# | Name | Location | Type | Details | Index | Description |
---|---|---|---|---|---|---|
.01 | immunization(+) | 0;1 | POINTER | 9999999.14 | B | This is the type of immunization that was given to the patient at the encounter. |
.02 | patient name(+) | 0;2 | POINTER | 9000001 | This is the patient who was given the immunization. | |
.03 | visit(+) | 0;3 | POINTER | 9000010 | AD | This is the encounter defined in the Visit file that represents when and where the immunization was given. |
.04 | series | 0;4 | SET OF CODES | P:PARTIALLY COMPLETE C:COMPLETE B:BOOSTER 1:SERIES 1 2:SERIES 2 3:SERIES 3 4:SERIES 4 5:SERIES 5 6:SERIES 6 7:SERIES 7 8:SERIES 8 | This field allows the provider to specify which series of immunization type was given to the patient. | |
.05 | lot | 0;5 | POINTER | 9999999.41 | This Indian Health Service field indicates the lot number associated with this immunization. | |
.06 | reaction | 0;6 | SET OF CODES | 1:FEVER 2:IRRITABILITY 3:LOCAL REACTION OR SWELLING 4:VOMITING 5:RASH OR ITCHING 6:LETHARGY 7:CONVULSIONS 8:ARTHRITIS OR ARTHRALGIAS 9:ANAPHYLAXIS OR COLLAPSE 10:RESPIRATORY DISTRESS 11:OTHER 0:NONE | This is the reaction that may have been observed by the provider as a result of the immunization given. | |
.07 | contraindicated | 0;7 | SET OF CODES | 1:YES (DO NOT REPEAT THIS VACCINE). 0:NO (OK TO USE IN THE FUTURE) | This field allows the immunization to be recorded as contraindicated. Reminders will include a check to see if the previous immunization was contraindicated before creating reminders. | |
.08 | dose override | 0;8 | SET OF CODES | 0:@ 1:INVALID--BAD STORAGE 2:INVALID--DEFECTIVE 3:INVALID--EXPIRED 4:INVALID--ADMIN ERROR 9:FORCED VALID | This Indian Health Service field indicates the dose override status of this immunization. | |
.09 | injection site | 0;9 | SET OF CODES | LTI:Left Thigh IM LTS:Left Thigh SQ RTI:Right Thigh IM RTS:Right Thigh SQ BTI:Both Thighs IM LDI:Left Delt IM LAS:Left Arm SQ RDI:Right Delt IM RAS:Right Arm SQ O:Oral IN:Nasal LID:Left Arm Intradermal RID:Right Arm Intradermal | This Indian Health Service field identifies the body site where the immunization was administered. | |
.11 | volume | 0;11 | NUMERIC | This Indian Health Service field indicates the volume of vaccine administered for this immunization. | ||
.12 | date of vac info statement | 0;12 | DATE-TIME | This Indian Health Service field indicates the date the vaccine information statement associated with this immunization was offered/given to the patient. | ||
.13 | created by v cpt entry | 0;13 | NUMERIC | This Indian Health Service field identifies the V CPT entry, if any, that created this V Immunization entry. | ||
.14 | vac eligibility | 0;14 | POINTER | 9002084.83 | This Indian Health Service field indicates the Vaccine for Children (VFC) Program eligibility for this patient on this visit. | |
.15 | import from outside registry | 0;15 | SET OF CODES | 1:IMPORTED 0:NOT IMPORTED 2:EDITED AFTER IMPORT | This Indian Health Service field indicated the import status of this immunization from an outside registry. | |
.16 | ndc | 0;16 | POINTER | 9002084.95 | This Indian Health Service field identifies the National Drug Code (NDC) for this vaccine. | |
1 | administrative notes | 1;1 | FREE TEXT | This Indian Health Service field is a free text field used to document administrative information about this immunization. | ||
2 | vis offered/given to patient | 2;0 | MULTIPLE | 9000010.112 | This is the Vaccine Information Statement (VIS) that was offered to the patient prior to the administration of the immunization, along with the date/time it was offered. | |
3 | other diagnosis | 3;0 | MULTIPLE | 9000010.113 | This is a list of diagnoses for this immunization event, in addition to the Primary Diagnosis selected for this event. | |
1101 | remarks | 11;0 | WORD-PROCESSING | This is additional comments or remarks related to the immunization given to the patient. | ||
1201 | event date and time | 12;1 | DATE-TIME | This is the date and time the immunization was given. This date and time may be different from the visit date and time. For example, for clinic appointment visits, the visit date and time is the date and time of the appointment, not the time the provider performed the clinical event. The date may be an imprecise date. Date and time may be within 30 days before or after the visit date, with the restriction the date cannot be a future date. | ||
1202 | ordering provider | 12;2 | POINTER | 200 | The field can be used to document the provider who ordered the immunization. | |
1203 | clinic | 12;3 | POINTER | 40.7 | This Indian Health Service field indicates the clinic stop associated with this visit. | |
1204 | encounter provider | 12;4 | POINTER | 200 | This is the provider who gave this immunization. | |
1205 | date/time recorded | 12;5 | DATE-TIME | This timestamp field is the date and time of documentation of administration of the immunization. This field is set automatically when the EVENT DATE AND TIME is entered. | ||
1206 | immunization documenter | 12;6 | POINTER | 200 | This is the person/provider who documented this immunization by entering the data into the system by whatever means. | |
1207 | lot number(+) | 12;7 | POINTER | 9999999.41 | LN | This is the lot number of the Immunization entered for this event. It is not designed to be edited manually, but automatically set when an Immunization is selected. |
1208 | parent | 12;8 | POINTER | 9000010.11 | This Indian Health Service field indicates the parent immunization, if any, associated with this immunization, such as for immunizations given in series. | |
1209 | external key | 12;9 | FREE TEXT | This Indian Health Service free text field identifies the external key associated with this immunization. | ||
1210 | outside provider name | 12;10 | FREE TEXT | This Indian Health Service field contains the name of the outside provider associated with this immunization. | ||
1213 | ancillary pov | 12;13 | POINTER | 80 | This Indian Health Service field indicated the ancillary diagnosis related to this immunization. | |
1214 | user last update | 12;14 | POINTER | 200 | This Indian Health Service field indicates the user who last updated information for this immunization. | |
1215 | ordering location | 12;15 | POINTER | 44 | This Indian Health Service field indicated the hospital location ordering this immunization. | |
1216 | date/time entered | 12;16 | DATE-TIME | This Indian Health Service field indicates the date and time that this immunization information was entered into this record. | ||
1217 | entered by | 12;17 | POINTER | 200 | This Indian Health Service field indicates the user who entered this immunization record. | |
1218 | date/time last modified | 12;18 | DATE-TIME | This Indian Health Service field indicates the date and time this immunization record was last modified. | ||
1219 | last modified by | 12;19 | POINTER | 200 | This Indian Health Service field indicates the user who last modified this immunization record. | |
1301 | event information source(+) | 13;1 | POINTER | 920.1 | This is the source of the information obtained for this immunization event. If this is a new event for this patient, no entry is required. | |
1302 | route of administration | 13;2 | POINTER | 920.2 | This is the method this vaccine was administered. Select from the list provided. | |
1303 | site of administration (body) | 13;3 | POINTER | 920.3 | This is the area of the patient's body through which the vaccine was administered. | |
1304 | primary diagnosis | 13;4 | POINTER | 80 | This is the primary (or initial) diagnosis for this immunization event. It is selected from the ISC DIAGNOSIS file. | |
1312 | dosage | 13;12 | FREE TEXT | This is the amount of this vaccine to be administered for this event. It is free text, 3 to 30 characters, and should be in the format of an amount followed by units of measure, such as "30 cc". | ||
2601 | snomed ct | 26;0 | MULTIPLE | 9000010.1126 | This Indian Health Service field indicates the SNOMED Clinical Terms (CT) that describe this immunization and their preferred terms. | |
2701 | loinc codes | 27;0 | MULTIPLE | 9000010.1127 | This Indian Health Service field is the LOINC codes that identifies this immunization, along with their descriptions. | |
80101 | edited flag | 801;1 | SET OF CODES | 1:EDITED | This field is automatically set to 1 if PCE detects that any original immunization data is being edited. | |
80102 | audit trail | 801;2 | FREE TEXT | This field is populated automatically by the PCE filing logic. The format of the field is as follows: Pointer to PCE data source file_"-"_A for Add or E for Edit_" "_DUZ of the person who entered the data_";"... | ||
81101 | comments | 811;1 | FREE TEXT | This is a comment related to the patient's immunization. The provider may enter this manually via the PCE User Interface. | ||
81201 | verified | 812;1 | SET OF CODES | 1:ELECTRONICALLY SIGNED 2:VERIFIED BY PACKAGE | This is used to note how the event was verified and is automatically entered by the software. | |
81202 | package | 812;2 | POINTER | 9.4 | This is the VistA package from which this immunization record originated through PCE. | |
81203 | data source | 812;3 | POINTER | 839.7 | This is the data source for this immunization, automatically entered through the PCS software and uneditable by users. |