APHDR Data Sets

Army Public Health Data Repository (APHDR)

MDR-USAPHC (22).xlsx

APHDR Data Sets

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Document [xlsx]
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Overview

1. Cover Letter
2. MDR-USAPHC(Prov) Atr

Sheet 1: 1. Cover Letter
This tab, 1.Cover Letter, descripes the information in tab 2.



Tab
Description
2. MDR-USAPHC(Prov) Atr Report on the attributes available for selection. Explaination of the report column heads appears below, titled Column Definitions.




Column Definitions



Column Name Description
A Source Name of Data Source
B SourceTabOrd Ordinal Position of Table in Data Dictionary received from Source System-used internally
C SourceTable Name of the Table from which the data element is extracted from Source System
D SourceFieldOrd Ordinal Position of the data element in a Table in the Source System Data Dictionary-used internally
E FieldName Name of the data element (please use the literal format as in the column)
F PII/HIPAA Sensitive Please note YES, NO or DI (De-Identification)for the element PII or HIPAA sensitivity. If the element is PII or HIPAA sensitive and it will be de-identified, enter DI. A blank enter will be considered the same as a NO.
G NIMH (or USAPHC(Prov)) Approval User has accepted this as a valid element for their use-drop down list-Yes or No
H NIMH (or USAPHC(Prov)) SP2Delta Date the data element requested in Spiral-2. This will help in revising your existing extract routines
I FieldType This is the data type.
J Nullability This is the Nullability condition
K Primary Key Indicator if data element is a primary key (PK) or foreign key (FK) in this table
L Title Data Element Name
M Desc Dictionary meaning of the data element and enumerated values if applicable
N Values Information on values the element may have
O Notes Notes concerning the element
P FDM Comments Please add any comments that will help us understand the output extract.
Q ADS Comment Please add any comments on authoritativeness
R Code Table Reference Reference to code table.

Note: Please see the xlsx file titled "MDR Lookup Table (April 2009)" for detailed information on MDR code tables

Sheet 2: 2. MDR-USAPHC(Prov) Atr
Source Source Tab Ord SourceTable Source Field Ord FieldName PII/HIPAA Sensitive USAPHC (Prov) Approval USAPHC (Prov) SP2Delta FieldType Nullability Primary Key Title Desc Values Notes FDM Comments ADS Comment Code Table Reference
MDR 1 APPT 1 APPTDT
Yes 8/26/2009 yyyymmdd

Appointment Date Date of the appointment. e.g., 16022



MDR 1 APPT 2 APPTIDNO
Yes 8/26/2009 $10

Appointment IEN The appointment identifier number. The AIN is the system generated unique appointment identifier for that system. The Appointment Prefix and AIN combine to create a unique identifier.




MDR 1 APPT 3 APPTMIN
Yes 8/26/2009 mmm

Duration Length of the appointment measured in minutes.




MDR 1 APPT 4 APPTSTAT
Yes 8/26/2009 $2

Appointment Status Indicates the status of the patient's appointment.




MDR 1 APPT 5 APPTTYPE
Yes 8/26/2009 $6

Appointment Type Code indicating the type of appointment.




MDR 1 APPT 6 CMAC
Yes 8/26/2009 $1

CMAC Provider Class Class of provider, as defined by CHAMPUS payment policies. 0 - 4 0 = non-provider
1 = MD
2 = Psychologists
3 = Counselors
4 = Other providers


MDR 1 APPT 6 COMBEN
Yes 11/26/2010 1


Added to data dictionary 11/26/2010




MDR 1 APPT 7 DDS
Yes 8/26/2009 $2

DEERS Dependent Suffix DEERS specific code indicating the relationship of the beneficiary to the sponsor. (Not the same of the family member prefix in CHCS).




MDR 1 APPT 8 DMISID
Yes 8/26/2009 $4

Treatment DMIS ID Code that identifies the MTF responsible for the patient appointment.




MDR 1 APPT 9 HIPAAPRV
Yes 8/26/2009 $10

Provider Specialty (HIPAA) Primary provider category according to HIPAA defined codes for the attending provider. e.g., 207RR0522X



MDR 1 APPT 10 HOSPSTAT
Yes 8/26/2009 $1

Patient Status Inpatient/Outpatient indicator that the patient had at the time of the encounter. This field is supposed to be called "PATSTAT", and may change in the future. I, O, Blank I = Inpatient
O = Outpatient
Blank = Outpatient


MDR 1 APPT 11 HPROVID
Yes 8/26/2009 $15

Provider ID (HIPAA) HIPAA compliant provider ID. e.g., 1110000960



MDR 1 APPT 12 IAPPTDT
Yes 8/26/2009 8

Appointment Date Date of the appointment (SAS format).




MDR 1 APPT 13 PATAGE
Yes 8/26/2009 3

Patient Age Patient's age at the appointment date. e.g., 65



MDR 1 APPT 14 PROVID
Yes 8/26/2009 $15

Provider ID (Old) CHCS Provider ID. e.g., FUNKW



MDR 1 APPT 15 PROVSPEC
Yes 8/26/2009 $3

Provider Specialty (Old) A code that identifies the health service provider's medical specialty. Codes and meanings come from CHCS. e.g., 001 See Provider Specialty Codes for DC for codes and descriptions.


MDR 1 APPT 16 RANKPAY DI Yes 8/26/2009 $4

Sponsor Rank A code that represents the sponsor's military rank. 07 , 10 , 11, CD, E1 - E9, O1 - O9, W1 - W5, ZZ CD = Cadet
E1 - E4 = Junior Enlisted
E5 - E9 = Senior Enlisted
O1 - O3 = Junior Officer
O4 - O9, 10, 11 = Senior Officer
W1 - W5 = Warrant Officer
ZZ = All Others


MDR 1 APPT 17 SEX
Yes 8/26/2009 $1

Sex Patient's gender. F, M, Blank F = Female
M = Male
Blank = unknown


MDR 1 APPT 18 SPONSSN DI Yes 8/26/2009 $9

Sponsor SSN The sponsor’s SSN as assigned by the Social Security Administration. e.g., 123456789



MDR 2 CAPER 1 ACTDUR
Yes 8/13/2009 char(10)

Actual Appointment Duration Placeholder




MDR 2 CAPER 2 ADD1SPEC
Yes 8/13/2009 char(3)

Additional Provider 1 Specialty Code A code that identifies the health service provider's medical specialty. Codes and meanings come from CHCS (938 values). CHCS codes. A code that identifies the health service provider's medical specialty. Codes and meanings come from CHCS (938 values).


MDR 2 CAPER 3 ADD2SPEC
Yes 8/13/2009 char(3)

Additional Provider 2 Specialty Code A code that identifies the health service provider's medical specialty. Codes and meanings come from CHCS (938 values). CHCS codes. A code that identifies the health service provider's medical specialty. Codes and meanings come from CHCS (938 values).


MDR 2 CAPER 4 ADD3SPEC
Yes 8/13/2009 char(3)

Additional Provider 3 Specialty Code A code that identifies the health service provider's medical specialty. Codes and meanings come from CHCS (938 values). CHCS codes. A code that identifies the health service provider's medical specialty. Codes and meanings come from CHCS (938 values).


MDR 2 CAPER 5 CANCSTAT
Yes 8/13/2009 char(1)

Appointment Cancellation Status Type Type of appointment cancellation. 5, 8, 9 5 = Cancelled by provider
8 = Cancelled by facility
9 = Cancelled by patient


MDR 2 CAPER 6 PROVID
Yes 8/13/2009 char(9)

Appointment Provider ID Unique provider identifier for the provider rendering care.
Entered by MTF staff, the Provider ID normally consists of eight characters of the provider’s last name and first initial of first name, or some combination of last name A-numeric characters to arrive at a unique identifier (unique to the CHCS site).


MDR 2 CAPER 7 PROVSPEC
Yes 8/13/2009 char(3)

Appointment Provider Specialty Code A code that identifies the health service provider's medical specialty. Codes and meanings come from CHCS (938 values).
See Provider Specialty Codes for DC for codes and descriptions.


MDR 2 CAPER 8 PROVTYPE
Yes 8/13/2009 char(1)

Appointment Provider Type Code Appointment provider’s type. B, C, F, H, P, T B = Fee basis
C = Certification & Accreditation (C&A)
F = Full time
H = House staff
P = Partnership
T = Part time


MDR 2 CAPER 9 APPTSTAT
Yes 8/13/2009 char(1)

Appointment Status Type Appointment type status. 2, 3, 4, 5, 6, 7, 8 2 Kept
3 Cancel
4 No show
5 Walk-in
6 Sick call
7 Telephone consult
8 Leave Without Being Seen (LWOBS)


MDR 2 CAPER 10 APPTTYPE
Yes 8/13/2009 char(6)

Appointment Type The appointment type. ACUT, ACUT$, APV, EROOM, EST, EST$, GRP, GRP$, N-MTF, OPAC, OPAC$, PCM, PCM$, PROC, PROC$, RNDS*, ROUT, ROUTS, SPEC, SPEC$, T-CON, WELL, WELL$ ACUT = Acute appointment
ACUT$ = Acute appointment
APV = Ambulatory Procedure Visit
EROOM = Emergency Room
EST = Established/follow up
EST$ = Established/follow up
GRP = Group/class appointment
GRP$ = Group/class appointment
N-MTF = Non-MTF appointment
OPAC = Open Access Appointment
OPAC$ = Open Access Appointment
PCM = Initial Primary Care appointment
PCM$ = Initial Primary Care appointment
PROC = Procedure appointment
PROC$ = Procedure appointment
RNDS* = Inpatient ward appointment
ROUT = Routine appointment
ROUTS = Routine appointment
ROUT$ = Routine appointment
SPEC = Initial Specialty Care appointment
SPEC$ = Initial Specialty Care appointment
T-CON* = Telephone consult
T-CON = Telephone consult
WELL = Wellness/Health Promotion Appointment
WELL$ = Wellness/Health Promotion Appointment


MDR 2 CAPER 11 ASSGNDUR
Yes 8/13/2009 N(8)

Assigned Appointment Duration Duration of appointment for the encounter identified in increments of minutes, maximum 99999.




MDR 2 CAPER 12 CPT1
Yes 8/13/2009 char(5)

CPT/HCPCS Code 1 CPT/HCPCS code for the encounter based on the order of entry.




MDR 2 CAPER 13 CPT10
Yes 8/13/2009 char(5)

CPT/HCPCS Code 10 CPT/HCPCS code for the encounter based on the order of entry.




MDR 2 CAPER 14 CPT10DX
Yes 8/13/2009 char(4)

CPT/HCPCS Code 10-Diagnosis Pointer Associates a procedure with at least one diagnosis. A maximum number of pointers for up to 4 confirmed diagnoses. Whole number between 1 and 9876 (each position points to a diagnosis). 1-9876



MDR 2 CAPER 15 CPT10MIN
Yes 8/13/2009 N(8)

CPT/HCPCS Code 10-Min of Anesthesia Minutes of anesthesia applied during the associated procedure. Placeholder.




MDR 2 CAPER 16 CPT10MOD1
Yes 8/13/2009 char(2)

CPT/HCPCS Code 10-Modifier 1 First entered Modifier to the associated CPT/HCPCS code.




MDR 2 CAPER 17 CPT10MOD2
Yes 8/13/2009 char(2)

CPT/HCPCS Code 10-Modifier 2 Second entered Modifier to the associated CPT/HCPCS code.




MDR 2 CAPER 18 CPT10MOD3
Yes 8/13/2009 char(2)

CPT/HCPCS Code 10-Modifier 3 Third entered Modifier to the associated CPT/HCPCS code.




MDR 2 CAPER 19 CPT10PROV
Yes 8/13/2009 char(5)

CPT/HCPCS Code 10-Provider Linkage Correlates to a provider associated with the specified Procedure. A maximum number of provider pointers for linkage to a procedure is three. Whole number between 0 and 432 (each position points to a provider). 0-432



MDR 2 CAPER 20 CPT10UNITS
Yes 8/13/2009 N(8)

CPT/HCPCS Code 10-Units of Care A multiplier indicating how many of a particular procedure/service was given during the encounter. A whole number between 1 and 999. 1-999



MDR 2 CAPER 21 CPT1DX
Yes 8/13/2009 char(4)

CPT/HCPCS Code 1-Diagnosis Pointer Associates a procedure with at least one diagnosis. A maximum number of pointers for up to 4 confirmed diagnoses. Whole number between 1 and 9876 (each position points to a diagnosis). 1-9876



MDR 2 CAPER 22 CPT1MIN
Yes 8/13/2009 N(8)

CPT/HCPCS Code 1-Min of Anesthesia Minutes of anesthesia applied during the associated procedure. Placeholder.




MDR 2 CAPER 23 CPT1MOD1
Yes 8/13/2009 char(2)

CPT/HCPCS Code 1-Modifier 1 First entered Modifier to the associated CPT/HCPCS code.




MDR 2 CAPER 24 CPT1MOD2
Yes 8/13/2009 char(2)

CPT/HCPCS Code 1-Modifier 2 Second entered Modifier to the associated CPT/HCPCS code.




MDR 2 CAPER 25 CPT1MOD3
Yes 8/13/2009 char(2)

CPT/HCPCS Code 1-Modifier 3 Third entered Modifier to the associated CPT/HCPCS code.




MDR 2 CAPER 26 CPT1PROV
Yes 8/13/2009 char(5)

CPT/HCPCS Code 1-Provider Linkage Correlates to a provider associated with the specified Procedure. A maximum number of provider pointers for linkage to a procedure is three. Whole number between 0 and 432 (each position points to a provider). 0-432



MDR 2 CAPER 27 CPT1UNITS
Yes 8/13/2009 N(8)

CPT/HCPCS Code 1-Units of Care A multiplier indicating how many of a particular procedure/service was given during the encounter. A whole number between 1 and 999. 1-999



MDR 2 CAPER 28 CPT2
Yes 8/13/2009 char(5)

CPT/HCPCS Code 2 CPT/HCPCS code for the encounter based on the order of entry.




MDR 2 CAPER 29 CPT2DX
Yes 8/13/2009 char(4)

CPT/HCPCS Code 2-Diagnosis Pointer Associates a procedure with at least one diagnosis. A maximum number of pointers for up to 4 confirmed diagnoses. Whole number between 1 and 9876 (each position points to a diagnosis). 1-9876



MDR 2 CAPER 30 CPT2MIN
Yes 8/13/2009 N(8)

CPT/HCPCS Code 2-Min of Anesthesia Minutes of anesthesia applied during the associated procedure. Placeholder.




MDR 2 CAPER 31 CPT2MOD1
Yes 8/13/2009 char(2)

CPT/HCPCS Code 2-Modifier 1 First entered Modifier to the associated CPT/HCPCS code.




MDR 2 CAPER 32 CPT2MOD2
Yes 8/13/2009 char(2)

CPT/HCPCS Code 2-Modifier 2 Second entered Modifier to the associated CPT/HCPCS code.




MDR 2 CAPER 33 CPT2MOD3
Yes 8/13/2009 char(2)

CPT/HCPCS Code 2-Modifier 3 Third entered Modifier to the associated CPT/HCPCS code.




MDR 2 CAPER 34 CPT2PROV
Yes 8/13/2009 char(5)

CPT/HCPCS Code 2-Provider Linkage Correlates to a provider associated with the specified Procedure. A maximum number of provider pointers for linkage to a procedure is three. Whole number between 0 and 432 (each position points to a provider). 0-432



MDR 2 CAPER 35 CPT2UNITS
Yes 8/13/2009 N(8)

CPT/HCPCS Code 2-Units of Care A multiplier indicating how many of a particular procedure/service was given during the encounter. A whole number between 1 and 999. 1-999



MDR 2 CAPER 36 CPT3
Yes 8/13/2009 char(5)

CPT/HCPCS Code 3 CPT/HCPCS code for the encounter based on the order of entry.




MDR 2 CAPER 37 CPT3DX
Yes 8/13/2009 char(4)

CPT/HCPCS Code 3-Diagnosis Pointer Associates a procedure with at least one diagnosis. A maximum number of pointers for up to 4 confirmed diagnoses. Whole number between 1 and 9876 (each position points to a diagnosis). 1-9876



MDR 2 CAPER 38 CPT3MIN
Yes 8/13/2009 N(8)

CPT/HCPCS Code 3-Min of Anesthesia Minutes of anesthesia applied during the associated procedure. Placeholder.




MDR 2 CAPER 39 CPT3MOD1
Yes 8/13/2009 char(2)

CPT/HCPCS Code 3-Modifier 1 First entered Modifier to the associated CPT/HCPCS code.




MDR 2 CAPER 40 CPT3MOD2
Yes 8/13/2009 char(2)

CPT/HCPCS Code 3-Modifier 2 Second entered Modifier to the associated CPT/HCPCS code.




MDR 2 CAPER 41 CPT3MOD3
Yes 8/13/2009 char(2)

CPT/HCPCS Code 3-Modifier 3 Third entered Modifier to the associated CPT/HCPCS code.




MDR 2 CAPER 42 CPT3PROV
Yes 8/13/2009 char(5)

CPT/HCPCS Code 3-Provider Linkage Correlates to a provider associated with the specified Procedure. A maximum number of provider pointers for linkage to a procedure is three. Whole number between 0 and 432 (each position points to a provider). 0-432



MDR 2 CAPER 43 CPT3UNITS
Yes 8/13/2009 N(8)

CPT/HCPCS Code 3-Units of Care A multiplier indicating how many of a particular procedure/service was given during the encounter. A whole number between 1 and 999. 1-999



MDR 2 CAPER 44 CPT4
Yes 8/13/2009 char(5)

CPT/HCPCS Code 4 CPT/HCPCS code for the encounter based on the order of entry.




MDR 2 CAPER 45 CPT4DX
Yes 8/13/2009 char(4)

CPT/HCPCS Code 4-Diagnosis Pointer Associates a procedure with at least one diagnosis. A maximum number of pointers for up to 4 confirmed diagnoses. Whole number between 1 and 9876 (each position points to a diagnosis). 1-9876



MDR 2 CAPER 46 CPT4MIN
Yes 8/13/2009 N(8)

CPT/HCPCS Code 4-Min of Anesthesia Minutes of anesthesia applied during the associated procedure. Placeholder.




MDR 2 CAPER 47 CPT4MOD1
Yes 8/13/2009 char(2)

CPT/HCPCS Code 4-Modifier 1 First entered Modifier to the associated CPT/HCPCS code.




MDR 2 CAPER 48 CPT4MOD2
Yes 8/13/2009 char(2)

CPT/HCPCS Code 4-Modifier 2 Second entered Modifier to the associated CPT/HCPCS code.




MDR 2 CAPER 49 CPT4MOD3
Yes 8/13/2009 char(2)

CPT/HCPCS Code 4-Modifier 3 Third entered Modifier to the associated CPT/HCPCS code.




MDR 2 CAPER 50 CPT4PROV
Yes 8/13/2009 char(5)

CPT/HCPCS Code 4-Provider Linkage Correlates to a provider associated with the specified Procedure. A maximum number of provider pointers for linkage to a procedure is three. Whole number between 0 and 432 (each position points to a provider). 0-432



MDR 2 CAPER 51 CPT4UNITS
Yes 8/13/2009 N(8)

CPT/HCPCS Code 4-Units of Care A multiplier indicating how many of a particular procedure/service was given during the encounter. A whole number between 1 and 999. 1-999



MDR 2 CAPER 52 CPT5
Yes 8/13/2009 char(5)

CPT/HCPCS Code 5 CPT/HCPCS code for the encounter based on the order of entry.




MDR 2 CAPER 53 CPT5DX
Yes 8/13/2009 char(4)

CPT/HCPCS Code 5-Diagnosis Pointer Associates a procedure with at least one diagnosis. A maximum number of pointers for up to 4 confirmed diagnoses. Whole number between 1 and 9876 (each position points to a diagnosis). 1-9876



MDR 2 CAPER 54 CPT5MIN
Yes 8/13/2009 N(8)

CPT/HCPCS Code 5-Min of Anesthesia Minutes of anesthesia applied during the associated procedure. Placeholder.




MDR 2 CAPER 55 CPT5MOD1
Yes 8/13/2009 char(2)

CPT/HCPCS Code 5-Modifier 1 First entered Modifier to the associated CPT/HCPCS code.




MDR 2 CAPER 56 CPT5MOD2
Yes 8/13/2009 char(2)

CPT/HCPCS Code 5-Modifier 2 Second entered Modifier to the associated CPT/HCPCS code.




MDR 2 CAPER 57 CPT5MOD3
Yes 8/13/2009 char(2)

CPT/HCPCS Code 5-Modifier 3 Third entered Modifier to the associated CPT/HCPCS code.




MDR 2 CAPER 58 CPT5PROV
Yes 8/13/2009 char(5)

CPT/HCPCS Code 5-Provider Linkage Correlates to a provider associated with the specified Procedure. A maximum number of provider pointers for linkage to a procedure is three. Whole number between 0 and 432 (each position points to a provider). 0-432



MDR 2 CAPER 59 CPT5UNITS
Yes 8/13/2009 N(8)

CPT/HCPCS Code 5-Units of Care A multiplier indicating how many of a particular procedure/service was given during the encounter. A whole number between 1 and 999. 1-999



MDR 2 CAPER 60 CPT6
Yes 8/13/2009 char(5)

CPT/HCPCS Code 6 CPT/HCPCS code for the encounter based on the order of entry.




MDR 2 CAPER 61 CPT6DX
Yes 8/13/2009 char(4)

CPT/HCPCS Code 6-Diagnosis Pointer Associates a procedure with at least one diagnosis. A maximum number of pointers for up to 4 confirmed diagnoses. Whole number between 1 and 9876 (each position points to a diagnosis). 1-9876



MDR 2 CAPER 62 CPT6MIN
Yes 8/13/2009 N(8)

CPT/HCPCS Code 6-Min of Anesthesia Minutes of anesthesia applied during the associated procedure. Placeholder.




MDR 2 CAPER 63 CPT6MOD1
Yes 8/13/2009 char(2)

CPT/HCPCS Code 6-Modifier 1 First entered Modifier to the associated CPT/HCPCS code.




MDR 2 CAPER 64 CPT6MOD2
Yes 8/13/2009 char(2)

CPT/HCPCS Code 6-Modifier 2 Second entered Modifier to the associated CPT/HCPCS code.




MDR 2 CAPER 65 CPT6MOD3
Yes 8/13/2009 char(2)

CPT/HCPCS Code 6-Modifier 3 Third entered Modifier to the associated CPT/HCPCS code.




MDR 2 CAPER 66 CPT6PROV
Yes 8/13/2009 char(5)

CPT/HCPCS Code 6-Provider Linkage Correlates to a provider associated with the specified Procedure. A maximum number of provider pointers for linkage to a procedure is three. Whole number between 0 and 432 (each position points to a provider). 0-432



MDR 2 CAPER 67 CPT6UNITS
Yes 8/13/2009 N(8)

CPT/HCPCS Code 6-Units of Care A multiplier indicating how many of a particular procedure/service was given during the encounter. A whole number between 1 and 999. 1-999



MDR 2 CAPER 68 CPT7
Yes 8/13/2009 char(5)

CPT/HCPCS Code 7 CPT/HCPCS code for the encounter based on the order of entry.




MDR 2 CAPER 69 CPT7DX
Yes 8/13/2009 char(4)

CPT/HCPCS Code 7-Diagnosis Pointer Associates a procedure with at least one diagnosis. A maximum number of pointers for up to 4 confirmed diagnoses. Whole number between 1 and 9876 (each position points to a diagnosis). 1-9876



MDR 2 CAPER 70 CPT7MIN
Yes 8/13/2009 N(8)

CPT/HCPCS Code 7-Min of Anesthesia Minutes of anesthesia applied during the associated procedure. Placeholder.




MDR 2 CAPER 71 CPT7MOD1
Yes 8/13/2009 char(2)

CPT/HCPCS Code 7-Modifier 1 First entered Modifier to the associated CPT/HCPCS code.




MDR 2 CAPER 72 CPT7MOD2
Yes 8/13/2009 char(2)

CPT/HCPCS Code 7-Modifier 2 Second entered Modifier to the associated CPT/HCPCS code.




MDR 2 CAPER 73 CPT7MOD3
Yes 8/13/2009 char(2)

CPT/HCPCS Code 7-Modifier 3 Third entered Modifier to the associated CPT/HCPCS code.




MDR 2 CAPER 74 CPT7PROV
Yes 8/13/2009 char(5)

CPT/HCPCS Code 7-Provider Linkage Correlates to a provider associated with the specified Procedure. A maximum number of provider pointers for linkage to a procedure is three. Whole number between 0 and 432 (each position points to a provider). 0-432



MDR 2 CAPER 75 CPT7UNITS
Yes 8/13/2009 N(8)

CPT/HCPCS Code 7-Units of Care A multiplier indicating how many of a particular procedure/service was given during the encounter. A whole number between 1 and 999. 1-999



MDR 2 CAPER 76 CPT8
Yes 8/13/2009 char(5)

CPT/HCPCS Code 8 CPT/HCPCS code for the encounter based on the order of entry.




MDR 2 CAPER 77 CPT8DX
Yes 8/13/2009 char(4)

CPT/HCPCS Code 8-Diagnosis Pointer Associates a procedure with at least one diagnosis. A maximum number of pointers for up to 4 confirmed diagnoses. Whole number between 1 and 9876 (each position points to a diagnosis). 1-9876



MDR 2 CAPER 78 CPT8MIN
Yes 8/13/2009 N(8)

CPT/HCPCS Code 8-Min of Anesthesia Minutes of anesthesia applied during the associated procedure. Placeholder.




MDR 2 CAPER 79 CPT8MOD1
Yes 8/13/2009 char(2)

CPT/HCPCS Code 8-Modifier 1 First entered Modifier to the associated CPT/HCPCS code.




MDR 2 CAPER 80 CPT8MOD2
Yes 8/13/2009 char(2)

CPT/HCPCS Code 8-Modifier 2 Second entered Modifier to the associated CPT/HCPCS code.




MDR 2 CAPER 81 CPT8MOD3
Yes 8/13/2009 char(2)

CPT/HCPCS Code 8-Modifier 3 Third entered Modifier to the associated CPT/HCPCS code.




MDR 2 CAPER 82 CPT8PROV
Yes 8/13/2009 char(5)

CPT/HCPCS Code 8-Provider Linkage Correlates to a provider associated with the specified Procedure. A maximum number of provider pointers for linkage to a procedure is three. Whole number between 0 and 432 (each position points to a provider). 0-432



MDR 2 CAPER 83 CPT8UNITS
Yes 8/13/2009 N(8)

CPT/HCPCS Code 8-Units of Care A multiplier indicating how many of a particular procedure/service was given during the encounter. A whole number between 1 and 999. 1-999



MDR 2 CAPER 84 CPT9
Yes 8/13/2009 char(5)

CPT/HCPCS Code 9 CPT/HCPCS code for the encounter based on the order of entry.




MDR 2 CAPER 85 CPT9DX
Yes 8/13/2009 char(4)

CPT/HCPCS Code 9-Diagnosis Pointer Associates a procedure with at least one diagnosis. A maximum number of pointers for up to 4 confirmed diagnoses. Whole number between 1 and 9876 (each position points to a diagnosis). 1-9876



MDR 2 CAPER 86 CPT9MIN
Yes 8/13/2009 N(8)

CPT/HCPCS Code 9-Min of Anesthesia Minutes of anesthesia applied during the associated procedure. Placeholder.




MDR 2 CAPER 87 CPT9MOD1
Yes 8/13/2009 char(2)

CPT/HCPCS Code 9-Modifier 1 First entered Modifier to the associated CPT/HCPCS code.




MDR 2 CAPER 88 CPT9MOD2
Yes 8/13/2009 char(2)

CPT/HCPCS Code 9-Modifier 2 Second entered Modifier to the associated CPT/HCPCS code.




MDR 2 CAPER 89 CPT9MOD3
Yes 8/13/2009 char(2)

CPT/HCPCS Code 9-Modifier 3 Third entered Modifier to the associated CPT/HCPCS code.




MDR 2 CAPER 90 CPT9PROV
Yes 8/13/2009 char(5)

CPT/HCPCS Code 9-Provider Linkage Correlates to a provider associated with the specified Procedure. A maximum number of provider pointers for linkage to a procedure is three. Whole number between 0 and 432 (each position points to a provider). 0-432



MDR 2 CAPER 91 CPT9UNITS
Yes 8/13/2009 N(8)

CPT/HCPCS Code 9-Units of Care A multiplier indicating how many of a particular procedure/service was given during the encounter. A whole number between 1 and 999. 1-999



MDR 2 CAPER 92 INJDATE
Yes 8/13/2009 char(8)

Date of Injury The approximate date the injury occurred. yyyymmdd



MDR 2 CAPER 93 DEPLOYRELN
Yes 8/13/2009 char(1)

Deployed Relationship Identifies the deployment relationship. Placeholder.
No values currently entered.


MDR 2 CAPER 94 DEPLOYCNTRY
Yes 8/13/2009 char(2)

Deployment Country Identifies the country of deployment. Placeholder.
No values currently entered.


MDR 2 CAPER 95 DEPLOYCOND
Yes 8/13/2009 char(1)

Deployment Related Illness/Condition Identifier for deployment related illness and condition code. Placeholder.
No values currently entered.


MDR 2 CAPER 96 DISPCODE
Yes 8/13/2009 char(1)

Disposition Code The disposition code as marked on the outpatient and rounds encounters.

Note: The numeric codes are only for outpatient and the alpha codes are for inpatient encounters. Values of A - G only apply to encounters when the Inpatient Indicator = 1. Disposition Code types H, M, O, R, S, and U will only apply to non-privileged provider T-Con encounters and are currently used by only a small number of sites.		 1-8, A, B, C, D, E, F, G, H, M, O, R, S, U 1 = Released without limitations
2 = Released with work duty limitations
3 = Sick at home/quarters
4 = Immediate referral
5 = Left without being seen
6 = Left against medical advice
7 = Admitted
8 = Expired

A = Transferred to another hospital
B = Transferred to skilled nursing facility (SNF)
C = Transferred to another clinical service
D = Continued stay
E = Left against medical advice
F = Discharged home
G = Expired
H = Advice Assessment
M = Medication Refill Forwarded
O = Other Not Elsewhere Classified
R = Referred for Appointment
S = Released to Self Care
U = Referred to ER


MDR 2 CAPER 97 STANAG
Yes 8/13/2009 char(3)

DOD Specific Injury Code DoD specific injury codes using NATO Standardization Agreement (STANAG) codes. Placeholder 000 - 999 000 - 059 = Accidents in air transport
100 - 149 = Accidents in land transport
150 - 199 = Accidents in water transport
200 - 249 = Athletics & sports
250 - 299 = Reactions, complications, misadventures in medical/surgical procs; late complications or effects
300 - 479 = Instrumentalities of war, when employed by the enemy in wartime
480 - 499 = Accidents in connection w/ own instrumentalities of war, when employed as such in wartime
500 - 599 = Guns, explosives, related agents; exc when used as instrumentalities of war in wartime
600 - 699 = Machinery, tools, selected agents
700 - 799 = Poisons, fire, hot & corrosive substances
800 - 899 = Specified environmental factors (natural or artificial environment)
900 - 999 = Falls & miscellaneous other/unspecified agents


MDR 2 CAPER 98 DX1
Yes 8/13/2009 char(7)

DX (ICD-9-CM) Code #1 International Classification of Diseases, 9th edition (ICD-9) entered diagnosis code.




MDR 2 CAPER 99 DX10
Yes 8/13/2009 char(7)

DX (ICD-9-CM) Code #10 ICD-9 entered diagnosis code.




MDR 2 CAPER 100 DX10EXT
Yes 8/13/2009 char(1)

DX (ICD-9-CM) Code #10-DOD Extender ICD-9 extender code.




MDR 2 CAPER 101 DX10PRI
Yes 8/13/2009 char(1)

DX (ICD-9-CM) Code #10-Priority The level of priority of the diagnosis for the visit. 1, 2, 3, 4, U 1, 2, 3, 4, or U (unconfirmed).


MDR 2 CAPER 102 DX1EXT
Yes 8/13/2009 char(1)

DX (ICD-9-CM) Code #1-DOD Extender ICD-9 extender code.




MDR 2 CAPER 103 DX1PRI
Yes 8/13/2009 char(1)

DX (ICD-9-CM) Code #1-Priority The level of priority of the diagnosis for the visit. 1, 2, 3, 4, U 1, 2, 3, 4, or U (unconfirmed).


MDR 2 CAPER 104 DX2
Yes 8/13/2009 char(7)

DX (ICD-9-CM) Code #2 ICD-9 entered diagnosis code.




MDR 2 CAPER 105 DX2EXT
Yes 8/13/2009 char(1)

DX (ICD-9-CM) Code #2-DOD Extender ICD-9 extender code.




MDR 2 CAPER 106 DX2PRI
Yes 8/13/2009 char(1)

DX (ICD-9-CM) Code #2-Priority The level of priority of the diagnosis for the visit. 1, 2, 3, 4, U 1, 2, 3, 4, or U (unconfirmed).


MDR 2 CAPER 107 DX3
Yes 8/13/2009 char(7)

DX (ICD-9-CM) Code #3 ICD-9 entered diagnosis code.




MDR 2 CAPER 108 DX3EXT
Yes 8/13/2009 char(1)

DX (ICD-9-CM) Code #3-DOD Extender ICD-9 extender code.




MDR 2 CAPER 109 DX3PRI
Yes 8/13/2009 char(1)

DX (ICD-9-CM) Code #3-Priority The level of priority of the diagnosis for the visit. 1, 2, 3, 4, U 1, 2, 3, 4, or U (unconfirmed).


MDR 2 CAPER 110 DX4
Yes 8/13/2009 char(7)

DX (ICD-9-CM) Code #4 ICD-9 entered diagnosis code.




MDR 2 CAPER 111 DX4EXT
Yes 8/13/2009 char(1)

DX (ICD-9-CM) Code #4-DOD Extender ICD-9 extender code.




MDR 2 CAPER 112 DX4PRI
Yes 8/13/2009 char(1)

DX (ICD-9-CM) Code #4-Priority The level of priority of the diagnosis for the visit. 1, 2, 3, 4, U 1, 2, 3, 4, or U (unconfirmed).


MDR 2 CAPER 113 DX5
Yes 8/13/2009 char(7)

DX (ICD-9-CM) Code #5 ICD-9 entered diagnosis code.




MDR 2 CAPER 114 DX5EXT
Yes 8/13/2009 char(1)

DX (ICD-9-CM) Code #5-DOD Extender ICD-9 extender code.




MDR 2 CAPER 115 DX5PRI
Yes 8/13/2009 char(1)

DX (ICD-9-CM) Code #5-Priority The level of priority of the diagnosis for the visit. 1, 2, 3, 4, U 1, 2, 3, 4, or U (unconfirmed).


MDR 2 CAPER 116 DX6
Yes 8/13/2009 char(7)

DX (ICD-9-CM) Code #6 ICD-9 entered diagnosis code.




MDR 2 CAPER 117 DX6EXT
Yes 8/13/2009 char(1)

DX (ICD-9-CM) Code #6-DOD Extender ICD-9 extender code.




MDR 2 CAPER 118 DX6PRI
Yes 8/13/2009 char(1)

DX (ICD-9-CM) Code #6-Priority The level of priority of the diagnosis for the visit. 1, 2, 3, 4, U 1, 2, 3, 4, or U (unconfirmed).


MDR 2 CAPER 119 DX7
Yes 8/13/2009 char(7)

DX (ICD-9-CM) Code #7 ICD-9 entered diagnosis code.




MDR 2 CAPER 120 DX7EXT
Yes 8/13/2009 char(1)

DX (ICD-9-CM) Code #7-DOD Extender ICD-9 extender code.




MDR 2 CAPER 121 DX7PRI
Yes 8/13/2009 char(1)

DX (ICD-9-CM) Code #7-Priority The level of priority of the diagnosis for the visit. 1, 2, 3, 4, U 1, 2, 3, 4, or U (unconfirmed).


MDR 2 CAPER 122 DX8
Yes 8/13/2009 char(7)

DX (ICD-9-CM) Code #8 ICD-9 entered diagnosis code.




MDR 2 CAPER 123 DX8EXT
Yes 8/13/2009 char(1)

DX (ICD-9-CM) Code #8-DOD Extender ICD-9 extender code.




MDR 2 CAPER 124 DX8PRI
Yes 8/13/2009 char(1)

DX (ICD-9-CM) Code #8-Priority The level of priority of the diagnosis for the visit. 1, 2, 3, 4, U 1, 2, 3, 4, or U (unconfirmed).


MDR 2 CAPER 125 DX9
Yes 8/13/2009 char(7)

DX (ICD-9-CM) Code #9 ICD-9 entered diagnosis code.




MDR 2 CAPER 126 DX9EXT
Yes 8/13/2009 char(1)

DX (ICD-9-CM) Code #9-DOD Extender ICD-9 extender code.




MDR 2 CAPER 127 DX9PRI
Yes 8/13/2009 char(1)

DX (ICD-9-CM) Code #9-Priority The level of priority of the diagnosis for the visit. 1, 2, 3, 4, U 1, 2, 3, 4, or U (unconfirmed).


MDR 2 CAPER 128 COMPLAINT
Yes 8/13/2009 char(5)

DX(ICD-9-CM) Code, Encounter Chief Complaint The ICD-9 code identifying the patient’s main reason for seeking medical care.




MDR 2 CAPER 129 EM1
Yes 8/13/2009 char(5)

E&M Code 1 Evaluation & Management (E&M) Code for the encounter, based on order of entry. E&M Codes are CPT Codes in the range of 99201-99499. 99201-99499



MDR 2 CAPER 130 EM1DX
Yes 8/13/2009 char(4)

E&M Code 1-Diagnosis Pointer Associates the E&M Code with at least one diagnosis. Whole number between 1 and 4321 (each position points to the priority of a diagnosis). 1-4321



MDR 2 CAPER 131 EM1MOD1
Yes 8/13/2009 char(2)

E&M Code 1-Modifier 1 E&M Code Modifier associated with the specific E&M Code.




MDR 2 CAPER 132 EM1MOD2
Yes 8/13/2009 char(2)

E&M Code 1-Modifier 2 E&M Code Modifier associated with the specific E&M Code.




MDR 2 CAPER 133 EM1MOD3
Yes 8/13/2009 char(2)

E&M Code 1-Modifier 3 E&M Code Modifier associated with the specific E&M Code.




MDR 2 CAPER 134 EM1PROV
Yes 8/13/2009 char(5)

E&M Code 1-Provider Pointers Associates the E&M Code with at least one provider. Whole number between 1 and 54321 (each position points to one provider). 1-54321



MDR 2 CAPER 135 EM1UNITS
Yes 8/13/2009 N(8)

E&M Code 1-Units of Care Multiplier used for prolonged services for the specific E&M Code. Whole number between 1 and 4. 1, 2, 3, 4



MDR 2 CAPER 136 EM2
Yes 8/13/2009 char(5)

E&M Code 2 E&M Code for the encounter, based on order of entry. 99201-99499



MDR 2 CAPER 137 EM2DX
Yes 8/13/2009 char(4)

E&M Code 2-Diagnosis Pointer Associates the E&M Code with at least one diagnosis. Whole number between 1 and 4321 (each position points to the priority of a diagnosis). 1-4321



MDR 2 CAPER 138 EM2MOD1
Yes 8/13/2009 char(2)

E&M Code 2-Modifier 1 E&M Code Modifier associated with the specific E&M Code.




MDR 2 CAPER 139 EM2MOD2
Yes 8/13/2009 char(2)

E&M Code 2-Modifier 2 E&M Code Modifier associated with the specific E&M Code.




MDR 2 CAPER 140 EM2MOD3
Yes 8/13/2009 char(2)

E&M Code 2-Modifier 3 E&M Code Modifier associated with the specific E&M Code.




MDR 2 CAPER 141 EM2PROV
Yes 8/13/2009 char(5)

E&M Code 2-Provider Pointers Associates the E&M Code with at least one provider. Whole number between 1 and 54321 (each position points to one provider). 1-54321



MDR 2 CAPER 142 EM2UNITS
Yes 8/13/2009 N(8)

E&M Code 2-Units of Care Multiplier used for prolonged services for the specific E&M Code. Whole number between 1 and 4. 1, 2, 3, 4



MDR 2 CAPER 143 EM3
Yes 8/13/2009 char(5)

E&M Code 3 E&M Code for the encounter, based on order of entry. 99201-99499



MDR 2 CAPER 144 EM3DX
Yes 8/13/2009 char(4)

E&M Code 3-Diagnosis Pointer Associates the E&M Code with at least one diagnosis. Whole number between 1 and 4321 (each position points to the priority of a diagnosis). 1-4321



MDR 2 CAPER 145 EM3MOD1
Yes 8/13/2009 char(2)

E&M Code 3-Modifier 1 E&M Code Modifier associated with the specific E&M Code.




MDR 2 CAPER 146 EM3MOD2
Yes 8/13/2009 char(2)

E&M Code 3-Modifier 2 E&M Code Modifier associated with the specific E&M Code.




MDR 2 CAPER 147 EM3MOD3
Yes 8/13/2009 char(2)

E&M Code 3-Modifier 3 E&M Code Modifier associated with the specific E&M Code.




MDR 2 CAPER 148 EM3PROV
Yes 8/13/2009 char(5)

E&M Code 3-Provider Pointers Associates the E&M Code with at least one provider. Whole number between 1 and 54321 (each position points to one provider). 1-54321



MDR 2 CAPER 149 EM3UNITS
Yes 8/13/2009 N(8)

E&M Code 3-Units of Care Multiplier used for prolonged services for the specific E&M Code. Whole number between 1 and 4. 1, 2, 3, 4



MDR 2 CAPER 150 FMP
Yes 8/13/2009 char(2)

Family Member Prefix The code that represents the prefix that the medical community uses to identify medical records. 01-19,20,30-39,40,45, 50,55,60-69,90-95,97,98, or 99. 01-19 = Dependent children of sponsor
20 = Sponsor
30-39 = Spouse of sponsor
40-44 = Mother of sponsor
45-49 = Father of sponsor
50-54 = Mother-in-law of sponsor
55-59 = Father-in-law of sponsor
60-69 = Other dependents
90-95 = Beneficiary authorized by statute
98 = Civilian Humanitarian
99 = All others not elsewhere classified


MDR 2 CAPER 151 INJGEOGLOC
Yes 8/13/2009 char(5)

Injury Geographic Location Geographic location of accident available when Injury Cause Code is “AA”.




MDR 2 CAPER 152 INJPOA
Yes 8/13/2009 char(54)

Injury Place of Accident The location/place description of where the injury occurred.
This is a free text field.


MDR 2 CAPER 153 INJPOE
Yes 8/13/2009 char(54)

Injury Place of Employment Place of employment at the time of the injury if the injury occurred due to a function or action of the employment.
This is a free text field.


MDR 2 CAPER 154 INJREL
Yes 8/13/2009 char(1)

Injury Related Injury related indicator for the encounter. 0, 1 0 = No injury
1 = Yes - injury


MDR 2 CAPER 155 INJCODE1
Yes 8/13/2009 char(2)

Injury Related/Cause Code 1 The first injury cause code entered by the user during encounter completion. AA, AP, EM, OA AA = Auto accident
AP = Another party responsible
EM = Employment
OA = Other accident


MDR 2 CAPER 156 INJCODE2
Yes 8/13/2009 char(2)

Injury Related/Cause Code 2 The second injury cause code entered by the user during encounter completion. AA, AP, EM, OA AA = Auto accident
AP = Another party responsible
EM = Employment
OA = Other accident


MDR 2 CAPER 157 INJCODE3
Yes 8/13/2009 char(2)

Injury Related/Cause Code 3 The third injury cause code entered by the user during encounter completion. AA, AP, EM, OA AA = Auto accident
AP = Another party responsible
EM = Employment
OA = Other accident


MDR 2 CAPER 158 INPAPPT
Yes 8/13/2009 char(1)

Inpatient Appointment An indicator based upon the identification of the appointment as being related to the inpatient episode of acre. 0, 1 0 = Outpatient
1 = Inpatient related


MDR 2 CAPER 159 MTF_PRN
Yes 8/13/2009 char(11)

Inpatient DMISID & Patient Register Number DMIS ID of the inpatient treatment MTF and Register Number associated with a RNDS appointment (i.e., inpatient ward appointment).




MDR 2 CAPER 160 MARITAL
Yes 8/13/2009 char(1)

Marital Status Indicates the legal status of a person as it relates to marriage. A, D, I, L, M, S, W, Z A = Annulled
D = Divorced
I = Interlocutory
L = Legally separated
M = Married
S = Single, never married
W = Widowed
Z = Unknown


MDR 2 CAPER 161 RANKPAY DI Yes 8/13/2009 char(3)

Military Grade/Rank A code that represents the patient's military rank. Codes and meanings come from CHCS (231 codes). E1-E10, O1-O11 CD = Cadet
E1 - E10 = Enlisted
O1 - O11 = Officer
W1 - W5 = Warrant Officer


MDR 2 CAPER 162 ENCDATE
Yes 8/13/2009 char(8)

Modified Appointment (Encounter) Date Removed slashes from ENCDATE_R yyyymmdd



MDR 2 CAPER 163 PATCAT_R
Yes 8/13/2009 char(5)

Patient Category Identifies the beneficiary status of the person being treated.
See Patient Categories for codes and descriptions.


MDR 2 CAPER 164 PATDOB
Yes 8/13/2009 char(8)

Patient Date of Birth Date when the person was born (YYYYMMDD). yyyymmdd



MDR 2 CAPER 165 PATSEX
Yes 8/13/2009 char(1)

Patient Gender A code used to denote a patient's gender. F, M F = female
M = male


MDR 2 CAPER 166 HOSPSTAT
Yes 8/13/2009 char(1)

Patient Hospital Status An indicator of that the patient had at the time of the encounter. Codes as follows: 0, 1 1 = Inpatient
0 = Outpatient
Blank = Outpatient


MDR 2 CAPER 167 EDIPN_R
Yes 8/13/2009 char(10)

Patient Identifier (EDIPN) Unique patient identifier supplied by the Defense Manpower Data Center (DMDC). The Electronic Data Interchange Person Number (EDI_PN).




MDR 2 CAPER 168 PATZIP_R
Yes 8/13/2009 #N/A

Patient Zip Code The postal zip code for the city where a person is located. For OCONUS locations, the value could be an APO, FPO or country zip code.
This field may contain hyphens. See PATZIP for the field with no hyphens.


MDR 2 CAPER 169 ENCDATE_R
Yes 8/13/2009 char(8)

Raw Appointment (Encounter) Date, CCYYMMDD The date of the appointment. Format: YYYYMMDD.




MDR 2 CAPER 170 REASON
Yes 8/13/2009 char(75)

Reason for Appointment A free text field to describe the reason the patient has for seeking care.




MDR 2 CAPER 171 REF_NO
Yes 8/13/2009 char(11)

Referral Number The Referral Number automatically assigned by the system when a referral is created through the Managed Care Module.




MDR 2 CAPER 172 REFID
Yes 8/13/2009 char(9)

Referring Provider ID The Provider ID of the HCDP referring the patient for specialty care or consult.




MDR 2 CAPER 173 DMISID
Yes 8/13/2009 char(4)

Treatment DMIS ID The Defense Medical Information System (DMIS) identification number that identifies the clinic where the patient was treated.
See DMIS Information for list of DMIS ID.


MDR 3 Casualty 1 sponssn DI Yes 8/13/2009 Char(9)

Sponsor SSN Social security number of active duty member.




MDR 3 Casualty 2 dob
Yes 8/13/2009 SAS Date

Date of Birth Date of birth of individual.




MDR 3 Casualty 3 rank DI Yes 8/13/2009 Char(5)

Rank Military rank of individual. See Death Rank Table See Death Rank Table.


MDR 3 Casualty 4 dds
Yes 8/13/2009 Char(2)

DDS DEERS Dependent Suffix. 20 Set to '20' for all files received from casualty feed.


MDR 3 Casualty 5 dthdate
Yes 8/13/2009 SAS Date

Death Date Date of recorded death.




MDR 3 Casualty 6 source
Yes 8/13/2009 Char(1)

Source Source of death information. C Set to 'C' for all files received from casualty feed.


MDR 3 Casualty 7 dthcode
Yes 8/13/2009 Char(1)

Death Code Flag that indicates whether the record contains a death. Y Set to 'Y' for all files received from casualty feed.


MDR 3 Casualty 8 rel
Yes 8/13/2009 Char(1)

Relationship First digit of DDS, which defines whether patient is sponsor, spouse, dependent, or other. 2 Set to '2' for all files received from casualty feed.


MDR 5 DESPROC_Clinical 1 DMISID
Yes 8/13/2009 Char(4)

DMIS ID DMIS ID Representing one of eight Designated Provider Enrolling sites. 190 - 198 0190 = Johns Hopkins Medical Services Corporation
0191 = Brighton Marine Health Care
0192 = CHRISTUS Health-St Johns
0193 = St. Vincent Catholic Medical Centers of NY
0194 = Pacific Medical Clinics
0196 = CHRISTUS Health-St. Joseph’s
0197 = CHRISTUS Health-St. Mary's (inactive)
0198 = Martin’s Point Health Care


MDR 5 DESPROC_Clinical 2 FAMID
Yes 8/13/2009 Char(9)

DEERS Family Identifier Identifier that uniquely identifies a family for the purposes of DoD benefits.
Assigned by DEERS.


MDR 5 DESPROC_Clinical 3 BENID
Yes 8/13/2009 Char(2)

DEERS Beneficiary Identifier Identifier that uniquely identifies a family member for the purposes of DoD benefits. 00 - 99 00 = Sponsor
01 - 99 = Dependents


MDR 5 DESPROC_Clinical 4 PATID
Yes 8/13/2009 Char(10)

Patient Identifier Identifier associated with a specific patient.
Same as the EDIPN in the PITE.


MDR 5 DESPROC_Clinical 5 SPONSSN DI Yes 8/13/2009 Char(9)

Sponsor Social Security Number Social Security Number of the beneficiary's sponsor.




MDR 5 DESPROC_Clinical 6 DDS
Yes 8/13/2009 Char(2)

Legacy DEERS Dependent Suffix DEERS specific code indicating the relationship of the beneficiary to the sponsor. 01 - 19, 20,
30 - 75, 98		 01 - 19 = Dependent Child
20 = Sponsor
30 - 39 = Spouse of sponsor
40 - 44 = Mother of sponsor
45 - 49 = Father of sponsor
50 - 54 = Mother-In-Law of sponsor
55 - 59 = Father-In-Law of sponsor
60 - 69 = Other eligible dependents
70 - 74 = Unknown by DEERS
75 = Pseudo DDS unknown by contractor
98 = Service secretary designee


MDR 5 DESPROC_Clinical 7 RECID
Yes 8/13/2009 Char(12)

Unique Patient Reference Number Unique claim or episode of care number.
Valid claim, invoice encounter, or reference number that uniquely identifies the encounter.
Valid claim, invoice encounter, or reference number that uniquely identifies the encounter. Every transaction type "I" record will have a separate unique number. On transactions "C", "D", and "F", the record will have the originally submitted unique patient reference number.


MDR 5 DESPROC_Clinical 8 TRANTYPE
Yes 8/13/2009 Char(1)

Transaction Type Code to indicate the transaction type of the record on Clinical and Pharmacy submissions. I, F, C, D I = Initial submission
F = Further episode submission
C = Correction submission
D = Delete submission
The "F" Transaction is an overflow record of additional information from the preceding record.


MDR 5 DESPROC_Clinical 9 FY
Yes 8/13/2009 Num(8)

Fiscal Year Fiscal year the drug was dispensed. 2002+ Derived from the latest encounter date.


MDR 5 DESPROC_Clinical 10 FM
Yes 8/13/2009 Num(8)

Fiscal Month Fiscal month the drug was dispensed. 1 - 12 1 = October 7 = April
2 = November 8 = May
3 = December 9 = June
4 = January 10 = July
5 = February 11 = August
6 = March 12 = September

Derived from the latest encounter date.


MDR 5 DESPROC_Clinical 11 ENC
Yes 8/13/2009 Char(1)

Encounter Setting Setting of patient encounter/episode of care. H, I, O H = Hospital Services
I = Inpatient Professional Services
O = Outpatient Professional Services


MDR 5 DESPROC_Clinical 12 PDX
Yes 8/13/2009 Char(7)

Patient Principal/Primary Diagnosis ICD-9-CM code, in the inpatient setting, identifying the condition established, after study, to be chiefly responsible for the patient to have obtained medical care; or in the outpatient setting, the reason for the encounter.




MDR 5 DESPROC_Clinical 13 DXJ
Yes 8/13/2009 Char(7)

Patient Diagnosis J ICD-9-CM code identifying a j diagnosis that affects the care, management, or treatment provided during an inpatient or outpatient encounter.
J = diagnosis code 2 - 12


MDR 5 DESPROC_Clinical 14 PROVID
Yes 8/13/2009 Char(18)

Unique Provider ID Number Facility created unique provider ID number.




MDR 5 DESPROC_Clinical 15 SPC
Yes 8/13/2009 Char(2)

Major Spec/Institution Type Provider Major Specialty code or type of institution where care was provided.
See Designated Provider Code List.


MDR 5 DESPROC_Clinical 16 ORDERPHY
Yes 8/13/2009 Char(18)

Ordering Physician Provider who ordered ancillary services, or who referred patient for specialty or inpatient care.
For Inpatient and Outpatient Professional Services Records, this field is equal to the Unique Provider ID for the physician who ordered the services; field should be blank for Hospital Services.


MDR 5 DESPROC_Clinical 17 ERFLAG
Yes 8/13/2009 Char(1)

Emergency Flag Flag indicating emergency ambulatory care. Y, N



MDR 5 DESPROC_Clinical 18 ADMDATE
Yes 8/13/2009 Date(8)

Date of Related Admission
(SAS Date)		 Date of admission for inpatient hospital care related to professional services.




MDR 5 DESPROC_Clinical 19 DISPDATE
Yes 8/13/2009 Date(8)

Date of Related Disposition
(SAS Date)		 Date of disposition for inpatient hospital care related to professional services.




MDR 5 DESPROC_Clinical 20 NUMSVCS
Yes 8/13/2009 Char(1)

Number of Services Number of professional services provided.




MDR 5 DESPROC_Clinical 21 SVCBEG1
Yes 8/13/2009 Date(8)

Service 1 Start Date
(SAS Date)		 Start date the provider provided service for this encounter.
J = Service 1 - 6


MDR 5 DESPROC_Clinical 22 SVCEND1
Yes 8/13/2009 Date(8)

Service 1 End Date
(SAS Date)		 Last date the provider provided service for this encounter.
J = Service 1 - 6


MDR 5 DESPROC_Clinical 23 SVCPLC1
Yes 8/13/2009 Char(2)

Service 1 Place Of Service Code that represents the type of setting in which provider performed the service/procedure.
See Designated Provider Code List
J = Service 1 - 6


MDR 5 DESPROC_Clinical 25 SVCDX1
Yes 8/13/2009 Char(7)

Service 1 Related Diagnosis Code ICD-9-CM code for the diagnosis or related sign, symptom, or finding responsible for the service provided.
J = Service 1 - 6


MDR 5 DESPROC_Clinical 26 SVCQTY1
Yes 8/13/2009 Char(3)

Service 1 Quantity Number of days or units, most commonly used for multiple visits, units of supplies, anesthesia units, or oxygen volume
J = Service 1 - 6


MDR 5 DESPROC_Clinical 27 SVCBEG2
Yes 8/13/2009 Date(8)

Service 2 Start Date
(SAS Date)		 Start date the provider provided service for this encounter.




MDR 5 DESPROC_Clinical 28 SVCEND2
Yes 8/13/2009 Date(8)

Service 2 End Date
(SAS Date)		 Last date the provider provided service for this encounter.




MDR 5 DESPROC_Clinical 29 SVCPLC2
Yes 8/13/2009 Char(2)

Service 2 Place Of Service Code that represents the type of setting in which provider performed the service/procedure.




MDR 5 DESPROC_Clinical 31 SVCDX2
Yes 8/13/2009 Char(7)

Service 2 Related Diagnosis Code ICD-9-CM code for the diagnosis or related sign, symptom, or finding responsible for the service provided.




MDR 5 DESPROC_Clinical 32 SVCQTY2
Yes 8/13/2009 Char(3)

Service 2 Quantity Number of days or units, most commonly used for multiple visits, units of supplies, anesthesia units, or oxygen volume




MDR 5 DESPROC_Clinical 33 SVCBEG3
Yes 8/13/2009 Date(8)

Service 3 Start Date
(SAS Date)		 Start date the provider provided service for this encounter.




MDR 5 DESPROC_Clinical 34 SVCEND3
Yes 8/13/2009 Date(8)

Service 3 End Date
(SAS Date)		 Last date the provider provided service for this encounter.




MDR 5 DESPROC_Clinical 35 SVCPLC3
Yes 8/13/2009 Char(2)

Service 3 Place Of Service Code that represents the type of setting in which provider performed the service/procedure.




MDR 5 DESPROC_Clinical 37 SVCDX3
Yes 8/13/2009 Char(7)

Service 3 Related Diagnosis Code ICD-9-CM code for the diagnosis or related sign, symptom, or finding responsible for the service provided.




MDR 5 DESPROC_Clinical 38 SVCQTY3
Yes 8/13/2009 Char(3)

Service 3 Quantity Number of days or units, most commonly used for multiple visits, units of supplies, anesthesia units, or oxygen volume




MDR 5 DESPROC_Clinical 39 SVCBEG4
Yes 8/13/2009 Date(8)

Service 4 Start Date
(SAS Date)		 Start date the provider provided service for this encounter.




MDR 5 DESPROC_Clinical 40 SVCEND4
Yes 8/13/2009 Date(8)

Service 4 End Date
(SAS Date)		 Last date the provider provided service for this encounter.




MDR 5 DESPROC_Clinical 41 SVCPLC4
Yes 8/13/2009 Char(2)

Service 4 Place Of Service Code that represents the type of setting in which provider performed the service/procedure.




MDR 5 DESPROC_Clinical 43 SVCDX4
Yes 8/13/2009 Char(7)

Service 4 Related Diagnosis Code ICD-9-CM code for the diagnosis or related sign, symptom, or finding responsible for the service provided.




MDR 5 DESPROC_Clinical 44 SVCQTY4
Yes 8/13/2009 Char(3)

Service 4 Quantity Number of days or units, most commonly used for multiple visits, units of supplies, anesthesia units, or oxygen volume




MDR 5 DESPROC_Clinical 45 SVCBEG5
Yes 8/13/2009 Date(8)

Service 5 Start Date
(SAS Date)		 Start date the provider provided service for this encounter.




MDR 5 DESPROC_Clinical 46 SVCEND5
Yes 8/13/2009 Date(8)

Service 5 End Date
(SAS Date)		 Last date the provider provided service for this encounter.




MDR 5 DESPROC_Clinical 47 SVCPLC5
Yes 8/13/2009 Char(2)

Service 5 Place Of Service Code that represents the type of setting in which provider performed the service/procedure.




MDR 5 DESPROC_Clinical 49 SVCDX5
Yes 8/13/2009 Char(7)

Service 5 Related Diagnosis Code ICD-9-CM code for the diagnosis or related sign, symptom, or finding responsible for the service provided.




MDR 5 DESPROC_Clinical 50 SVCQTY5
Yes 8/13/2009 Char(3)

Service 5 Quantity Number of days or units, most commonly used for multiple visits, units of supplies, anesthesia units, or oxygen volume




MDR 5 DESPROC_Clinical 51 SVCBEG6
Yes 8/13/2009 Date(8)

Service 6 Start Date
(SAS Date)		 Start date the provider provided service for this encounter.




MDR 5 DESPROC_Clinical 52 SVCEND6
Yes 8/13/2009 Date(8)

Service 6 End Date
(SAS Date)		 Last date the provider provided service for this encounter.




MDR 5 DESPROC_Clinical 53 SVCPLC6
Yes 8/13/2009 Char(2)

Service 6 Place Of Service Code that represents the type of setting in which provider performed the service/procedure.




MDR 5 DESPROC_Clinical 55 SVCDX6
Yes 8/13/2009 Char(7)

Service 6 Related Diagnosis Code ICD-9-CM code for the diagnosis or related sign, symptom, or finding responsible for the service provided.




MDR 5 DESPROC_Clinical 56 SVCQTY6
Yes 8/13/2009 Char(3)

Service 6 Quantity Number of days or units, most commonly used for multiple visits, units of supplies, anesthesia units, or oxygen volume




MDR 5 DESPROC_Clinical 57 HOSPADM
Yes 8/13/2009 Date(8)

Hospital Service Admission Date (SAS Date) Date of hospital admission.




MDR 5 DESPROC_Clinical 58 HOSPTYPE
Yes 8/13/2009 Char(1)

Hospital Service Admission Type The code to indicate admission type for hospital services stay.
1 = Emergency
2 = Urgent
3 = Elective
4 = Newborn


MDR 5 DESPROC_Clinical 59 HOSPSRC
Yes 8/13/2009 Char(1)

Hospital Service Admission Source The code to indicate source of admission for this hospital stay. 1 - 9 1 = Physician Referral
2 = Clinic Referral
3 = HMO Referral
4 = Transfer from a Hospital
5 = Transfer from a Skilled Nursing Facility
6 = Transfer from Another Health Care Facility
7 = Emergency
8 = Court / Law Enforcement
9 = Information Not Available


MDR 5 DESPROC_Clinical 60 HOSPSTAT
Yes 8/13/2009 Char(2)

Hospital Service Disposition Status The code to indicate status of patient upon discharge from the hospital. 01 - 07, 09, 10,
20, 21 - 29, 30,
31 - 39, 40 - 99		 01 = Discharge to home or self-care
02 = Discharged/Transferred to another short-term general hospital
03 = Discharged/Transferred skilled nursing facility (SNF)
04 = Discharged/Transferred to an intermediate care facility (ICF)
05 = Discharged/Transferred to another type of institution
06 = Discharged/Transferred to home under care of organized home health service organization
07 = Left against medical advice
09 = Reserved for national assignment
10 - 19 = Discharged to be defined at state level, if necessary
20 = Deceased
21 - 29 = Deceased to be defined at state level, if necessary
30 = Still a patient
31 - 39 = Still a patient to be defined at state level, if necessary
*40 = Expired at home
*41 = Expired in a medical facility; e.g., hospital, SNF, ICF, free standing hospice
*42 = Expired-Place Unknown
43 - 99 = Reserved for National Assignment

*For use only on Medicare claims for hospital care


MDR 5 DESPROC_Clinical 61 HOSPDISP
Yes 8/13/2009 Date(8)

Hospital Service Disposition Date (SAS Date) Date of discharge from hospital.




MDR 5 DESPROC_Clinical 62 DRG
Yes 8/13/2009 Char(3)

Diagnosis Related Group (DRG)





MDR 5 DESPROC_Clinical 63 HOSPPRCP
Yes 8/13/2009 Char(7)

Hospital Service Patient Principal Procedure ICD-9-CM code identifying the principal procedure performed during hospital stay.




MDR 5 DESPROC_Clinical 64 HOSPPRCJ
Yes 8/13/2009 Char(7)

Hospital Service Patient
Procedure J		 ICD-9-CM code identifying the Jth procedure performed during hospital stay.
J = Procedure 2 - 6


MDR 5 DESPROC_Clinical 65 LASTENC
Yes 8/13/2009 Date(8)

Latest Encounter Date (SAS Date) Equals the latest encounter date on the record. Encounter dates considered include the disposition date, hospital service disposition date, and service end dates 1-6.




MDR 6 DESPROV_Pharmacy 1 DMISID
Yes 8/13/2009 Char(4)

DMIS ID DMIS ID Representing one of eight Designated Provider Enrolling sites. 190 - 198 0190 = Johns Hopkins Medical Services Corporation
0191 = Brighton Marine Health Care
0192 = CHRISTUS Health-St Johns
0193 = St. Vincent Catholic Medical Centers of NY
0194 = Pacific Medical Clinics
0196 = CHRISTUS Health-St. Joseph’s
0197 = CHRISTUS Health-St. Mary's (inactive)
0198 = Martin’s Point Health Care


MDR 6 DESPROV_Pharmacy 2 FAMID
Yes 8/13/2009 Char(9)

DEERS Family Identifier Identifier that uniquely identifies a family for the purposes of DoD benefits.
Assigned by DEERS


MDR 6 DESPROV_Pharmacy 3 BENID
Yes 8/13/2009 Char(2)

DEERS Beneficiary Identifier Identifier that uniquely identifies a family member for the purposes of DoD benefits. 00 - 99 00 = Sponsor
01 - 99 = Dependents


MDR 6 DESPROV_Pharmacy 4 PATID
Yes 8/13/2009 Char(10)

Patient Identifier Identifier associated with a specific patient.
Same as the EDIPN in the PITE


MDR 6 DESPROV_Pharmacy 5 SPONSSN DI Yes 8/13/2009 Char(9)

Sponsor Social Security Number (SSN) Social Security Number of the beneficiary's sponsor.




MDR 6 DESPROV_Pharmacy 6 DDS
Yes 8/13/2009 Char(2)

Legacy DEERS Dependent Suffix DEERS specific code indicating the relationship of the beneficiary to the sponsor. 01 - 98 01 - 19 = Dependent Child
20 = Sponsor
30 - 39 = Spouse of sponsor
40 - 44 = Mother of sponsor
45 - 49 = Father of sponsor
50 - 54 = Mother-In-Law of sponsor
55 - 59 = Father-In-Law of sponsor
60 - 69 = Other eligible dependents
70 - 74 = Unknown by DEERS
75 = Pseudo DDS unknown by contractor
98 = Service secretary designee


MDR 6 DESPROV_Pharmacy 7 DOB
Yes 8/13/2009 Date(8)

Patient’s Date Of Birth Date of birth of the patient.
SAS Date


MDR 6 DESPROV_Pharmacy 8 SEX
Yes 12/17/2009 Char(1)

Patient’s Gender Code used to indicate the gender of the patient.




MDR 6 DESPROV_Pharmacy 9 QTY
Yes 8/13/2009 Char(6)

Quantity Dispensed Drug quantity the patient physically received, not the amount prescribed by the physician.




MDR 6 DESPROV_Pharmacy 10 DISPDATE
Yes 8/13/2009 Date(8)

Date Dispensed Date the prescription was dispensed.
SAS Date


MDR 6 DESPROV_Pharmacy 11 NDC
Yes 8/13/2009 Char(11)

National Drug Code Number Specific nation drug code number assigned for the drug, or the default values for the durable medical equipment and compound drugs.
Valid Nation Drug Code

Valid NDC for DME = 55555555551
Valid NDC for Compounds = 8888888881


MDR 6 DESPROV_Pharmacy 12 RECID
Yes 8/13/2009 Char(12)

Unique Patient Reference Number Unique claim or episode of care number
Valid claim, invoice encounter, or reference number that uniquely identifies the encounter. Every transaction type "I" record will have a separate unique number. On transactions "C", "D", and "F", the record will have the originally submitted unique patient reference number.


MDR 6 DESPROV_Pharmacy 13 DAYSSUP
Yes 8/13/2009 Num(3)

Number Of Days Provided Number of days the filled prescription will cover.




MDR 6 DESPROV_Pharmacy 14 PROVID
Yes 8/13/2009 Char(18)

Provider Prescribing Medication Unique provider identifier number of the physician prescribing the medication.




MDR 6 DESPROV_Pharmacy 15 GENERIC
Yes 8/13/2009 Char(1)

Dispensed As Written Indicator Code indicating if the drug was dispensed as written on the prescription. 0 - 9 0 = Not Product Selection Indicated
1 = Substitution NOT Allowed. Brand Drug Mandated by person who Prescribed it.
2 = Substitution Allowed. Patient Requested Brand Drug.
3 = Substitution Allowed. Pharmacist Selected Brand Drug.
4 = Substitution Allowed. Generic Not in Stock.
5 = Substitution Allowed. Brand Drug Dispensed as Generic.
6 = Override
7 = Substitution NOT Allowed. Brand Drug Mandated by Law.
8 = Substitution Allowed. Generic Not Available in Marketplace.
9 = Other
Blank is not a valid value.


MDR 6 DESPROV_Pharmacy 16 TRANTYPE
Yes 8/13/2009 Char(1)

Transaction Type Code to indicate the transaction type of the record on Clinical and Pharmacy submissions. I, F, C, D I = Initial submission
F = Further episode submission
C = Correction submission
D = Delete submission
The "F" Transaction is an overflow record of additional information from the preceding record.


MDR 7 Encounter_Death 1 sponssn DI Yes 8/13/2009 Char(9)

Sponsor SSN Social security number of active duty member.




MDR 7 Encounter_Death 2 dob
Yes 8/13/2009 SAS Date

Date of Birth Date of birth of individual.




MDR 7 Encounter_Death 3 edipn
Yes 8/13/2009 Char(10)

EDIPN Unique Identifier of individual.
Blank in 56% of records.


MDR 7 Encounter_Death 4 dds
Yes 8/13/2009 Char(2)

DDS DEERS Dependent Suffix: Code maintained by DEERS that uniquely identifies the beneficiary within the family. 01 - 19, 20,
30 - 39, 40 - 44, 45 - 49, 50 - 54, 55 - 59, 60 - 69, 70 - 74, 75, 98		 01 - 19 = Dependent Child
20 = Sponsor
30 - 39 = Spouse of sponsor
40 - 44 = Mother of sponsor
45 - 49 = Father of sponsor
50 - 54 = Mother-In-Law of sponsor
55 - 59 = Father-In-Law of sponsor
60 - 69 = Other eligible dependents
70 - 74 = Unknown by DEERS
75 = Pseudo DDS unknown by contractor
98 = Service secretary designee


MDR 7 Encounter_Death 5 gender
Yes 8/13/2009 Char(1)

Gender Patient/beneficiary Gender. M, F M = Male
F = Female


MDR 7 Encounter_Death 6 dthdate
Yes 8/13/2009 SAS Date

Death Date Date of recorded death.




MDR 7 Encounter_Death 7 source
Yes 8/13/2009 Char(1)

Source Source of death information. H, S, A H = HCSR/TED-Institutional
S = SIDR
A = SADR


MDR 7 Encounter_Death 8 dthcode
Yes 8/13/2009 Char(1)

Death Code Flag that indicates whether the record contains a death. Y Set to 'Y' for all files.


MDR 7 Encounter_Death 9 rel
Yes 8/13/2009 Char(1)

Relationship First digit of DDS, which defines whether patient is sponsor, spouse, dependent, or other. 0 - 7, 9 0 - 1 = Dependent Child
2 = Sponsor
3 = Spouse of sponsor
4 = Parent of sponsor
5 = Parent-In-Law of sponsor
6 = Other eligible dependents
7 = Unknown
9 = Service secretary designee


MDR 8 HCSR-I 1 111
Yes 8/13/2009 $1

Program Indicator Code Identifies to which TRICARE program the services being reported on the claim are related. i, h i = institutional
h = program for the handicapped


MDR 8 HCSR-I 2 128 DI Yes 8/13/2009 $9

Sponsor SSN Sponsor social security account number or veterans administration file number. 111111111 All blanks = NATO & security agent claims (extremely rare)
First 3 digits zeroes = deceased sponsor only


MDR 8 HCSR-I 3 137 DI Yes 8/13/2009 $2

Sponsor Pay Grade Sponsor's pay grade code. 00 - 14, 19 - 31, 40 - 58, 90, 95, 99 00 = unknown enlisted
01 - 09 = enlisted (e1 - e9)
10 = unknown warrant officer
11 - 14 = warrant officer (w1 - w4)
19 = academy of navy OCS students
20 = unknown officer
21 - 31 = officer (01 - 011)
40 = unknown civil service
41 - 58 = GS1 - GS18
90 = unknown
95 = not applicable (including CHAMPVA)
99 = other


MDR 8 HCSR-I 4 139
Yes 8/13/2009 $1

Sponsor Branch of Service Branch of service of sponsor. A, E, F, I, M, N, P, C A = Army
E = Public Health Service
F = Air Force
I = NOAA
M = Marines
N = Navy
P = Coast Guard
C = CHAMPVA


MDR 8 HCSR-I 5 140
Yes 8/13/2009 $1

Sponsor Status Status of sponsor at the time of health care delivery. A, B A = Active Duty
B = Presidential Appointee
C = Civil Servant
D = DAV
E = DoD Contract Employee
F = Former Member
G = Guard
H = Medal of Honor
I = Non-DoD Civil Servant
J = Academy Student
K = NAF DoD Employee
L = Lighthouse Keeper
M = Non Government Agency Personnel
N = Guard
O = Non-DoD contract employee
P = TAMP
Q = Reserve Retiree (not ready for retired pay)
S = Reserve
T = Foreign Military
U = Authorized foreign national
V = Reserve
W = DoD benefit from prior relationship
Z = Unknown


MDR 8 HCSR-I 6 141
Yes 8/13/2009 $1

Patient Relationship Code indicating relationship of patient to sponsor.
Blank = Sponsor
C = Child
F = Un-remarried widow
G = Unmarried widow
H = Unmarried former spouse 20/20/20
L = Parent in Law
M = Step parent in law
P = Parent
R = Un-remarried former spouse 20/20/15
S = Spouse
T = Un-remarried former spouse 20/20/20
U = Step parent
V = Step child
W = Ward
X = Other
Y = Un-remarried former spouse 20/20/15
Z = Unknown


MDR 8 HCSR-I 7 178
Yes 12/17/2009 $8

Patient DOB Patient date of birth.




MDR 8 HCSR-I 8 186
Yes 12/17/2009 $2

DEERS Dependent Suffix Code Code maintained by DEERS that uniquely identifies the patient within the family.




MDR 8 HCSR-I 10 198
Yes 8/13/2009 $2

Enrollment Code Code indicating enrollment status of patient. Some values of this code are not related to enrollment however.




MDR 8 HCSR-I 11 212
Yes 8/13/2009 $2

Major Diagnostic Category Code Code representing MDC. Only populated when NAS issued.




MDR 8 HCSR-I 12 214
Yes 8/13/2009 $2

Derived Major Diagnostic Code Code indicating major diagnostic category. Populated for all claims.




MDR 8 HCSR-I 13 216
Yes 8/13/2009 $1

NAS Issue Reason Code Code representing the reason that the NAS was issued. 1 1 = Facilities unavailable
2 = Professional capability unavailable
3 = Medically inappropriate
4 = Facilities temporarily N/A
5 = Professional capability temporarily N/A
6 = Facilities permanently unavailable
7 = Enrollee network care authorization, restricted NAS
8 = Enrollee non-network care authorization, restricted NAS
9 = Non-enrolled, authorized network care only


MDR 8 HCSR-I 14 304
Yes 8/13/2009 $1

Reservist Status Code Code indicating the status of the sponsor while called up for GWOT (only applies to guard/reserve and their family members.) A, E, O, M, T, I, L A = Early Alert for Guard/Reserve E = TAMP extended for Guard/Reserve O = TAMP original for Guard/Reserve
M = Mobilization for Guard/Reserve T = TAMP for Guard/Reserve
I = TAMP for involuntary separation from Active Duty
L = TAMP for stop/loss from Active Duty


MDR 8 HCSR-I 15 305
Yes 8/13/2009 $2

Special Operations Code Code indicating the operation under which the sponsor was activated (applies only to guard/reserve and their family members, and only for GWOT activations.)
08 = Noble Eagle, 09 = Enduring Freedom, 10 = Iraqi Freedom. Many records for Iraqi Freedom are coded as either 08 or 09.


MDR 8 HCSR-I 16 322
Yes 8/13/2009 $1

ICD Edition ID Number Code identifying edition number of ICD-9 Codes.




MDR 8 HCSR-I 17 358
Yes 8/13/2009 $6

Principle Diagnosis Code The ICD-9 CM code which represents the diagnosis which led to the admission.




MDR 8 HCSR-I 18 364
Yes 8/13/2009 $6

Secondary Diagnosis Code 1 Secondary ICD-9 CM code.




MDR 8 HCSR-I 19 370
Yes 8/13/2009 $6

Secondary Diagnosis Code 2 Secondary ICD-9 CM code.




MDR 8 HCSR-I 20 376
Yes 8/13/2009 $6

Secondary Diagnosis Code 3 Secondary ICD-9 CM code.




MDR 8 HCSR-I 21 382
Yes 8/13/2009 $6

Secondary Diagnosis Code 4 Secondary ICD-9 CM code.




MDR 8 HCSR-I 22 388
Yes 8/13/2009 $6

Secondary Diagnosis Code 5 Secondary ICD-9 CM code.




MDR 8 HCSR-I 23 394
Yes 8/13/2009 $6

Secondary Diagnosis Code 6 Secondary ICD-9 CM code.




MDR 8 HCSR-I 24 400
Yes 8/13/2009 $6

Secondary Diagnosis Code 7 Secondary ICD-9 CM code.




MDR 8 HCSR-I 25 406
Yes 8/13/2009 $6

Secondary Diagnosis Code 8 Secondary ICD-9 CM code.




MDR 8 HCSR-I 26 427
Yes 8/13/2009 $3

MTF Code Catchment area ID code, populated only for beneficiaries residing within U.S. catchment areas (no assignments for overseas or non-catchment areas).




MDR 8 HCSR-I 27 435
Yes 8/13/2009 $3

Patient Age Patient's age at the time of DEERS check. 123 See DMIS ID Codes.


MDR 8 HCSR-I 28 465
Yes 8/13/2009 $1

Beneficiary Category Categorization of beneficiaries based on DEERS sponsor status and beneficiary relationship to sponsor.




MDR 8 HCSR-I 29 470
Yes 8/13/2009 $2

Type of Institution Code Code indicating the type of institution in which the patient is treated. 1, 2, 3, 4 1=Active Duty Family 2=Retiree 3=All others
4=Active Duty (includes guard, also non-military services) ** Note that Inactive Guard and Reserve are coded as AD and their family members are classified as ADFM. These beneficiaries are not on active duty.


MDR 8 HCSR-I 30 482
Yes 8/13/2009 $1

Type of Admission Code A code indicating the type of the admission. 1 - 4 1 = Emergency
2 = Urgent
3 = Elective
4 = Newborn


MDR 8 HCSR-I 31 483
Yes 8/13/2009 $1

Source of Admission Code Indicates the source of admission.
1 = Physician Referral
2 = Clinic Referral
3 = HMO Referral
4 = Transfer from a hospital
5 = Transfer from a SNF
6 = Transfer from another health care facility
7 = ER
8 = Court/Law Enforcement
9 = N/A
A = Normal Delivery
B = Premature Delivery
C = Sick Baby
D = Extramural Baby


MDR 8 HCSR-I 32 484
Yes 8/13/2009 $2

Discharge Status Code Indicates status at disposition.
01 = Discharged
02 = Transferred
03 = Discharge/Trans. to SNF
04 = Discharge/Trans. to ICF
05 = Discharge/Trans. to another inst. or outpatient care
06 = Discharge/Trans. to Home Health
07 = Left AMA
08 = Discharge/Trans. to home IV provider
20 = Expired
30 = Still a patient
40 = Died at home
41 = Died in medical facility
42 = Place of Death unknown
43 = Discharge/Trans. to federal hospital
50 = Hospice - Home
51 = Hospice - Medical Facility


MDR 8 HCSR-I 33 486
Yes 8/13/2009 8

Begin Date of Care Begin Date of Billing Period. For most institutional records, this will be the admission date.




MDR 8 HCSR-I 34 494
Yes 8/13/2009 8

End Date of Care End Date of Billing Period.




MDR 8 HCSR-I 35 502
Yes 8/13/2009 SN1

Number of Births Number of births, both live and stillborn, occurring during delivery.




MDR 8 HCSR-I 36 503
Yes 8/13/2009 SN3

Total Bed Days Total number of days of hospital care during the period covered by the HCSR whether or not allowable.




MDR 8 HCSR-I 37 509
Yes 8/13/2009 $6

Admission Diagnosis Code Code identifying diagnosis for which the patient was admitted to the institution.




MDR 8 HCSR-I 38 515
Yes 8/13/2009 $5

Principle OP-NS Procedure Code Principle ICD-9 CM procedure code.




MDR 8 HCSR-I 39 520
Yes 8/13/2009 $5

Secondary OP-NS Procedure Code 1 Secondary ICD-9 CM procedure code.




MDR 8 HCSR-I 40 525
Yes 8/13/2009 $5

Secondary OP-NS Procedure Code 2 Secondary ICD-9 CM procedure code.




MDR 8 HCSR-I 41 530
Yes 8/13/2009 $5

Secondary OP-NS Procedure Code 3 Secondary ICD-9 CM procedure code.




MDR 8 HCSR-I 42 535
Yes 8/13/2009 $5

Secondary OP-NS Procedure Code 4 Secondary ICD-9 CM procedure code.




MDR 8 HCSR-I 43 540
Yes 8/13/2009 $5

Secondary OP-NS Procedure Code 5 Secondary ICD-9 CM procedure code.




MDR 8 HCSR-I 44 548
Yes 8/13/2009 $2

DRG Grouper Edition Identifies the edition number of the diagnosis related grouper which is used to determine the DRG.




MDR 8 HCSR-I 45 553
Yes 8/13/2009 $2

Category of Care Indicates major category of care.
1st Character:
A = Psych
B = OB
C = Gyno
D = Surgical
E = Medical
F = Dental
G = Drug
H = Program for the Handicapped

2nd Character:
1 = Peds
2 = Delivery
3 = Peds and Delivery
Blank = Neither Peds nor Delivery


MDR 8 HCSR-I 46 555
Yes 8/13/2009 $3

DRG Derived Code TRICARE Diagnosis Related Group. Populated for every record.




MDR 8 HCSR-I 47 571
Yes 8/13/2009 $1

Preventable Admission Code indicating whether the care provided is one of 9 conditions where access to primary care/preventive services may reduce the likelihood of admission to a hospital. This measure does not imply a particular patient should not have been admitted. A, B, C, D, G, H, P, U, T, 0 A = Asthma
B = Bacterial Pneumonia
C = COPD
D = Diabetes
G = Gastroenteritis
H = Congestive Heart Failure
P = Angina Pectoris
U = Urinary Tract Infection/Kidney
T = (Tissue) Cellulitis
0 = Not a preventable admission


MDR 8 HCSR-I 48 87 for TED records, 90 for HCSR records
Yes 8/13/2009 If HCSR Based, $21, If TED Based, $24

HCSR or TED Number Number that uniquely identifies the claim.
Unique claim number.


MDR 9 HCSRN_FY00+ 1 76 Yes Yes 8/13/2009 $10

DEERS Person ID Person identifier of patient.




MDR 9 HCSRN_FY00+ 2 87 for TED records, 90 for HCSR records
Yes 8/13/2009 If HCSR Based, $21, If TED Based, $24

HCSR or TED Number Number that uniquely identifies the claim. This field is part of the primary key to this file.
Use this value to track M2 claims data to other data sources, such as CDIS.


MDR 9 HCSRN_FY00+ 3 128 DI Yes 8/13/2009 $9

Sponsor SSN Sponsor social security account number or veterans administration file number.
All blanks=NATO and security agent claims (extremely rare), First 3 digits zeroes=Deceased sponsor only


MDR 9 HCSRN_FY00+ 4 137 DI Yes 8/13/2009 $2

Sponsor Pay Grade Sponsor's pay grade code. 00-14, 19-31, 40-58, 90, 95, 99 00=Unknown enlisted
01-09=Enlisted (e1-e9)
10=Unknown warrant officer
11-14=Warrant officer (w1-w4)
19=Academy of navy OCS students
20=Unknown officer
21-31=Officer (01-011)
40=Unknown civil service
41-58=GS1-GS18
90=Unknown
95=Not applicable (including CHAMPVA)
99=Other


MDR 9 HCSRN_FY00+ 5 140
Yes 8/13/2009 $1

Sponsor Status Status of sponsor at the time of health care delivery.
A=Active Duty
B=Presidential Appointee
C=Civil Servant
D=DAV
E=DoD Contract Employee
F=Former Member
G=Guard
H=Medal of Honor
I=Non-DoD Civil Servant
J=Academy Student
K=NAF DoD Employee
L=Lighthouse Keeper
M=Non Government Agency Personnel
N=Guard
O=Non-DoD contract employee
P=TAMP
Q=Reserve Retiree (not ready for retired pay)
S=Reserve
T=Foreign Military
U=Authorized foreign national
V=Reserve
W=DoD benefit from prior relationship
Z=Unknown


MDR 9 HCSRN_FY00+ 6 186
Yes 8/13/2009 $2

DEERS Dependent Suffix Code Code maintained by DEERS that uniquely identifies the patient within the family.
01-19=Dependent Child
20=Sponsor
30-39=Spouse of sponsor
40-44=Mother of sponsor
45-49=Father of sponsor
50-54=Mother-In-Law of sponsor
55-59=Father-In-Law of sponsor
60-69=Other eligible dependents
70-74=Unknown by DEERS
75=Pseudo DDS unknown by contractor
98=Service secretary designee


MDR 9 HCSRN_FY00+ 7 188
Yes 8/13/2009 $1

Patient Sex Gender of patient. F, M M=Male
F=Female


MDR 9 HCSRN_FY00+ 8 214
Yes 8/13/2009 $2

Derived Major Diagnostic Code Code indicating major diagnostic category. Populated for all claims. 01, 02 See MDC Codes.


MDR 9 HCSRN_FY00+ 9 322
Yes 8/13/2009 $1

ICD Edition ID Number Code identifying edition number of ICD-9 Codes.
9=ICD-9 CM


MDR 9 HCSRN_FY00+ 10 358
Yes 8/13/2009 $6

Principle Diagnosis Code The ICD-9 CM code which represents the diagnosis which led to the admission.




MDR 9 HCSRN_FY00+ 11 364
Yes 8/13/2009 $6

Secondary Diagnosis Code 1 Secondary ICD-9 CM code.




MDR 9 HCSRN_FY00+ 12 370
Yes 8/13/2009 $6

Secondary Diagnosis Code 2 Secondary ICD-9 CM code.




MDR 9 HCSRN_FY00+ 13 376
Yes 8/13/2009 $6

Secondary Diagnosis Code 3 Secondary ICD-9 CM code.




MDR 9 HCSRN_FY00+ 14 382
Yes 8/13/2009 $6

Secondary Diagnosis Code 4 Secondary ICD-9 CM code.




MDR 9 HCSRN_FY00+ 15 435
Yes 8/13/2009 3

Patient Age Patient's age based on earliest date of care on claim.




MDR 9 HCSRN_FY00+ 16 487
Yes 8/13/2009 $1

Procedure Text ID Identifies version of procedure code. 4, 8 4=CPT4
8=ADA Dental Codes


MDR 9 HCSRN_FY00+ 17 490
Yes 8/13/2009 $5

Procedure Code HCPCS/CPT4, or TMA Specific code billed on this line item. 99499



MDR 9 HCSRN_FY00+ 18 495
Yes 8/13/2009 SN2

Number of Services The number of services billed for on this line item (associated with procedure code).




MDR 9 HCSRN_FY00+ 19 517
Yes 8/13/2009 $8

Begin Date of Care The beginning date of care for the procedure code.
YYYYMMDD. ** Note that for global CPT codes, the dates will generally only reflect the date that the primary procedure was performed. The line item likely includes additional dates of services.


MDR 9 HCSRN_FY00+ 20 525
Yes 8/13/2009 $8

End Date of Care The last date of care for the procedure code.
YYYYMMDD. ** Note that for global CPT codes, the dates will generally only reflect the date that the primary procedure was performed. The line item likely includes additional dates of services.


MDR 9 HCSRN_FY00+ 21 533
Yes 8/13/2009 $2

Place of Service Code indicating the place that the service was provided. ** Note that "place of service=26" represents care provided within an MTF.
www.tricare.osd.mil/datadictionary


MDR 9 HCSRN_FY00+ 22 535
Yes 8/13/2009 $1

Type of Service 1 Code representing the setting of the service.
www.tricare.osd.mil/datadictionary


MDR 9 HCSRN_FY00+ 23 536
Yes 8/13/2009 $1

Type of Service 2 Code representing type of service.
www.tricare.osd.mil/datadictionary


MDR 9 HCSRN_FY00+ 24 541
Yes 8/13/2009 $2

CPT Modifier 1 The 1st modifier for the procedure code.
www.tricare.osd.mil/datadictionary


MDR 9 HCSRN_FY00+ 25 543
Yes 8/13/2009 $2

CPT Modifier 2 The 2nd modifier for the procedure code.
www.tricare.osd.mil/datadictionary


MDR 9 HCSRN_FY00+ 26 553
Yes 8/13/2009 $2

Category of Care Category of care used in historical contract settlements.
1st Character:
A=Psych
B=OB
C=Gynecology
D=Surgical
E=Medical
F=Dental
G=Drug
H=Program for the Handicapped.

2nd Character:
1=Peds
2=Delivery
3=Peds and Delivery
Blank=Neither Peds nor Delivery


MDR 9 HCSRN_FY00+ 27 559
Yes 8/13/2009 $1

Reservist Status Code Code indicating the status of the sponsor while called up for GWOT (only applies to guard/reserve and their family members.) A, E, O, M, T, I, L A = Early Alert for Guard/Reserve E = TAMP extended for Guard/Reserve O = TAMP original for Guard/Reserve
M = Mobilization for Guard/Reserve T = TAMP for Guard/Reserve
I = TAMP for involuntary separation from Active Duty
L = TAMP for stop/loss from Active Duty


MDR 9 HCSRN_FY00+ 28 465
Yes 12/17/2009 $1

Beneficiary Category Categorization of beneficiaries based on DEERS sponsor status and beneficiary relationship to sponsor. 1, 2, 3, 4 1=Active Duty Family 2=Retiree 3=All others 4=Active Duty (includes guard, also non-military services) ** Note that Inactive Guard and Reserve are coded as AD and their family members are classified as ADFM. These beneficiaries are not on active duty.


MDR 10 HCSR-N_pre_FY00_A 1 128 DI Yes 8/13/2009 $9

Sponsor SSN Sponsor social security account number or veterans administration file number.
All blanks=NATO & security agent claims (extremely rare), First 3 digits zeroes=Deceased sponsor only


MDR 10 HCSR-N_pre_FY00_A 2 137 DI Yes 8/13/2009 $2

Sponsor Pay Grade Sponsor's pay grade code. 00 - 14, 19 - 31, 40 - 58, 90, 95, 99 00=unknown enlisted
01 - 09=Enlisted (e1 - e9)
10=Unknown warrant officer
11 - 14=Warrant officer (w1 - w4)
19=Academy of navy OCS students
20=Unknown officer
21 - 31=Officer (01-011)
40=Unknown civil service
41 - 58=GS1 - GS18
90=Unknown
95=Not applicable (including CHAMPVA)
99=Other


MDR 10 HCSR-N_pre_FY00_A 3 140
Yes 8/13/2009 $1

Sponsor Status Status of sponsor at the time of health care delivery.
A=Active Duty
B=Presidential Appointee
C=Civil Servant
D=DAV
E=DoD Contract Employee
F=Former Member
G=Guard
H=Medal of Honor
I=Non-DoD Civil Servant
J=Academy Student
K=NAF DoD Employee
L=Lighthouse Keeper
M=Non Government Agency Personnel
N=Guard
O=Non-DoD contract employee
P=TAMP
Q=Reserve Retiree (not ready for retired pay)
S=Reserve
T=Foreign Military
U=Authorized foreign national
V=Reserve
W=DoD benefit from prior relationship
Z=Unknown


MDR 10 HCSR-N_pre_FY00_A 4 178
Yes 8/13/2009 $8

Patient DOB Patient date of birth. YYYYMMDD Date of birth of patient.


MDR 10 HCSR-N_pre_FY00_A 5 186
Yes 8/13/2009 $2

DEERS Dependent Suffix Code Code maintained by DEERS that uniquely identifies the patient within the family.
01 - 19=Dependent Child
20=Sponsor
30 - 39=Spouse of sponsor
40 - 44=Mother of sponsor
45 - 49=Father of sponsor
50 - 54=Mother-In-Law of sponsor
55 - 59=Father-In-Law of sponsor
60 - 69=Other eligible dependents
70 - 74=Unknown by DEERS
75=Pseudo DDS unknown by contractor
98=Service secretary designee


MDR 10 HCSR-N_pre_FY00_A 6 188
Yes 8/13/2009 $1

Patient Sex Gender of patient. F, M M=Male
F=Female


MDR 10 HCSR-N_pre_FY00_A 7 198
Yes 8/13/2009 $2

Enrollment Code Code indicating enrollment status of patient. Some values of this code are not related to enrollment however.
AD enrollees are not identifiable. This fields will contain values for "supplemental care" for all active duty. See Enrollment Status.


MDR 10 HCSR-N_pre_FY00_A 8 212
Yes 8/13/2009 $2

Major Diagnostic Category Code Code representing MDC. Only populated when NAS issued. 01, 02 See MDC Codes.


MDR 10 HCSR-N_pre_FY00_A 9 214
Yes 8/13/2009 $2

Derived Major Diagnostic Code Code indicating major diagnostic category. Populated for all claims. 01, 02 See MDC Codes.


MDR 10 HCSR-N_pre_FY00_A 10 322
Yes 8/13/2009 $1

ICD Edition ID Number Code identifying edition number of ICD-9 Codes.
9=ICD-9 CM


MDR 10 HCSR-N_pre_FY00_A 11 358
Yes 8/13/2009 $6

Principle Diagnosis Code The ICD-9 CM code which represents the diagnosis which led to the admission.




MDR 10 HCSR-N_pre_FY00_A 12 364
Yes 8/13/2009 $6

Secondary Diagnosis Code 1 Secondary ICD-9 CM code.




MDR 10 HCSR-N_pre_FY00_A 13 370
Yes 8/13/2009 $6

Secondary Diagnosis Code 2 Secondary ICD-9 CM code.




MDR 10 HCSR-N_pre_FY00_A 14 376
Yes 8/13/2009 $6

Secondary Diagnosis Code 3 Secondary ICD-9 CM code.




MDR 10 HCSR-N_pre_FY00_A 15 382
Yes 8/13/2009 $6

Secondary Diagnosis Code 4 Secondary ICD-9 CM code.




MDR 10 HCSR-N_pre_FY00_A 16 435
Yes 8/13/2009 3

Patient Age Patient's age based on earliest date of care on claim.




MDR 10 HCSR-N_pre_FY00_A 17 481
Yes 8/13/2009 $4

Care End Date Year Calendar year of end date of care of primary procedure on claim. 2001



MDR 10 HCSR-N_pre_FY00_A 18 485
Yes 8/13/2009 $2

Care End Date Month Calendar month of end date of care of primary procedure on claim. 10



MDR 11 HCSR-N_pre_FY00_B 1 128 DI Yes 8/13/2009 $9

Sponsor SSN Sponsor social security account number or veterans administration file number.
CPT4 codes begin with a number, HCPCS Level II Codes begin with a letter. TMA - Specific codes are described in the ADP Manual.


MDR 11 HCSR-N_pre_FY00_B 2 586
Yes 8/13/2009 $5

Procedure Code 1 - Procedure Code 25 Up to 25 separate fields representing the billed procedure code for line item n. HCPCS/CPT4, or TMA Specific codes. 99499 YYYYMMDD


MDR 11 HCSR-N_pre_FY00_B 3 613
Yes 8/13/2009 $8

Begin Date 1 - Begin Date 25 Up to 25 separate fields representing the begin date of care for line item n.




MDR 11 HCSR-N_pre_FY00_B 4 621
Yes 8/13/2009 $8

End Date 1 - End Date 25 Up to 25 separate fields representing the end date of care for line item n.
www.tricare.osd.mil/datadictionary


MDR 11 HCSR-N_pre_FY00_B 5 629
Yes 8/13/2009 $2

Place of Service 1 - Place of Service 25 Up to 25 separate fields representing the place of service for line item n.
www.tricare.osd.mil/datadictionary


MDR 11 HCSR-N_pre_FY00_B 6 631
Yes 8/13/2009 $1

Type of Service 1, 1 - Type of Service 1, 25 Up to 25 separate fields representing the "type of service" for line item n.
www.tricare.osd.mil/datadictionary


MDR 11 HCSR-N_pre_FY00_B 7 632
Yes 8/13/2009 $1

Type of Service 2, 1 - Type of Service 2, 25 Up to 25 separate fields representing the type of service for line item n.
www.tricare.osd.mil/datadictionary


MDR 11 HCSR-N_pre_FY00_B 8 637
Yes 8/13/2009 $2

CPT Modifier 1, 1 - CPT Modifier 1, 25 Up to 25 separate fields representing the 1st CPT modifier for the procedure code for line item n.
www.tricare.osd.mil/datadictionary


MDR 11 HCSR-N_pre_FY00_B 9 639
Yes 8/13/2009 $2

CPT Modifier 2, 1 - CPT Modifier 2, 25 Up to 25 separate fields representing the 2nd CPT modifier for the procedure code for line item n.
1=Primary procedure
0=Not the primary procedure


MDR 11 HCSR-N_pre_FY00_B 10 648
Yes 8/13/2009 $1

Primary Procedure Flag 1 - Primary Procedure Flag 25 Code indicating whether or not this line item represents the primary procedure for a given claim.
1st Character:
A=Psych
B=OB
C=Gynecology
D=Surgical
E=Medical
F=Dental
G=Drug
H=Program for the Handicapped

2nd Character:
1=Peds
2=Delivery
3=Peds and Delivery
Blank=neither Peds nor Delivery


MDR 11 HCSR-N_pre_FY00_B 11 649
Yes 8/13/2009 $2

Category of Care Category of care used in contract settlements.
Use this value to track M2 claims data to other data sources, such as CDIS.


MDR 11 HCSR-N_pre_FY00_B 12 87 for TED records, 90 for HCSR records
Yes 8/13/2009 If HCSR Based, $21, If TED Based, $24

HCSR or TED Number Number that uniquely identifies the claim.




MDR 12 Master_Death 1 sponssn DI Yes 8/13/2009 Char(9)

Sponsor SSN Social security number of active duty member.




MDR 12 Master_Death 2 dob
Yes 8/13/2009 SAS Date

Date of Birth Date of birth of individual.




MDR 12 Master_Death 3 edipn
Yes 8/13/2009 Char(10)

EDIPN Unique Identifier of individual.




MDR 12 Master_Death 4 dds
Yes 8/13/2009 Char(2)

DDS DEERS Dependent Suffix: Code maintained by DEERS that uniquely identifies the beneficiary within the family. 01-19, 20,
30-39, 40-44, 45-49, 50-54, 55-59, 60-69, 70-74, 75, 98		 01-19=Dependent Child
20=Sponsor
30-39=Spouse of sponsor
40-44=Mother of sponsor
45-49=Father of sponsor
50-54=Mother-In-Law of sponsor
55-59=Father-In-Law of sponsor
60-69=Other eligible dependents
70-74=Unknown by DEERS
75=Pseudo DDS unknown by contractor
98=Service secretary designee


MDR 12 Master_Death 5 gender
Yes 8/13/2009 Char(1)

Gender Patient/beneficiary Gender. M, F M=Male
F=Female


MDR 12 Master_Death 6 dthdate
Yes 8/13/2009 SAS Date

Death Date Date of recorded death.




MDR 12 Master_Death 7 source
Yes 8/13/2009 Char(1)

Source Source of death information. H, S, A, C H=HCSR/TED-Institutional
S=SIDR
A=SADR
C=Casualty


MDR 12 Master_Death 8 dthcode
Yes 8/13/2009 Char(1)

Death Code Flag that indicates whether the record contains a death. Y Set to 'Y' for all files


MDR 12 Master_Death 9 rel
Yes 8/13/2009 Char(1)

Relationship First digit of DDS, which defines whether patient is sponsor, spouse, dependent, or other. 0-7, 9 0-1=Dependent Child
2=Sponsor
3=Spouse of sponsor
4=Parent of sponsor
5=Parent-In-Law of sponsor
6=Other eligible dependents
7=Unknown
9=Service secretary designee


MDR 13 PDTS 1 1-8
Yes 8/13/2009 YYYYMMDD

Date Dispensed Key The date that the pharmaceutical was dispensed to the patient.




MDR 13 PDTS 2 17-23
Yes 8/13/2009 Char (7)

Rx Number





MDR 13 PDTS 3 24-30
Yes 8/13/2009 Char (7)

MCSC Code





MDR 13 PDTS 4 31-39
Yes 8/13/2009 N (9.3)

Quantity (Modified) The metric quantity of the pharmaceutical. e.g., 90.000



MDR 13 PDTS 5 40-42
Yes 8/13/2009 N (3)

Days Supply The number of days supply of the pharmaceutical that was dispensed. e.g., 180



MDR 13 PDTS 6 91
Yes 8/13/2009 Char (1)

Generic Indicator Indicator that the pharmaceutical is a generic brand. M, O, N, Y, X M = Single source brand
O = Brand that has generic equivalents
N = Proprietary with no equivalent
Y = Generic brand
X = Non-drug item


MDR 13 PDTS 7 92-93
Yes 8/13/2009 Char (2)

New Refill Code-FILLCODE The sequence in the refill cycle. 00, 01, . . 00 = First prescription fill
01 = First refill
02 = Second refill, etc.


MDR 13 PDTS 8 94-95
Yes 8/13/2009 Char (2)

Compound Code Indicator of whether the pharmaceutical is a compound. Y, N, NS Y = Yes
N = No
NS = Not Submitted


MDR 13 PDTS 9 96
Yes 8/13/2009 Char (1)

DAW (Dispensed As Written) Dispensed as Written Code. 0 - 9, D, S, blank 0 = No product selection indicated
1 = Substitution not allowed by provider
2 = Substitution allowed - patient requested product dispensed
3 = Substitution allowed - pharmacist selected product dispensed
4 = Substitution allowed - generic drug not in stock
5 = Substitution allowed - brand drug dispensed as generic
6 = Override
7 = Substitution not allowed - brand drug mandated by law
8 = Substitution allowed - generic drug not available in marketplace
9 = Other
D, S, Blank = unknown


MDR 13 PDTS 10 131-140
Yes 8/13/2009 Char (10)

DEA Number Doctor's DEA (Drug Enforcement Agency) Number (or SSN for an MTF prescriber). e.g., 1234567890



MDR 13 PDTS 11 141-151
Yes 8/13/2009 Char (11)

NDC The National Drug Code that denotes a particular product as to manufacturer, drug, and package size.




MDR 13 PDTS 12 170-178 DI Yes 8/13/2009 Char (9)

Sponsor Social Security Number Sponsor social security number or Veterans Administration file number. e.g., 123456789 First 9 characters of Subscriber ID. If Subscriber ID is invalid (not 11 characters), merge Universal Patient Identifier (starting in FY04) with PITE and use SSN from PITE.


MDR 13 PDTS 13 179-180
Yes 8/13/2009 Char (2)

DEERS Dependent Suffix DEERS Dependent Suffix: Code maintained by DEERS that uniquely identifies the patient within the family. 01 - 19, 20,
30 - 39, 40 - 44, 45 - 49, 50 - 54, 55 - 59, 60 - 69, 70 - 74, 75, 98, 0X		 01 - 19 = Dependent Child
20 = Sponsor
30 - 39 = Spouse of sponsor
40 - 44 = Mother of sponsor
45 - 49 = Father of sponsor
50 - 54 = Mother-In-Law of sponsor
55 - 59 = Father-In-Law of sponsor
60 - 69 = Other eligible dependents
70 - 74 = Unknown by DEERS
75 = Pseudo DDS unknown by contractor
98 = Service secretary designee

Positions 10 - 11 of Subscriber ID. If Subscriber ID is invalid (not 11 characters), merge Universal Patient Identifier (starting in FY04) with PITE and use DDS from PITE. If DDS is still missing after PITE merge, set DDS to "0X" if Date Dispensed - Birth date <= 30 days. (A newborn not yet registered to DEERS.)


MDR 13 PDTS 14 184-195
Yes 8/13/2009 Char (12)

Provider Code-NCPDPNUM National Council for Prescription Drug Programs (NCPDP) code. e.g., 0580680



MDR 13 PDTS 15 214-240
Yes 8/13/2009 Char (27)

Product Name The name of the prescription drug. e.g., MOTRIN, AMOXICILLIN



MDR 13 PDTS 16 241-250
Yes 8/13/2009 Char (10)

Product Strength Drug strength description. e.g., 5MG, 100MG, 32MG



MDR 13 PDTS 17 251-252
Yes 8/13/2009 Char (2)

Product Form Form that the prescription drug is in. e.g., TA, TS, CA, CB See Product Form Codes.


MDR 13 PDTS 18 253-257
Yes 8/13/2009 Char (5)

GCN Generic Code Number across different NDCs of like drug, strength, etc. e.g., 00132



MDR 13 PDTS 19 258
Yes 8/13/2009 Char (1)

DEA Class Proscribing authority class for controlled substances. 0, 2, 3, 4, 5, blank



MDR 13 PDTS 20 259-264
Yes 8/13/2009 Char (6)

Therapeutic Class A code that represents the American Hospital Formulary Service (AHFS) classification system for grouping pharmaceuticals with similar therapeutic uses. e.g., 280804 See AHFS Therapeutic Class.


MDR 13 PDTS 21 265
Yes 8/13/2009 Char (1)

Maintenance Drug
Y, N Y = Yes, N = No


MDR 13 PDTS 22 294
Yes 8/13/2009 Char (1)

Sex Patient's gender. F, M, U, Z, blank F = Female
M = Male
U, Z, blank = Unknown


MDR 13 PDTS 23 295-302
Yes 8/13/2009 YYYYMMDD

Birth Date Patient's date of birth.




MDR 13 PDTS 24 308-312
Yes 8/13/2009 Char (5)

Zip Code (Pharmacy) The postal ZIP code of the pharmacy that issued the prescription. e.g., 49341



MDR 13 PDTS 25 313
Yes 8/13/2009 Char (1)

Fill Location The MHS system that provided and delivered the pharmaceutical to the patient. C, D, M, T C = Clinician Administered Drug (Drugs that were administered by an MTF and fall within a specific list of drugs determined by the Pharmacoeconomic Center (PEC) that are not normally self-administered by a patient. E.g., injections given in a clinic, chemotherapy and other cancer drugs.)
D = Direct Care (includes VA mail order pharmacy refills made on behalf of participating MTFs in FY03 and FY04. See Note.)
M = Managed Care Support Contractor (MCSC)
T = TMOP (Formerly NMOP)
NOTE: If Source System = D, Refill Number not equal 00, and Pharmacy ID in (4524395, 3210717, 0581896) (Ft. Hood, Kirtland, and San Diego respectively) then these records are refills done at the VA via CMOP


MDR 13 PDTS 26 314-317
Yes 8/13/2009 Char (4)

PDTS Fill Location Fill Location as received. MCSC, MTF, Mail, Retail



MDR 13 PDTS 27 333-335
Yes 8/13/2009 Char (3)

Beneficiary Category Beneficiary Category: Patient's beneficiary classification as derived from DEERS. ACT, DA, GRD, DGR, IGR, IDG, RET, DR, DS, OTH, Z ACT = Active Duty
DA = Dependent of Active Duty
GRD = Guard/Reserve
DGR = Dependent of Guard/Reserve
IGR = Inactive Guard/Reserve
IDG = Dependent of Inactive Guard/Reserve
RET = Retiree
DR = Dependent of Retiree
DS = Survivor
OTH = Other
Z = Unknown


MDR 13 PDTS 28 362
Yes 8/13/2009 Char (1)

Sponsor Service The code that represents the branch classification of Service with which the sponsor is affiliated, as indicated in DEERS. A, C, D, F, H, M, N, O, X, 1, 2, 3, 4, blank A = Army
C = Coast Guard
D = Office of the Secretary of Defense
F = Air Force
H = The Commissioned Corps of the Public Health Service
M = Marine Corps
N = Navy
O = The Commissioned Corps of the National Oceanic and Atmospheric Administration
X = Not Applicable
1 = Foreign Army
2 = Foreign Navy
3 = Foreign Marine Corps
4 = Foreign Air Force
blank = Unknown


MDR 13 PDTS 29 363-366
Yes 8/13/2009 Char (4)

Treatment DMIS ID Treatment DMIS ID, facility that dispensed the prescription.
Only populated for Direct Care scripts. Treatment DMIS ID is derived from the association of a NCPDP (Pharmacy) ID with the facility's DMIS ID.

See DMIS ID Information for IDs and names.


MDR 13 PDTS 30 367-369
Yes 8/13/2009 N (3) (3)

Age Patient's age in years at issue date.




MDR 13 PDTS 31 392-401 Yes Yes 8/13/2009 Char (10)

Universal Patient Identifier A unique identifier of a person, as assigned by DEERS. This is sometimes, under HIPAA, called the Electronic Data Interchange - Patient Identifier (EDI-PN).
This field is populated beginning in FY04. If it is missing, it is populated using a SSN/DDS/Family Sequence ID merge with PITE.


MDR 13 PDTS 32 426-434
Yes 8/13/2009 N (9.3)

Raw Metric Decimal Quantity The metric quantity of the pharmaceutical.
As received.


MDR 13 PDTS 33 480-481
Yes 8/13/2009 Char (2)

Reservist Special Operation Code The identifier that represents the special operation. 08, 09, 10 08 = Operation Noble Eagle
09 = Operation Enduring Freedom
10 = Iraqi Freedom


MDR 13 PDTS 34 482
Yes 8/13/2009 Char (1)

Reservist Status Code Entitlement status at the time of care. A, E, O, M, T, I, L A = Early Alert for Guard/Reserve E = TAMP extended for Guard/Reserve O = TAMP original for Guard/Reserve
M = Mobilization for Guard/Reserve T = TAMP for Guard/Reserve
I = TAMP for involuntary separation from Active Duty
L = TAMP for stop/loss from Active Duty


MDR 13 PDTS 35 484
Yes 8/13/2009 Char (1)

Marital Status Patient's marital status at issue date. A, D, I, L, M, N, W, Z From LVM4. (MRTL_STAT_CD). Populated FY03+
A = Annulled
D = Divorced
I = Interlocutory decree
L = Legally separated
M = Married
N = Never married
W = Widow or widower
Z = Unknown


MDR 13 PDTS 36 583-586
Yes 8/13/2009 Char (4)

Ordering Site Ordering DMIS ID, facility that dispensed the prescription.
Populated starting in FY06.
Only populated for Direct Care scripts. Ordering DMIS ID is derived from the association of a NCPDP (Pharmacy) ID with the facility's DMIS ID.

See DMIS ID Information for IDs and names.


MDR 13 PDTS 37 587-606
Yes 8/13/2009 Char (20)

Prof Enc Record ID-A - APPTIEN SADR/Appt Record ID associated with script.
Populated FY06+.


MDR 13 PDTS 38 607-608
Yes 8/13/2009 Char (2)

Person Association Reason Code The code that represents the underlying basis of an association of one person to another person. For example, a person is a child of another person. AA, AB, AC, AD, AE, AF, AH, AI, AX, BB, BC, BD, BE, BF, BG, CA, ZZ, Blank AA=Spouse
AB=Child
AC=Foster Child
AD=Parent
AE=Parent-in-law
AF=Stepchild
AH=Stepparent
AI=In loco parentis
AX=Emergency Contact
BB=Ward
BC=Former Spouse (not assignable after RAPIDS 6.3)
BD=Self (i.e., the person and the other person are the same person)
BE=Joint marriage spouse
BF=Other health insurance subscriber
BG=Pre-adoptive child
CA=Member of household headed by sponsor's former spouse (child, stepchild, or ward only)
ZZ, Blank=Unknown


MDR 14 Referral 1 apptdmisid
Yes 8/13/2009 $4

Treatment DMISID





MDR 14 Referral 2 patcat
Yes 8/13/2009 $3

Patient Category Code





MDR 14 Referral 3 refdate
Yes 8/13/2009 $8

Referral Date

Put into YYYYMMDD format based on the first 8 characters of the Referral date and time.


MDR 14 Referral 4 begdate
Yes 8/13/2009 $8

Referral Start Date

 YYYYMMDD


MDR 14 Referral 5 enddate
Yes 8/13/2009 $8

Referral End Date

 YYYYMMDD


MDR 14 Referral 6 visits
Yes 8/13/2009 2

Number of Visits Authorized





MDR 14 Referral 7 atc_cat
Yes 8/13/2009 $1

Access to Care Category





MDR 14 Referral 8 pocdmis
Yes 8/13/2009 $4

Referring to Clinic DMIS ID





MDR 14 Referral 9 appttype
Yes 8/13/2009 $10

Appointment Type





MDR 14 Referral 10 apptstat
Yes 8/13/2009 $7

Appointment Status





MDR 14 Referral 11 parc
Yes 8/13/2009 $2

Person Association Reason Code

 See VM6 Specification.


MDR 14 Referral 12 bencatx
Yes 8/13/2009 $3

Beneficiary Category





MDR 14 Referral 13 status
Yes 8/13/2009 $22

Status
1-5 1=Active Duty, 2=Fam mbr of Active Duty, 3=Retired, 4=Fam mbr of Retired, 5=Other


MDR 14 Referral 15 Reftoprv_id
Yes 8/13/2009









MDR 15 Referral_to_Crosswalk 1 refnum
Yes 11/16/2009 $11

Record ID

Position 6-16 of the host concatenated with the referral internal entry number


MDR 15 Referral_to_Crosswalk 2 apptdmisid
Yes 8/13/2009 $4

Treatment DMISID





MDR 15 Referral_to_Crosswalk 3 apptien
Yes 8/13/2009 $10

Associated Record ID

Position 6-15 of the host DMIS ID concatenated with the Appointment ien.


MDR 15 Referral_to_Crosswalk 4 refbyprv_id
Yes 8/13/2009 $9

Referring Provider REFBY (CHCS Provider ID)




MDR 16 Reservist 1 SPONSSN DI Yes 11/16/2009 $9

Sponsor SSN Sponsor Social Security Number. 111111111



MDR 16 Reservist 2 PEC
Yes 11/16/2009 $2

Personnel Entitlement Condition Type Code The code that represents the type of condition that occurred while a sponsor was in a personnel category and organization that affected the entitlements of the sponsor and/or the sponsor’s dependents.
Code values are defined in the DEERS PITE Data Dictionary.


MDR 16 Reservist 3 BEGDATE
Yes 11/16/2009 SAS Date

Personnel Entitlement Condition Begin Date The begin date of a condition that occurred while a sponsor was in a personnel category and organization that affected the entitlements of the sponsor and/or the sponsor’s dependents. NOTE: If the condition represents an event, then the date of that event is stored in the personnel entitlement condition begin date. The personnel entitlement condition end date will be blank.




MDR 16 Reservist 4 ENDDATE
Yes 11/16/2009 SAS Date

Personnel Entitlement Condition End Date The end date of a condition that occurred while a sponsor was in a personnel category and organization that affected the entitlements of the sponsor and/or the sponsor’s dependents. NOTE: If the condition represents an event, then the date of that event is stored in the personnel entitlement condition begin date. The personnel entitlement condition end date will be blank.




MDR 16 Reservist 5 SOC
Yes 11/16/2009 $2

Reservist Special Operation Code The identifier that represents the special operation. 08, 09, 10 08=Operation Noble Eagle
09=Operation Enduring Freedom
10=Operation Iraqi Freedom


MDR 16 Reservist 6 DOB
Yes 11/16/2009 SAS Date

Person Date of Birth The date when a person was born.




MDR 16 Reservist 7 GENDER
Yes 11/16/2009 $1

Person Sex Code The code that represents a classification of a person according to reproductive functions. F, M, Z F=Female
M=Male
Z=Unknown


MDR 16 Reservist 8 SVC
Yes 11/16/2009 $1

Sponsor Service Derived Sponsor Service from Personnel Organization Code. A, F, N, M, O A=Army
F=Air Force
N=Navy
M=Marines
O=Other


MDR 16 Reservist 9 STATUS
Yes 11/16/2009 $1

Reservist Status Code Derived Reservist Status Code from Personnel Entitlement Condition Type Code. A, E, O, M, T, I, L A = Early Alert for Guard/Reserve E = TAMP extended for Guard/Reserve O = TAMP original for Guard/Reserve
M = Mobilization for Guard/Reserve T = TAMP for Guard/Reserve
I = TAMP for involuntary separation from Active Duty
L = TAMP for stop/loss from Active Duty


MDR 17 SADR 1 AMBSURG
Yes 11/16/2009 Char (1)

Raw Same Day Surgery Same day surgery indicator. 0, 1 0 = Not Same Day Surgery
1 = Same Day Surgery


MDR 17 SADR 2 APPTINFR
Yes 8/13/2009 Char (1)

Appointment Inferred Identifies records added to the SADR file in the event an appointment record exists but a SADR does not. Y, N Y = Inferred based on appointment record. N = Originated as a SADR.


MDR 17 SADR 3 APPTSTAT
Yes 8/13/2009 Char (1)

Appointment Status Type Appointment type. 1, 3, 4, 6 1 = Scheduled
3 = Walk-in
4 = Sick call
6 = Telephone consult


MDR 17 SADR 4 APPTTYPE
Yes 8/13/2009 Char (6)

Appointment Type from Appointment Data

ACUT = Acute appointment
ACUT$ = Acute appointment
APV = Ambulatory Procedure Visit
EROOM = Emergency Room
EST = Established/follow up
EST$ = Established/follow up
GRP = Group/class appointment
GRP$ = Group/class appointment
N-MTF = Non-MTF appointment
OPAC = Open Access Appointment
OPAC$ = Open Access Appointment
PCM = Initial Primary Care appointment
PCM$ = Initial Primary Care appointment
PROC = Procedure appointment
PROC$ = Procedure appointment
RNDS* = Inpatient ward appointment
ROUT = Routine appointment
ROUTS = Routine appointment
ROUT$ = Routine appointment
SPEC = Initial Specialty Care appointment
SPEC$ = Initial Specialty Care appointment
T-CON* = Telephone consult
T-CON = Telephone consult
WELL = Wellness/Health Promotion Appointment
WELL$ = Wellness/Health Promotion Appointment


MDR 17 SADR 5 BENCATX
Yes 8/13/2009 Char (3)

Beneficiary Category Category of beneficiary derived from the longitudinal LVM4 and BENCAT. ACT, DA, DCO, DGR, DR, DS, GRD, IDG, IGR, NAT, OTH, RET, UNK ACT = Active Duty Member
DA = Dependent of Active Duty
DCO = Direct Care Only
DGR = Dependent of Guard/Reserve
DR = Dependent of Retired
DS = Dependent of Survivor
GRD = Guard
IDG = Inactive Guard/Reserve Dependent
IGR = Inactive Guard/Reserve
NAT = NATO
OTH = Other
RET = Retired
UNK =Unknown

Populated FY04+.


MDR 17 SADR 6 CPT
Yes 8/13/2009 Char (5)

CPT Code - E&M Evaluation and Management Code: the level of patient care provided at that particular outpatient visit. 99201 - 99499 Required by SADR.


MDR 17 SADR 7 CPTMOD1
Yes 8/13/2009 Char(2)

CPT Code - E&M #1 Modifier

Populated FY03+.


MDR 17 SADR 8 CPTUOS
Yes 8/13/2009 N

CPT Code - E&M #1 Quantity

Populated FY03+.


MDR 17 SADR 9 CPT4VER
Yes 8/13/2009 Char (1)

CPT Version (year) Indicates the year of the most recent update of the Current Procedural Terminology (CPT4) Code Table in ADM. The last digit of the update year is used. The ADM table is updated from a CHCS code table. 0 - 9



MDR 17 SADR 10 CPT1
Yes 8/13/2009 Char (5)

CPT Code -Proc #1 1 Procedure's code.
Populated FY03+.


MDR 17 SADR 11 CPT2
Yes 8/13/2009 Char (5)

CPT Code -Proc #2 2 Procedure's code.




MDR 17 SADR 12 CPT3
Yes 8/13/2009 Char (5)

CPT Code -Proc #3 3 Procedure's code.




MDR 17 SADR 13 CPT4
Yes 8/13/2009 Char (5)

CPT Code -Proc #4 4 Procedure's code.




MDR 17 SADR 14 CPT5
Yes 8/13/2009 Char (5)

CPT Code -Proc #5 5 Procedure's code.




MDR 17 SADR 15 CPT6
Yes 8/13/2009 Char (5)

CPT Code -Proc #6 6 Procedure's code.




MDR 17 SADR 16 CPT7
Yes 8/13/2009 Char (5)

CPT Code -Proc #7 7 Procedure's code.




MDR 17 SADR 17 CPT8
Yes 8/13/2009 Char (5)

CPT Code -Proc #8 8 Procedure's code.




MDR 17 SADR 18 CPT9
Yes 8/13/2009 Char (5)

CPT Code -Proc #9 9 Procedure's code.




MDR 17 SADR 19 CPT10
Yes 8/13/2009 Char(5)

CPT Code -Proc #10 10 Procedure's code.




MDR 17 SADR 20 CPT1MOD1
Yes 8/13/2009 Char(2)

CPT Code - Proc #1 Modifier #1 1 Procedure's first modifier
Populated FY03+.


MDR 17 SADR 21 CPT2MOD1
Yes 8/13/2009 Char(2)

CPT Code - Proc #2 Modifier #1 2 Procedure's first modifier




MDR 17 SADR 22 CPT3MOD1
Yes 8/13/2009 Char(2)

CPT Code - Proc #3 Modifier #1 3 Procedure's first modifier




MDR 17 SADR 23 CPT4MOD1
Yes 8/13/2009 Char(2)

CPT Code - Proc #4 Modifier #1 4 Procedure's first modifier




MDR 17 SADR 24 CPT5MOD1
Yes 8/13/2009 Char(2)

CPT Code - Proc #5 Modifier #1 5 Procedure's first modifier




MDR 17 SADR 25 CPT6MOD1
Yes 8/13/2009 Char(2)

CPT Code - Proc #6 Modifier #1 6 Procedure's first modifier




MDR 17 SADR 26 CPT7MOD1
Yes 8/13/2009 Char(2)

CPT Code - Proc #7 Modifier #1 7 Procedure's first modifier




MDR 17 SADR 27 CPT8MOD1
Yes 8/13/2009 Char(2)

CPT Code - Proc #8 Modifier #1 8 Procedure's first modifier




MDR 17 SADR 28 CPT9MOD1
Yes 8/13/2009 Char(2)

CPT Code - Proc #9 Modifier #1 9 Procedure's first modifier




MDR 17 SADR 29 CPT10MOD1
Yes 8/13/2009 Char(2)

CPT Code - Proc #10 Modifier #1 10 Procedure's first modifier




MDR 17 SADR 30 CPT1UOS
Yes 8/13/2009 N

CPT Code - Proc #1 Quantity 1 Procedure's units of service
Populated FY03+.


MDR 17 SADR 31 CPT2UOS
Yes 8/13/2009 N

CPT Code - Proc #2 Quantity 2 Procedure's units of service




MDR 17 SADR 32 CPT3UOS
Yes 8/13/2009 N

CPT Code - Proc #3 Quantity 3 Procedure's units of service




MDR 17 SADR 33 CPT4UOS
Yes 8/13/2009 N

CPT Code - Proc #4 Quantity 4 Procedure's units of service




MDR 17 SADR 34 CPT5UOS
Yes 8/13/2009 N

CPT Code - Proc #5 Quantity 5 Procedure's units of service




MDR 17 SADR 35 CPT6UOS
Yes 8/13/2009 N

CPT Code - Proc #6 Quantity 6 Procedure's units of service




MDR 17 SADR 36 CPT7UOS
Yes 8/13/2009 N

CPT Code - Proc #7 Quantity 7 Procedure's units of service




MDR 17 SADR 37 CPT8UOS
Yes 8/13/2009 N

CPT Code - Proc #8 Quantity 8 Procedure's units of service




MDR 17 SADR 38 CPT9UOS
Yes 8/13/2009 N

CPT Code - Proc #9 Quantity 9 Procedure's units of service




MDR 17 SADR 39 CPT10UOS
Yes 8/13/2009 N

CPT Code - Proc #10 Quantity 10 Procedure's units of service




MDR 17 SADR 40 DDS
Yes 8/13/2009 Char (2)

DEERS Dependent Suffix DEERS specific code indicating the relationship of the beneficiary to the sponsor. (Not the same of the family member prefix in CHCS).

As found in the merge to the MPI.		 01 - 19, 20,
30 - 39, 40 - 44, 45 - 49, 50 - 54, 55 - 59, 60 - 69, 70 - 74, 75, 98		 01 - 19 = Dependent Child
20 = Sponsor
30 - 39 = Spouse of sponsor
40 - 44 = Mother of sponsor
45 - 49 = Father of sponsor
50 - 54 = Mother-In-Law of sponsor
55 - 59 = Father-In-Law of sponsor
60 - 69 = Other eligible dependents
70 - 74 = Unknown by DEERS
75 = Pseudo DDS unknown by contractor
98 = Service secretary designee
Blank if no DDS


MDR 17 SADR 41 DISPCODE
Yes 8/13/2009 Char (1)

Disposition Code Code representing visit outcome as marked on the encounter form. 1 - 8,
A - H,
M, O, R, S, U		 1 = Released without limitations
2 = Released with work duty limitations
3 = Sick at home/quarters
4 = Immediate referral
5 = Left without being seen
6 = Left against medical advice
7 = Admitted
8 = Expired

A = Transferred to another hospital
B = Transferred to skilled nursing facility (SNF)
C = Transferred to another clinical service
D = Continued stay
E = Left against medical advice
F = Discharged home
G = Expired
H = Advice Assessment
M = Medication Refill Forwarded
O = Other Not Elsewhere Classified
R = Referred for Appointment
S = Released to Self Care
U = Referred to ER

Note: The numeric codes are only for outpatient and the alpha codes are for inpatient encounters. Values of A - G only apply to encounters when the Inpatient Indicator = 1. Disposition Code types H, M, O, R, S, and U will only apply to non-privileged provider T-Con encounters and are currently used by only a small number of sites.


MDR 17 SADR 42 DMISID
Yes 8/13/2009 Char (4)

Treatment DMIS ID Code that identifies the MTF responsible for the treatment of the patient during the episode of care.
See DMIS Information for list of DMIS ID.


MDR 17 SADR 43 EM2
Yes 8/13/2009 Char(5)

CPT Code - E&M #2 2 E&M code.
Populated FY03+.
This 1st E&M code is called CPT.


MDR 17 SADR 44 EM3
Yes 8/13/2009 Char(5)

CPT Code - E&M #3 3 E&M code.




MDR 17 SADR 45 EM2MOD1
Yes 8/13/2009 Char(2)

CPT Code - E&M #j Modifier 1 2 E&M code's first modifier.
Populated FY03+.


MDR 17 SADR 46 EM3MOD1
Yes 8/13/2009 Char(2)

CPT Code - E&M #j Modifier 1 3 E&M code's first modifier.




MDR 17 SADR 47 EM2UOS
Yes 8/13/2009 N

CPT Code - E&M #j Quantity 2 E&M code's units of service.
Populated FY03+.


MDR 17 SADR 48 EM3UOS
Yes 8/13/2009 N

CPT Code - E&M #j Quantity 3 E&M code's units of service.




MDR 17 SADR 49 ENCDATE
Yes 8/13/2009 Char (8)

Encounter Date Date of the encounter. Derived from ENCDATE1 in that slashes are removed to create the yyyymmdd format. yyyymmdd This is NOT a SAS date.


MDR 17 SADR 50 FMP
Yes 8/13/2009 Char (2)

Family Member Prefix A DoD - define code which defines the relationship of the patient to the sponsor. 01 - 19,
20, 30 - 39,
40, 45, 50,
55, 60 - 69,
90 - 95, 98, 99		 01 - 19 = Dependent Child of Sponsor
20 = Sponsor
30 - 39 = Spouse/Former Spouse
40 = Mother/Step-Mother of Sponsor
45 = Father, Step-Father of Sponsor
50 = Mother-In-Law of Sponsor
55 = Father-In-Law of Sponsor
60 - 69 = Other Authorized Dependent of Sponsor
90 - 95 = Bene Authorized by Statute
98 = Civilian Emergencies
99 = All Other, Not Elsewhere Classified


MDR 17 SADR 51 HOSPSTAT
Yes 8/13/2009 Char (1)

Patient Hospital Status Inpatient/Outpatient indicator that the patient had at the time of the encounter. 1, 0, Blank 1 = Inpatient
0 = Outpatient
Blank = Outpatient


MDR 17 SADR 52 ICD1
Yes 8/13/2009 Char (9)

ICD-9-CM, Diagnosis #1 ICD-9-CM diagnosis code.
Left aligned.
Decimal place is assumed after the third position. See DoD Extenders for descriptions of those diagnosis codes with extenders.


MDR 17 SADR 53 ICD2
Yes 8/13/2009 Char (9)

ICD-9-CM, Diagnosis #2 ICD-9-CM diagnosis code.




MDR 17 SADR 54 ICD3
Yes 8/13/2009 Char (9)

ICD-9-CM, Diagnosis #3 ICD-9-CM diagnosis code.




MDR 17 SADR 55 ICD4
Yes 8/13/2009 Char (9)

ICD-9-CM, Diagnosis #4 ICD-9-CM diagnosis code.




MDR 17 SADR 56 ICD9VER
Yes 8/13/2009 Char (1)

ICD9-CM-Version (year) Indicates the year of the most recent update of the ICD Code Table in ADM. The last digit of the update year is used. The ADM table is updated from a CHCS code table. 0 - 9



MDR 17 SADR 57 INJCAUSE
Yes 8/13/2009 Char (3)

Injury Related Cause Field serves as a flag for the encounter being related to an injury and the related cause. N, Y, YAA, YAP,
YEM, YOA		 N = No ("N" followed by two spaces)
Y = Yes ("Y" followed by two spaces)
YAA = Yes, auto accident
YAP = Yes, another party responsible
YEM = Yes, employment
YOA = Yes, other accident


MDR 17 SADR 58 INPAPPT
Yes 8/13/2009 Char (1)

Inpatient Flag A code that indicates an inpatient appointment. 0, 1 0 = Outpatient appointment
1 = Inpatient appointment


MDR 17 SADR 59 MARITAL
Yes 8/13/2009 Char (1)

Marital Status Indicates the legal status of a person as it relates to marriage. A, D, I, L, M, S, W, Z A = Annulled
D = Divorced
I = Interlocutory
L = Legally Separated
M = Married
S = Single, Never Married
W = Widowed
Z = Unknown


MDR 17 SADR 60 MDC
Yes 8/13/2009 Char (3)

Major Diagnostic Category Derived based on Diagnosis 1.
See Major Diagnostic Category worksheet for codes and descriptions. See DoD Extenders for descriptions of those diagnosis codes with extenders.

Populated FY05+.


MDR 17 SADR 61 PARC
Yes 8/13/2009 Char (2)

Person Association Reason Code





MDR 17 SADR 62 PATAGE
Yes 8/13/2009 Num (8)

Patient Age Computed using ENCDATE and PATDOB.




MDR 17 SADR 63 PATCAT
Yes 8/13/2009 Char (3)

Patient Category Identifies the beneficiary status of the person being treated.
See Patient Categories for codes and descriptions.
FY03+: TRS adjustment.
FY02 and before: No transformation. (Char(4))


MDR 17 SADR 64 PATDOB
Yes 8/13/2009 Char (8)

Patient Date of Birth Date when the patient was born. yyyymmdd This is NOT a SAS date.


MDR 17 SADR 65 PATSEX
Yes 8/13/2009 Char (1)

Gender Patient's gender. F, M, Blank F = Female
M = Male
Blank = unknown


MDR 17 SADR 66 PATSSN DI Yes 8/13/2009 Char (9)

SSN of Patient Patient's Social Security Number. e.g., 123456789



MDR 17 SADR 67 PATSTAT
Yes 8/13/2009 Char (1)

Patient Status as reported in the Appointment Data

Only populated for FY03+. Data sent to M2.


MDR 17 SADR 68 PATUNIQ Yes Yes 8/13/2009 Char (10)

Unique Patient Identifier A unique identifier of a person, as assigned by DEERS. This is sometimes, under HIPAA, called the Electronic Data Interchange - Patient Identifier (EDI-PN).

As found in the merge to the MPI.




MDR 17 SADR 69 PROVCLAS
Yes 8/13/2009 Char (5)

Appointment Provider Class Associates the provider to the clinic and is local specific.




MDR 2 SADR 69 PROVID
Yes 8/13/2009 char(9)

Appointment Provider ID Unique provider identifier for the provider rendering care.
Entered by MTF staff, the Provider ID normally consists of eight characters of the provider’s last name and first initial of first name, or some combination of last name A-numeric characters to arrive at a unique identifier (unique to the CHCS site).


MDR 17 SADR 70 PROVSPEC
Yes 8/13/2009 Char (3)

Provider Specialty Code A code that identifies the health service provider's medical specialty. Codes and meanings come from CHCS (938 values).
See Provider Specialty Codes for DC for codes and descriptions.

This field is fed to the M2.


MDR 17 SADR 71 PROVTYPE
Yes 8/13/2009 Char (1)

Provider Type A code that is used to categorize a health service provider within an encounter. B, C, F, H, P, T B = Fee Basis
C = C and A
F = Full-time
H = House staff
P = Partnership
T = Part-time


MDR 17 SADR 72 RANKPAY DI Yes 8/13/2009 Char (3)

Sponsor Rank/Paygrade A code that represents the patient's military rank. 02 - 09, CD, E1 - E9, O1 - O9, W1 - W5 CD = Cadet
E1 - E9 = Enlisted
02 - 09, O1 - O9 = Officer
W1 - W5 = Warrant Officer


MDR 17 SADR 73 RDDS
Yes 8/13/2009 Char (2)

Raw DEERS Dependent Suffix DEERS Dependent Suffix: Code maintained by DEERS that uniquely identifies the beneficiary within the family.

No derivation. As received on the SADR from CHCS/AHLTA.		 01 - 19, 20,
30 - 39, 40 - 44, 45 - 49, 50 - 54, 55 - 59, 60 - 69, 70 - 74, 75, 98		 01 - 19 = Dependent Child
20 = Sponsor
30 - 39 = Spouse of sponsor
40 - 44 = Mother of sponsor
45 - 49 = Father of sponsor
50 - 54 = Mother-In-Law of sponsor
55 - 59 = Father-In-Law of sponsor
60 - 69 = Other eligible dependents
70 - 74 = Unknown by DEERS
75 = Pseudo DDS unknown by contractor
98 = Service secretary designee


MDR 17 SADR 74 REFNUM
Yes 8/13/2009 Char (11)

Referral Number





MDR 17 SADR 75 RPATUNIQ Yes Yes 8/13/2009 Char (10)

Raw Unique Person Identifier The identifier that is used to represent the person within a Department of Defense Electronic Data Interchange.

No derivation. As received on the SADR from CHCS/AHLTA.
DOD_EDI_PN_ID:
DEERS Electronic Data Interchange Person ID.


MDR 17 SADR 76 SDS
Yes 8/13/2009 Char (1)

Same Day Surgery
N, Y N = Not a SDS
Y = SDS


MDR 17 SADR 77 SEC2ROLE
Yes 8/13/2009 Char (1)

Secondary Provider #2 Role A code that describes the different functions that the secondary giver of care played in service delivery. 1 - 5 1 = Attending provider
2 = Assisting provider
3 = Supervising provider
4 = Nurse
5 = Para-professional
6 = Operating Provider #1
7 = Surgeon
8 = Anesthesia
9 = GME


MDR 17 SADR 78 SEC2SPC
Yes 8/13/2009 Char (3)

Secondary Prov #2 Specialty Secondary provider specialty.
See Provider Specialty Codes for DC for codes and descriptions.


MDR 17 SADR 79 SECROLE
Yes 8/13/2009 Char (1)

Secondary Provider #1 Role A code that describes the different functions that the secondary giver of care played in service delivery. 1 - 5 1 = Attending provider
2 = Assisting provider
3 = Supervising provider
4 = Nurse
5 = Para-professional
6 = Operating Provider #1
7 = Surgeon
8 = Anesthesia
9 = GME


MDR 17 SADR 80 SECSPC
Yes 8/13/2009 Char (3)

Secondary Prov #1 Specialty Secondary provider specialty.
See Provider Specialty Codes for DC for codes and descriptions.


MDR 17 SADR 81 SPC
Yes 8/13/2009 Char (3)

Provider Specialty (cleaned) Primary Provider specialty.
See Provider Specialty Codes for DC for codes and descriptions.

This field is NOT the field fed to the M2.


MDR 17 SADR 82 SPONSSN DI Yes 8/13/2009 Char (9)

Sponsor SSN The sponsor’s SSN as assigned by the Social Security Administration.

As found in the merge to the MPI.




MDR 17 SADR 83 STATUS
Yes 8/13/2009 Char (1)

Reservist Status Code Merge to the Reservist Table File by Sponsor SSN. Reservist Status Code is appended to the encounter record if the encounter date occurred during the time frame in which the beneficiary is eligible to receive TRICARE benefits, that is, is within the begin and end dates inclusive on a matching Reservist Table file record. A, E, O, M, T, I, L A = Early Alert for Guard/Reserve E = TAMP extended for Guard/Reserve O = TAMP original for Guard/Reserve
M = Mobilization for Guard/Reserve T = TAMP for Guard/Reserve
I = TAMP for involuntary separation from Active Duty
L = TAMP for stop/loss from Active Duty


MDR 17 SADR 85 REF_PROV
Yes 11/16/2009 Char (14)

Referring Provider





MDR 17 SADR 86 SEC2PROV
Yes 11/16/2009 Char (9)

Secondary Provider #2 ID Secondary provider identification designated with internal entry number (IEN).
Entered by MTF staff, the Provider ID normally consists of eight characters of the provider’s last name and first initial of first name, or some combination of last name A-numeric characters to arrive at a unique identifier (unique to the MTF).


MDR 17 SADR 87 SECPROV
Yes 11/16/2009 Char (9)

Secondary Provider #1 ID Secondary provider identification designated with internal entry number (IEN).
Entered by MTF staff, the Provider ID normally consists of eight characters of the provider’s last name and first initial of first name, or some combination of last name A-numeric characters to arrive at a unique identifier (unique to the MTF).


MDR 18 SIDR 1 AACUTE
Yes 12/11/2009 Char (1)

Adult Acute Composite

This field is a SAS date.


MDR 18 SIDR 2 AAMPDIAB
Yes 12/11/2009 Char (1)

Lower-extremity Amputation among patients with Diabetes
0, 1, 3-8,
C, L, S		 0 = ER, Direct to Military Hospital
1 = Direct to Military Hosp from other than ER
3 = AD Direct to Non-US Armed Svcs Hosp,
never transferred to Military Hosp
4 = Initial Adm in Non-US Armed Svcs Hosp,
transferred to Military Hosp (AD Only)
5 = Initial Adm in Non-US Armed Svcs Hosp,
transferred to Military Hosp (Non-AD Only)
6 = Transfer from Army Hospital
7 = Transfer from Navy Hospital
8 = Transfer from Air Force Hospital
C = Carded for Record Only (CRO)
L = Live birth in this Hospital
S = Adm resulting from APV, Direct to Military MTF


MDR 18 SIDR 3 AASTH
Yes 12/11/2009 Char (1)

Adult Asthma





MDR 18 SIDR 4 AAWP
Yes 12/11/2009 Char (1)

Angina without Procedure





MDR 18 SIDR 5 ABACPN
Yes 12/11/2009 Char (1)

Bacterial Pneumonia





MDR 18 SIDR 6 ACHF
Yes 12/11/2009 Char (1)

Congestive Heart Failure Admission





MDR 18 SIDR 7 ACHRON
Yes 12/11/2009 Char (1)

Adult Chronic Composite





MDR 18 SIDR 8 ACOPD
Yes 12/11/2009 Char (1)

Chronic Obstructive Pulmonary Disorder





MDR 18 SIDR 9 ADHYD
Yes 12/11/2009 Char (1)

Dehydration





MDR 18 SIDR 10 ADMDATE
Yes 8/13/2009 Num (8)

Admission Date Date of admission.




MDR 18 SIDR 11 ADMSRC
Yes 8/13/2009 Char (1)

Admission Source Patient's source of admission.




MDR 18 SIDR 12 AHYPTN
Yes 12/17/2009 Char (1)

Hypertension Admission





MDR 18 SIDR 13 ALBW
Yes 12/17/2009 Char (1)

Low Birth Weight





MDR 18 SIDR 14 ALTDIAB
Yes 12/17/2009 Char (1)

Diabetes Long Term Complications





MDR 18 SIDR 15 AOVALL
Yes 12/17/2009 Char (1)

Adult Overall Composite
1 Given the value 1 if astdiab = 1 or altdiab = 1 or acopd = 1 or ahyptn = 1 or achf = 1 or adhyd = 1 or abacpn = 1 or auti = 1 or aawp = 1 or auncdiab = 1 or aasth = 1 or aampdiab = 1.


MDR 18 SIDR 16 APAPPD
Yes 12/17/2009 Char (1)

Perforated Appendix





MDR 18 SIDR 17 ASTDIAB
Yes 12/17/2009 Char (1)

Short Term Diabetes Complications





MDR 18 SIDR 19 AUTI
Yes 12/17/2009 Char (1)

Urinary Tract Infection





MDR 18 SIDR 20 AUTOPSY
Yes 12/17/2009 Char (1)

Autopsy Indicator Indicates whether or not an autopsy was performed.




MDR 18 SIDR 21 BDAYS1
Yes 8/13/2009 Num (8)

Bed Days, Excl Bassinet Days Number of days a patient occupied a bed excluding Bassinet days.




MDR 18 SIDR 22 BEDCIV
Yes 8/13/2009 Num (8)

Bed Days Civilian Hospitals Number of days a patient spent in a civilian hospital.




MDR 18 SIDR 23 BEDOTHER
Yes 8/13/2009 Num (8)

Bed Days Other Federal Facilities Number of days a patient spent in another federal facility (not another military MTF).




MDR 18 SIDR 24 BENCATX
Yes 8/13/2009 Char (3)

Beneficiary Category from LVM4 Beneficiary category of the patient based on the longitudinal enrollment file (LVM4). If no match is found to the LVM4, then the value from DMISBENF is used. ACT, DA, DCO, DGR, DR, DS, GRD, IDG, IGR, NAT, OTH, RET, UNK ACT = Active Duty Member
DA = Dependent of Active Duty
DCO = Direct Care Only
DGR = Dependent of Guard/Reserve
DR = Dependent of Retired
DS = Dependent of Survivor
GRD = Guard
IDG = Inactive Guard/Reserve Dependent
IGR = Inactive Guard/Reserve
NAT = NATO
OTH = Other
RET = Retired
UNK = Unknown

Populated FY04+.


MDR 18 SIDR 25 BENFCAT1
PATCAT1
Yes 8/13/2009 Char (3)

Beneficiary Category Detailed patient beneficiary category as received on the raw SIDR record. e.g., A14 PATCAT1 for FY03 and forward.
BENFCAT1 for FY02 and backwards.
See Patient Categories for codes and descriptions.


MDR 18 SIDR 26 BIRTDATE
Yes 8/13/2009 Num (8)

Date of Birth Patient's date of birth.
This field is a SAS date.


MDR 18 SIDR 27 CALCDAYS
Yes 8/13/2009 Num (8)

Calculated Bed Days The same as DMISDAYS but values of zero (0) have been changed to one (1).




MDR 18 SIDR 28 CMADM
Yes 8/13/2009 Num (3)

Admission Calendar Month Calendar month of admission date. 1 - 12 1 = January 7 = July
2 = February 8 = August
3 = March 9 = September
4 = April 10 = October
5 = May 11 = November
6 = June 12 = December


MDR 18 SIDR 29 COMBENF
Yes 8/13/2009 Char (1)

Beneficiary Category (common) Broadest category of beneficiaries (available for all files). 1 - 4 1 = Dependent of Active Duty/Guard/Reserve
2 = Retired
3 = Dependent of Retired/Survivor, Other, Unknown, IDG*, IGR*
4 = Active Duty and Guard
*For FY03+ only; otherwise they aren't identified in the data.


MDR 18 SIDR 30 CONVLEAV
Yes 8/13/2009 Num (8)

Convalescent Leave Days Number of days on authorized leave status that are considered sick days if they occur before the patient is discharged. It is granted to active duty members while under medical/dental care and prescribed for recuperation or convalescence.




MDR 18 SIDR 31 CYADM
Yes 8/13/2009 Num (4)

Admission Calendar Year Calendar year of admission date. e.g., 2001



MDR 18 SIDR 32 DCWID
Yes 8/13/2009 Char (5)

Direct Care Workload ID Unique identification code of a treatment facility (MTF) that reports or has reported direct care workload (biometrics) data, if applicable. e.g., 35949



MDR 18 SIDR 33 DDS
Yes 8/13/2009 Char (2)

DEERS Dependent Suffix DEERS specific code indicating the relationship of the beneficiary to the sponsor. (Not the same of the family member prefix in CHCS). 01-19, 20,
30-39, 40-44, 45-49, 50-54, 55-59, 60-69, 70-74, 75, 98		 01 - 19 = Dependent Child
20 = Sponsor
30 - 39 = Spouse of sponsor
40 - 44 = Mother of sponsor
45 - 49 = Father of sponsor
50 - 54 = Mother-In-Law of sponsor
55 - 59 = Father-In-Law of sponsor
60 - 69 = Other eligible dependents
70 - 74 = Unknown by DEERS
75 = Pseudo DDS unknown by contractor
98 = Service secretary designee


MDR 18 SIDR 34 DEATH
Yes 8/13/2009 Char (1)

Death Indicator Indicates which diagnosis code was the cause of death. 1 - 8 For example, the value "3" indicates the third diagnosis code was the cause of death.


MDR 18 SIDR 35 DIAGAMT
Yes 8/13/2009 Num (8)

# Of Diagnoses Coded Number of diagnostic fields containing codes. 1 - 20



MDR 18 SIDR 36 DISPDATE
Yes 8/13/2009 Num (8)

Disposition Date Date patient was discharged from the MTF.
This field is a SAS date.


MDR 18 SIDR 37 DISPTYPE
Yes 8/13/2009 Char (2)

Disposition Type Type of disposition. 00 -30 00 = Medical holding, Active Duty Only
01 = Returned to duty, Active Duty Only
04 = AWOL, Active Duty Only
05 = Home, non-Active Duty
06 = Against Medical Advice (AMA), non-AD
10 = Separated/retired PDRL
11 = Separated/retired TDRL
12 = Separation with severance pay
13 = Separation without severance pay
14 = Nondisability separation for drug/alcohol
15 = Failure to met medical standards
21 = Transferred to Army MTF
22 = Transferred to Navy MTF
23 = Transferred to Air Force MTF
24 = Discharged to other federal facility
26 = Discharged to civilian acute care (non-AD)
27 = Discharged to civilian skilled nursing
facility (non-AD)
28 = Discharged to civilian intermediate care
facility (non-AD)
30 = Died


MDR 18 SIDR 38 DMISAGE
Yes 8/13/2009 Char (1)

DMIS Patient Age Group DMIS defined age groups. A - H, X A = 0 - 4
B = 5 - 14
C = 15 - 17
D = 18 - 24
E = 25 - 34
F = 35 - 44
G = 45 - 64
H = 65+
X = Unknown


MDR 18 SIDR 39 DMISDAYS
Yes 8/13/2009 Num (8)

Total Bed Days Number of days a patient actually occupied a bed and counted where the patient was at the census-taking hour in the MTF. It includes beds, cribs, and bassinets in the neonatal intensive care unit. A bed day is counted when a patient is admitted and discharged the same day.
BDAYS1 + BASSDAYS

This field contains values of zero (0).


MDR 18 SIDR 40 DMISSEX
Yes 8/13/2009 Char (1)

DMIS Patient Sex Patient's gender. F, M, Blank F = Female
M = Male
Blank = unknown


MDR 18 SIDR 41 DX1
Yes 8/13/2009 Char (8)

Principal ICD9 Diagnosis Code The primary diagnosis code of the admission. e.g., 49300 ICD-9-CM diagnosis code. Left aligned.
Decimal place is assumed after the third position. See DoD Extenders for descriptions of those diagnosis codes with extenders.


MDR 18 SIDR 42 DX2
Yes 8/13/2009 Char (8)

2 Diagnosis Code 2 ICD-9-CM diagnosis code. They are each their own field.




MDR 18 SIDR 43 DX3
Yes 8/13/2009 Char (8)

3 Diagnosis Code 3 ICD-9-CM diagnosis code. They are each their own field.




MDR 18 SIDR 44 DX4
Yes 8/13/2009 Char (8)

4 Diagnosis Code 4 ICD-9-CM diagnosis code. They are each their own field.




MDR 18 SIDR 45 DX5
Yes 8/13/2009 Char (8)

5 Diagnosis Code 5 ICD-9-CM diagnosis code. They are each their own field.




MDR 18 SIDR 46 DX6
Yes 8/13/2009 Char (8)

6 Diagnosis Code 6 ICD-9-CM diagnosis code. They are each their own field.




MDR 18 SIDR 47 DX7
Yes 8/13/2009 Char (8)

7 Diagnosis Code 7 ICD-9-CM diagnosis code. They are each their own field.




MDR 18 SIDR 48 DX8
Yes 8/13/2009 Char (8)

8 Diagnosis Code 8 ICD-9-CM diagnosis code. They are each their own field.




MDR 18 SIDR 49 DX9
Yes 8/13/2009 Char (8)

9 Diagnosis Code 9 ICD-9-CM diagnosis code. They are each their own field.




MDR 18 SIDR 50 DX10
Yes 8/13/2009 Char (8)

10 Diagnosis Code 10 ICD-9-CM diagnosis code. They are each their own field.




MDR 18 SIDR 51 DX11
Yes 8/13/2009 Char (8)

11 Diagnosis Code 11 ICD-9-CM diagnosis code. They are each their own field.




MDR 18 SIDR 52 DX12
Yes 8/13/2009 Char (8)

12 Diagnosis Code 12 ICD-9-CM diagnosis code. They are each their own field.




MDR 18 SIDR 53 DX13
Yes 8/13/2009 Char (8)

13 Diagnosis Code 13 ICD-9-CM diagnosis code. They are each their own field.




MDR 18 SIDR 54 DX14
Yes 8/13/2009 Char (8)

14 Diagnosis Code 14 ICD-9-CM diagnosis code. They are each their own field.




MDR 18 SIDR 55 DX15
Yes 8/13/2009 Char (8)

15 Diagnosis Code 15 ICD-9-CM diagnosis code. They are each their own field.




MDR 18 SIDR 56 DX16
Yes 8/13/2009 Char (8)

16 Diagnosis Code 16 ICD-9-CM diagnosis code. They are each their own field.




MDR 18 SIDR 57 DX17
Yes 8/13/2009 Char (8)

17 Diagnosis Code 17 ICD-9-CM diagnosis code. They are each their own field.




MDR 18 SIDR 58 DX18
Yes 8/13/2009 Char (8)

18 Diagnosis Code 18 ICD-9-CM diagnosis code. They are each their own field.




MDR 18 SIDR 59 DX19
Yes 8/13/2009 Char (8)

19 Diagnosis Code 19 ICD-9-CM diagnosis code. They are each their own field.




MDR 18 SIDR 60 DX20
Yes 8/13/2009 Char (8)

20 Diagnosis Code 20 ICD-9-CM diagnosis code. They are each their own field.




MDR 18 SIDR 61 DX1POA
Yes 8/13/2009 Char(1)

Present on Admission per Diagnosis Code 1 ICD9 Diagnosis Code Present on Admission N, Y, U, N, 1, blank Y = diagnosis was present at time of admission
N = diagnosis was not present at time of admission
U = insufficient documentation to determine if POA
W= provider unable to clinically determine if POA
1 / blank = exempt from POA reporting
Populated FY09+.


MDR 18 SIDR 62 DX2POA
Yes 8/13/2009 Char(1)

Present on Admission per Diagnosis Code 2 ICD9 Diagnosis Code Present on Admission




MDR 18 SIDR 63 DX3POA
Yes 8/13/2009 Char(1)

Present on Admission per Diagnosis Code 3 ICD9 Diagnosis Code Present on Admission




MDR 18 SIDR 64 DX4POA
Yes 8/13/2009 Char(1)

Present on Admission per Diagnosis Code 4 ICD9 Diagnosis Code Present on Admission




MDR 18 SIDR 65 DX5POA
Yes 8/13/2009 Char(1)

Present on Admission per Diagnosis Code 5 ICD9 Diagnosis Code Present on Admission




MDR 18 SIDR 66 DX6POA
Yes 8/13/2009 Char(1)

Present on Admission per Diagnosis Code 6 ICD9 Diagnosis Code Present on Admission




MDR 18 SIDR 67 DX7POA
Yes 8/13/2009 Char(1)

Present on Admission per Diagnosis Code 7 ICD9 Diagnosis Code Present on Admission




MDR 18 SIDR 68 DX8POA
Yes 8/13/2009 Char(1)

Present on Admission per Diagnosis Code 8 ICD9 Diagnosis Code Present on Admission




MDR 18 SIDR 69 DX9POA
Yes 8/13/2009 Char(1)

Present on Admission per Diagnosis Code 9 ICD9 Diagnosis Code Present on Admission




MDR 18 SIDR 70 DX10POA
Yes 8/13/2009 Char(1)

Present on Admission per Diagnosis Code 10 ICD9 Diagnosis Code Present on Admission




MDR 18 SIDR 71 DX11POA
Yes 8/13/2009 Char(1)

Present on Admission per Diagnosis Code 11 ICD9 Diagnosis Code Present on Admission




MDR 18 SIDR 72 DX12POA
Yes 8/13/2009 Char(1)

Present on Admission per Diagnosis Code 12 ICD9 Diagnosis Code Present on Admission




MDR 18 SIDR 73 DX13POA
Yes 8/13/2009 Char(1)

Present on Admission per Diagnosis Code 13 ICD9 Diagnosis Code Present on Admission




MDR 18 SIDR 74 DX14POA
Yes 8/13/2009 Char(1)

Present on Admission per Diagnosis Code 14 ICD9 Diagnosis Code Present on Admission




MDR 18 SIDR 75 DX15POA
Yes 8/13/2009 Char(1)

Present on Admission per Diagnosis Code 15 ICD9 Diagnosis Code Present on Admission




MDR 18 SIDR 76 DX16POA
Yes 8/13/2009 Char(1)

Present on Admission per Diagnosis Code 16 ICD9 Diagnosis Code Present on Admission




MDR 18 SIDR 77 DX17POA
Yes 8/13/2009 Char(1)

Present on Admission per Diagnosis Code 17 ICD9 Diagnosis Code Present on Admission




MDR 18 SIDR 78 DX18POA
Yes 8/13/2009 Char(1)

Present on Admission per Diagnosis Code 18 ICD9 Diagnosis Code Present on Admission




MDR 18 SIDR 79 DX19POA
Yes 8/13/2009 Char(1)

Present on Admission per Diagnosis Code 19 ICD9 Diagnosis Code Present on Admission




MDR 18 SIDR 80 DX20POA
Yes 8/13/2009 Char(1)

Present on Admission per Diagnosis Code 20 ICD9 Diagnosis Code Present on Admission




MDR 18 SIDR 81 FLYSTAT
Yes 8/13/2009 Char (1)

Flying Status Indication of active duty patient's flying status. N, Y, Blank N = No
Y = Yes
Blank = Unknown


MDR 18 SIDR 82 FMADM
Yes 8/13/2009 Num (3)

Admission Fiscal Month Fiscal month of admission date. 1 - 12 1 = October 7 = April
2 = November 8 = May
3 = December 9 = June
4 = January 10 = July
5 = February 11 = August
6 = March 12 = September


MDR 18 SIDR 83 FMP
Yes 8/13/2009 Char (2)

Family Member Prefix A DoD-define code which defines the relationship of the patient to the sponsor. 01 - 15, 19,
20, 30 - 39,
40, 45, 50,
55, 60 - 69, 90 - 95,
98, 99		 01 - 19 = Dependent Child of Sponsor
20 = Sponsor
30 - 39 = Spouse/Former Spouse
40 = Mother/Step-Mother of Sponsor
45 = Father, Step-Father of Sponsor
50 = Mother-In-Law of Sponsor
55 = Father-In-Law of Sponsor
60 - 69 = Other Authorized Dep of Sponsor
90 - 95 = Bene Authorized by Statute
98 = Civilian Emergencies
99 = All Other, Not Elsewhere Classified


MDR 18 SIDR 84 FYADM
Yes 8/13/2009 Num (4)

Admission Fiscal Year Fiscal year of admission date. e.g., 2002



MDR 18 SIDR 85 ICUDAYS
Yes 8/13/2009 Num (8)

Bed Days in ICU Total number of days spent in a bed in all intensive care units at the reporting MTF.




MDR 18 SIDR 86 INITADM
Yes 8/13/2009 Num (8)

Initial Admission Date Date the patient was first admitted to an MTF/hospital for the current, uninterrupted episode of hospitalization.
This field is a SAS date.


MDR 18 SIDR 87 LENGTHSV
Yes 8/13/2009 Char (3)

Length of Service The amount of time the patient was part of the military service.




MDR 18 SIDR 88 MARITAL
Yes 8/13/2009 Char (1)

Marital Status Marital status of patient. A, D, I, L,
M, S, W, Z		 A = Annulled
D = Divorced
I = Interlocutory
L = Legally Separated
M = Married
S = Single, Never Married
W = Widowed
Z = Unknown


MDR 18 SIDR 89 MDC
Yes 8/13/2009 Char (2)

Major Diagnostic Category The MDC of the DRG assigned by the TRICARE grouper.
See Major Diagnostic Category worksheet for codes and descriptions.


MDR 18 SIDR 90 MEDHLDAY
Yes 8/13/2009 Num (8)

Medical Hold Days Number of days a patient spent assigned/attached to a medical holding company (Active Duty only). These patients are well enough to leave an operating bed but not well enough to return to a regular unit.




MDR 18 SIDR 91 MSDRGSURG
Yes 8/13/2009 Char(1)

MS-DRG Medical/Surgical Indicator Medical / Surgical indicator based on the MSDRG.
M = Medical
S = Surgical


MDR 18 SIDR 92 MSFLAG
Yes 8/13/2009 Char (1)

Medical/Surgical Indicator Medical / Surgical indicator based on the DRG. M, S M = Medical
S = Surgical


MDR 18 SIDR 93 MTF
Yes 8/13/2009 Char (4)

Medical Treatment Facility Treating hospital (DMIS ID).
See DMIS Information for list of DMIS ID.


MDR 18 SIDR 94 MTFINIT
Yes 8/13/2009 Char (6)

MTF of Initial Admission The facility that first admitted the patient for an episode of care for transferred/moved patients. e.g., 060109 Region and DMIS ID for military hospitals or the following for non-military hospitals: C = Civilian, V = Veterans Administration, P = Public and Indian Health, M = Foreign Military, B = Other and the two digit state or country code.


MDR 18 SIDR 95 OUTCAT
Yes 8/13/2009 Char (1)

Outlier Status Flag Indicator of long or short stay outlier based on long/short thresholds per DRG. 0, 1, 2 0 = Not an outlier
1 = Short stay outlier
2 = Long stay outlier


MDR 18 SIDR 96 PACUTE
Yes 8/13/2009 Char (1)

Pediatric Acute Composite
0, 1 0 = otherwise 1 = if pgastro, or puti equal 1


MDR 18 SIDR 97 PADCDACT
Yes 8/13/2009 Char (1)

Combined Acute Adult and Pediatric Composite
0, 1 0 = otherwise 1 = if aacute, or pacute equal 1


MDR 18 SIDR 98 PADCDCHN
Yes 8/13/2009 Char (1)

Combined Chronic Adult and Pediatric Composite
0, 1 0 = otherwise 1 = if achron, or pchron equal 1


MDR 18 SIDR 99 PADCDOVL
Yes 8/13/2009 Char (1)

Combined Overall Adult and Pediatric Composite
0, 1 0 = otherwise 1 = if aovall, or povall equal 1


MDR 18 SIDR 101 PARC
Yes 8/13/2009 Char (2)

Person Association Reason Code

See MPI specification.


MDR 18 SIDR 102 PASTH
Yes 12/17/2009 Char (1)

Pediatric Asthma Admission





MDR 18 SIDR 103 PATSSN DI Yes 8/13/2009 Char (9)

Patient SSN Patient's Social Security Number. e.g., 123456789



MDR 18 SIDR 104 PATUNIQ Yes Yes 8/13/2009 Char (10)

Unique Patient Identifier A unique identifier of a person, as assigned by DEERS. This is sometimes, under HIPAA, called the Electronic Data Interchange - Patient Identifier (EDI-PN).




MDR 18 SIDR 105 PCHRON
Yes 12/17/2009 Char (1)

Pediatric Chronic Composite





MDR 18 SIDR 106 PCMIDLVM
Yes 8/13/2009 Char (18)

PCM ID from the LVM4/LVM6 Data

Populated for FY04+ only. Based on LVM4/LVM6 merge.


MDR 18 SIDR 107 PGASTRO
Yes 12/17/2009 Char (1)

Pediatric Gastroenteritis





MDR 18 SIDR 108 PNA1
Yes 8/13/2009 N (2)

Procedure Number #1 The procedure number associated with the procedure code identified in segment 2 or 6.




MDR 18 SIDR 109 PNA2
Yes 8/13/2009 N (2)

Procedure Number #2 The procedure number associated with the procedure code identified in segment 2 or 6.




MDR 18 SIDR 110 PNA3
Yes 8/13/2009 N (2)

Procedure Number #3 The procedure number associated with the procedure code identified in segment 2 or 6.




MDR 18 SIDR 111 PNA4
Yes 8/13/2009 N (2)

Procedure Number #4 The procedure number associated with the procedure code identified in segment 2 or 6.




MDR 18 SIDR 112 PNA5
Yes 8/13/2009 N (2)

Procedure Number #5 The procedure number associated with the procedure code identified in segment 2 or 6.




MDR 18 SIDR 113 PNA6
Yes 8/13/2009 N (2)

Procedure Number #6 The procedure number associated with the procedure code identified in segment 2 or 6.




MDR 18 SIDR 114 PNA7
Yes 8/13/2009 N (2)

Procedure Number #7 The procedure number associated with the procedure code identified in segment 2 or 6.




MDR 18 SIDR 115 PNA8
Yes 8/13/2009 N (2)

Procedure Number #8 The procedure number associated with the procedure code identified in segment 2 or 6.




MDR 18 SIDR 116 PNA9
Yes 8/13/2009 N (2)

Procedure Number #9 The procedure number associated with the procedure code identified in segment 2 or 6.




MDR 18 SIDR 117 PNA10
Yes 8/13/2009 N (2)

Procedure Number #10 The procedure number associated with the procedure code identified in segment 2 or 6.




MDR 18 SIDR 118 PNA11
Yes 8/13/2009 N (2)

Procedure Number #11 The procedure number associated with the procedure code identified in segment 2 or 6.




MDR 18 SIDR 119 PNA1PNP1
Yes 8/13/2009 Char (10)

Provider #1 NPI ID for Procedure #1 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 120 PNA2PNP1
Yes 8/13/2009 Char (10)

Provider #1 NPI ID for Procedure #2 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 121 PNA3PNP1
Yes 8/13/2009 Char (10)

Provider #1 NPI ID for Procedure #3 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 122 PNA4PNP1
Yes 8/13/2009 Char (10)

Provider #1 NPI ID for Procedure #4 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 123 PNA5PNP1
Yes 8/13/2009 Char (10)

Provider #1 NPI ID for Procedure #5 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 124 PNA6PNP1
Yes 8/13/2009 Char (10)

Provider #1 NPI ID for Procedure #6 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 125 PNA7PNP1
Yes 8/13/2009 Char (10)

Provider #1 NPI ID for Procedure #7 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 126 PNA8PNP1
Yes 8/13/2009 Char (10)

Provider #1 NPI ID for Procedure #8 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 127 PNA9PNP1
Yes 8/13/2009 Char (10)

Provider #1 NPI ID for Procedure #9 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 128 PNA10PNP1
Yes 8/13/2009 Char (10)

Provider #1 NPI ID for Procedure #10 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 129 PNA11PNP1
Yes 8/13/2009 Char (10)

Provider #1 NPI ID for Procedure #11 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 130 PNA1PNP2
Yes 8/13/2009 Char (10)

Provider #2 NPI ID for Procedure #1 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 131 PNA2PNP2
Yes 8/13/2009 Char (10)

Provider #2 NPI ID for Procedure #2 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 132 PNA3PNP2
Yes 8/13/2009 Char (10)

Provider #2 NPI ID for Procedure #3 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 133 PNA4PNP2
Yes 8/13/2009 Char (10)

Provider #2 NPI ID for Procedure #4 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 134 PNA5PNP2
Yes 8/13/2009 Char (10)

Provider #2 NPI ID for Procedure #5 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 135 PNA6PNP2
Yes 8/13/2009 Char (10)

Provider #2 NPI ID for Procedure #6 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 136 PNA7PNP2
Yes 8/13/2009 Char (10)

Provider #2 NPI ID for Procedure #7 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 137 PNA8PNP2
Yes 8/13/2009 Char (10)

Provider #2 NPI ID for Procedure #8 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 138 PNA9PNP2
Yes 8/13/2009 Char (10)

Provider #2 NPI ID for Procedure #9 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 139 PNA10PNP2
Yes 8/13/2009 Char (10)

Provider #2 NPI ID for Procedure #10 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 140 PNA11PNP2
Yes 8/13/2009 Char (10)

Provider #2 NPI ID for Procedure #11 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 141 PNA1PNP3
Yes 8/13/2009 Char (10)

Provider #3 NPI ID for Procedure #1 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 142 PNA2PNP3
Yes 8/13/2009 Char (10)

Provider #3 NPI ID for Procedure #2 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 143 PNA3PNP3
Yes 8/13/2009 Char (10)

Provider #3 NPI ID for Procedure #3 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 144 PNA4PNP3
Yes 8/13/2009 Char (10)

Provider #3 NPI ID for Procedure #4 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 145 PNA5PNP3
Yes 8/13/2009 Char (10)

Provider #3 NPI ID for Procedure #5 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 146 PNA6PNP3
Yes 8/13/2009 Char (10)

Provider #3 NPI ID for Procedure #6 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 147 PNA7PNP3
Yes 8/13/2009 Char (10)

Provider #3 NPI ID for Procedure #7 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 148 PNA8PNP3
Yes 8/13/2009 Char (10)

Provider #3 NPI ID for Procedure #8 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 149 PNA9PNP3
Yes 8/13/2009 Char (10)

Provider #3 NPI ID for Procedure #9 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 150 PNA10PNP3
Yes 8/13/2009 Char (10)

Provider #3 NPI ID for Procedure #10 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 151 PNA11PNP3
Yes 8/13/2009 Char (10)

Provider #3 NPI ID for Procedure #11 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 152 PNA1PNP4
Yes 8/13/2009 Char (10)

Provider #4 NPI ID for Procedure #1 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 153 PNA2PNP4
Yes 8/13/2009 Char (10)

Provider #4 NPI ID for Procedure #2 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 154 PNA3PNP4
Yes 8/13/2009 Char (10)

Provider #4 NPI ID for Procedure #3 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 155 PNA4PNP4
Yes 8/13/2009 Char (10)

Provider #4 NPI ID for Procedure #4 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 156 PNA5PNP4
Yes 8/13/2009 Char (10)

Provider #4 NPI ID for Procedure #5 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 157 PNA6PNP4
Yes 8/13/2009 Char (10)

Provider #4 NPI ID for Procedure #6 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 158 PNA7PNP4
Yes 8/13/2009 Char (10)

Provider #4 NPI ID for Procedure #7 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 159 PNA8PNP4
Yes 8/13/2009 Char (10)

Provider #4 NPI ID for Procedure #8 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 160 PNA9PNP4
Yes 8/13/2009 Char (10)

Provider #4 NPI ID for Procedure #9 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 161 PNA10PNP4
Yes 8/13/2009 Char (10)

Provider #4 NPI ID for Procedure #10 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 162 PNA11PNP4
Yes 8/13/2009 Char (10)

Provider #4 NPI ID for Procedure #11 The nth provider's NPI ID for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 163 PNA1QUAL1
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #1, Procedure #1 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 164 PNA2QUAL1
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #1, Procedure #2 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 165 PNA3QUAL1
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #1, Procedure #3 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 166 PNA4QUAL1
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #1, Procedure #4 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 167 PNA5QUAL1
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #1, Procedure #5 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 168 PNA6QUAL1
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #1, Procedure #6 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 169 PNA7QUAL1
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #1, Procedure #7 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 170 PNA8QUAL1
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #1, Procedure #8 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 171 PNA9QUAL1
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #1, Procedure #9 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 172 PNA10QUAL1
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #1, Procedure #10 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 173 PNA11QUAL1
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #1, Procedure #11 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 174 PNA1QUAL2
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #2, Procedure #1 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 175 PNA2QUAL2
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #2, Procedure #2 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 176 PNA3QUAL2
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #2, Procedure #3 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 177 PNA4QUAL2
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #2, Procedure #4 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 178 PNA5QUAL2
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #2, Procedure #5 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 179 PNA6QUAL2
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #2, Procedure #6 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 180 PNA7QUAL2
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #2, Procedure #7 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 181 PNA8QUAL2
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #2, Procedure #8 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 182 PNA9QUAL2
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #2, Procedure #9 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 183 PNA10QUAL2
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #2, Procedure #10 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 184 PNA11QUAL2
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #2, Procedure #11 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 185 PNA1QUAL3
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #3, Procedure #1 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 186 PNA2QUAL3
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #3, Procedure #2 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 187 PNA3QUAL3
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #3, Procedure #3 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 188 PNA4QUAL3
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #3, Procedure #4 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 189 PNA5QUAL3
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #3, Procedure #5 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 190 PNA6QUAL3
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #3, Procedure #6 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 191 PNA7QUAL3
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #3, Procedure #7 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 192 PNA8QUAL3
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #3, Procedure #8 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 193 PNA9QUAL3
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #3, Procedure #9 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 194 PNA10QUAL3
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #3, Procedure #10 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 195 PNA11QUAL3
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #3, Procedure #11 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 196 PNA1QUAL4
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #4, Procedure #1 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 197 PNA2QUAL4
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #4, Procedure #2 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 198 PNA3QUAL4
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #4, Procedure #3 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 199 PNA4QUAL4
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #4, Procedure #4 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 200 PNA5QUAL4
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #4, Procedure #5 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 201 PNA6QUAL4
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #4, Procedure #6 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 202 PNA7QUAL4
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #4, Procedure #7 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 203 PNA8QUAL4
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #4, Procedure #8 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 204 PNA9QUAL4
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #4, Procedure #9 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 205 PNA10QUAL4
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #4, Procedure #10 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 206 PNA11QUAL4
Yes 8/13/2009 Char (1)

NPI Qualifier for Provider #4, Procedure #11 The nth provider's NPI Qualifier for Procedure j,
where n = 1-4, j = 1-11




MDR 18 SIDR 207 PNORDETH
Yes 8/13/2009 Num (8,6)

Death MTF Peer Norm Expected number of deaths for case(s) of selected combination of diagnostic and demographic characteristics in the MHS Peer Group.




MDR 18 SIDR 208 POVALL
Yes 8/13/2009 Char (1)

Pediatric Overall Composite
0, 1 0 = otherwise 1 = if pasth, pstdiab, pgastro, or puti equal 1


MDR 18 SIDR 209 PROC1
Yes 8/13/2009 Char (8)

1 ICD9 Procedure Code ICD9 Procedure Codes. Each is their own field but are condensed in the DD to save room.
ICD-9-CM procedure code. Left aligned.
Decimal place is assumed after the second position.


MDR 18 SIDR 210 PROC2
Yes 8/13/2009 Char (8)

2 ICD9 Procedure Code ICD9 Procedure Codes. Each is their own field but are condensed in the DD to save room.




MDR 18 SIDR 211 PROC3
Yes 8/13/2009 Char (8)

3 ICD9 Procedure Code ICD9 Procedure Codes. Each is their own field but are condensed in the DD to save room.




MDR 18 SIDR 212 PROC4
Yes 8/13/2009 Char (8)

4 ICD9 Procedure Code ICD9 Procedure Codes. Each is their own field but are condensed in the DD to save room.




MDR 18 SIDR 213 PROC5
Yes 8/13/2009 Char (8)

5 ICD9 Procedure Code ICD9 Procedure Codes. Each is their own field but are condensed in the DD to save room.




MDR 18 SIDR 214 PROC6
Yes 8/13/2009 Char (8)

6 ICD9 Procedure Code ICD9 Procedure Codes. Each is their own field but are condensed in the DD to save room.




MDR 18 SIDR 215 PROC7
Yes 8/13/2009 Char (8)

7 ICD9 Procedure Code ICD9 Procedure Codes. Each is their own field but are condensed in the DD to save room.




MDR 18 SIDR 216 PROC8
Yes 8/13/2009 Char (8)

8 ICD9 Procedure Code ICD9 Procedure Codes. Each is their own field but are condensed in the DD to save room.




MDR 18 SIDR 217 PROC9
Yes 8/13/2009 Char (8)

9 ICD9 Procedure Code ICD9 Procedure Codes. Each is their own field but are condensed in the DD to save room.




MDR 18 SIDR 218 PROC10
Yes 8/13/2009 Char (8)

10 ICD9 Procedure Code ICD9 Procedure Codes. Each is their own field but are condensed in the DD to save room.




MDR 18 SIDR 219 PROC11
Yes 8/13/2009 Char (8)

11 ICD9 Procedure Code ICD9 Procedure Codes. Each is their own field but are condensed in the DD to save room.




MDR 18 SIDR 220 PROC12
Yes 8/13/2009 Char (8)

12 ICD9 Procedure Code ICD9 Procedure Codes. Each is their own field but are condensed in the DD to save room.




MDR 18 SIDR 221 PROC13
Yes 8/13/2009 Char (8)

13 ICD9 Procedure Code ICD9 Procedure Codes. Each is their own field but are condensed in the DD to save room.




MDR 18 SIDR 222 PROC14
Yes 8/13/2009 Char (8)

14 ICD9 Procedure Code ICD9 Procedure Codes. Each is their own field but are condensed in the DD to save room.




MDR 18 SIDR 223 PROC15
Yes 8/13/2009 Char (8)

15 ICD9 Procedure Code ICD9 Procedure Codes. Each is their own field but are condensed in the DD to save room.




MDR 18 SIDR 224 PROC16
Yes 8/13/2009 Char (8)

16 ICD9 Procedure Code ICD9 Procedure Codes. Each is their own field but are condensed in the DD to save room.




MDR 18 SIDR 225 PROC17
Yes 8/13/2009 Char (8)

17 ICD9 Procedure Code ICD9 Procedure Codes. Each is their own field but are condensed in the DD to save room.




MDR 18 SIDR 226 PROC18
Yes 8/13/2009 Char (8)

18 ICD9 Procedure Code ICD9 Procedure Codes. Each is their own field but are condensed in the DD to save room.




MDR 18 SIDR 227 PROC19
Yes 8/13/2009 Char (8)

19 ICD9 Procedure Code ICD9 Procedure Codes. Each is their own field but are condensed in the DD to save room.




MDR 18 SIDR 228 PROC20
Yes 8/13/2009 Char (8)

20 ICD9 Procedure Code ICD9 Procedure Codes. Each is their own field but are condensed in the DD to save room.




MDR 18 SIDR 229 PROCAMT
Yes 8/13/2009 Num (8)

# Of Procedures Coded Number of procedure fields containing codes.




MDR 18 SIDR 230 PROV11
Yes 8/13/2009 Char (9)

Provider #1 of Procedure #1 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 231 PROV12
Yes 8/13/2009 Char (9)

Provider #1 of Procedure #2 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 232 PROV13
Yes 8/13/2009 Char (9)

Provider #1 of Procedure #3 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 233 PROV14
Yes 8/13/2009 Char (9)

Provider #1 of Procedure #4 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 234 PROV15
Yes 8/13/2009 Char (9)

Provider #1 of Procedure #5 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 235 PROV16
Yes 8/13/2009 Char (9)

Provider #1 of Procedure #6 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 236 PROV17
Yes 8/13/2009 Char (9)

Provider #1 of Procedure #7 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 237 PROV18
Yes 8/13/2009 Char (9)

Provider #1 of Procedure #8 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 238 PROV19
Yes 8/13/2009 Char (9)

Provider #1 of Procedure #9 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 239 PROV110
Yes 8/13/2009 Char (9)

Provider #1 of Procedure #10 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 240 PROV111
Yes 8/13/2009 Char (9)

Provider #1 of Procedure #11 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 241 PROV112
Yes 8/13/2009 Char (9)

Provider #1 of Procedure #12 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 242 PROV113
Yes 8/13/2009 Char (9)

Provider #1 of Procedure #13 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 243 PROV114
Yes 8/13/2009 Char (9)

Provider #1 of Procedure #14 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 244 PROV115
Yes 8/13/2009 Char (9)

Provider #1 of Procedure #15 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 245 PROV116
Yes 8/13/2009 Char (9)

Provider #1 of Procedure #16 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 246 PROV117
Yes 8/13/2009 Char (9)

Provider #1 of Procedure #17 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 247 PROV118
Yes 8/13/2009 Char (9)

Provider #1 of Procedure #18 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 248 PROV119
Yes 8/13/2009 Char (9)

Provider #1 of Procedure #19 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 249 PROV120
Yes 8/13/2009 Char (9)

Provider #1 of Procedure #20 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 250 PROV21
Yes 8/13/2009 Char (9)

Provider #2 of Procedure #1 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 251 PROV22
Yes 8/13/2009 Char (9)

Provider #2 of Procedure #2 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 252 PROV23
Yes 8/13/2009 Char (9)

Provider #2 of Procedure #3 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 253 PROV24
Yes 8/13/2009 Char (9)

Provider #2 of Procedure #4 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 254 PROV25
Yes 8/13/2009 Char (9)

Provider #2 of Procedure #5 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 255 PROV26
Yes 8/13/2009 Char (9)

Provider #2 of Procedure #6 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 256 PROV27
Yes 8/13/2009 Char (9)

Provider #2 of Procedure #7 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 257 PROV28
Yes 8/13/2009 Char (9)

Provider #2 of Procedure #8 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 258 PROV29
Yes 8/13/2009 Char (9)

Provider #2 of Procedure #9 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 259 PROV210
Yes 8/13/2009 Char (9)

Provider #2 of Procedure #10 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 260 PROV211
Yes 8/13/2009 Char (9)

Provider #2 of Procedure #11 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 261 PROV212
Yes 8/13/2009 Char (9)

Provider #2 of Procedure #12 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 262 PROV213
Yes 8/13/2009 Char (9)

Provider #2 of Procedure #13 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 263 PROV214
Yes 8/13/2009 Char (9)

Provider #2 of Procedure #14 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 264 PROV215
Yes 8/13/2009 Char (9)

Provider #2 of Procedure #15 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 265 PROV216
Yes 8/13/2009 Char (9)

Provider #2 of Procedure #16 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 266 PROV217
Yes 8/13/2009 Char (9)

Provider #2 of Procedure #17 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 267 PROV218
Yes 8/13/2009 Char (9)

Provider #2 of Procedure #18 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 268 PROV219
Yes 8/13/2009 Char (9)

Provider #2 of Procedure #19 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 269 PROV220
Yes 8/13/2009 Char (9)

Provider #2 of Procedure #20 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 270 PROV31
Yes 8/13/2009 Char (9)

Provider #3 of Procedure #1 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 271 PROV32
Yes 8/13/2009 Char (9)

Provider #3 of Procedure #2 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 272 PROV33
Yes 8/13/2009 Char (9)

Provider #3 of Procedure #3 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 273 PROV34
Yes 8/13/2009 Char (9)

Provider #3 of Procedure #4 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 274 PROV35
Yes 8/13/2009 Char (9)

Provider #3 of Procedure #5 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 275 PROV36
Yes 8/13/2009 Char (9)

Provider #3 of Procedure #6 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 276 PROV37
Yes 8/13/2009 Char (9)

Provider #3 of Procedure #7 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 277 PROV38
Yes 8/13/2009 Char (9)

Provider #3 of Procedure #8 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 278 PROV39
Yes 8/13/2009 Char (9)

Provider #3 of Procedure #9 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 279 PROV310
Yes 8/13/2009 Char (9)

Provider #3 of Procedure #10 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 280 PROV311
Yes 8/13/2009 Char (9)

Provider #3 of Procedure #11 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 281 PROV312
Yes 8/13/2009 Char (9)

Provider #3 of Procedure #12 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 282 PROV313
Yes 8/13/2009 Char (9)

Provider #3 of Procedure #13 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 283 PROV314
Yes 8/13/2009 Char (9)

Provider #3 of Procedure #14 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 284 PROV315
Yes 8/13/2009 Char (9)

Provider #3 of Procedure #15 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 285 PROV316
Yes 8/13/2009 Char (9)

Provider #3 of Procedure #16 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 286 PROV317
Yes 8/13/2009 Char (9)

Provider #3 of Procedure #17 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 287 PROV318
Yes 8/13/2009 Char (9)

Provider #3 of Procedure #18 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 288 PROV319
Yes 8/13/2009 Char (9)

Provider #3 of Procedure #19 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 289 PROV320
Yes 8/13/2009 Char (9)

Provider #3 of Procedure #20 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 290 PROV41
Yes 8/13/2009 Char (9)

Provider #4 of Procedure #1 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 291 PROV42
Yes 8/13/2009 Char (9)

Provider #4 of Procedure #2 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 292 PROV43
Yes 8/13/2009 Char (9)

Provider #4 of Procedure #3 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 293 PROV44
Yes 8/13/2009 Char (9)

Provider #4 of Procedure #4 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 294 PROV45
Yes 8/13/2009 Char (9)

Provider #4 of Procedure #5 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 295 PROV46
Yes 8/13/2009 Char (9)

Provider #4 of Procedure #6 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 296 PROV47
Yes 8/13/2009 Char (9)

Provider #4 of Procedure #7 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 297 PROV48
Yes 8/13/2009 Char (9)

Provider #4 of Procedure #8 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 298 PROV49
Yes 8/13/2009 Char (9)

Provider #4 of Procedure #9 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 299 PROV410
Yes 8/13/2009 Char (9)

Provider #4 of Procedure #10 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 300 PROV411
Yes 8/13/2009 Char (9)

Provider #4 of Procedure #11 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 301 PROV412
Yes 8/13/2009 Char (9)

Provider #4 of Procedure #12 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 302 PROV413
Yes 8/13/2009 Char (9)

Provider #4 of Procedure #13 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 303 PROV414
Yes 8/13/2009 Char (9)

Provider #4 of Procedure #14 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 304 PROV415
Yes 8/13/2009 Char (9)

Provider #4 of Procedure #15 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 305 PROV416
Yes 8/13/2009 Char (9)

Provider #4 of Procedure #16 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 306 PROV417
Yes 8/13/2009 Char (9)

Provider #4 of Procedure #17 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 307 PROV418
Yes 8/13/2009 Char (9)

Provider #4 of Procedure #18 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 308 PROV419
Yes 8/13/2009 Char (9)

Provider #4 of Procedure #19 Provider Id's for each procedure. Up to 4 providers per procedure.




MDR 18 SIDR 309 PROV420
Yes 8/13/2009 Char (9)

Provider #4 of Procedure #20 Provider Id's for each procedure. Up to 4 providers per procedure.
n = 1 - 4, the Nth provider who participated in the Kth procedure.
k = 1 - 20, the Kth ICD9 Procedure


MDR 18 SIDR 310 PRVADM
Yes 8/13/2009 Char (1)

Preventable Admission Indicator Represents admission deemed preventable based on DRG, Diagnosis 1-8, and Age criteria. A, B, C, D,
G, H, P, U,
T, 0		 A = Asthma
B = Bacterial Pneumonia
C = COPD
D = Diabetics
G = Gastroenteritis
H = Congestive Heart Failure
P = Angina Pectoris
U = Urinary Tract Infection/Kidney
T = (Tissue) Cellulitis
0 (zero) = Not a preventable admission


MDR 21 SIDR 311 pstdiab
Yes 12/17/2009 $1

Pediatric Short term Diabetes Indicates whether this record meets AHRQ's preventable admission criteria for pediatric short term diabetes complications




MDR 21 SIDR 312 puti
Yes 12/17/2009 $1

Pediatric Urinary Tract Infection Indicates whether this record meets AHRQ's preventable admission criteria for pediatric UTI




MDR 18 SIDR 313 QUARDAYS
Yes 8/13/2009 Num (8)

Quarters Days Number of days a patient spent assigned to quarters, home, clinic observation bed, or infirmary (Active Duty only).




MDR 18 SIDR 314 RAWDRG
Yes 8/13/2009 Char (3)

Raw DRG Diagnosis Related Group as submitted from CHCS.




MDR 18 SIDR 315 RDDS
Yes 8/13/2009 Char (2)

Raw Deers Dependent Suffix DEERS Dependent Suffix: Code maintained by DEERS that uniquely identifies the beneficiary within the family.

No derivation. As received on the SADR from CHCS/AHLTA.		 01 - 19, 20,
30 - 39, 40 - 44, 45 - 49, 50 - 54, 55 - 59, 60 - 69, 70 - 74, 75, 98		 01-19 = Dependent Child
20 = Sponsor
30-39 = Spouse of sponsor
40-44 = Mother of sponsor
45-49 = Father of sponsor
50-54 = Mother-In-Law of sponsor
55-59 = Father-In-Law of sponsor
60-69 = Other eligible dependents
70-74 = Unknown by DEERS
75 = Pseudo DDS unknown by contractor
98 = Service secretary designee


MDR 18 SIDR 316 RECAGE
Yes 8/13/2009 Num (8)

Age at Disposition Numeric age of patient at disposition.




MDR 18 SIDR 317 RPATUNIQ Yes Yes 8/13/2009 Char (10)

Raw Unique Person Identifier The identifier that is used to represent the person within a Department of Defense Electronic Data Interchange.

No derivation. As received on the SADR from CHCS/AHLTA.
DOD_EDI_PN_ID:
DEERS Electronic Data Interchange Person ID.


MDR 18 SIDR 318 SICKDAYS
Yes 8/13/2009 Num (8)

Total Sick Days This MTF Sum of Bed Days Excluding Bassinets; Supplemental Care; Bassinet Days (Neonatal); Bed Days Other Fed Facility; Bed Days Civilian Hospital; Cooperative Care; Convalescent Leave; Medical Hold Days.




MDR 18 SIDR 319 SOC
Yes 8/13/2009 Char (2)

Reservist Special Operation Code The identifier that represents the special operation. 08, 09, 10 08 = Operation Noble Eagle
09 = Operation Enduring Freedom
10 = Operation Iraqi Freedom


MDR 18 SIDR 320 SPONSSN DI Yes 8/13/2009 Char (9)

Sponsor SSN
e.g., 123456789



MDR 18 SIDR 321 STANAG
Yes 8/13/2009 Char (3)

Cause Of Injury
000 - 999 000 - 059 = Accidents in air transport
100 - 149 = Accidents in land transport
150 - 199 = Accidents in water transport
200 - 249 = Athletics & sports
250 - 299 = Reactions, complications, misadventures in medical/surgical procs; late complications or effects
300 - 479 = Instrumentalities of war, when employed by the enemy in wartime
480 - 499 = Accidents in connection w/ own instrumentalities of war, when employed as such in wartime
500 - 599 = Guns, explosives, related agents; exc when used as instrumentalities of war in wartime
600 - 699 = Machinery, tools, selected agents
700 - 799 = Poisons, fire, hot & corrosive substances
800 - 899 = Specified environmental factors (natural or artificial environment)
900 - 999 = Falls & miscellaneous other/unspecified agents


MDR 18 SIDR 322 STATUS
Yes 8/13/2009 Char (1)

Reservist Status Code Derived Reservist Status Code from Personnel Entitlement Condition Type Code. A, E, O, M, T, I, L A = Early Alert for Guard/Reserve E = TAMP extended for Guard/Reserve O = TAMP original for Guard/Reserve
M = Mobilization for Guard/Reserve T = TAMP for Guard/Reserve
I = TAMP for involuntary separation from Active Duty
L = TAMP for stop/loss from Active Duty


MDR 18 SIDR 323 TRAUMA
Yes 8/13/2009 Char (1)

Trauma Indicator
0 - 9 0 = Battle wound/injury, direct result of action by or
against an organized enemy (declared war only).
1 = Battle wound/injury, other battle casualties.
2 = Intentionally inflicted nonbattle injury, results of
intervention of legal authority.
3 = Intentionally inflicted nonbattle injury, assault or
intentionally inflicted by another person.
4 = Intentionally inflicted nonbattle injury, intentionally
self-inflicted.
5 = Accidental injury, active duty only, occurring while
off duty (leave, pass, AWOL, and other off duty).
6 = Accidental injury, active duty only, schemes
(maneuvers) / exercises.
7 = Accidental injury, active duty only, all other scheduled
training (including basic training, assault courses, etc.).
8 = Accidental injury, active duty only, occurring while on
duty, except as in code 6 or 7 above.
9 = Accidental injury, all patients, unknown whether on
or off duty; non-military injuries.


MDR 20 TED-NI 1 tedno
Yes 8/13/2009 $24

TED Number Unique key identifying the claim. Concatenation of the filing date, filing state/country code, sequence number, time stamp and adjustment key. This field, along with the line item number, is a unique identifier for the claim.




MDR 20 TED-NI 2 sponssn DI Yes 8/13/2009 $9

Sponsor SSN  Generally contains the sponsor social number. 999999999



MDR 20 TED-NI 3 patdob
Yes 8/13/2009 yyyymmdd

Date of Birth Birth date of patient. 19850101



MDR 20 TED-NI 4 edi_pn
Yes 8/13/2009 $10

EDI_PN Person ID, assigned by DEERS. Best field to uniquely identify a patient, when available. 1111111111



MDR 20 TED-NI 5 deersid
Yes 8/13/2009 $11

DEERS Patient ID Identifier assigned by DEERS to identify a patient. 11111111111



MDR 20 TED-NI 6 patsex
Yes 8/13/2009 $1

Gender Gender of patient. F, M F=Female
M=Male


MDR 20 TED-NI 7 dx1
Yes 8/13/2009 $6

Principle Diagnosis After study, the ICD-9 CM diagnosis code which represents the diagnosis which led to the admission.




MDR 20 TED-NI 8 dx2
Yes 8/13/2009 $6

Secondary Diagnosis 1 Secondary ICD-9 CM diagnosis code.




MDR 20 TED-NI 9 dx3
Yes 8/13/2009 $6

Secondary Diagnosis 2 Secondary ICD-9 CM diagnosis code.




MDR 20 TED-NI 10 dx4
Yes 8/13/2009 $6

Secondary Diagnosis 3 Secondary ICD-9 CM diagnosis code.




MDR 20 TED-NI 11 dx5
Yes 8/13/2009 $6

Secondary Diagnosis 4 Secondary ICD-9 CM diagnosis code.




MDR 20 TED-NI 12 dx6
Yes 8/13/2009 $6

Secondary Diagnosis 5 Secondary ICD-9 CM diagnosis code.




MDR 20 TED-NI 13 dx7
Yes 8/13/2009 $6

Secondary Diagnosis 6 Secondary ICD-9 CM diagnosis code.




MDR 20 TED-NI 14 dx8
Yes 8/13/2009 $6

Secondary Diagnosis 7 Secondary ICD-9 CM diagnosis code.




MDR 20 TED-NI 15 comben
Yes 8/13/2009 $1

Beneficiary Category Code identifying category of beneficiary. This data element is based on information submitted on the claim. 1, 2, 3, 4 1=Active Duty Family
2=Retiree
3=All others
4=AD (includes guard, also non-military services)


MDR 20 TED-NI 16 dxedit
Yes 8/13/2009 $1

Diagnosis Code Edition Number Edition number of ICD clinical code data (diagnosis and procedure).




MDR 20 TED-NI 17 mdc
Yes 8/13/2009 $2

Derived MDC Major Diagnostic Category 01, 02 See MDC Codes.


MDR 20 TED-NI 18 patage
Yes 8/13/2009 3

Patient Age Age of patient.




MDR 20 TED-NI 19 begdate
Yes 8/13/2009 yyyymmdd

Begin Date of Care Begin date of billing period.




MDR 20 TED-NI 20 enddate
Yes 8/13/2009 yyyymmdd

End Date of Care End date of billing period.




MDR 20 TED-NI 21 cpt
Yes 8/13/2009 $5

Procedure Code HCPCS Code for this claim.
Includes some TMA-Specific codes


MDR 20 TED-NI 22 cptmod1
Yes 8/13/2009 $2

Procedure Code Modifier 1 Code indicating modification to the reported procedure code.
See CPT Modifiers.


MDR 20 TED-NI 23 cptmod2
Yes 8/13/2009 $2

Procedure Code Modifier 2





MDR 20 TED-NI 24 cptmod3
Yes 8/13/2009 $2

Procedure Code Modifier 3





MDR 20 TED-NI 25 cptmod4
Yes 8/13/2009 $2

Procedure Code Modifier 4

See CPT Modifiers.


MDR 20 TED-NI 26 ndc
Yes 8/13/2009 $11

National Drug Code Code indicating the drug, dosage, package size and vendor for a claim. Only populated on pharmacy records since TRx and TMOP
Code list is proprietary. See www.fda.gov for detailed list, though it may not be fully inclusive. The PDTS data files include a drug name and may be easier to use.


MDR 20 TED-NI 27 svcs
Yes 8/13/2009 SN3

Number of Services Number of units of service associated with procedure code and modifiers.




MDR 20 TED-NI 28 typsvc1
Yes 8/13/2009 $1

Type of Service 1 Code representing the setting of the service.
A=Ambulatory surgery cost-share as inpatient (Active Duty Only)
C=Air Force CAM Primary/Preventative Outpatient (effective prior to 04/97)
I=Inpatient
K=Emergency Room Admission cost shared as inpatient
O=Outpatient-excluding M, P, or N below
M=Outpatient maternity cost-share as inpatient
N=Outpatient cost-shared as inpatient
P=Outpatient partial psychiatric hospitalization


MDR 20 TED-NI 29 typsvc2
Yes 8/13/2009 $1

Type of Service 2 Code representing type of service.
1=Medical Care
2=Surgery
3=Consultation
4=Diagnostic/Therapeutic X-Ray
5=Diagnostic Laboratory
6=Radiation Therapy
7=Anesthesia
8=Assistance at Surgery
9=Other Medical Service
A=DME Rental/Purchase
B=Drugs
C=Ambulatory Surgery
D=Hospice
E=Second Opinion on Elective Surgery
F=Maternity
G=Dental
H=Mental Health Care
I=Ambulance
J=Program for Persons with Disabilities
K=Physical/occupational therapy
L=Speech Therapy; M=Mail Order Rx


MDR 20 TED-NI 30 paygrd DI Yes 8/13/2009 $2

Sponsor Pay Grade Code indicating pay grade of sponsor of patient. Use with pay plan. 01 01-09=Enlisted (E1-E9)
11-15=Warrant Officer (W1-W5)
19=Academy or Navy OSC students
20=Unknown Officer
21-31=Officer (O1-O11)
41-58=GS1-GS18
90=Unknown (Including NATO)
95=Not Applicable
99=Other


MDR 20 TED-NI 31 memrln
Yes 8/13/2009 $1

Member Relationship Code Code indicating relationship of member to sponsor. A A=Self (i.e., the person and the other person are the same person)
B=Spouse
C=Child or stepchild
D=Pre-adoptive child
E=Ward
F=Dependent parent, dependent stepparent, dependent parent-in-law, or dependent stepparent-in-law
G=Surviving spouse
H=Former spouse (20/20/20) (not assignable after RAPIDS 6.3)
I=Former spouse (20/20/15) (not assignable after RAPIDS 6.3)
J=Former spouse (10/20/10) (not assignable after RAPIDS 6.3)
K=Former spouse (transitional assistance (composite)) (not assignable after RAPIDS 6.3)


MDR 20 TED-NI 32 primepx
Yes 8/13/2009 $1

Primary Procedure Code Indicates whether this line item is the primary procedure on the claim.




MDR 20 TED-NI 33 provspec
Yes 8/13/2009 $2

Provider Specialty Code Code indicating specialty of the provider.
Note that this field is not consistent with the direct care coding scheme. Take caution when comparing direct and purchased care. Also note that one provider may have more than one specialty. This code is derived from the specialty that the provider submitted on the claim.


MDR 20 TED-NI 34 res_stat
Yes 8/13/2009 $1

Reservist Status Code Code indicating the status of the sponsor while called up for GWOT (only applies to guard/reserve and their family members.) A, E, O, M, T, I, L A = Early Alert for Guard/Reserve E = TAMP extended for Guard/Reserve O = TAMP original for Guard/Reserve
M = Mobilization for Guard/Reserve T = TAMP for Guard/Reserve
I = TAMP for involuntary separation from Active Duty
L = TAMP for stop/loss from Active Duty


MDR 20 TED-NI 35 soc
Yes 8/13/2009 $2

Special Operations Code Code indicating the operation under which the sponsor was activated (applies only to guard/reserve and their family members, and only for GWOT activations.)
08=Noble Eagle 09=Enduring Freedom 10=Iraqi Freedom Many records for Iraqi Freedom are coded as either 08 or 09.


MDR 20 TED-NI 36 bencat
Yes 8/13/2009 $3

DEERS Beneficiary Category Code identifying the beneficiary category of the patient. Derived from MDR DEERS Longitudinal File. This field is more detailed than the beneficiary category that comes in on the claim, allowing for segregation of guard/reserve, inactive guard/reserve and their family members.
ACT=Active Duty; RET=Retirees; GRD=Guard/Reserve with orders>30 days; IGR=Inactive Guard/Reserve; DA=Dependents of Active Duty; DR=Dependents of Retirees;
DS=Survivors; DGR=Dependent of Guard/Reserve w/ orders >30 days; IDG=Dependent of Inactive Guard; OTH=Other; Z=Unknown


MDR 20 TED-NI 37 race
Yes 8/13/2009 $1

DEERS Race Code Code indicating the race of the beneficiary. Derived from MDR DEERS Longitudinal File.
C=White
M=Asian or Pacific Islander
N=Black
R=American Indian or Alaskan native
X=Other
Z=Unknown


MDR 20 TED-NI 38 ethnic
Yes 8/13/2009 $1

DEERS Ethnicity Code Code indicating ethnicity of the beneficiary. Derived from MDR DEERS Longitudinal File.
A=American Indian/Alaskan Native
B=Asian or Pacific Islander
C=Black, not Hispanic
D=White, not Hispanic
E=Hispanic
X=Other
Z=Unknown


MDR 20 TED-NI 39 DDS
Yes 8/13/2009 $2

DEERS Dependent Suffix Code indicating relationship of beneficiary to sponsor.. Not populated in FY08 or later
Not populated for FY08+.
01-19=Dependent Child
20=Sponsor
30-39=Spouse of sponsor
40-44=Mother of sponsor
45-49=Father of sponsor
50-54=Mother-In-Law of sponsor
55-59=Father-In-Law of sponsor
60-69=Other eligible dependents
70-74=Unknown by DEERS
75=Pseudo DDS unknown by contractor
98=Service secretary designee 0X=Newborn not elsewhere classified


MDR 20 TED-NI 40 cy
Yes 8/13/2009 $4

Calendar Year Calendar year of end date of care. 2006



MDR 20 TED-NI 41 cm
Yes 8/13/2009 $2

Calendar Month Calendar month of end date of care. 12



MDR 20 TED-NI 42 tedind
Yes 8/13/2009 $1

TED Indicator Code indicating whether the claim is a TED or a HCSR. T, A, H T=TED
A=TED Adjustment to a HCSR
H=HCSR


MDR 20 TED-NI 43 pic
Yes 8/13/2009 $1

Program Indicator Code Code indicating program under which care is delivered. D D=Drug
H=Program for the Handicapped
I=Institutional (excluding D, H and T)
N=Non-Institutional (excluding D, H and T)
T=Dental (excluding D and H)


MDR 20 TED-NI 44 agegrp
Yes 8/13/2009 $1

Age Group Code Code indicating age group of beneficiary. A-H, Z A=0 to 4
B=5 to 14
C=15 to 17
D=18 to 24
E=25 to 34
F=35 to 44
G=45 to 64
H=65 and over
Z=Unknown


MDR 20 TED-NI 45 hospdep
Yes 8/13/2009 $2

Hospital Department Number Code that categorizes care into specialty areas.
1=Adverse Reactions
2=Allergy
3=Cardiology
4=Dermatology
5=Endocrinology
6=Gastroenterology
7=Hematology
8=Infectious Disease
9=Nephrology
10=Neurology
11=Nutritional
12=Pulmonary/Respiratory
13=Rheumatology
14=Other
15=Dental
16=Obstetrics
17=Gynecology
18=Ophthalmology
19=Mental Health
20=Drug
21=Special Pediatrics
22=ENT
23=General Surgery
24=Neurosurgery
25=Orthopedics
26=Thoracic Surgery
27=Urology


MDR 20 TED-NI 46 enc
Yes 8/13/2009 3

Number of Encounters Estimated number of encounters. Will not include pre or post op visits, but is generally a better measure to use than "number of visits".




MDR 20 TED-NI 47 623-624
Yes 8/13/2009 char

Person Association Reason Code Also called PARC. The code that represents the reason that an association between a person and another person ended or is expected to end. (Currently not populated for FY2005, FY2006) AA, AB, AC, AD, AE, AF, AH, AI, AX, BB, BC, BD, BE, BF, BG, CA, ZZ AA=Spouse; AB=Child; AC=Foster Child; AD=Parent
AE=Parent-in-law; AF=Stepchild; AH=Stepparent; AI=In loco parentis; AX=Emergency contact; BB=Ward; BC=Former spouse (not assignable after RAPIDS 6.3);
BD=Self (i.e., the person and the other person are the same person). Transaction only–not stored; BE=Joint marriage spouse; BF=Other health insurance subscriber;
BG=Pre-adoptive child; CA=Member of household headed by sponsor's former spouse (child, stepchild, or ward only); ZZ=Unknown


MDR 18 TED-NI 48 PARC
Yes 8/13/2009 Char (2)

Person Association Reason Code

See MPI specification.


MDR 5 TED-NI 11 ENC
Yes 8/13/2009 Char(1)

Encounter Setting Setting of patient encounter/episode of care. H, I, O H = Hospital Services
I = Inpatient Professional Services
O = Outpatient Professional Services


MDR 21 TED-I 1 tedno
Yes 8/13/2009 $24

TED Number Unique key identifying the claim. Concatenation of the filing date, filing state/country code, sequence number, time stamp and adjustment key.




MDR 21 TED-I 2 sponssn DI Yes 8/13/2009 $9

Sponsor SSN  Generally contains the sponsor social number. 999999999



MDR 21 TED-I 3 paygrd DI Yes 8/13/2009 $2

Sponsor Pay Grade Code indicating pay grade of sponsor of patient. Use with pay plan. 01 01-09=Enlisted (E1-E9)
11-15=Warrant Officer (W1-W5)
19=Academy or Navy OSC students
20=Unknown Officer
21-31=Officer (O1-O11)
41-58=GS1-GS18
90=Unknown (Including NATO)
95=Not Applicable
99=Other


MDR 21 TED-I 4 memcat
Yes 8/13/2009 $1

Sponsor Status Code indicating status of sponsor. R A=Active duty member
B=Presidential Appointee
C=DoD civil service employee, except Presidential Appointee
D=Disabled American veteran
E=DoD contract employee
F=Former member (Reserve service, discharged from the Ready Reserve or Standby Reserve following notification of retirement eligibility)
H=Medal of Honor recipient
I=Non-DoD civil service employee, except Presidential Appointee
J=Academy student
K=Non-Appropriated Fund DoD employees
L=Lighthouse service
M=Non-government agency personnel
N=National Guard member
O=Non-DoD contract employee
Q=Reserve retiree not yet eligible for retired pay (gray area retiree)
R=Retired military member eligible for retired pay
T=Foreign military
U=Authorized foreign national civilian
V=Reserve member
W=DoD Beneficiary, a person who receives benefits from the DoD based on prior association, condition or authorization, an example is a former spouse
Z=Unknown


MDR 21 TED-I 5 memrln
Yes 8/13/2009 $1

Member Relationship Code Code indicating relationship of member to sponsor. A A=Self (i.e., the person and the other person are the same person)
B=Spouse
C=Child or stepchild
D=Pre-adoptive child
E=Ward
F=Dependent parent, dependent stepparent, dependent parent-in-law, or dependent stepparent-in-law
G=Surviving spouse
H=Former spouse (20/20/20) (not assignable after RAPIDS 6.3)
I=Former spouse (20/20/15) (not assignable after RAPIDS 6.3)
J=Former spouse (10/20/10) (not assignable after RAPIDS 6.3)
K=Former spouse (transitional assistance (composite)) (not assignable after RAPIDS 6.3)


MDR 21 TED-I 6 patdob
Yes 8/13/2009 yyyymmdd

Date of Birth Birth date of patient. 19850101



MDR 21 TED-I 7 edi_pn
Yes 8/13/2009 $10

EDI_PN Person ID, assigned by DEERS. Best field to uniquely identify a patient, when available. 1111111111



MDR 21 TED-I 8 deersid
Yes 8/13/2009 $11

DEERS Patient ID Identifier assigned by DEERS to identify a patient. 11111111111



MDR 21 TED-I 9 patsex
Yes 8/13/2009 $1

Gender Gender of patient. F, M F=Female
M=Male


MDR 21 TED-I 10 provnpi
Yes 8/13/2009 $10

Provider Individual NPI Placeholder for individual national provider ID. Not expected to be populated for some time.




MDR 21 TED-I 11 insttype
Yes 8/13/2009 $2

Type of Institution Code indicating the type of institution where care was delivered.
See Institution Types.


MDR 21 TED-I 12 admtype
Yes 8/13/2009 $1

Type of Admission Code indicating the type of admission. 1, 2, 3, 4,5 1=Emergency; 2=Urgent; 3=Elective
4=Newborn; 5=Trauma Center


MDR 21 TED-I 13 admsrc
Yes 8/13/2009 $1

Source of Admission Code indicating how the patient came to the institution. This field is commonly used to identify transfers, admissions from the ER, and births. Note that records are often coded with "information not available" however. 1-9, A-D 1=Physician referral
2=Clinic referral
3=HMO referral
4=Transfer from a hospital
5=Transfer from a skilled nursing facility
6=Transfer from another health care facility
7=Emergency Room
8=Court/Law Enforcement
9=Information Not Available
A=Transfer from a Critical Access Hospital
B=Transfer from Another HHA
C=Readmission to the Same Home Health Agency
For Newborn:
1=Normal Delivery
2=Premature Delivery
3=Sick Baby
4=Extramural baby; D=Transfer from Hospital in same facility resulting in separate claim


MDR 21 TED-I 14 admdate
Yes 8/13/2009 yyyymmdd

Admission Date Date patient was admitted to the institution. In the case of an interim claim, the admission date should not change.




MDR 21 TED-I 15 dispstat
Yes 8/13/2009 $2

Disposition Status Code indicating how the patient left the institution. This field is often used to identify transfers, deaths, and routine discharges. Can also be used to identify which patients are still in the hospital.
01=Discharged
02=Transferred
03=Discharged/transferred to a skilled nursing facility (SNF)
04=Discharged/transferred to an intermediate care facility (ICF)
05=Discharged/transferred to another type of institution
06=Discharged/transferred to home under care of a home health agency
07=Left against medical advice
08=Discharged/transferred to home under care of home IV provider
20=Expired or did not recover, Christian Science Patient
30=Still a patient (interim bill)
40=Died at home
41=Died in a facility
42=Place of death unknown
43=Discharged/Transferred to a federal hospital
50=Discharged to hospice at home
51=Discharged to hospice-medical facility


MDR 21 TED-I 16 begdate
Yes 8/13/2009 yyyymmdd

Begin Date of Care Begin date of billing period.




MDR 21 TED-I 17 enddate
Yes 8/13/2009 yyyymmdd

End Date of Care End date of billing period.




MDR 21 TED-I 18 admdx
Yes 8/13/2009 $6

Admitting Diagnosis ICD-9 code indicating the diagnosis for which patient was admitted.




MDR 21 TED-I 19 dx1
Yes 8/13/2009 $6

Principle Diagnosis After study, the ICD-9 CM diagnosis code which represents the diagnosis which led to the admission.




MDR 21 TED-I 20 dxn
Yes 8/13/2009 $6

Secondary Diagnosis 1 - Seconday Diagnosis 11 Secondary ICD-9 CM diagnosis code.
11 separate data elements. N=1 to 11


MDR 21 TED-I 21 proc1
Yes 8/13/2009 $5

Principle Procedure Principle ICD-9 CM procedure code.




MDR 21 TED-I 22 proc2
Yes 8/13/2009 $5

2 Procedure 2 ICD-9 CM procedure code.




MDR 21 TED-I 23 proc3
Yes 8/13/2009 $5

3 Procedure 3 ICD-9 CM procedure code.




MDR 21 TED-I 24 proc4
Yes 8/13/2009 $5

4 Procedure 4 ICD-9 CM procedure code.




MDR 21 TED-I 25 proc5
Yes 8/13/2009 $5

5 Procedure 5 ICD-9 CM procedure code.




MDR 21 TED-I 26 proc6
Yes 8/13/2009 $5

6 Procedure 6 ICD-9 CM procedure code.




MDR 21 TED-I 27 proc7
Yes 8/13/2009 $5

7 Procedure 7 ICD-9 CM procedure code.




MDR 21 TED-I 28 proc8
Yes 8/13/2009 $5

8 Procedure 8 ICD-9 CM procedure code.




MDR 21 TED-I 29 proc9
Yes 8/13/2009 $5

9 Procedure 9 ICD-9 CM procedure code.




MDR 21 TED-I 30 proc10
Yes 8/13/2009 $5

10 Procedure 10 ICD-9 CM procedure code.




MDR 21 TED-I 31 proc11
Yes 8/13/2009 $5

11 Procedure 11 ICD-9 CM procedure code.




MDR 21 TED-I 32 comben
Yes 8/13/2009 $1

Beneficiary Category Code identifying category of beneficiary. 1, 2, 3, 4 1=Active Duty Family
2=Retiree
3=All others
4=AD (includes guard, also non-military services)


MDR 21 TED-I 33 dxedit
Yes 8/13/2009 $1

Diagnosis Code Edition Number Edition number of ICD clinical code data (diagnosis and procedure).




MDR 21 TED-I 34 drg
Yes 8/13/2009 $3

Derived DRG DRG assigned using the TRICARE DRG Grouper. This field is always populated.




MDR 21 TED-I 35 mdc
Yes 8/13/2009 $2

Derived MDC MDC assigned using the TRICARE DRG Grouper. 01, 02 See MDC Codes.


MDR 21 TED-I 36 ac_drg
Yes 8/13/2009 $3

Acute Care DRG Same as derived DRG, except that DRG is set to 000 if the facility is not an acute care facility. 001 See DRG Codes.


MDR 21 TED-I 37 res_stat
Yes 8/13/2009 $1

Reservist Status Code Code indicating the status of the sponsor while called up for GWOT (only applies to guard/reserve and their family members.) A, E, O, M, T, I, L A = Early Alert for Guard/Reserve E = TAMP extended for Guard/Reserve O = TAMP original for Guard/Reserve
M = Mobilization for Guard/Reserve T = TAMP for Guard/Reserve
I = TAMP for involuntary separation from Active Duty
L = TAMP for stop/loss from Active Duty


MDR 21 TED-I 38 soc
Yes 8/13/2009 $2

Special Operations Code Code indicating the operation under which the sponsor was activated (applies only to guard/reserve and their family members, and only for GWOT activations.)
08=Noble Eagle, 09=Enduring Freedom, 10=Iraqi Freedom. Many records for Iraqi Freedom are coded as either 08 or 09.


MDR 21 TED-I 39 patage
Yes 8/13/2009 3

Patient Age Age of patient.




MDR 21 TED-I 40 days
Yes 8/13/2009 SN3

Bed Days Bed Days for this claim.




MDR 21 TED-I 41 denrsite
Yes 8/13/2009 $4

DEERS Enrollment DMISID Enrollment DMISID derived from MDR DEERS Longitudinal File. This field is updated when the MDR receives updated information about a patient's demographics. This means that using this field, your data will represent the most accurate enrollment site of the beneficiary on the date of admission. Especially valuable to identify newborn records for enrolled patients.
Use in conjunction with DEERS ACV to isolate Prime for Plus.


MDR 21 TED-I 42 bencat
Yes 8/13/2009 $3

DEERS Beneficiary Category Code identifying the beneficiary category of the patient. Derived from MDR DEERS Longitudinal File. This field is more detailed than the beneficiary category that comes in on the claim, allowing for segregation of guard/reserve, inactive guard/reserve and their family members.
ACT=Active Duty; RET=Retirees; GRD=Guard/Reserve with orders>30 days; IGR=Inactive Guard/Reserve; DA=Dependents of Active Duty; DR=Dependents of Retirees;
DS=Survivors; DGR=Dependent of Guard/Reserve w/ orders >30 days; IDG=Dependent of Inactive Guard; OTH=Other; Z=Unknown


MDR 21 TED-I 43 race
Yes 8/13/2009 $1

DEERS Race Code Code indicating the race of the beneficiary. Derived from MDR DEERS Longitudinal File.
C=White
M=Asian or Pacific Islander
N=Black
R=American Indian or Alaskan native
X=Other
Z=Unknown


MDR 21 TED-I 44 ethnic
Yes 8/13/2009 $1

DEERS Ethnicity Code Code indicating ethnicity of the beneficiary. Derived from MDR DEERS Longitudinal File.
A=American Indian/Alaskan Native
B=Asian or Pacific Islander
C=Black, not Hispanic
D=white, not Hispanic
E=Hispanic
X=Other
Z=Unknown


MDR 21 TED-I 45 DDS
Yes 8/13/2009 $2

DEERS Dependent Suffix Code indicating relationship of beneficiary to sponsor.
Not populated for FY08+.
01-19=Dependent Child
20=Sponsor
30-39=Spouse of sponsor
40-44=Mother of sponsor
45-49=Father of sponsor
50-54=Mother-In-Law of sponsor
55-59=Father-In-Law of sponsor
60-69=Other eligible dependents 0X=Newborn not elsewhere classified


MDR 21 TED-I 46 catcare
Yes 8/13/2009 $2

Category of Care Code indicating the type of care.
1st Character:
A=Psych
B=OB
C=Gynecology
D=Surgical
E=Medical
F=Dental
G=Drug
H=Program for the Handicapped

2nd Character:
1=Peds
2=Delivery
3=Peds and Delivery
blank=neither Peds nor Delivery


MDR 21 TED-I 47 totdays
Yes 8/13/2009 $3

Total Bed Days Total bed days, including all interim claims. Only populated on the claim representing a discharge.




MDR 21 TED-I 48 cy
Yes 8/13/2009 $4

Calendar Year Calendar year of end date of care.




MDR 21 TED-I 49 cm
Yes 8/13/2009 $2

Calendar Month Calendar month of end date of care.




MDR 21 TED-I 50 prevadm
Yes 8/13/2009 $1

Preventable Admission Indicator Code indicating whether the care provided is one of 9 conditions where access to primary care/preventive services may reduce the likelihood of admission to a hospital. This measure does not imply a particular patient should not have been admitted.
A=Asthma
B=Bacterial Pneumonia
C=COPD
D=Diabetes
G=Gastroenteritis
H=Congestive Heart Failure
P=Angina Pectoris
U=Urinary Tract Infection/Kidney
T=(Tissue) Cellulitis
0=Not a preventable admission


MDR 21 TED-I 51 tedind
Yes 8/13/2009 $1

TED Indicator Code indicating whether the claim is a TED or a HCSR. T, A, H T=TED
A=TED Adjustment to a HCSR
H=HCSR


MDR 21 TED-I 52 births
Yes 8/13/2009 8

Number of Births Number of births for this record, includes stillbirths, only populated on mother's records.




MDR 21 TED-I 53 agegrp
Yes 8/13/2009 $1

Age Group Code Code indicating age group of beneficiary. A-H, Z A=0 to 4
B=5 to 14
C=15 to 17
D=18 to 24
E=25 to 34
F=35 to 44
G=45 to 64
H=65 and over
Z=Unknown


MDR 21 TED-I 54 hospdep
Yes 8/13/2009 $2

Hospital Department Number Code that categorizes care into specialty areas.
1=Adverse Reactions
2=Allergy
3=Cardiology
4=Dermatology
5=Endocrinology
6=Gastroenterology
7=Hematology
8=Infectious Disease
9=Nephrology
10=Neurology
11=Nutritional
12=Pulmonary/Respiratory
13=Rheumatology
14=Other
15=Dental
16=Obstetrics
17=Gynecology
18=Ophthalmology
19=Mental Health
20=Drug
21=Special Pediatrics
22=ENT
23=General Surgery
24=Neurosurgery
25=Orthopedics
26=Thoracic Surgery
27=Urology


MDR 21 TED-I 56 apappd
Yes 12/17/2009 $1

Perforated Appendix Indicates whether this record meets AHRQ's preventable admission criteria for perforated appendix. Always 0 for children.




MDR 21 TED-I 57 altdiab
Yes 12/17/2009 $1

Diabetes Long Term Complications Indicates whether this record meets AHRQ's preventable admission criteria for long term diabetes complications. Always 0 for children.




MDR 21 TED-I 58 acopd
Yes 12/17/2009 $1

Chronic Obstructive Pulmonary Disorder Indicates whether this record meets AHRQ's preventable admission criteria for chronic obstructive pulmonary disorder. Always 0 for children.




MDR 21 TED-I 59 ahyptn
Yes 12/17/2009 $1

Hypertension Admission Indicates whether this record meets AHRQ's preventable admission criteria for hypertension. Always 0 for children.




MDR 21 TED-I 60 achf
Yes 12/17/2009 $1

Heart Failure Admission Indicates whether this record meets AHRQ's preventable admission criteria for heart failure. Always 0 for children.




MDR 21 TED-I 61 albw
Yes 12/17/2009 $1

Low Birth Weight Indicates whether this record meets AHRQ's preventable admission criteria for low birth weight




MDR 21 TED-I 62 adhyd
Yes 12/17/2009 $1

Dehydration Indicates whether this record meets AHRQ's preventable admission criteria for dehydration. Always 0 for children.




MDR 21 TED-I 63 abacpn
Yes 12/17/2009 $1

Bacterial Pneumonia Indicates whether this record meets AHRQ's preventable admission criteria for bacterial pneumonia. Always 0 for children.




MDR 21 TED-I 64 auti
Yes 12/17/2009 $1

Urinary Tract Infection Indicates whether this record meets AHRQ's preventable admission criteria for urinary tract infection. Always 0 for children.




MDR 21 TED-I 65 aawp
Yes 12/17/2009 $1

Angina without Procedure Indicates whether this record meets AHRQ's preventable admission criteria for angina w/o procedure. Always 0 for children.




MDR 21 TED-I 66 auncdiab
Yes 12/17/2009 $1

Uncontrolled Diabetes Indicates whether this record meets AHRQ's preventable admission criteria for uncontrolled diabetes. Always 0 for children.




MDR 21 TED-I 67 aasth
Yes 12/17/2009 $1

Adult Asthma Indicates whether this record meets AHRQ's preventable admission criteria for adult asthma. Always 0 for children.




MDR 21 TED-I 68 aampdiab
Yes 12/17/2009 $1

Lower-extremity Amputation among patients with Diabetes Indicates whether this record meets AHRQ's preventable admission criteria for lower extremity amputations among patients with diabetes. Always 0 for children.




MDR 21 TED-I 69 aovall
Yes 12/17/2009 $1

Adult Overall Composite Indicates whether any of the adult preventable admission criteria were met.




MDR 21 TED-I 70 aacute
Yes 12/17/2009 $1

Adult Acute Composite Indicates whether any of the adult preventable admission criteria for acute conditions were met (dehydration, bacterial pneumonia, or UTI)




MDR 21 TED-I 71 achron
Yes 12/17/2009 $1

Adult Chronic Composite Indicates whether any of the adult preventable admission criteria for chronic conditions were met (heart failure, diabetes, COPD, asthma, angina and hypertension)




MDR 21 TED-I 73 pstdiab
Yes 12/17/2009 $1

Pediatric Short term Diabetes Indicates whether this record meets AHRQ's preventable admission criteria for pediatric short term diabetes complications




MDR 21 TED-I 74 pgastro
Yes 12/17/2009 $1

Pediatric Gastroenteritis Indicates whether this record meets AHRQ's preventable admission criteria for pediatric gastroenteritis




MDR 21 TED-I 76 puti
Yes 12/17/2009 $1

Pediatric Urinary Tract Infection Indicates whether this record meets AHRQ's preventable admission criteria for pediatric UTI




MDR 21 TED-I 77 povall
Yes 12/17/2009 $1

Pediatric Overall Composite Indicates whether any of the pediatric preventable admission criteria were met.




MDR 21 TED-I 78 pchron
Yes 12/17/2009 $1

Pediatric Chronic Composite Indicates whether any of the pediatric preventable admission criteria for chronic conditions were met (heart failure, diabetes, COPD, asthma, angina and hypertension)




MDR 18 TED-I 79 PASTH
Yes 12/17/2009 Char (1)

Pediatric Asthma Admission





MDR 18 TED-I 80 PADCDACT
Yes 8/13/2009 Char (1)

Combined Acute Adult and Pediatric Composite
0, 1 0 = otherwise 1 = if aacute, or pacute equal 1


MDR 18 TED-I 81 PADCDCHN
Yes 8/13/2009 Char (1)

Combined Chronic Adult and Pediatric Composite
0, 1 0 = otherwise 1 = if achron, or pchron equal 1


MDR 18 TED-I 81 PACUTE
Yes 8/13/2009 Char (1)

Pediatric Acute Composite
0, 1 0 = otherwise 1 = if pgastro, or puti equal 1


MDR 18 TED-I 82 DX9
Yes 8/13/2009 Char (8)

9 Diagnosis Code 9 ICD-9-CM diagnosis code. They are each their own field.




MDR 18 TED-I 83 ASTDIAB
Yes 12/17/2009 Char (1)

Short Term Diabetes Complications





MDR 100 Ancillary - Lab Rad 1 apptno
Yes 12/17/2009 $20

Appointment record ID The appointment identifier number.




MDR 100 Ancillary - Lab Rad 2 cpt
Yes 12/17/2009 $5

CPT Code Procedure Code.




MDR 100 Ancillary - Lab Rad 3 cptmod
Yes 12/17/2009 $2

Modifier of the CPT code Modifier of the laboratory test or radiology exam performed. 00,26,32,90, TC For Lab:
00=test ordered and performed in-house
26=pathologist interpretation, professional component
32=test performed for an outside facility
90=test referred to a reference/external facility
For Rad:
00 = blank
26 = professional component
32 or TC = technical component


MDR 100 Ancillary - Lab Rad 4 drvcount
Yes 12/17/2009 $2

Derived Number of Services??? Corrected Number of times CPT code was performed. 0-99



MDR 100 Ancillary - Lab Rad 5 dx1
Yes 12/17/2009 $6

ICD9 Diagnosis Code 1 Principle Diagnosis. null or blank ACT = Active Duty
DA = Dependent of Active Duty
DCO = Direct Care Only
DR = Dependent of Retired
DGR=Dependent of Guard
DS = Dependent of Survivor
GRD = Guard / Reserve
IGR = Inactive Guard / Reserve
IDG = Inactive Dependent of Guard / Reserve
NAT = NATO
OTH = Other
RET = Retired
UNK = Unknown


MDR 100 Ancillary - Lab Rad 6 dx2
Yes 12/17/2009 $6

ICD9 Diagnosis Code 2 Diagnosis Code 2. null or blank 6th character accommodates ICD-9 extender codes. Will remain blank until the CCE lab/rad is activated.


MDR 100 Ancillary - Lab Rad 7 dx3
Yes 12/17/2009 $6

ICD9 Diagnosis Code 3 Diagnosis Code 3. null or blank 6th character accommodates ICD-9 extender codes. Will remain blank until the CCE lab/rad is activated.


MDR 100 Ancillary - Lab Rad 8 dx4
Yes 12/17/2009 $6

ICD9 Diagnosis Code 4 Diagnosis Code 4. null or blank 6th character accommodates ICD-9 extender codes. Will remain blank until the CCE lab/rad is activated.


MDR 100 Ancillary - Lab Rad 9 inpt
Yes 12/17/2009 $1

Inpatient indicator Indicates whether or not the ancillary came from an inpatient encounter. Y,N See HCDP Code worksheet. Only populated if patient is enrolled on the date of service.


MDR 100 Ancillary - Lab Rad 10 labflag
Yes 12/17/2009 $1

Laboratory Flag Indicates where lab tests were ordered or performed. blank, I,O,E Y = Yes
N = No


MDR 100 Ancillary - Lab Rad 11 orddmis
Yes 12/17/2009 $4

Ordering DMIS ID DMIS ID of the requesting location for the order. e.g., 0039 Y = Yes
N = No


MDR 100 Ancillary - Lab Rad 12 orderid
Yes 12/17/2009 $12

Provider Order Number CHCS code of the Order Number of the Provider.




MDR 100 Ancillary - Lab Rad 13 patage
Yes 12/17/2009 3

Patient Age Patient's age on date of service. numeric AA=Spouse, AB=Child, AC=Foster Child, AD=Parent, AE=Parent in Law, AF=Stepchild, AH=Stepparent, AI=In loco parentis, BB=Ward, BC=Former Spouse (prior to FY04), BD=Self, BE= Joint Marriage Spouse, BF=OHI Subscriber, BG=Pre Adoptive Child, CA=Member of household headed by former spouse, ZZ or blank=Unknown


MDR 100 Ancillary - Lab Rad 14 servdate
Yes 12/17/2009 $8

Date Of Service For LAB: Specimen collection date.
For RAD: If "Exam Only" this is the date that the procedure was performed. If "Read Only" or "Complete" this the date that the exam was read by a Radiologist.		 yyyymmdd Physician or Work Expense RVU


MDR 100 Ancillary - Lab Rad 15 sex
Yes 12/17/2009 $1

Gender Beneficiary gender. M, F, Z A formatted SAS numeric date.


MDR 100 Ancillary - Lab Rad 16 soc
Yes 12/17/2009 $2

Special Operation Code The identifier that represents the special operation. 00, 01, 02, 03, 04, 05, 06, 07,08, 09, 10, 98,99, blank M=Male
F=Female
Z=Unknown


MDR 100 Ancillary - Lab Rad 17 tmtdmis
Yes 12/17/2009 $4

Treatment DMIS ID DMIS ID of the MTF providing the service. e.g., 0039 A=Army
C=Coast Guard
F=Air Force
M=Marine Corps
N=Navy
V=Navy Afloat
X=Other
Z=Unknown


MDR 100 Ancillary - Lab Rad 18 FMP
Yes 12/17/2009 char(2)

Family Member Prefix - for linkage The code that represents the prefix that the medical community uses to identify medical records. 01-19,20,30-39,40,45, 50,55,60-69,90-95,97,98, or 99. 01-19 = Dependent children of sponsor
20 = Sponsor
30-39 = Spouse of sponsor
40-44 = Mother of sponsor
45-49 = Father of sponsor
50-54 = Mother-in-law of sponsor
55-59 = Father-in-law of sponsor
60-69 = Other dependents
90-95 = Beneficiary authorized by statute
98 = Civilian Humanitarian
99 = All others not elsewhere classified


MDR 100 Ancillary - Lab Rad 19 SPONSSN DI Yes 12/17/2009 $9

Sponsor SSN - for linkage The sponsor’s SSN as assigned by the Social Security Administration. e.g., 123456789



MDR 100 Ancillary - Lab Rad 20 comben
Yes 12/17/2009 $1

Beneficiary Category - for linkage Code identifying category of beneficiary. 1, 2, 3, 4 1=Active Duty Family
2=Retiree
3=All others
4=AD (includes guard, also non-military services)


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