| # | Name | Location | Type | Details | Index | Description |
|---|---|---|---|---|---|---|
| .01 | sequence number(+) | 0;1 | NUMERIC | B | The record number for this extract entry. | |
| 1 | year month | 0;2 | FREE TEXT | A six character numeric 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 | Date on which the service was provided. | ||
| 9 | time | 0;10 | FREE TEXT | Time the service was provided (6-digit military time). | ||
| 10 | treating specialty | 0;11 | FREE TEXT | The PTF CODE of the treating specialty associated with this extract record form the SPECIALTY file (#42.4). | ||
| 11 | ordering provider | 0;12 | FREE TEXT | Provider ordering the patient feeding. | ||
| 12 | ordering provider person class | 0;13 | FREE TEXT | VA Code of the Person Class of the patient's Ordering Provider as of the date of this extract record. | ||
| 13 | primary care provider | 0;14 | FREE TEXT | The primary care provider assigned to this patient through the Primary Care Management Module (PCMM) application. | ||
| 14 | primary care prv person class | 0;15 | FREE TEXT | VA Code of the Person Class of the Primary Care Provider as of the date of this extract record. | ||
| 15 | primary care team | 0;16 | POINTER | 404.51 | The primary care team assigned to this patient in the PCMM module. | |
| 16 | master patient index | 0;17 | FREE TEXT | Unique national VA patient identifier. | ||
| 17 | date of birth | 0;18 | FREE TEXT | Patient's date of birth. | ||
| 18 | sex | 0;19 | SET OF CODES | M:MALE F:FEMALE | Patient's gender. | |
| 19 | race 1 | 0;20 | FREE TEXT | Self-reported by patient as recorded in VistA patient file. | ||
| 20 | ethnicity | 0;21 | SET OF CODES | D:DECLINED TO ANSWER H:HISPANIC OR LATINO N:NOT HISPANIC OR LATINO U:UNKNOWN BY PATIENT | The patient's PTF ethnicity code. | |
| 21 | veteran | 0;22 | BOOLEAN | N:NO Y:YES | Patient's veteran status. | |
| 22 | enrollment status | 0;23 | POINTER | 27.15 | Patient's enrollment status. | |
| 23 | enrollment location | 0;24 | FREE TEXT | The facility that the patient chooses to designate as his preferred location for care. | ||
| 24 | enrollment category | 0;25 | FREE TEXT | Patient's enrollment category. | ||
| 25 | enrollment priority | 0;26 | FREE TEXT | This field contains the enrollment priority group and the enrollment priority subgroup. | ||
| 26 | eligibility | 0;27 | FREE TEXT | Patient's Primary Eligibility converted to NPCD eligibility code; Eligibility code is based on veteran or non-veteran status. | ||
| 27 | period of service | 0;28 | FREE TEXT | The period of service, which best classifies this patient based on eligibility code. | ||
| 28 | agent orange status | 0;29 | SET OF CODES | N:NO Y:YES U:UNKNOWN | Indicates whether patient was exposed to Agent Orange. | |
| 29 | agent orange location | 0;30 | SET OF CODES | K:KOREAN DMZ V:VIETNAM O:OTHER | Indicates the location where the patient was exposed to Agent Orange. | |
| 30 | radiation status | 0;31 | SET OF CODES | Y:YES N:NO U:UNKNOWN | Indicates if patient claims exposure to ionizing radiation. | |
| 31 | sw asia conditions | 0;32 | SET OF CODES | Y:YES N:NO U:UNKNOWN | This field is used to indicate if patient claims exposure to Southwest Asia Conditions. | |
| 32 | mst status | 0;33 | SET OF CODES | N:No, Screened does not report MST Y:Yes, Screened reports MST U:Unknown, not screened D:Screened Declines to answer | Indicates the Military Sexual Trauma (MST) status of a patient on the date of the encounter. | |
| 33 | head & neck cancer indicator | 0;34 | BOOLEAN | Y:YES N:NO | Identifies whether patient has head and/or neck cancer. | |
| 34 | pow status | 0;35 | BOOLEAN | N:NO Y:YES | Indicates if patient was confined as a Prisoner of War | |
| 35 | pow location | 0;36 | POINTER | 22 | If POW Status is indicated, this is the POW confinement location. | |
| 36 | purple heart indicator | 0;37 | BOOLEAN | Y:YES N:NO | Indicates whether or not a patient is a Purple Heart recipient. | |
| 37 | means test | 0;38 | 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. | |
| 38 | state code | 0;39 | FREE TEXT | The state in which the patient resides | ||
| 39 | county code | 0;40 | FREE TEXT | The county in which the patient resides | ||
| 40 | zip+4 | 1;1 | FREE TEXT | The ZIP code for where the patient resides. The 5-character ZIP code is provided if ZIP+4 is not available. | ||
| 41 | observation patient indicator | 1;2 | SET OF CODES | NO:NO YES:YES | Indicates if patient is considered to be an observation patient. | |
| 42 | rrtp, prrtp, saartp indicator | 1;3 | 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. | |
| 43 | encounter number | 1;4 | FREE TEXT | The unique number assigned for DSS. | ||
| 44 | patient division | 1;5 | FREE TEXT | Division in which patient's bed is located | ||
| 45 | food production division | 1;6 | FREE TEXT | Station number where the kitchen is located. | ||
| 46 | delivery division | 1;7 | FREE TEXT | Station number where the meal was delivered. | ||
| 47 | product feeder key | 1;8 | FREE TEXT | Standardized DSS product assigned by DSS NUTRITION PRODUCT worksheet. | ||
| 48 | food production facility | 1;9 | FREE TEXT | Kitchen location where product was prepared. | ||
| 49 | delivery location type | 1;10 | SET OF CODES | T:TRAY C:CAFETERIA D:DINING ROOM | Delivery point for product associated with the specific diet that was delivered on the selected date. | |
| 50 | delivery feeder location | 1;11 | FREE TEXT | DSS identifier indicating patient location where product was delivered. | ||
| 51 | quantity | 1;12 | NUMERIC | Product quantity. | ||
| 52 | cboc status | 1;13 | BOOLEAN | Y:YES | Indicates if the patient was seen at a Community Based Outpatient Clinic (CBOC). | |
| 53 | user enrollee | 1;14 | SET OF CODES | U:USER ENROLLED | Indicates whether a veteran has user enrollee status for the current or future fiscal year. | |
| 54 | patient type | 1;15 | 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. | |
| 55 | cv status eligibility | 1;16 | 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. | |
| 56 | national patient record flag | 1;17 | BOOLEAN | Y:YES | This field records that the patient's record contains 1 or more Category 1 (National) Patient Record Flags. | |
| 57 | eri | 1;18 | SET OF CODES | K:HURRICANE KATRINA | This field identifies patients from impacted ZIP code areas designated by the Federal Emergency Management Agency (FEMA). | |
| 58 | admission date | 1;19 | FREE TEXT | Date on which the patient's admission occurred. | ||
| 59 | oef/oif | 1;20 | 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. | ||
| 60 | oef/oif return date | 1;21 | 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. | ||
| 61 | tf units | 1;22 | SET OF CODES | ML:ML GM:GM | Indicates the unit of measurement used for the tube feeding. | |
| 62 | ordering provider npi | 1;23 | FREE TEXT | A standard unique life-long identifier of the ordering provider who ordered the patient feeding. This field has a length of fifteen characters. | ||
| 63 | primary care provider npi | 1;24 | FREE TEXT | A standard unique life-long identifier of the primary care provider. This field has a length of fifteen characters. | ||
| 64 | country code | 1;25 | FREE TEXT | This is the code for the country associated with the address. | ||
| 65 | shad status | 1;26 | SET OF CODES | Y:YES N:NO U:UNKNOWN | Indicates whether patient meets requirements for Shipboard Hazard and Defense (SHAD) status. | |
| 66 | patcat | 1;27 | 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. |
Not Referenced