
| SEQUENCE NUMBER | YEAR MONTH | OVERBOOKED INDICATOR | SECONDARY PROVIDER #2 PC | SECONDARY PROVIDER #2 NPI | SECONDARY PROVIDER #3 | SECONDARY PROVIDER #3 PC | SECONDARY PROVIDER #3 NPI | SECONDARY PROVIDER #4 | SECONDARY PROVIDER #4 PC | SECONDARY PROVIDER #4 NPI | SECONDARY PROVIDER #5 | SECONDARY PROVIDER #5 PC | *PLACEHOLDER | SECONDARY PROVIDER #5 NPI | ED DISPOSITION CODE | PRIMARY ICD-10 CODE | SECONDARY ICD-10 CODE #1 | SECONDARY ICD-10 CODE #2 | SECONDARY ICD-10 CODE #3 | SECONDARY ICD-10 CODE #4 | ENCOUNTER SC | VIETNAM | SECONDARY PROVIDER #6 | TREATING SPECIALITY | SECONDARY PROVIDER #6 PC | SECONDARY PROVIDER #6 NPI | SECONDARY PROVIDER #7 | SECONDARY PROVIDER #7 PC | SECONDARY PROVIDER #7 NPI | CAMP LEJEUNE STATUS | ENCOUNTER CAMP LEJEUNE | PRIMARY PROCEDURE | COMBAT VETERAN INDICATOR | COMBAT VETERAN LOCATION | TIME | CLINIC IEN | NEW FEEDER KEY | PATIENT DIVISION | CPT, QTY & MODIFIERS #1 | CPT, QTY & MODIFIERS #2 | CPT, QTY & MODIFIERS #3 | CPT, QTY & MODIFIERS #4 | CPT, QTY & MODIFIERS #5 | CPT, QTY & MODIFIERS #6 | CPT, QTY & MODIFIERS #7 | PLACEHOLD PRIMARY CARE TEAM | CPT, QTY & MODIFIERS #8 | CPT, QTY & MODIFIERS #9 | CPT, QTY & MODIFIERS #10 | CPT, QTY & MODIFIERS #11 | CPT, QTY & MODIFIERS #12 | CPT, QTY & MODIFIERS #13 | CPT, QTY & MODIFIERS #14 | CPT, QTY & MODIFIERS #15 | CPT, QTY & MODIFIERS #16 | CPT, QTY & MODIFIERS #17 | PLACEHOLD PC PROVIDER | CPT, QTY & MODIFIERS #18 | CPT, QTY & MODIFIERS #19 | CPT, QTY & MODIFIERS #20 | CPT, QTY & MODIFIERS #21 | CPT, QTY & MODIFIERS #22 | CPT, QTY & MODIFIERS #23 | CPT, QTY & MODIFIERS #24 | CPT, QTY & MODIFIERS #25 | SERVICE CONNECTED STATUS | NON-COUNT FLAG | PLACEHOLD PC PROV PERSON CLASS | PLACEHOLD CERNER1 | ADMISSION DATE | ADMISSION TIME | PLACEHOLD CERNER2 | NEW MPI | PROVIDER TAXONOMY | PROVIDER STATION | FEEDER LOCATION | CPRS PROVIDER STATION | SELF IDENTIFIED GENDER | PROVIDER | PROVIDER PERSON CLASS | PLACEHOLD CPT QTY & MODS #1 | EXTRACT NUMBER | PLACEHOLD CPT QTY & MODS #2 | PLACEHOLD CPT QTY & MODS #3 | PLACEHOLD CPT QTY & MODS #4 | PLACEHOLD CPT QTY & MODS #5 | PLACEHOLD CPT QTY & MODS #6 | PLACEHOLD CPT QTY & MODS #7 | PLACEHOLD CPT QTY & MODS #8 | PLACEHOLDER | FACILITY | DATE OF BIRTH | ELIGIBILITY | VETERAN | PLACEHOLD RACE | POW STATUS | POW LOCATION | RADIATION STATUS | RADIATION ENCOUNTER INDICATOR | PATIENT NO. - DFN | AGENT ORANGE STATUS | AGENT ORANGE ENC INDICATOR | PLACEHOLD MPI | PLACEHOLD DSS PRODUCT DEPT | SEX | ZIP+4 | ENCOUNTER ELIGIBILITY | MST STATUS | SSN | MST ENCOUNTER INDICATOR | PLACEHOLD SHARE AGREEMNT PAYOR | PLACEHOLD SHARE AGREEMNT INSUR | ENROLLMENT LOCATION | STATE CODE | COUNTY CODE | PLACEHOLD ASSOC PC PROVIDER | PLACEHOLD AS PC PROV PERSON CL | DOM,PRRTP AND SAARTP INDICATOR | NAME | ENROLLMENT CATEGORY | ENROLLMENT STATUS | SHAD STATUS | PURPLE HEART INDICATOR | PERIOD OF SERVICE | OBSERVATION PATIENT INDICATOR | ENCOUNTER NUMBER | AGENT ORANGE LOCATION | PRODUCTION DIVISION CODE | APPOINTMENT TYPE | IN/OUT PATIENT INDICATOR | PURPOSE OF VISIT | PLACEHOLD MEANS TEST | HEAD & NECK CANCER INDICATOR | PLACEHOLD ETHNICITY | PLACEHOLD RACE 1 | CBOC STATUS INDICATOR | PLACEHOLD DSS IP # | ENROLLMENT PRIORITY | USER ENROLLEE | PATIENT TYPE | DAY | CV STATUS ELIGIBILITY | CV ELIGIBILITY END DATE | ENCOUNTER CV | PLACEHOLD NAT'L PAT REC FLAG | SW ASIA CONDITIONS | ENCOUNTER SWAC | ERI | ENC HEAD/NECK CA | OEF/OIF | OEF/OIF RETURN DATE | PLACEHOLD FEEDER KEY | PLACEHOLD ASSOC PC PROV NPI | PLACEHOLD PC PROVIDER NPI | PROVIDER NPI | COUNTRY CODE | ENCOUNTER SHAD | PATCAT | SECONDARY PROVIDER #1 | SECONDARY PROVIDER #1 PC | SECONDARY PROVIDER #1 NPI | SECONDARY PROVIDER #2 |
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