13_Attachment_J-3_MDR_Data_Dictionary.xlsx
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Table of Contents The MDR Data Dictionary is organized using tabs that generally correspond to the data elements as named in the MDR. The tabs are arranged in the order their data is presented on the MDR, with an informational tab following those that pertain to a specific data type. Appendices' information is presented last, with the tabs in alphabetical order. To move to a specific tab, click on the tab name. Names in blue are for organizational purposes only and are not tabs.
| Detail Files | Reference Tables / Appendices |
| ADDP Claims | ACV Codes |
| ADDP Provider | AD Strength Accounting Codes |
| Address (Restricted) | AGR Code |
| Ancillary - Lab Rad | AHFS Therapeutic Class Codes |
| Appointment-Master | APC Grouper Codes |
| Appointment-Weekly | APC and RVU Conversion Factors |
| CAPER (Basic) | APG Grouper Codes |
| CAPER (Enhanced) | APPT Request Status Codes |
| Case Management | CAPER Change Codes |
| Casualty Death | Case Management Acuity levels |
| Casualty Death (Restricted) | CCS Category Codes (HCPCS) |
| CDR Appointments | CDR Appointment Types |
| CDR Chemistry | County Codes |
| CDR Historical Procedure | Country Codes |
| CDR Immunizations | CPT Codes Designated Facility |
| CDR Medications | CPT Modifiers |
| CDR Microbiology Results | Death Rank Codes |
| CDR Microbiology Susceptibility | DEERS Contractor Codes |
| CDR Patient | DEERS Country Codes |
| CDR Pathology | DEERS DoD Occupation Codes |
| CDR Pathology Lookup | DEERS HCDP Codes |
| CDR Radiology Results | DEERS Origination/ Verification Codes |
| CDR Vitals | DEERS PCM Specialty Codes |
| Completion Factors - SADR | DEERS Regions |
| Completion Factors - SIDR | Dental Insured Enrollment Management Contractor Enrollment End Reason Code |
| CPT Table | Dental Insurance HCDP Plan Coverage Code |
| Customer Satisfaction Survey (CSS) | Derived Medical Insured Enrollment Mgmt Contractor Enrollment End Reason Code |
| Dental Readiness File (DRF) | Designated Provider Codes |
| Designated Provider (Clinical) | Diagnosis Related Group Codes |
| Designated Provider (Pharmacy) | Medicare Severity DRGs (MS-DRGs) |
| Designated Provider (Provider) | Disposition Status |
| DMHRSi-HR | DMHRSi-Job ID |
| DMIS ID Index Table | DMHRSi-Org ID |
| DMIS ID - Normative Data | DMHRSi-PG ID |
| Encounter Death | DMIS ID Information |
| TRICARE Enrollment | DoD Extenders |
| Enrollment MEPRS Code File | Enrollment Status Codes |
| TRICARE Enrollment - Normative Data | Entitlement (Personnel) Condition Type Codes |
| Health Care Provider Record (HCPR) | Filing State Country Codes |
| HCSR Institutional | HCDP Codes |
| HCSR Non-Institutional FY00+ | HIPPS Codes |
| HCSR Non-Institutional pre FY00 | Hospital Department Number |
| Health Risk | Immunizations Manufacturers |
| ICD9 Diagnosis Codes | Injury Codes |
| ICD9 Procedure Codes | Institution Type |
| IIW OCO | LVM4 Values |
| Longitudinal Eligibility | LVM6 Values |
| Longitudinal Enrollment | Major Diagnostic Category Codes |
| Longitudinal VM4 (LVM4) | Member Category Codes |
| Longitudinal VM6 (LVM6) | MCFAS Pay Grades |
| Master Death | MEPRS Codes 2 |
| MEPRS | MEPRS Codes 3 |
| MEPRS - Ancillary | MEPRS Definitions |
| MEPRS-Duty Indicator | MEPRS DoD Occupation Codes |
| MEPRS-Expense Detail | Metropolitan Statistical Area (MSA) Codes |
| MEPRS-MEPRS3 Codes | Military Occupation Codes |
| MEPRS-MEPRS4 Descriptions | MTF Location Codes |
| MEPRS - Normative Data | NAS Exception Codes |
| MEPRS-Occ Codes | OPPS Payment Status Indicator |
| MEPRS-Personnel | Override Codes (TED/HCSR) |
| MEPRS-Personnel Category | Patient Category Codes |
| MEPRS-Skill Type | Pay Plan Codes |
| MEPRS-Workload Detail | Place of Service |
| MMSO Dental Care Claims | Product Form Codes |
| MMSO Dental Providers | Provider Specialty Codes for Direct Care |
| MPI (Master Person Index) | Provider Specialty Codes for Purchased Care |
| NPPES | Provider Specialty Codes, HIPAA Taxonomy |
| Omni CAD | Provider State Country Codes |
| Other Health Insurance Table (OHI ) | Provider State Country Code Map |
| PITE Aggregate | Rank Codes |
| PITE Beneficiary Level | RSVCC's |
| PDTS | Service Branch |
| PDTS Summary | Source Health Care Data |
| PEP | Special Operations codes |
| Referral | Special Processing Codes |
| Referral to Crosswalk | Special Rate Codes |
| Reservist | State & Country Codes - DC |
| Risk Adjustment | State & Country Codes - PC |
| SADR | Voucher Branch of Service Codes |
| SIDR | |
| Special Operations Code (DEERS) | |
| Standard Insurance Table (SIT) | |
| TDP Claims | |
| TDP Provider | |
| TED-I Header | |
| TED-I Revenue | |
| TED-NI | |
| TEDPR | |
| VM4BEN (DEERS Beneficiary Level) | |
| VM4 - TRICARE Enrollment | |
| VM4 - TRICARE Longitudinal Enrollment | |
| VM4AGG (DEERS VM4 Aggregate) | |
| VM6 - PAGG (PITE Aggregate) | |
| VM6BEN (VM6 Beneficiary Level) | |
| VM6 - ENR (TRICARE Enrollment) | |
| VM6 - LENR (TRICARE Longitudinal Enrollment) | |
| WWR |
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Summary of Changes
| The April 2014 edition of the MDR Data Dictionary reflects modifications made since the March 2014 version. | |
| MDR Blasters can be access at: | http://tricare.mil/tma/dhcape/data/fs.aspx |
Summary of Changes
| Tab | Additions/Modifications |
| Ancillary - Lab Rad | Notes: Inpatient Record ID |
| DMIS ID Information | Monthly Update |
| NPPES | New Data Element: MTF Match Flag & EDI_PN |
| PITE Beneficiary Level | Notes: DoD Occupation Code |
| VM6BEN | New Object: High Cost User Flag, Added Dental Readiness Classification |
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Return to the Table of Contents #'Table%20of%20Contents'!A1http://tricare.mil/tma/dhcape/data/fs.aspx Address (PITE)
| PITE/Appointment Address File | |||||
| Common File Name: address.sas7bdat | |||||
| Dataset Location: /mdr/restricted/addr/dYYMMDD/ | |||||
| Update Frequency: Updated monthly | Source System: CHCS and VM4 | ||||
| Description: File contains beneficary address and telephone information. | |||||
| Data Element | Definition | Format | Position or SAS Variable | Values | Notes |
| CHCS MAILING ADDRESS LINE 1 | Beneficiary's Mailing Address, Line 1, from CHCS | Char 40 | C_ADDR1 | Set to blank if no CHCS record for this EDI_PN; otherwise, filled with value of field in column "address file reference". | |
| CHCS MAILING ADDRESS LINE 2 | Beneficary's Mailing Address, Line 2, from CHCS | Char 40 | C_ADDR2 | Set to blank if no CHCS record for this EDI_PN; otherwise, filled with value of field in column "address file reference". | |
| CHCS MAILING ADDRESS LINE 3 | Beneficary's Mailing Address, Line 3, from CHCS | Char 40 | C_ADDR3 | Set to blank if no CHCS record for this EDI_PN; otherwise, filled with value of field in column "address file reference". | |
| CHCS CITY | Beneficary's City, from CHCS | Char 20 | C_CITY | Set to blank if no CHCS record for this EDI_PN; otherwise, filled with value of field in column "address file reference". | |
| CHCS HOME TELEPHONE NUMBER | Beneficiary's Home Telephone Number, from CHCS | Char 14 | C_HMFON | Set to blank if no CHCS record for this EDI_PN; otherwise, filled with value of field in column "address file reference". | |
| CHCS FIRST NAME | Beneficary's First Name from CHCS | Char 20 | C_NAME1 | Set to blank if no CHCS record for this EDI_PN; otherwise, filled with value of field in column "address file reference". | |
| CHCS LAST NAME | Beneficary's First Name from CHCS | Char 26 | C_NAME2 | Set to blank if no CHCS record for this EDI_PN; otherwise, filled with value of field in column "address file reference". | |
| CHCS STATE | Beneficiary's State, from CHCS | Char 2 | C_STATE | Set to blank if no CHCS record for this EDI_PN; otherwise, filled with value of field in column "address file reference". | |
| CHCS LAST UPDATE DATE | CHCS Last Update Date | Num 8 | C_UPDT | Set to blank if no CHCS record for this EDI_PN; otherwise, filled with value of field in column "address file reference". | |
| CHCS ZIP CODE | Beneficiary's Zip Code, from CHCS | Char 5 | C_ZIP | Set to blank if no CHCS record for this EDI_PN; otherwise, filled with value of field in column "address file reference". | |
| DEERS MAILING ADDRESS LINE 1 | Beneficiary's Mailing Address, Line 1, from VM4 file | Char 40 | D_ADDR1 | Set to blank if no VM4 record for this EDI_PN; otherwise, filled with value of field in column "address file reference". | |
| DEERS MAILING ADDRESS LINE 2 | Beneficiary's Mailing Address, Line 2, from VM4 file | Char 40 | D_ADDR2 | Set to blank if no VM4 record for this EDI_PN; otherwise, filled with value of field in column "address file reference". | |
| DEERS CADENCY | Beneficiary's Cadency, from VM4 file | Char 4 | D_CADNCY | Set to blank if no VM4 record for this EDI_PN; otherwise, filled with value of field in column "address file reference". | |
| DEERS CITY | Beneficiary's City, from VM4 file | Char 20 | D_CITY | Set to blank if no VM4 record for this EDI_PN; otherwise, filled with value of field in column "address file reference". | |
| DEERS COUNTRY | Beneficiary's Country, from VM4 file | Char 2 | D_CNTRY | Set to blank if no VM4 record for this EDI_PN; otherwise, filled with value of field in column "address file reference". | |
| DEERS HOME TELEPHONE NUMBER | Beneficiary's Home Telephone Number, from VM4 file | Char 20 | D_HMFON | Set to blank if no VM4 record for this EDI_PN; otherwise, filled with value of field in column "address file reference". | |
| DEERS FIRST NAME | Beneficiary's First Name, from VM4 file | Char 20 | D_NAME1 | Set to blank if no VM4 record for this EDI_PN; otherwise, filled with value of field in column "address file reference". | |
| DEERS LAST NAME | Beneficiary's Last Name, from VM4 file | Char 26 | D_NAME2 | Set to blank if no VM4 record for this EDI_PN; otherwise, filled with value of field in column "address file reference". | |
| DEERS STATE | Beneficiary's State, from VM4 file | Char 2 | D_STATE | Set to blank if no VM4 record for this EDI_PN; otherwise, filled with value of field in column "address file reference". | |
| DEERS LAST UPDATE DATE | DEERs Last Update Date | Num 8 | D_UPDT | Set to blank if no VM4 record for this EDI_PN; otherwise, filled with value of field in column "address file reference". | |
| DEERS WORK TELEPHONE NUMBER | Beneficiary's Work Telephone Number, from VM4 file | Char 20 | D_WKFON | Set to blank if no VM4 record for this EDI_PN; otherwise, filled with value of field in column "address file reference". | |
| DEERS ZIP CODE | Beneficiary's Zip Code, from VM4 file | Char 5 | D_ZIP | Set to blank if no VM4 record for this EDI_PN; otherwise, filled with value of field in column "address file reference". | |
| DEERS ZIP CODE EXTENDER | Beneficiary's Zip Code Extender, from VM4 file | Char 4 | D_ZIPX | Set to blank if no VM4 record for this EDI_PN; otherwise, filled with value of field in column "address file reference". | |
| UNIQUE PERSON ID | Unique Person Id | Char 10 | EDI_PN | No transformation. File key. |
January 2005 Version &A Page &P of &N
ADDP Claims
| Active Duty Dental Plan (ADDP) DENTAL CARE CLAIMS | |||||
| Common File Name: fy**.sas7bdat | |||||
| Dataset Location: /mdr/pub/dental/addp/claims/fy** | |||||
| Update Frequency: Updated monthly | Source System: ADDP contractor | ||||
| Description: Active duty dental claims | |||||
| Data Element | Definition | Format | Position or SAS Variable | Values | Notes |
| DEERS Alternative Care Value | Indicates patients medical enrollment status on the date of service. | $1 | acv | A, B, D, E, F, G, H, J, L, M, Q, R, U, V, Null | A=Active Duty Prime |
B=TRICARE Global Remote Overseas Prime Active Duty D=TRICARE Senior Prime E=Non-Active Duty Prime F=TRICARE Global Remote Overseas Prime Active Duty Family Member G=TRICARE Plus, (Includes Private Sector Coverage, TFL) H=TRICARE Overseas Prime Active Duty J=TRICARE Overseas Prime Active Duty Family Member L=TRICARE Plus, DC Entitlement Only (No Private Sector Coverage, No TFL) M=AD not reported enrolled (added FY05) Q=AD enrolled to Op Forces R=TRICARE Reserve Select
U=USTF/USFHP
V=TRICARE Retired Reserve Null = Not Enrolled Adjustment Code Indicates the adjustment made to claim. Only populated on claims that have been adjusted. $1 adjcode A, B, C, D, E, F, G, H, I, J, or Null A = Additional payment B = History change C = Refund reprocess D = Cancel refund E = Transfer funds F = Utilization transfer/original (intraplan) G = Utilization transfer/secondary (intraplan) H = Administration I = Refund J = Product line transfer (interface claim) Null = Not adjusted
| Adjustment Reason | Code identifying the reason for non-payment of services or adjustment of the detail line item. | $2 | adjkey | ||
| Age Group | The patient's age group. | $1 | agegrp | A, B, C, D, E, F, G, H or 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 = All others
| Allowed Amount | The amount allowed under the plan for the specified services. | 9.2 | allow | ||
| Anterior/Posterior Flag | Indicates anterior/posterior location. | $1 | ap_id | A or P | A = Anterior |
P = Posterior
| Amount Paid | The approved amount that the plan would pay towards the dental services. | 9.2 | approved | ||
| Authorization Number | Number of authorization for services. | $16 | authnum | ||
| Date of Service | The date that dental services were first provided for this claim. | YYYYMMDD | begdate | ||
| DEERS Beneficiary Category | Beneficiary Category on date of service, from match to DEERS data. Records with an "UNK" value were generally not found in DEERS on the date of service. | $3 | bencat | ACT, GRD or IGR | ACT = Active Duty |
DA = Dependent of Active Duty DCO = Direct Care Only DR = Dependent of Retired DS = Dependent of Survivor GRD = Guard/Reserve IDG = Dependent of Inactive Guard IGR = Inactive Guard/Reserve
NAT = NATO
OTH = Other RET = Retired Z = Unknown
| Billed Charge | The amount charged by the provider for services. | 9.2 | bill | ||
| Buccal Surface Indicator | Indicates buccal surface. | $1 | buc_ind | N or Y | N = No |
Y = Yes
| Residence Catchment Area Id | Patient's catchment area ID. Indicates which inpatient MTF the patient lives near, if any. | $4 | catch | See DMIS Information for list of DMIS ID. | |
| CDT Code | Current Dental Terminology (CDT) procedure code for the service. | $5 | cdt | ||
| CDT Version # | The CDT version that was used to determine the procedure code. | $2 | cdtvers | ||
| Change Date (MDR) | Set to the most recent date that any data element on the MDR record was changed. For records that never change, this will be equal to the initial processing date. | yyyymmdd | chgdate | ||
| Claim Number | The unique number for the claim. | $13 | claimid | ||
| Claim Finalized Date | The date that the claim was adjudicated and payment decisions made. | YYYYMMDD | clmfindt | ||
| Claim Paid Date | The date that the claim was paid. | YYYYMMDD | clmpddt | ||
| Claim Receipt Date | The date that the claim was received for payment. | YYYYMMDD | clmrecdt | ||
| CM | Calendar month of service date | $2 | cm | 01, 02, 03, 04, 05, 06, 07, 08, 09, 10, 11 or 12 | |
| Ben Cat Common | Common Beneficiary Category on date of service. Based on beneficiary category. | $1 | comben | 1 - 4 | 1 = Dependents of Active Duty or Guard/Reserve on Active Duty |
2 = Retired 3 = All Others 4 = Active Duty and Guard/Reserve on Active Duty
| CY | Calendar year of service date | $4 | cy | ex: 2009 | |
| Derived DTF Referral Indicator | Derived field based on the dental treatment facility code that is found on the claim. If coded then the DTF Referral Indicator is defined as "Y", if not coded the indicator is defined as "N". | $1 | d_dtfref | N or Y | N = No |
Y = Yes (DTF Referral)
| DEERS Zip Code | Patient's zip code on date of service, from match to DEERS data. | $5 | deerszip | ||
| DEERS Enrollment DMIS Id | DMIS id of the facility where the patient is enrolled to on date of service, from match to DEERS data. | $4 | denrsite | See DMIS Information for list of DMIS ID. | |
| Dental Readiness Classification | Code indicating the provider's assessment of the member's dental readiness. | $1 | dentalclass | 1, 2 or 3 | 1 = No dental treatment needed |
2 = Minor dental treatment needed 3 = Urgent or emergent dental care required Dental HCDP Flag IF the HCDP code is coded as dental, the patient is eligible (Y) if not the patient is not eligible (N). $1 dhcdp_fl Y or N Y = eligible N = not eligible Distal Surface Indicator Indicates distal surface. $1 dis_ind N or Y N = No Y = Yes
| Dental Treatment Facility Code | A code representing the referring Dental Treatment Facility | $4 | dtf_dmisid | See DMIS Information for list of DMIS ID. | |
| DEERS Sponsor Service | Patient's sponsor service on date of service, from match to DEERS data. | $1 | dsponsvc | ||
| DEERS Sponsor Service Aggregate | Patient's sponsor service aggregate on date of service, from match to DEERS data. | $1 | dsvcagg | ||
| DTF Area | Code found on the claim indicating whether the care was provided in a DTF Service Area or if the claim is considered remote. | $1 | dtf_area | D or R | D = DTF area |
R = Remote
| DEERS Person ID - Derived | Unique person identifier. This data element is a vast improvement over the raw DEERS Person ID, which is frequently blank. | $10 | edipn | ||
| End Date of Care | The last date that dental services were provided for this claim. | YYYYMMDD | enddate | ||
| DEERS Ethnicity Code | Patient's ethnicity code on date of service, from match to DEERS data. | $1 | ethnic | 1-9, D, E, G, H, J, K, L, Q, S, V, W, X, Y, Z | 1 = Other Hispanic |
2 = US or Canadian Indian Tribe 3 = Other Asian 4 = Puerto Rican 5 = Filipino 6 = Mexican 7 = Eskimo 8 = Aleut 9 = Cuban D = Indian E = Melanesian G = Chinese H = Guamanian J = Japanese K = Korean L = Polynesian Q = Pacific Islander NEC S = Latin America w/ Hispanic descent V = Vietnamese W = Micronesian X = Other Y = None Z = Unknown
| Extract Date | The date the data was processed. | $7 | extr_dt | dyymmdd | |
| Facial Surface Indicator | Indicates facial surface. | $1 | fac_ind | N or Y | N = No |
Y = Yes
| Facility Practice Expense RVU | Facility practice expense RVU. | 7.2 | facpervu | ||
| FM | Fiscal Month of service date. | $2 | fm | 01, 02, 03, 04, 05, 06, 07, 08, 09, 10, 11 or 12 | 01 = October |
02 = November etc.
12 = September
| FY | Fiscal Year of service date. | $4 | fy | ex: 2009 | |
| DEERS Health Care Delivery Program Code | Code that indicates the medical enrollment plan the patient has. | $3 | hcdp | See HCDP codes. | |
| Performing Provider HIPAA Taxonomy | Indicates the provider specialty. | $10 | hipaaspec | ||
| Incisal Surface Indicator | Indicates incisal surface. | $1 | inc_ind | N or Y | N = No |
Y = Yes
| Date of last exam. | Date of last exam. | YYYYMMDD | lastexam | 00000000 | Currently not coded. |
| Claim Line Item Number | The line number of a particular service on the bill. | $4 | linenum | ||
| Line Item Rejection Reason Code | The reason for the rejection of the line-item within the claim. | $5 | linerej | ||
| Lingual Surface Indicator | Indicates lingual surface. | $1 | ling_ind | N or Y | N = No |
Y = Yes DEERS Medicare Flag Indicates patients Medicare status. $1 medflag A, B, C or N A = Medicare A Only B = Medicare B Only C = Medicare A and B Z = No Medicare Mesial Surface Indicator Indicates mesial surface. $1 mes_ind N or Y N = No Y = Yes
| Patient MTF Service Area | Indicates which MTF the patients lives near. | $4 | mtfsvcarea | See DMIS Information for list of DMIS ID. | |
| Provider Network Status | Indicates whether or not the provider is a network or non-network provider. | $1 | network | 1, 2 or 3 | 1 = Network provider |
2 = Non-network provider 3 = Not Eligible New Record Flag New Record Flag $1 new_rec 1 or 0 1 = this version of the record was received in most recent processing cycle 0 = Otherwise
| Non-Facility Practice Expense RVU | Non-Facility Practice Expense RVU. | 7.2 | nfpervu | ||
| National Provider ID (Ind) | National Provider ID (NPI) number of the individual provider rendering dental services. | $14 | npi | ||
| National Provider ID (Group) | National Provider ID (NPI) number of the provider's group rendering dental services. | $14 | npigroup | ||
| Occlusial Surface Indicator | Indicates occlusal surface. | $1 | occl_ind | N or Y | N = No |
Y = Yes
| Other Carrier Payment | Payments made by Other Health Insurance (OHI) towards the Provider Charges. | 9.2 | ohi | ||
| Oral Health Initiative Flag | A code indicating if this service is part of an Oral Health Initiative. | $1 | oral_ind | N or Y | N = No |
Y = Yes Person Association Reason Code Code identifying the person association reason code, based on master person index merge. $2 parc 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 parents AX = Emergency Contact BB = Ward, BC = Former Spouse BD = Self 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
| Age | Patient's age. | 3. | patage | ||
| Date Of Birth | Service member’s birth date. | yyyymmdd | patdob | ||
| First Name | First name of Active Duty Service Member. | $25 | patfname | ||
| Last Name | Last name of Active Duty Service Member. | $35 | patlname | ||
| Middle Name | Middle name of Active Duty Service Member. | $25 | patmname | ||
| Sex | Service member’s gender. | $1 | patsex | F, M or X | F = Female |
M = Male X = Unknown
| DEERS PCM Id | PCM ID on date of service, from match to DEERS data. | $32 | pcmid | ||
| Provider MTF Service Area | Provider's MTF service area. | $4 | pmtfsvcarea | See DMIS Information for list of DMIS ID. | |
| Prior Placement Date | The date of prior placement. | YYYYMMDD | prepldt | ||
| Residence Prism Area Id | Indicates which medical clinic a patient lives near. | $4 | prism | See DMIS Information for list of DMIS ID. | |
| DEERS Medical Privilege Code | Patient's medical privilege code on date of service, from match to DEERS data. | $1 | privcode | 0, 1, 2, 3, 4, 5, 6, 7, 8, A, B, C, M, U | 0 = Not Eligible for MHS benefits |
1 = Direct Care Only 2 = Direct Care and MHS Purchased Care 3 = Not Eligible, some dependents eligible 4 = Transitional Direct Care Only 5 = Transitional Direct Care and MHS Purchased Care 6 = Transitional Direct Care and Medicare A Only 7 = Direct Care and Medicare A Only 8 = Other A = Direct Care, MHS Purchased Care, Medicare A B = Transitional Direct Care, MHS Purchased Care, Medicare A C = CHAMPUS Only M = TRICARE for Life only U = USFHP/USTF Enrollee Z = unknown
| Initial Processing Date | Initial Processing Date (MDR). | yyyymmdd | procdate | |
| Performing Provider | A unique number assigned to an individual or organization which performs health care services. | $9 | provid | |
| Performing Provider Specialty Code | Code describing the provider’s specialty. | $3 | provspec | 020 = Anesthesia |
025 = General Dentistry 029 = Multi-Specialty Group 032 = Oral Surgery 033 = Endodontics 034 = Orthodontics 036 = Pediatric Dentistry 037 = Periodontics 038 = Prosthodontics 055 = Emergency Medicine 079 = Certified Registered Nurse Anesthetist 083 = DME Supplier 084 = Multi-Specialty 110 = Dental Hygienist
| Provider Suffix | The Professional Degree which a doctor receives upon graduation from a college or university (ex: DDS, DMD). | $3 | provsuff | ||
| Performing Provider Zip Code | The business address Zip code of the provider. | $5 | provzip | ||
| Provider Catchment Area Id | Provider's catchment area id. | $4 | pvcatch | See DMIS Information for list of DMIS ID. | |
| Provider Prism Area Id | Provider's prism area id. | $4 | pvprism | See DMIS Information for list of DMIS ID. | |
| Provider TNEX Region | Provider's TNEX region. | $1 | pvtnex | A, N, O, S and W | A = Alaska |
N = North
O = OCONUS
S = South W = West Quadrant Identifies the quadrant of dental care. $2 quadrant LL, LR, UL or UR LL = lower left LR = lower right UL = upper left UR = upper right DEERS Race Code Patient's race code on date of service, from match to DEERS data. $1 race C, M, N, R, X, Z C = White M = Asian or Pacific Islander N = Blank R = American Indian or Alaskan Native X = Other Z = Unknown ADDP Service Area Flag defining if the beneficiary is eligible for the Remote Active Duty Dental Program. This derived field is based on the patient's DEERS zip code matched to the service area file. $4 raddpfl 1 or 0 1 = Eligible 0 = Not Eligible
| Person Identifier - Raw | Unique Patient Id, EDIPN | $10 | redi_pn | ||
| Referral Number | A unique referral number associated with the claim. | $16 | refnum | ||
| Claim Rejection Reason Code | The reason for the rejection of the claim. | $5 | rejrea | ||
| DEERS Relationship to Sponsor | Patient's relationship to sponsor on date of service, from match to DEERS data. | $1 | relcode | 1,2,3,4 | 1 = Child |
2 = Self 3 = Spouse or Former Spouse 4 = Other Z = Unknown Replacement Reason The replacement code representing the reason a specific crown, prosthesis, inlay or onlay is to be replaced. $1 replrea 1-4 1 = Lost 2 = Broken 3 = Accident 4 = No longer serviceable Reservist Status Reservist Status $1 res_stat 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 Residence Region Patient's residence region. $2 resreg 01-16, AK, 00, UK, XX or Blank 01 = Northeast 02 = Mid-Atlantic 03 = Southeast 04 = Gulf South 05 = Heartland 06 = Southwest 07, 08 = TRICARE Central 09 = Southern California 10 = Golden Gate 11 = Northwest 12 = TRICARE Pacific 13 = Europe 14 = Western Pacific/Asia 15 = Central/South America & Other OCONUS 16 = Unknown AK = Alaska XX or Blank = Unknown TNEX Region Patient's TNEX region. $1 restnex A, N, O, S and W A = Alaska N = North
O = OCONUS
S = South W = West
| Sponsor SSN - Raw | Social Security Number (SSN) of Active Duty Service Member as it appears on the claim. A derived version of this element is also available, should the feed data be blank. | $9 | rsponssn | ||
| Work RVU | Work RVU | 7.2 | rvu | ||
| Benefit Category | Identifies the general benefit category of the service provided. | $5 | servcat | A SURG, ANES, CIO, CONSUL, D DIAG, D GENL, D ORAL, D PREV, D PROS, M ORAL, M REST, ORTHO, PERIO, or SURG | A SURG = Assistant surgery |
ANES = Anesthesia CIO = Crowns, Inlays, and Onlays CONSUL = Consultation D DIAG = Dental Diagnostic D GENL = Dental General Services D ORAL = Dental Oral Surgery D PREV = Dental Preventive D PROS = Dental Prosthetic M ORAL = Medical/Surgical Oral Surgery M REST = Minor Restorative ORTHO = Orthodontic PERIO = Periodontic SURG = Surgery Special Operations Code Indicates the contingency operation for which a Guard or Reserve member is activated or receiving TAMP benefits through at the time of care. Populated on both sponsor and family member records. This data element does not indicate that the guard or reserve member went to theater, rather, that the orders that activated the member indicated a contingency operation. Use with Reservist Status Code to indicate the status of the Guard/Reserve member.
$2 soc 08, 09, 10 00 = Not Applicable 01 = Operation Desert Storm 02 = Los Angeles Riots 03 = Haiti 04 = Somalia 05 = Bosnia 06 = Kosovo 07 = Southern Watch 08 = Noble Eagle 09 = Enduring Freedom 10 = Iraqi Freedom 98 = Not a special operation 99 = Other (Take caution with these values. It is often evident that Iraqi Freedom records are miscoded as 08 or 09.)
| Sponsor SSN - Derived | Code identifying the sponsor SSN, based on master person index merge if SSN is missing in the source data. | $9 | sponssn | ||
| Branch of Service | A code that represents the branch of service with which the Active Duty Service Member is affiliated. | $1 | svc | A, C, F, H, M, N, O or Z | A = Army |
C = Coast Guard F = Air Force H = Commissioned Corps of the Public Health Service M = Marine Corps N = Navy O = Commissioned Corps of the National Oceanographic and Atmospheric Administration (NOAA) Z= Afloat
| Provider Tax ID | The Taxpayer Identification Number (TIN) of the provider. | $9 | taxid | ||
| Tooth Number | The tooth entered on the pricing grid on the Claim Adjudication screen. | $2 | tooth | ||
| Third Party Liability | The amount paid by Third Party Liability (TPL) plan carriers towards the Provider Charges. | 9.2 | tpliab | ||
| MMSO Residual Claims Indicator | Indicates that this is a residual claim. | $1 | MMSO_ind | N or Y | N = No |
Y = Yes Blank = Unknown
Note: This data element was added in March 2010 and was not coded prior.
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Return to the Table of Contents #'Table%20of%20Contents'!A1 ADDP Provider
| Active Duty Dental Plan (ADDP) Provider File | |||||
| Common File Name: providers.sas7bdat | |||||
| Dataset Location: /mdr/pub/dental/addp/provider | |||||
| Update Frequency: Updated monthly | Source System: ADDP contractor | ||||
| Description: Active duty dental providers | |||||
| Data Element | Definition | Format | Position or SAS Variable | Values | Notes |
| Delete Month | Last month of feed data that the provider ID was present in. | YYYYMM | del_mnth | ||
| Provider Taxonomy | A HIPAA unique alphanumeric code structured into three distinct levels including provider type, classification, and area of specialization. | $10 | hipaaprv | ||
| Provider Network Status | Indicates whether or not the provider is a network or non-network provider (at the date of service). | $1 | network | ||
| NPI Individual | National Provider ID (NPI) number of the provider. | $14 | npi | ||
| NPI Group | National Provider ID (NPI) number of the provider. | $14 | npigroup | ||
| Processing Date | Date this record was added to the MDR dataset initially. | $8 | procdate | Fill with the date this record was initially added to the MDR dataset. | |
| Provider Street Address Line 1 | Provider’s business street address line 1. | $36 | provadd1 | ||
| Provider Street Address Line 2 | Provider’s business street address line 2. | $36 | provadd2 | ||
| Country Code | Provider’s business country code. | $3 | provctry | ||
| Provider Group Name | The text name of the dental group (if service was performed by a provider who is part of a group). | $53 | provgrpname | ||
| Provider ID | A unique number assigned to an individual or organization which performs health care services. | $9 | provid | ||
| Individual Provider Name | The text name of the individual provider. | $53 | provname | ||
| Provider Specialty | Code describing the provider’s specialty. | $3 | provspec | ||
| Provider SSN | Social Security Number (SSN) of the dental provider. | $9 | provssn | ||
| State | Provider’s business state code. | $2 | provst | ||
| Provider Zip Code | Provider Zip Code. | $9 | provzip | ||
| Provider Tax ID | The Taxpayer Identification Number (TIN) of the provider. | $9 | taxid | ||
| Provider Termination Flag | Derived Provider Termination Flag | $1 | term_flg | T or Blank | T = provider is terminated during file update process |
Blank = otherwise
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Return to the Table of Contents #'Table%20of%20Contents'!A1 Address (Resticted)
| ADDRESS FILE (Restricted) | |||||
| Common File Name: /mdr/restricted/addr/dyymmdd/ | |||||
| Dataset Location: address.sas7bdat | |||||
| Update Frequency: Updated monthly | Source System: DEERS, CHCS | ||||
| Description: Beneficiary addresses, as recorded in DEERS or CHCS | |||||
| Data Element | Definition | Format | Position or SAS Variable | Values | Notes |
| DEERS EDI_PN | DEERS Person ID of beneficiary | $10 | edi_pn | ||
| Patient SSN | Social Security Number of Beneficiary | $9 | patssn | ||
| DEERS First Name | First name of beneficiary | $20 | d_name1 | ||
| DEERS Last Name | Last name of beneficiary | $27 | d_name2 | ||
| DEERS Cadency | Cadency of beneficiary | $4 | d_cadncy | ||
| DEERS Mailing Address, Line 1 | 1st line of DEERS Mailing Address | $40 | d_addr1 | ||
| DEERS Mailing Address, Line 2 | 2nd line of DEERS Mailing Address | $40 | d_addr2 | ||
| DEERS City | DEERS City | $20 | d_city | ||
| DEERS Country | DEERS Country | $2 | d_cntry | ||
| DEERS State | DEERS State | $2 | d_state | ||
| DEERS Zip Code | DEERS ZIP Code | $5 | d_zip | ||
| DEERS Zip + 4 | DEERS ZIP Code Extension | $4 | d_zip4 | ||
| DEERS Work Telephone Number | DEERS Work Telephone Number | $20 | d_wkfon | ||
| DEERS Home Telephone Number | DEERS Home Telephone Number | $20 | d_hmfon | ||
| DEERS Last Update Date | DEERS Last Update Date | SAS Date | d_updt | ||
| CHCS First Name | CHCS First Name | $20 | c_name1 | ||
| CHCS Last Name | CHCS Last Name | $26 | c_name2 | ||
| CHCS Mailing Address, Line 1 | 1st line of CHCS Mailing Address | $40 | c_addr1 | ||
| CHCS Mailing Address, Line 2 | 2nd line of CHCS Mailing Address | $40 | c_addr2 | ||
| CHCS Mailing Address, Line 2 | CHCS City | $40 | c_addr3 | ||
| CHCS City | CHCS Country | $20 | c_city | ||
| CHCS State | CHCS State | $2 | c_state | ||
| CHCS Zip Code | CHCS ZIP Code | $5 | c_zip | ||
| CHCS Home Telephone Number | CHCS Home Telephone Number | $14 | c_hmfon | ||
| CHCS Last Update Date | CHCS Last Update Date | SAS Date | c_updt |
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Return to the Table of Contents #'Table%20of%20Contents'!A1 Ancillary - Lab Rad
| Lab-Rad Ancillary Files | |
| Common File Name: fyXX, where XX=05+ | |
| Dataset Location: /mdr/pub/ancillary/fyXX/ancillary.fyXX, where XX=05+ | |
| Update Frequency: Updated monthly | Source System: CHCS |
Only ordering MEPRS code beginning with B, C, D, and FC
| Description: Ancillary laboratory and radiology files | ||||||
| Data Element | Definition | Format | Position or SAS Variable | Values | Notes | |
| Accession/Exam Number | For LAB: Number assigned by CHCS when a specimen is logged into the LAB system. | |||||
| For RAD: Number assigned by CHCS when a radiology exam is ordered. | $17 | accessno | Accession Number | |||
| ACV | Indicates the enrollment status of the beneficiary. | |||||
| Appended using the Longitudinal VM4. | $1 | acv | A, B, D, E, F, G, H, J, L, M, Q, R, U, V, Null | A=Active Duty Prime |
B=TRICARE Global Remote Overseas Prime Active Duty D=TRICARE Senior Prime E=TRICARE Prime (non-Active Duty) F=TRICARE Global Remote Overseas Prime Active Duty Family Member G=TRICARE Plus, (Includes Private Sector Coverage, TFL) H=TRICARE Overseas Prime Active Duty J=TRICARE Overseas Prime Active Duty Family Member L=TRICARE Plus, DC Entitlement Only (No Private Sector Coverage, No TFL) M=AD not reported enrolled (added FY05) Q=AD enrolled to Op Forces R=TRICARE Reserve Select U=USTF Enrolled V=TRICARE Retired Reserve Null = Not Enrolled
| ACV derived | Indicates the enrollment status of the beneficiary. | ||
| Equal to ACV if not missing, else ACV of record. | $1 | acv1 | A, B, C, D, E, |
F, G, H, J, I, L,
| M,N, Q, R, S, U, V, W, Z | See above. | |||||
| ACV of record | Indicates the enrollment status of the beneficiary. Derived from HCDPR that came on record. | $1 | acv2 | A, B, C, D, E, F, G, H, I, J, K, L, N, P, R, S, U, W, Z | HCDPCODE to ACV2 mapping: |
A = 106, 128 B = 155 C = 003, 005, 007, 009, 010, 012, 015, 017, 018, 020, 021, 022, 023 D = 120 E = 107, 108, 110, 111, 112, 113, 116, 117, 129, 130, 131, 132, 134, 135, 136, 137 F = 156, 157 G = 140, 142, 144, 146, 147, 149 H = 103, 152 I = 123, 124, 125, 126 J = 104, 153, 154 K = 105 L = 141, 143, 145, 148, 150, 151 N = 001, 002, 004, 006, 008, 011, 013, 014, 016, 019, 024 P = 101 S = 121, 122 U = 109, 114, 115, 118, 119, 133, 138, 139 W = 127 R = 401, 402 Z = All others
| Appointment record ID | The appointment identifier number. | $20 | apptno | |
| Beneficiary Category | Category of beneficiary. | |||
| Appended using longitudinal derivation of VM4. | $3 | bencat | ACT, DA, DCO, DR, DGR, DS, GRD, IGR, IDG, NAT, OTH, RET, UNK | ACT=Active Duty |
DA=Dependents of Active Duty DGR=Dependent of Guard/Reserve on Active Duty DR=Dependents of Retiree DS=Dependent Survivor GRD=Guard/Reserve on Active Duty IDG=Dependent of Inactive Guard/Reserve IGR=Inactive Guard/Reserve OTH=Other RET=Retirees UNK = Unknown DCO = Direct Care Only
NAT = NATO
| BPA Catchment Area ID | BPA Catchment Area ID. | $4 | bpacatch | BPA Catchment Area of patient residence based on patient zip and sponsor service and the OmniCad matching the service date. | |
| Catchment Area ID | The catchment area surrounding an MTF or noncatchment area based on beneficiary zip code, sponsor service, FY and FM. | $4 | catch | e.g., 0039 | Derived from merge with Omni-CAD and based on bene zip, sponsor service, fy, and fm corresponding to Service Date. |
| Host Platform DMIS ID | DMIS ID of the CHCS Host platform sending the data. | $4 | chcsdmis | e.g., 0039 | |
| Beneficiary Category (common) | Broadest category of beneficiary. | $1 | comben | 1 - 4 | 1 = Dependents of Active Duty or Guard/Reserve on Active Duty |
2 = Retired 3 = All Others 4 = Active Duty and Guard/Reserve on Active Duty
| Number of Services on record | Raw Number of times CPT code was performed. | 2.0 | count | 0 to 99 | See Derived Number of Services (drvcount) |
| CPT Code | Procedure Code. | $5 | cpt | ||
| Modifier of the CPT code | Modifier of the laboratory test or radiology exam performed. | $2 | cptmod | 00,26,32,90, TC | For Lab: |
00=test ordered and performed in-house 26=pathologist interpretation (professional component) 32=test performed in-house for an outside lab (technical component) 90=test sent to a reference/external laboratory For Rad:
26 = professional component TC = technical component
DDS DEERS Dependent Suffix. $2 dds blank, 01-19, 20, 30-39, 40-44, 45-49,50-54, 55-59, 60-69, 75, 90-95, 98, 99 01-19 = Dep Child of Sponsor 20 = Sponsor 30-39 = Spouse/Former Spouse 40-44 = Mother/Step-Mother of Sponsor 45-49 = Father, Step-Father of Sponsor 50-54 = Mother-In-Law of Sponsor 55 -59= Father-In-Law of Sponsor 60-69 = Other Authorized Dep of Sponsor 70-74 Unknown by DEERS 75=Pseudo DDS unknown by contractor 90-95 = Bene Authorized by Statute 98 = Service secretary designee 99 = All Other, Not Elsewhere Classified DEERS Match Flag Indicates whether match was made during merge to longitudinal VM4. $1 deers 1,0 1 = DEERS match 0 = no match
| Date of Birth | The date a person was born. | $8 | dob | yyyymmdd | |
| Derived Number of Services | Corrected Number of times CPT code was performed. | $2 | drvcount | 0-99 | For Lab: |
For cptmod=90 (referred to a reference/external facility), drvcount=1; representing MTF workload.
For Rad:
If CPT code or CPT modifiers indicate bilateral code and the number of services on record is greater than 1, then drvcount=count/2.
| ICD9 Diagnosis Code 1 | Principle Diagnosis. | $6 | dx1 | null or blank | 6th character accommodates ICD-9 extender codes. Will remain blank until the CCE lab/rad is activated. |
| ICD9 Diagnosis Code 2 | Diagnosis Code 2. | $6 | dx2 | null or blank | 6th character accommodates ICD-9 extender codes. Will remain blank until the CCE lab/rad is activated. |
| ICD9 Diagnosis Code 3 | Diagnosis Code 3. | $6 | dx3 | null or blank | 6th character accommodates ICD-9 extender codes. Will remain blank until the CCE lab/rad is activated. |
| ICD9 Diagnosis Code 4 | Diagnosis Code 4. | $6 | dx4 | null or blank | 6th character accommodates ICD-9 extender codes. Will remain blank until the CCE lab/rad is activated. |
| EDI-PN | The identifier that is used to represent the person within a Department of Defense Electronic Data Interchange. | $10 | edipn | Results of MPI merge procedures. | |
| Enrollment DMIS ID | The DMIS ID of the facility where the member is enrolled. | $4 | enrdmis | e.g., 0039 | Appended using longitudinal derivation of VM4. |
| HSSC Enrollment Region | HSSC region of Enrollment DMIS. | $1 | enrreg | N, S, W,O,A,blank | |
| External Indicator | Indicates if the procedure was performed in an external lab. | $1 | external | Y,N | Y = Yes |
N = No
| File Date | Date file harvested/created in CHCS. | $8 | filedate | yyyymmdd | Derived from the Date/Time used in the ASCII file name from CHCS. |
| Family Member Prefix | A DoD-define code which defines the relationship of the patient to the sponsor. | $2 | fmp | blank, 01-19, 20, 30-39, |
40, 45, 50, 55, 60-66, 69, 90-94, 98, 99 01-19 = Dep 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
| Relative value units (facility practice) | Facility Practice Expense RVU of CPT Code, derived from merge with CPT Weight Table. | 6.2 | fprvu | numeric | Facility Practice Expense RVU |
| Full Cost | Full Cost. | 8.2 | fullcost | Based on MEPRS costs and RVUs. | |
| DEERS HCDP code | HCDP Code from DEERS LVM4 match. | $3 | hcdplvm4 | 000-013, 017, 018, 021, 106-113, 116-119, 121, 122, 128-132, 140, 142-146, 150, 152-157, 401-402, 413-414 | HCDP code in longitudinal derivation of VM4. |
| HCDP of record | Code to identify the patient's DoD Health Care Delivery Program plan coverage on the date of service. | $3 | hcdpr | 000-013, 017, 018, 021, 106-113, 116-119, 121, 122, 128-132, 140, 142-146, 150, 152-157, 401-402, 413-414 | See HCDP Codes worksheet. Only populated if patient is enrolled on the date of service. |
| Inpatient indicator | Indicates whether or not the ancillary came from an inpatient encounter. | $1 | inpt | Y,N | Y = Yes |
N = No Laboratory Flag Indicates where lab tests were ordered or performed. $1 labflag blank, I,O,E I = test ordered and performed in-house O = test performed for outside facility E = test sent to outside referral lab
| M2 Key | Base62 of the MDR Key. | $6 | m2key | Base62 of the MDR Key. | |
| MDR Key | A numeric number identifying a CHCS entry. | 8.0 | mdrkey | numeric | Sequential counter of records. |
| Medicare Eligibility | Medicare Eligibility. | $1 | medelg | A, B, C, N | A = Part A only |
B = Part B only C = Part A & B N = Not Eligible
| MEPRS Parent | MEPRS Parent of the Treatment DMIS. | $4 | meprdmis | e.g., 0039 | |
| Ordering MEPRS Code | 4th level MEPRS code of the requesting location. | $4 | meprscd | e.g., AAAA | |
| Record Type Modifier | For LAB: Indicator to specify whether the results were entered directly into CHCS or came from CoPath | ||||
| For RAD: Modifiers that are used exclusively for Radiology CPTs, indicating bilateral and/or portable procedures. | $2 | mod | blank, 50, 51, 99, AP | LAB: |
AP = Anatomic Pathology Order generated on CoPath
RAD:
50 = bilateral complete 51 = bilateral EXAM only 99 = bilateral and portable
| MPI Status Flag | EDI-PN was obtained from MPI file. | $1 | mpiflag | E,blank | E indicates that a blank field was placed |
| Relative value units (non-facility practice) | Non-facility Practice Expense RVU of CPT Code, derived from merge with CPT Weight Table. | 6.2 | nprvu | numeric | Non-facility Practice Expense RVU |
| OHI Indicator | Denotes whether the patient has Other Health Insurance. | $1 | ohi | Y,N | Y = Yes |
N = No
| Ordering DMIS ID | DMIS ID of the requesting location for the order. | $4 | orddmis | e.g., 0039 | |
| Provider Order Number | CHCS code of the Order Number of the Provider. | $12 | orderid | ||
| Person Association Reason Code | Code indicating the beneficiary's relationship to the sponsor. | $2 | parc | AA, AB, AC, AD, AE, AF, AH AI, 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 parents AX = Emergency Contact BB = Ward, BC = Former Spouse BD = Self BE = Joint marriage spouse BF = Other health insurance subscriber BG = Pre-adoptive child CA = Memeber of household headed by sponsor's former spouse (child, stepchild or ward only) ZZ = unknown
| Patient Age | Patient's age on date of service. | 3.0 | patage | numeric | ||
| Patient Category Code | Code that defines the DoD Beneficiary Status of the person for whom the service has been provided. | $3 | patcat | See Patient Categories for codes and descriptions. | ||
| Beneficiary Residence Region | Beneficiary Region of patient residence. | $2 | patregn | 01 - 16, | ||
| AK, XX, Blank | 01 = Northeast |
02 = Mid-Atlantic 03 = Southeast 04 = Gulf South 05 = Heartland 06 = Southwest 07,08 = TRICARE Central 09 = Southern California 10 = Golden Gate 11 = Northwest 12 = TRICARE Pacific 13 = Europe 14 = Western Pacific/Asia 15 = Central/South America & Other
OCONUS
16 = Unknown AK = Alaska XX or Blank = Unknown
| Beneficiary zip code | Zip Code. | $5 | patzip | NONE if not matched. | |
| PCM ID | The identifier that uniquely represents a Primary Care Manager. | $18 | pcmid | Appended using longitudinal derivation of VM4. | |
| Parent DMIS | Parent DMIS Id if the treatment DMIS. | $4 | pdmis | e.g., 0039 | |
| PRISM Area ID | The prism area surrounding an MTF or noncatchment area based on beneficiary zip code, sponsor service, FY and FM. | $4 | prism | e.g., 0039 | Derived from merge with Omni-CAD and based on bene zip, sponsor service, fy, and fm corresponding to Service Date. |
| Privilege Code | Code indicating type of eligibility for medical benefits. | $1 | privcode | blank, 1, 2, 4, 5, 6, 7, A, B, C, M, U | 1 = Direct Care Only |
2 = Direct Care and CHAMPUS 4 = Transitional Direct Care Only 5 = Transitional Direct Care and CHAMPUS 6 = Transitional Direct Care and Medicare, not CHAMPUS Eligible 7 = Direct Care and Medicare, not CHAMPUS Eligible A = Direct Care and CHAMPUS and Medicare B = Transitional Direct Care and CHAMPUS and Medicare C = CHAMPUS Only M = TRICARE for Life Only U = USFHP/USTF Enrollee
| Inpatient Record ID | CHCS Inpatient Register Number. | $12 | prn | ||
| Process Flag | Flag to indicate the operation to be performed with record, process flag. | $1 | procflag | N,U, C | N = New |
U = Update C = Cancel Record Type Unique character identifying the ancillary with which the data in this record is associated. $1 rectype L,R L = Laboratory Data R = Radiology Data
| EDI-PN, Raw | The identifier that is used to represent the person within a Department of Defense Electronic Data Interchange. | $10 | redipn | EDI-PN on the record. | |
| Relationship (to sponsor) | First digit of FMP, which defines whether patient is sponsor, spouse, dependent, or other. Children with a FMP first digit of 0 are transformed to rel=1. | $1 | rel | 1,2,3,4 | 1 = Dependent Child |
2 = Sponsor 3 = Spouse of sponsor 4 = Any other category, such as Parent of sponsor, Other eligible dependents, Unknown, Service secretary designee
| Sponsor SSN, Raw | The sponsor’s SSN as assigned by the Social Security Administration. | $9 | rsponssn | Sponsor SSN on the record. | ||
| HSSC Residence Region | HSSC region of Beneficiary zip code. | $1 | rsreg | N, S, W,O,A,blank | ||
| Relative value units (total) | Sum of non-facility practice and work RVUs. | 6.2 | rvu | numeric | The total of Non-Practice RVUs + Work RVUs (nprvu+ruvwork) | |
| Relative value units (work) | Work RVU of CPT Code, derived from merge with CPT Weight Table. | 6.2 | rvuwork | numeric | Physician or Work Expense RVU | |
| 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. | 8.0 | servdate | yyyymmdd | A formatted SAS numeric date. | ||
| Gender | Beneficiary gender. | $1 | sex | M, F, Z | M = Male |
F = Female Z = Unknown Special Operations Code Indicates the contingency operation for which a Guard or Reserve member is activated or receiving TAMP benefits through at the time of care. Populated on both sponsor and family member records. This data element does not indicate that the guard or reserve member went to theater, rather, that the orders that activated the member indicated a contingency operation. Use with Reservist Status Code to indicate the status of the Guard/Reserve member.
$2 soc 00, 01, 02, 03, 04, 05, 06, 07,08, 09, 10, 98,99, blank 00 = Not Applicable 01 = Operation Desert Storm 02 = Los Angeles Riots 03 = Haiti 04 = Somalia 05 = Bosnia 06 = Kosovo 07 = Southern Watch 08 = Noble Eagle 09 = Enduring Freedom 10 = Iraqi Freedom 98 = Not a special operation 99 = Other (Take caution with these values. It is often evident that Iraqi Freedom records are miscoded as 08 or 09.)
Space Available Flag Indicates whether the patient is considered space available care or not, based on the ACV of the patient. $1 spaflag blank, N, Y N = ACV of A, B, D, E, F, H, J, M, P, Q Y = all other ACV
| Sponsor SSN | The sponsor’s SSN as assigned by the Social Security Administration. | $9 | sponssn | Results of MPI merge procedures. | |
| Status Code | Derived Reservist Status Code from Personnel Entitlement Condition Type Code. | $1 | status | A, M, O, E, blank | A = Early Alert |
M = Mobilization O = Original TAMP E = Extended TAMP Sponsor Branch of Service Code indicating service of sponsor. $1 svc A, C, F, H, M, N, O, X, 4 Z A = Army C = Coast Guard F = Air Force H = Public Health Service M = Marines N = Navy
O = NOAA
X = Other/Unknown 4 = Foreign Military Z=Unknown Sponsor Branch of Service, Aggregate Code indicating service of sponsor. $1 svcagg A, C, F, I, M, N, V, X, Z A = Army C = Coast Guard F = Air Force M = Marine Corps N = Navy V = Navy Afloat X = Other Z = Unknown
| Treatment DMIS ID | DMIS ID of the MTF providing the service. | $4 | tmtdmis | e.g., 0039 | |
| HSSC Treatment Region | HSSC region of Treatment DMIS. | $1 | tmtreg | N, S, W,O,A,blank | A = Alaska |
N = North O = Overseas S = South W = West Treatment Service Branch of service for the treatment DMIS. $1 tmtsvc A, B, C, D, F, G, I, J, L, M, N, O, P, Q, R, S, T, V, X, Blank A = Army DHP B = Army Civilian Resource Sharing C = Coast Guard D = Army Line Unit F = Air Force DHP G = AF Civilian Resource Sharing I = Inactive J = US Defense Attache Office (USDAO) L = AF Line Unit M = Managed Care Support Contractor N = Navy DHP O = Other P= National Capital Region Medical Directorate (NCRMD) Q = Navy Line Unit R = Navy Civilian Resource Sharing S = Non-catchment T = US Family Health Plan (USFHP), FY 1998-2001, 2007-2009 U = US Family Health Plan (USFHP), FY 2002-2006 V = Veterans Admin X = Administrative Blank = Unknown TRICARE Prime Remote Eligibility Flag indicates whether beneficiary is an Active Duty or Guard/Reserve sponsor or family member who is geographically eligible for TRICARE Prime Remote. $1 tprelig Y,N Y = Yes N = No TRICARE Prime Remote Flag Indicates whether the Beneficiary Zip Code is in a TRICARE Prime Remote area. $1 tprflag Y,N Y = zip code designated as TPR site N = zip code is not designated as TPR site Underwritten Region Region for which this claim is underwritten. $1 undflag N,S, W N = North S = South W = West (excl AK) A = Alaska
O = OCONUS
Variable Cost Variable Cost. 8.2 varcost numeric Based on MEPRS costs and RVUs.
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Return to the Table of Contents #'Table%20of%20Contents'!A1 Appointment Master
| Appointment Data File | |||||
| Common File Name: fyXX.sas7bdat, where XX=02+ | |||||
| Dataset Location: /mdr/pub/appt/detail/fyXX/fyXX, where XX=02+ | |||||
| Update Frequency: Updated weekly and organized into annual files | Source System: CHCS | ||||
| Description: Appointment-Level Data Records | |||||
| Data Element | Definition | Format | SAS Variable | Values | Notes |
| Access to Care Category | Indicates the access to care category | $15 | ATCCAT | ACUTE, DROUTINE, FUTURE REQUEST, ROUTINE, SPECIALTY, WELLNESS | ACUTE, DROUTINE, FUTURE REQUEST, ROUTINE, SPECIALTY, WELLNESS |
| Age Group | DMIS defined age groups. | $1 | DMISAGE | 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 Alternate Care Value - Derivation #2 Indicates the enrollment status of the beneficiary at the time of the appointment. Use this ACV value as opposed to ACV, raw. $1 ACV A, B, D, E, F, G, H, J, L, M, Q, R, U, V, Null A=Active Duty Prime B=TRICARE Global Remote Overseas Prime Active Duty D=TRICARE Senior Prime E=Non-Active Duty Prime F=TRICARE Global Remote Overseas Prime Active Duty Family Member G=TRICARE Plus, (Includes Private Sector Coverage, TFL) H=TRICARE Overseas Prime Active Duty J=TRICARE Overseas Prime Active Duty Family Member L=TRICARE Plus, DC Entitlement Only (No Private Sector Coverage, No TFL) M=AD not reported enrolled (added FY05) Q=AD enrolled to Op Forces R=TRICARE Reserve Select
U=USTF/USFHP
V=TRICARE Retired Reserve Null = Not Enrolled
| Alternate Care Value - Raw | Indicates the enrollment status of the beneficiary as reported in CHCS. The value of this element is suspect. Use ACV, derivation #2 instead. | |||
| $1 | ACV1 | A, B, D, E, F, G, H, J, L, M, Q, R, U, V, Null | See above. | |
| Alternate Care Value Group | Indicates the group of ACV. | $1 | ACV_GRP | 1=Prime |
2=Overseas Remote 3=Plus 4= Designated Provider 5=Reliant 6=Other
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