File Generic_Code_Sheet(2100) Data List
| ID |
READY FOR BATCHING |
READY FOR TRANSMISSION |
SCHEDULED TRANSMISSION DATE |
BATCH NUMBER |
STACK DOCUMENT |
BATCH PRIORITY |
PREPARED BY |
SYSTEM IDENTIFIER |
EDIT TEMPLATE NAME |
ADMISSIONS(MED) INC TRFS |
CHANGES IN BEDSECTION(+MED) |
DEATHS(MED) |
DISCHARGES(MED) |
CHANGES IN BEDSECTION(-MED) |
BO (MED PTS REMAINING EOP) |
ABO (MED PTS REMAINING EOP) |
TOTAL DAYS OF CARE(MED) |
REIMBUR.DAYS UNAUTH CARE(MED) |
ADMISSIONS(SURG) INC TRFS |
CHANGES IN BEDSECTION(+SURG) |
DEATHS(SURG) |
DISCHARGES(SURG) |
CHANGES IN BEDSECTION(-SURG) |
BO (SURG PTS REMAINING EOP) |
ABO (SURG PTS REMAINING EOP) |
TOTAL DAYS OF CARE(SURG) |
REIMBUR.DAYS UNAUTH CARE(SURG) |
ADMISSIONS(PSYC) INC TRFS |
CHANGES IN BEDSECTION(+PSYC) |
DEATHS(PSYC) |
DISCHARGES(PSYC) |
CHANGES IN BEDSECTION(-PSYC) |
BO (PSYC PTS REMAINING EOP) |
ABO (PSYC PTS REMAINING EOP) |
TOTAL DAYS OF CARE(PSYC) |
REIMBUR.DAYS UNAUTH CARE(PSYC) |
TOTAL ADMISSIONS |
TRANSFERS IN |
CHANGES IN BEDSECTION(+) |
DEATHS,BO AND ABO |
DISCHARGE TO OPT/NSC |
DISCHARGES NOT OPT/NSC |
TRANSFERS OUT |
CHANGES IN BEDSECTION(-) |
BED OCCUPANTS EOM |
ABSENT BED OCCUPANTS EOM |
PATIENT DAYS OF CARE |
PATIENT DAYS OF CARE ( >45) |
DAYS OF AUTH ABSENCE <96HRS |
CATEGORY A ON WAITING LIST EOM |
CATEGORY B ON WAITING LIST EOM |
CATEGORY C ON WAIT LIST EOM |
OPERATING BEDS EOM |
FEMALE PATIENTS REMAINING EOM |
DIALYSIS OPERATING BEDS |
SEG START CHAR |
VERSION NUMBER |
DEPT CODE |
SEGMENT MODIFIER |
NUMBER OF APPLICATIONS |
HOSP CARE RECEIVED |
HOSP WAIT LIST |
NHCU CARE RECEIVED |
NHCU WAIT LIST |
DOMICILIARY CARE RECEIVED |
DOM WAIT LIST |
OUTPATIENT CARE RECEIVED |
EXAMINED, NO FURTHER CARE |
CANCELLED |
INELIG-DENTAL |
INELIG-PLASTIC SURGERY |
INELIG-STERILIZATION |
INELIG-PREGNANCY |
INELIG-OTHER |
HOSPITAL TYPE OF SERV |
NHCU CARE TYPE OF SERV |
DOMICILIARY TYPE OF SERV |
OPT CARE TYPE OF SERV |
DISPOSITION TO COMMUNITY |
DISPOSITION TO OTHER |
TRT MOD UNAVAIL-HOSP |
TRT MOD UNAVAIL-NHCU |
TRT MOD UNAVAIL-DOM |
TRT MOD UNAVAIL-OPT |
TRT MOD UNAVAIL-TO COMMUNITY |
TRT MOD UNAVAIL-TO OTHER VA |
TRT MOD UNAVAIL-TO FEE |
TRT MOD UNAVAIL-TO OTHER |
LOW PRIORITY-HOSP CARE |
LOW PRIORITY-NHCU CARE |
LOW PRIORITY-DOM CARE |
LOW PRIORITY-OPT CARE |
LOW PRIORITY-TO COMMUNITY |
LOW PRIORITY-TO OTHER CARE |
LOW PRIORITY-TO FEE |
LOW PRIORITY-TO OTHER |
PENDING DETERMINATION |
WON'T PAY DEDUCTIBLE |
NON-VETERAN APPLICANTS |
SC 50% OR MORE |
AA/HB;POW;WW1(NSC) |
SC LESS THAN 50% |
NSC,RECEIVING VA PENSION |
OTHER NSC |
DOMICILIARY MEMBER(NSC) |
CHAMP VA |
COLLATERAL OF VETERAN |
VA EMPLOYEE |
OTHER FEDERAL AGENCY |
ALLIED VETERAN |
HUMANITARIAN EMERGENCY |
SHARING AGREEMENT |
INSURANCE |
C&P EXAM |
10-10 |
SCHEDULED VISIT |
UNSCHEDULED VISIT |
MENTAL HYGIENE GROUP |
MENTAL HYGIENE INDIVIDUAL |
DAY TREATMENT CENTER |
DAY HOSPITAL |
READJUSTMENT COUNSELING |
HBHC |
ADMIS AFTER REHOSP >30 DAYS |
ADMISSIONS - ALL OTHERS |
TRANSFERS IN SIMILAR FACIL |
FROM ASIH |
DISCHARGES |
TRANSFERS OUT-SIMILAR FACIL |
TO ASIH |
ASIH |
DISCHARGES-ASIH |
DIED-ASIH |
ADMIS AFTER REHOSP >15 DAYS |
TRANSFERS IN FROM CNH |
TRANSFERS OUT TO CNH |
SC PATIENTS PLACED |
MEDICARE |
MEDICAID |
VA AUTH OUTPT VISITS(MED) |
VA AUTH OUTPT VISITS(SURG) |
VA AUTH OUTPT VISITS(PSYC) |
1-DAY INP DIALYSIS VISITS(MED) |
ADMISSIONS FROM SNH/SHH(DOM) |
ADMISSIONS OTHER (DOM) |
FROM AA >96HRS (DOM) |
DISCHARGES TO SNH/SHH (DOM) |
DISCHARGES OTHER (DOM) |
DEATHS (DOM) |
TO AA >96HRS (DOM) |
BED OCCUPANTS EOP (DOM) |
MEMBER DAYS OF CARE (DOM) |
ADMISSIONS FROM DOM/SHH (SNH) |
ADMISSIONS OTHER (SNH) |
FROM AA >96HRS (SNH) |
DISCHARGES TO DOM/SHH (SNH) |
DISCHARGES OTHER (SNH) |
DEATHS (SNH) |
TO AA >96HRS (SNH) |
BED OCCUPANTS EOP (SNH) |
PATIENT DAYS OF CARE (SNH) |
ADMISSIONS TO DOM/SNH (SHH) |
ADMISSIONS OTHER (SHH) |
FROM AA >96HRS (SHH) |
DISCHARGE TO DOM/SNH (SHH) |
DISCHARGE OTHER (SHH) |
DEATHS (SHH) |
TO AA >96HRS (SHH) |
BED OCCUPANTS EOP (SHH) |
PATIENT DAYS OF CARE (SHH) |
FEMALE PATIENTS EOP (DOM) |
FEMALE PATIENTS EOP (SNH) |
FEMALE PATIENTS EOP (SHH) |
NON-VET BED OCCUPANTS EOP(DOM) |
NON-VET BED OCCUPANTS EOP(SNH) |
NON-VET BED OCCUPANTS EOP(SHH) |
TOTAL BEDS EOP (DOM) |
TOTAL BEDS EOP (SNH) |
TOTAL BEDS EOP (SHH) |
BED CAPACITY EOP BY VA (DOM) |
BED CAPACITY EOP BY VA (SNH) |
BED CAPACITY EOP BY VA (SHH) |
PATIENT DAYS OF CARE (1-45) |
REC'D FR ADJ PR1 AUDIO |
REC'D FR ADJ PR1 PSYCH |
REC'D FR ADJ PR1 OTHER |
REC'D FR ADJ PR2 AUDIO |
REC'D FR ADJ PR2 PSYCH |
REC'D FR ADJ PR2 OTHER |
RET TO ADJ PR1 AUDIO |
RET TO ADJ PR1 PSYCH |
RET TO ADJ PR1 OTHER |
RET TO ADJ PR2 AUDIO |
RET TO ADJ PR2 PSYCH |
RET TO ADJ PR2 OTHER |
PEND 1MO OR LESS PR1 AUDIO |
PEND 1MO OR LESS PR1 PSYCH |
PEND 1MO OR LESS PR1 OTHER |
PEND 1MO OR LESS PR2 AUDIO |
PEND 1MO OR LESS PR2 PSYCH |
PEND 1MO OR LESS PR2 OTHER |
PEND 2MO OR LESS PR1 AUDIO |
PEND 2MO OR LESS PR1 PSYCH |
PEND 2MO OR LESS PR1 OTHER |
PEND 2MO OR LESS PR2 AUDIO |
PEND 2MO OR LESS PR2 PSYCH |
PEND 2MO OR LESS PR2 OTHER |
PEND LESS THAN 6MO PR1 AUDIO |
PEND LESS THAN 6MO PR1 PSYCH |
PEND LESS THAN 6MO PR1 OTHER |
PEND LESS THAN 6MO PR2 AUDIO |
PEND LESS THAN 6MO PR2 PSYCH |
PEND LESS THAN 6MO PR2 OTHER |
PEND 6 TO <12 MO PR1 AUDIO |
PEND 6 TO <12 MO PR1 PSYCH |
PEND 6 TO <12 MO PR1 OTHER |
PEND 6 TO <12 MO PR2 AUDIO |
PEND 6 TO <12 MO PR2 PSYCH |
PEND 6 TO <12 MO PR2 OTHER |
PEND 12MO AND OVER PR1 AUDIO |
PEND 12MO AND OVER PR1 PSYCH |
PEND 12MO AND OVER PR1 OTHER |
PEND 12MO AND OVER PR2 AUDIO |
PEND 12MO AND OVER PR2 PSYCH |
PEND 12MO AND OVER PR2 OTHER |
TOT PEND EOM PR1 AUDIO |
TOT PEND EOM PR1 PSYCH |
TOT PEND EOM PR1 OTHER |
TOT PEND EOM PR2 AUDIO |
TOT PEND EOM PR2 PSYCH |
TOT PEND EOM PR2 OTHER |
NEW CASES |
REOPENED CASES |
NO FURTHER TREATMENT REQ(-) |
TO REHOSP PSY BEDSECTION(-) |
OTHER (-) |
ACTIVE CASES EOP < 1 YEAR |
ACTIVE CASES EOP 1-5 YEARS |
ACTIVE CASES EOP > 5 YEARS |
DAYS OF MHC OPERATION |
PROFESSIONAL FTEE |
NON-PROFESSIONAL FTEE |
# OF PTS SEEN BY PSYCHIATRIST |
# OF PTS SEEN BY PSYCHOLOGIST |
# OF PTS SEEN BY SOCIAL WORKER |
# OF PTS SEEN BY NURSE |
# OF PTS SEEN BY OTHER |
TOT # OF DIFF SC VETS TREATED |
TOT # OF DIFF NSC VETS TREATED |
TOT # DIFF V.N.ERA VETS TREAT |
WAITING LIST EOP |
SUPPORT VISITS |
PENDING PRIOR MONTH |
RECEIVED |
RETURNED COMPLETED |
RETURNED INCOMPLETE |
PENDING EOM |
AVG PROCESSING TIME (DAYS) |
OVER 3 DAYS TO SCHEDULE |
OVER 30 DAYS TO EXAMINE |
PEND 90 DAYS OR LESS |
PEND 91 DAYS TO 120 DAYS |
PEND 121 DAYS TO 150 DAYS |
PEND 151 DAYS TO 180 DAYS |
PEND 181 DAYS TO 365 DAYS |
PEND 366 DAYS AND OVER |
SKULL |
CHEST (Single View) |
CHEST (Multiple View) |
CARDIAC SERIES |
ABDOMEN-KUB |
OBSTRUCTIVE SERIES |
SPINE AND SACROILIAC(Skeletal) |
BONE AND JOINTS(Skeletal) |
GASTROINTESTINAL |
GENITOURINARY |
CHOLECYSTOGRAM(ORAL) |
CHOLANGIOGRAM |
LAMINAGRAM |
BRONCHOGRAM |
DIGITAL SUB.ANGIOGRAPHY |
CEREBRAL(ANGIO or CATH) |
VISCERAL(ANGIO or CATH) |
PERIPHERAL(ANGIO or CATH) |
VENOGRAM |
MYELOGRAM |
COMPUTED TOMOGRAPHY |
INTERVENTIONAL RADIOGRAPHY |
ULTRASOUND/ECHOENCEPHALOGRAM |
OTHER |
EXAM IN OR AT SURGERY |
BEDSIDE EXAM |
CINE RUN |
PATIENT VISITS |
NUMBER OF FILMS USED |
# OF FEET OF CINE ROLLS USED |
VA PATIENTS(Superficial X-RAY) |
VA VISITS(Superficial X-RAY) |
VA PATIENTS(Deep X-RAY) |
VA VISITS(Deep X-RAY) |
VA PATIENTS(Cobalt Tel.) |
VA VISITS(Cobalt Tel.) |
VA PATIENTS(Lin.ACC.&Betatron) |
VA VISITS(Lin ACC &Betatron) |
VA PATIENTS(Radio Implts/APPL) |
VA VISITS(Radio Implts/APPL) |
VA CONSULTATION |
VA TREATMENT PLANNING |
VA FOLLOW-UP VISITS |
VA SPECIAL PROCEDURES |
CONTRACT PTS(Superf X-RAY) |
CONTRACT VISITS(Superf X-RAY) |
CONTRACT PTS(Deep X-RAY) |
CONTRACT VISITS(Deep X-RAY) |
CONTRACT PTS(Cobalt Teleth) |
CONTRACT VISITS(Cobalt Tel) |
CONTRACT PTS(Lin ACC/Betatron) |
CONTRACT VISITS(Lin ACC/Betat) |
CONTRACT PTS(Radio Imp/Appl) |
CONTRACT VISITS(Radio Imp/App) |
CONTRACT CONSUTATIONS |
CONTRACT TREATMENT PLANNING |
CONTRACT FOLLOW-UP VISITS |
CONTRACT SPECIAL PROCEDURES |
PAID HOURS(DIAG TECH) |
AVAILABLE HOURS(DIAG TECH) |
PAID HOURS(THERAP TECH) |
AVAILABLE HOURS(THERAP TECH) |
TOTAL TECH FTE |
(2) ADDITION/REESTABLISHMENT |
(3) ALPHA CODE FOR ITEM 2 |
(4) CARD NUMBER |
(5) MEDICAL DISTRICT NUMBER |
NAME OF COMMUNITY NH |
CITY OF COMMUNITY NH |
STATE CODE OF CNH |
COUNTY CODE OF CNH |
(10) LEVEL OF CARE |
NUMBER OF BEDS IN CNH |
(11A) NO. OF INTERMEDIATE BEDS |
NH INSPECTED/ACCREDITED |
PER DIEM RATE (HIGH) |
PER DIEM RATE (LOW) |
CERT.MEDICARE/MEDICAID |
TOTAL NUMBER OF VETS IN NH |
NO. VETS INTERMEDIATE HOME |
DATE OF LAST ASSESSMENT |
(16) REPEAT COLUMNS 1-5 |
(17) CARD NUMBER |
(18) STREET ADDRESS OF NH |
(19) ZIP CODE OF NH |
CNH 40 BLANKS |
TRANSFERS IN FROM OTHER SITES |
TRANSFERS RETD TO OTHER SITES |
TFRS PEND RTN TO OTHER SITES |
TRANSFERS OUT TO OTHER SITES |
TRANSFERS RETD FROM OTH SITES |
TFRS PEND RTN FROM OTH SITES |
INSUFFICIENT RCD FR VARO |
FEE TRANSACTION DATE |
FEE REFERENCE NUMBER |
FEE SYSTEM IDENTIFIER |
BATCH TYPE |
FACILITY NUMBER |
CAWP DOLLAR AMOUNT |
CATCQ DOLLAR AMOUNT |
CATFOQ DOLLAR AMOUNT |
CCRAQ DOLLAR AMOUNT |
CAW DOLLAR AMT |
REM NO OF DEBTS |
IAM NO OF DEBTS |
DAM NO OF DEBTS |
CCRAM NO OF DEBTS |
CCPRAM DOLLAR AMOUNT |
PSEUDO INDICATOR |
CAWFM NO OF DEBTS |
CATCM NO OF DEBTS |
CATFOM NO OF DEBTS |
REM DOLLAR AMOUNT |
IAM DOLLAR AMOUNT |
DEM DOLLAR AMOUNT |
CCRAM DOLLAR AMOUNT |
CAWF DOLLAR AMOUNT |
CAWPM DOLLAR AMOUNT |
CATCM DOLLAR AMOUNT |
SOCIAL SECURITY NUMBER |
CATFOM DOLLAR AMOUNT |
PAID TRANSMISSION NUMBER |
C&A DA |
MONTH |
DAY |
YEAR |
NO. OF 10-2418A TRANSMITTED |
TOTAL PAY AND NON PAY VISITS |
BLANK-6 |
BLANK-3 |
STREET ADDRESS |
CITY |
STATE |
ZIP CODE |
SEX |
BIRTH DATE |
ENTRY DATE |
TERMINATION DATE |
COMBINATION 1 |
COMBINATION 2 |
COMBINATION 3 |
COMBINATION 4 |
COMBINATION 5 |
COMBINATION 6 |
YEARS OF SERVICE |
TOTAL CUM HOURS |
LAST AWARD HOURS |
LAST AWARD MO/YR |
FORM NUMBER |
DATE EVALUATED |
STATE CODE |
COUNTY CODE |
ELIGIBILITY |
BIRTH YEAR |
PERIOD OF SERVICE |
RACE/ETHNICITY |
MARITAL STATUS |
USUAL LIVING ARRANGEMENTS |
LAST AGENCY PROVIDING CARE |
TYPE OF AGENCY |
ACTION |
PRIMARY REASON FOR REJECTION |
DISPOSITION OF REJECTION |
PATIENTS FULL NAME |
HBHC ADMISSION DATE |
PRIMARY DIAGNOSIS |
VISION (WITH LENSES IF WORN) |
HEARING (WITH AID IF WORN) |
EXPRESSIVE COMMUNICATION |
RECEPTIVE COMMUNICATION |
BATHING/SHOWER ACTIVITY |
DRESSING ACTIVITY |
USING TOILET ACTIVITY |
TRANSFER ACTIVITY |
EATING ACTIVITY |
WALKING ACTIVITY |
CONTINENCE (BOWEL) |
CONTINENCE (BLADDER) |
MOBILITY (WITH MECHANICAL AID) |
ADAPTIVE TASKS |
BEHAVIOR PROBLEMS |
DISORIENTATION/MEMORY/IMPAIR |
DISTURBANCE OF MOOD |
CAREGIVER LIMITATIONS |
PAD HBHC5 46 SPACES |
PROVIDER #, DIGIT 1 |
PROVIDER #, DIGIT 2 |
PROVIDER #, DIGIT 3 |
DATE OF VISIT |
PATIENTS LAST NAME |
TYPE OF VISIT |
DISCHARGE DATE |
DISCHARGE STATUS |
TRANSFER DESTINATION |
PAD 2 SPACES |
PAD HBHC 73 SPACES |
TRANSACTION NUMBER |
TYPE |
REQUISITION NUMBER |
FTS TELEPHONE NUMBER |
DEPOT STOCK NUMBER |
UNIT OF USE |
QUANTITY ORDERED |
PAD FORM 7 SPACES |
PAD FORM 35 SPACES (AT END) |
LAST NAME |
FIRST NAME |
TERMINATION STARS |
C&A STATION NUMBER |
IDENTIFICATION NUMBER |
NAME CODE |
DAY NUMBER |
TRANS TYPE |
DECIMAL SUFFIX |
PARTICIPANT'S NAME |
C&A TITLE |
C&A TYPE |
DATE OF APPOINTMENT |
OCCUPATION SERIES |
ADDRESS LINE 1 |
ADDRESS LINE 2 |
C&A CITY |
C&A STATE |
C&A ZIP CODE |
ASSISTED (FULL CARE)-DIAL. |
LIMITED/SELF CARE DIALY. |
HOME (SELF) DIALY. TRAINING |
MAINT. DIALY. SHIFTS/DAY |
OPERATING DAYS PER WEEK |
REC. CARE FROM RPTG. UNIT |
CARE IN NON-VA UNIT |
ADMITTED FOR FIRST TIME(ADD.) |
TRANS. FROM OTHER VA DIALY. |
COST CENTER |
RETURNING/ OTHER VA/NON VA |
RETURNING-TRANSPLANTATION |
OTHER ADM./RE-ADM. (DIALY.) |
DEATHS (DIALY.) |
RECOVERED KIDNEY FUNCTION |
RECEIVED TRANSPLANT |
TRANSFERRED TO OTHER VA DIAL. |
DISCHARGED TO NON-VA |
OTHER LOSSES (DIALY.) |
ACUTE ASSISTED HEMODIALYSIS |
SUB ACCOUNT |
ACUTE ASSISTED PERI. DIALY. |
CHRONIC ASSISTED HEMO. INP. |
CHRONIC ASSISTED HEMO. OUTPT. |
CHRONIC ASSISTED PERI. INP. |
CHRONIC ASSISTED PERI. OUTP. |
LIMITED/SELF CARE HEMO. INP. |
LIMITED/SELF CARE HEMO. OUTPT. |
LIMITED/SELF CARE PERI. INP. |
LIMITED/SELF CARE PERI. OUTPT. |
HEMO. INP. (HOME TRAINING) |
RESERVED |
HEMO OUTPT. (HOME TRAINING) |
PERI. INP. (HOME TRAINING) |
PERI. OUTPT. (HOME TRAINING) |
HEMO. (HOME DIALYSIS) |
PERI. (HOME DIALYSIS) |
TOTAL DIALY. PAT. REMAINING |
CONTRACT/FEE BASIS (HEMO.) |
CONTRACT/FEE BASIS (PERI.) |
CONTRACT/FEE BASIS (TOTAL) |
S-C FOR RENAL DISEASE |
NUMBER OF VISITS |
S-C OTHER (DIALY.) |
NON-VA PATIENTS TREATED |
AWAITING TRANSPLANT |
ACUTE ASS. HEMO. TREATMENTS |
CHRONIC ASS. HEMO. TREATMENTS |
LIMITED/SELF HEMO. TREATMENTS |
ACUTE ASS. PERI. TREATMENTS |
CHRONIC ASS. PERI. TREATMENTS |
LIMITED/SELF PERI. TREATMENTS |
TOTAL DIALY. CENTER TREATMENTS |
AMOUNT-DOLLARS/CENTS |
AVG. TREATMENTS/BED/WEEK |
HEMO. TRAINING TREATMENTS |
PERIDIAL. TRAINING TREATMENTS |
HOME HEMODIALYSIS TREATMENTS |
HOME PERIDIAL. TREATMENTS |
TREATMENTS ON NON-VETERANS |
HOME HEMO. (INIT. TRN. COMP.) |
LIMITED/SELF HEMO. INIT. TRNG. |
HOME PERI. INIT. TRNG. COMP. |
LIMITED/SELF INIT. TRNG. |
PER DIEM-DOLLARS/CENTS |
TISSUE TYPING TESTS |
FEE PAID (HEMO.-OWN FACILITY) |
FEE PAID (PERI.-OWN FACILITY) |
FEE PAID (HEMO.-OTHER FAC.) |
FEE PAID (PERI.-OTHER FAC.) |
ID NUMBER IDENTIFIER |
TOTAL CRF. PATIENTS DIALYZED |
DIALYZED-DIABETIC |
DIALYZED-FRACTION DIABETIC |
DIALYZED-AGE 55 OR OVER |
DIALYZED-FRACTION 55 OR OVER |
DIALYZED-90 DAYS OR LESS |
DIAL.-DEATHS 90 DAYS OR LESS |
ID NUMBER CHANGE |
DIALY.-FRACTION CRF < 91 DAYS |
DIALYZED OVER 90 DAYS |
DIAL.-DEATHS OVER 90 DAYS |
FRACTION CRF > 90 DAYS |
DIALYZED-TOTAL ARF PATIENTS |
DIALYZED-DEATHS (ARF) |
DIALYZED-FRACTION CRF-ARF |
NO PAY |
DAY 1 |
BEDS |
ADMISSIONS |
DISCHARGES-MEDICINE |
TRANSFERS OUT TO ANOTHER ICU |
TRANSFERS OUT TO WARD |
DEATHS IN ICU |
PATIENTS REMAINING |
PATIENT DAYS OF CARE (M) |
CARDIOPULMONARY RESUSCITATIONS |
DESIGNATED BEDS (MED/SUR) |
DAY 2 |
DESIGNATED BEDS (MED/COR) |
DESIGNATED BEDS (MED/SURG/COR) |
FTEE-PHYSICIANS |
FTEE-PHYSICIAN ASSISTANTS |
FTEE-NURSES |
FTEE-NURSING ASSISTANTS |
FTEE-NON PROFESSIONAL |
FTEE-ADMINISTRATIVE |
FTEE-OTHER |
FTEE-DIALYSIS TECH/THERAPIST |
DAY 3 |
FTEE-SOCIAL WORKERS |
FTEE-DIETITIANS |
FTEE-TECHNICIANS |
FTEE-CLERKS |
DAY 4 |
DAY 5 |
DAY 6 |
DAY 7 |
DAY 8 |
DAY 9 |
DAY 10 |
DAY 11 |
AUTHORIZED FTEE |
ACTUAL FTEE |
ON DUTY HOURS-AUDIOLOGIST |
ON DUTY HRS-SPEECH PATHOLOGIST |
HEARING AID EVALUATIONS |
ASS. OF SOCIAL EFFICIENCY |
CONSULTS-AUDIOLOGY |
AURAL REHAB PATIENTS |
CASES COMPLETED |
DAY 12 |
CASE HISTORIES-AUDIOLOGY |
SCREENING-AUDIOLOGY |
PURE TONE AIR CONDUCTION |
PURE TONE BONE CONDUCTION |
SPEECH AUDIOMETRY |
STENGER TESTS |
TONE DECAY |
OTO-IMMITTANCE |
EVOKED POTENTIALS |
ENG |
DAY 13 |
OTHER SITE OF LESION TESTS |
CENTRAL AUDITORY TESTS |
AURAL REHAB TESTS |
DIAGNOSTIC REPORT |
TREATMENT PLANNING-AUDIOLOGY |
AURAL REHAB |
FAMILY COUNSELING-AUDIOLOGY |
PROGRESS NOTES-AUDIOLOGY |
OTHER CONTACTS-AUDIOLOGY |
PROSTHETICS EVALUATION-AUD. |
DAY 14 |
ROUNDS-AUDIOLOGY |
EQUIP. MAINT. CALIBRATION-AUD. |
HEARING CONSERVATION |
STUDENT TRAINING-AUDIOLOGY |
ON STATION TRAVEL-AUDIOLOGY |
OFF STATION TRAVEL-AUDIOLOGY |
CONSULTS-SPEECH PATHOLOGY |
PATIENTS WAITING FOR THERAPY |
CASE HISTORIES-SPEECH PATH. |
SCREENING-SPEECH PATHOLOGY |
DAY 15 |
COMP. LANG. COG EVALUATIONS |
SPEC. LIMITED LANG. COG EVAL. |
ORAL MOTOR STRUCTURAL EVAL. |
VOICE RESONANCE ARTIC. EVAL. |
FLUENCY EVALUATIONS |
DYSPHAGIA EVALUATIONS |
DIAGNOSTIC REPORTS |
TREATMENT PLANNING-SP. PATH. |
THERAPY SESSION PLANNING |
TREATMENT-SPEECH PATHOLOGY |
DAY 16 |
FAMILY COUNSELING-SPEECH PATH. |
PROGRESS NOTES-SPEECH PATH. |
OTHER CONTACTS-SPEECH PATH. |
PROSTHETICS EVAL.-SPEECH PATH. |
ROUNDS-SPEECH PATHOLOGY |
EQUIP. MAIN. CAL.-SPEECH |
STUDENT TRAINING-SPEECH PATH. |
ON STATION TRAVEL-SPEECH PATH. |
OFF STATION TRAVEL-SPEECH PATH |
ADMINISTRATIVE HOURS |
DAY 17 |
MEETINGS |
CONTINUING EDUCATION RECEIVED |
OTHER TRAINING RECEIVED |
TRAINING GIVEN |
SERVICE STATUS |
RESEARCH HOURS |
SECRETERIAL/CLER. HRS. |
DAY 18 |
DAY 19 |
DAY 20 |
DAY 21 |
TOTAL CATHERIZATIONS |
EVENTUALLY HAD CARDIAC SURGERY |
LEFT HEART PROCEDURES |
RIGHT HEART PROCEDURES |
TEMPORARY PACEMAKERS |
PERMANENT PACEMAKERS |
ANGIOPLASTY |
STREPTOKINASE |
DIGITAL CONTRAST |
DAY 22 |
ELECTROPHYSIOLOGY |
RESEARCH USE OF CCL |
USE OTHER THAN CARDIOLOGY |
USE BY OTHER FEDERAL AGENCIES |
USE BY PRIVATE SECTOR |
MYOCARDIAL INFARCTION |
STROKE |
PERFORATION |
PERIPHERAL VASCULAR |
OTHER MAJOR COMPLICATIONS |
DAY 23 |
DEATHS (CARDIAC CATH) |
DAY 24 |
DAY 25 |
DAY 26 |
DAY 27 |
DAY 28 |
DAY 29 |
DAY 30 |
DAY 31 |
S/C PATIENTS ON HOME OXYGEN |
S/C PATIENTS DROPPED |
S/C PATIENTS STARTED |
N/S/C PATIENTS ON HOME OXYGEN |
N/S/C PATIENTS DROPPED |
N/S/C NEW PATIENTS STARTED |
PATIENTS ON COMPRESSED GAS |
PATIENTS ON LIQUID OXYGEN |
PATIENTS ON RENTED CONCEN. |
PAY VISITS |
PATIENTS ON OWNED CONCEN. |
OXY. DEPENDENT VENTILATOR PAT. |
QUARTERLY COST-COMPRESSED GAS |
QUARTERLY COSTS-LIQUID OXYGEN |
QUARTERLY COSTS-RENTED CONCEN. |
QUAT. COSTS-VA OWNED CONCEN. |
QUARTERLY COSTS-VENTILATORS |
NO PAY VISITS |
NUMBER OF DEBTS (QUARTERLY) |
SEGMENT NUMBER |
MODIFIER |
NUMBER OF DEBITS (MONTHLY) |
DOLLAR AMOUNT (MONTHLY) |
DOLLAR AMOUNT (QUARTERLY) |
REQ NO. DEBTS |
IAQ NO DEBTS |
DEQ NO DEBTS |
CCRAQ NO BEBTS |
CAQ NO DEBTS |
CAWQ NO DEBTS |
CATQ NO DEBTS |
REQ DOLLAR AMOUNT |
IAQ DOLLAR AMT |
DAQ DOLLAR AMT |
CCPRAQ DOLLAR AMT |
MIP NUMBER OF DEBTS |
MIP DOLLAR AMOUNT |
MC SEGMENT MODIFIER |
J41-43 ZEROES |
TOTAL ANESTHETICS ADMINISTERED |
TOTAL INHALATION (02) |
TOTAL INTRAVENOUS (03) |
TOTAL INFILTRATION (04) |
TOTAL FIELD BLOCK (05) |
TOTAL NERVE BLOCK (06) |
TOTAL SPINAL OR EPIDURAL (07) |
TOTAL TOPICAL (08) |
TOTAL RECTAL (09) |
TOTAL OTHER (10) |
SURG, ANES, TOTAL |
SURG, ANES, # DEATHS |
SURG, NURSE, TOTAL |
SURG, NURSE, DEATHS |
SURG, OTHER, TOTAL |
SURG, OTHER, DEATHS |
DIAG, ANES, TOTAL |
DIAG, ANES, DEATHS |
DIAG, NURSE, TOTAL |
DIAG, NURSE, DEATHS |
DIAG, OTHER, TOTAL |
DIAG, OTHER, DEATHS |
TOTAL NUMBER OF DEATHS (23) |
DEATHS, INHALATION |
DEATHS, IVS |
DEATHS, INFILTRATION |
DEATHS, FIELD |
DEATHS, NERVE |
DEATHS, SPINAL |
DEATHS, TOPICAL |
DEATHS, RECTAL |
DEATHS, OTHER |
ANES CAUSE DEATH, DEFINITE |
ANES CAUSE DEATH, MAYBE |
ANES CAUSE DEATH, NO WAY JOSE |
UNIT DOSES ADMIN 01 |
AVG COST PER DOSE 02 |
WARD STOCK 03 |
AUTO REPLENISHMENT 04 |
AVG COST PER DOSE 05 |
WARD STOCK 06 |
AUTO REPLENISHMENT 07 |
AVG COST PER UNIT 08 |
TOTAL NUMBER 09 |
AVERAGE COST 10 |
ADMIXTURES 11 |
AVG UNIT COST 12 |
PIGGY BACKS 13 |
AVG UNIT COST 14 |
HYPERAL FLUIDS 15 |
AVG UNIT COST 16 |
FLUIDS AND ADMIN SETS 17 |
AVG UNIT COST 18 |
CONTROLLED SUBS ORDERS 19 |
AVG UNIT COST 20 |
REGULAR 21 |
OVERTIME 22 |
REGULAR 23 |
OVERTIME 24 |
OUTPT SERVICE CONNECTED 001 |
A&A HOUSEBOUND 002 |
ALL OTHER 003 |
METHADONE 004 |
MEDICATION REQUESTS 005 |
FEE BASIS 006 |
STAFF 007 |
NEW 008 |
REFILL 009 |
WINDOW 010 |
MAILOUT 011 |
AVG RX INGREDIENT COST 012 |
REGULAR 013 |
OVERTIME 014 |
REGULAR 015 |
OVERTIME 016 |
TOTAL # OF RXs 017 |
TOTAL COST OF RXs 018 |
MEDICATION 019 |
MEDICAL SUPPLIES 020 |
OTHER SUPPLIES 021 |
BLOOD FRACT & REL PDCTS 022 |
RESIDENTS & INTERNS 023 |
OTHER EDUCATIONAL 024 |
VOL SERVICE 025 |
OTH PTNT ORIENT ACT 026 |
INV PROTOCOLS 027 |
INVESTIG DRUG RXs 028 |
BEG BUDGET FY |
OFFSET CASH ACCOUNT |
DEPOSIT NUMBER |
BILLED FUND |
ACCOMPLISHED YEAR |
ACCOMPLISHED MONTH |
ACCOMPLISHED DAY |
HDR EXP REV GL IND |
REVERSAL FISC YEAR |
REVERSAL FISC MONTH |
BUDGET OVERRIDE IND |
LINE AMOUNT (SVB) |
LINE ACTION (SVB) |
LINE DESCRITION (SVB) |
EXP REV GL IND (SVB) |
TREASURY SCHEDULE NO. |
ADVANCE FLAG |
OBLIGATION FISCAL YR |
CLOSED BEG BUDGET FY |
CLOSED END BUDGET FY |
CLOSED FUND |
PAYMENT OFFSET IND |
XDIVISION |
TRAVEL ADVANCE FLAG |
CHECK NUMBER FILLER |
LESS THAN 25 (001) |
25-34 (002) |
35-44 (003) |
45-55 (004) |
56-64 (005) |
65-74 (006) |
75-84 (007) |
85 & UP (008) |
TO INDIVIDUAL LIVING (009) |
TO HOSPITAL (010) |
OTHER INSTITUTION CARE (011) |
DEATH (012) |
LESS THAN 1 YR. (013) |
1-2 (014) |
3-5 YRS (015) |
OVER 5 YRS. (016) |
LESS THAN 25 (017) |
25-34 (018) |
35-44 (019) |
45-54 (020) |
55-64 (021) |
65-74 (022) |
75-84 (023) |
85 & UP (024) |
TO INDIVIDUAL LIVING (025) |
TO HOSPITAL (026) |
OTHER INSTITUTION CARE (027) |
DEATH (028) |
LESS THAN 1 YR. (029) |
1-2 YRS. (030) |
3-5 YRS. (031) |
OVER 5 YRS. (032) |
LESS THAN 25 (033) |
25-34 (034) |
35-44 (035) |
45-54 (036) |
55-64 (037) |
65-74 (038) |
75-84 (039) |
85 & OVER (040) |
TO INDIVIDUAL LIVING (041) |
TO HOSPITAL (042) |
OTHER INSTITUTION CARE (043) |
DEATH (044) |
LESS THAN 1 YR. (045) |
1-2 YRS. (046) |
3-5 YRS. (047) |
OVER 5 YRS. (048) |
LESS THAN 25 (049) |
25-34 (050) |
35-44 (051) |
45-54 (052) |
55-64 (053) |
65-74 (054) |
75-84 (055) |
85 & UP (056) |
TO INDIVIDUAL LIVING (057) |
TO HOSPITAL (058) |
OTHER INSTITUTION CARE (059) |
DEATH (060) |
LESS THAN 1 YR. (061) |
1-2 YRS (062) |
3-5 YRS (063) |
OVER 5 YRS. (064) |
LESS THAN 25 (065) |
25-34 (066) |
35-44 (067) |
45-54 (068) |
55-64 (069) |
65-74 (070) |
75-84 (071) |
85 & UP (072) |
TO INDIVIDUAL LIVING (073) |
TO HOSPITAL (074) |
OTHER INSTITUTION CARE (075) |
DEATH (076) |
LESS THAN 1 YR. (077) |
1-2 YRS. (078) |
3-5 YRS (079) |
OVER 5 YRS. (080) |
HOSPITAL (081) |
NHCU (082) |
CNH (083) |
VA DOM (084) |
COMM. (085) |
OTHER (086) |
1-3 BEDS (001) |
4-6 BEDS (002) |
7-15 (003) |
16-25 (004) |
OVER 25 BEDS (005) |
MEDICAL/SURGICAL (006) |
PSYCHOSIS/NEUROSIS (007) |
ORGANIC & SENILE DISEASE (008) |
SUBSTANCE ABUSE (009) |
ALL OTHER (010) |
NSC (011) |
LESS THAN 50% (012) |
50% OR MORE SC (013) |
VETERANS INCOMP. (014) |
VETERANS COMPETENT (015) |
GAINS (001) |
TREATMENT GOAL ACHIEVED (002) |
REHOSPITALIZATION (003) |
DEATHS IN HOME (004) |
OTHER LOSSES (005) |
REMAINING HBHC PATIENTS (006) |
PATIENT DAYS OF CARE (007) |
S.C. (008) |
N.S.C. (009) |
# REC. OF A&A BENEFITS (010) |
S.C. (011) |
N.S.C. (012) |
PHYSICIAN (013) |
RN (014) |
LPN (015) |
DIETITIAN (016) |
SOCIAL WORKER (017) |
RMS (018) |
HOME HEALTH AIDE (019) |
STUDENTS (020) |
OTHERS (021) |
PHYSICIAN (022) |
RN (023) |
LPN (024) |
DIETITIAN (025) |
SOCIAL WORKER (026) |
RMS (027) |
HOME HEALTH AIDE (028) |
STUDENTS (029) |
OTHER (030) |
DATE OF POSITION VACANCY |
SUPERVISORY LEVEL |
POSITION NUMBER |
FLSA |
FUNCTIONAL CODE |
PAY PLAN |
OCCUPATIONAL SERIES & TITLE |
GRADE |
ORGANIZATION & COST CENTER |
DUTY BASIS |
TRANSACTION CODE |
DUTY STATION |
NUMBER OF VACANCIES |
GRADE OF POSITION-2 |
GRADE OF POSITION-3 |
GRADE OF POSITION-4 |
ASSIGNMENT CODE |
PAY PLAN |
HOURLY RATE |
VA ONLY |
CHIEF OR ASST CHIEF |
PART-TIME POSITION |
RESERVED-1 |
MODIFICATION DOCUMENT |
SECURITY CODE |
FCP UPDATED |
PROTESTANT CENSUS |
CATHOLIC CENSUS |
JEWISH CENSUS |
EASTERN ORTHODOX CENSUS |
CENSUS (OTHER) |
CENSUS (NO PREFERENCE) |
PROTESTANT CONTRACT CHAPLAINS |
CATHOLIC CONTRACT CHAPLAINS |
JEWISH CONTRACT CHAPLAINS |
E ORTHODOX CONTRACT CHAPLAINS |
PROTESTANT CONTRACT $'S |
CATHOLIC CONTRACT $'S |
JEWISH CONTRACT $'S |
E ORTHODOX CONTRACT $'S |
PROTESTANT FEE BASIS |
CATHOLIC FEE BASIS |
JEWISH FEE BASIS |
E ORTHODOX FEE BASIS |
PROTESTANT FEE BASIS $'S |
CATHOLIC FEE BASIS $'S |
JEWISH FEE BASIS $'S |
E ORTHODOX FEE BASIS $'S |
FULL TIME CHAPLAINS |
PART TIME CHAPLAINS |
INTERMITTENT CHAPLAINS |
PROTESTANT CHAPLAINS |
CATHOLIC CHAPLAINS |
JEWISH CHAPLAINS |
E ORTHODOX CHAPLAINS |
RELIGIOUS SERVICES (TIMES) |
RELIGIOUS SERVICES (PERSONS) |
GROUP MEETINGS (TIMES) |
GROUP MEETINGS (PERSONS) |
HOLY COMMUNION (CHAPEL) |
HOLY COMMUNION (BEDSIDE) |
CONFESSIONS |
MINISTRY TO DYING |
EMERGENCY CALLS |
VISITS TO SERIOUSLY ILL |
VISITS TO NEWLY ADMITTED |
PRE & POST SURGERY VISITS |
PATIENT/RELATIVE CONSULTATIONS |
CONSULTATIONS W/STAFF |
FUNERALS (SERVICES) |
FUNERALS (ATTENDANCE) |
AMBULATORY CARE (PERSONS) |
RADIO & TV (TIMES) |
USE OF VISUAL AIDS (TIMES) |
ORIENTATION LECTURES |
STAFF MEETINGS |
MENTAL HEALTH CARE MEETINGS |
SERVICES BY VISITING CLERGY |
VOLUNTEERS (PERSONS) |
VOLUNTEER (HOURS) |
REGULAR VISITATIONS |
OUTPATIENTS SEEN (TIMES) |
MENTAL HEALTH SETTING |
POST TRAUMATIC STRESS |
AIDS/HIV |
SUBSTANCE ABUSE |
HOMELESS |
BEREAVEMENT |
ONCOLOGY |
PERSON ABUSE |
GERIATRIC |
COLLATERAL VISITS |
VETS CENTER |
MGMT COMMITTEE (HRS TRAIN) |
MGMT COMMITTEE (HRS SPENT) |
MULTI-DISCIPLINARY |
ETHIC COMMITTEE CHAIRMAN |
ETHIC COMMITTEE MEMBER |
CHAPEL OFFERINGS (PROTESTANT) |
OTHER DONATIONS (PROTESTANT) |
SUPPLIES/EQUIP (PROTESTANT) |
CONTRIBUTIONS (PROTESTANT) |
HONORARIA (PROTESTANT) |
BALANCE EOP (PROTESTANT) |
AUDIT (PROTESTANT) |
CHAPEL OFFERINGS (CATHOLIC) |
OTHER DONATIONS (CATHOLIC) |
SUPPLIES/EQUIP (CATHOLIC) |
CONTRIBUTIONS (CATHOLIC) |
HONORARIA (CATHOLIC) |
BALANCE EOP (CATHOLIC) |
AUDIT (CATHOLIC) |
CHAPEL OFFERINGS (JEWISH) |
OTHER DONATIONS (JEWISH) |
SUPPLIES/EQUIP (JEWISH) |
CONTRIBUTIONS (JEWISH) |
HONORARIA (JEWISH) |
BALANCE EOP (JEWISH) |
AUDIT (JEWISH) |
CHAPEL OFFERINGS (E ORTHODOX) |
OTHER DONATIONS (E ORTHODOX) |
SUPPLIES/EQUIP (E ORTHODOX) |
CONTRIBUTIONS (E ORTHODOX) |
HONORARIA (E ORTHODOX) |
BALANCE EOP (E ORTHODOX) |
AUDIT (E ORTHODOX) |
PHOTO I |
PHOTO II |
PHOTO III |
PHOTO IV |
% PERS COST (PHOTO) |
% SUPPLY COST (PHOTO) |
% SPACE COST (PHOTO) |
EQUIPMENT COST (PHOTO) |
ILL/GRA I |
ILL/GRA II |
ILL/GRA III |
ILL/GRA IV |
% PERS COST (ILL/GRA) |
% SUPPLY COST (ILL/GRA) |
% SPACE COST (ILL/GRA) |
EQUIPMENT COST (ILL/GRA) |
CAG I |
CAG II |
CAG III |
CAG IV |
% PERS COST (CAG) |
% SUPPLY COST (CAG) |
% SPACE COST (CAG) |
EQUIPMENT COST (CAG) |
A/V I |
A/V II |
A/V III |
A/V IV |
% PERS COST (A/V) |
% SUPPLY COST (A/V) |
% SPACE COST (A/V) |
EQUIPMENT COST (A/V) |
MISC/ADMIN OPERATIONS |
% PERS COST (MO/A) |
% SUPPLY COST (MO/A) |
% SPACE COST (MO/A) |
EQUIPMENT COST (MO/A) |
PERSONNEL (TOTAL COST) |
SUPPLIES/SERVICES (TOTAL COST) |
SPACE (TOTAL COST) |
MEDICAL REQUESTS |
NON MEDICAL REQUESTS |
RESEARCH REQUESTS |
HOURS WORKED (CHIEF) |
HOURS WORKED (CLERICAL) |
HOURS WORKED (VOLUNTEER) |
HOURS WORKED (PRODUCTION) |
HOURS WORKED (TRAINEES) |
HOURS WORKED (ALL EMPLOYEES) |
HOURS PAID (CHIEF) |
HOURS PAID (CLERICAL) |
HOURS PAID (PRODUCTION) |
HOURS PAID OT (ALL EMPLOYEES) |
LWOP HOURS |
COP 45-DAY |
FTEE PAID |
SEGMENT ID 2 |
SEGMENT ID 3 |
SEGMENT ID 4 |
SEGMENT ID 5 |
SEGMENT ID 6 |
PSYCHIATRIC I |
PSYCHIATRIC II |
PSYCHIATRIC III |
PSYCHIATRIC IV |
NO. OF PSYCHIATRIC WARDS |
ALCOHOL & DRUG DEP TRMT I |
ALCOHOL & DRUG DEP TRMT II |
ALCOHOL & DRUG DEP TRMT III |
ALCOHOL & DRUG DEP TRMT IV |
NO. OF ALCOHOL/DRUG TRMT WARDS |
SURGICAL I |
SURGICAL II |
SURGICAL III |
SURGICAL IV |
NO. OF SURGICAL WARDS |
MEDICAL I |
MEDICAL II |
MEDICAL III |
MEDICAL IV |
NO. OF MEDICAL WARDS |
SPINAL CORD INJURY I |
SPINAL CORD INJURY II |
SPINAL CORD INJURY III |
SPINAL CORD INJURY IV |
SPINAL CORD INJURY V |
NO. OF SPINAL CORD INJ WARDS |
NURSING HOME CARE I |
NURSING HOME CARE II |
NURSING HOME CARE III |
NO. OF NURSING HOME CARE WARDS |
NO. OF HEMODIALYSIS TREATMENTS |
NO. OF HEMODIALYSIS UNITS |
HEMODIALYSIS DAYS OF OPERATION |
INTERMEDIATE CARE I |
INTERMEDIATE CARE II |
INTERMEDIATE CARE III |
NO. OF INTERMEDIATE WARDS |
DOMICILIARY (MEMBERS) |
DOMICILIARY (UNITS) |
CRITICAL CARE I |
CRITICAL CARE II |
CRITICAL CARE III |
NO. OF CRITICAL CARE UNITS |
OPERATING ROOM I |
OPERATING ROOM II |
OPERATING ROOM III |
OPERATING ROOM IV |
NO. OF OPERATING ROOMS |
RECOVERY ROOM I |
RECOVERY ROOM II |
RECOVERY ROOM III |
NO. OF RECOVERY ROOM BEDS |
AMBULATORY CARE I |
AMBULATORY CARE II |
AMBULATORY CARE III |
AMBULATORY CARE IV |
AMBULATORY CARE V |
AMBULATORY SURGERY I |
AMBULATORY SURGERY II |
AMBULATORY SURGERY III |
AMBULATORY SURGERY IV |
AMBULATORY SURGERY RECOVERY I |
AMBULATORY SURGERY RECOVERY II |
AMBULATORY SURG RECOVERY III |
PSYCHIATRIC (RN) |
PSYCHIATRIC (LPN) |
PSYCHIATRIC (NA) |
SURGICAL (RN) |
SURGICAL (LPN) |
SURGICAL (NA) |
MEDICAL (RN) |
MEDICAL (LPN) |
MEDICAL (NA) |
SPINAL CORD INJURY (RN) |
SPINAL CORD INJURY (LPN) |
SPINAL CORD INJURY (NA) |
IMMEDIATE CARE (RN) |
IMMEDIATE CARE (LPN) |
IMMEDIATE CARE (NA) |
NURSING HOME CARE (RN) |
NURSING HOME CARE (LPN) |
NURSING HOME CARE (NA) |
CRITICAL CARE (RN) |
CRITICAL CARE (LPN) |
CRITICAL CARE (NA) |
HEMODIALYSIS (RN) |
HEMODIALYSIS (LPN) |
HEMODIALYSIS (NA) |
OPERATING ROOM (RN) |
OPERATING ROOM (LPN) |
OPERATING ROOM (NA) |
ESCORT ACTIVITIES (RN) |
ESCORT ACTIVITIES (LPN) |
ESCORT ACTIVITIES (NA) |
DOMICILIARY (RN) |
DOMICILIARY (LPN) |
DOMICILIARY (NA) |
AMBULATORY CARE (RN) |
AMBULATORY CARE (LPN) |
AMBULATORY CARE (NA) |
HOSPITAL BASED HOME CARE (RN) |
HOSPITAL BASED HOME CARE (LPN) |
HOSPITAL BASED HOME CARE (NA) |
SATELLITE CLINICS (RN) |
SATELLITE CLINICS (LPN) |
SATELLITE CLINICS (NA) |
RECOVERY ROOM (RN) |
RECOVERY ROOM (LPN) |
RECOVERY ROOM (NA) |
ALCOHOL/DRUG DEP TRMT (RN) |
ALCOHOL/DRUG DEP TRMT (LPN) |
ALCOHOL/DRUG DEP TRMT (NA) |
AMBULATORY SURGERY (RN) |
AMBULATORY SURGERY (LPN) |
AMBULATORY SURGERY (NA) |
AMBULATORY SURG RECOVERY (RN) |
AMBULATORY SURG RECOVERY (LPN) |
AMBULATORY SURG RECOVERY (NA) |
RN FTEE CEILING |
LPN FTEE CEILING |
NA FTEE CEILING |
CLERICAL FTEE CEILING |
ADMIN OFFICER FTEE CEILING |
CLINICAL SPEC FTEE CEILING |
NURSE PRAC FTEE CEILING |
INFECT CTRL FTEE CEILING |
PUB HLTH FTEE CEILING |
STAFF NURSE FTEE CEILING |
CHIEF NURSE FTEE CEILING |
ASST CHIEF FTEE CEILING |
ASSOC CHIEF FTEE CEILING |
ADMN SUPERVISOR FTEE CEILING |
ADMN HEAD NURSE FTEE CEILING |
OTHER ADMN FTEE CEILING |
RESEARCH FTEE CEILING |
ASSOC CHIEF RES FTEE CEILING |
ASSOC CHIEF ED FTEE CEILING |
INSTRUCTOR FTEE CEILING |
RN POSITIONS FILLED |
LPN POSITIONS FILLED |
NA POSITIONS FILLED |
CLERICAL POSITIONS FILLED |
ADMIN OFFICER POSITIONS FILLED |
CLINICAL SPEC POSITIONS FILLED |
NURSE PRAC POSITIONS FILLED |
INFECT CTRL POSITIONS FILLED |
PUB HLTH POSITIONS FILLED |
STAFF NURSE POSITIONS FILLED |
CHIEF NURSE POSITIONS FILLED |
ASST CHIEF POSITIONS FILLED |
ASSOC CHIEF POSITIONS FILLED |
SUPERVISOR POSITIONS FILLED |
HEAD NURSE POSITIONS FILLED |
OTHER POSITIONS FILLED |
RESEARCH POSITIONS FILLED |
ASSOC CHIEF RESHR POSITIONS |
ASSOC CHIEF ED POSITIONS |
INSTRUCTOR POSITIONS FILLED |
SEGMENT DELIMITER 2 |
SEGMENT DELIMITER 3 |
SEGMENT DELIMITER 4 |
SEGMENT DELIMITER 5 |
SEGMENT DELIMITER 6 |
561 (SUPERVISORY HOURS) |
562 (SUPERVISORY HOURS) |
563 (SUPERVISORY HOURS) |
564 (SUPERVISORY HOURS) |
565 (SUPERVISORY HOURS) |
566 (SUPERVISORY HOURS) |
567 (SUPERVISORY HOURS) |
570 (SUPERVISORY HOURS) |
571 (SUPERVISORY HOURS) |
572 (SUPERVISORY HOURS) |
573 (SUPERVISORY HOURS) |
575 (SUPERVISORY HOURS) |
577 (SUPERVISORY HOURS) |
561 (LABOR HOURS) |
562 (LABOR HOURS) |
563 (LABOR HOURS) |
564 (LABOR HOURS) |
565 (LABOR HOURS) |
566 (LABOR HOURS) |
567 (LABOR HOURS) |
570 (LABOR HOURS) |
571 (LABOR HOURS) |
572 (LABOR HOURS) |
573 (LABOR HOURS) |
575 (LABOR HOURS) |
577 (LABOR HOURS) |
561 (THERAPY HOURS) |
563 (THERAPY HOURS) |
564 (THERAPY HOURS) |
565 (THERAPY HOURS) |
566 (THERAPY HOURS) |
567 (THERAPY HOURS) |
570 (THERAPY HOURS) |
571 (THERAPY HOURS) |
572 (THERAPY HOURS) |
573 (THERAPY HOURS) |
575 (THERAPY HOURS) |
577 (THERAPY HOURS) |
OT/COMP HOURS WORKED |
VACANT BED UNITS SERVICED |
DIET (FTEE ASSIGNED) |
OR (FTEE ASSIGNED) |
NHQ (FTEE ASSIGNED) |
HQ (FTEE ASSIGNED) |
CANT (FTEE ASSIGNED) |
FURNITURE HANDLING (FTEE) |
G-1 STAFFING STANDARDS |
G-2 STAFFING STANDARDS |
PSYCHIATRY (NET SQUARE FEET) |
INTERMEDIATE (NET SQUARE FEET) |
MEDICINE (NET SQUARE FEET) |
NEUROLOGY (NET SQUARE FEET) |
REHAB MEDICINE (NET SQ FEET) |
SPINAL CORD INJURY (NET SQ FT) |
SURGERY (NET SQUARE FEET) |
NHCU (NET SQUARE FEET) |
DOMICILIARY (NET SQ FEET) |
CLINICS (NET SQUARE FEET) |
DENTAL (NET SQUARE FEET) |
RESEARCH (NET SQUARE FEET) |
ADMINISTRATIVE (NET SQ FEET) |
OTHER (NET SQUARE FEET) |
PSYCHIATRY (MAN HOURS) |
INTERMEDIATE (MAN HOURS) |
MEDICINE (MAN HOURS) |
NEUROLOGY (MAN HOURS) |
REHAB MEDICINE (MAN HOURS) |
SPINAL CORD INJURY (MAN HRS) |
SURGERY (MAN HOURS) |
NHCU (MAN HOURS) |
DOMICILIARY (MAN HOURS) |
CLINICS (MAN HOURS) |
DENTAL (MAN HOURS) |
RESEARCH (MAN HOURS) |
ADMINISTRATIVE (MAN HOURS) |
OTHER (MAN HOURS) |
FACILITY GROSS SQ FOOTAGE |
MULTI-ACTIVITY LDRY (LBS) |
SINGLE-ACTIVITY LDRY (LBS) |
COMMERCIAL CONTRACT (LBS) |
ALL OTHER (LBS) |
UNIFORMS (PIECE COUNT) |
PATIENT'S CLOTHING (COUNT) |
DIETETICS (PIECE COUNT) |
CANTEEN (PIECE COUNT) |
LAUNDRY SQUARE FOOTAGE |
SATELLITE FACILITY (1) |
SATELLITE FACILITY (2) |
SATELLITE FACILITY (3) |
SATELLITE FACILITY (4) |
SATELLITE FACILITY (5) |
SATELLITE FACILITY (6) |
PSYCHIATRY (LBS ISSUED) |
INTERMEDIATE (LBS ISSUED) |
MEDICINE (LBS ISSUED) |
NEUROLOGY (LBS ISSUED) |
REHAB MEDICINE (LBS ISSUED) |
SPINAL CORD INJURY (LBS ISS) |
SURGERY (LBS ISSUED) |
NHCU (LBS ISSUED) |
DOMICILIARY (LBS ISSUED) |
CLINICS (LBS ISSUED) |
DENTAL (LBS ISSUED) |
RESEARCH (LBS ISSUED) |
ADMINISTRATIVE (LBS ISSUED) |
OTHER (LBS ISSUED) |
UTILITY COST |
OFFICE OF THE CHIEF |
ENVIRONMENTAL CARE |
TEXTILE CARE |
INTERIOR DESIGN |
VOLUNTEER HOURS |
NON-PAID HOURS |
MEAT, FISH, ETC. TOTAL COST |
MILK TOTAL COST |
FRUITS/VEGS TOTAL COST |
BREAD, ETC. TOTAL COST |
NUT. PROD. TOTAL COST |
MISC. TOTAL COST |
INVENTORY TOTAL VALUE |
INPATIENT MEALS |
OUTPATIENT MEALS |
PAID MEALS |
GRATUITOUS MEALS |
TOTAL MEALS SERVED |
HOBBIES (HOURS) |
MUSIC (HOURS) |
GAMES/SPORTS/ATHLETICS (HRS) |
SPECIAL EVENTS (HOURS) |
DANCE (HOURS) |
CREATIVE COMMUNICATION (HRS) |
SOCIAL RECREATION (HOURS) |
OUTDOOR RECREATION (HOURS) |
PHYSICAL FITNESS (HOURS) |
SPECTATOR EVENTS (HOURS) |
LEISURE/EDUC/COUNSEL (HRS) |
SPECIAL THERAPY (HOURS) |
HOBBIES (ATTENDANCE) |
MUSIC (ATTENDANCE) |
GAMES/SPORTS/ATH (ATTENDANCE) |
SPECIAL EVENTS (ATTENDANCE) |
DANCE (ATTENDANCE) |
CREATIVE COMM (ATTENDANCE) |
SOCIAL RECREATION (ATTENDANCE) |
OUTDOOR REC (ATTENDANCE) |
PHYSICAL FITNESS (ATTENDANCE) |
SPECTATOR EVENTS (ATTENDANCE) |
LEISURE/EDUC/COUN (ATTENDANCE) |
SPECIAL THERAPY (ATTENDANCE) |
VA GIVEN (TRAINING HRS) |
VA TAKEN (TRAINING HRS) |
OTHER GIVEN (TRAINING HRS) |
OTHER TAKEN (TRAINING HRS) |
RESEARCH STAFF HOURS |
PATIENT TRMT MEETINGS |
RECREATION (ADMIN HRS) |
MEDICAL CTR (ADMIN HRS) |
PROFESSIONAL (OTHER MEETING) |
COMMUNITY (OTHER MEETING) |
BUDGET |
WEEKEND/HOLIDAY HOURS |
THERAPIST HOURS |
ASSISTANTS HOURS |
CLERICAL HOURS |
OTHER HOURS |
RECREATION EQUIPMENT |
RECREATION MATERIALS |
PROGRAM SERVICES |
PERSONAL COMFORT |
PLANNED OFF FACILITY COMM |
HOBBIES |
MUSIC |
GAMES/SPORTS/ATHLETICS |
SPECIAL EVENTS |
DANCE |
CREATIVE COMMUNICATION |
SOCIAL RECREATION |
OUTDOOR RECREATION |
PHYSICAL FITNESS |
SPECTATOR EVENTS |
LEISURE/EDUC/COUNSELING |
SPECIAL THERAPY PROGRAMS |
PSYCHIATRY (UNITS) |
INTERMEDIATE MEDICINE (UNITS) |
MEDICINE (UNITS) |
NEUROLOGY (UNITS) |
REHAB MEDICINE (UNITS) |
BLIND REHABILITATION (UNITS) |
DRUG DEP TRMT INPATIENT |
ALCOHOL TRMT INPATIENT |
SCI INPATIENT |
SURGERY (INC NEUROSURGERY) |
VA NURSING HOME |
DAY TEATMENT CENTER |
DAY HOSPITAL PROGRAM |
VA DOMICILIARY |
COMM NURSING HOME |
MENTAL HEALTH (OUTPATIENT) |
DRUG DEP (OUTPATIENT) |
ALCOHOL TRMT (OUTPATIENT) |
SCI (OUTPATIENT) |
MEDICAL/SURGICAL (OUTPATIENT) |
QUARTER |
FISCAL YEAR |
FACILITY CODE SUFFIX |
ID (PART-1) |
SPECIALTY ASSIGNMENT (PART-1) |
FTEE (PART-1) |
CONTRACT STARTING DATE |
CONTRACT TERMINATION DATE |
TOTAL CONTRACT COST |
GAIN OR LOSS INDICATOR |
SPECIALTY ASSIGNMENT (PART-2) |
DUTY STATUS (PART-2) |
PHYSICIAN GRADE (PART-2) |
PHYSICIAN STEP (PART-2) |
DIPLOMATE STATUS (PART-2) |
DATE 0F BIRTH (PART-2) |
EDUCATION STATUS (PART-2) |
GAIN FROM CODE (PART-2) |
MONTHS SPENT RECRUITING-PT 2 |
OFFERS MADE |
LOSS TO CODE |
LENGTH OF VA SERVICE |
DUTY STATUS (PART-3) |
SPECIALTY ASSIGNMENT (PART-3) |
TYPE OF POSITION |
MONTHS VACANT |
MONTHS SPENT RECRUITING-PT 3 |
OFFERS MADE BY VA |
OFFERS REFUSED |
PHYSICIAN GRADE (PART-3) |
PHYSICIAN STEP (PART-3) |
DIPLOMATE STATUS (PART-3) |
DATE OF BIRTH (PART-3) |
EDUCATION STATUS (PART-3) |
GAIN FROM CODE (PART-3) |
MONTH REPORTING FOR DUTY |
ID (PART-4) |
FTEE (PART-4) |
POSITIVE ADJUSTMENTS |
NEGATIVE ADJUSTMENTS |
FWS PARAMETERS (COLUMNS 1-9) |
FWS PARAMETERS (COLUMNS 10-19) |
FWS PARAMETERS (COLUMNS 20-29) |
FWS PARAMETERS (COLUMNS 30-39) |
FWS PARAMETERS (COLUMNS 40-49) |
FWS PARAMETERS (COLUMNS 50-59) |
FWS PARAMETERS (COLUMNS 60-69) |
FWS PARAMETERS (COLUMNS 70-78) |
FWS PARAMETERS (COLUMN 79) |
FWS PARAMETERS (COLUMN 80) |
AREA CODE |
ESTABLISHMENT CODE |
STATUS |
SIC CODE |
WEIGHT |
TOTAL NUMBER OF EMPLOYEES |
PREVIOUS PARTICIPATION |
ESTABLISHMENT NAME |
NON-PARTICIPATION CODE |
FORM ID |
TYPE OF SURVEY |
OVERTIME DAILY RATE |
OVERTIME DAILY HOURS |
OVERTIME WEEKLY RATE |
OVERTIME WEEKLY HOURS |
SUNDAY RATE |
HOLIDAY RATE |
NORMAL WORKWEEK |
NR TRD-CRFT-LBR(PLANT) WORKERS |
MONTH OF RAISES |
COLLECTIVE BARGAINING CONTRACT |
FIRST INCREASE GRANTED |
REASON FOR INCREASE GRANTED-1 |
SECOND INCREASE GRANTED |
REASON FOR INCREASE GRANTED-2 |
TOTAL INCREASES GRANTED |
JOB NUMBER |
JOB MATCH-1 |
NUMBER OF EMPLOYEES-1 |
STRAIGHT TIME HOURLY RATE-1 |
COLA |
BONUS PER HOUR |
NUMBER OF STEPS |
MINIMUM JOB RATE |
MAXIMUM JOB RATE |
REASON FOR RATE CHANGE |
INCENTIVE RATE |
GUARANTEED MINIMUM |
MULTIPLE JOB MATCH |
FIRST INCREASE PENDING |
REASON FOR PENDING INCREASE-1 |
SECOND INCREASE PENDING |
REASON FOR PENDING INCREASE-2 |
TOTAL INCREASES PENDING |
JOB MATCH-2 |
NUMBER OF EMPLOYEES-2 |
STRAIGHT TIME HOURLY RATE-2 |
JOB MATCH-3 |
NUMBER OF EMPLOYEES-3 |
STRAIGHT TIME HOURLY RATE-3 |
JOB MATCH-4 |
NUMBER OF EMPLOYEES-4 |
STRAIGHT TIME HOURLY RATE-4 |
JOB MATCH-5 |
NUMBER OF EMPLOYEES-5 |
STRAIGHT TIME HOURLY RATE-5 |
JOB MATCH-6 |
NUMBER OF EMPLOYEES-6 |
STRAIGHT TIME HOURLY RATE-6 |
CONTINUATION COUNT |
REPORT PERIOD |
PERIOD ENDING |
SERVICE |
SECTION |
PAGE NUMBER |
502 - EMPLOYEE SEPARATIONS |
509 - EMPLOYEE HEAD COUNT |
100 - TOTAL HOURS WORKED |
200 - TOTAL PAID HOURS |
205 - PAID OVERTIME HOURS |
215 - COP HOURS |
300 - TOTAL UNPAID LWOP & AWOL |
400 - TOTAL FUNDED FTEE |
405 - MAN-HOURS BORROWED |
410 - MAN-HOURS LOANED |
701 - VOLUNTEER HOURS WORKED |
SYSTEM ID |
VENDOR ID |
VENDOR ADDRESS CODE |
MILEAGE |
MILEAGE COST |
FISC YEAR |
FISC MONTH |
HOME ORG |
HDR FUND |
TRANSACTION TYPE |
TRAVEL PURPOSES |
RECORD YEAR |
RECORD MONTH |
RECORD DAY |
NUMBER OF DAYS |
YEAR TRAVEL BEGINS |
MONTH TRAVEL BEGINS |
DAY TRAVEL BEGINS |
YEAR TRAVEL ENDS |
MONTH TRAVEL ENDS |
DAY TRAVEL ENDS |
BUDGET FY |
END BUDGET FY |
VENDOR NAME |
VENDOR ADDRESS 1 |
VENDOR ADDRESS 2 |
CITY (FMS) |
STATE CODE (FMS) |
ZIP CODE (FMS) |
HDR PF IND |
HDR REF TRANS CODE |
HDR REF TRANS NUMBER |
XORGANIZATION SUBMIT |
TICKET AMT |
DOCUMENT ACTION |
HEADER EXCEPTION AMT |
EXCEPTION INC DEC |
EXCEPTION CODE |
TOTAL VERIFIED AMT |
WTA AMT |
TAX WITHHELD AMT |
TAX WITHHELD INC DEC |
TAXABLE AMT |
TAXABLE INC DEC |
OWED EMPLOYEE |
OWED INC DEC |
FICA WAGE AMT |
FICA INC DEC |
AGENCY SCHEDULE NO |
PMT SEQUENCE NUMBER |
PRINT CHECK FLAG |
DISBURSING OFFICE |
NO CHECK DISB FLAG |
AGENCY SCHD FISC YR |
VOUCHER SCHEDULE CAT |
TRAVEL TYPE1 |
TO TRANS CODE 1 |
TO TRANS NUMBER 1 |
TRAVEL ADVANCE NUMBER 1 |
APPLIED AMT 1 |
APPLIED 1 INC DEC |
ADV BALANCE 1 |
HEADER DESCRIPTION 1 |
TRAVEL TYPE2 |
TO TRANS CODE 2 |
TO TRANS NUMBER 2 |
TRAVEL ADVANCE NUMBER 2 |
APPLIED AMT 2 |
APPLIED 2 INC DEC |
ADV BALANCE 2 |
HEADER DESCRIPTION 2 |
TRAVEL TYPE3 |
TO TRANS CODE 3 |
TO TRANS NUMBER 3 |
TRAVEL ADVANCE NUMBER 3 |
APPLIED AMT 3 |
APPLIED 3 INC DEC |
ADV BALANCE 3 |
HEADER DESCRIPTION 3 |
TYPE OF VOUCHER |
OCR PRINT FLAG |
SCHEDULE DISB FLAG |
TRAVEL DATE BEGINS |
TRAVEL DATE ENDS |
SCHEDULED PAY DATE |
UNAPPLIED DEP NUM |
TRAVEL TYPE |
CREDIT CARD FLAG |
PRINT FLAG |
TO VENDOR ADDRESS 1 |
TO VENDOR ADDRESS 2 |
TO CITY |
TO STATE CODE |
TO ZIP CODE |
OUTSTANDING BALANCE |
REMAINING ADVANCE |
TEXT TYPE |
END TRAVEL DESC |
TRAVEL MODE CODES |
TRAVEL PURPOSE CODES |
PCS AUTH CODES |
PER DIEM CODE |
PER DIEM AMOUNT |
PER DIEM INC DEC |
OBLIG TRANS TYPE |
TOTAL OBLIGATION |
TRAVEL ITINERARY 1 |
TRAVEL ITINERARY 2 |
ADVANCE TRANS TYPE |
TOTAL ADVANCE |
TOTAL ADV INC DEC |
ADVANCE VNDR ADDR |
YEAR REQUIRED |
MONTH REQUIRED |
DAY REQUIRED |
COMMENT LINE 1 |
COMMENT LINE 2 |
ADV VENDOR ADDRESS 1 |
ADV VENDOR ADDRESS 2 |
ADV CITY |
ADV STATE CODE |
ADV ZIP CODE |
PICK UP CHECK |
SEQ NUMBER |
TRAVEL ADVANCE NUMB |
HEADER XORGANIZATION |
HEADER SUB ORG |
HEADER COST ORG |
HEADER COST SUB ORG |
HEADER JOB NUMBER |
HEADER XPROGRAM |
HEADER REPORT CAT |
HEADER DESCRIPTION |
ADV FUND |
ADV BUDGET FY |
ADV END BUDGET FY |
AGAENCY SCHD FISC YR |
CHECK ADVANCE |
CHECK ADV INC DEC |
CASH ADVANCE |
CASH ADV INC DEC |
HDR BUDGET FY |
HDR END BUDGET FY |
HDR TRANS TYPE |
DOCUMENT TYPE |
SCHED YEAR |
SCHED MONTH |
SCHED DAY |
VOUCHER SCHEDULE TYP |
DOCUMENT DESCRIPTION |
FA IND |
DOCUMENT TOTAL |
VENDOR ADDRESS LINE1 |
VENDOR ADDRESS LINE2 |
HAND PICK CK IND |
COMMENTS TO PRINT |
DISCOUNT DAYS 1 |
DISCOUNT PERCENT 1 |
DISCOUNT AMOUNT 1 |
DISCOUNT DAYS 2 |
DISCOUNT PERCENT 2 |
DISCOUNT AMOUNT 2 |
DISCOUNT DAYS 3 |
DISCOUNT PERCENT 3 |
DISCOUNT AMOUNT 3 |
HDR DISC LOST RSN CD |
PROX EOM 1 |
PROX EOM 2 |
PROX EOM 3 |
INTR AGCY SYMBOL |
DIRECT DISB NUMBER |
AGREEMENT NUMBER |
ADVANCE LIQ AMT |
DATE COVERED FROM |
DATE COVERED TO |
COVERED FROM YEAR |
COVERED FROM MONTH |
COVERED FROM DAY |
COVERED TO YEAR |
COVERED TO MONTH |
COVERED TO DAY |
HDR VENDOR ID |
HDR VENDOR ADDR CODE |
HDR VENDOR NAME |
HDR VENDOR ADDRESS 1 |
HDR VENDOR ADDRESS 2 |
COLLECTION DUE DATE |
ACCTG TRANS TYPE |
FUND |
VEND ADDRESS LINE1 |
VEND ADDRESS LINE2 |
VEND CITY |
VEND STATE CODE |
VEND ZIP 1 |
VEND ZIP 2 |
GTR NUMBER |
BILL PRINT FLAG |
COLLECTED DUE YY |
COLLECTED DUE MM |
COLLECTED DUE DD |
INTEREST RATE |
WAIVER FLAG |
CAUSE OF OVERPAYMENT |
CASE HIST FLAG |
TICKET AS OF DATE |
VENDOR INVOICE |
YEAR OF PAYMENT |
MONTH OF PAYMENT |
DAY OF PAYMENT |
BEGIN YEAR |
BEGIN MONTH |
BEGIN DAY |
VENDOR INVOICE YEAR |
VENDOR INVOICE MONTH |
VENDOR INVOICE DAY |
INT REASON CODE |
TRANS TYPE (FMS) |
REF ADV TRANS CODE |
REF ADV TRANS NUMBER |
REF ADV TRANS LINE |
VI TRANS CODE |
TELETICKET FLAG |
START DATE |
END DATE |
HEADER BUDGET FY |
HEADER END BUDGET FY |
HEADER FUND |
RESP PERSON |
VENDOR ADDR1 |
VENDOR ADDR2 |
VENDOR CONTACT |
CONFIRMATION ORDER |
FOB POINT |
DELIVERY YY |
DELIVERY MM |
DELIVERY DD |
BLANKET NUMBER |
BUYER |
SHIP ADDRESS CODE |
ENDING YY |
ENDING MM |
ENDING DD |
ENDING DATE DESC |
INSPECT ACCEPT DAYS |
NEG PAYMENT DAYS |
NO OF OPTIONS |
PURCHASE METHOD |
EFFECTIVE YY |
EFFECTIVE MM |
EFFECTIVE DD |
ALT PAY ID |
ALT PAY ADDRESS CODE |
ALT PAY NAME |
PRINT PO |
RECEIVER REQUIRED |
VENDOR INV REQUIRED |
COURSE CODE |
TRAINING CODE |
VENDOR CLASS |
DUTY HOURS |
OFF DUTY HOURS |
CONTRACT NUMBER |
INVITATION NUMBER |
ASSOC TRAN CODE HDR |
ASSOC DOC ID HDR |
AUTO ACCRUE IND |
HDR WAREHOUSE CODE |
SHIP ADDR CODE VIA |
RELATED GBL |
DISCOUNT TYPE |
GPO PROGRAM |
GPO JACKET |
PUBLICATION CTL |
BILLING ADDRESS |
RECEIVED BY |
CARRIER CODE |
CARRIER NAME |
CARRIER NUM |
CLEAR ALL |
COMMENTS (FMS-RC) |
RECEIVER DLN |
REF TRANS CODE |
REF TRANS NUMBER |
VENDOR ADDR IND |
REVERSAL FISC YEAR (RC) |
REVERSAL FISC MONTH (RC) |
FMSB FCP 1 |
FMSB FCP 2 |
FMSB POST TR TYPE |
FMSB POST THRU QTR |
FMSB DATE |
FMSB ACCTG PRD |
FMSB FUND |
FMSB BUDGET FYS |
FMSB TOTAL CHANGE AMT |
FMSB PEND/APRV/POST IND |
FMSB PEND TR TYPE |
FMSB APRV TR TYPE |
SELLING CONTROL POINT IEN |
BUYING CONTROL POINT IEN |
TRANSACTION DATE |
BENEFICIARY ID |
BENEF ADDRESS CODE |
HOLDBACK TOTAL |
HDR ACCEPT YEAR |
HDR ACCEPT MONTH |
HDR ACCEPT DAY |
HDR VENDOR INVOICE |
HDR VI YEAR |
HDR VI MONTH |
HDR VI DAY |
HDR VI LOG YEAR |
HDR VI LOG MONTH |
HDR VI LOG DAY |
HDR INT REASON CODE |
PROMPT PAY TYPE |
WORK INSTALLED |
NET PAYMENT AMT |
HOLDBACK PYMT AMT |
HDR INVOICE DLN |
HDR INVOICE DLN SEQ |
HDR RECEIVER DLN |
HDR RECEIVER DLN SEQ |
FISCAL APRV |
ACCP/DEL DATE |
INVOICE DATE |
LOG DATE |
STATION NUMBER |
CODE |
LINE |
CLINIC |
PATIENT IDENTIFICATION NUMBER |
PATIENT LAST NAME |
PATIENT FIRST NAME |
PATIENT MI |
ETHNIC BACKGROUND CODE (EBC) |
PATIENT SEX |
PATIENT DATE OF BIRTH |
COUNSELOR ID NUMBER |
ACTION CODE |
TYPE CODE |
ACTION EFFECTIVE DATE |
TREATMENT MODALITY |
DDCSS DATA CODE |
END OF DATA INDICATOR |
EFFECTIVE DATE '01' SEQUENCE |
PICKUP CODE |
MEDICATION SEQUENCE |
DOSAGE |
DOSAGE DURATION |
HCF TEXT CODE |
HCF SPACE |
HCF TEXT |
MEDICATION FOR WEEK OF |
DOSAGE CODE-MONDAY |
DOSAGE-MONDAY |
DOSAGE CODE-TUESDAY |
DOSAGE-TUESDAY |
DOSAGE CODE-WEDNESDAY |
DOSAGE-WEDNESDAY |
DOSAGE CODE-THURSDAY |
DOSAGE-THURSDAY |
DOSAGE CODE-FRIDAY |
DOSAGE-FRIDAY |
DOSAGE CODE-SATURDAY |
DOSAGE-SATURDAY |
DOSAGE CODE-SUNDAY |
DOSAGE-SUNDAY |
SPECIMEN COLLECTION DATE |
MORPHINE PRESCRIBED |
DRUG NAME/CODE MORPHINE |
MORPHINE RESULT |
BARBITURATE PRESCRIBED |
DRUG NAME/CODE BARBITURATE |
BARBITURATE RESULT |
AMPHETAMINE PRESCRIBED |
DRUG NAME/CODE AMPHETAMINE |
AMPHETAMINE RESULT |
METHADONE PRESCRIBED |
DRUG NAME/CODE METHADONE |
METHADONE RESULT |
OTHER DRUG 1 PRESCRIBED |
DRUG NAME/CODE OTHER 1 |
OTHER DRUG 1 RESULT |
OTHER DRUG 2 PRESCRIBED |
DRUG NAME/CODE OTHER 2 |
OTHER DRUG 2 RESULT |
OTHER DRUG 3 PRESCRIBED |
DRUG NAME/CODE OTHER 3 |
OTHER DRUG 3 RESULT |
NOT TESTED-QTY NOT SUFFICIENT |
COUNSELING SESSION DATE |
SUBJ DISC/REASON FOR ABS 1 |
SUBJ DISC/REASON FOR ABS 2 |
SUBJ DISC/REASON FOR ABS 3 |
HCF CENTRAL OFFICE USE ONLY |
KEYPUNCH CODE SHEET |
SEG. START CHAR. |
VERSION NO. |
DEPT. CODE |
SEG. MODIFIER |
001-3 CHAR |
002-3 CHAR |
003-3 CHAR |
004-3 CHAR |
005-3 CHAR |
006-3 CHAR |
007-3 CHAR |
008-3 CHAR |
009-3 CHAR |
010-3 CHAR |
011-3 CHAR |
012-3 CHAR |
013-3 CHAR |
014-3 CHAR |
015-3 CHAR |
016-3 CHAR |
017-3 CHAR |
018-3 CHAR |
019-3 CHAR |
020-3 CHAR |
021-3 CHAR |
022-3 CHAR |
023-3 CHAR |
024-3 CHAR |
025-3 CHAR |
026-3 CHAR |
027-3 CHAR |
028-3 CHAR |
029-3 CHAR |
030-3 CHAR |
031-3 CHAR |
032-3 CHAR |
033-3 CHAR |
034-3 CHAR |
035-3 CHAR |
036-3 CHAR |
037-3 CHAR |
038-3 CHAR |
039-3 CHAR |
040-3 CHAR |
041-3 CHAR |
042-3 CHAR |
043-3 CHAR |
044-3 CHAR |
045-3 CHAR |
046-3 CHAR |
047-3 CHAR |
048-3 CHAR |
049-3 CHAR |
050-3 CHAR |
051-3 CHAR |
052-3 CHAR |
053-3 CHAR |
054-3 CHAR |
055-3 CHAR |
056-3 CHAR |
057-3 CHAR |
058-3 CHAR |
059-3 CHAR |
060-3 CHAR |
061-3 CHAR |
062-3 CHAR |
063-3 CHAR |
064-3 CHAR |
065-3 CHAR |
066-3 CHAR |
067-3 CHAR |
068-3 CHAR |
069-3 CHAR |
070-3 CHAR |
071-3 CHAR |
072-3 CHAR |
073-3 CHAR |
074-3 CHAR |
075-3 CHAR |
076-3 CHAR |
077-3 CHAR |
078-3 CHAR |
079-3 CHAR |
080-3 CHAR |
081-3 CHAR |
082-3 CHAR |
083-3 CHAR |
084-3 CHAR |
085-3 CHAR |
086-3 CHAR |
087-3 CHAR |
088-3 CHAR |
089-3 CHAR |
090-3 CHAR |
091-3 CHAR |
092-3 CHAR |
093-3 CHAR |
094-3 CHAR |
095-3 CHAR |
001-4 CHAR |
002-4 CHAR |
003-4 CHAR |
004-4 CHAR |
005-4 CHAR |
006-4 CHAR |
007-4 CHAR |
008-4 CHAR |
009-4 CHAR |
010-4 CHAR |
011-4 CHAR |
012-4 CHAR |
013-4 CHAR |
014-4 CHAR |
015-4 CHAR |
016-4 CHAR |
017-4 CHAR |
018-4 CHAR |
019-4 CHAR |
020-4 CHAR |
021-4 CHAR |
022-4 CHAR |
023-4 CHAR |
024-4 CHAR |
025-4 CHAR |
026-4 CHAR |
027-4 CHAR |
028-4 CHAR |
029-4 CHAR |
030-4 CHAR |
031-4 CHAR |
032-4 CHAR |
033-4 CHAR |
034-4 CHAR |
035-4 CHAR |
036-4 CHAR |
037-4 CHAR |
038-4 CHAR |
039-4 CHAR |
040-4 CHAR |
041-4 CHAR |
042-4 CHAR |
043-4 CHAR |
044-4 CHAR |
045-4 CHAR |
046-4 CHAR |
047-4 CHAR |
048-4 CHAR |
049-4 CHAR |
050-4 CHAR |
051-4 CHAR |
052-4 CHAR |
053-4 CHAR |
054-4 CHAR |
055-4 CHAR |
056-4 CHAR |
057-4 CHAR |
058-4 CHAR |
059-4 CHAR |
060-4 CHAR |
061-4 CHAR |
062-4 CHAR |
063-4 CHAR |
064-4 CHAR |
065-4 CHAR |
066-4 CHAR |
067-4 CHAR |
068-4 CHAR |
069-4 CHAR |
070-4 CHAR |
071-4 CHAR |
072-4 CHAR |
073-4 CHAR |
074-4 CHAR |
075-4 CHAR |
076-4 CHAR |
077-4 CHAR |
078-4 CHAR |
079-4 CHAR |
080-4 CHAR |
081-4 CHAR |
082-4 CHAR |
083-4 CHAR |
084-4 CHAR |
085-4 CHAR |
086-4 CHAR |
087-4 CHAR |
088-4 CHAR |
089-4 CHAR |
090-4 CHAR |
091-4 CHAR |
092-4 CHAR |
093-4 CHAR |
094-4 CHAR |
095-4 CHAR |
001-5 CHAR |
002-5 CHAR |
003-5 CHAR |
004-5 CHAR |
005-5 CHAR |
006-5 CHAR |
007-5 CHAR |
008-5 CHAR |
009-5 CHAR |
010-5 CHAR |
011-5 CHAR |
012-5 CHAR |
013-5 CHAR |
014-5 CHAR |
015-5 CHAR |
016-5 CHAR |
017-5 CHAR |
018-5 CHAR |
019-5 CHAR |
020-5 CHAR |
021-5 CHAR |
022-5 CHAR |
023-5 CHAR |
024-5 CHAR |
025-5 CHAR |
026-5 CHAR |
027-5 CHAR |
028-5 CHAR |
029-5 CHAR |
030-5 CHAR |
031-5 CHAR |
032-5 CHAR |
033-5 CHAR |
034-5 CHAR |
035-5 CHAR |
036-5 CHAR |
037-5 CHAR |
038-5 CHAR |
039-5 CHAR |
040-5 CHAR |
041-5 CHAR |
042-5 CHAR |
043-5 CHAR |
044-5 CHAR |
045-5 CHAR |
046-5 CHAR |
047-5 CHAR |
048-5 CHAR |
049-5 CHAR |
050-5 CHAR |
051-5 CHAR |
052-5 CHAR |
053-5 CHAR |
054-5 CHAR |
055-5 CHAR |
056-5 CHAR |
057-5 CHAR |
058-5 CHAR |
059-5 CHAR |
060-5 CHAR |
061-5 CHAR |
062-5 CHAR |
063-5 CHAR |
064-5 CHAR |
065-5 CHAR |
066-5 CHAR |
067-5 CHAR |
068-5 CHAR |
069-5 CHAR |
070-5 CHAR |
071-5 CHAR |
072-5 CHAR |
073-5 CHAR |
074-5 CHAR |
075-5 CHAR |
076-5 CHAR |
077-5 CHAR |
078-5 CHAR |
079-5 CHAR |
080-5 CHAR |
001-6 CHAR |
002-6 CHAR |
003-6 CHAR |
004-6 CHAR |
005-6 CHAR |
006-6 CHAR |
007-6 CHAR |
008-6 CHAR |
009-6 CHAR |
010-6 CHAR |
011-6 CHAR |
012-6 CHAR |
013-6 CHAR |
014-6 CHAR |
015-6 CHAR |
016-6 CHAR |
017-6 CHAR |
018-6 CHAR |
019-6 CHAR |
020-6 CHAR |
021-6 CHAR |
022-6 CHAR |
023-6 CHAR |
024-6 CHAR |
025-6 CHAR |
026-6 CHAR |
027-6 CHAR |
028-6 CHAR |
029-6 CHAR |
030-6 CHAR |
031-6 CHAR |
032-6 CHAR |
033-6 CHAR |
034-6 CHAR |
035-6 CHAR |
036-6 CHAR |
037-6 CHAR |
038-6 CHAR |
039-6 CHAR |
040-6 CHAR |
041-6 CHAR |
042-6 CHAR |
043-6 CHAR |
044-6 CHAR |
045-6 CHAR |
046-6 CHAR |
047-6 CHAR |
048-6 CHAR |
049-6 CHAR |
050-6 CHAR |
051-6 CHAR |
052-6 CHAR |
053-6 CHAR |
054-6 CHAR |
055-6 CHAR |
056-6 CHAR |
057-6 CHAR |
058-6 CHAR |
059-6 CHAR |
060-6 CHAR |
061-6 CHAR |
062-6 CHAR |
063-6 CHAR |
064-6 CHAR |
065-6 CHAR |
066-6 CHAR |
001-2 CHAR |
002-2 CHAR |
003-2 CHAR |
004-2 CHAR |
005-2 CHAR |
006-2 CHAR |
007-2 CHAR |
008-2 CHAR |
009-2 CHAR |
010-2 CHAR |
011-2 CHAR |
012-2 CHAR |
013-2 CHAR |
014-2 CHAR |
015-2 CHAR |
016-2 CHAR |
017-2 CHAR |
018-2 CHAR |
019-2 CHAR |
020-2 CHAR |
021-2 CHAR |
022-2 CHAR |
023-2 CHAR |
024-2 CHAR |
025-2 CHAR |
026-2 CHAR |
027-2 CHAR |
028-2 CHAR |
029-2 CHAR |
030-2 CHAR |
031-2 CHAR |
032-2 CHAR |
033-2 CHAR |
034-2 CHAR |
035-2 CHAR |
036-2 CHAR |
037-2 CHAR |
038-2 CHAR |
039-2 CHAR |
040-2 CHAR |
041-2 CHAR |
042-2 CHAR |
043-2 CHAR |
044-2 CHAR |
045-2 CHAR |
046-2 CHAR |
047-2 CHAR |
048-2 CHAR |
049-2 CHAR |
050-2 CHAR |
051-2 CHAR |
052-2 CHAR |
053-2 CHAR |
054-2 CHAR |
055-2 CHAR |
056-2 CHAR |
057-2 CHAR |
058-2 CHAR |
059-2 CHAR |
060-2 CHAR |
061-2 CHAR |
062-2 CHAR |
063-2 CHAR |
064-2 CHAR |
065-2 CHAR |
066-2 CHAR |
067-2 CHAR |
068-2 CHAR |
069-2 CHAR |
070-2 CHAR |
071-2 CHAR |
072-2 CHAR |
073-2 CHAR |
074-2 CHAR |
075-2 CHAR |
076-2 CHAR |
077-2 CHAR |
078-2 CHAR |
079-2 CHAR |
080-2 CHAR |
081-2 CHAR |
082-2 CHAR |
083-2 CHAR |
084-2 CHAR |
085-2 CHAR |
086-2 CHAR |
087-2 CHAR |
088-2 CHAR |
089-2 CHAR |
090-2 CHAR |
091-2 CHAR |
092-2 CHAR |
093-2 CHAR |
094-2 CHAR |
095-2 CHAR |
014-7 CHAR |
039-7 CHAR |
094-8 CHAR |
SUFFIX |
TRANSACTION TYPE/SEGMENT |
CANTEEN (FORCED ENTRIES) |
CASHIER (FORCED ENTRIES) |
PHARMACY (FORCED ENTRIES) |
LOCKER AREAS (FORCED ENTRIES) |
ALL OTHER (FORCED ENTRIES) |
PERSONAL PROPERTY (OVER $50) |
PERSONAL PROPERTY (UNDER $50) |
PERSONAL PROPERTY (TOTAL LOSS) |
GOVERNMENT PROPERTY (OVER $50) |
GOV'T PROPERTY (UNDER $50) |
GOV'T PROPERTY (TOTAL LOSS) |
COIN MACHINE THEFTS |
COIN MACHINE (TOTAL LOSS) |
AUTO THEFT-GOV'T VEHICLE |
GOV'T VEHICLE (TOTAL LOSS) |
AUTO THEFT-PRIVATE VEHICLE |
PRIVATE VEHICLE (TOTAL LOSS) |
DRUG THEFTS |
DRUG THEFTS-ATTEMPTED |
ARMED ROBBERY |
STRONG-ARM ROBBERY |
ROBBERY (OVER $50) |
ROBBERY (UNDER $50) |
ROBBERY (DRUGS ONLY) |
TOTAL DOLLAR LOSS TO ROBBERY |
ASSAULT WITH DANGEROUS WEAPON |
ASSAULT WITH NO WEAPON |
SIMPLE ASSAULT |
ASSAULT BY PATIENTS |
ASSAULT BY EMPLOYEES |
ASSAULT BY OUTSIDERS |
ASSAULT BY UNKNOWN PERSONS |
ASSAULT ON PATIENTS |
ASSAULT ON EMPLOYEES |
ASSAULT ON OUTSIDERS |
FORCIBLE RAPE |
ATTEMPTED RAPE |
PATIENTS COMMITTING RAPE |
EMPLOYEES COMMITTING RAPE |
OUTSIDERS COMMITTING RAPE |
OTHER PERSONS COMMITTING RAPE |
RAPE OF PATIENTS |
RAPE OF EMPLOYEES |
RAPE OF OUTSIDERS |
DISTURBANCE BY OUTSIDERS |
EMPLOYEE/PATIENT DISTURBANCE |
BOMB THREATS |
THREATS TO EMPLOYEES |
NEGLIGENT MANSLAUGHTER |
NON-NEGLIGENT MANSLAUGHTER |
MANSLAUGHTER BY PATIENTS |
MANSLAUGHTER BY EMPLOYEES |
MANSLAUGHTER BY OUTSIDERS |
MANSLAUGHTER BY UNKNOWN PERSON |
MANSLAUGHTER ON PATIENT |
MANSLAUGHTER ON EMPLOYEE |
MANSLAUGHTER ON OUTSIDER |
PATIENT VANDALISM |
EMPLOYEE VANDALISM |
OUTSIDE VANDALISM |
VANDALISM (TOTAL DOLLAR LOSS) |
COURTESY PARKING VIOLATIONS |
MOVING VIOLATIONS |
TRAFFIC COURT VIOLATION NOTICE |
ARSON |
TOTAL DOLLAR LOSS DUE TO ARSON |
LIQUOR POSSESSION/INTRODUCTION |
DRUG POSSESSION/INTRODUCTION |
RECEIPT/SELL STOLEN PROPERTY |
WEAPON POSSESSION |
VICE SOLICITING |
STOPS FOR QUESTIONING |
PHYSICAL ARRESTS |
ARRESTS THRU US DIST. COURT |
DATE CREATED |
CREATED BY |
AMIS MONTH/YEAR |
AUTOMATIC TERMINATOR |