
File PATIENT(2) Data List
| NAME |
SEX |
SELF IDENTIFIED GENDER |
SEXUAL ORIENTATION |
SEXUAL ORIENTATION FREE TEXT |
DATE OF BIRTH |
AGE |
MARITAL STATUS |
RACE |
OCCUPATION |
RELIGIOUS PREFERENCE |
DUPLICATE STATUS |
PATIENT MERGED TO |
CHECK FOR DUPLICATE |
SOCIAL SECURITY NUMBER |
TERMINAL DIGIT OF SSN |
1U4N |
PSEUDO SSN REASON |
SSN VERIFICATION STATUS |
REMARKS |
PLACE OF BIRTH [CITY] |
PLACE OF BIRTH [STATE] |
PLACE OF BIRTH COUNTRY |
PLACE OF BIRTH PROVINCE |
WHO ENTERED PATIENT |
DATE ENTERED INTO FILE |
HOW WAS PATIENT ENTERED? |
WARD LOCATION |
ROOM-BED |
CURRENT MOVEMENT |
TREATING SPECIALTY |
PROVIDER |
ATTENDING PHYSICIAN |
CURRENT ADMISSION |
LAST DMMS EPISODE NUMBER |
LODGER WARD LOCATION |
CURRENT ROOM |
EXCLUDE FROM FACILITY DIR |
STREET ADDRESS [LINE 1] |
ZIP+4 |
STREET ADDRESS CASS IND |
MAILING ADDR OVERRIDE IND |
STREET ADDRESS [LINE 2] |
STREET ADDRESS [LINE 3] |
CITY |
STATE |
RESIDENTIAL ADDRESS [LINE 1] |
RESIDENTIAL ADDRESS [LINE 2] |
RESIDENTIAL ADDRESS [LINE 3] |
RESIDENTIAL CITY |
RESIDENTIAL STATE |
RESIDENTIAL ZIP+4 |
RESIDENTIAL COUNTY |
RESIDENTIAL PROVINCE |
RESIDENTIAL POSTAL CODE |
RESIDENTIAL COUNTRY |
RESIDENTIAL ADDR CHANGE DT/TM |
RESIDENTIAL ADDR CHANGE SITE |
RESIDENTIAL ADDR CHANGE SOURCE |
RESIDENTIAL ADDR CHANGE USER |
RESIDENTIAL ADDR CASS IND |
RESIDENTIAL ADDR OVERRIDE IND |
ZIP CODE |
COUNTY |
PROVINCE |
POSTAL CODE |
COUNTRY |
ADDRESS CHANGE DT/TM |
ADDRESS CHANGE SOURCE |
ADDRESS CHANGE SITE |
BAD ADDRESS INDICATOR |
TEMPORARY ADDRESS ACTIVE? |
TEMPORARY STREET [LINE 1] |
TEMPORARY ADDRESS COUNTY |
TEMPORARY ZIP+4 |
TEMPORARY ADDRESS CHANGE DT/TM |
TEMPORARY ADDRESS CHANGE SITE |
TEMPORARY ADDR CASS IND |
TEMPORARY COUNTRY CODE |
TEMPORARY EXTENSION |
TEMPORARY STREET [LINE 2] |
TEMPORARY STREET [LINE 3] |
TEMPORARY CITY |
TEMPORARY STATE |
TEMPORARY ZIP CODE |
TEMPORARY ADDRESS START DATE |
TEMPORARY ADDRESS END DATE |
TEMPORARY PHONE NUMBER |
ADDRESS CHANGE USER |
TEMPORARY ADDRESS PROVINCE |
TEMPORARY ADDRESS POSTAL CODE |
TEMPORARY ADDRESS COUNTRY |
PHONE NUMBER [RESIDENCE] |
CELLULAR NUMBER CHANGE SOURCE |
CELLULAR NUMBER CHANGE SITE |
PAGER NUMBER CHANGE DT/TM |
PAGER NUMBER CHANGE SOURCE |
PAGER NUMBER CHANGE SITE |
CONFIDENTIAL PHONE NUMBER |
EMAIL ADDRESS INDICATOR |
EMAIL ADDRESS INDICATOR DT/TM |
EMAIL ADDRESS CHANGE USER |
CELLULAR NUMBER CHANGE USER |
PHONE NUMBER [WORK] |
CONFIDENTIAL COUNTRY CODE |
RESIDENCE NUMBER CHANGE DT/TM |
EXTENSION [RESIDENCE] |
EXTENSION [CELLULAR] |
EXTENSION [WORK] |
CONFIDENTIAL EXTENSION |
RESIDENCE NUMBER CHANGE SOURCE |
RESIDENCE NUMBER CHANGE SITE |
RESIDENCE NUMBER CHANGE USER |
PHONE [WORK] CHANGE USER |
PHONE [WORK] CHANGE DT/TM |
COUNTRY CODE [RESIDENCE] |
COUNTRY CODE [CELLULAR] |
COUNTRY CODE [WORK] |
EMAIL ADDRESS |
PHONE NUMBER [CELLULAR] |
PAGER NUMBER |
EMAIL ADDRESS CHANGE DT/TM |
EMAIL ADDRESS CHANGE SOURCE |
EMAIL ADDRESS CHANGE SITE |
CELLULAR NUMBER CHANGE DT/TM |
CURRENT MEANS TEST STATUS |
CONFIDENTIAL ADDRESS CATEGORY |
CONFIDENTIAL ADDRESS ACTIVE? |
CONFIDENTIAL STREET [LINE 1] |
CONFIDENTIAL ADDRESS COUNTY |
CONFIDENTIAL ADDR CHANGE DT/TM |
CONFIDENTIAL ADDR CHANGE SITE |
CONFIDENTIAL ADDR PROVINCE |
CONFIDENTIAL ADDR POSTAL CODE |
CONFIDENTIAL ADDR COUNTRY |
CONFIDENTIAL ADDR CASS IND |
CONFIDENTIAL ADDR CHANGE USER |
CONFIDENTIAL PHONE CHANGE USER |
CONFIDENTIAL STREET [LINE 2] |
CONFIDENTIAL ADDR OVERRIDE IND |
CONFIDENTIAL STREET [LINE 3] |
CONFIDENTIAL ADDRESS CITY |
CONFIDENTIAL ADDRESS STATE |
CONFIDENTIAL ADDRESS ZIP CODE |
CONFIDENTIAL START DATE |
CONFIDENTIAL END DATE |
INELIGIBLE DATE |
MISSING PERSON DATE |
MISSING OR INELIGIBLE |
INELIGIBLE TWX SOURCE |
INELIGIBLE TWX CITY |
INELIGIBLE TWX STATE |
INELIGIBLE VARO DECISION |
MISSING PERSON TWX SOURCE |
MISSING PERSON TWX CITY |
MISSING PERSON TWX STATE |
FEE HOSPITAL I.D. |
EMERGENCY RESPONSE INDICATOR |
HISTORIC KATRINA ERI |
DIVISION |
K2-COUNTRY |
K-WORK PHONE NUMBER |
PRIMARY NOK CHANGE DATE/TIME |
K2-PROVINCE |
K2-POSTAL CODE |
K2-RELATIONSHIP TYPE |
K-NAME OF PRIMARY NOK |
K2-WORK PHONE NUMBER |
SECONDARY NOK CHANGE DATE/TIME |
K-RELATIONSHIP TO PATIENT |
K-ADDRESS SAME AS PATIENT'S? |
K-STREET ADDRESS [LINE 1] |
K-STREET ADDRESS [LINE 2] |
K-STREET ADDRESS [LINE 3] |
K-CITY |
K-STATE |
K-ZIP CODE |
K-PHONE NUMBER |
K2-NAME OF SECONDARY NOK |
K2-RELATIONSHIP TO PATIENT |
K2-ADDRESS SAME AS PATIENT'S? |
K2-STREET ADDRESS [LINE 1] |
K2-STREET ADDRESS [LINE 2] |
K2-STREET ADDRESS [LINE 3] |
K2-CITY |
K2-STATE |
K2-ZIP CODE |
K2-PHONE NUMBER |
E-ZIP+4 |
D-ZIP+4 |
K2-ZIP+4 |
E2-ZIP+4 |
EMPLOYER ZIP+4 |
SPOUSE'S EMP ZIP+4 |
K-ZIP+4 |
K-COUNTRY |
K-PROVINCE |
K-POSTAL CODE |
K-RELATIONSHIP TYPE |
FATHER'S NAME |
MOTHER'S NAME |
MOTHER'S MAIDEN NAME |
PREFERRED NAME |
PRONOUN |
PRONOUN DESCRIPTION |
SPOUSE'S EMPLOYER NAME |
SPOUSE'S OCCUPATION |
SPOUSE'S EMPLOYMENT STATUS |
SPOUSE'S RETIREMENT DATE |
SPOUSE'S EMP STREET [LINE 1] |
SPOUSE'S EMP STREET [LINE 2] |
SPOUSE'S EMP STREET [LINE 3] |
SPOUSE'S EMPLOYER'S CITY |
SPOUSE'S EMPLOYER'S STATE |
SPOUSE'S EMP ZIP CODE |
SPOUSE'S EMP PHONE NUMBER |
ZIP+4 (CIVIL) |
ZIP+4 (VA) |
DATE RULED INCOMPETENT (VA) |
INSTITUTION (VA) |
GUARDIAN (VA) |
RELATIONSHIP (VA) |
STREET ADDRESS 1 (VA) |
STREET ADDRESS 2 (VA) |
CITY (VA) |
STATE (VA) |
ZIP (VA) |
PHONE (VA) |
DATE RULED INCOMPETENT (CIVIL) |
INSTITUTION (CIVIL) |
GUARDIAN (CIVIL) |
RELATIONSHIP (CIVIL) |
STREET ADDRESS 1 (CIVIL) |
STREET ADDRESS 2 (CIVIL) |
CITY (CIVIL) |
STATE (CIVIL) |
ZIP (CIVIL) |
PHONE (CIVIL) |
RATED INCOMPETENT? |
SERVICE CONNECTED? |
SC AWARD DATE |
P&T EFFECTIVE DATE |
EFF. DATE COMBINED SC% EVAL. |
SERVICE CONNECTED PERCENTAGE |
RECEIVING VA DISABILITY? |
AMOUNT OF VA DISABILITY |
P&T |
UNEMPLOYABLE |
MONETARY BEN. VERIFY DATE |
INELIGIBLE REASON |
AGENCY/ALLIED COUNTRY |
*CATEGORY OF BENEFICIARY |
EMPLOYER NAME |
EMPLOYMENT STATUS |
DATE OF RETIREMENT |
GOVERNMENT AGENCY |
EMPLOYER STREET [LINE 1] |
EMPLOYER STREET [LINE 2] |
EMPLOYER STREET [LINE 3] |
EMPLOYER CITY |
EMPLOYER STATE |
EMPLOYER ZIP CODE |
EMPLOYER PHONE NUMBER |
*CLAIM FOLDER LOCATION |
INSURANCE TYPE |
CLAIM NUMBER |
CLAIM FOLDER LOCATION |
COVERED BY HEALTH INSURANCE? |
VIETNAM SERVICE INDICATED? |
AGENT ORANGE EXPOS. INDICATED? |
RADIATION EXPOSURE INDICATED? |
VIETNAM FROM DATE |
VIETNAM TO DATE |
AGENT ORANGE REGISTRATION DATE |
AGENT ORANGE REPORTED TO C.O. |
AGENT ORANGE EXAM DATE |
AGENT ORANGE REGISTRATION # |
RADIATION REGISTRATION DATE |
PROJ 112/SHAD |
TOXIC EXPOSURE RISK ACTIVITY |
PERSIAN GULF INDICATOR |
PERSIAN GULF LAST CHANGE DATE |
RADIATION EXPOSURE METHOD |
AGENT ORANGE EXPOSURE LOCATION |
FILIPINO VETERAN PROOF |
SERVICE [OEF OR OIF] |
MILITARY SERVICE EPISODE |
CAMP LEJEUNE |
CAMP LEJEUNE DATE |
CAMP LEJEUNE CHANGE SITE |
CAMP LEJEUNE SOURCE |
CAMP LEJEUNE DATA ENTRY LOCKED |
SERVICE VERIFICATION DATE |
PERSIAN GULF SERVICE? |
PERSIAN GULF FROM DATE |
PERSIAN GULF TO DATE |
SOUTHWEST ASIA CONDITIONS? |
SW ASIA COND REGISTRATION DATE |
SW ASIA COND EXAM DATE |
SOMALIA SERVICE INDICATED? |
SOMALIA FROM DATE |
SOMALIA TO DATE |
YUGOSLAVIA SERVICE INDICATED? |
YUGOSLAVIA FROM DATE |
YUGOSLAVIA TO DATE |
LEBANON SERVICE INDICATED? |
LEBANON FROM DATE |
LEBANON TO DATE |
GRENADA SERVICE INDICATED? |
GRENADA FROM DATE |
GRENADA TO DATE |
PANAMA SERVICE INDICATED? |
PANAMA FROM DATE |
PANAMA TO DATE |
PERIOD OF SERVICE |
SERVICE DISCHARGE TYPE [LAST] |
SERVICE BRANCH [LAST] |
SERVICE ENTRY DATE [LAST] |
SERVICE SEPARATION DATE [LAST] |
SERVICE NUMBER [LAST] |
SERVICE SECOND EPISODE? |
SERVICE DISCHARGE TYPE [NTL] |
SERVICE BRANCH [NTL] |
SERVICE COMPONENT [LAST] |
SERVICE COMPONENT [NTL] |
SERVICE COMPONENT [NNTL] |
SERVICE ENTRY DATE [NTL] |
SERVICE SEPARATION DATE [NTL] |
SERVICE NUMBER [NTL] |
SERVICE THIRD EPISODE? |
SERVICE DISCHARGE TYPE [NNTL] |
SERVICE BRANCH [NNTL] |
SERVICE ENTRY DATE [NNTL] |
SERVICE SEPARATION DATE [NNTL] |
SERVICE NUMBER [NNTL] |
E-WORK PHONE NUMBER |
E-CONTACT CHANGE DATE/TIME |
E-EMER. CONTACT SAME AS NOK? |
E-COUNTRY |
E-PROVINCE |
E-POSTAL CODE |
E-RELATIONSHIP TYPE |
E-NAME |
E2-WORK PHONE NUMBER |
E2-COUNTRY |
E2-PROVINCE |
E2-POSTAL CODE |
E2-RELATIONSHIP TYPE |
E2-NAME OF SECONDARY CONTACT |
E2-CONTACT CHANGE DATE/TIME |
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-PHONE NUMBER |
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-PHONE NUMBER |
D-WORK PHONE NUMBER |
D-COUNTRY |
D-PROVINCE |
D-POSTAL CODE |
D-RELATIONSHIP TYPE |
D-DESIGNEE SAME AS NOK? |
D-NAME OF DESIGNEE |
DESIGNEE CHANGE DATE/TIME |
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-PHONE NUMBER |
DATE OF DEATH |
DEATH ENTERED BY |
SOURCE OF NOTIFICATION |
DATE OF DEATH LAST UPDATED |
LAST EDITED BY |
SUPPORTING DOCUMENT TYPE |
DATE OF DEATH OPTION USED |
COLLATERAL SPONSOR'S NAME |
MILITARY DISABILITY RETIREMENT |
DISCHARGE DUE TO DISABILITY |
PRIMARY ELIGIBILITY CODE |
ELIGIBILITY STATUS |
ELIGIBILITY STATUS DATE |
ELIGIBILITY VERIF. SOURCE |
ELIGIBILITY INTERIM RESPONSE |
ELIGIBILITY VERIF. METHOD |
ELIGIBILITY STATUS ENTERED BY |
USER ENROLLEE VALID THROUGH |
USER ENROLLEE SITE |
DISABILITY RET. FROM MILITARY? |
RECEIVING A&A BENEFITS? |
AMOUNT OF AID & ATTENDANCE |
RECEIVING HOUSEBOUND BENEFITS? |
AMOUNT OF HOUSEBOUND |
RECEIVING SOCIAL SECURITY? |
*AMOUNT OF SOCIAL SECURITY |
RECEIVING A VA PENSION? |
AMOUNT OF VA PENSION |
*AMOUNT OF MILITARY RETIREMENT |
RECEIVING MILITARY RETIREMENT? |
AMOUNT OF GI INSURANCE |
GI INSURANCE POLICY? |
AMOUNT OF SSI |
RECEIVING SUP. SECURITY (SSI)? |
AMOUNT OF OTHER RETIREMENT |
TYPE OF OTHER RETIREMENT |
AMOUNT OF OTHER INCOME |
TOTAL ANNUAL VA CHECK AMOUNT |
PRIMARY LONG ID |
PRIMARY SHORT ID |
SERVICE DENTAL INJURY? |
SERVICE TEETH EXTRACTED? |
DATE OF DENTAL TREATMENT |
RATED DISABILITIES (VA) |
SERVICE CONNECTED CONDITIONS |
ELIGIBLE FOR MEDICAID? |
DATE MEDICAID LAST ASKED |
MEDICAID NUMBER |
PENSION AWARD EFFECTIVE DATE |
PENSION AWARD REASON |
PENSION TERMINATED DATE |
PENSION TERMINATED REASON 1 |
PENSION TERMINATED REASON 2 |
PENSION TERMINATED REASON 3 |
PENSION TERMINATED REASON 4 |
CLASS II DENTAL INDICATOR |
DENTAL APPL DUE BEFORE DATE |
PENSION INDICATOR LOCK |
PENSION AWARD LOCK |
VETERAN CATASTROPHICALLY DISABLED? |
DECIDED BY |
DATE OF DECISION |
FACILITY MAKING DETERMINATION |
REVIEW DATE |
METHOD OF DETERMINATION |
DATE VETERAN REQUESTED CD EVAL |
DATE FACILITY INITIATED REVIEW |
DATE VETERAN WAS NOTIFIED |
CD STATUS DIAGNOSES |
CD STATUS PROCEDURES |
CD STATUS CONDITIONS |
CD HISTORY DATE |
CD DESCRIPTORS |
POW STATUS INDICATED? |
POW CONFINEMENT LOCATION |
POW FROM DATE |
POW TO DATE |
POW STATUS VERIFIED |
COMBAT SERVICE INDICATED? |
COMBAT SERVICE LOCATION |
COMBAT FROM DATE |
COMBAT TO DATE |
COMBAT VETERAN END DATE |
CV DATE EDITED |
CURRENT PH INDICATOR |
CURRENT PURPLE HEART STATUS |
CURRENT PURPLE HEART REMARKS |
PH DIVISION |
CURRENT MOH INDICATOR |
MOH AWARD DATE |
MOH STATUS DATE |
MOH COPAYMENT EXEMPTION DATE |
EXPANDED MH CARE TYPE |
AUTOMATIC CHANGE DATE |
PRESUMPTIVE PSYCHOSIS CATEGORY |
INDIAN SELF IDENTIFICATION |
INDIAN START DATE |
INDIAN ATTESTATION DATE |
INDIAN END DATE |
INDIAN SELF IDENT CHANGE DT/TM |
INDIAN SELF IDENT CHANGE USER |
TEST PATIENT INDICATOR |
ALIAS |
NAME COMPONENTS |
K-NAME COMPONENTS |
K2-NAME COMPONENTS |
FATHER'S NAME COMPONENTS |
MOTHER'S NAME COMPONENTS |
MOTHERS MAIDEN NAME COMPONENTS |
E-NAME COMPONENTS |
E2-NAME COMPONENTS |
D-NAME COMPONENTS |
DISPOSITION LOG-IN DATE/TIME |
RECEIVED VA CARE PREVIOUSLY? |
MOST RECENT DATE OF CARE |
APPOINTMENT REQUEST DATE |
ORIGINAL APPOINTMENT REQUEST |
ORIGINAL APPT REQUEST DATE |
ORIG APPT REQUEST CHG DT/TM |
APPT REQUEST 1010EZ CHG DT/TM |
MOST RECENT LOCATION OF CARE |
2ND MOST RECENT DATE OF CARE |
2ND MOST RECENT LOCATION |
MOST RECENT 1010EZ |
COMBAT INDICATED ON 1010EZ |
DISABILITY DISCHARGE ON 1010EZ |
APPOINTMENT REQUEST ON 1010EZ |
APPOINTMENT REQUEST STATUS |
DATE STATUS LAST EDITED |
APPOINTMENT REQUEST COMMENT |
DATE COMMENT LAST EDITED |
FUGITIVE FELON FLAG |
FFF ENTERED BY |
FFF DATE ENTERED |
FFF REMOVED BY |
FFF DATE REMOVED |
FFF REMOVAL REMARKS |
INITIAL ODS TREATMENT RECEIVED |
RECALLED TO ACTIVE DUTY |
RANK |
CNH CURRENT |
APPOINTMENT |
VETERAN (Y/N)? |
ARCHIVED DATA |
COMMUNITY CARE PROGRAM |
RACE INFORMATION |
DATE LAST EICD RUN |
DENTAL CLASSIFICATION |
DENTAL ELIGIBILITY EXPIRATION |
CURRENT HEALTH BENEFIT PLAN |
HISTORY HEALTH BENEFIT PLAN |
CURRENT ENROLLMENT |
PREFERRED FACILITY |
SOURCE DESIGNATION |
PT APPLIED FOR ENROLLMENT? |
ENROLLMENT CLINIC |
VTS PATIENT FLAG |
PATIENT ELIGIBILITIES |
TYPE |
CONDITION |
DATE ENTERED ON SI LIST |
*CURRENT PC PRACTITIONER |
*CURRENT PC TEAM |
*REACTIONS |
PH DATE/TIME UPDATED |
NETWORK IDENTIFIER |
MHV SOCIALIZATION |
MHV REGISTERED |
MHV AUTHENTICATED |
MHV SECURE MESSAGING |
MHVREG UPDATE DATE/TIME |
MHVAUTH UPDATE DATE/TIME |
MHVSM UPDATE DATE/TIME |
MHV REGISTER DECLINED TEXT |
MHV AUTH DECLINED TEXT |
MHV MSG DECLINED TEXT |
MHV REGISTER DECLINED REASON |
MHV AUTH DECLINED REASON |
MHV MSG DECLINED REASON |
MHV MSG ACTIONS |
MHV AUTH ACTIONS |
*HEIGHT(cm) |
*WEIGHT(kg) |
SPINAL CORD INJURY |
ETHNICITY INFORMATION |
LABORATORY REFERENCE |
LAB REFERRAL REF |
LANGUAGE DATE/TIME |
DISCHARGED TO CERNER |
INTEGRATION CONTROL NUMBER |
ICN CHECKSUM |
COORDINATING MASTER OF RECORD |
LOCALLY ASSIGNED ICN |
SUBSCRIPTION CONTROL NUMBER |
CMOR ACTIVITY SCORE |
SCORE CALCULATION DATE |
TEMPORARY ID NUMBER |
FOREIGN ID NUMBER |
FULL ICN |
INDIVIDUAL TAX ID |
FULL ICN HISTORY |
ICN HISTORY |
CMOR HISTORY |
MULTIPLE BIRTH INDICATOR |
ABSENCE DIVISION |
INPATIENT WARD |
LAST MEANS TEST |