES | Indicates if patient is considered to be an observation patient. | |
| 36 | encounter number | 1;10 | FREE TEXT | The unique number assigned for DSS. | ||
| 37 | ordering provider | 1;11 | FREE TEXT | The provider who ordered the IV product. | ||
| 38 | ordering stop code | 1;12 | FREE TEXT | This field contains the stop code associated with the order. | ||
| 39 | ordering date | 1;13 | FREE TEXT | Date the order was verified by Nurse. | ||
| 40 | requesting physician | 1;14 | FREE TEXT | For future development; currently set to null. | ||
| 41 | production division code | 1;15 | FREE TEXT | Identifies the division/facility where the work was performed. | ||
| 42 | means test | 1;16 | 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. | |
| 43 | eligibility | 1;17 | FREE TEXT | Appropriate eligibility code based on veteran or non-veteran status. | ||
| 44 | date of birth | 1;18 | FREE TEXT | Patient's date of birth. | ||
| 45 | sex | 1;19 | SET OF CODES | M:MALE F:FEMALE | Patient's gender. | |
| 46 | state | 1;20 | FREE TEXT | The state in which the patient resides. | ||
| 47 | county | 1;21 | FREE TEXT | The county in which the patient resides. | ||
| 48 | zip+4 | 1;22 | FREE TEXT | The ZIP code for where the patient resides. The 5-character ZIP code is provided if ZIP+4 is not available. | ||
| 49 | veteran | 1;23 | BOOLEAN | Y:YES N:NO | Patient's Veteran status. | |
| 50 | period of service | 1;24 | FREE TEXT | The period of service that best classifies the patient based on eligibility code. | ||
| 51 | pow status | 1;25 | SET OF CODES | Y:YES N:NO U:UNKNOWN | Indicates if patient was confined as a Prisoner of War. | |
| 52 | pow location | 1;26 | 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 | |
| 53 | radiation status | 1;27 | SET OF CODES | Y:YES N:NO U:UNKNOWN | Indicates if patient claims exposure to ionizing radiation. | |
| 54 | agent orange status | 1;28 | SET OF CODES | Y:YES N:NO U:UNKNOWN | Indicates whether patient was exposed to Agent Orange. | |
| 55 | agent orange location | 1;29 | FREE TEXT | Indicates the location where the patient was exposed to Agent Orange. | ||
| 56 | purple heart indicator | 1;30 | BOOLEAN | Y:YES N:NO | Indicates whether or not a patient is a Purple Heart recipient. | |
| 57 | mst status | 1;31 | SET OF CODES | Y:Yes, screened reports MST N:Screened, does not report MST D:Screened, declines to answer U:Unknown, not screened | Indicates the Military Sexual Trauma (MST) status of a patient on the date of the encounter. | |
| 58 | enrollment location | 1;32 | FREE TEXT | The facility that the patient chooses to designate as his preferred location for care. | ||
| 59 | enrollment category | 1;33 | FREE TEXT | Patient's enrollment category. | ||
| 60 | enrollment status | 1;34 | FREE TEXT | Patient's enrollment status. | ||
| 61 | shad status | 1;35 | SET OF CODES | Y:YES N:NO U:UNKNOWN | Indicates whether patient meets requirements for Shipboard Hazard and Defense (SHAD). | |
| 62 | cnh status | 1;36 | SET OF CODES | YES:YES NO:NO | This field is used to indicate whether a patient is currently in a contract nursing home. | |
| 63 | placeholder | 1;37 | FREE TEXT | Currently NULL. | ||
| 64 | head & neck cancer indicator | 2;1 | BOOLEAN | Y:YES N:NO | Identifies whether patient has head and/or neck cancer. | |
| 65 | ethnicity | 2;2 | FREE TEXT | The patient's PTF Ethnicity code. | ||
| 66 | race 1 | 2;3 | FREE TEXT | Self-reported by patient as recorded in VistA patient file. | ||
| 67 | placeholder | 2;4 | POINTER | 50 | Currently NULL. This field is not currently used. | |
| 68 | placeholder | 2;5 | NUMERIC | Currently NULL. This field is not currently used. | ||
| 69 | placeholder | 2;6 | FREE TEXT | Currently NULL. This field is not currently used. | ||
| 70 | placeholder | 2;7 | BOOLEAN | Y:YES N:NO | Currently NULL. This field is not currently used. | |
| 71 | ordering provider person class | 2;8 | FREE TEXT | The VA code of the Person Class of the Ordering Provider as of the date of this extract record. | ||
| 72 | dss ip # | 2;9 | NUMERIC | The nationally defined DSS Intermediate Product Number designated to the patient care product. | ||
| 73 | enrollment priority | 2;10 | FREE TEXT | This field contains the enrollment priority group and the enrollment priority subgroup. | ||
| 74 | user enrollee | 2;11 | SET OF CODES | U:USER ENROLLED | Indicates whether a Veteran has User Enrollee status for the current or future fiscal year. | |
| 75 | patient type | 2;12 | 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. | |
| 76 | cv status eligibility | 2;13 | 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. | |
| 77 | cv eligibility end date | 2;14 | 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. | ||
| 78 | encounter cv | 2;15 | 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. | |
| 79 | national patient record flag | 2;16 | BOOLEAN | Y:YES | This field records whether the patient's record contains 1 or more active category 1 (National) Patient Record Flags. | |
| 80 | eri | 2;17 | FREE TEXT | This field identifies patients from impacted zip code areas designated by the Federal Emergency Management Agency (FEMA). | ||
| 81 | sw asia conditions | 2;18 | 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. | |
| 82 | oef/oif | 2;19 | 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;20 | 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. | ||
| 84 | associate pc provider npi | 2;21 | FREE TEXT | A standard unique life-long identifier of the associate primary care provider. This field has a length of fifteen characters. | ||
| 85 | ordering provider npi | 2;22 | FREE TEXT | A standard unique life-long identifier of the provider who ordered the intravenous product. This field has a length of fifteen characters. | ||
| 86 | primary care provider npi | 2;23 | FREE TEXT | A standard unique life-long identifier of the primary care provider. This field has a length of fifteen characters. | ||
| 87 | country code | 2;24 | FREE TEXT | This is the code for the country associated with the address. | ||
| 88 | patcat | 2;25 | 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. | |
| 89 | encounter sc | 2;26 | BOOLEAN | Y:YES N:NO | Indicates if treatment provided during this patient encounter is Service Connected. | |
| 90 | camp lejeune status | 2;27 | 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. | |
| 91 | encounter camp lejeune | 2;28 | 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. | |
| 92 | combat veteran indicator | 2;29 | BOOLEAN | Y:YES N:NO | Identifies if the patient served in a combat zone. | |
| 93 | combat veteran location | 2;30 | FREE TEXT | Identifies the war in which the combat service was incurred. |
Not Referenced