Data Dictionary
1.0. Service Intensity
| 1 | ID | Value |
| 2 | 1 | Intensive |
| 3 | 2 | Non-Intensive |
2.0. Relationship to insured
ID | Value | |
|---|---|---|
| 1 | 1 | Self |
| 2 | 2 | Child |
3.0. Funder Sequence
ID | Value | |
|---|---|---|
| 1 | 1 | Primary |
| 2 | 2 | Secondary |
| 3 | 3 | Tertiary |
4.0. Authorization Signature
ID | Value | |
|---|---|---|
| 1 | 1 | Signature on File |
| 2 | 2 | No Signature on File |
5.0. Authorization Received (authorizationSubmissionTypeID)
ID | Value | |
|---|---|---|
| 1 | 1 | Yes |
| 2 | 2 | Pending |
| 3 | 3 | Not Needed |
6.0. Appointment Type
ID | Value | |
|---|---|---|
| 1 | 1 | Billable |
| 2 | 2 | Non-billable |
| 3 | 3 | Travel |
7.0 Place of Service
ID | Value | |
|---|---|---|
| 1 | 1 | 03 - School |
| 2 | 2 | 11 - Office |
| 3 | 3 | 12 - Home |
| 4 | 4 | 01 - Pharmacy |
| 5 | 5 | 99 - Other Place of Service |
| 6 | 6 | 04 - Homeless Shelter |
| 7 | 7 | 05 - Indian Health Service Free-standing Facility |
| 8 | 8 | 06 - Indian Health Service Provider-based Facility |
| 9 | 9 | 07 - Tribal 638 Free-standing Facility |
| 10 | 10 | 08 - Tribal 638 Provider-based Facility |
| 11 | 11 | 09 - Prison/Correctional Facility |
| 12 | 12 | 13 - Assisted Living Facility |
| 13 | 13 | 14 - Group Home |
| 14 | 14 | 15 - Mobile Unit |
| 15 | 15 | 16 - Temporary Lodging |
| 16 | 16 | 17 - Walk-in Retail Health Clinic |
| 17 | 17 | 18 - Place of Employment-Worksite |
| 18 | 18 | 19 - Off Campus-Outpatient Hospital |
| 19 | 19 | 20 - Urgent Care Facility |
| 20 | 20 | 21 - Inpatient Hospital |
| 21 | 21 | 22 - On Campus-Outpatient Hospital |
| 22 | 22 | 23 - Emergency Room – Hospital |
| 23 | 23 | 24 - Ambulatory Surgical Center |
| 24 | 24 | 25 - Birthing Center |
| 25 | 25 | 26 - Military Treatment Facility |
| 26 | 26 | 31 - Skilled Nursing Facility |
| 27 | 27 | 32 - Nursing Facility |
| 28 | 28 | 33 - Custodial Care Facility |
| 29 | 29 | 34 - Hospice |
| 30 | 30 | 41 - Ambulance - Land |
| 31 | 31 | 42 - Ambulance – Air or Water |
| 32 | 32 | 49 - Independent Clinic |
| 33 | 33 | 50 - Federally Qualified Health Center |
| 34 | 34 | 51 - Inpatient Psychiatric Facility |
| 35 | 35 | 52 - Psychiatric Facility-Partial Hospitalization |
| 36 | 36 | 53 - Community Mental Health Center |
| 37 | 37 | 54 - Intermediate Care Facility/ Individuals with Intellectual Disabilities |
| 38 | 38 | 55 - Residential Substance Abuse Treatment Facility |
| 39 | 39 | 56 - Psychiatric Residential Treatment Center |
| 40 | 40 | 57 - Non-residential Substance Abuse Treatment Facility |
| 41 | 41 | 60 - Mass Immunization Center |
| 42 | 42 | 61 - Comprehensive Inpatient Rehabilitation Facility |
| 43 | 43 | 62 - Comprehensive Outpatient Rehabilitation Facility |
| 44 | 44 | 65 - End-Stage Renal Disease Treatment Facility |
| 45 | 45 | 71 - Public Health Clinic |
| 46 | 46 | 72 - Rural Health Clinic |
| 47 | 47 | 81 - Independent Laboratory |
| 48 | 48 | 02 - Telehealth-Other than in Patient Home |
| 49 | 49 | 10 - Telehealth-In Patient Home |
8.0. Time Zone
ID | DisplayName |
|---|---|
1 | (UTC-12) International Date Line West |
2 | (UTC-10) Hawaii |
3 | (UTC-09) Alaska |
4 | (UTC-08) Baja California |
5 | (UTC-08) Pacific Time (US & Canada) |
6 | (UTC-07) Arizona |
7 | (UTC-07) Chihuahua, La Paz, Mazatlan |
8 | (UTC-07) Mountain Time (US & Canada) |
9 | (UTC-06) Central America |
10 | (UTC-06) Central Time (US & Canada) |
11 | (UTC-06) Guadalajara, Mexico City, Monterrey |
12 | (UTC-06) Saskatchewan |
13 | (UTC-05) Bogota, Lima, Quito, Rio Branco |
14 | (UTC-05) Chetumal |
15 | (UTC-05) Eastern Time (US & Canada) |
16 | (UTC-05) Indiana (East) |
17 | (UTC-04:30) Caracas |
18 | (UTC-04) Asuncion |
19 | (UTC-04) Atlantic Time (Canada) |
20 | (UTC-04) Cuiaba |
21 | (UTC-04) Georgetown, La Paz, Manaus, San Juan |
22 | (UTC-03:30) Newfoundland |
23 | (UTC-03) Brasilia |
24 | (UTC-03) Buenos Aires |
25 | (UTC-03) Cayenne, Fortaleza |
26 | (UTC-03) Greenland |
27 | (UTC-03) Montevideo |
28 | (UTC-03) Salvador |
29 | (UTC-03) Santiago |
30 | (UTC-02) Mid-Atlantic - Old |
31 | (UTC-01) Azores |
32 | (UTC-01) Cabo Verde Is. |
33 | (UTC) Casablanca |
34 | (UTC) Dublin, Edinburgh, Lisbon, London |
35 | (UTC) Monrovia, Reykjavik |
36 | (UTC+01) Amsterdam, Berlin, Bern, Rome, Stockholm, Vienna |
37 | (UTC+01) Belgrade, Bratislava, Budapest, Ljubljana, Prague |
38 | (UTC+01) Brussels, Copenhagen, Madrid, Paris |
39 | (UTC+01) Sarajevo, Skopje, Warsaw, Zagreb |
40 | (UTC+01) West Central Africa |
41 | (UTC+01) Windhoek |
42 | (UTC+02) Amman |
43 | (UTC+02) Athens, Bucharest |
44 | (UTC+02) Beirut |
45 | (UTC+02) Cairo |
46 | (UTC+02) Damascus |
47 | (UTC+02) E. Europe |
48 | (UTC+02) Harare, Pretoria |
49 | (UTC+02) Helsinki, Kyiv, Riga, Sofia, Tallinn, Vilnius |
50 | (UTC+02) Istanbul |
51 | (UTC+02) Jerusalem |
52 | (UTC+02) Kaliningrad (RTZ 1) |
53 | (UTC+02) Tripoli |
54 | (UTC+03) Baghdad |
55 | (UTC+03) Kuwait, Riyadh |
56 | (UTC+03) Minsk |
57 | (UTC+03) Moscow, St. Petersburg, Volgograd (RTZ 2) |
58 | (UTC+03) Nairobi |
59 | (UTC+03:30) Tehran |
60 | (UTC+04) Abu Dhabi, Muscat |
61 | (UTC+04) Baku |
62 | (UTC+04) Izhevsk, Samara (RTZ 3) |
63 | (UTC+04) Port Louis |
64 | (UTC+04) Tbilisi |
65 | (UTC+04) Yerevan |
66 | (UTC+04:30) Kabul |
67 | (UTC+05) Ashgabat, Tashkent |
68 | (UTC+05) Ekaterinburg (RTZ 4) |
69 | (UTC+05) Islamabad, Karachi |
70 | (UTC+05:30) Chennai, Kolkata, Mumbai, New Delhi |
71 | (UTC+05:30) Sri Jayawardenepura |
72 | (UTC+05:45) Kathmandu |
73 | (UTC+06) Astana |
74 | (UTC+06) Dhaka |
75 | (UTC+06) Novosibirsk (RTZ 5) |
76 | (UTC+06:30) Yangon (Rangoon) |
77 | (UTC+07) Bangkok, Hanoi, Jakarta |
78 | (UTC+07) Krasnoyarsk (RTZ 6) |
79 | (UTC+08) Beijing, Chongqing, Hong Kong, Urumqi |
80 | (UTC+08) Irkutsk (RTZ 7) |
81 | (UTC+08) Kuala Lumpur, Singapore |
82 | (UTC+08) Perth |
83 | (UTC+08) Taipei |
84 | (UTC+08) Ulaanbaatar |
85 | (UTC+09) Osaka, Sapporo, Tokyo |
86 | (UTC+09) Seoul |
87 | (UTC+09) Yakutsk (RTZ 8) |
88 | (UTC+09:30) Adelaide |
89 | (UTC+09:30) Darwin |
90 | (UTC+10) Brisbane |
91 | (UTC+10) Canberra, Melbourne, Sydney |
92 | (UTC+10) Guam, Port Moresby |
93 | (UTC+10) Hobart |
94 | (UTC+10) Magadan |
95 | (UTC+10) Vladivostok, Magadan (RTZ 9) |
96 | (UTC+11) Chokurdakh (RTZ 10) |
97 | (UTC+11) Solomon Is., New Caledonia |
98 | (UTC+12) Anadyr, Petropavlovsk-Kamchatsky (RTZ 11) |
99 | (UTC+12) Auckland, Wellington |
100 | (UTC+12) Fiji |
101 | (UTC+12) Petropavlovsk-Kamchatsky - Old |
102 | (UTC+13) Nuku'alofa |
103 | (UTC+13) Samoa |
104 | (UTC+14) Kiritimati Island |
105 | (UTC-11) |
9.0. Location
ID | Value |
|---|---|
1 | Staff Home |
2 | Client Home |
10.0. Client Gender
ID | Value | |
|---|---|---|
| 1 | 1 | Male |
| 2 | 2 | Female |
| 3 | 3 | Non-binary |
11.0. Cancellation Types
ID | Value | |
|---|---|---|
| 1 | 1 | Staff Member |
| 2 | 2 | Client |
12.0 Day Types
ID | Value | |
|---|---|---|
| 1 | 1 | Mon |
| 2 | 2 | Tue |
| 3 | 3 | Wed |
| 4 | 4 | Thu |
| 5 | 5 | Fri |
| 6 | 6 | Sat |
| 7 | 0 | Sun |
13.0 States
ID | State Value | State Abbr | |
|---|---|---|---|
| 1 | 1 | Alaska | AK |
| 2 | 2 | Alabama | AL |
| 3 | 3 | Arkansas | AR |
| 4 | 4 | Arizona | AZ |
| 5 | 5 | California | CA |
| 6 | 6 | Colorado | CO |
| 7 | 7 | Connecticut | CT |
| 8 | 8 | Washington D.C. | DC |
| 9 | 9 | Delaware | DE |
| 10 | 10 | Florida | FL |
| 11 | 11 | Georgia | GA |
| 12 | 12 | Hawaii | HI |
| 13 | 13 | Iowa | IA |
| 14 | 14 | Idaho | ID |
| 15 | 15 | Illinois | IL |
| 16 | 16 | Indiana | IN |
| 17 | 17 | Kansas | KS |
| 18 | 18 | Kentucky | KY |
| 19 | 19 | Louisiana | LA |
| 20 | 20 | Massachusetts | MA |
| 21 | 21 | Maryland | MD |
| 22 | 22 | Maine | ME |
| 23 | 23 | Michigan | MI |
| 24 | 24 | Minnesota | MN |
| 25 | 25 | Missouri | MO |
| 26 | 26 | Mississippi | MS |
| 27 | 27 | Montana | MT |
| 28 | 28 | North Carolina | NC |
| 29 | 29 | North Dakota | ND |
| 30 | 30 | Nebraska | NE |
| 31 | 31 | New Hampshire | NH |
| 32 | 32 | New Jersey | NJ |
| 33 | 33 | New Mexico | NM |
| 34 | 34 | Nevada | NV |
| 35 | 35 | New York | NY |
| 36 | 36 | Ohio | OH |
| 37 | 37 | Oklahoma | OK |
| 38 | 38 | Oregon | OR |
| 39 | 39 | Pennsylvania | PA |
| 40 | 40 | Rhode Island | RI |
| 41 | 41 | South Carolina | SC |
| 42 | 42 | South Dakota | SD |
| 43 | 43 | Tennessee | TN |
| 44 | 44 | Texas | TX |
| 45 | 45 | Utah | UT |
| 46 | 46 | Virginia | VA |
| 47 | 47 | Vermont | VT |
| 48 | 48 | Washington | WA |
| 49 | 49 | Wisconsin | WI |
| 50 | 50 | West Virginia | WV |
| 51 | 51 | Wyoming | WY |
| 52 | 52 | Puerto Rico | PR |
14.0 Marital Status
ID | Value | |
|---|---|---|
| 1 | 1 | Single |
| 2 | 2 | Married |
| 3 | 3 | Divorced |
15.0. Authorization Frequency
ID | Value | |
|---|---|---|
| 1 | 1 | Daily |
| 2 | 2 | Weekly |
| 3 | 3 | Monthly |
| 4 | 4 | Total |
16.0. Rendering Provider Types
ID | Value | |
|---|---|---|
| 1 | 1 | Agency |
| 2 | 2 | Provider Assigned to Appointment |
| 3 | 3 | Staff Member |
17.0 Appointment Status
ID | Value |
|---|---|
1 | Scheduled |
2 | Needs Verification |
3 | Completed |
4 | Cancelled - Needs Reschedule |
5 | Cancelled - Cannot Reschedule |
6 | Archived |
18.0 Authorization Distribution Type ( authorizationDistrubtionId)
ID | Value |
|---|---|
1 | Service |
2 | Authorization |