Data Dictionary

ID

Value

1

Intensive

2

Non-Intensive

1

Self

2

Child

1

Primary

2

Secondary

3

Tertiary

1

Signature on File

2

No Signature on File

1

Yes

2

Pending

3

Not Needed

1

Billable

2

Non-billable

3

Travel

1

03 - School

2

11 - Office

3

12 - Home

4

01 - Pharmacy

5

99 - Other Place of Service

6

04 - Homeless Shelter

7

05 - Indian Health Service Free-standing Facility

8

06 - Indian Health Service Provider-based Facility

9

07 - Tribal 638 Free-standing Facility

10

08 - Tribal 638 Provider-based Facility

11

09 - Prison/Correctional Facility

12

13 - Assisted Living Facility

13

14 - Group Home

14

15 - Mobile Unit

15

16 - Temporary Lodging

16

17 - Walk-in Retail Health Clinic

17

18 - Place of Employment-Worksite

18

19 - Off Campus-Outpatient Hospital

19

20 - Urgent Care Facility

20

21 - Inpatient Hospital

21

22 - On Campus-Outpatient Hospital

22

23 - Emergency Room – Hospital

23

24 - Ambulatory Surgical Center

24

25 - Birthing Center

25

26 - Military Treatment Facility

26

31 - Skilled Nursing Facility

27

32 - Nursing Facility

28

33 - Custodial Care Facility

29

34 - Hospice

30

41 - Ambulance - Land

31

42 - Ambulance – Air or Water

32

49 - Independent Clinic

33

50 - Federally Qualified Health Center

34

51 - Inpatient Psychiatric Facility

35

52 - Psychiatric Facility-Partial Hospitalization

36

53 - Community Mental Health Center

37

54 - Intermediate Care Facility/ Individuals with Intellectual Disabilities

38

55 - Residential Substance Abuse Treatment Facility

39

56 - Psychiatric Residential Treatment Center

40

57 - Non-residential Substance Abuse Treatment Facility

41

60 - Mass Immunization Center

42

61 - Comprehensive Inpatient Rehabilitation Facility

43

62 - Comprehensive Outpatient Rehabilitation Facility

44

65 - End-Stage Renal Disease Treatment Facility

45

71 - Public Health Clinic

46

72 - Rural Health Clinic

47

81 - Independent Laboratory

48

02 - Telehealth-Other than in Patient Home

49

10 - Telehealth-In Patient Home

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)

1

Staff Home

2

Client Home

1

Male

2

Female

3

Non-binary

1

Staff Member

2

Client

1

Mon

2

Tue

3

Wed

4

Thu

5

Fri

6

Sat

0

Sun

1

Alaska

AK

2

Alabama

AL

3

Arkansas

AR

4

Arizona

AZ

5

California

CA

6

Colorado

CO

7

Connecticut

CT

8

Washington D.C.

DC

9

Delaware

DE

10

Florida

FL

11

Georgia

GA

12

Hawaii

HI

13

Iowa

IA

14

Idaho

ID

15

Illinois

IL

16

Indiana

IN

17

Kansas

KS

18

Kentucky

KY

19

Louisiana

LA

20

Massachusetts

MA

21

Maryland

MD

22

Maine

ME

23

Michigan

MI

24

Minnesota

MN

25

Missouri

MO

26

Mississippi

MS

27

Montana

MT

28

North Carolina

NC

29

North Dakota

ND

30

Nebraska

NE

31

New Hampshire

NH

32

New Jersey

NJ

33

New Mexico

NM

34

Nevada

NV

35

New York

NY

36

Ohio

OH

37

Oklahoma

OK

38

Oregon

OR

39

Pennsylvania

PA

40

Rhode Island

RI

41

South Carolina

SC

42

South Dakota

SD

43

Tennessee

TN

44

Texas

TX

45

Utah

UT

46

Virginia

VA

47

Vermont

VT

48

Washington

WA

49

Wisconsin

WI

50

West Virginia

WV

51

Wyoming

WY

52

Puerto Rico

PR

1

Single

2

Married

3

Divorced

1

Daily

2

Weekly

3

Monthly

4

Total

1

Agency

2

Provider Assigned to Appointment

3

Staff Member

1

Scheduled

2

Needs Verification

3

Completed

4

Cancelled - Needs Reschedule

5

Cancelled - Cannot Reschedule

6

Archived

1

Service

2

Authorization