GLOBAL MAP DATA DICTIONARY #2 -- PATIENT FILE 3/24/25 PAGE 1
STORED IN ^DPT( (26 ENTRIES) SITE: WWW.BMIRWIN.COM UCI: VISTA,VISTA (VERSION 5.3)
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The PATIENT file contains all the patients followed by the medical center/ Outpatient clinic. At a minimum each patient entry must
have a NAME, DATE OF BIRTH and SOCIAL SECURITY NUMBER. In order to add a new patient to the PATIENT file the user must also
indicate whether or not the patient is requesting to receive care as a VETERAN of the U.S. Armed Forces and specify the TYPE of
patient being added to the system. For the most part the information contained in this file is demographic in nature, i.e.,
address, employment, service history, etc., however data concerning admissions, appointments,etc., is also stored in this file.
The ADMISSION sub-field is scheduled to be moved into the new PATIENT MOVEMENT file by the end of calendar year 1989. Care should
be used when removing a patient from the PATIENT file since virtually all other DHCP modules do utilize data from this file. Of
the many fields in the file you will note that many are preceeded by an asterisk. Those fields are scheduled to be removed from
the file due to either lack of use or replacement by another field/file in the next release.
CROSS
REFERENCED BY: FULL ICN HISTORY(AAFICN), ICN HISTORY(AAICN), ATTENDING PHYSICIAN(AAP), INSURANCE TYPE(AB), NAME(ABUL),
DATE OF DISCHARGE(AC), CURRENT ADMISSION(ACA), *CATEGORY OF BENEFICIARY(ACB), CLAIM FOLDER LOCATION(ACFL4),
ZIP (CIVIL)(ACIVZIP), ZIP+4 (CIVIL)(ACIVZIP4), COORDINATING MASTER OF RECORD(ACMOR), CMOR ACTIVITY SCORE(ACMORS),
WARD LOCATION(ACN), COLLATERAL SPONSOR'S NAME(ACOL), CURRENT MEANS TEST STATUS(ACS), SOCIAL SECURITY NUMBER(AD),
D-ZIP CODE(AD1ZIP), D-ZIP+4(AD1ZIP4), ACTIVE(ADA), DATE OF DEATH(ADEP), DATE OF DEATH(ADGDBUL), NAME(ADGRU01),
SEX(ADGRU02), DATE OF BIRTH(ADGRU03), MARITAL STATUS(ADGRU05), RACE(ADGRU06), OCCUPATION(ADGRU07),
RELIGIOUS PREFERENCE(ADGRU08), SOCIAL SECURITY NUMBER(ADGRU09), PLACE OF BIRTH [CITY](ADGRU092),
PLACE OF BIRTH [STATE](ADGRU093), STREET ADDRESS [LINE 1](ADGRU111), ZIP+4(ADGRU1112),
STREET ADDRESS [LINE 2](ADGRU112), STREET ADDRESS [LINE 3](ADGRU113), CITY(ADGRU114), STATE(ADGRU115),
PHONE NUMBER [RESIDENCE](ADGRU131), PHONE NUMBER [WORK](ADGRU132), VETERAN (Y/N)?(ADGRU1901),
K-NAME OF PRIMARY NOK(ADGRU211), K-RELATIONSHIP TO PATIENT(ADGRU212), K-STREET ADDRESS [LINE 1](ADGRU213),
K-STREET ADDRESS [LINE 2](ADGRU214), K-CITY(ADGRU216), K-STATE(ADGRU217), K-PHONE NUMBER(ADGRU219),
SERVICE CONNECTED?(ADGRU301), SERVICE CONNECTED PERCENTAGE(ADGRU302), SERVICE ENTRY DATE [LAST](ADGRU326),
SERVICE SEPARATION DATE [LAST](ADGRU327), DATE OF DEATH(ADGRU351), MEDICAID NUMBER(ADGRU383),
LOG IN DATE/TIME(ADI), LOG IN DATE/TIME(ADIS), LOG OUT DATE TIME(ADIS4), DATE OF BIRTH(ADOB),
SERVICE ENTRY DATE [LAST](AE), APPOINTMENT REQUEST DATE(AEACL), DATE OF ENROLLMENT(AEB), E-ZIP CODE(AEC1ZIP),
E-ZIP+4(AEC1ZIP4), E2-ZIP+4(AEC2ZIP4), PRIMARY ELIGIBILITY CODE(AEL), ELIGIBILITY(AEL1),
EMPLOYER ZIP CODE(AEM1ZIP), EMPLOYER ZIP+4(AEM1ZIP4), ELIGIBILITY(AENR01), SEX(AENR02), MARITAL STATUS(AENR05),
RELIGIOUS PREFERENCE(AENR08), APPOINTMENT REQUEST DATE(AENR10101511), APPOINTMENT REQUEST ON 1010EZ(AENR1010159),
STREET ADDRESS [LINE 1](AENR111), ZIP+4(AENR1112), STREET ADDRESS [LINE 2](AENR112),
STREET ADDRESS [LINE 3](AENR113), CITY(AENR114), STATE(AENR115), RESIDENTIAL ADDRESS [LINE 1](AENR1151),
RESIDENTIAL ADDRESS [LINE 2](AENR1152), RESIDENTIAL ADDRESS [LINE 3](AENR1153), RESIDENTIAL CITY(AENR1154),
RESIDENTIAL STATE(AENR1155), RESIDENTIAL ZIP+4(AENR1156), RESIDENTIAL COUNTY(AENR1157), COUNTY(AENR117),
ADDRESS CHANGE DT/TM(AENR118), BAD ADDRESS INDICATOR(AENR121), TEMPORARY ADDRESS COUNTY(AENR12111),
TEMPORARY ADDRESS CHANGE DT/TM(AENR12113), TEMPORARY PHONE NUMBER(AENR1219), PHONE NUMBER [RESIDENCE](AENR131),
PHONE NUMBER [WORK](AENR132), CONFIDENTIAL ADDRESS COUNTY(AENR14111), CONFIDENTIAL ADDR CHANGE DT/TM(AENR14112),
INELIGIBLE DATE(AENR152), INELIGIBLE VARO DECISION(AENR1656), EMERGENCY RESPONSE INDICATOR(AENR181),
VETERAN (Y/N)?(AENR1901), RACE INFORMATION(AENR20201), ETHNICITY INFORMATION(AENR20601),
PRIMARY NOK CHANGE DATE/TIME(AENR21012), SECONDARY NOK CHANGE DATE/TIME(AENR211012),
PREFERRED FACILITY(AENR2702), RATED INCOMPETENT?(AENR293), SERVICE CONNECTED?(AENR301),
P&T EFFECTIVE DATE(AENR3013), SERVICE CONNECTED PERCENTAGE(AENR302), RECEIVING VA DISABILITY?(AENR3025),
P&T(AENR304), UNEMPLOYABLE(AENR305), INELIGIBLE REASON(AENR307), EMPLOYER NAME(AENR3111),
EMPLOYMENT STATUS(AENR31115), *CLAIM FOLDER LOCATION(AENR312), CLAIM NUMBER(AENR313),
COVERED BY HEALTH INSURANCE?(AENR3192), VIETNAM SERVICE INDICATED?(AENR32101),
AGENT ORANGE EXPOS. INDICATED?(AENR32102), RADIATION EXPOSURE INDICATED?(AENR32103),
VIETNAM FROM DATE(AENR32104), VIETNAM TO DATE(AENR32105), PROJ 112/SHAD(AENR32115),
RADIATION EXPOSURE METHOD(AENR3212), AGENT ORANGE EXPOSURE LOCATION(AENR3213), FILIPINO VETERAN PROOF(AENR3214),
PERSIAN GULF SERVICE?(AENR32201), PERSIAN GULF FROM DATE(AENR322011), PERSIAN GULF TO DATE(AENR322012),
SOUTHWEST ASIA CONDITIONS?(AENR322013), SOMALIA SERVICE INDICATED?(AENR322016), SOMALIA FROM DATE(AENR322017),
SOMALIA TO DATE(AENR322018), YUGOSLAVIA SERVICE INDICATED?(AENR322019), YUGOSLAVIA FROM DATE(AENR32202),
YUGOSLAVIA TO DATE(AENR322021), LEBANON SERVICE INDICATED?(AENR3221), LEBANON FROM DATE(AENR3222),
LEBANON TO DATE(AENR3223), GRENADA SERVICE INDICATED?(AENR3224), GRENADA FROM DATE(AENR3225),
GRENADA TO DATE(AENR3226), PANAMA SERVICE INDICATED?(AENR3227), PANAMA FROM DATE(AENR3228),
PANAMA TO DATE(AENR3229), PERIOD OF SERVICE(AENR323), SERVICE DISCHARGE TYPE [LAST](AENR324),
SERVICE BRANCH [LAST](AENR325), SERVICE ENTRY DATE [LAST](AENR326), SERVICE SEPARATION DATE [LAST](AENR327),
SERVICE NUMBER [LAST](AENR328), SERVICE DISCHARGE TYPE [NTL](AENR329), SERVICE BRANCH [NTL](AENR3291),
SERVICE COMPONENT [LAST](AENR32911), SERVICE COMPONENT [NTL](AENR32912), SERVICE COMPONENT [NNTL](AENR32913),
SERVICE ENTRY DATE [NTL](AENR3292), SERVICE SEPARATION DATE [NTL](AENR3293), SERVICE NUMBER [NTL](AENR3294),
SERVICE DISCHARGE TYPE [NNTL](AENR3295), SERVICE BRANCH [NNTL](AENR3296), SERVICE ENTRY DATE [NNTL](AENR3297),
SERVICE SEPARATION DATE [NNTL](AENR3298), SERVICE NUMBER [NNTL](AENR3299), E-CONTACT CHANGE DATE/TIME(AENR33012),
E2-CONTACT CHANGE DATE/TIME(AENR33112), DESIGNEE CHANGE DATE/TIME(AENR3412), DATE OF DEATH(AENR351),
SOURCE OF NOTIFICATION(AENR353), DATE OF DEATH LAST UPDATED(AENR354), MILITARY DISABILITY RETIREMENT(AENR3602),
DISCHARGE DUE TO DISABILITY(AENR3603), PRIMARY ELIGIBILITY CODE(AENR361), ELIGIBILITY STATUS(AENR3611),
ELIGIBILITY STATUS DATE(AENR3612), ELIGIBILITY VERIF. METHOD(AENR3615), USER ENROLLEE VALID THROUGH(AENR3617),
USER ENROLLEE SITE(AENR3618), DISABILITY RET. FROM MILITARY?(AENR362), RECEIVING A&A BENEFITS?(AENR36205),
RECEIVING HOUSEBOUND BENEFITS?(AENR36215), RECEIVING A VA PENSION?(AENR36235),
TOTAL ANNUAL VA CHECK AMOUNT(AENR36295), ELIGIBLE FOR MEDICAID?(AENR381), DATE MEDICAID LAST ASKED(AENR382),
PENSION AWARD EFFECTIVE DATE(AENR3851), PENSION AWARD REASON(AENR3852), DECIDED BY(AENR391),
DATE OF DECISION(AENR392), FACILITY MAKING DETERMINATION(AENR393), REVIEW DATE(AENR394),
METHOD OF DETERMINATION(AENR395), DATE VETERAN REQUESTED CD EVAL(AENR3951),
DATE FACILITY INITIATED REVIEW(AENR3952), DATE VETERAN WAS NOTIFIED(AENR3953),
CONFIDENTIAL ADDRESS ACTIVE?(AENR4105), POW STATUS INDICATED?(AENR525), POW CONFINEMENT LOCATION(AENR526),
POW FROM DATE(AENR527), POW TO DATE(AENR528), COMBAT SERVICE INDICATED?(AENR5291),
COMBAT SERVICE LOCATION(AENR5292), COMBAT FROM DATE(AENR5293), COMBAT TO DATE(AENR5294),
COMBAT VETERAN END DATE(AENR5295), COMBAT VETERAN END DATE(AENR52951), CURRENT PH INDICATOR(AENR531),
CURRENT PURPLE HEART STATUS(AENR532), CURRENT PURPLE HEART REMARKS(AENR533), EXPANDED MH CARE TYPE(AENR5501),
CURRENT ENROLLMENT(AENRC), POW STATUS INDICATED?(AENRL525), EMERGENCY RESPONSE INDICATOR(AERI),
DATE OF DEATH(AEXP1), SERVICE ENTRY DATE [NTL](AF), FULL ICN(AFICN), SERVICE BRANCH [LAST](AFV1),
SERVICE BRANCH [NTL](AFV2), SERVICE BRANCH [NNTL](AFV3), PRIMARY ELIGIBILITY CODE(AG),
TEMPORARY ADDRESS START DATE(AGU1), DISABILITY RET. FROM MILITARY?(AH), COORDINATING MASTER OF RECORD(AHCMOR),
INTEGRATION CONTROL NUMBER(AHICN), PRIMARY LONG ID(AHL7), COMBAT SERVICE INDICATED?(AI),
INTEGRATION CONTROL NUMBER(AICN), LOCALLY ASSIGNED ICN(AICNL), INDIAN SELF IDENT CHANGE DT/TM(AINC),
RESIDENTIAL ADDRESS [LINE 1](AIVM1151), RESIDENTIAL ADDRESS [LINE 2](AIVM1152),
RESIDENTIAL ADDRESS [LINE 3](AIVM1153), RESIDENTIAL CITY(AIVM1154), RESIDENTIAL STATE(AIVM1155),
RESIDENTIAL ZIP+4(AIVM1156), RESIDENTIAL COUNTY(AIVM1157), RECEIVING A&A BENEFITS?(AJ), COMBAT TO DATE(AK),
RECEIVING HOUSEBOUND BENEFITS?(AL), RECEIVING A VA PENSION?(AM), CURRENT MOH INDICATOR(AMHEN),
CURRENT MOH INDICATOR(AMHMT), NAME(AMPIMIS), ELIGIBLE FOR MEDICAID?(AMT), POW STATUS INDICATED?(AMTR),
VETERAN (Y/N)?(AN), VETERAN (Y/N)?(AN1), CHECK FOR DUPLICATE(ANEW), K-ZIP CODE(ANK1ZIP), K-ZIP+4(ANK1ZIP4),
K2-ZIP CODE(ANK2ZIP), K2-ZIP+4(ANK2ZIP4), WARD LOCATION(ANURS), ELIGIBILITY(AO), SOCIAL SECURITY NUMBER(AODS1),
STREET ADDRESS [LINE 1](AODS111), STREET ADDRESS [LINE 2](AODS112), STREET ADDRESS [LINE 3](AODS113),
CITY(AODS114), STATE(AODS115), ZIP CODE(AODS116), COUNTY(AODS117), NAME(AODS2), DATE OF BIRTH(AODS3),
SERVICE BRANCH [LAST](AODS4), RANK(AODS5), RECALLED TO ACTIVE DUTY(AODS6), CONDITION(AODS7),
ODS REGISTRATION ENTRY(AODSR), DATE OF DEATH(AOERR), *COMMENT - PATIENT POLICY(AP), PERIOD OF SERVICE(APOS),
PROVIDER(APR), DATE OF DEATH(APSJD), DATE OF DEATH(APSOD), TOTAL ANNUAL VA CHECK AMOUNT(AQ),
SERVICE CONNECTED PERCENTAGE(AR), INTEGRATION CONTROL NUMBER(AR), DATE OF DEATH(ARCDTH), CONDITION(AS),
DATE APPT. MADE(ASADM), SUBSCRIPTION CONTROL NUMBER(ASCN), SUBSCRIPTION CONTROL NUMBER(ASCN2),
SERVICE CONNECTED PERCENTAGE(ASCP), STATUS(ASDCN), SPOUSE'S EMP ZIP CODE(ASP1ZIP), SPOUSE'S EMP ZIP+4(ASP1ZIP4),
SEX(ASX), UNEMPLOYABLE(AT), TEST PATIENT INDICATOR(ATEST), SOCIAL SECURITY NUMBER(ATP), TREATING SPECIALTY(ATR),
TEMPORARY ZIP CODE(ATZIP), TEMPORARY ZIP+4(ATZIP4), DISCHARGE DUE TO DISABILITY(AU), FUGITIVE FELON FLAG(AUFFP),
MILITARY DISABILITY RETIREMENT(AV), SOCIAL SECURITY NUMBER(AVADPT6), NAME(AVAFC01), SEX(AVAFC02),
DATE OF BIRTH(AVAFC03), MARITAL STATUS(AVAFC05), RACE(AVAFC06), RELIGIOUS PREFERENCE(AVAFC08),
SOCIAL SECURITY NUMBER(AVAFC09), PLACE OF BIRTH [CITY](AVAFC092), PLACE OF BIRTH [STATE](AVAFC093),
STREET ADDRESS [LINE 1](AVAFC111), ZIP+4(AVAFC1112), STREET ADDRESS [LINE 2](AVAFC112),
STREET ADDRESS [LINE 3](AVAFC113), CITY(AVAFC114), STATE(AVAFC115), COUNTY(AVAFC117),
PHONE NUMBER [RESIDENCE](AVAFC131), PHONE NUMBER [WORK](AVAFC132), VETERAN (Y/N)?(AVAFC1901),
K-NAME OF PRIMARY NOK(AVAFC211), K-PHONE NUMBER(AVAFC219), MOTHER'S MAIDEN NAME(AVAFC2403),
SERVICE CONNECTED?(AVAFC301), SERVICE CONNECTED PERCENTAGE(AVAFC302), EMPLOYMENT STATUS(AVAFC31115),
CLAIM NUMBER(AVAFC313), PERIOD OF SERVICE(AVAFC323), DATE OF DEATH(AVAFC351), TYPE(AVAFC391), ZIP (VA)(AVAZIP),
ZIP+4 (VA)(AVAZIP4), VETERAN CATASTROPHICALLY DISABLED?(AVCDMT), FUGITIVE FELON FLAG(AXFFP),
K-NAME OF PRIMARY NOK(AXR), K2-NAME OF SECONDARY NOK(AXR1), SERVICE THIRD EPISODE?(AXR10),
TEMPORARY ADDRESS ACTIVE?(AXR11), TEMPORARY STREET [LINE 1](AXR12), TEMPORARY STREET [LINE 2](AXR13),
K-STREET ADDRESS [LINE 1](AXR14), K-STREET ADDRESS [LINE 2](AXR15), K2-STREET ADDRESS [LINE 1](AXR16),
K2-STREET ADDRESS [LINE 2](AXR17), SPOUSE'S EMP STREET [LINE 1](AXR18), SPOUSE'S EMP STREET [LINE 2](AXR19),
SPOUSE'S EMPLOYER NAME(AXR2), EMPLOYER STREET [LINE 1](AXR20), EMPLOYER STREET [LINE 2](AXR21),
E2-STREET ADDRESS [LINE 1](AXR22), E2-STREET ADDRESS [LINE 2](AXR23), E-STREET ADDRESS [LINE 1](AXR24),
E-STREET ADDRESS [LINE 2](AXR25), D-STREET ADDRESS [LINE 1](AXR26), D-STREET ADDRESS [LINE 2](AXR27),
PRIMARY ELIGIBILITY CODE(AXR28), STREET ADDRESS [LINE 1](AXR29), EMPLOYER NAME(AXR3),
STREET ADDRESS [LINE 2](AXR30), CONFIDENTIAL ADDRESS ACTIVE?(AXR31), CONFIDENTIAL STREET [LINE 1](AXR32),
CONFIDENTIAL STREET [LINE 2](AXR33), SERVICE BRANCH [LAST](AXR34), SERVICE BRANCH [NTL](AXR35),
SERVICE BRANCH [NNTL](AXR36), E-NAME(AXR4), E2-NAME OF SECONDARY CONTACT(AXR5), D-NAME OF DESIGNEE(AXR6),
INELIGIBLE DATE(AXR7), MISSING PERSON DATE(AXR8), SERVICE SECOND EPISODE?(AXR9), ZIP CODE(AZIP), ZIP+4(AZIP4),
NAME(B), ALIAS(B), SOCIAL SECURITY NUMBER(BS), NAME(BS5), SOCIAL SECURITY NUMBER(BS5),
CURRENT PURPLE HEART STATUS(C), WARD LOCATION(CN), CURRENT PH INDICATOR(D), DATE OF DEATH(DG714),
CV DATE EDITED(E), PHONE NUMBER [RESIDENCE](F), NAME(IVM01), SEX(IVM02), DATE OF BIRTH(IVM03),
SOCIAL SECURITY NUMBER(IVM09), STREET ADDRESS [LINE 1](IVM111), ZIP+4(IVM1112), STREET ADDRESS [LINE 2](IVM112),
STREET ADDRESS [LINE 3](IVM113), CITY(IVM114), STATE(IVM115), COUNTY(IVM117), PHONE NUMBER [RESIDENCE](IVM131),
PHONE NUMBER [WORK](IVM132), DATE OF DEATH(IVM351), HISTORIC KATRINA ERI(KATRI), LODGER WARD LOCATION(LD),
LONG ID(PID), SOCIAL SECURITY NUMBER(PX09), ROOM-BED(RM), SOCIAL SECURITY NUMBER(SSN),
VETERAN CATASTROPHICALLY DISABLED?(VCD), E2-ZIP CODE(ZEC2ZIP)
INDEXED BY: INSURANCE EXPIRATION DATE & EFFECTIVE DATE OF POLICY (ACHI), SERVICE SEPARATION DATE [LAST] & COMBAT TO DATE &
YUGOSLAVIA TO DATE & SOMALIA TO DATE & PERSIAN GULF TO DATE & COMBAT SERVICE INDICATED? & YUGOSLAVIA SERVICE
INDICATED? & SOMALIA SERVICE INDICATED? & PERSIAN GULF SERVICE? (ACVCOM), SERVICE SEPARATION DATE (ACVCOM2), CURRENT
ENROLLMENT (ADGFM27D01), DATE OF DEATH (ADGFM351), NAME (ADGFMD01), SEX (ADGFMD02), DATE OF BIRTH (ADGFMD03), SOCIAL
SECURITY NUMBER (ADGFMD09), DATE ENTERED INTO FILE (ADGFMD097), PROVIDER (ADGFMD104), STREET ADDRESS [LINE 1]
(ADGFMD111), ZIP+4 (ADGFMD1112), STREET ADDRESS [LINE 2] (ADGFMD112), STREET ADDRESS [LINE 3] (ADGFMD113), CITY
(ADGFMD114), STATE (ADGFMD115), ZIP CODE (ADGFMD116), CONFIDENTIAL PHONE NUMBER (ADGFMD1315), CURRENT MEANS TEST
STATUS (ADGFMD14), CONFIDENTIAL STREET [LINE 1] (ADGFMD1411), CONFIDENTIAL STREET [LINE 2] (ADGFMD1412),
CONFIDENTIAL STREET [LINE 3] (ADGFMD1413), CONFIDENTIAL ADDRESS CITY (ADGFMD1414), CONFIDENTIAL ADDRESS STATE
(ADGFMD1415), CONFIDENTIAL ADDRESS ZIP CODE (ADGFMD1416), CONFIDENTIAL START DATE (ADGFMD1417), CONFIDENTIAL END
DATE (ADGFMD1418), DATE OF DEATH (ADGFMD351), PRIMARY ELIGIBILITY CODE (ADGFMD361), TEMPORARY STREET [LINE 1] &
TEMPORARY STREET [LINE 2] & TEMPORARY STREET [LINE 3] & TEMPORARY CITY & TEMPORARY STATE & TEMPORARY ZIP CODE &
TEMPORARY ADDRESS START DATE & TEMPORARY ADDRESS END DATE & TEMPORARY ADDRESS ACTIVE? & TEMPORARY ZIP+4 & TEMPORARY
ADDRESS PROVINCE & TEMPORARY ADDRESS POSTAL CODE & TEMPORARY ADDRESS COUNTRY (ADTTM1), CONFIDENTIAL STREET [LINE 1]
& CONFIDENTIAL STREET [LINE 2] & CONFIDENTIAL STREET [LINE 3] & CONFIDENTIAL ADDRESS CITY & CONFIDENTIAL ADDRESS
STATE & CONFIDENTIAL ADDRESS ZIP CODE & CONFIDENTIAL START DATE & CONFIDENTIAL END DATE & CONFIDENTIAL ADDRESS
ACTIVE? & CONFIDENTIAL ADDR PROVINCE & CONFIDENTIAL ADDR POSTAL CODE & CONFIDENTIAL ADDR COUNTRY & CONFIDENTIAL
ADDRESS COUNTY & CONFIDENTIAL PHONE NUMBER (ADTTM2), K-NAME OF PRIMARY NOK & K-RELATIONSHIP TO PATIENT & K-STREET
ADDRESS [LINE 1] & K-STREET ADDRESS [LINE 2] & K-STREET ADDRESS [LINE 3] & K-CITY & K-STATE & K-ZIP CODE & K-ADDRESS
SAME AS PATIENT'S? & K-ZIP+4 & K-PHONE NUMBER & K-WORK PHONE NUMBER & K-COUNTRY & K-PROVINCE & K-POSTAL CODE &
K-RELATIONSHIP TYPE (ADTTM3), K2-NAME OF SECONDARY NOK & K2-RELATIONSHIP TO PATIENT & K2-STREET ADDRESS [LINE 1] &
K2-STREET ADDRESS [LINE 2] & K2-STREET ADDRESS [LINE 3] & K2-CITY & K2-STATE & K2-ZIP CODE & K2-ADDRESS SAME AS
PATIENT'S? & K2-ZIP+4 & K2-PHONE NUMBER & K2-WORK PHONE NUMBER & K2-COUNTRY & K2-PROVINCE & K2-POSTAL CODE &
K2-RELATIONSHIP TYPE (ADTTM4), E-NAME & E-RELATIONSHIP TO PATIENT & E-STREET ADDRESS [LINE 1] & E-STREET ADDRESS
[LINE 2] & E-STREET ADDRESS [LINE 3] & E-CITY & E-STATE & E-ZIP CODE & E-EMER. CONTACT SAME AS NOK? & E-ZIP+4 &
E-PHONE NUMBER & E-WORK PHONE NUMBER & E-COUNTRY & E-PROVINCE & E-POSTAL CODE & E-RELATIONSHIP TYPE (ADTTM5),
E2-NAME OF SECONDARY CONTACT & E2-RELATIONSHIP TO PATIENT & E2-STREET ADDRESS [LINE 1] & E2-STREET ADDRESS [LINE 2]
& E2-STREET ADDRESS [LINE 3] & E2-CITY & E2-STATE & E2-ZIP CODE & E2-ZIP+4 & E2-PHONE NUMBER & E2-WORK PHONE NUMBER
& E2-COUNTRY & E2-PROVINCE & E2-POSTAL CODE & E2-RELATIONSHIP TYPE (ADTTM6), D-NAME OF DESIGNEE & D-RELATIONSHIP TO
PATIENT & D-STREET ADDRESS [LINE 1] & D-STREET ADDRESS [LINE 2] & D-STREET ADDRESS [LINE 3] & D-CITY & D-STATE &
D-ZIP CODE & D-DESIGNEE SAME AS NOK? & D-ZIP+4 & D-PHONE NUMBER & D-WORK PHONE NUMBER & D-COUNTRY & D-PROVINCE &
D-POSTAL CODE & D-RELATIONSHIP TYPE (ADTTM7), RESIDENTIAL ADDRESS [LINE 1] & RESIDENTIAL ADDRESS [LINE 2] &
RESIDENTIAL ADDRESS [LINE 3] & RESIDENTIAL CITY & RESIDENTIAL STATE & RESIDENTIAL ZIP+4 & RESIDENTIAL PROVINCE &
RESIDENTIAL POSTAL CODE & RESIDENTIAL COUNTRY (ADTTM8), APPOINTMENT REQUEST ON 1010EZ (AEAR), EXPANDED MH CARE TYPE
(AEXPMH), SEXUAL ORIENTATION FREE TEXT (AHIST), SERVICE BRANCH [LAST] (AMSEL), SERVICE BRANCH [NTL] (AMSENL),
SERVICE BRANCH [NNTL] (AMSENNL), NAME (ANAM01), ATTORNEY'S NAME (ANAM1001), ALIAS (ANAM201), K-NAME OF PRIMARY NOK
(ANAM211), K2-NAME OF SECONDARY NOK (ANAM2191), FATHER'S NAME (ANAM2401), MOTHER'S NAME (ANAM2402), MOTHER'S MAIDEN
NAME (ANAM2403), E-NAME (ANAM331), E2-NAME OF SECONDARY CONTACT (ANAM3311), D-NAME OF DESIGNEE (ANAM341),
INTEGRATION CONTROL NUMBER (APRFEVT), TYPE (APTYPE), SERVICE ENTRY DATE [LAST] & SERVICE SEPARATION DATE [LAST]
(ASERLAST), SERVICE ENTRY DATE [NNTL] & SERVICE SEPARATION DATE [NNTL] (ASERNNTL), SERVICE ENTRY DATE [NTL] &
SERVICE SEPARATION DATE [NTL] (ASERNTL), SELF IDENTIFIED GENDER (AVAFC024), SEXUAL ORIENTATION FREE TEXT
(AVAFC0251), PSEUDO SSN REASON (AVAFC0906), PLACE OF BIRTH COUNTRY (AVAFC0931), PLACE OF BIRTH PROVINCE (AVAFC0932),
RESIDENTIAL ADDRESS [LINE 1] (AVAFC1151), RESIDENTIAL ADDRESS [LINE 2] (AVAFC1152), RESIDENTIAL ADDRESS [LINE 3]
(AVAFC1153), RESIDENTIAL CITY (AVAFC1154), RESIDENTIAL STATE (AVAFC1155), RESIDENTIAL ZIP+4 (AVAFC1156), RESIDENTIAL
PROVINCE (AVAFC11571), RESIDENTIAL POSTAL CODE (AVAFC11572), RESIDENTIAL COUNTRY (AVAFC11573), BAD ADDRESS INDICATOR
(AVAFC121), EMAIL ADDRESS (AVAFC133), PHONE NUMBER [CELLULAR] (AVAFC134), PREFERRED NAME (AVAFC2405), PRONOUN
DESCRIPTION (AVAFC24061), DEATH ENTERED BY (AVAFC352), SOURCE OF NOTIFICATION (AVAFC353), DATE OF DEATH LAST UPDATED
(AVAFC354), LAST EDITED BY (AVAFC355), SUPPORTING DOCUMENT TYPE (AVAFC357), POW STATUS INDICATED? (AVAFC525),
INDIVIDUAL TAX ID (AVAFC99111), MULTIPLE BIRTH INDICATOR (AVAFC994), DATE OF DEATH (AW), CLINIC (AX), PROVINCE
(AX1171), POSTAL CODE (AX1172), COUNTRY (AX1173), CONFIDENTIAL ADDR COUNTRY (AXCCNTRY), COUNTRY (AXCNTRY), D-COUNTRY
(AXDCTNRY), E2-COUNTRY (AXE2CTNRY), E-COUNTRY (AXECTNRY), EMAIL ADDRESS & PHONE NUMBER [CELLULAR] & PAGER NUMBER
(AXENR13), K2-COUNTRY (AXK2CTNRY), K-COUNTRY (AXKCTNRY), RESIDENTIAL COUNTRY (AXRCTNRY), TEMPORARY ADDRESS COUNTRY
(AXTCNTRY), STATUS (AY), ZIP+4 (AZIPLINK), ZIP CODE (AZIPLNK2), DATE ENTERED INTO FILE (BMS), DATE CREATED & SEXUAL
ORIENTATION (G202501), DATE LAST UPDATED & SEXUAL ORIENTATION (G202502), SEXUAL ORIENTATION & DATE CREATED
(G202503), SEXUAL ORIENTATION & DATE LAST UPDATED (G202504), NAME (NOP)
^DPT(D0,0)= (#.01) NAME [1F] ^ (#.02) SEX [2S] ^ (#.03) DATE OF BIRTH [3D] ^ ^ (#.05) MARITAL STATUS [5P:11] ^ (#.06) RACE
==>[6P:10] ^ (#.07) OCCUPATION [7F] ^ (#.08) RELIGIOUS PREFERENCE [8P:13] ^ (#.09) SOCIAL SECURITY NUMBER [9F] ^ (#.091)
==>REMARKS [10F] ^ (#.092) PLACE OF BIRTH [CITY] [11F] ^ (#.093) PLACE OF BIRTH [STATE] [12P:5] ^ ^ (#.14) CURRENT
==>MEANS TEST STATUS [14P:408.32] ^ (#.096) WHO ENTERED PATIENT [15P:200] ^ (#.097) DATE ENTERED INTO FILE [16D] ^
==>(#.098) HOW WAS PATIENT ENTERED? [17S] ^ (#.081) DUPLICATE STATUS [18S] ^ (#.082) PATIENT MERGED TO [19P:2] ^ (#.083)
==>CHECK FOR DUPLICATE [20S] ^ (#.6) TEST PATIENT INDICATOR [21S] ^
^DPT(D0,.01,0)=^2.01^^ (#1) ALIAS
^DPT(D0,.01,D1,0)= (#.01) ALIAS [1F] ^ (#1) ALIAS SSN [2F] ^ (#100.03) ALIAS COMPONENTS [3P:20] ^
^DPT(D0,.02,0)=^2.02P^^ (#2) RACE INFORMATION
^DPT(D0,.02,D1,0)= (#.01) RACE INFORMATION [1P:10] ^ (#.02) METHOD OF COLLECTION [2P:10.3] ^
^DPT(D0,.025,0)=^2.025P^^ (#.025) SEXUAL ORIENTATION
^DPT(D0,.025,D1,0)= (#.01) SEXUAL ORIENTATION [1P:47.77] ^ (#.02) STATUS [2S] ^ (#.03) DATE CREATED [3D] ^ (#.04) DATE LAST
==>UPDATED [4D] ^ (#.05) NOTE [5P:8925] ^ (#.06) TYPE OF UPDATE [6S] ^
^DPT(D0,.06,0)=^2.06PA^^ (#6) ETHNICITY INFORMATION
^DPT(D0,.06,D1,0)= (#.01) ETHNICITY INFORMATION [1P:10.2] ^ (#.02) METHOD OF COLLECTION [2P:10.3] ^
^DPT(D0,.1)= (#.1) WARD LOCATION [E1,30F] ^
^DPT(D0,.101)= (#.101) ROOM-BED [1F] ^
^DPT(D0,.102)= (#.102) CURRENT MOVEMENT [1P:405] ^
^DPT(D0,.103)= (#.103) TREATING SPECIALTY [1P:45.7] ^
^DPT(D0,.104)= (#.104) PROVIDER [1P:200] ^
^DPT(D0,.1041)= (#.1041) ATTENDING PHYSICIAN [1P:200] ^
^DPT(D0,.105)= (#.105) CURRENT ADMISSION [1P:405] ^
^DPT(D0,.106)= (#.106) LAST DMMS EPISODE NUMBER [1N] ^
^DPT(D0,.107)= (#.107) LODGER WARD LOCATION [1F] ^
^DPT(D0,.108)= (#.108) CURRENT ROOM [1P:405.4] ^
^DPT(D0,.109)= (#.109) EXCLUDE FROM FACILITY DIR [1S] ^
^DPT(D0,.11)= (#.111) STREET ADDRESS [LINE 1] [1F] ^ (#.112) STREET ADDRESS [LINE 2] [2F] ^ (#.113) STREET ADDRESS [LINE 3] [3F]
==>^ (#.114) CITY [4F] ^ (#.115) STATE [5P:5] ^ (#.116) ZIP CODE [6F] ^ (#.117) COUNTY [7N] ^ (#.1171) PROVINCE [8F] ^
==>(#.1172) POSTAL CODE [9F] ^ (#.1173) COUNTRY [10P:779.004] ^ ^ (#.1112) ZIP+4 [12F] ^ (#.118) ADDRESS CHANGE DT/TM
==>[13D] ^ (#.119) ADDRESS CHANGE SOURCE [14S] ^ (#.12) ADDRESS CHANGE SITE [15P:4] ^ (#.121) BAD ADDRESS INDICATOR
==>[16S] ^ (#.122) ADDRESS CHANGE USER [17P:200] ^ (#.1118) STREET ADDRESS CASS IND [18S] ^
^DPT(D0,.115)= (#.1151) RESIDENTIAL ADDRESS [LINE 1] [1F] ^ (#.1152) RESIDENTIAL ADDRESS [LINE 2] [2F] ^ (#.1153) RESIDENTIAL
==>ADDRESS [LINE 3] [3F] ^ (#.1154) RESIDENTIAL CITY [4F] ^ (#.1155) RESIDENTIAL STATE [5P:5] ^ (#.1156) RESIDENTIAL
==>ZIP+4 [6F] ^ (#.1157) RESIDENTIAL COUNTY [7N] ^ (#.11571) RESIDENTIAL PROVINCE [8F] ^ (#.11572) RESIDENTIAL POSTAL
==>CODE [9F] ^ (#.11573) RESIDENTIAL COUNTRY [10P:779.004] ^ (#.1158) RESIDENTIAL ADDR CHANGE DT/TM [11D] ^ (#.11582)
==>RESIDENTIAL ADDR CHANGE SOURCE [12S] ^ ^ ^ (#.11581) RESIDENTIAL ADDR CHANGE SITE [15P:4] ^ (#.11583)
==>RESIDENTIAL ADDR CHANGE USER [16P:200] ^ ^ ^ (#.1159) RESIDENTIAL ADDR CASS IND [19S] ^
^DPT(D0,.121)= (#.1211) TEMPORARY STREET [LINE 1] [1F] ^ (#.1212) TEMPORARY STREET [LINE 2] [2F] ^ (#.1213) TEMPORARY STREET
==>[LINE 3] [3F] ^ (#.1214) TEMPORARY CITY [4F] ^ (#.1215) TEMPORARY STATE [5P:5] ^ (#.1216) TEMPORARY ZIP CODE [6F]
==>^ (#.1217) TEMPORARY ADDRESS START DATE [7D] ^ (#.1218) TEMPORARY ADDRESS END DATE [8D] ^ (#.12105) TEMPORARY
==>ADDRESS ACTIVE? [9S] ^ (#.1219) TEMPORARY PHONE NUMBER [10F] ^ (#.12111) TEMPORARY ADDRESS COUNTY [11N] ^
==>(#.12112) TEMPORARY ZIP+4 [12F] ^ (#.12113) TEMPORARY ADDRESS CHANGE DT/TM [13D] ^ (#.12114) TEMPORARY ADDRESS
==>CHANGE SITE [14P:4] ^ (#.12115) TEMPORARY ADDR CASS IND [15S] ^ (#.12116) TEMPORARY COUNTRY CODE [16P:12.12] ^
==>(#.12117) TEMPORARY EXTENSION [17F] ^
^DPT(D0,.122)= (#.1221) TEMPORARY ADDRESS PROVINCE [1F] ^ (#.1222) TEMPORARY ADDRESS POSTAL CODE [2F] ^ (#.1223) TEMPORARY
==>ADDRESS COUNTRY [3P:779.004] ^
^DPT(D0,.13)= (#.131) PHONE NUMBER [RESIDENCE] [1F] ^ (#.132) PHONE NUMBER [WORK] [2F] ^ (#.133) EMAIL ADDRESS [3F] ^ (#.134)
==>PHONE NUMBER [CELLULAR] [4F] ^ (#.135) PAGER NUMBER [5F] ^ (#.136) EMAIL ADDRESS CHANGE DT/TM [6D] ^ (#.137) EMAIL
==>ADDRESS CHANGE SOURCE [7S] ^ (#.138) EMAIL ADDRESS CHANGE SITE [8P:4] ^ (#.139) CELLULAR NUMBER CHANGE DT/TM [9D] ^
==>(#.1311) CELLULAR NUMBER CHANGE SOURCE [10S] ^ (#.13111) CELLULAR NUMBER CHANGE SITE [11P:4] ^ (#.1312) PAGER
==>NUMBER CHANGE DT/TM [12D] ^ (#.1313) PAGER NUMBER CHANGE SOURCE [13S] ^ (#.1314) PAGER NUMBER CHANGE SITE [14P:4] ^
==>(#.1315) CONFIDENTIAL PHONE NUMBER [15F] ^ (#.1316) EMAIL ADDRESS INDICATOR [16S] ^ (#.1317) EMAIL ADDRESS
==>INDICATOR DT/TM [17D] ^ (#.1318) EMAIL ADDRESS CHANGE USER [18P:200] ^ (#.1319) CELLULAR NUMBER CHANGE USER
==>[19P:200] ^
^DPT(D0,.132)= (#.1321) RESIDENCE NUMBER CHANGE DT/TM [1D] ^ (#.1322) RESIDENCE NUMBER CHANGE SOURCE [2S] ^ (#.1323) RESIDENCE
==>NUMBER CHANGE SITE [3P:4] ^ (#.1324) RESIDENCE NUMBER CHANGE USER [4P:200] ^ (#.1325) PHONE [WORK] CHANGE USER
==>[5P:200] ^ (#.1326) PHONE [WORK] CHANGE DT/TM [6D] ^ (#.1327) COUNTRY CODE [RESIDENCE] [7P:12.12] ^ (#.1328)
==>COUNTRY CODE [CELLULAR] [8P:12.12] ^ (#.1329) COUNTRY CODE [WORK] [9P:12.12] ^ (#.13201) CONFIDENTIAL COUNTRY CODE
==>[10P:12.12] ^ (#.13211) EXTENSION [RESIDENCE] [11F] ^ (#.13212) EXTENSION [CELLULAR] [12F] ^ (#.13213) EXTENSION
==>[WORK] [13F] ^ (#.13214) CONFIDENTIAL EXTENSION [14F] ^
^DPT(D0,.14,0)=^2.141S^^ (#.141) CONFIDENTIAL ADDRESS CATEGORY
^DPT(D0,.14,D1,0)= (#.01) CONFIDENTIAL ADDRESS CATEGORY [1S] ^ (#1) CONFIDENTIAL CATEGORY ACTIVE [2S] ^
^DPT(D0,.141)= (#.1411) CONFIDENTIAL STREET [LINE 1] [1F] ^ (#.1412) CONFIDENTIAL STREET [LINE 2] [2F] ^ (#.1413) CONFIDENTIAL
==>STREET [LINE 3] [3F] ^ (#.1414) CONFIDENTIAL ADDRESS CITY [4F] ^ (#.1415) CONFIDENTIAL ADDRESS STATE [5P:5] ^
==>(#.1416) CONFIDENTIAL ADDRESS ZIP CODE [6F] ^ (#.1417) CONFIDENTIAL START DATE [7D] ^ (#.1418) CONFIDENTIAL END
==>DATE [8D] ^ (#.14105) CONFIDENTIAL ADDRESS ACTIVE? [9S] ^ ^ (#.14111) CONFIDENTIAL ADDRESS COUNTY [11N] ^
==>(#.14112) CONFIDENTIAL ADDR CHANGE DT/TM [12D] ^ (#.14113) CONFIDENTIAL ADDR CHANGE SITE [13P:4] ^ (#.14114)
==>CONFIDENTIAL ADDR PROVINCE [14F] ^ (#.14115) CONFIDENTIAL ADDR POSTAL CODE [15F] ^ (#.14116) CONFIDENTIAL ADDR
==>COUNTRY [16P:779.004] ^ (#.14117) CONFIDENTIAL ADDR CASS IND [17S] ^ (#.14118) CONFIDENTIAL ADDR CHANGE USER
==>[18P:200] ^ (#.14119) CONFIDENTIAL PHONE CHANGE USER [19P:200] ^
^DPT(D0,.15)= ^ (#.152) INELIGIBLE DATE [2D] ^ (#.153) MISSING PERSON DATE [3D] ^
^DPT(D0,.16,0)=^2.16A^^ (#.16) MISSING OR INELIGIBLE
^DPT(D0,.16,D1,0)= (#.01) MISSING OR INELIGIBLE [1W] ^
^DPT(D0,.17)= ^ (#.172) FEE HOSPITAL I.D. [2S] ^
^DPT(D0,.18)= (#.181) EMERGENCY RESPONSE INDICATOR [1S] ^
^DPT(D0,.207,0)=^2.07IDA^^ (#7) LANGUAGE DATE/TIME
^DPT(D0,.207,D1,0)= (#.01) LANGUAGE DATE/TIME [1D] ^ (#.02) PREFERRED LANGUAGE [2F] ^
^DPT(D0,.21)= (#.211) K-NAME OF PRIMARY NOK [1F] ^ (#.212) K-RELATIONSHIP TO PATIENT [2F] ^ (#.213) K-STREET ADDRESS [LINE 1]
==>[3F] ^ (#.214) K-STREET ADDRESS [LINE 2] [4F] ^ (#.215) K-STREET ADDRESS [LINE 3] [5F] ^ (#.216) K-CITY [6F] ^
==>(#.217) K-STATE [7P:5] ^ (#.218) K-ZIP CODE [8F] ^ (#.219) K-PHONE NUMBER [9F] ^ (#.2125) K-ADDRESS SAME AS
==>PATIENT'S? [10S] ^ (#.21011) K-WORK PHONE NUMBER [11F] ^ (#.221) K-COUNTRY [12P:779.004] ^ (#.222) K-PROVINCE [13F]
==>^ (#.223) K-POSTAL CODE [14F] ^ (#.224) K-RELATIONSHIP TYPE [15P:12.11] ^
^DPT(D0,.211)= (#.2191) K2-NAME OF SECONDARY NOK [1F] ^ (#.2192) K2-RELATIONSHIP TO PATIENT [2F] ^ (#.2193) K2-STREET ADDRESS
==>[LINE 1] [3F] ^ (#.2194) K2-STREET ADDRESS [LINE 2] [4F] ^ (#.2195) K2-STREET ADDRESS [LINE 3] [5F] ^ (#.2196)
==>K2-CITY [6F] ^ (#.2197) K2-STATE [7P:5] ^ (#.2198) K2-ZIP CODE [8F] ^ (#.2199) K2-PHONE NUMBER [9F] ^ (#.21925)
==>K2-ADDRESS SAME AS PATIENT'S? [10S] ^ (#.211011) K2-WORK PHONE NUMBER [11F] ^ (#.2101) K2-COUNTRY [12P:779.004] ^
==>(#.2102) K2-PROVINCE [13F] ^ (#.2103) K2-POSTAL CODE [14F] ^ (#.2104) K2-RELATIONSHIP TYPE [15P:12.11] ^
^DPT(D0,.212)= (#.21012) PRIMARY NOK CHANGE DATE/TIME [1D] ^ (#.211012) SECONDARY NOK CHANGE DATE/TIME [2D] ^
^DPT(D0,.22)= (#.2201) E-ZIP+4 [1F] ^ (#.2202) D-ZIP+4 [2F] ^ (#.2203) K2-ZIP+4 [3F] ^ (#.2204) E2-ZIP+4 [4F] ^ (#.2205) EMPLOYER
==>ZIP+4 [5F] ^ (#.2206) SPOUSE'S EMP ZIP+4 [6F] ^ (#.2207) K-ZIP+4 [7F] ^
^DPT(D0,.24)= (#.2401) FATHER'S NAME [1F] ^ (#.2402) MOTHER'S NAME [2F] ^ (#.2403) MOTHER'S MAIDEN NAME [3F] ^ (#.024) SELF
==>IDENTIFIED GENDER [4S] ^ (#.2405) PREFERRED NAME [5F] ^ (#.0931) PLACE OF BIRTH COUNTRY [6P:779.004] ^ (#.0932)
==>PLACE OF BIRTH PROVINCE [7F] ^
^DPT(D0,.2406,0)=^2.2406P^^ (#.2406) PRONOUN
^DPT(D0,.2406,D1,0)= (#.01) PRONOUN [1P:47.78] ^
^DPT(D0,.241)= (#.0251) SEXUAL ORIENTATION FREE TEXT [1F] ^ (#.24061) PRONOUN DESCRIPTION [2F] ^
^DPT(D0,.25)= (#.251) SPOUSE'S EMPLOYER NAME [1F] ^ (#.252) SPOUSE'S EMP STREET [LINE 1] [2F] ^ (#.253) SPOUSE'S EMP STREET [LINE
==>2] [3F] ^ (#.254) SPOUSE'S EMP STREET [LINE 3] [4F] ^ (#.255) SPOUSE'S EMPLOYER'S CITY [5F] ^ (#.256) SPOUSE'S
==>EMPLOYER'S STATE [6P:5] ^ (#.257) SPOUSE'S EMP ZIP CODE [7F] ^ (#.258) SPOUSE'S EMP PHONE NUMBER [8F] ^ ^ ^ ^ ^
==> ^ (#.2514) SPOUSE'S OCCUPATION [14F] ^ (#.2515) SPOUSE'S EMPLOYMENT STATUS [15S] ^ (#.2516) SPOUSE'S RETIREMENT
==>DATE [16D] ^
^DPT(D0,.29)= (#.291) DATE RULED INCOMPETENT (VA) [1D] ^ (#.292) DATE RULED INCOMPETENT (CIVIL) [2D] ^ (#.2911) INSTITUTION (VA)
==>[3P:4] ^ (#.2912) GUARDIAN (VA) [4F] ^ (#.2913) RELATIONSHIP (VA) [5F] ^ (#.2914) STREET ADDRESS 1 (VA) [6F] ^
==>(#.2915) STREET ADDRESS 2 (VA) [7F] ^ (#.2916) CITY (VA) [8F] ^ (#.2917) STATE (VA) [9P:5] ^ (#.2918) ZIP (VA)
==>[10F] ^ (#.2919) PHONE (VA) [11F] ^ (#.293) RATED INCOMPETENT? [12S] ^ (#.29013) ZIP+4 (VA) [13F] ^
^DPT(D0,.291)= ^ ^ (#.2921) INSTITUTION (CIVIL) [3F] ^ (#.2922) GUARDIAN (CIVIL) [4F] ^ (#.2923) RELATIONSHIP (CIVIL) [5F] ^
==>(#.2924) STREET ADDRESS 1 (CIVIL) [6F] ^ (#.2925) STREET ADDRESS 2 (CIVIL) [7F] ^ (#.2926) CITY (CIVIL) [8F] ^
==>(#.2927) STATE (CIVIL) [9P:5] ^ (#.2928) ZIP (CIVIL) [10F] ^ (#.2929) PHONE (CIVIL) [11F] ^ (#.290012) ZIP+4
==>(CIVIL) [12F] ^
^DPT(D0,.3)= (#.301) SERVICE CONNECTED? [1S] ^ (#.302) SERVICE CONNECTED PERCENTAGE [2N] ^ (#.303) AMOUNT OF VA DISABILITY [3N] ^
==>(#.304) P&T [4S] ^ (#.305) UNEMPLOYABLE [5S] ^ (#.306) MONETARY BEN. VERIFY DATE [6D] ^ (#.307) INELIGIBLE REASON
==>[7F] ^ ^ (#.309) AGENCY/ALLIED COUNTRY [9P:35] ^ (#.31) *CATEGORY OF BENEFICIARY [10P:45.82] ^ (#.3025) RECEIVING
==>VA DISABILITY? [11S] ^ (#.3012) SC AWARD DATE [12D] ^ (#.3013) P&T EFFECTIVE DATE [13D] ^ (#.3014) EFF. DATE
==>COMBINED SC% EVAL. [14D] ^
^DPT(D0,.31)= ^ (#.312) *CLAIM FOLDER LOCATION [2F] ^ (#.313) CLAIM NUMBER [3F] ^ (#.314) CLAIM FOLDER LOCATION [4P:4] ^ ^ ^
==>^ ^ ^ ^ (#.3192) COVERED BY HEALTH INSURANCE? [11S] ^
^DPT(D0,.311)= (#.3111) EMPLOYER NAME [1F] ^ (#.3112) GOVERNMENT AGENCY [2S] ^ (#.3113) EMPLOYER STREET [LINE 1] [3F] ^ (#.3114)
==>EMPLOYER STREET [LINE 2] [4F] ^ (#.3115) EMPLOYER STREET [LINE 3] [5F] ^ (#.3116) EMPLOYER CITY [6F] ^ (#.3117)
==>EMPLOYER STATE [7P:5] ^ (#.3118) EMPLOYER ZIP CODE [8F] ^ (#.3119) EMPLOYER PHONE NUMBER [9F] ^ ^ ^ ^ ^ ^
==>(#.31115) EMPLOYMENT STATUS [15S] ^ (#.31116) DATE OF RETIREMENT [16D] ^
^DPT(D0,.312,0)=^2.312IPA^^ (#.3121) INSURANCE TYPE
^DPT(D0,.312,D1,0)= (#.01) INSURANCE TYPE [1P:36] ^ (#1) *SUBSCRIBER ID [2F] ^ (#2) *GROUP NUMBER [3F] ^ (#3) INSURANCE
==>EXPIRATION DATE [4D] ^ ^ (#6) WHOSE INSURANCE [6S] ^ ^ (#8) EFFECTIVE DATE OF POLICY [8D] ^ ^ ^ ^ ^ ^
==>^ (#15) *GROUP NAME [15F] ^ (#16) PT. RELATIONSHIP TO INSURED [16S] ^ (#17) *NAME OF INSURED [17F] ^ (#.18)
==>GROUP PLAN [18P:355.3] ^ ^ (#.2) COORDINATION OF BENEFITS [20S] ^
^DPT(D0,.312,D1,1)= (#1.01) DATE ENTERED [1D] ^ (#1.02) ENTERED BY [2P:200] ^ (#1.03) DATE LAST VERIFIED [3D] ^ (#1.04) VERIFIED
==>BY [4P:200] ^ (#1.05) DATE LAST EDITED [5D] ^ (#1.06) LAST EDITED BY [6P:200] ^ ^ (#1.08) *COMMENT - PATIENT
==>POLICY [8F] ^ (#1.09) SOURCE OF INFORMATION [9P:355.12] ^ (#1.1) DATE OF SOURCE OF INFORMATION [10D] ^
^DPT(D0,.312,D1,2)= (#2.01) SEND BILL TO EMPLOYER [1S] ^ (#2.02) EMPLOYER CLAIMS STREET ADDRESS [2F] ^ (#2.03) EMPLOY CLAIM ST
==>ADDRESS LINE 2 [3F] ^ (#2.04) EMPLOY CLAIM ST ADDRESS LINE 3 [4F] ^ (#2.05) EMPLOYER CLAIMS CITY [5F] ^
==>(#2.06) EMPLOYER CLAIMS STATE [6P:5] ^ (#2.07) EMPLOYER CLAIMS ZIP CODE [7F] ^ (#2.08) EMPLOYER CLAIMS PHONE
==>[8F] ^ (#2.015) SUBSCRIBER'S EMPLOYER NAME [9F] ^ (#2.1) ESGHP [10S] ^ (#2.11) EMPLOYMENT STATUS [11S] ^
==>(#2.12) RETIREMENT DATE [12D] ^
^DPT(D0,.312,D1,3)= (#3.01) INSURED'S DOB [1D] ^ (#3.02) INSURED'S BRANCH [2P:23] ^ (#3.03) INSURED'S RANK [3F] ^ (#3.04) STOP
==>POLICY FROM BILLING [4S] ^ (#3.05) INSURED'S SSN [5F] ^ (#3.06) INSURED'S STREET 1 [6F] ^ (#3.07) INSURED'S
==>STREET 2 [7F] ^ (#3.08) INSURED'S CITY [8F] ^ (#3.09) INSURED'S STATE [9P:5] ^ (#3.1) INSURED'S ZIP [10F] ^
==>(#3.11) INSURED'S PHONE [11F] ^ (#3.12) INSURED'S SEX [12S] ^ (#3.13) INSURED'S COUNTRY [13F] ^ (#3.14)
==>INSURED'S COUNTRY SUBDIVISION [14F] ^
^DPT(D0,.312,D1,4)= (#4.01) PRIMARY CARE PROVIDER [1F] ^ (#4.02) PRIMARY PROVIDER PHONE [2F] ^ (#4.03) PT. RELATIONSHIP - HIPAA
==>[3S] ^ (#4.04) EIV AUTO-UPDATE [4S] ^ (#4.05) PHARMACY RELATIONSHIP CODE [5P:9002313.19] ^ (#4.06) PHARMACY
==>PERSON CODE [6F] ^
^DPT(D0,.312,D1,5)= (#5.01) PATIENT ID [1F] ^ (#5.02) SUBSCRIBER'S SEC QUALIFIER(1) [2S] ^ (#5.03) SUBSCRIBER'S SEC ID(1) [3F] ^
==>(#5.04) SUBSCRIBER'S SEC QUALIFIER(2) [4S] ^ (#5.05) SUBSCRIBER'S SEC ID(2) [5F] ^ (#5.06) SUBSCRIBER'S SEC
==>QUALIFIER(3) [6S] ^ (#5.07) SUBSCRIBER'S SEC ID(3) [7F] ^ (#5.08) PATIENT'S SEC QUALIFIER(1) [8S] ^ (#5.09)
==>PATIENT'S SECONDARY ID(1) [9F] ^ (#5.1) PATIENT'S SEC QUALIFIER(2) [10S] ^ (#5.11) PATIENT'S SECONDARY ID(2)
==>[11F] ^ (#5.12) PATIENT'S SEC QUALIFIER(3) [12S] ^ (#5.13) PATIENT'S SECONDARY ID(3) [13F] ^
^DPT(D0,.312,D1,6,0)=^2.322A^^ (#60) ELIGIBILITY/BENEFIT
^DPT(D0,.312,D1,6,D2,0)= (#.01) EB NUMBER [1N] ^ (#.02) ELIGIBILITY/BENEFIT INFO [2P:365.011] ^ (#.03) COVERAGE LEVEL
==>[3P:365.012] ^ (#.04) *SERVICE TYPE [4P:365.013] ^ (#.05) INSURANCE TYPE [5P:365.014] ^ (#.06) PLAN
==>COVERAGE DESCRIPTION [6F] ^ (#.07) TIME PERIOD QUALIFIER [7P:365.015] ^ (#.08) MONETARY AMOUNT [8F] ^
==>(#.09) PERCENT [9N] ^ (#.1) QUANTITY QUALIFIER [10P:365.016] ^ (#.11) QUANTITY [11F] ^ (#.12)
==>AUTHORIZATION/CERTIFICATION [12P:365.033] ^ (#.13) IN PLAN [13P:365.033] ^
^DPT(D0,.312,D1,6,D2,1)= (#1.01) PROCEDURE CODING METHOD [1P:365.035] ^ (#1.02) PROCEDURE CODE [2F] ^ (#1.03) PROCEDURE MODIFIER
==>1 [3F] ^ (#1.04) PROCEDURE MODIFIER 2 [4F] ^ (#1.05) PROCEDURE MODIFIER 3 [5F] ^ (#1.06) PROCEDURE
==>MODIFIER 4 [6F] ^
^DPT(D0,.312,D1,6,D2,2,0)=^2.3222^^ (#2) NOTES
^DPT(D0,.312,D1,6,D2,2,D3,0)= (#.01) NOTES [1W] ^
^DPT(D0,.312,D1,6,D2,3)= (#3.01) ENTITY ID CODE [1P:365.022] ^ (#3.02) ENTITY TYPE [2P:365.043] ^ (#3.03) NAME [3F] ^ (#3.04)
==>ENTITY ID [4F] ^ (#3.05) ENTITY ID QUALIFIER [5P:365.023] ^ (#3.06) ENTITY RELATIONSHIP CODE
==>[6P:365.031] ^
^DPT(D0,.312,D1,6,D2,4)= (#4.01) ADDRESS LINE 1 [1F] ^ (#4.02) ADDRESS LINE 2 [2F] ^ (#4.03) CITY [3F] ^ (#4.04) STATE [4P:5] ^
==>(#4.05) ZIP [5F] ^ (#4.06) COUNTRY CODE [6F] ^ (#4.07) LOCATION [7F] ^ (#4.08) LOCATION QUALIFIER
==>[8P:365.034] ^ (#4.09) SUBDIVISION CODE [9F] ^
^DPT(D0,.312,D1,6,D2,5)= (#5.01) PROVIDER CODE [1P:365.024] ^ (#5.02) REFERENCE ID [2F] ^ (#5.03) REFERENCE ID QUALIFIER
==>[3P:365.028] ^
^DPT(D0,.312,D1,6,D2,6,0)=^2.3226A^^ (#6) CONTACT INFORMATION
^DPT(D0,.312,D1,6,D2,6,D3,0)= (#.01) SEQUENCE [1N] ^ (#.02) NAME [2F] ^ (#.03) *COMMUNICATION NUMBER [3F] ^ (#.04) COMMUNICATION
==>QUALIFIER [4P:365.021] ^
^DPT(D0,.312,D1,6,D2,6,D3,1)= (#1) COMMUNICATION NUMBER [1F] ^
^DPT(D0,.312,D1,6,D2,7,0)=^2.3227A^^ (#7) HEALTHCARE SERVICES DELIVERY
^DPT(D0,.312,D1,6,D2,7,D3,0)= (#.01) SEQUENCE [1N] ^ (#.02) BENEFIT QUANTITY [2N] ^ (#.03) QUANTITY QUALIFIER [3P:365.016] ^
==>(#.04) SAMPLE SELECTION MODULUS [4F] ^ (#.05) UNITS OF MEASUREMENT [5P:365.029] ^ (#.06) TIME
==>PERIODS [6N] ^ (#.07) TIME PERIOD QUALIFIER [7P:365.015] ^ (#.08) DELIVERY FREQUENCY [8P:365.025] ^
==>(#.09) DELIVERY PATTERN [9P:365.036] ^
^DPT(D0,.312,D1,6,D2,8,0)=^2.3228A^^ (#8) SUBSCRIBER DATES
^DPT(D0,.312,D1,6,D2,8,D3,0)= (#.01) SEQUENCE [1N] ^ (#.02) DATE [2F] ^ (#.03) DATE QUALIFIER [3P:365.026] ^ (#.04) DATE FORMAT
==>[4P:365.032] ^
^DPT(D0,.312,D1,6,D2,9,0)=^2.3229A^^ (#9) SUBSCRIBER ADDITIONAL INFO
^DPT(D0,.312,D1,6,D2,9,D3,0)= (#.01) SEQUENCE [1N] ^ (#.02) PLACE OF SERVICE [2P:353.1] ^ (#.03) DIAGNOSIS [3P:80] ^ (#.04)
==>QUALIFIER [4P:365.044] ^ (#.05) NATURE OF INJURY CODE [5P:365.045] ^ (#.06) NATURE OF INJURY
==>CATEGORY [6F] ^ (#.07) NATURE OF INJURY TEXT [7F] ^
^DPT(D0,.312,D1,6,D2,10,0)=^2.32291^^ (#10) SUBSCRIBER REFERENCE ID
^DPT(D0,.312,D1,6,D2,10,D3,0)= (#.01) SEQUENCE [1N] ^ (#.02) REFERENCE ID [2F] ^ (#.03) REFERENCE ID QUALIFIER [3P:365.028] ^
==>(#.04) DESCRIPTION [4F] ^
^DPT(D0,.312,D1,6,D2,11,0)=^2.32292PA^^ (#11) SERVICE TYPES
^DPT(D0,.312,D1,6,D2,11,D3,0)= (#.01) SERVICE TYPES [1P:365.013] ^
^DPT(D0,.312,D1,7)= (#7.01) NAME OF INSURED [1F] ^ (#7.02) SUBSCRIBER ID [2F] ^ (#7.03) SUBSCRIBER ID ROLLBACK [3F] ^ (#7.04)
==>PATIENT ID ROLLBACK [4F] ^
^DPT(D0,.312,D1,8)= (#8.01) REQUESTED SERVICE DATE [1D] ^ (#8.02) REQUESTED SERVICE TYPE [2P:365.013] ^ (#8.03) EB DISPLAY ENTRY
==>[3P:365] ^
^DPT(D0,.312,D1,9,0)=^2.3129^^ (#9) GROUP REFERENCE INFORMATION
^DPT(D0,.312,D1,9,D2,0)= (#.01) SEQUENCE [1N] ^ (#.02) REFERENCE ID (GROUP) [2F] ^ (#.03) REF ID QUALIFIER (GROUP) [3P:365.028] ^
==>(#.04) DESCRIPTION [4F] ^
^DPT(D0,.312,D1,10,0)=^2.332^^ (#10) GROUP PROVIDER INFO
^DPT(D0,.312,D1,10,D2,0)= (#.01) SEQUENCE [1N] ^ (#.02) PROVIDER CODE [2P:365.024] ^ (#.03) PROV REFERENCE ID [3F] ^
^DPT(D0,.312,D1,11,0)=^2.31211^^ (#11) HEALTH CARE CODE INFORMATION
^DPT(D0,.312,D1,11,D2,0)= (#.01) SEQUENCE [1N] ^ (#.02) DIAGNOSIS CODE [2P:80] ^ (#.03) DIAGNOSIS CODE QUALIFIER [3F] ^ (#.04)
==>PRIMARY OR SECONDARY? [4S] ^
^DPT(D0,.312,D1,12)= (#12.01) MILITARY INFO STATUS CODE [1P:365.039] ^ (#12.02) MILITARY EMPLOYMENT STATUS [2P:365.046] ^
==>(#12.03) MILITARY GOVT AFFILIATION CODE [3P:365.041] ^ (#12.04) MILITARY PERSONNEL DESCRIPTION [4F] ^
==>(#12.05) MILITARY SERVICE RANK CODE [5P:365.042] ^ (#12.06) DATE TIME PERIOD FORMAT QUAL [6P:365.032] ^
==>(#12.07) DATE TIME PERIOD [7F] ^
^DPT(D0,.312,D1,13,0)=^2.342DA^^ (#1.18) COMMENT - SUBSCRIBER POLICY
^DPT(D0,.312,D1,13,D2,0)= (#.01) COMMENT DATE/TIME [1D] ^ (#.02) LAST EDITED BY [2P:200] ^ ^ (#.04) PERSON CONTACTED [4F] ^
==>(#.05) CONTACT PHONE # [5F] ^ (#.06) CALL REFERENCE NUMBER [6F] ^ (#.07) METHOD OF CONTACT [7S] ^
==>(#.08) AUTHORIZATION NUMBER [8F] ^
^DPT(D0,.312,D1,13,D2,1)= (#.03) COMMENT [1F] ^
^DPT(D0,.32)= ^ (#.322) SERVICE VERIFICATION DATE [2D] ^ (#.323) PERIOD OF SERVICE [3P:21] ^ (#.324) SERVICE DISCHARGE TYPE
==>[LAST] [4P:25] ^ (#.325) SERVICE BRANCH [LAST] [5P:23] ^ (#.326) SERVICE ENTRY DATE [LAST] [6D] ^ (#.327) SERVICE
==>SEPARATION DATE [LAST] [7D] ^ (#.328) SERVICE NUMBER [LAST] [8F] ^ (#.329) SERVICE DISCHARGE TYPE [NTL] [9P:25] ^
==>(#.3291) SERVICE BRANCH [NTL] [10P:23] ^ (#.3292) SERVICE ENTRY DATE [NTL] [11D] ^ (#.3293) SERVICE SEPARATION DATE
==>[NTL] [12D] ^ (#.3294) SERVICE NUMBER [NTL] [13F] ^ (#.3295) SERVICE DISCHARGE TYPE [NNTL] [14P:25] ^ (#.3296)
==>SERVICE BRANCH [NNTL] [15P:23] ^ (#.3297) SERVICE ENTRY DATE [NNTL] [16D] ^ (#.3298) SERVICE SEPARATION DATE [NNTL]
==>[17D] ^ (#.3299) SERVICE NUMBER [NNTL] [18F] ^ (#.3285) SERVICE SECOND EPISODE? [19S] ^ (#.32945) SERVICE THIRD
==>EPISODE? [20S] ^
^DPT(D0,.321)= (#.32101) VIETNAM SERVICE INDICATED? [1S] ^ (#.32102) AGENT ORANGE EXPOS. INDICATED? [2S] ^ (#.32103) RADIATION
==>EXPOSURE INDICATED? [3S] ^ (#.32104) VIETNAM FROM DATE [4D] ^ (#.32105) VIETNAM TO DATE [5D] ^ ^ (#.32107) AGENT
==>ORANGE REGISTRATION DATE [7D] ^ (#.32108) AGENT ORANGE REPORTED TO C.O. [8D] ^ (#.32109) AGENT ORANGE EXAM DATE
==>[9D] ^ (#.3211) AGENT ORANGE REGISTRATION # [10N] ^ (#.32111) RADIATION REGISTRATION DATE [11D] ^ (#.3212)
==>RADIATION EXPOSURE METHOD [12S] ^ (#.3213) AGENT ORANGE EXPOSURE LOCATION [13S] ^ (#.3214) FILIPINO VETERAN PROOF
==>[14S] ^ (#.32115) PROJ 112/SHAD [15S] ^ (#.32116) TOXIC EXPOSURE RISK ACTIVITY [16S] ^ (#.32117) PERSIAN GULF
==>INDICATOR [17S] ^ (#.32118) PERSIAN GULF LAST CHANGE DATE [18D] ^
^DPT(D0,.3215,0)=^2.3215IS^^ (#.3215) SERVICE [OEF OR OIF]
^DPT(D0,.3215,D1,0)= (#.01) LOCATION OF SERVICE [1S] ^ (#.02) OEF/OIF FROM DATE [2D] ^ (#.03) OEF/OIF TO DATE [3D] ^ (#.04) DATA
==>LOCKED [4S] ^ (#.05) RECORDED DATE/TIME [5D] ^ (#.06) ENTERED BY SITE [6P:4] ^
^DPT(D0,.3216,0)=^2.3216D^^ (#.3216) MILITARY SERVICE EPISODE
^DPT(D0,.3216,D1,0)= (#.01) SERVICE ENTRY DATE [1D] ^ (#.02) SERVICE SEPARATION DATE [2D] ^ (#.03) SERVICE BRANCH [3P:23] ^
==>(#.04) SERVICE COMPONENT [4S] ^ (#.05) SERVICE NUMBER [5F] ^ (#.06) SERVICE DISCHARGE TYPE [6P:25] ^ (#.07)
==>DATA LOCKED [7S] ^ (#.08) FUTURE DISCHARGE DATE [8D] ^ (#.09) REASON FOR EARLY SEPARATION [9F] ^ (#.1)
==>SEPARATION REASON CODE [10P:26] ^
^DPT(D0,.3217)= (#.321701) CAMP LEJEUNE [1S] ^ (#.321702) CAMP LEJEUNE DATE [2D] ^ (#.321703) CAMP LEJEUNE CHANGE SITE [3F] ^
==>(#.321704) CAMP LEJEUNE SOURCE [4F] ^
^DPT(D0,.32171)= (#.32171) CAMP LEJEUNE DATA ENTRY LOCKED [1S] ^
^DPT(D0,.322)= (#.3221) LEBANON SERVICE INDICATED? [1S] ^ (#.3222) LEBANON FROM DATE [2D] ^ (#.3223) LEBANON TO DATE [3D] ^
==>(#.3224) GRENADA SERVICE INDICATED? [4S] ^ (#.3225) GRENADA FROM DATE [5D] ^ (#.3226) GRENADA TO DATE [6D] ^
==>(#.3227) PANAMA SERVICE INDICATED? [7S] ^ (#.3228) PANAMA FROM DATE [8D] ^ (#.3229) PANAMA TO DATE [9D] ^
==>(#.32201) PERSIAN GULF SERVICE? [10S] ^ (#.322011) PERSIAN GULF FROM DATE [11D] ^ (#.322012) PERSIAN GULF TO DATE
==>[12D] ^ (#.322013) SOUTHWEST ASIA CONDITIONS? [13S] ^ (#.322014) SW ASIA COND REGISTRATION DATE [14D] ^ (#.322015)
==>SW ASIA COND EXAM DATE [15D] ^ (#.322016) SOMALIA SERVICE INDICATED? [16S] ^ (#.322017) SOMALIA FROM DATE [17D] ^
==>(#.322018) SOMALIA TO DATE [18D] ^ (#.322019) YUGOSLAVIA SERVICE INDICATED? [19S] ^ (#.32202) YUGOSLAVIA FROM DATE
==>[20D] ^ (#.322021) YUGOSLAVIA TO DATE [21D] ^
^DPT(D0,.3291)= (#.32911) SERVICE COMPONENT [LAST] [1S] ^ (#.32912) SERVICE COMPONENT [NTL] [2S] ^ (#.32913) SERVICE COMPONENT
==>[NNTL] [3S] ^
^DPT(D0,.33)= (#.331) E-NAME [1F] ^ (#.332) E-RELATIONSHIP TO PATIENT [2F] ^ (#.333) E-STREET ADDRESS [LINE 1] [3F] ^ (#.334)
==>E-STREET ADDRESS [LINE 2] [4F] ^ (#.335) E-STREET ADDRESS [LINE 3] [5F] ^ (#.336) E-CITY [6F] ^ (#.337) E-STATE
==>[7P:5] ^ (#.338) E-ZIP CODE [8F] ^ (#.339) E-PHONE NUMBER [9F] ^ (#.3305) E-EMER. CONTACT SAME AS NOK? [10S] ^
==>(#.33011) E-WORK PHONE NUMBER [11F] ^ (#.3306) E-COUNTRY [12P:779.004] ^ (#.3307) E-PROVINCE [13F] ^ (#.3308)
==>E-POSTAL CODE [14F] ^ (#.3309) E-RELATIONSHIP TYPE [15P:12.11] ^
^DPT(D0,.331)= (#.3311) E2-NAME OF SECONDARY CONTACT [1F] ^ (#.3312) E2-RELATIONSHIP TO PATIENT [2F] ^ (#.3313) E2-STREET ADDRESS
==>[LINE 1] [3F] ^ (#.3314) E2-STREET ADDRESS [LINE 2] [4F] ^ (#.3315) E2-STREET ADDRESS [LINE 3] [5F] ^ (#.3316)
==>E2-CITY [6F] ^ (#.3317) E2-STATE [7P:5] ^ (#.3318) E2-ZIP CODE [8F] ^ (#.3319) E2-PHONE NUMBER [9F] ^ ^
==>(#.331011) E2-WORK PHONE NUMBER [11F] ^ (#.331012) E2-COUNTRY [12P:779.004] ^ (#.331013) E2-PROVINCE [13F] ^
==>(#.331014) E2-POSTAL CODE [14F] ^ (#.331015) E2-RELATIONSHIP TYPE [15P:12.11] ^
^DPT(D0,.332)= (#.33012) E-CONTACT CHANGE DATE/TIME [1D] ^ (#.33112) E2-CONTACT CHANGE DATE/TIME [2D] ^ (#.3412) DESIGNEE CHANGE
==>DATE/TIME [3D] ^
^DPT(D0,.34)= (#.341) D-NAME OF DESIGNEE [1F] ^ (#.342) D-RELATIONSHIP TO PATIENT [2F] ^ (#.343) D-STREET ADDRESS [LINE 1] [3F] ^
==>(#.344) D-STREET ADDRESS [LINE 2] [4F] ^ (#.345) D-STREET ADDRESS [LINE 3] [5F] ^ (#.346) D-CITY [6F] ^ (#.347)
==>D-STATE [7P:5] ^ (#.348) D-ZIP CODE [8F] ^ (#.349) D-PHONE NUMBER [9F] ^ (#.3405) D-DESIGNEE SAME AS NOK? [10S] ^
==>(#.34011) D-WORK PHONE NUMBER [11F] ^ (#.34012) D-COUNTRY [12P:779.004] ^ (#.34013) D-PROVINCE [13F] ^ (#.34014)
==>D-POSTAL CODE [14F] ^ (#.34015) D-RELATIONSHIP TYPE [15P:12.11] ^
^DPT(D0,.35)= (#.351) DATE OF DEATH [1D] ^ (#.352) DEATH ENTERED BY [2P:200] ^ (#.353) SOURCE OF NOTIFICATION [3P:47.76] ^
==>(#.354) DATE OF DEATH LAST UPDATED [4D] ^ (#.355) LAST EDITED BY [5P:200] ^ ^ (#.357) SUPPORTING DOCUMENT TYPE
==>[7P:47.75] ^ (#.358) DATE OF DEATH OPTION USED [8S] ^
^DPT(D0,.36)= (#.361) PRIMARY ELIGIBILITY CODE [1P:8] ^ (#.362) DISABILITY RET. FROM MILITARY? [2S] ^ (#.363) PRIMARY LONG ID
==>[3F] ^ (#.364) PRIMARY SHORT ID [4F] ^ ^ ^ ^ (#.368) SERVICE DENTAL INJURY? [8S] ^ (#.369) SERVICE TEETH
==>EXTRACTED? [9S] ^ ^ (#.3601) COLLATERAL SPONSOR'S NAME [11P:2] ^ (#.3602) MILITARY DISABILITY RETIREMENT [12S] ^
==>(#.3603) DISCHARGE DUE TO DISABILITY [13S] ^
^DPT(D0,.361)= (#.3611) ELIGIBILITY STATUS [1S] ^ (#.3612) ELIGIBILITY STATUS DATE [2D] ^ (#.3613) ELIGIBILITY VERIF. SOURCE [3S]
==>^ (#.3614) ELIGIBILITY INTERIM RESPONSE [4D] ^ (#.3615) ELIGIBILITY VERIF. METHOD [5F] ^ (#.3616) ELIGIBILITY
==>STATUS ENTERED BY [6P:200] ^ (#.3617) USER ENROLLEE VALID THROUGH [7D] ^ (#.3618) USER ENROLLEE SITE [8P:4] ^
^DPT(D0,.362)= (#.3621) AMOUNT OF AID & ATTENDANCE [1N] ^ (#.3622) AMOUNT OF HOUSEBOUND [2N] ^ (#.3623) *AMOUNT OF SOCIAL
==>SECURITY [3N] ^ (#.3624) AMOUNT OF VA PENSION [4N] ^ (#.3625) *AMOUNT OF MILITARY RETIREMENT [5N] ^ (#.3626)
==>AMOUNT OF GI INSURANCE [6N] ^ (#.3627) AMOUNT OF SSI [7N] ^ (#.3628) AMOUNT OF OTHER RETIREMENT [8N] ^ (#.3629)
==>AMOUNT OF OTHER INCOME [9N] ^ ^ ^ (#.36205) RECEIVING A&A BENEFITS? [12S] ^ (#.36215) RECEIVING HOUSEBOUND
==>BENEFITS? [13S] ^ (#.36235) RECEIVING A VA PENSION? [14S] ^ (#.36225) RECEIVING SOCIAL SECURITY? [15S] ^ (#.36255)
==>RECEIVING MILITARY RETIREMENT? [16S] ^ (#.36265) GI INSURANCE POLICY? [17S] ^ (#.36285) TYPE OF OTHER RETIREMENT
==>[18S] ^ (#.36275) RECEIVING SUP. SECURITY (SSI)? [19S] ^ (#.36295) TOTAL ANNUAL VA CHECK AMOUNT [20N] ^
^DPT(D0,.37,0)=^2.11D^^ (#.37) DATE OF DENTAL TREATMENT
^DPT(D0,.37,D1,0)= (#.01) DATE OF DENTAL TREATMENT [1D] ^ (#2) CONDITION [2F] ^ (#3) DATE CONDITION FIRST NOTICED [3D] ^
^DPT(D0,.372,0)=^2.04P^^ (#.3721) RATED DISABILITIES (VA)
^DPT(D0,.372,D1,0)= (#.01) RATED DISABILITIES (VA) [1P:31] ^ (#2) DISABILITY % [2N] ^ (#3) SERVICE CONNECTED [3S] ^ (#4)
==>EXTREMITY AFFECTED [4S] ^ (#5) ORIGINAL EFFECTIVE DATE [5D] ^ (#6) CURRENT EFFECTIVE DATE [6D] ^
^DPT(D0,.373,0)=^2.05A^^ (#.3731) SERVICE CONNECTED CONDITIONS
^DPT(D0,.373,D1,0)= (#.01) SERVICE CONNECTED CONDITIONS [1F] ^ (#.02) PERCENTAGE [2N] ^
^DPT(D0,.38)= (#.381) ELIGIBLE FOR MEDICAID? [1S] ^ (#.382) DATE MEDICAID LAST ASKED [2D] ^ (#.383) MEDICAID NUMBER [3F] ^
^DPT(D0,.385)= (#.3851) PENSION AWARD EFFECTIVE DATE [1D] ^ (#.3852) PENSION AWARD REASON [2P:27.18] ^ (#.3853) PENSION
==>TERMINATED DATE [3D] ^ (#.3854) PENSION TERMINATED REASON 1 [4P:27.18] ^ (#.3855) PENSION TERMINATED REASON 2
==>[5P:27.18] ^ (#.3856) PENSION TERMINATED REASON 3 [6P:27.18] ^ (#.3857) PENSION TERMINATED REASON 4 [7P:27.18] ^
==>(#.3858) CLASS II DENTAL INDICATOR [8S] ^ (#.3859) DENTAL APPL DUE BEFORE DATE [9D] ^ (#.386) PENSION INDICATOR
==>LOCK [10S] ^ (#.3861) PENSION AWARD LOCK [11S] ^
^DPT(D0,.39)= (#.391) DECIDED BY [1F] ^ (#.392) DATE OF DECISION [2D] ^ (#.393) FACILITY MAKING DETERMINATION [3P:4] ^ (#.394)
==>REVIEW DATE [4D] ^ (#.395) METHOD OF DETERMINATION [5S] ^ (#.39) VETERAN CATASTROPHICALLY DISABLED? [6S] ^ (#.3951)
==>DATE VETERAN REQUESTED CD EVAL [7D] ^ (#.3952) DATE FACILITY INITIATED REVIEW [8D] ^ (#.3953) DATE VETERAN WAS
==>NOTIFIED [9D] ^
^DPT(D0,.396,0)=^2.396P^^ (#.396) CD STATUS DIAGNOSES
^DPT(D0,.396,D1,0)= (#.01) CD STATUS DIAGNOSES [1P:27.17] ^
^DPT(D0,.397,0)=^2.397P^^ (#.397) CD STATUS PROCEDURES
^DPT(D0,.397,D1,0)= (#.01) CD STATUS PROCEDURES [1P:27.17] ^ (#1) AFFECTED EXTREMITY [2S] ^
^DPT(D0,.398,0)=^2.398P^^ (#.398) CD STATUS CONDITIONS
^DPT(D0,.398,D1,0)= (#.01) CD STATUS CONDITIONS [1P:27.17] ^ (#1) SCORE [2N] ^ (#2) PERMANENT INDICATOR [3S] ^
^DPT(D0,.399,0)=^2.399DA^^ (#.399) CD HISTORY DATE
^DPT(D0,.399,D1,0)= (#.01) CD HISTORY DATE [1D] ^ (#.391) DECIDED BY [2F] ^ (#.392) DATE OF DECISION [3D] ^ (#.393) FACILITY
==>MAKING DETERMINATION [4P:4] ^ (#.394) REVIEW DATE [5D] ^ (#.395) METHOD OF DETERMINATION [6S] ^ (#.39)
==>VETERAN CATASTROPHICALLY DISABLED? [7S] ^ (#.3951) DATE VETERAN REQUESTED CD EVAL [8D] ^ (#.3952) DATE
==>FACILITY INITIATED REVIEW [9D] ^ (#.3953) DATE VETERAN WAS NOTIFIED [10D] ^
^DPT(D0,.399,D1,1,0)=^2.409PA^^ (#.396) CD REASON
^DPT(D0,.399,D1,1,D2,0)= (#.01) CD REASON [1P:27.17] ^ (#1) AFFECTED EXTREMITY [2S] ^ (#2) SCORE [3N] ^ (#3) PERMANENT INDICATOR
==>[4S] ^
^DPT(D0,.401,0)=^2.401P^^ (#.401) CD DESCRIPTORS
^DPT(D0,.401,D1,0)= (#.01) CD DESCRIPTORS [1P:27.17] ^
^DPT(D0,.52)= ^ ^ ^ ^ (#.525) POW STATUS INDICATED? [5S] ^ (#.526) POW CONFINEMENT LOCATION [6P:22] ^ (#.527) POW FROM DATE
==>[7D] ^ (#.528) POW TO DATE [8D] ^ (#.529) POW STATUS VERIFIED [9D] ^ ^ (#.5291) COMBAT SERVICE INDICATED? [11S] ^
==>(#.5292) COMBAT SERVICE LOCATION [12P:22] ^ (#.5293) COMBAT FROM DATE [13D] ^ (#.5294) COMBAT TO DATE [14D] ^
==>(#.5295) COMBAT VETERAN END DATE [15D] ^ (#.5296) CV DATE EDITED [16D] ^
^DPT(D0,.53)= (#.531) CURRENT PH INDICATOR [1S] ^ (#.532) CURRENT PURPLE HEART STATUS [2S] ^ (#.533) CURRENT PURPLE HEART REMARKS
==>[3S] ^ (#.535) PH DIVISION [4P:4] ^
^DPT(D0,.54)= (#.541) CURRENT MOH INDICATOR [1S] ^ (#.542) MOH AWARD DATE [2D] ^ (#.543) MOH STATUS DATE [3D] ^ (#.544) MOH
==>COPAYMENT EXEMPTION DATE [4D] ^
^DPT(D0,.55)= (#.5501) EXPANDED MH CARE TYPE [1S] ^ (#.5502) AUTOMATIC CHANGE DATE [2D] ^
^DPT(D0,.56)= (#.5601) PRESUMPTIVE PSYCHOSIS CATEGORY [1S] ^
^DPT(D0,.57)= (#.571) INDIAN SELF IDENTIFICATION [1S] ^ (#.572) INDIAN START DATE [2D] ^ (#.573) INDIAN ATTESTATION DATE [3D] ^
==>(#.574) INDIAN END DATE [4D] ^ (#.575) INDIAN SELF IDENT CHANGE DT/TM [5D] ^ (#.576) INDIAN SELF IDENT CHANGE USER
==>[6P:200] ^
^DPT(D0,1,0)=^2.0537026DA^^ (#537026) MHV SOCIALIZATION
^DPT(D0,1,D1,0)= (#.01) SOCIALIZATION DATE [1D] ^ (#1) SOCIALIZATION RESPONSE [2P:390.01] ^
^DPT(D0,1,D1,1,0)=^2.5370262PA^^ (#2) SOCIALIZATION ACTIONS
^DPT(D0,1,D1,1,D2,0)= (#.01) SOCIALIZATION ACTIONS [1P:390.02] ^
^DPT(D0,2)= (#537027) MHV REGISTERED [1S] ^ (#537028) MHV AUTHENTICATED [2S] ^ (#537029) MHV SECURE MESSAGING [3S] ^ (#537030)
==>MHVREG UPDATE DATE/TIME [4D] ^ (#537031) MHVAUTH UPDATE DATE/TIME [5D] ^ (#537032) MHVSM UPDATE DATE/TIME [6D] ^
==>(#537036) MHV REGISTER DECLINED REASON [7P:390.03] ^ (#537037) MHV AUTH DECLINED REASON [8P:390.03] ^ (#537038) MHV
==>MSG DECLINED REASON [9P:390.03] ^
^DPT(D0,2.1)= (#537033) MHV REGISTER DECLINED TEXT [1F] ^
^DPT(D0,2.2)= (#537034) MHV AUTH DECLINED TEXT [1F] ^
^DPT(D0,2.3)= (#537035) MHV MSG DECLINED TEXT [1F] ^
^DPT(D0,3,0)=^2.0537041P^^ (#537041) MHV MSG ACTIONS
^DPT(D0,3,D1,0)= (#.01) MHV MSG ACTIONS [1P:390.02] ^
^DPT(D0,4,0)=^2.0537042P^^ (#537042) MHV AUTH ACTIONS
^DPT(D0,4,D1,0)= (#.01) MHV AUTH ACTIONS [1P:390.02] ^
^DPT(D0,5,0)=^2.191DA^^ (#1910) COMMUNITY CARE PROGRAM
^DPT(D0,5,D1,0)= (#.01) CCP LAST UPDATED DATE [1D] ^ (#1) COMMUNITY CARE PROGRAM CODE [2S] ^ (#2) EFFECTIVE DATE [3D] ^ (#3) END
==>DATE [4D] ^ (#4) ARCHIVE [5S] ^
^DPT(D0,57)= (#57.1) *HEIGHT(cm) [1N] ^ (#57.2) *WEIGHT(kg) [2N] ^ ^ (#57.4) SPINAL CORD INJURY [4S] ^
^DPT(D0,1010.15)= (#1010.151) MOST RECENT DATE OF CARE [1D] ^ (#1010.152) MOST RECENT LOCATION OF CARE [2P:4] ^ (#1010.153) 2ND
==>MOST RECENT DATE OF CARE [3D] ^ (#1010.154) 2ND MOST RECENT LOCATION [4P:4] ^ (#1010.15) RECEIVED VA CARE
==>PREVIOUSLY? [5S] ^ (#1010.156) MOST RECENT 1010EZ [6P:712] ^ (#1010.157) COMBAT INDICATED ON 1010EZ [7S] ^
==>(#1010.158) DISABILITY DISCHARGE ON 1010EZ [8S] ^ (#1010.159) APPOINTMENT REQUEST ON 1010EZ [9S] ^ ^
==>(#1010.1511) APPOINTMENT REQUEST DATE [11D] ^ (#1010.1512) ORIGINAL APPOINTMENT REQUEST [12S] ^ (#1010.1513)
==>ORIGINAL APPT REQUEST DATE [13D] ^ (#1010.1514) ORIG APPT REQUEST CHG DT/TM [14D] ^ (#1010.1515) APPT REQUEST
==>1010EZ CHG DT/TM [15D] ^
^DPT(D0,1010.16)= (#1010.161) APPOINTMENT REQUEST STATUS [1S] ^ (#1010.162) DATE STATUS LAST EDITED [2D] ^ (#1010.163)
==>APPOINTMENT REQUEST COMMENT [3F] ^ (#1010.164) DATE COMMENT LAST EDITED [4D] ^
^DPT(D0,3000)= (#3000) VTS PATIENT FLAG [1S] ^
^DPT(D0,537025)= (#537025) NETWORK IDENTIFIER [1F] ^
^DPT(D0,ARCH,0)=^2.12SA^^ (#1903) ARCHIVED DATA
^DPT(D0,ARCH,D1,0)= (#.01) DATA TYPE [1S] ^
^DPT(D0,ARCH,D1,1,0)=^2.13DA^^ (#1) DATE OF ARCHIVE
^DPT(D0,ARCH,D1,1,D2,0)= (#.01) DATE OF ARCHIVE [1D] ^ (#1) TAPE # [2F] ^ (#2) BEGIN ARCHIVE DATE [3D] ^ (#3) END ARCHIVE DATE
==>[4D] ^ (#4) NUMBER OF RECORDS ARCHIVED [5N] ^
^DPT(D0,DAC)= (#401.3) CONDITION [1S] ^ (#401.4) DATE ENTERED ON SI LIST [2D] ^
^DPT(D0,DE,0)=^2.001P^^ (#3) ENROLLMENT CLINIC
^DPT(D0,DE,D1,0)= (#.01) ENROLLMENT CLINIC [1P:44] ^ (#2) CURRENT STATUS [2S] ^
^DPT(D0,DE,D1,1,0)=^2.011D^^ (#1) ENROLLMENT DATA
^DPT(D0,DE,D1,1,D2,0)= (#.01) DATE OF ENROLLMENT [1D] ^ (#1) OPT OR AC [2S] ^ (#3) DATE OF DISCHARGE [3D] ^ (#4) REASON FOR
==>DISCHARGE [4F] ^ (#5) REVIEW DATE [5D] ^
^DPT(D0,DENT)= (#220) DENTAL CLASSIFICATION [1P:220.2] ^ (#220.1) DENTAL ELIGIBILITY EXPIRATION [2D] ^
^DPT(D0,DIS,0)=^2.101DA^^ (#1000) DISPOSITION LOG-IN DATE/TIME
^DPT(D0,DIS,D1,0)= (#.01) LOG IN DATE/TIME [1D] ^ (#1) STATUS [2S] ^ (#2) TYPE OF BENEFIT APPLIED FOR [3S] ^ (#3) FACILITY
==>APPLYING TO [4P:40.8] ^ (#4) WHO ENTERED 10/10 [5P:200] ^ (#5) LOG OUT DATE TIME [6D] ^ (#6) DISPOSITION
==>[7P:37] ^ (#8) REASON FOR LATE DISPOSITION [8P:30] ^ (#9) WHO DISPOSITIONED [9P:200] ^ (#50) ACTIVE [10S] ^
==>(#2.1) TYPE OF CARE APPLIED FOR [11S] ^ (#12) *ELIGIBLE FOR MEDICAID [12S] ^ (#13) REGISTRATION ELIGIBILITY
==>CODE [13P:8] ^ (#14) ELIG VERIFIED AT REGISTRATION [14S] ^ (#15) SC AT REGISTRATION [15S] ^ (#16) SC% AT
==>REGISTRATION [16N] ^ (#17) AMIS 420 SEGMENT [17P:391.1] ^ (#18) OUTPATIENT ENCOUNTER [18P:409.68] ^ (#19)
==>ENCOUNTER CONVERSION STATUS [19S] ^ (#.2) 10-10T REGISTRATION [20S] ^ (#100.21) ATTORNEY'S NAME COMPONENTS
==>[21P:20] ^ (#7) EXAMINED IN MEDICAL CENTER [22S] ^
^DPT(D0,DIS,D1,1)= (#10) DESCRIPTION OF INCIDENT [1F] ^
^DPT(D0,DIS,D1,2)= (#20) NEED RELATED TO OCCUPATION [1S] ^ (#21) WORKMEN'S COMP CLAIM FILED [2S] ^ (#22) WORKMEN'S COMP CLAIM
==>NUMBER [3F] ^ (#23) NEED RELATED TO AN ACCIDENT [4S] ^ (#24) INJURY CAUSED BY [5F] ^ (#25) INJURING PARTIES
==>INSURANCE [6P:36] ^ (#26) FILED AGAINST INJURING PARTY [7S] ^
^DPT(D0,DIS,D1,3)= (#30) ATTORNEY'S NAME [1F] ^ (#31) A-ADDRESS 1 [2F] ^ (#32) A-ADDRESS 2 [3F] ^ (#33) A-ADDRESS 3 [4F] ^ (#34)
==>A-CITY [5F] ^ (#35) A-STATE [6P:5] ^ (#36) A-ZIP CODE [7F] ^ (#37) A-PHONE [8F] ^ (#38) A-ZIP+4 [9F] ^
^DPT(D0,DIS,D1,ODS)= (#11500.01) ODS AT REGISTRATION? [1S] ^ (#11500.02) ODS REGISTRATION ENTRY [2P:11500.4] ^
^DPT(D0,E,0)=^2.0361IP^^ (#361) PATIENT ELIGIBILITIES
^DPT(D0,E,D1,0)= (#.01) ELIGIBILITY [1P:8] ^ ^ (#.03) LONG ID [3F] ^ (#.04) SHORT ID [4F] ^
^DPT(D0,ENR)= (#27.01) CURRENT ENROLLMENT [1P:27.11] ^ (#27.02) PREFERRED FACILITY [2P:4] ^ (#27.03) SOURCE DESIGNATION [3S] ^
==>(#27.04) PT APPLIED FOR ENROLLMENT? [4S] ^
^DPT(D0,FFP)= (#1100.01) FUGITIVE FELON FLAG [1S] ^ (#1100.02) FFF ENTERED BY [2P:200] ^ (#1100.03) FFF DATE ENTERED [3D] ^
==>(#1100.04) FFF REMOVED BY [4P:200] ^ (#1100.05) FFF DATE REMOVED [5D] ^ ^ ^ ^ (#1100.09) FFF REMOVAL REMARKS
==>[9F] ^
^DPT(D0,HBP,0)=^2.2511PA^^ (#25.01) CURRENT HEALTH BENEFIT PLAN
^DPT(D0,HBP,D1,0)= (#.01) CURRENT HBP CODE [1P:25.11] ^ (#1) ASSIGNED DATE AND TIME [2D] ^ (#2) ASSIGNED ENTERED BY [3P:200] ^
==>(#3) ASSIGNED ENTERED SITE [4P:4] ^ (#4) CURRENT SOURCE [5S] ^
^DPT(D0,HBP1,0)=^2.2512DA^^ (#25.02) HISTORY HEALTH BENEFIT PLAN
^DPT(D0,HBP1,D1,0)= (#.01) HISTORY HBP DATE/TIME [1D] ^ (#1) HISTORY HBP CODE [2P:25.11] ^ (#2) HISTORY ENTERED BY [3P:200] ^
==>(#3) HISTORY ENTERED SITE [4P:4] ^ (#4) HISTORY ASSIGNMENT [5S] ^ (#5) HISTORY SOURCE [6S] ^
^DPT(D0,INE)= (#.1651) INELIGIBLE TWX SOURCE [1S] ^ ^ (#.1653) INELIGIBLE TWX CITY [3F] ^ (#.1654) INELIGIBLE TWX STATE [4P:5] ^
==> ^ (#.1656) INELIGIBLE VARO DECISION [6F] ^ (#.1657) MISSING PERSON TWX SOURCE [7S] ^ (#.1658) MISSING PERSON TWX
==>CITY [8F] ^ (#.1659) MISSING PERSON TWX STATE [9P:5] ^
^DPT(D0,INS)= (#2001) DATE LAST EICD RUN [1D] ^
^DPT(D0,KATR)= (#.182) HISTORIC KATRINA ERI [1S] ^
^DPT(D0,LR)= (#63) LABORATORY REFERENCE [1P:63] ^
^DPT(D0,LRT)= (#67) LAB REFERRAL REF [1P:67] ^
^DPT(D0,MPI)= (#991.01) INTEGRATION CONTROL NUMBER [1N] ^ (#991.02) ICN CHECKSUM [2F] ^ (#991.03) COORDINATING MASTER OF RECORD
==>[3P:4] ^ (#991.04) LOCALLY ASSIGNED ICN [4S] ^ (#991.05) SUBSCRIPTION CONTROL NUMBER [5P:774] ^ (#991.06) CMOR
==>ACTIVITY SCORE [6N] ^ (#991.07) SCORE CALCULATION DATE [7D] ^ (#991.08) TEMPORARY ID NUMBER [8F] ^ (#991.09)
==>FOREIGN ID NUMBER [9F] ^ (#991.1) FULL ICN [10F] ^ (#991.11) INDIVIDUAL TAX ID [11N] ^
^DPT(D0,MPICMOR,0)=^2.0993A^^ (#993) CMOR HISTORY
^DPT(D0,MPICMOR,D1,0)= (#.01) CMOR HISTORY [1N] ^ (#1) CMOR ACTIVITY SCORE [2N] ^ (#2) CMOR SCORE CALCULATION DATE [3D] ^ (#3)
==>CMOR CHANGE DATE [4D] ^
^DPT(D0,MPIFHIS,0)=^2.0992A^^ (#992) ICN HISTORY
^DPT(D0,MPIFHIS,D1,0)= (#.01) ICN HISTORY [1N] ^ (#1) ICN CHECKSUM [2N] ^ (#2) CMOR [3P:4] ^ (#3) DATE/TIME OF CHANGE [4D] ^
^DPT(D0,MPIFICNHIS,0)=^2.0991A^^ (#991.91) FULL ICN HISTORY
^DPT(D0,MPIFICNHIS,D1,0)= (#.01) FULL ICN HISTORY [1F] ^
^DPT(D0,MPIMB)= (#994) MULTIPLE BIRTH INDICATOR [1S] ^
^DPT(D0,NAME)= (#1.01) NAME COMPONENTS [1P:20] ^ (#1.02) K-NAME COMPONENTS [2P:20] ^ (#1.03) K2-NAME COMPONENTS [3P:20] ^ (#1.04)
==>FATHER'S NAME COMPONENTS [4P:20] ^ (#1.05) MOTHER'S NAME COMPONENTS [5P:20] ^ (#1.06) MOTHERS MAIDEN NAME
==>COMPONENTS [6P:20] ^ (#1.07) E-NAME COMPONENTS [7P:20] ^ (#1.08) E2-NAME COMPONENTS [8P:20] ^ (#1.09) D-NAME
==>COMPONENTS [9P:20] ^
^DPT(D0,NHC)= (#148) CNH CURRENT [1S] ^
^DPT(D0,ODS)= (#11500.01) INITIAL ODS TREATMENT RECEIVED [1D] ^ (#11500.02) RECALLED TO ACTIVE DUTY [2S] ^ (#11500.03) RANK
==>[3P:25002.1] ^
^DPT(D0,PC)= (#404.01) *CURRENT PC PRACTITIONER [1P:200] ^ (#404.02) *CURRENT PC TEAM [2P:404.51] ^
^DPT(D0,PH,0)=^2.0534DA^^ (#534) PH DATE/TIME UPDATED
^DPT(D0,PH,D1,0)= (#.01) PH DATE/TIME UPDATED [1D] ^ (#1) PH? [2S] ^ (#2) PH STATUS [3S] ^ (#3) PH REMARKS [4S] ^ (#4) PH USER
==>[5F] ^
^DPT(D0,PI)= (#53) *REACTIONS [1S] ^
^DPT(D0,S,0)=^2.98P^^ (#1900) APPOINTMENT
^DPT(D0,S,D1,0)= (#.01) CLINIC [1P:44] ^ (#3) STATUS [2S] ^ (#5) LAB DATE/TIME [3D] ^ (#6) X-RAY DATE/TIME [4D] ^ (#7) EKG
==>DATE/TIME [5D] ^ (#8) ROUTING SLIP PRINTED [6S] ^ (#9) PURPOSE OF VISIT [7S] ^ (#10) SPECIAL SURVEY DISPOSITION
==>[8N] ^ (#11) NUMBER OF COLLATERAL SEEN [9N] ^ (#12) AUTO-REBOOKED APPT. DATE/TIME [10D] ^ (#13) COLLATERAL VISIT
==>[11S] ^ (#14) NO-SHOW/CANCELLED BY [12P:200] ^ (#8.5) ROUTING SLIP PRINT DATE [13D] ^ (#15) NO-SHOW/CANCEL
==>DATE/TIME [14D] ^ (#16) CANCELLATION REASON [15P:409.2] ^ (#9.5) APPOINTMENT TYPE [16P:409.1] ^ (#18) APPT.
==>CANCELLED [17P:44] ^ (#19) DATA ENTRY CLERK [18P:200] ^ (#20) DATE APPT. MADE [19D] ^ (#21) OUTPATIENT ENCOUNTER
==>[20P:409.68] ^ (#22) ENCOUNTER FORMS PRINTED [21S] ^ (#23) ENCOUNTER FORMS AS ADD-ONS [22S] ^ (#23.1) ENCOUNTER
==>CONVERSION STATUS [23S] ^ (#24) APPOINTMENT TYPE SUB-CATEGORY [24P:35.2] ^ (#25) SCHEDULING REQUEST TYPE [25S] ^
==>(#26) NEXT AVA. APPT. INDICATOR [26S] ^
^DPT(D0,S,D1,1)= (#27) DESIRED DATE OF APPOINTMENT [1D] ^ (#28) FOLLOW-UP VISIT [2S] ^ (#29) SCHEDULING APPLICATION [3F] ^ (#30)
==>SCHEDULER NAME [4F] ^
^DPT(D0,S,D1,R)= (#17) CANCELLATION REMARKS [1F] ^
^DPT(D0,SSN)= (#.0906) PSEUDO SSN REASON [1S] ^ (#.0907) SSN VERIFICATION STATUS [2S] ^
^DPT(D0,TYPE)= (#391) TYPE [1P:391] ^
^DPT(D0,VET)= (#1901) VETERAN (Y/N)? [1S] ^
INPUT TEMPLATE(S):
^DIE(1505)= A1CK VARO/DHCP Compiled: ^A1CKC
^DIE(421)= DG CONSISTENCY CHECKER Compiled: ^DGRPXC
^DIE(413)= DG EMPLOYER
^DIE(420)= DG LOAD EDIT SCREEN 7 Compiled: ^DGRPX7
^DIE(418)= DGCOLLATERAL
^DIE(1719)= DGEN NEACL
^DIE(414)= DGREG
^DIE(415)= DGREGE
^DIE(416)= DGREGEO
^DIE(422)= DGRP COLLATERAL REGISTER Compiled: ^DGRPXR
^DIE(1476)= DGRPT 10-10T REGISTRATION Compiled: ^DGRPTX
^DIE(965)= DVBA C ADD 2507 PAT Compiled: ^DVBAXA
^DIE(961)= DVBA ELIGIBILITY EDIT
^DIE(960)= DVBHINQ UPDATE Compiled: ^DVBHCE
^DIE(417)= FBAA ADDRESS EDIT
^DIE(1717)= IBCN PATIENT INSURANCE
^DIE(866)= PSO OUTPT
^DIE(867)= PSO OUTPTA
^DIE(486)= SDM1 Compiled: ^SDM1T
PRINT TEMPLATE(S):
^DIPT(1407)= DG BAI
^DIPT(193)= DG FEMALE HISTORICAL
^DIPT(191)= DG FEMALE INPATIENTS
^DIPT(190)= DG SI LIST
^DIPT(192)= DGDISPOSTIONS
^DIPT(1218)= DGENCD ELIG CODE
^DIPT(1219)= DGENCD ELIG HDR
^DIPT(195)= DGOPENDISPOSITIONS
^DIPT(513)= DVBHINQ PAT-HINQ COMP Compiled: ^DVBHCG
^DIPT(253)= IBNOTVER
^DIPT(477)= RT WARD LIST
^DIPT(1563)= SDL--PREAPPOINTMENT LETTERS
SORT TEMPLATE(S):
^DIBT(839)= DG BAI
^DIBT(102)= DG FEMALE INPATIENTS
^DIBT(103)= DPTNS 02/03/88@08:57
^DIBT(133)= IBNOTVER
^DIBT(134)= IBNOTVER1
^DIBT(224)= RT ALL INPATIENTS
^DIBT(223)= RT WARD LIST
FORM(S)/BLOCK(S):