Exhibit_7_-_T3_Data_Dictionary.pdf
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- HT0011-13-R-0001
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- Defense Health Agency
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Exhibit 7 - T3 Data Dictionary
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Text version
Defense Manpower Data Center
Defense Enrollment Eligibility Reporting System/Military Health System
(DEERS/MHS)
Data Dictionary Medical-Dental Edition
Version 1.0.08
25 October 2012
Prepared for The Office of the Undersecretary of Defense
(Personnel and Readiness) and
Defense Manpower Data Center
DEERS Data Dictionary, Medical-Dental Edition Version 1.0.08
Release Date: 25 October 2012 Page ii
Document Information Medical-Dental Edition
Document Contents This document contains a specialized subset of the contents of the DEERS Data Dictionary that medical and dental applications, as well as the applications and software programs serving or supporting those applications, use to process DEERS benefits data. The Medical-Dental Edition of the DEERS Data Dictionary replaced the TNEX Edition, which was last published in October 2007.
Data Dictionary Purpose The purpose of the DEERS Data Dictionary is to:
1) Record and standardize data elements used as transfer records fields, object slots, and database table columns
2) Provide a reference for DEERS technical staff, contractors, and other authorized personnel
3) Populate the data element definitions and value definitions given in DMDC Tools applications
Data Elements A data element is the metadata that acts as a container for instances of data.
In this document, data elements are presented in the following format.
Business Name: The full English name of a data element. Health Care Delivery Program Plan Coverage Code is the business names for HCDP_PLN_CVG_CD.
System Name: The abbreviated name of a data element used in code, such as the name of an attribute in a Java object, a slot in a KB object, a table column, or a field in a transfer record. HCDP_PLN_CVG_CD is the system name for Health Care Delivery Program Plan Coverage Code.
Definition: Briefly describes what data the data element captures, and sometimes what the data element is used for.
For example, the Health Care Delivery Program Plan Coverage Code (HCDP_PLN_CVG_CD) is defined as: The code that represents the plan coverage a family member or sponsor has within a health care delivery program type.
Display Length: Indicates the number of bytes a data element is designed to hold and display. The PDR database, its satellite databases, and applications that access and update those databases do not pack the data stored or passed.
Begin Date: Provides an approximate date when a data element was first entered into the DEERS Data Dictionary Database.
Valid Values: A combination of alpha/numeric codes (for example, A, B, C; 01, 02, 03; A1, A2, A3) that represent a value definition. The value definition describes the data being captured. To save space, only the codes are stored on the database. Some types of data elements (such as dates, identifiers, text, names, and amounts) do not have predetermined values.
Release Date: 25 October 2012 Page iii
Table of Contents
Active Duty Eligibility Quantity ................................................................................. Error! Bookmark not defined.
Active Duty Family Enrollment Quantity ................................................................... Error! Bookmark not defined.
Active Duty Individual Enrollment Quantity .............................................................. Error! Bookmark not defined.
Active Guard/Reserve Service Legal Authority Begin Calendar Date ........................ Error! Bookmark not defined.
Active Guard/Reserve Service Legal Authority Code ................................................. Error! Bookmark not defined.
Active Guard/Reserve Service Legal Authority End Calendar Date ........................... Error! Bookmark not defined.
Active X Data Object Community Protocol Name ...................................................... Error! Bookmark not defined.
Active X Data Object Host Internet Protocol Address Identifier ................................ Error! Bookmark not defined.
Active X Data Object Host String Name ..................................................................... Error! Bookmark not defined.
Active X Data Object Port Identifier ........................................................................... Error! Bookmark not defined.
Active X Data Object Region Name ............................................................................ Error! Bookmark not defined.
Active X Data Object Source Route Indicator Code ................................................... Error! Bookmark not defined.
Active X Data Object User Name ............................................................................... Error! Bookmark not defined.
Active X Data Object User Password Text.................................................................. Error! Bookmark not defined.
Add Missing Eligibility Indicator Code ....................................................................... Error! Bookmark not defined.
Administering Facility DMIS Identifier ...................................................................... Error! Bookmark not defined.
Administrative Sex Code ............................................................................................. Error! Bookmark not defined.
Age Group Code .......................................................................................................... Error! Bookmark not defined.
Aging Code .................................................................................................................. Error! Bookmark not defined.
Alternate Rank Overlay Code ...................................................................................... Error! Bookmark not defined.
Application Identifier .................................................................................................. Error! Bookmark not defined.
Application Version Identifier ..................................................................................... Error! Bookmark not defined.
Approval Authority Person First Name ....................................................................... Error! Bookmark not defined.
Approval Authority Person Last Name ....................................................................... Error! Bookmark not defined.
Approval Authority Rank Text .................................................................................... Error! Bookmark not defined.
Approval Authority Title Text ..................................................................................... Error! Bookmark not defined.
Assigned HCDP Modifier Code .................................................................................. Error! Bookmark not defined.
Assigned HCDP Priority Code .................................................................................... Error! Bookmark not defined.
Assigned Health Care Delivery Program Access/Update Code .................................. Error! Bookmark not defined.
Assigned Health Care Delivery Program End Eligibility End Reason Code ............... Error! Bookmark not defined.
Assigned Health Care Delivery Program End Eligibility Source Code ....................... Error! Bookmark not defined.
Assigned Health Care Delivery Program End Eligibility Termination Reason Code . Error! Bookmark not defined.
Assigned Health Care Delivery Program Segment Identifier ...................................... Error! Bookmark not defined.
At Over CAP Transaction Date ................................................................................... Error! Bookmark not defined.
At Over CAP Transaction Time .................................................................................. Error! Bookmark not defined.
Automatic Dependent Eligibility Indicator Code ........................................................ Error! Bookmark not defined.
Automatic Dependent Eligibility Maximum Age Quantity ......................................... Error! Bookmark not defined.
Beneficiary Affiliation Effective Calendar Date ......................................................... Error! Bookmark not defined.
Beneficiary Affiliation Expiration Calendar Date ....................................................... Error! Bookmark not defined.
Beneficiary Affiliation Segment Identifier .................................................................. Error! Bookmark not defined.
Beneficiary DEERS Beneficiary Identifier .................................................................. Error! Bookmark not defined.
Beneficiary DEERS Family Identifier ......................................................................... Error! Bookmark not defined.
Beneficiary Web Enrollment FAQ Answer Text ......................................................... Error! Bookmark not defined.
Beneficiary Web Enrollment FAQ Category Code ..................................................... Error! Bookmark not defined.
Beneficiary Web Enrollment FAQ Category Name Text ............................................ Error! Bookmark not defined.
Beneficiary Web Enrollment FAQ Identifier .............................................................. Error! Bookmark not defined.
Beneficiary Web Enrollment FAQ Question Text ....................................................... Error! Bookmark not defined.
Beneficiary Web Enrollment Transaction Date ........................................................... Error! Bookmark not defined.
Beneficiary Web Enrollment Transaction Type .......................................................... Error! Bookmark not defined.
Benefit Authoritative Source Text ............................................................................... Error! Bookmark not defined.
Benefit Description Text ............................................................................................. Error! Bookmark not defined.
Benefit Effective Date ................................................................................................. Error! Bookmark not defined.
Benefit Eligibility Period Code ................................................................................... Error! Bookmark not defined.
Benefit End Date ......................................................................................................... Error! Bookmark not defined.
Release Date: 25 October 2012 Page iv
Benefit Name ............................................................................................................... Error! Bookmark not defined.
Benefits Determination Driver Identifier ..................................................................... Error! Bookmark not defined.
Benefits Notification Driver Identifier ........................................................................ Error! Bookmark not defined.
Benefits Notification Segment Identifier ..................................................................... Error! Bookmark not defined.
Benefits Notification Status Code ............................................................................... Error! Bookmark not defined.
Benefits Notification Status Date ................................................................................ Error! Bookmark not defined.
Benefits Notification Status Error Code ...................................................................... Error! Bookmark not defined.
Benefits Notification Type Code ................................................................................. Error! Bookmark not defined.
Benefits Notification Vendor Mail Date ...................................................................... Error! Bookmark not defined.
Benefits Notification Vendor Status Code ................................................................... Error! Bookmark not defined.
Benefits Notification Vendor Status Date ................................................................... Error! Bookmark not defined.
Benefits Notification Vendor Status Error Code ......................................................... Error! Bookmark not defined.
Blood Type Code ......................................................................................................... Error! Bookmark not defined.
Blood Type Verification Code ..................................................................................... Error! Bookmark not defined.
Blood Type Verification Status Code .......................................................................... Error! Bookmark not defined.
Care Reason for Request Text ..................................................................................... Error! Bookmark not defined.
Care Referral Authorization Begin Date ..................................................................... Error! Bookmark not defined.
Care Referral Authorization Code ............................................................................... Error! Bookmark not defined.
Care Referral Authorization Date ................................................................................ Error! Bookmark not defined.
Care Referral Authorization Expiration Date .............................................................. Error! Bookmark not defined.
Care Referral Begin Date............................................................................................. Error! Bookmark not defined.
Care Referral Clinical Service Date ............................................................................. Error! Bookmark not defined.
Care Referral Cross-Reference Access/Update Code .................................................. Error! Bookmark not defined.
Care Referral Cross-Reference Segment Identifier ..................................................... Error! Bookmark not defined.
Care Referral Expiration Date ..................................................................................... Error! Bookmark not defined.
Care Referral Identifier ................................................................................................ Error! Bookmark not defined.
Care Referral Request Date ......................................................................................... Error! Bookmark not defined.
Care Referral Request Priority Code ........................................................................... Error! Bookmark not defined.
Care Referral Request Time ........................................................................................ Error! Bookmark not defined.
Care Referral Satellite Segment Identifier ................................................................... Error! Bookmark not defined.
Care Request Reason Text ........................................................................................... Error! Bookmark not defined.
Catastrophic Cap Report Type Code ........................................................................... Error! Bookmark not defined.
Catastrophic Cap/Deductible Applied Premium Payment Amount ............................. Error! Bookmark not defined.
Catastrophic Cap/Deductible Detail Lock Type Code ................................................. Error! Bookmark not defined.
Catastrophic Cap/Deductible Detail Segment Identifier .............................................. Error! Bookmark not defined.
Catastrophic Cap/Deductible Detail Source Contractor Code ..................................... Error! Bookmark not defined.
Catastrophic Cap/Deductible Detail Totals Applied Type Code ................................. Error! Bookmark not defined.
Catastrophic Cap/Deductible Detail Transaction Calendar Date ................................. Error! Bookmark not defined.
Catastrophic Cap/Deductible Detail Transaction Time ............................................... Error! Bookmark not defined.
Catastrophic Cap/Deductible Detail Type Code .......................................................... Error! Bookmark not defined.
Catastrophic Cap/Deductible Detail Update Identifier ................................................ Error! Bookmark not defined.
Catastrophic Cap/Deductible Detail Update Indicator Code ....................................... Error! Bookmark not defined.
Catastrophic Cap/Deductible Enrollment Period Begin Calendar Date ....................... Error! Bookmark not defined.
Catastrophic Cap/Deductible Fiscal Year Access/Update Code .................................. Error! Bookmark not defined.
Catastrophic Cap/Deductible Inquiry Period Begin Calendar Date ............................. Error! Bookmark not defined.
Catastrophic Cap/Deductible Inquiry Period End Calendar Date ................................ Error! Bookmark not defined.
Catastrophic Cap/Deductible Lock Access/Update Code ............................................ Error! Bookmark not defined.
Catastrophic Cap/Deductible Lock Calendar Date ...................................................... Error! Bookmark not defined.
Catastrophic Cap/Deductible Lock Calendar Date-Time ............................................ Error! Bookmark not defined.
Catastrophic Cap/Deductible Lock Contractor Code ................................................... Error! Bookmark not defined.
Catastrophic Cap/Deductible Lock Indicator Code ..................................................... Error! Bookmark not defined.
Catastrophic Cap/Deductible Lock Return Code ......................................................... Error! Bookmark not defined.
Catastrophic Cap/Deductible Lock Source System Name ........................................... Error! Bookmark not defined.
Catastrophic Cap/Deductible Lock Status Indicator Code .......................................... Error! Bookmark not defined.
Catastrophic Cap/Deductible Lock Time .................................................................... Error! Bookmark not defined.
Catastrophic Cap/Deductible Split Claim Identifier .................................................... Error! Bookmark not defined.
Catastrophic Cap/Deductible Status Code ................................................................... Error! Bookmark not defined.
Catastrophic Cap/Deductible Totals/Lock Inquiry Type Code .................................... Error! Bookmark not defined.
Release Date: 25 October 2012 Page v
Catchment Name ......................................................................................................... Error! Bookmark not defined.
Certificate of Credible Coverage Information Text ..................................................... Error! Bookmark not defined.
CHCBP System Indicator Code ................................................................................... Error! Bookmark not defined.
CHCS System Indicator Code ..................................................................................... Error! Bookmark not defined.
Civilian Health Care Copayment Code ....................................................................... Error! Bookmark not defined.
Civilian Health Care End Eligibility End Reason Code .............................................. Error! Bookmark not defined.
Civilian Health Care End Eligibility Source Code ...................................................... Error! Bookmark not defined.
Civilian Health Care Entitlement Segment Identifier .................................................. Error! Bookmark not defined.
Civilian Health Care Entitlement Type Begin Eligibility Calendar Date .................... Error! Bookmark not defined.
Civilian Health Care Entitlement Type Code .............................................................. Error! Bookmark not defined.
Civilian Health Care Entitlement Type End Eligibility Calendar Date ....................... Error! Bookmark not defined.
Civilian Primary Care Manager Location Identifier .................................................... Error! Bookmark not defined.
Civilian Primary Care Manager Location Sequence Identifier .................................... Error! Bookmark not defined.
Civilian Primary Care Manager Place of Care Hold Type Code ................................. Error! Bookmark not defined.
Civilian Primary Care Manager Place of Care Sequence Identifier ............................ Error! Bookmark not defined.
Claim Mailing Address 1 Text .................................................................................... Error! Bookmark not defined.
Claim Mailing Address 2 Text .................................................................................... Error! Bookmark not defined.
Claim Mailing Address Line 1 Text ............................................................................ Error! Bookmark not defined.
Claim Mailing Address Line 2 Text ............................................................................ Error! Bookmark not defined.
Claim Mailing Address Line 3 Text ............................................................................ Error! Bookmark not defined.
Claim Mailing Address Line 4 Text ............................................................................ Error! Bookmark not defined.
Claim Procedure Contact Information Text ................................................................. Error! Bookmark not defined.
Claim Processing System Indicator Code .................................................................... Error! Bookmark not defined.
Claim Service Period Begin Calendar Date ................................................................. Error! Bookmark not defined.
Claim Service Period End Calendar Date .................................................................... Error! Bookmark not defined.
Command Interest Code .............................................................................................. Error! Bookmark not defined.
Command Interest Name ............................................................................................. Error! Bookmark not defined.
Command Security Code ............................................................................................. Error! Bookmark not defined.
Command Security Name ............................................................................................ Error! Bookmark not defined.
Composite Health Care System Conversion Calendar Date ........................................ Error! Bookmark not defined.
Composite Health Care System Version Code ............................................................ Error! Bookmark not defined.
Contact Relationship Code .......................................................................................... Error! Bookmark not defined.
Contact Relationship Type Code ................................................................................. Error! Bookmark not defined.
Contractor Fee Payment Access/Update Code ............................................................ Error! Bookmark not defined.
Contractor Operator Identifier ..................................................................................... Error! Bookmark not defined.
Control Identifier ......................................................................................................... Error! Bookmark not defined.
Conversion Lead Days Quantity .................................................................................. Error! Bookmark not defined.
Copayment Waiver Code ............................................................................................. Error! Bookmark not defined.
Country Code ............................................................................................................... Error! Bookmark not defined.
Country Name ............................................................................................................. Error! Bookmark not defined.
Cross-Reference DEERS Beneficiary Identifier .......................................................... Error! Bookmark not defined.
Cross-Reference DEERS Family Identifier ................................................................. Error! Bookmark not defined.
Cumulative Fee Waiver Amount ................................................................................. Error! Bookmark not defined.
Cumulative Response Time ......................................................................................... Error! Bookmark not defined.
Current Health Care Delivery Program Contractor Code ............................................ Error! Bookmark not defined.
Current Health Care Delivery Program Contractor Type Code ................................... Error! Bookmark not defined.
DEERS Beneficiary Identifier ..................................................................................... Error! Bookmark not defined.
DEERS Benefit Access/Update Code .......................................................................... Error! Bookmark not defined.
DEERS Direct Access Composite Health Care System Code ..................................... Error! Bookmark not defined.
DEERS Family Identifier ............................................................................................ Error! Bookmark not defined.
DEERS Identifier ......................................................................................................... Error! Bookmark not defined.
DEERS Indicator Code ................................................................................................ Error! Bookmark not defined.
Defense Blood Supply System Indicator Code ............................................................ Error! Bookmark not defined.
Defense Medical Information System Identifier .......................................................... Error! Bookmark not defined.
Defense Medical Information System Provider Identifier ........................................... Error! Bookmark not defined.
Dental Begin Coverage Calendar Date ........................................................................ Error! Bookmark not defined.
Dental Begin Coverage Run Calendar Date ................................................................ Error! Bookmark not defined.
Dental Begin Coverage Transaction Code ................................................................... Error! Bookmark not defined.
Release Date: 25 October 2012 Page vi
Dental Benefit Eligibility Segment Identifier .............................................................. Error! Bookmark not defined.
Dental Benefit Eligibility Type Begin Calendar Date ................................................. Error! Bookmark not defined.
Dental Benefit Eligibility Type End Calendar Date .................................................... Error! Bookmark not defined.
Dental Benefit Redetermination Calendar Date .......................................................... Error! Bookmark not defined.
Dental Benefit Redetermination Code ......................................................................... Error! Bookmark not defined.
Dental Eligibility Discrepancy Code ........................................................................... Error! Bookmark not defined.
Dental End Coverage Calendar Date ........................................................................... Error! Bookmark not defined.
Dental End Coverage Reason Code ............................................................................. Error! Bookmark not defined.
Dental End Coverage Run Calendar Date ................................................................... Error! Bookmark not defined.
Dental End Coverage Transaction Code ...................................................................... Error! Bookmark not defined.
Dental Error Begin Calendar Date ............................................................................... Error! Bookmark not defined.
Dental Error Code ........................................................................................................ Error! Bookmark not defined.
Dental Error End Calendar Date .................................................................................. Error! Bookmark not defined.
Dental Error Program Code ......................................................................................... Error! Bookmark not defined.
Dental Error Segment Identifier .................................................................................. Error! Bookmark not defined.
Dental Other Health Insurance Indicator Code ............................................................ Error! Bookmark not defined.
Dental Plan Person Role Code ..................................................................................... Error! Bookmark not defined.
Dental Plan Type Code ................................................................................................ Error! Bookmark not defined.
Dental Premium Code ................................................................................................. Error! Bookmark not defined.
Dental Premium End Coverage Reason Code ............................................................. Error! Bookmark not defined.
Dental Premium Enrollment Calendar Date ................................................................ Error! Bookmark not defined.
Dental Premium Finance Calendar Date ..................................................................... Error! Bookmark not defined.
Dental Premium Finance Code .................................................................................... Error! Bookmark not defined.
Dental Premium Insurer Calendar Date ....................................................................... Error! Bookmark not defined.
Dental Premium Insurer Code ..................................................................................... Error! Bookmark not defined.
Dental Premium Run Calendar Date ........................................................................... Error! Bookmark not defined.
Dental Premium Transaction Code .............................................................................. Error! Bookmark not defined.
Dental Program Code .................................................................................................. Error! Bookmark not defined.
Dental Segment Identifier ............................................................................................ Error! Bookmark not defined.
Dental System Indicator Code ..................................................................................... Error! Bookmark not defined.
Department of Veterans Affairs Patient Type Text ..................................................... Error! Bookmark not defined.
Dependent Continued Health Care Benefit Program Qualifying Plan Indicator Code Error! Bookmark not defined.
Dependent DEERS Beneficiary Identifier ................................................................... Error! Bookmark not defined.
Dependent DEERS Family Identifier .......................................................................... Error! Bookmark not defined.
Dependent Enrollment Category Code ........................................................................ Error! Bookmark not defined.
Dependent Person Birth Calendar Date ....................................................................... Error! Bookmark not defined.
Dependent Person First Name ..................................................................................... Error! Bookmark not defined.
Dependent Person Identifier ........................................................................................ Error! Bookmark not defined.
Dependent Person Identifier Type Code ...................................................................... Error! Bookmark not defined.
Dependent Person Last Name ...................................................................................... Error! Bookmark not defined.
Dependent Person Middle Name ................................................................................. Error! Bookmark not defined.
Dependent Person Sex Code ........................................................................................ Error! Bookmark not defined.
Direct Care Benefit Access/Update Code .................................................................... Error! Bookmark not defined.
Direct Care Benefit Segment Identifier ....................................................................... Error! Bookmark not defined.
Direct Care Benefit Type Begin Eligibility Calendar Date ......................................... Error! Bookmark not defined.
Direct Care Benefit Type Begin Eligibility Calendar Date Change Indicator Code .... Error! Bookmark not defined.
Direct Care Benefit Type Code ................................................................................... Error! Bookmark not defined.
Direct Care Benefit Type Code Change Indicator Code .............................................. Error! Bookmark not defined.
Direct Care Benefit Type End Eligibility Calendar Date ............................................ Error! Bookmark not defined.
Direct Care End Eligibility End Reason Code ............................................................. Error! Bookmark not defined.
Direct Care End Eligibility Source Code ..................................................................... Error! Bookmark not defined.
Direct Care Primary Care Manager Primary Care Manager Group Place of Care Segment IdentifierError! Bookmark not defined.
Disenrollment Letter Text............................................................................................ Error! Bookmark not defined.
Disenrollment Letter Text Code .................................................................................. Error! Bookmark not defined.
DMDC Identifier ......................................................................................................... Error! Bookmark not defined.
DMDC Support Office Hearing Impaired Information Text ....................................... Error! Bookmark not defined.
DMDC Support Office Involuntary Disenrollment Information Text ......................... Error! Bookmark not defined.
DNA Sample Indicator Code ....................................................................................... Error! Bookmark not defined.
Release Date: 25 October 2012 Page vii
DoD Electronic Data Interchange Person Cross-Reference Identifier ......................... Error! Bookmark not defined.
DoD Electronic Data Interchange Person Identifier .................................................... Error! Bookmark not defined.
DoD Electronic Data Interchange Person Identifier Change Effective Calendar Date Error! Bookmark not defined.
DoD Electronic Data Interchange Person Identifier Notification Calendar Date ........ Error! Bookmark not defined.
DoD Electronic Data Interchange Person Identifier Notification Calendar Date Change Indicator CodeError! Bookmark not defined.
Duplicate Identifier ...................................................................................................... Error! Bookmark not defined.
Electronic Data Interchange Classification Access/Update Code ............................... Error! Bookmark not defined.
Electronic Data Interchange Message Control Identifier ............................................. Error! Bookmark not defined.
Electronic Data Interchange Satellite Access/Update Code ........................................ Error! Bookmark not defined.
Electronic Data Interchange System Classification Code ............................................ Error! Bookmark not defined.
Electronic Data Interchange System Identifier ............................................................ Error! Bookmark not defined.
Eligibility and Enrollment Synchronization Rule List ................................................. Error! Bookmark not defined.
Eligibility Begin Calendar Date ................................................................................... Error! Bookmark not defined.
Eligibility Discrepancy Code ....................................................................................... Error! Bookmark not defined.
Eligibility Health Care Delivery Program Applied Code ............................................ Error! Bookmark not defined.
Eligibility Removal Begin Calendar Date ................................................................... Error! Bookmark not defined.
Eligibility Removal End Calendar Date ...................................................................... Error! Bookmark not defined.
Eligibility Required Plan Coverage Code .................................................................... Error! Bookmark not defined.
Eligible Health Care Delivery Program Begin Calendar Date..................................... Error! Bookmark not defined.
Eligible Health Care Delivery Program End Calendar Date ........................................ Error! Bookmark not defined.
Eligible Health Care Delivery Program Plan Coverage Code ..................................... Error! Bookmark not defined.
Eligible Health Care Delivery Program Plan Rule Code ............................................. Error! Bookmark not defined.
Email Address Text ..................................................................................................... Error! Bookmark not defined.
Email Address Text Change Indicator Code ............................................................... Error! Bookmark not defined.
Email Address Use Priority Code ................................................................................ Error! Bookmark not defined.
Emergency Care Contact Information Text ................................................................. Error! Bookmark not defined.
Emergency Contact Address City Name ..................................................................... Error! Bookmark not defined.
Emergency Contact Address Country Code ................................................................ Error! Bookmark not defined.
Emergency Contact Address Effective Calendar Date ................................................ Error! Bookmark not defined.
Emergency Contact Address Line 1 Text .................................................................... Error! Bookmark not defined.
Emergency Contact Address Line 2 Text .................................................................... Error! Bookmark not defined.
Emergency Contact Address US Postal Region State Code ........................................ Error! Bookmark not defined.
Emergency Contact Address US Postal Region ZIP Code .......................................... Error! Bookmark not defined.
Emergency Contact Address US Postal Region ZIP Extension Code ......................... Error! Bookmark not defined.
Emergency Contact Telephone Number Code ............................................................ Error! Bookmark not defined.
Enrolled Health Care Delivery Program Plan Coverage Code .................................... Error! Bookmark not defined.
Enrollee Category Code ............................................................................................... Error! Bookmark not defined.
Enrollment Card Category Text ................................................................................... Error! Bookmark not defined.
Enrollment Card Dental Claim Information Text ........................................................ Error! Bookmark not defined.
Enrollment Card Dental Information Text ................................................................... Error! Bookmark not defined.
Enrollment Card Dependent Policy Category Text ..................................................... Error! Bookmark not defined.
Enrollment Card DMIS Name ..................................................................................... Error! Bookmark not defined.
Enrollment Card Email Address Text .......................................................................... Error! Bookmark not defined.
Enrollment Card Health Care Plan Short Name .......................................................... Error! Bookmark not defined.
Enrollment Card Letter Type Code ............................................................................. Error! Bookmark not defined.
Enrollment Card Personnel Category Code ................................................................. Error! Bookmark not defined.
Enrollment Card Request Add Update Code ............................................................... Error! Bookmark not defined.
Enrollment Card Request Code ................................................................................... Error! Bookmark not defined.
Enrollment Card Request Contractor Code ................................................................. Error! Bookmark not defined.
Enrollment Card Request Date .................................................................................... Error! Bookmark not defined.
Enrollment Card Request Instance Identifier ............................................................... Error! Bookmark not defined.
Enrollment Card Request Segment Identifier .............................................................. Error! Bookmark not defined.
Enrollment Card Request Source Code ....................................................................... Error! Bookmark not defined.
Enrollment Card Request Type Code .......................................................................... Error! Bookmark not defined.
Enrollment Card Request Update Code ....................................................................... Error! Bookmark not defined.
Enrollment Card Sponsor Policy Category Text (Obsolete) ........................................ Error! Bookmark not defined.
Enrollment Card Status Code ...................................................................................... Error! Bookmark not defined.
Enrollment Card Status Date ....................................................................................... Error! Bookmark not defined.
Release Date: 25 October 2012 Page viii
Enrollment Card Status Error Code ............................................................................. Error! Bookmark not defined.
Enrollment Card Type Code ........................................................................................ Error! Bookmark not defined.
Enrollment Card Vendor Mailing Calendar Date ........................................................ Error! Bookmark not defined.
Enrollment Card Vendor Status Calendar Date ........................................................... Error! Bookmark not defined.
Enrollment Card Vendor Status Code ......................................................................... Error! Bookmark not defined.
Enrollment Card Vendor Status Error Code ................................................................ Error! Bookmark not defined.
Enrollment Fee Segment Quantity ............................................................................... Error! Bookmark not defined.
Enrollment Management Contractor Enrollment Begin Calendar Date ...................... Error! Bookmark not defined.
Enrollment Management Contractor Enrollment End Calendar Date ......................... Error! Bookmark not defined.
Enrollment Management Contractor Enrollment End Reason Code ........................... Error! Bookmark not defined.
Enrollment Management Contractor Enrollment End Reason Extension Code .......... Error! Bookmark not defined.
Enrollment Management Contractor Enrollment End Reason Text ............................ Error! Bookmark not defined.
Enrollment Management Contractor Enrollment Projected End Calendar Date ......... Error! Bookmark not defined.
Enrollment Management Contractor Enrollment Projected End Calendar Date Certainty CodeError! Bookmark not defined.
Enrollment Management Contractor Enrollment Residence Mailing Address US Postal Region ZIP CodeError! Bookmark not define Enrollment Management Contractor Enrollment Residence Mailing Address US Postal Region ZIP Extension
Code ......................................................................................................................... Error! Bookmark not defined.
Enrollment Management Contractor Enrollment Termination Calendar Date ............ Error! Bookmark not defined.
Enrollment Management Contractor Enrollment Termination Reason Code .............. Error! Bookmark not defined.
Enrollment Management Contractor Enrollment Termination Reason Extension CodeError! Bookmark not defined.
Enrollment Management Contractor Enrollment Work Mailing Address US Postal Region ZIP CodeError! Bookmark not defined.
Enrollment Management Contractor Health Care Delivery Program Enrollment Application Received Calendar
Date .......................................................................................................................... Error! Bookmark not defined.
Enrollment Management Contractor Lockout Period Code ........................................ Error! Bookmark not defined.
Enrollment Management Contractor Lockout Period Termination Reason Text ........ Error! Bookmark not defined.
Enrollment Medical Contractor Enrollment Termination Reason Code Extension TextError! Bookmark not defined.
Enrollment Military Treatment Facility Association Indicator Code .......................... Error! Bookmark not defined.
Enrollment Period Begin Quantity .............................................................................. Error! Bookmark not defined.
Enrollment Period Begin Quantity Code ..................................................................... Error! Bookmark not defined.
Enrollment Period End Quantity ................................................................................. Error! Bookmark not defined.
Enrollment Year Catastrophic Cap/Deductible Begin Date ........................................ Error! Bookmark not defined.
Enrollment Year Catastrophic Cap/Deductible End Date ............................................ Error! Bookmark not defined.
Entitlement Redetermination Code .............................................................................. Error! Bookmark not defined.
Entitlement Redetermination Effective Calendar Date ................................................ Error! Bookmark not defined.
Entitlement Redetermination Source Code .................................................................. Error! Bookmark not defined.
Episode of Care Code .................................................................................................. Error! Bookmark not defined.
Episode of Care Description Text ................................................................................ Error! Bookmark not defined.
Error Code ................................................................................................................... Error! Bookmark not defined.
Error Code Quantity .................................................................................................... Error! Bookmark not defined.
Ethnicity-National Origin Code ................................................................................... Error! Bookmark not defined.
Excluded Member Relationship Text .......................................................................... Error! Bookmark not defined.
Facility DMIS Code ..................................................................................................... Error! Bookmark not defined.
Facility Host Indicator Code ........................................................................................ Error! Bookmark not defined.
Facility Service Code ................................................................................................... Error! Bookmark not defined.
Faith Group Code ........................................................................................................ Error! Bookmark not defined.
Family Catastrophic Cap/Deductible Total Transaction Date ..................................... Error! Bookmark not defined.
Family Catastrophic Cap/Deductible Total Transaction Time .................................... Error! Bookmark not defined.
Family Enrollment Year Catastrophic Cap Contribution Amount .............................. Error! Bookmark not defined.
Family Enrollment Year Credit Access/Update Code ................................................. Error! Bookmark not defined.
Family Enrollment Year Credit Amount ..................................................................... Error! Bookmark not defined.
Family Enrollment Year Credit Instance Identifier ..................................................... Error! Bookmark not defined.
Family Enrollment Year Credit Segment Identifier ..................................................... Error! Bookmark not defined.
Family Enrollment Year Credit Transaction Date ....................................................... Error! Bookmark not defined.
Family Enrollment Year Credit Transaction Time ...................................................... Error! Bookmark not defined.
Family Enrollment Year Credit Update Code ............................................................. Error! Bookmark not defined.
Family Enrollment Year Deductible Contribution Amount ........................................ Error! Bookmark not defined.
Family Enrollment Year Point of Service Deductible Contribution Amount .............. Error! Bookmark not defined.
Family Fiscal Year Catastrophic Cap Contribution Amount ....................................... Error! Bookmark not defined.
Release Date: 25 October 2012 Page ix
Family Fiscal Year Catastrophic Cap Cumulative Amount ......................................... Error! Bookmark not defined.
Family Fiscal Year Deductible Contribution Amount ................................................. Error! Bookmark not defined.
Family Fiscal Year Deductible Cumulative Amount ................................................... Error! Bookmark not defined.
Family Fiscal Year Point of Service Deductible Contribution Amount ...................... Error! Bookmark not defined.
Family Fiscal Year Point of Service Deductible Cumulative Amount ........................ Error! Bookmark not defined.
Family Member Account Answer Status Code ........................................................... Error! Bookmark not defined.
Family Member Account Answer Text .....................................
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