STANDARD DATA DICTIONARY #52.91 -- TPB ELIGIBILITY FILE 6/27/25 PAGE 1
STORED IN ^PS(52.91, *** NO DATA STORED YET *** SITE: WWW.BMIRWIN.COM UCI: VISTA,VISTA (VERSION 7.0)
DATA NAME GLOBAL DATA
ELEMENT TITLE LOCATION TYPE
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Transitional Pharmacy Benefit Project (TPB), Phase I (patch PSO*7*145) introduces a new file called TPB ELIGIBILITY file (#52.91),
to store patient data for those who are enrolled in VHA's health care system and eligible for the pharmacy benefit as required by
the Directive, Code of Federal Regulations (CFR) 38 CFR Part 17 RIN 2900-AL68, "Medication Prescribed by Non-VA Physicians".
DD ACCESS: @
RD ACCESS: @
WR ACCESS: @
DEL ACCESS: @
LAYGO ACCESS: @
AUDIT ACCESS: @
APPLICATION GROUP(S): PS
CROSS
REFERENCED BY: INACTIVATION OF BENEFIT DATE(AD), PATIENT(B)
INDEXED BY: INSTITUTION (AC), DATE PHARMACY BENEFIT BEGAN & INACTIVATION OF BENEFIT DATE & INACTIVATION REASON CODE & DESIRED
APPOINTMENT DATE & WAIT TYPE & STATION NUMBER & EXCLUSION REASON & PRIMARY CARE SCHEDULE APT DATE (AX)
52.91,.01 PATIENT 0;1 POINTER TO PATIENT FILE (#2) (Required)
INPUT TRANSFORM: S DINUM=X
LAST EDITED: AUG 07, 2003
HELP-PROMPT: NAME MUST BE 3-30 CHARACTERS, NOT NUMERIC OR STARTING WITH PUNCTUATION
DESCRIPTION:
This is the patient IEN who is eligible for this new service.
DELETE TEST: 1,0)= I 1 D EN^DDIOL("Patient entries CANNOT be deleted.")
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
CROSS-REFERENCE: 52.91^B
1)= S ^PS(52.91,"B",$E(X,1,30),DA)=""
2)= K ^PS(52.91,"B",$E(X,1,30),DA)
52.91,1 DATE PHARMACY BENEFIT BEGAN 0;2 DATE (Required)
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:X<1 X
LAST EDITED: AUG 06, 2003
HELP-PROMPT: (No range limit on date)
DESCRIPTION: This is the date the entry was made into the file during extraction either from the EWL or from the
Schedule Appointment set by the post-install routine. Manual entry to this file is also allowed for
eligible patient, and it will be set to the current date.
TECHNICAL DESCR:
Not editable.
RECORD INDEXES: AX (#254)
52.91,2 INACTIVATION OF BENEFIT DATE 0;3 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X I $D(X),$D(^PS(52.91,DA,0)),X<$P(^(0),U,2) D EN^DDIOL("INACTIVATION
DATE CANNOT BE BEFORE DATE PHARMACY BENEFIT BEGAN","","$C(7),!?5") K X
LAST EDITED: AUG 29, 2003
HELP-PROMPT: (No range limit on date)
DESCRIPTION: This date can be set manually when the patient is no longer eligible for this benefit; or when the
Non-VA prescriptions are either Discontinued or Expired; or set automatically due to a Date of
Death entered in the Patient file (#2).
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
CROSS-REFERENCE: 52.91^AD^MUMPS
1)= D RXPAT^PSOTPCAN
2)= Q
This cross reference sets the RX Patient status in the PHARMACY PATIENT file (#55) to null if this
date entered is not a future date, and the RX Patient Status is equal to "NON-VA". It sets the
global: ^PS(55,DA,"PS")="".
RECORD INDEXES: AX (#254)
52.91,3 INACTIVATION REASON CODE 0;4 SET
'1' FOR SEEN BY VA PROVIDER;
'2' FOR NO/SHOW/CANCELLATION;
'3' FOR PATIENT ENDED;
'4' FOR NON-FORMULARY RX NOT ACCEPTED;
'5' FOR PATIENT EXPIRED;
'6' FOR ALL RX'S INACTIVE;
'7' FOR EXCLUSION;
'8' FOR PATIENT REFUSED APPT;
'9' FOR PATIENT UNREACHABLE;
'10' FOR PROGRAM ENDED;
LAST EDITED: NOV 16, 2005
DESCRIPTION: This field contains a code representing the reason for inactivating a patient for this benefit.
EXCLUSION code 7, is hidden and not user selectable. It is used by the post-install routine during
initial extraction.
SCREEN: S DIC("S")="I Y'=7"
EXPLANATION: Only these codes are allowed for manual entry.
RECORD INDEXES: AX (#254)
52.91,4 DESIRED APPOINTMENT DATE 0;5 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:X<1 X I $D(X),$D(^PS(52.91,DA,0)),X<$P(^(0),U,2) D EN^DDIOL("DESIRED APPO
INTMENT DATE CANNOT BE BEFORE DATE PHARMACY BENEFIT BEGAN","","$C(7),!?5") K X
LAST EDITED: AUG 06, 2003
HELP-PROMPT: Enter the desired date for the appointment.
DESCRIPTION:
Set by the EWL/Scheduling extract and is obtained from Scheduling file.
TECHNICAL DESCR: Set by the EWL, DESIRED DATE OF APPOINTMENT field (#22) of the SD WAIT LIST file (#409.3), piece 16
of the 0 node; or from Scheduling, the DESIRED APPOINTMENT DATE field (#27) of the APPOINTMENT
subfile (#1900) of the PATIENT file (#2), piece 1 of the 1 node. If there is more than one desired
appointment in Scheduling then the one that is closest to the date the extract was run is used.
Not editable.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
RECORD INDEXES: AX (#254)
52.91,5 WAIT TYPE 0;6 SET
'E' FOR EWL;
'M' FOR MANUAL;
'S' FOR SCHEDULED APPOINTMENT;
'X' FOR SCHEDULED APPOINTMENT & EWL;
LAST EDITED: AUG 17, 2003
HELP-PROMPT: Select one Wait List Type.
DESCRIPTION:
The type of wait the patient is assigned.
TECHNICAL DESCR:
"M" is set for manual entry. Not editable.
RECORD INDEXES: AX (#254)
52.91,6 STATION NUMBER 0;7 FREE TEXT (Required)
INPUT TRANSFORM: K:$L(X)>7!($L(X)<3)!'(X?3N.AN) X
LAST EDITED: AUG 06, 2003
HELP-PROMPT: Answer must be 3-7 characters in length
DESCRIPTION:
7 digit STATION NUMBER. First 3 digit station number plus any modifiers.
TECHNICAL DESCR: An attempt to obtain the clinic from the Patient file (#2) will be performed in order to
auto-populate the Station Number. Can be entered manually. It's a required field.
RECORD INDEXES: AX (#254)
52.91,7 INSTITUTION 0;8 POINTER TO INSTITUTION FILE (#4) (Required)
LAST EDITED: AUG 07, 2003
DESCRIPTION:
Is set by the EWL/Scheduling extract and is obtained from the Institution File (#4, field .01)
TECHNICAL DESCR: During manual entry, if this field is found null (due to timeout), then the record will be marked
as inactive and the INACTIVATION REASON CODE will be set 3 (Patient Ended).
FIELD INDEX: AC (#253) MUMPS IR ACTION
Short Descr: Sets the "AC" x-ref.
Set Logic: S ^PS(52.91,"AC",$E(X,1,30),DA)="" S:$$PATCH^XPDUTL("PSO*7.0*146") ^PS(52.91,"AX",DT,DA)="" Q
Kill Logic: K ^PS(52.91,"AC",$E(X,1,30),DA) S:$$PATCH^XPDUTL("PSO*7.0*146") ^PS(52.91,"AX",DT,DA)="" Q
X(1): INSTITUTION (52.91,7) (Subscr 1) (forwards)
52.91,8 EXCLUSION REASON 0;9 SET
'1' FOR ACTIVE RX;
'2' FOR ACTUAL APPT. < 30 DAYS FROM DATE APPT. MADE;
'3' FOR BOTH;
LAST EDITED: AUG 17, 2003
DESCRIPTION:
Exclusion reason codes.
RECORD INDEXES: AX (#254)
52.91,9 PRIMARY CARE SCHEDULE APT DATE 0;10 DATE
INPUT TRANSFORM: S %DT="ETX" D ^%DT S X=Y K:X<1 X
LAST EDITED: AUG 21, 2003
HELP-PROMPT: (No range limit on date)
DESCRIPTION: This is the date that a primary care appointment was scheduled. This field is populated only by the
post-install routine during initial extraction.
RECORD INDEXES: AX (#254)
52.91,10 RX # 0;11 FREE TEXT
INPUT TRANSFORM: K:$L(X)>15!($L(X)<1) X
LAST EDITED: AUG 07, 2003
HELP-PROMPT: Answer must be 1-15 characters in length
DESCRIPTION:
Rx# if found during the extraction that made the patient flagged as excluded for this service.
52.91,11 DATE LETTER PRINTED 0;12 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:X<1 X
LAST EDITED: AUG 07, 2003
HELP-PROMPT: (No range limit on date)
DESCRIPTION:
Date the letter was printed.
FILES POINTED TO FIELDS
INSTITUTION (#4) INSTITUTION (#7)
PATIENT (#2) PATIENT (#.01)
File #52.91
Record Indexes:
AX (#254) RECORD MUMPS IR ACTION
Short Descr: Triggers the "AX" x-ref only during manual edit.
Set Logic: S:$$PATCH^XPDUTL("PSO*7.0*146") ^PS(52.91,"AX",DT,DA)="" Q
Set Cond: N I S (X,I)=0 F S I=$O(X1(I)) Q:'I I X1(I)'=X2(I) S X=1 Q
Kill Logic: S:$$PATCH^XPDUTL("PSO*7.0*146") ^PS(52.91,"AX",DT,DA)="" Q
Kill Cond: N I S (X,I)=0 F S I=$O(X1(I)) Q:'I I X1(I)'=X2(I) S X=1 Q
X(1): DATE PHARMACY BENEFIT BEGAN (52.91,1) (Subscr 1) (forwards)
X(2): INACTIVATION OF BENEFIT DATE (52.91,2) (forwards)
X(3): INACTIVATION REASON CODE (52.91,3) (forwards)
X(4): DESIRED APPOINTMENT DATE (52.91,4) (forwards)
X(5): WAIT TYPE (52.91,5) (forwards)
X(6): STATION NUMBER (52.91,6) (forwards)
X(7): EXCLUSION REASON (52.91,8) (forwards)
X(8): PRIMARY CARE SCHEDULE APT DATE (52.91,9) (forwards)
INPUT TEMPLATE(S):
PRINT TEMPLATE(S):
SORT TEMPLATE(S):
FORM(S)/BLOCK(S):