GLOBAL MAP DATA DICTIONARY #509850.9 -- AUDIOMETRIC EXAM DATA FILE 3/24/25 PAGE 1
STORED IN ^ACK(509850.9, *** NO DATA STORED YET *** SITE: WWW.BMIRWIN.COM UCI: VISTA,VISTA (VERSION 3.0)
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This file is used to maintain a record of audiological exams. It contains all of the air conduction, bone conduction and word
recognition test results.
When signed (DATE SIGNED field), the results are transmitted to the Denver Distribution Center to be stored in a national database.
The information from the last exam received for a patient is also added to hearing aid orders for the patient placed through the
Remote Order Entry System(ROES3.0) at the DDC.
Data for this file is only entered through the Audiometric Exam Module GUI application: ACKQROES3E. Entering data in any other
way, may have unpredictable results, as help for individual fields and most data validation takes place in that application.
An accompanying GUI application: ACKQROES3 uses the data in this file to create a graphical audiogram.
CROSS
REFERENCED BY: TESTING STATION(AC), DATE/TIME OF VISIT(B), PATIENT(DFN), PATIENT(DFN2), ICN(ICN), DFN NAME TEXT(NAME),
PATIENT(NL4), DFN NAME TEXT(NM), PATIENT(NM2), SSN TEXT(SSN), PATIENT(SSN2)
INDEXED BY: PATIENT & DATE/TIME OF VISIT (DFN), DFN NAME TEXT & SSN TEXT (NAME)
^ACK(509850.9,D0,0)= (#.01) DATE/TIME OF VISIT [1D] ^ (#.02) PATIENT [2P:2] ^ (#.03) EXAMINING AUDIOLOGIST [3P:200] ^ (#.04)
==>REFERRAL SOURCE [4P:44] ^ (#.05) AGE AT VISIT [5N] ^ (#.06) *VA ELIGIBILITY STATUS [6S] ^ (#.07) TYPE OF
==>VISIT [7F] ^ (#.08) TRANSDUCER TYPE [8S] ^ (#.09) DATE SIGNED [9D] ^ (#.1) TESTING STATION [10P:4] ^ (#.11)
==>ICN [11F] ^ (#.12) DATE SENT TO DDC [12D] ^ (#.13) MESSAGE NUMBER [13P:3.9] ^ (#.14) CLAIM NUMBER [14F] ^
==>(#.15) RETRANSMISSION DATE [15D] ^ (#.16) RETRANSMISSION USER [16P:200] ^
^ACK(509850.9,D0,1)= (#1.01) RIGHT FOUR FREQUENCY PTA [1N] ^ (#1.02) LEFT FOUR FREQUENCY PTA [2N] ^ (#1.03) RIGHT THREE FREQUENCY
==>PTA [3N] ^ (#1.04) LEFT THREE FREQUENCY PTA [4N] ^ (#1.05) RIGHT TWO FREQUENCY PTA [5N] ^ (#1.06) LEFT TWO
==>FREQUENCY PTA [6N] ^ (#1.07) RIGHT MCL [7N] ^ (#1.08) RIGHT UCL [8N] ^ (#1.09) LEFT MCL [9N] ^ (#1.1) LEFT
==>UCL [10N] ^ (#1.11) R TYMPANOGRAM TYPE [11S] ^ (#1.12) L TYMPANOGRAM TYPE [12S] ^
^ACK(509850.9,D0,10)= (#10.01) INITIAL A/C THRESHOLD R 125 [1F] ^ (#10.02) INITIAL A/C THRESHOLD R 250 [2F] ^ (#10.03) INITIAL
==>A/C THRESHOLD R 500 [3F] ^ (#10.04) INITIAL A/C THRESHOLD R 750 [4F] ^ (#10.05) INITIAL A/C THRESHOLD R
==>1000 [5F] ^ (#10.06) INITIAL A/C THRESHOLD R 1500 [6F] ^ (#10.07) INITIAL A/C THRESHOLD R 2000 [7F] ^
==>(#10.08) INITIAL A/C THRESHOLD R 3000 [8F] ^ (#10.09) INITIAL A/C THRESHOLD R 4000 [9F] ^ (#10.1) INITIAL
==>A/C THRESHOLD R 6000 [10F] ^ (#10.11) INITIAL A/C THRESHOLD R 8000 [11F] ^ (#10.12) INITIAL A/C THRESHOLD R
==>12000 [12F] ^
^ACK(509850.9,D0,11)= (#11.01) *INITIAL A/C THRESH TAG R 125 [1S] ^ (#11.02) *INITIAL A/C THRESH TAG R 250 [2S] ^ (#11.03)
==>*INITIAL A/C THRESH TAG R 500 [3S] ^ (#11.04) *INITIAL A/C THRESH TAG R 750 [4S] ^ (#11.05) *INITIAL A/C
==>THRESH TAG R 1000 [5S] ^ (#11.06) *INITIAL A/C THRESH TAG R 1500 [6S] ^ (#11.07) *INITIAL A/C THRESH TAG R
==>2000 [7S] ^ (#11.08) *INITIAL A/C THRESH TAG R 3000 [8S] ^ (#11.09) *INITIAL A/C THRESH TAG R 4000 [9S] ^
==>(#11.1) *INITIAL A/C THRESH TAG R 6000 [10S] ^ (#11.11) *INITIAL A/C THRESH TAG R 8000 [11S] ^ (#11.12)
==>*INITIAL A/C THRESH TAG R12000 [12S] ^
^ACK(509850.9,D0,15)= (#15.01) RETEST A/C THRESHOLD R 125 [1F] ^ (#15.02) RETEST A/C THRESHOLD R 250 [2F] ^ (#15.03) RETEST A/C
==>THRESHOLD R 500 [3F] ^ (#15.04) RETEST A/C THRESHOLD R 750 [4F] ^ (#15.05) RETEST A/C THRESHOLD R 1000 [5F]
==>^ (#15.06) RETEST A/C THRESHOLD R 1500 [6F] ^ (#15.07) RETEST A/C THRESHOLD R 2000 [7F] ^ (#15.08) RETEST
==>A/C THRESHOLD R 3000 [8F] ^ (#15.09) RETEST A/C THRESHOLD R 4000 [9F] ^ (#15.1) RETEST A/C THRESHOLD R 6000
==>[10F] ^ (#15.11) RETEST A/C THRESHOLD R 8000 [11F] ^
^ACK(509850.9,D0,20)= (#20.01) FINAL A/C THRESHOLD R 125 [1F] ^ (#20.02) FINAL A/C THRESHOLD R 250 [2F] ^ (#20.03) FINAL A/C
==>THRESHOLD R 500 [3F] ^ (#20.04) FINAL A/C THRESHOLD R 750 [4F] ^ (#20.05) FINAL A/C THRESHOLD R 1000 [5F] ^
==>(#20.06) FINAL A/C THRESHOLD R 1500 [6F] ^ (#20.07) FINAL A/C THRESHOLD R 2000 [7F] ^ (#20.08) FINAL A/C
==>THRESHOLD R 3000 [8F] ^ (#20.09) FINAL A/C THRESHOLD R 4000 [9F] ^ (#20.1) FINAL A/C THRESHOLD R 6000 [10F]
==>^ (#20.11) FINAL A/C THRESHOLD R 8000 [11F] ^ (#20.12) FINAL A/C THRESHOLD R 12000 [12F] ^
^ACK(509850.9,D0,21)= (#21.01) *REPEAT A/C THRESH TAG R 125 [1S] ^ (#21.02) *REPEAT A/C THRESH TAG R 250 [2S] ^ (#21.03) *REPEAT
==>A/C THRESH TAG R 500 [3S] ^ (#21.04) *REPEAT A/C THRESH TAG R 750 [4S] ^ (#21.05) *REPEAT A/C THRESH TAG R
==>1000 [5S] ^ (#21.06) *REPEAT A/C THRESH TAG R 1500 [6S] ^ (#21.07) *REPEAT A/C THRESH TAG R 2000 [7S] ^
==>(#21.08) *REPEAT A/C THRESH TAG R 3000 [8S] ^ (#21.09) *REPEAT A/C THRESH TAG R 4000 [9S] ^ (#21.1) *REPEAT
==>A/C THRESH TAG R 6000 [10S] ^ (#21.11) *REPEAT A/C THRESH TAG R 8000 [11S] ^ (#21.12) *REPEAT A/C THRESH
==>TAG R 12000 [12S] ^
^ACK(509850.9,D0,30)= (#30.01) INITIAL A/C THRESHOLD L 125 [1F] ^ (#30.02) INITIAL A/C THRESHOLD L 250 [2F] ^ (#30.03) INITIAL
==>A/C THRESHOLD L 500 [3F] ^ (#30.04) INITIAL A/C THRESHOLD L 750 [4F] ^ (#30.05) INITIAL A/C THRESHOLD L
==>1000 [5F] ^ (#30.06) INITIAL A/C THRESHOLD L 1500 [6F] ^ (#30.07) INITIAL A/C THRESHOLD L 2000 [7F] ^
==>(#30.08) INITIAL A/C THRESHOLD L 3000 [8F] ^ (#30.09) INITIAL A/C THRESHOLD L 4000 [9F] ^ (#30.1) INITIAL
==>A/C THRESHOLD L 6000 [10F] ^ (#30.11) INITIAL A/C THRESHOLD L 8000 [11F] ^ (#30.12) INITIAL A/C THRESHOLD L
==>12000 [12F] ^
^ACK(509850.9,D0,31)= (#31.01) *INITIAL A/C THRESH TAG L 125 [1S] ^ (#31.02) *INITIAL A/C THRESH TAG L 250 [2S] ^ (#31.03)
==>*INITIAL A/C THRESH TAG L 500 [3S] ^ (#31.04) *INITIAL A/C THRESH TAG L 750 [4S] ^ (#31.05) *INITIAL A/C
==>THRESH TAG L 1000 [5S] ^ (#31.06) *INITIAL A/C THRESH TAG L 1500 [6S] ^ (#31.07) *INITIAL A/C THRESH TAG L
==>2000 [7S] ^ (#31.08) *INITIAL A/C THRESH TAG L 3000 [8S] ^ (#31.09) *INITIAL A/C THRESH TAG L 4000 [9S] ^
==>(#31.1) *INITIAL A/C THRESH TAG L 6000 [10S] ^ (#31.11) *INITIAL A/C THRESH TAG L 8000 [11S] ^ (#31.12)
==>*INITIAL A/C THRESH TAG L12000 [12S] ^
^ACK(509850.9,D0,35)= (#35.01) RETEST A/C THRESHOLD L 125 [1F] ^ (#35.02) RETEST A/C THRESHOLD L 250 [2F] ^ (#35.03) RETEST A/C
==>THRESHOLD L 500 [3F] ^ (#35.04) RETEST A/C THRESHOLD L 750 [4F] ^ (#35.05) RETEST A/C THRESHOLD L 1000 [5F]
==>^ (#35.06) RETEST A/C THRESHOLD L 1500 [6F] ^ (#35.07) RETEST A/C THRESHOLD L 2000 [7F] ^ (#35.08) RETEST
==>A/C THRESHOLD L 3000 [8F] ^ (#35.09) RETEST A/C THRESHOLD L 4000 [9F] ^ (#35.1) RETEST A/C THRESHOLD L 6000
==>[10F] ^ (#35.11) RETEST A/C THRESHOLD L 8000 [11F] ^
^ACK(509850.9,D0,40)= (#40.01) FINAL A/C THRESHOLD L 125 [1F] ^ (#40.02) FINAL A/C THRESHOLD L 250 [2F] ^ (#40.03) FINAL A/C
==>THRESHOLD L 500 [3F] ^ (#40.04) FINAL A/C THRESHOLD L 750 [4F] ^ (#40.05) FINAL A/C THRESHOLD L 1000 [5F] ^
==>(#40.06) FINAL A/C THRESHOLD L 1500 [6F] ^ (#40.07) FINAL A/C THRESHOLD L 2000 [7F] ^ (#40.08) FINAL A/C
==>THRESHOLD L 3000 [8F] ^ (#40.09) FINAL A/C THRESHOLD L 4000 [9F] ^ (#40.1) FINAL A/C THRESHOLD L 6000 [10F]
==>^ (#40.11) FINAL A/C THRESHOLD L 8000 [11F] ^ (#40.12) FINAL A/C THRESHOLD L 12000 [12F] ^
^ACK(509850.9,D0,41)= (#41.01) *REPEAT A/C THRESH TAG L 125 [1S] ^ (#41.02) *REPEAT A/C THRESH TAG L 250 [2S] ^ (#41.03) *REPEAT
==>A/C THRESH TAG 500 [3S] ^ (#41.04) *REPEAT A/C THRESH TAAG L 750 [4S] ^ (#41.05) *REPEAT A/C THRESH TAG L
==>1000 [5S] ^ (#41.06) *REPEAT A/C THRESHOLD TAG 1500 [6S] ^ (#41.07) *REPEAT A/C THRESH TAG L 2000 [7S] ^
==>(#41.08) *REPEAT A/C THRESH TAG L 3000 [8S] ^ (#41.09) *REPEAT A/C THRESH TAG L 4000 [9S] ^ (#41.1) *REPEAT
==>A/C THRESH TAG L 6000 [10S] ^ (#41.11) *REPEAT A/C THRESH TAG L 8000 [11S] ^ (#41.12) *REPEAT A/C THRESH
==>TAG L 12000 [12S] ^
^ACK(509850.9,D0,50)= (#50.01) *INITIAL A/C MASK LEVEL R 125 [1N] ^ (#50.02) *INITIAL A/C MASK LEVEL R 250 [2N] ^ (#50.03)
==>*INITIAL A/C MASK LEVELR 500 [3N] ^ (#50.04) *INITIAL A/C MASK LEVEL R 750 [4N] ^ (#50.05) *INITIAL A/C
==>MASK LEVEL R 1000 [5N] ^ (#50.06) *INITIAL A/C MASK LEVEL R 1500 [6N] ^ (#50.07) *INITIAL A/C MASK LEVEL R
==>2000 [7N] ^ (#50.08) *INITIAL A/C MASK LEVEL R 3000 [8N] ^ (#50.09) *INITIAL A/C MASK LEVEL R 4000 [9N] ^
==>(#50.1) *INITIAL A/C MASK LEVEL R 6000 [10N] ^ (#50.11) *INITIAL A/C MASK LEVEL R 8000 [11N] ^ (#50.12)
==>*INITIAL A/C MASK LEVEL R12000 [12N] ^
^ACK(509850.9,D0,51)= (#51.01) FINAL A/C MASK LEVEL R 125 [1F] ^ (#51.02) FINAL A/C MASK LEVEL R 250 [2F] ^ (#51.03) FINAL A/C
==>MASK LEVEL R 500 [3F] ^ (#51.04) FINAL A/C MASK LEVEL R 750 [4F] ^ (#51.05) FINAL A/C MASK LEVEL R 1000
==>[5F] ^ (#51.06) FINAL A/C MASK LEVEL R 1500 [6F] ^ (#51.07) FINAL A/C MASK LEVEL R 2000 [7F] ^ (#51.08)
==>FINAL A/C MASK LEVEL R 3000 [8F] ^ (#51.09) FINAL A/C MASK LEVEL R 4000 [9F] ^ (#51.1) FINAL A/C MASK LEVEL
==>R 6000 [10F] ^ (#51.11) FINAL A/C MASK LEVEL R 8000 [11F] ^ (#51.12) FINAL A/C MASK LEVEL R 12000 [12F] ^
^ACK(509850.9,D0,60)= (#60.01) *INITIAL A/C MASK LEVEL L 125 [1N] ^ (#60.02) *INITIAL A/C MASK LEVEL L 250 [2N] ^ (#60.03)
==>*INITIAL A/C MASK LEVEL L 500 [3N] ^ (#60.04) *INITIAL A/C MASK LEVEL L 750 [4N] ^ (#60.05) *INITIAL A/C
==>MASK LEVEL L 1000 [5N] ^ (#60.06) *INITIAL A/C MASK LEVEL L 1500 [6N] ^ (#60.07) *INITIAL A/C MASK LEVEL L
==>2000 [7N] ^ (#60.08) *INITIAL A/C MASK LEVEL L 3000 [8N] ^ (#60.09) *INITIAL A/C MASK LEVEL L 4000 [9N] ^
==>(#60.1) *INITIAL A/C MASK LEVEL L 6000 [10N] ^ (#60.11) *INITIAL A/C MASK LEVEL L 8000 [11N] ^ (#60.12)
==>*INITIAL A/C MASK LEVEL L12000 [12N] ^
^ACK(509850.9,D0,61)= (#61.01) FINAL A/C MASK LEVEL L 125 [1F] ^ (#61.02) FINAL A/C MASK LEVEL L 250 [2F] ^ (#61.03) FINAL A/C
==>MASK LEVEL L 500 [3F] ^ (#61.04) FINAL A/C MASK LEVEL L 750 [4F] ^ (#61.05) FINAL A/C MASK LEVEL L 1000
==>[5F] ^ (#61.06) FINAL A/C MASK LEVEL L 1500 [6F] ^ (#61.07) FINAL A/C MASK LEVEL L 2000 [7F] ^ (#61.08)
==>FINAL A/C MASK LEVEL L 3000 [8F] ^ (#61.09) FINAL A/C MASK LEVEL L 4000 [9F] ^ (#61.1) FINAL A/C MASK LEVEL
==>L 6000 [10F] ^ (#61.11) FINAL A/C MASK LEVEL L 8000 [11F] ^ (#61.12) FINAL A/C MASK LEVEL L 12000 [12F] ^
^ACK(509850.9,D0,70)= (#70.01) INITIAL B/C THRESHOLD R 250 [1F] ^ (#70.02) INITIAL B/C THRESHOLD R 500 [2F] ^ (#70.03) INITIAL
==>B/C THRESHOLD R 750 [3F] ^ (#70.04) INITIAL B/C THRESHOLD R 1000 [4F] ^ (#70.05) INITIAL B/C THRESHOLD R
==>1500 [5F] ^ (#70.06) INITIAL B/C THRESHOLD R 2000 [6F] ^ (#70.07) INITIAL B/C THRESHOLD R 3000 [7F] ^
==>(#70.08) INITIAL B/C THRESHOLD R 4000 [8F] ^ (#70.09) INITIAL B/C THRESHOLD R 6000 [9F] ^
^ACK(509850.9,D0,71)= (#71.01) *INITIAL B/C THRESH TAG R 250 [1S] ^ (#71.02) *INITIAL B/C THRESH TAG R 500 [2S] ^ (#71.03)
==>*INITIAL B/C THRESH TAG R 750 [3S] ^ (#71.04) *INITIAL B/C THRESH TAG R 1000 [4S] ^ (#71.05) *INITIAL B/C
==>THRESH TAG R 1000 [5S] ^ (#71.06) *INITIAL B/C THRESH TAG R 2000 [6S] ^ (#71.07) *INITIAL B/C THRESH TAG R
==>3000 [7S] ^ (#71.08) *INITIAL B/C THRESH TAG R 4000 [8S] ^ (#71.09) *INITIAL B/C THRESH TAG R 6000 [9S] ^
^ACK(509850.9,D0,72)= (#72.01) RETEST B/C THRESHOLD R 250 [1F] ^ (#72.02) RETEST B/C THRESHOLD R 500 [2F] ^ (#72.03) RETEST B/C
==>THRESHOLD R 750 [3F] ^ (#72.04) RETEST B/C THRESHOLD R 1000 [4F] ^ (#72.05) RETEST B/C THRESHOLD R 1500
==>[5F] ^ (#72.06) RETEST B/C THRESHOLD R 2000 [6F] ^ (#72.07) RETEST B/C THRESHOLD R 3000 [7F] ^ (#72.08)
==>RETEST B/C THRESHOLD R 4000 [8F] ^ (#72.09) RETEST B/C THRESHOLD R 6000 [9F] ^
^ACK(509850.9,D0,75)= (#75.01) FINAL B/C THRESHOLD R 250 [1F] ^ (#75.02) FINAL B/C THRESHOLD R 500 [2F] ^ (#75.03) FINAL B/C
==>THRESHOLD R 750 [3F] ^ (#75.04) FINAL B/C THRESHOLD R 1000 [4F] ^ (#75.05) FINAL B/C THRESHOLD R 1500 [5F]
==>^ (#75.06) FINAL B/C THRESHOLD R 2000 [6F] ^ (#75.07) FINAL B/C THRESHOLD R 3000 [7F] ^ (#75.08) FINAL B/C
==>THRESHOLD R 4000 [8F] ^ (#75.09) FINAL B/C THRESHOLD R 6000 [9F] ^
^ACK(509850.9,D0,76)= (#76.01) *REPEAT B/C THRESH TAG R 250 [1S] ^ (#76.02) *REPEAT B/C THRESH TAG R 500 [2S] ^ (#76.03) *REPEAT
==>B/C THRESH TAG R 750 [3S] ^ (#76.04) *REPEAT B/C THRESH TAG R 1000 [4S] ^ (#76.05) *REPEAT B/C THRESH TAG R
==>1500 [5S] ^ (#76.06) *REPEAT B/C THRESH TAG R 2000 [6S] ^ (#76.07) *REPEAT B/C THRESH TAG R 3000 [7S] ^
==>(#76.08) *REPEAT B/C THRESH TAG R 4000 [8S] ^ (#76.09) *REPEAT B/C THRESH TAG R 6000 [9S] ^
^ACK(509850.9,D0,80)= (#80.01) INITIAL B/C THRESHOLD L 250 [1F] ^ (#80.02) INITIAL B/C THRESHOLD L 500 [2F] ^ (#80.03) INITIAL
==>B/C THRESHOLD L 750 [3F] ^ (#80.04) INITIAL B/C THRESHOLD L 1000 [4F] ^ (#80.05) INITIAL B/C THRESHOLD L
==>1500 [5F] ^ (#80.06) INITIAL B/C THRESHOLD L 2000 [6F] ^ (#80.07) INITIAL B/C THRESHOLD L 3000 [7F] ^
==>(#80.08) INITIAL B/C THRESHOLD L 4000 [8F] ^ (#80.09) INITIAL B/C THRESHOLD L 6000 [9F] ^
^ACK(509850.9,D0,81)= (#81.01) *INITIAL B/C THRESH TAG L 250 [1S] ^ (#81.02) *INITIAL B/C THRESH TAG L 500 [2S] ^ (#81.03)
==>*INITIAL B/C THRESH TAG L 750 [3S] ^ (#81.04) *INITIAL B/C THRESH TAG L 1000 [4S] ^ (#81.05) *INITIAL B/C
==>THRESH TAG L 1500 [5S] ^ (#81.06) *INITIAL B/C THRESH TAG L 2000 [6S] ^ (#81.07) *INITIAL B/C THRESH TAG L
==>3000 [7S] ^ (#81.08) *INITIAL B/C THRESH TAG L 1000 [8S] ^ (#81.09) *INITIAL B/C THRESH TAG L 6000 [9S] ^
^ACK(509850.9,D0,82)= (#82.01) RETEST B/C THRESHOLD L 250 [1F] ^ (#82.02) RETEST B/C THRESHOLD L 500 [2F] ^ (#82.03) RETEST B/C
==>THRESHOLD L 750 [3F] ^ (#82.04) RETEST B/C THRESHOLD L 1000 [4F] ^ (#82.05) RETEST B/C THRESHOLD L 1500
==>[5F] ^ (#82.06) RETEST B/C THRESHOLD L 2000 [6F] ^ (#82.07) RETEST B/C THRESHOLD L 3000 [7F] ^ (#82.08)
==>RETEST B/C THRESHOLD L 4000 [8F] ^ (#82.09) RETEST B/C THRESHOLD L 6000 [9F] ^
^ACK(509850.9,D0,85)= (#85.01) FINAL B/C THRESHOLD L 250 [1F] ^ (#85.02) FINAL B/C THRESHOLD L 500 [2F] ^ (#85.03) FINAL B/C
==>THRESHOLD L 750 [3F] ^ (#85.04) FINAL B/C THRESHOLD L 1000 [4F] ^ (#85.05) FINAL B/C THRESHOLD L 1500 [5F]
==>^ (#85.06) FINAL B/C THRESHOLD L 2000 [6F] ^ (#85.07) FINAL B/C THRESHOLD L 3000 [7F] ^ (#85.08) FINAL B/C
==>THRESHOLD L 4000 [8F] ^ (#85.09) FINAL B/C THRESHOLD L 6000 [9F] ^
^ACK(509850.9,D0,86)= (#86.01) *REPEAT B/C THRESH TAG L 250 [1S] ^ (#86.02) *REPEAT B/C THRESH TAG L 500 [2S] ^ (#86.03) *REPEAT
==>B/C THRESH TAG L 750 [3S] ^ (#86.04) *REPEAT B/C THRESH TAG L 1000 [4S] ^ (#86.05) *REPEAT B/C THRESH TAG
==>L 1500 [5S] ^ (#86.06) *REPEAT B/C THRESH TAG L 2000 [6S] ^ (#86.07) *REPEAT B/C THRESH TAG L 3000 [7S] ^
==>(#86.08) *REPEAT B/C THRESH TAG L 4000 [8S] ^ (#86.09) *REPEAT B/C THRESH TAG L 6000 [9S] ^
^ACK(509850.9,D0,90)= (#90.01) *INITIAL B/C MASK LEVEL R 250 [1N] ^ (#90.02) *INITIAL B/C MASK LEVEL R 500 [2N] ^ (#90.03)
==>*INITIAL B/C MASK LEVEL R 750 [3N] ^ (#90.04) *INITIAL B/C MASK LEVEL R 1000 [4N] ^ (#90.05) *INITIAL B/C
==>MASK LEVEL R 1500 [5N] ^ (#90.06) *INITIAL B/C MASK LEVEL R 2000 [6N] ^ (#90.07) *INITIAL B/C MASK LEVEL R
==>3000 [7N] ^ (#90.08) *INITIAL B/C MASK LEVEL R 4000 [8N] ^ (#90.09) *INITIAL B/C MASK LEVEL R 6000 [9N] ^
^ACK(509850.9,D0,91)= (#91.01) FINAL B/C MASK LEVEL R 250 [1F] ^ (#91.02) FINAL B/C MASK LEVEL R 500 [2F] ^ (#91.03) FINAL B/C
==>MASK LEVEL R 750 [3F] ^ (#91.04) FINAL B/C MASK LEVEL R 1000 [4F] ^ (#91.05) FINAL B/C MASK LEVEL R 1500
==>[5F] ^ (#91.06) FINAL B/C MASK LEVEL R 2000 [6F] ^ (#91.07) FINAL B/C MASK LEVEL R 3000 [7F] ^ (#91.08)
==>FINAL B/C MASK LEVEL R 4000 [8F] ^ (#91.09) FINAL B/C MASK LEVEL R 6000 [9F] ^
^ACK(509850.9,D0,100)= (#100.01) *INITIAL B/C MASK LEVEL L [1N] ^ (#100.02) *INITIAL B/C MASK LEVEL L 500 [2N] ^ (#100.03)
==>*INITIAL B/C MASK LEVEL L 750 [3N] ^ (#100.04) *INITIAL B/C MASK LEVEL L 1000 [4N] ^ (#100.05) *INITIAL
==>B/C MASK LEVEL L 1500 [5N] ^ (#100.06) *INITIAL B/C MASK LEVEL L 2000 [6N] ^ (#100.07) *INITIAL B/C MASK
==>LEVEL L 3000 [7N] ^ (#100.08) *INITIAL B/C MASK LEVEL L 4000 [8N] ^ (#100.09) *INITIAL B/C MASK LEVEL 6000
==>[9N] ^
^ACK(509850.9,D0,101)= (#101.01) FINAL B/C MASK LEVEL L 250 [1F] ^ (#101.02) FINAL B/C MASK LEVEL L 500 [2F] ^ (#101.03) FINAL
==>B/C MASK LEVEL L 750 [3F] ^ (#101.04) FINAL B/C MASK LEVEL L 1000 [4F] ^ (#101.05) FINAL B/C MASK LEVEL L
==>1500 [5F] ^ (#101.06) FINAL B/C MASK LEVEL L 2000 [6F] ^ (#101.07) FINAL B/C MASK LEVEL L 3000 [7F] ^
==>(#101.08) FINAL B/C MASK LEVEL L 4000 [8F] ^ (#101.09) FINAL B/C MASK LEVEL L 6000 [9F] ^
^ACK(509850.9,D0,110)= ^ ^ (#110.03) MATERIAL R-1 [3S] ^ (#110.04) PERCENT CORRECT R-1 [4F] ^ (#110.05) PRESENTATION METHOD R-1
==>[5S] ^ (#110.06) PRESENTATION LEVEL R-1 [6N] ^ (#110.07) MASKING LEVEL R-1 [7F] ^ (#110.08) *WORD LIST R-2
==>[8S] ^ (#110.09) PERCENT CORRECT R-2 [9F] ^ (#110.1) *PRESENTATION METHOD R-2 [10S] ^ (#110.11)
==>PRESENTATION LEVEL R-2 [11N] ^ (#110.12) MASKING LEVEL R-2 [12F] ^ (#110.13) *WORD LIST R-3 [13S] ^
==>(#110.14) PERCENT CORRECT R-3 [14F] ^ (#110.15) *PRESENTATION METHOD R-3 [15S] ^ (#110.16) PRESENTATION
==>LEVEL R-3 [16N] ^ (#110.17) MASKING LEVEL R-3 [17F] ^ (#110.18) *WORD LIST R-4 [18S] ^ (#110.19) PERCENT
==>CORRECT R-4 [19F] ^ (#110.2) *PRESENTATION METHOD R-4 [20S] ^ (#110.21) PRESENTATION LEVEL R-4 [21N] ^
==>(#110.22) MASKING LEVEL R-4 [22F] ^ (#110.23) *WORD LIST R-5 [23S] ^ (#110.24) PERCENT CORRECT R-5 [24F] ^
==>(#110.25) *PRESENTATION METHOD R-5 [25S] ^ (#110.26) PRESENTATION LEVEL R-5 [26N] ^ (#110.27) MASKING
==>LEVEL R-5 [27F] ^ (#110.28) LIST R-1 [28F] ^ (#110.29) LIST R-2 [29F] ^ (#110.3) LIST R-3 [30F] ^
==>(#110.31) LIST R-4 [31F] ^ (#110.32) LIST R-5 [32F] ^
^ACK(509850.9,D0,111)= ^ ^ (#111.03) MATERIAL L-1 [3S] ^ (#111.04) PERCENT CORRECT L-1 [4F] ^ (#111.05) *PRESENTATION METHOD
==>L-1 [5S] ^ (#111.06) PRESENTATION LEVEL L-1 [6N] ^ (#111.07) MASKING LEVEL L-1 [7F] ^ (#111.08) *WORD LIST
==>L-2 [8S] ^ (#111.09) PERCENT CORRECT L-2 [9F] ^ (#111.1) *PRESENTATION METHOD L-2 [10S] ^ (#111.11)
==>PRESENTATION LEVEL L-2 [11N] ^ (#111.12) MASKING LEVEL L-2 [12F] ^ (#111.13) *WORD LIST L-3 [13S] ^
==>(#111.14) PERCENT CORRECT L-3 [14F] ^ (#111.15) *PRESENTATION METHOD L-3 [15S] ^ (#111.16) PRESENTATION
==>LEVEL L-3 [16N] ^ (#111.17) MASKING LEVEL L-3 [17F] ^ (#111.18) *WORD LIST L-4 [18S] ^ (#111.19) PERCENT
==>CORRECT L-4 [19F] ^ (#111.2) *PRESENTATION METHOD L-4 [20S] ^ (#111.21) PRESENTATION LEVEL L-4 [21N] ^
==>(#111.22) MASKING LEVEL L-4 [22F] ^ (#111.23) *WORD LIST L-5 [23S] ^ (#111.24) PERCENT CORRECT L-5 [24F] ^
==>(#111.25) *PRESENTATION METHOD L-5 [25S] ^ (#111.26) PRESENTATION LEVEL L-5 [26N] ^ (#111.27) MASKING
==>LEVEL L-5 [27F] ^ (#111.28) LIST L-1 [28F] ^ (#111.29) LIST L-2 [29F] ^ (#111.3) LIST L-3 [30F] ^
==>(#111.31) LIST L-4 [31F] ^ (#111.32) LIST L-5 [32F] ^
^ACK(509850.9,D0,112)= ^ ^ (#112.03) CI WORD LIST R-1 [3S] ^ (#112.04) CI PERCENT CORRECT R-1 [4N] ^ ^ ^ ^ (#112.08) CI WORD
==>LIST R-2 [8S] ^ (#112.09) CI PERCENT CORRECT R-2 [9N] ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^
==> ^ (#112.28) CI NOISE PERCENT RIGHT [28N] ^ (#112.29) CI NOISE MATERIAL RIGHT [29S] ^
^ACK(509850.9,D0,113)= ^ ^ (#113.03) CI WORD LIST L-1 [3S] ^ (#113.04) CI PERCENT CORRECT L-1 [4N] ^ ^ ^ ^ (#113.08) CI WORD
==>LIST L-2 [8S] ^ (#113.09) CI PERCENT CORRECT L-2 [9N] ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^
==> ^ (#113.28) CI NOISE PERCENT LEFT [28N] ^ (#113.29) CI NOISE MATERIAL LEFT [29S] ^
^ACK(509850.9,D0,115)= (#115.01) INITIAL SRT THRESH R [1F] ^ (#115.02) REPEAT SRT THRESH R [2F] ^ (#115.03) INITIAL SRT MASK
==>LEVEL R [3F] ^ (#115.04) FINAL SRT MASK LEVEL R [4F] ^ (#115.05) INITIAL SRT THRESH L [5F] ^ (#115.06)
==>REPEAT SRT THRESH L [6F] ^ (#115.07) INITIAL SRT MASK LEVEL L [7F] ^ (#115.08) FINAL SRT MASK LEVEL L [8F]
==>^ (#115.09) PBMAX R [9N] ^ (#115.1) PBMIN R [10N] ^ (#115.11) PI/PB R [11N] ^ (#115.12) PBMAX L [12N] ^
==>(#115.13) PBMIN L [13N] ^ (#115.14) PI/PB L [14N] ^ (#115.15) *FINAL SRT TAG R [15S] ^ (#115.16) *FINAL
==>SRT TAG L [16S] ^ (#115.17) *INITIAL SRT TAG R [17S] ^ (#115.18) *INITIAL SRT TAG L [18S] ^ (#115.19)
==>APPLIED MAX R [19N] ^ (#115.2) APPLIED MAX L [20N] ^
^ACK(509850.9,D0,120)= (#120.01) MIDDLE EAR PRESSURE R [1F] ^ (#120.02) PK IMMITTANCE 226 R [2N] ^ (#120.03) VEQ - EQUIV EAR
==>CANAL VOL R [3N] ^ (#120.04) IAR THRESHOLD R 500 [4F] ^ (#120.05) IAR THRESHOLD R 1000 [5F] ^ (#120.06)
==>IAR THRESHOLD R 2000 [6F] ^ (#120.07) IAR THRESHOLD R 4000 [7F] ^ (#120.08) CAR THRESHOLD R 500 [8F] ^
==>(#120.09) CAR THRESHOLD R 1000 [9F] ^ (#120.1) CAR THRESHOLD R 2000 [10F] ^ (#120.11) CAR THRESHOLD R 4000
==>[11F] ^ (#120.12) ACOUSTIC REFLEX DECAY R 500 [12S] ^ (#120.13) ACOUSTIC REFLEX DECAY R 1000 [13S] ^
==>(#120.14) AR HALF LIFE 500 R [14F] ^ (#120.15) AR HALF LIFE 1000 R [15F] ^ (#120.16) INTER-TEST
==>CONSISTENCY R [16S] ^ (#120.17) IAR BBN R [17F] ^ (#120.18) CAR BBN R [18F] ^ (#120.19) PK IMMITTANCE 678
==>R [19N] ^ (#120.2) WEBER R [20F] ^ (#120.21) PT STENGER R [21F] ^ (#120.22) RINNE R [22F] ^ (#120.23)
==>OTHER TEST R [23F] ^
^ACK(509850.9,D0,121)= (#121.01) MIDDLE EAR PRESSURE L [1F] ^ (#121.02) PK IMMITTANCE 226 L [2N] ^ (#121.03) VEQ - EQUIV EAR
==>CANAL VOL L [3N] ^ (#121.04) IAR THRESHOLD L 500 [4F] ^ (#121.05) IAR THRESHOLD L 1000 [5F] ^ (#121.06)
==>IAR THRESHOLD L 2000 [6F] ^ (#121.07) IAR THRESHOLD L 4000 [7F] ^ (#121.08) CAR THRESHOLD L 500 [8F] ^
==>(#121.09) CAR THRESHOLD L 1000 [9F] ^ (#121.1) CAR THRESHOLD L 2000 [10F] ^ (#121.11) CAR THRESHOLD L 4000
==>[11F] ^ (#121.12) ACOUSTIC REFLEX DECAY L 500 [12S] ^ (#121.13) ACOUSTIC REFLEX DECAY L 1000 [13S] ^
==>(#121.14) AR HALF LIFE 500 L [14F] ^ (#121.15) AR HALF LIFE 1000 L [15F] ^ (#121.16) INTER-TEST
==>CONSISTENCY L [16S] ^ (#121.17) IAR BBN L [17F] ^ (#121.18) CAR BBN L [18F] ^ (#121.19) PK IMMITTANCE 678
==>L [19N] ^ (#121.2) WEBER L [20F] ^ (#121.21) PT STENGER L [21F] ^ (#121.22) RINNE L [22F] ^ (#121.23)
==>OTHER TEST L [23F] ^
^ACK(509850.9,D0,122,0)=^509850.9122^^ (#122) COMMENTS
^ACK(509850.9,D0,122,D1,0)= (#.01) COMMENTS [1W] ^
^ACK(509850.9,D0,791000)= (#791000.01) SSN TEXT [1F] ^ (#791000.02) DFN NAME TEXT [2F] ^ (#791000.03) EXAMINER NAME TEXT [3F] ^
==>(#791000.04) REFERRAL SOURCE TEXT [4F] ^ (#791000.05) BIRTH DATE [5F] ^ (#791000.06) *ELIGIBILITY
==>STATUS TEXT [6F] ^ (#791000.07) TYPE OF VET TEXT [7F] ^ (#791000.08) STATION NUMBER [8F] ^ (#791000.09)
==>DATE SIGNED AT SITE [9D] ^ (#791000.1) AUDIOMETRIC DATA IEN AT SITE [10N] ^ (#791000.11) SENDING USER
==>[11F] ^ (#791000.12) SENDING SERVICE [12F] ^
INPUT TEMPLATE(S):
PRINT TEMPLATE(S):
SORT TEMPLATE(S):
FORM(S)/BLOCK(S):