United States Health Information Knowledgebase

 

File Submission Comparison

Selected Items
Action Item Name Version State Type Organization
Provider File Submission December 1, 2010 - v2.1 Massachusetts File Specification Massachusetts Center for Health Information and Analysis (MCHIA)
Provider File Submission June 7, 2013 - v3.1 Massachusetts File Specification Massachusetts Center for Health Information and Analysis (MCHIA)
Provider File Submission October 1, 2014 - v4.0 Massachusetts File Specification Massachusetts Center for Health Information and Analysis (MCHIA)
File Specification: Provider File Submission - December 1, 2010 - v2.1 (Massachusetts) Provider File Submission - June 7, 2013 - v3.1 (Massachusetts) Provider File Submission - October 1, 2014 - v4.0 (Massachusetts)
[Shared] Responsible Organization:
Massachusetts Center for Health Information and Analysis Massachusetts Center for Health Information and Analysis Massachusetts Center for Health Information and Analysis
[Shared] Definition:
A MA APCD file containing information on all types of health care provider entities. Typically these are active, contracted providers. A MA APCD file containing information on all types of health care provider entities. Typically these are active, contracted providers. A MA APCD file containing information on all types of health care provider entities. Typically these are active, contracted providers.
File Specification: Provider File Submission - December 1, 2010 - v2.1 (Massachusetts) Provider File Submission - June 7, 2013 - v3.1 (Massachusetts) Provider File Submission - October 1, 2014 - v4.0 (Massachusetts)
HD001
[Shared] Name: Record Type
[Shared] Type: Text
[Shared] Length: 2
Codes:
HD
 
[Shared] Name: Record Type
[Shared] Type: Text
[Shared] Length: 2
Codes:
HD
Header Elements
[Shared] Name: Record Type
[Shared] Type: Text
[Shared] Length: 2
Codes:
HD
Header Elements
HD002
[Unshared] Name: Payer
[Unshared] Type: Text
[Unshared] Length: 8
[Unshared] Name: Submitter
[Unshared] Type: Integer
[Unshared] Length: 6
[Unshared] Name: Submitter
[Unshared] Type: Integer
[Unshared] Length: 6
HD003
[Shared] Name: National Plan ID
[Unshared] Type: Text
[Unshared] Length: 30
[Shared] Name: National Plan ID
[Unshared] Type: Integer
[Unshared] Length: 10
[Shared] Name: National Plan ID
[Unshared] Type: Integer
[Unshared] Length: 10
HD004
[Shared] Name: Type of File
[Shared] Type: Text
[Shared] Length: 2
Codes:
PV
 
[Shared] Name: Type of File
[Shared] Type: Text
[Shared] Length: 2
Codes:
PV
PROVIDER
[Shared] Name: Type of File
[Shared] Type: Text
[Shared] Length: 2
Codes:
PV
PROVIDER
HD005
[Shared] Name: Period Beginning Date
[Unshared] Type: Date Period
[Shared] Length: 6
[Shared] Name: Period Beginning Date
[Unshared] Type: Date Period - Integer
[Shared] Length: 6
[Shared] Name: Period Beginning Date
[Unshared] Type: Date Period - Integer
[Shared] Length: 6
HD006
[Shared] Name: Period Ending Date
[Unshared] Type: Date Period
[Shared] Length: 6
[Shared] Name: Period Ending Date
[Unshared] Type: Date Period - Integer
[Shared] Length: 6
[Shared] Name: Period Ending Date
[Unshared] Type: Date Period - Integer
[Shared] Length: 6
HD007
[Shared] Name: Record Count
[Shared] Type: Integer
[Shared] Length: 10
[Shared] Name: Record Count
[Shared] Type: Integer
[Shared] Length: 10
[Shared] Name: Record Count
[Shared] Type: Integer
[Shared] Length: 10
HD008
[Shared] Name: Comments
[Shared] Type: Text
[Shared] Length: 80
[Shared] Name: Comments
[Shared] Type: Text
[Shared] Length: 80
[Shared] Name: Comments
[Shared] Type: Text
[Shared] Length: 80
HD009
Data Element: HD009
not present in this file submission.
[Unshared] Name: APCD Version Number
[Unshared] Type: Decimal - Numeric
[Unshared] Length: 3
Codes:
2.1
Prior Version; valid only for reporting periods prior to October 2013
3.0
Current Version; required for reporting periods as of October 2013
 
 
[Unshared] Name: APCD Version Number
[Unshared] Type: Decimal - Numeric
[Unshared] Length: 3
Codes:
2.1
Prior Version; valid only for reporting periods prior to October 2013
3.0
Version 3.0; required for reporting periods as of October 2013; No longer VALID as of May 2015
4.0
Version 4.0: required for reporting periods October 2013 onward as of May 2015
PV001
[Unshared] Name: Payer
[Unshared] Type: Text
[Unshared] Length: 8
[Unshared] Name: Submitter
[Unshared] Type: Integer
[Unshared] Length: 6
[Unshared] Name: Submitter
[Unshared] Type: Integer
[Unshared] Length: 6
PV002
[Shared] Name: Plan Provider ID
[Shared] Type: Text
[Shared] Length: 30
[Shared] Name: Plan Provider ID
[Shared] Type: Text
[Shared] Length: 30
[Shared] Name: Plan Provider ID
[Shared] Type: Text
[Shared] Length: 30
PV003
[Shared] Name: Tax Id
[Unshared] Type: Text
[Unshared] Length: 12
[Shared] Name: Tax Id
[Unshared] Type: Numeric
[Unshared] Length: 9
[Shared] Name: Tax Id
[Unshared] Type: Numeric
[Unshared] Length: 9
PV004
[Shared] Name: UPIN Id
[Shared] Type: Text
[Unshared] Length: 10
[Shared] Name: UPIN Id
[Shared] Type: Text
[Unshared] Length: 6
[Shared] Name: UPIN Id
[Shared] Type: Text
[Unshared] Length: 6
PV005
[Shared] Name: DEA ID
[Shared] Type: Text
[Unshared] Length: 10
[Shared] Name: DEA ID
[Shared] Type: Text
[Unshared] Length: 9
[Shared] Name: DEA ID
[Shared] Type: Text
[Unshared] Length: 9
PV006
[Shared] Name: License Id
[Shared] Type: Text
[Shared] Length: 25
[Shared] Name: License Id
[Shared] Type: Text
[Shared] Length: 25
[Shared] Name: License Id
[Shared] Type: Text
[Shared] Length: 25
PV007
[Shared] Name: Medicaid Id
[Shared] Type: Text
[Shared] Length: 25
[Shared] Name: Medicaid Id
[Shared] Type: Text
[Shared] Length: 25
[Shared] Name: Medicaid Id
[Shared] Type: Text
[Shared] Length: 25
PV008
[Shared] Name: Last Name
[Shared] Type: Text
[Shared] Length: 50
[Shared] Name: Last Name
[Shared] Type: Text
[Shared] Length: 50
[Shared] Name: Last Name
[Shared] Type: Text
[Shared] Length: 50
PV009
[Shared] Name: First Name
[Shared] Type: Text
[Shared] Length: 50
[Shared] Name: First Name
[Shared] Type: Text
[Shared] Length: 50
[Shared] Name: First Name
[Shared] Type: Text
[Shared] Length: 50
PV010
[Shared] Name: Middle Initial
[Shared] Type: Text
[Shared] Length: 1
[Shared] Name: Middle Initial
[Shared] Type: Text
[Shared] Length: 1
[Shared] Name: Middle Initial
[Shared] Type: Text
[Shared] Length: 1
PV011
[Shared] Name: Suffix
[Unshared] Type: Text
[Unshared] Length: 2
Codes:
 
 
 
 
 
 
 
 
 
 
 
 
[Shared] Name: Suffix
[Unshared] Type: Lookup Table - Integer
[Unshared] Length: 1
Codes:
0
Unknown / Not Applicable
1
I.
2
II.
3
III.
4
Jr.
5
Sr.
[Shared] Name: Suffix
[Unshared] Type: Lookup Table - Integer
[Unshared] Length: 1
Codes:
0
Unknown / Not Applicable
1
I.
2
II.
3
III.
4
Jr.
5
Sr.
PV012
[Shared] Name: Entity Name
[Shared] Type: Text
[Shared] Length: 100
[Shared] Name: Entity Name
[Shared] Type: Text
[Shared] Length: 100
[Shared] Name: Entity Name
[Shared] Type: Text
[Shared] Length: 100
PV013
[Shared] Name: Entity Code
[Unshared] Type: Text
[Unshared] Length: 10
Codes:
01
Academic Institution
02
Adult Foster Care
03
Ambulance Services
04
Hospital Based Clinic
05
Stand-Alone, Walk-In/Urgent Care Clinic
06
Other Clinic
07
Community Health Center - General
08
Community Health Center - Urgent Care
09
Government Agency
10
Health Care Corporation
11
Home Health Agency
12
Acute Hospital
13
Chronic Hospital
14
Rehabilitation Hospital
15
Psychiatric Hospital
16
DPH Hospital
17
State Hospital
18
Veterans Hospital
19
DMH Hospital
20
Sub-Acute Hospital
21
Licensed Hospital Satellite Emergency Facility
22
Hospital Emergency Center
23
Nursing Home
24
Freestanding Ambulatory Surgery Center
25
Hospital Licensed Ambulatory Surgery Center
26
Non-Health Corporations
27
School Based Health Center
28
Rest Home
29
Licensed Hospital Satellite Facility
30
Hospital Licensed Health Center
31
Other
 
 
 
 
 
 
 
 
 
 
 
 
 
 
[Shared] Name: Entity Code
[Unshared] Type: Lookup Table - Text
[Unshared] Length: 2
Codes:
01
Academic Institution
02
Adult Foster Care
03
Ambulance Services
04
Hospital Based Clinic
05
Stand-Alone, Walk-In/Urgent Care Clinic
06
Other Clinic
07
Community Health Center - General
08
Community Health Center - Urgent Care
09
Government Agency
10
Health Care Corporation
11
Home Health Agency
12
Acute Hospital
13
Chronic Hospital
14
Rehabilitation Hospital
15
Psychiatric Hospital
16
DPH Hospital
17
State Hospital
18
Veterans Hospital
19
DMH Hospital
20
Sub-Acute Hospital
21
Licensed Hospital Satellite Emergency Facility
22
Hospital Emergency Center
23
Nursing Home
24
Freestanding Ambulatory Surgery Center
25
Hospital Licensed Ambulatory Surgery Center
26
Non-Health Corporations
27
School Based Health Center
28
Rest Home
29
Licensed Hospital Satellite Facility
30
Hospital Licensed Health Center
31
Other Facility
40
Physician (PV034 = 1)
50
Physician Group (PV034 = 3)
60
Nurse (PV034 = 1)
70
Clinician (PV034 = 1)
80
Technician (PV034 = 1)
90
Pharmacy / Site or Mail Order (PV034 = 4 or 5)
99
Other Individual or Group (PV034 = 1 or 3)
[Shared] Name: Entity Code
[Unshared] Type: Lookup Table - Text
[Unshared] Length: 2
Codes:
01
Academic Institution
02
Adult Foster Care
03
Ambulance Services
04
Hospital Based Clinic
05
Stand-Alone, Walk-In/Urgent Care Clinic
06
Other Clinic
07
Community Health Center - General
08
Community Health Center - Urgent Care
09
Government Agency
10
Health Care Corporation
11
Home Health Agency
12
Acute Hospital
13
Chronic Hospital
14
Rehabilitation Hospital
15
Psychiatric Hospital
16
DPH Hospital
17
State Hospital
18
Veterans Hospital
19
DMH Hospital
20
Sub-Acute Hospital
21
Licensed Hospital Satellite Emergency Facility
22
Hospital Emergency Center
23
Nursing Home
24
Freestanding Ambulatory Surgery Center
25
Hospital Licensed Ambulatory Surgery Center
26
Non-Health Corporations
27
School Based Health Center
28
Rest Home
29
Licensed Hospital Satellite Facility
30
Hospital Licensed Health Center
31
Other Facility
40
Physician (PV034 = 1)
50
Physician Group (PV034 = 3)
60
Nurse (PV034 = 1)
70
Clinician (PV034 = 1)
80
Technician (PV034 = 1)
90
Pharmacy / Site or Mail Order (PV034 = 4 or 5)
99
Other Individual or Group (PV034 = 1 or 3)
PV014
[Shared] Name: Gender Code
[Unshared] Type: Text
[Shared] Length: 1
Codes:
F
Female
M
Male
O
Other
U
Unknown
[Shared] Name: Gender Code
[Unshared] Type: Lookup Table - Text
[Shared] Length: 1
Codes:
F
Female
M
Male
O
Other
U
Unknown
[Shared] Name: Gender Code
[Unshared] Type: Lookup Table - Text
[Shared] Length: 1
Codes:
F
Female
M
Male
O
Other
U
Unknown
PV015
[Shared] Name: DOB Date
[Unshared] Type: Date
[Shared] Length: 8
[Shared] Name: DOB Date
[Unshared] Type: Full Date - Integer
[Shared] Length: 8
[Shared] Name: DOB Date
[Unshared] Type: Full Date - Integer
[Shared] Length: 8
PV016
[Unshared] Name: Street Address1 Name
[Shared] Type: Text
[Shared] Length: 50
[Unshared] Name: Provider Street Address 1
[Shared] Type: Text
[Shared] Length: 50
[Unshared] Name: Provider Street Address 1
[Shared] Type: Text
[Shared] Length: 50
PV017
[Unshared] Name: Street Address2 Name
[Shared] Type: Text
[Shared] Length: 50
[Unshared] Name: Provider Street Address 2
[Shared] Type: Text
[Shared] Length: 50
[Unshared] Name: Provider Street Address 2
[Shared] Type: Text
[Shared] Length: 50
PV018
[Shared] Name: City Name
[Shared] Type: Text
[Shared] Length: 35
[Shared] Name: City Name
[Shared] Type: Text
[Shared] Length: 35
[Shared] Name: City Name
[Shared] Type: Text
[Shared] Length: 35
PV019
[Shared] Name: State Code
[Unshared] Type: Text
[Shared] Length: 2
[Shared] Name: State Code
[Unshared] Type: External Code Source 2 - Text
[Shared] Length: 2
[Shared] Name: State Code
[Unshared] Type: External Code Source 2 - Text
[Shared] Length: 2
PV020
[Shared] Name: Country Code
[Unshared] Type: Text
[Shared] Length: 3
[Shared] Name: Country Code
[Unshared] Type: External Code Source 1 - Text
[Shared] Length: 3
[Shared] Name: Country Code
[Unshared] Type: External Code Source 1 - Text
[Shared] Length: 3
PV021
[Shared] Name: Zip Code
[Unshared] Type: Text
[Unshared] Length: 10
[Shared] Name: Zip Code
[Unshared] Type: External Code Source 2 - Text
[Unshared] Length: 9
[Shared] Name: Zip Code
[Unshared] Type: External Code Source 2 - Text
[Unshared] Length: 9
PV022
[Shared] Name: Taxonomy
[Unshared] Type: Text
[Shared] Length: 10
[Shared] Name: Taxonomy
[Unshared] Type: External Code Source 5 - Text
[Shared] Length: 10
[Shared] Name: Taxonomy
[Unshared] Type: External Code Source 5 - Text
[Shared] Length: 10
PV023
[Shared] Name: Mailing Street Address1 Name
[Shared] Type: Text
[Shared] Length: 50
[Shared] Name: Mailing Street Address1 Name
[Shared] Type: Text
[Shared] Length: 50
[Shared] Name: Mailing Street Address1 Name
[Shared] Type: Text
[Shared] Length: 50
PV024
[Shared] Name: Mailing Street Address2 Name
[Shared] Type: Text
[Shared] Length: 50
[Shared] Name: Mailing Street Address2 Name
[Shared] Type: Text
[Shared] Length: 50
[Shared] Name: Mailing Street Address2 Name
[Shared] Type: Text
[Shared] Length: 50
PV025
[Shared] Name: Mailing City Name
[Shared] Type: Text
[Shared] Length: 35
[Shared] Name: Mailing City Name
[Shared] Type: Text
[Shared] Length: 35
[Shared] Name: Mailing City Name
[Shared] Type: Text
[Shared] Length: 35
PV026
[Shared] Name: Mailing State Code
[Unshared] Type: Text
[Shared] Length: 2
[Shared] Name: Mailing State Code
[Unshared] Type: External Code Source 2 - Text
[Shared] Length: 2
[Shared] Name: Mailing State Code
[Unshared] Type: External Code Source 2 - Text
[Shared] Length: 2
PV027
[Shared] Name: Mailing Country Code
[Unshared] Type: Text
[Shared] Length: 3
[Shared] Name: Mailing Country Code
[Unshared] Type: External Code Source 1 - Text
[Shared] Length: 3
[Shared] Name: Mailing Country Code
[Unshared] Type: External Code Source 1 - Text
[Shared] Length: 3
PV028
[Shared] Name: Mailing Zip Code
[Unshared] Type: Text
[Unshared] Length: 10
[Shared] Name: Mailing Zip Code
[Unshared] Type: External Code Source 2 - Text
[Unshared] Length: 9
[Shared] Name: Mailing Zip Code
[Unshared] Type: External Code Source 2 - Text
[Unshared] Length: 9
PV029
[Shared] Name: Provider Type Code
[Unshared] Type: Text
[Shared] Length: 10
[Shared] Name: Provider Type Code
[Unshared] Type: Carrier Defined Table - Text
[Shared] Length: 10
[Shared] Name: Provider Type Code
[Unshared] Type: Carrier Defined Table - Text
[Shared] Length: 10
PV030
[Shared] Name: Primary Specialty Code
[Unshared] Type: Text
[Unshared] Length: 10
[Shared] Name: Primary Specialty Code
[Unshared] Type: External Code Source 4 - Integer
[Unshared] Length: 3
[Shared] Name: Primary Specialty Code
[Unshared] Type: External Code Source 4 - Integer
[Unshared] Length: 3
PV031
[Unshared] Name: Filler
[Unshared] Type: Filler
[Unshared] Length: 1
[Unshared] Name: Provider Organization ID
[Unshared] Type: Integer
[Unshared] Length: 6
[Unshared] Name: Provider Organization ID
[Unshared] Type: Integer
[Unshared] Length: 6
PV032
[Unshared] Name: Filler
[Unshared] Type: Filler
[Unshared] Length: 20
[Unshared] Name: Registered Provider Organization ID (RPO)
[Unshared] Type: Text
[Unshared] Length: 30
[Unshared] Name: Registered Provider Organization ID (RPO)
[Unshared] Type: Text
[Unshared] Length: 30
PV033
[Shared] Name: Filler
[Shared] Type: Filler
[Unshared] Length: 30
[Shared] Name: Filler
[Shared] Type: Filler
[Unshared] Length: 0
[Shared] Name: Filler
[Shared] Type: Filler
[Unshared] Length: 0
PV034
[Unshared] Name: ProviderIDCode
[Unshared] Type: Text
[Unshared] Length: 5
Codes:
0
Other; any type of entity not otherwise defined that performs health care services.
1
Person; physician, clinician, orthodontist, and any individual that is licensed/certified to perform health care services.
2
Facility; hospital, health center, long term care, rehabilitation and any building that is licensed to transact health care services.
3
Professional Group; collection of licensed/certified health care professionals that are practicing health care services under the same entity name and Federal Tax Identification Number.
4
Retail Site; brick-and-mortar licensed/certified place of transaction that is not solely a health care entity, i.e., pharmacies, independent laboratories, vision services.
5
E-Site; internet-based order/logistic system of health care services, typically in the form of durable medical equipment, pharmacy or vision services. Address assigned should be the address of the company delivering services or order fulfillment.
6
Financial Parent; financial governing body that does not perform health care services itself but directs and finances health care service entities, usually through a Board of Directors.
7
Transportation; any form of transport that conveys a patient to/from a healthcare provider
[Unshared] Name: Provider ID Code
[Unshared] Type: Lookup Table - Integer
[Unshared] Length: 1
Codes:
0
Other; any type of entity not otherwise defined that performs health care services.
1
Person; physician, clinician, orthodontist, and any individual that is licensed/certified to perform health care services.
2
Facility; hospital, health center, long term care, rehabilitation and any building that is licensed to transact health care services.
3
Professional Group; collection of licensed/certified health care professionals that are practicing health care services under the same entity name and Federal Tax Identification Number.
4
Retail Site; brick-and-mortar licensed/certified place of transaction that is not solely a health care entity, i.e., pharmacies, independent laboratories, vision services.
5
E-Site; internet-based order/logistic system of health care services, typically in the form of durable medical equipment, pharmacy or vision services. Address assigned should be the address of the company delivering services or order fulfillment.
6
Financial Parent; financial governing body that does not perform health care services itself but directs and finances health care service entities, usually through a Board of Directors.
7
Transportation; any form of transport that conveys a patient to/from a healthcare provider.
[Unshared] Name: Provider ID Code
[Unshared] Type: Lookup Table - Integer
[Unshared] Length: 1
Codes:
0
Other; any type of entity not otherwise defined that performs health care services.
1
Person; physician, clinician, orthodontist, and any individual that is licensed/certified to perform health care services.
2
Facility; hospital, health center, long term care, rehabilitation and any building that is licensed to transact health care services.
3
Professional Group; collection of licensed/certified health care professionals that are practicing health care services under the same entity name and Federal Tax Identification Number.
4
Retail Site; brick-and-mortar licensed/certified place of transaction that is not solely a health care entity, i.e., pharmacies, independent laboratories, vision services.
5
E-Site; internet-based order/logistic system of health care services, typically in the form of durable medical equipment, pharmacy or vision services. Address assigned should be the address of the company delivering services or order fulfillment.
6
Financial Parent; financial governing body that does not perform health care services itself but directs and finances health care service entities, usually through a Board of Directors.
7
Transportation; any form of transport that conveys a patient to/from a healthcare provider.
PV035
[Shared] Name: SSN Id
[Unshared] Type: Text
[Shared] Length: 9
[Shared] Name: SSN Id
[Unshared] Type: Numeric
[Shared] Length: 9
[Shared] Name: SSN Id
[Unshared] Type: Numeric
[Shared] Length: 9
PV036
[Unshared] Name: Medicare Id
[Shared] Type: Text
[Shared] Length: 30
[Unshared] Name: Medicare ID
[Shared] Type: Text
[Shared] Length: 30
[Unshared] Name: Medicare ID
[Shared] Type: Text
[Shared] Length: 30
PV037
[Shared] Name: Begin Date
[Unshared] Type: Date
[Shared] Length: 8
[Shared] Name: Begin Date
[Unshared] Type: Full Date - Integer
[Shared] Length: 8
[Shared] Name: Begin Date
[Unshared] Type: Full Date - Integer
[Shared] Length: 8
PV038
[Shared] Name: End Date
[Unshared] Type: Date
[Shared] Length: 8
[Shared] Name: End Date
[Unshared] Type: Full Date - Integer
[Shared] Length: 8
[Shared] Name: End Date
[Unshared] Type: Full Date - Integer
[Shared] Length: 8
PV039
[Shared] Name: National Provider ID
[Unshared] Type: Text
[Unshared] Length: 25
[Shared] Name: National Provider ID
[Unshared] Type: External Code Source 3 - Integer
[Unshared] Length: 10
[Shared] Name: National Provider ID
[Unshared] Type: External Code Source 3 - Integer
[Unshared] Length: 10
PV040
[Unshared] Name: National Provider2 ID
[Unshared] Type: Text
[Unshared] Length: 25
[Unshared] Name: National Provider ID 2
[Unshared] Type: External Code Source 3 - Integer
[Unshared] Length: 10
[Unshared] Name: National Provider ID 2
[Unshared] Type: External Code Source 3 - Integer
[Unshared] Length: 10
PV041
[Shared] Name: GIC Provider Link ID
[Shared] Type: Text
[Shared] Length: 25
[Shared] Name: GIC Provider Link ID
[Shared] Type: Text
[Shared] Length: 25
[Shared] Name: GIC Provider Link ID
[Shared] Type: Text
[Shared] Length: 25
PV042
[Unshared] Name: Secondary Specialty2 Code
[Unshared] Type: Text
[Shared] Length: 10
[Unshared] Name: Proprietary Specialty Code
[Unshared] Type: Carrier Defined Table - Text
[Shared] Length: 10
[Unshared] Name: Proprietary Specialty Code
[Unshared] Type: Carrier Defined Table - Text
[Shared] Length: 10
PV043
[Unshared] Name: Secondary Specialty3 Code
[Unshared] Type: Text
[Shared] Length: 10
[Unshared] Name: Other Specialty Code 2
[Unshared] Type: Carrier Defined Table - OR - External Code Source 4 - Integer
[Shared] Length: 10
[Unshared] Name: Other Specialty Code 2
[Unshared] Type: Carrier Defined Table - OR - External Code Source 4 - Integer - OR - Carrier Defined Table
[Shared] Length: 10
PV044
[Unshared] Name: Secondary Specialty4 Code
[Unshared] Type: Text
[Shared] Length: 10
[Unshared] Name: Other Specialty Code 3
[Unshared] Type: Carrier Defined Table - OR - External Code Source 4 - Integer
[Shared] Length: 10
[Unshared] Name: Other Specialty Code 3
[Unshared] Type: Carrier Defined Table - OR - External Code Source 4 - Integer - OR - Carrier Defined Table
[Shared] Length: 10
PV045
[Unshared] Name: P4PFlag
[Unshared] Type: Text
[Shared] Length: 1
Codes:
1
Yes
2
No
3
Unknown
4
Other
5
Not Applicable
[Unshared] Name: Pay for Performance Flag
[Unshared] Type: Lookup Table - Integer
[Shared] Length: 1
Codes:
1
Yes
2
No
3
Unknown
4
Other
5
Not Applicable
[Unshared] Name: Pay for Performance Flag
[Unshared] Type: Lookup Table - Integer
[Shared] Length: 1
Codes:
1
Yes
2
No
3
Unknown
4
Other
5
Not Applicable
PV046
[Unshared] Name: NonClaimsFlag
[Unshared] Type: Text
[Shared] Length: 1
Codes:
1
Yes
2
No
3
Unknown
4
Other
5
Not Applicable
[Unshared] Name: NonClaims Flag
[Unshared] Type: Lookup Table - Integer
[Shared] Length: 1
Codes:
1
Yes
2
No
3
Unknown
4
Other
5
Not Applicable
[Unshared] Name: NonClaims Flag
[Unshared] Type: Lookup Table - Integer
[Shared] Length: 1
Codes:
1
Yes
2
No
3
Unknown
4
Other
5
Not Applicable
PV047
[Unshared] Name: Uses Electronic Medical Records
[Unshared] Type: Text
[Shared] Length: 1
Codes:
1
Yes
2
No
3
Unknown
4
Other
5
Not Applicable
[Unshared] Name: Uses Electronic Health Records
[Unshared] Type: Lookup Table - Integer
[Shared] Length: 1
Codes:
1
Yes
2
No
3
Unknown
4
Other
5
Not Applicable
[Unshared] Name: Filler
[Unshared] Type: filler
[Shared] Length: 1
Codes:
 
 
 
 
 
 
 
 
 
 
PV048
[Unshared] Name: EMR Vendor
[Unshared] Type: Text
[Shared] Length: 40
[Unshared] Name: EHR Vendor
[Unshared] Type: Text
[Shared] Length: 40
[Unshared] Name: Filler
[Unshared] Type: Filler
[Shared] Length: 40
PV049
[Shared] Name: Accepting New Patients
[Unshared] Type: Text
[Shared] Length: 1
Codes:
1
Yes
2
No
3
Unknown
4
Other
5
Not Applicable
[Shared] Name: Accepting New Patients
[Unshared] Type: Lookup Table - Integer
[Shared] Length: 1
Codes:
1
Yes
2
No
3
Unknown
4
Other
5
Not Applicable
[Shared] Name: Accepting New Patients
[Unshared] Type: Lookup Table - Integer
[Shared] Length: 1
Codes:
1
Yes
2
No
3
Unknown
4
Other
5
Not Applicable
PV050
[Unshared] Name: Offers e-Visits
[Unshared] Type: Text
[Shared] Length: 1
Codes:
1
Yes
2
No
3
Unknown
4
Other
5
Not Applicable
[Unshared] Name: Offers e-Visits
[Unshared] Type: Lookup Table - Integer
[Shared] Length: 1
Codes:
1
Yes
2
No
3
Unknown
4
Other
5
Not Applicable
[Unshared] Name: Filler
[Unshared] Type: Filler
[Shared] Length: 1
Codes:
 
 
 
 
 
 
 
 
 
 
PV051
[Shared] Name: Filler
[Shared] Type: Filler
[Unshared] Length: 20
[Shared] Name: Filler
[Shared] Type: Filler
[Unshared] Length: 0
[Shared] Name: Filler
[Shared] Type: Filler
[Unshared] Length: 0
PV052
[Shared] Name: Has multiple offices
[Unshared] Type: Text
[Shared] Length: 1
Codes:
1
Yes
2
No
3
Unknown
4
Other
5
Not Applicable
[Shared] Name: Has multiple offices
[Unshared] Type: Lookup Table - Integer
[Shared] Length: 1
Codes:
1
Yes
2
No
3
Unknown
4
Other
5
Not Applicable
[Shared] Name: Has multiple offices
[Unshared] Type: Lookup Table - Integer
[Shared] Length: 1
Codes:
1
Yes
2
No
3
Unknown
4
Other
5
Not Applicable
PV053
[Shared] Name: Filler
[Shared] Type: Text
[Unshared] Length: 1
[Shared] Name: Filler
[Shared] Type: Text
[Unshared] Length: 0
[Shared] Name: Filler
[Shared] Type: Text
[Unshared] Length: 0
PV054
[Unshared] Name: Medical/Healthcare Home ID
[Shared] Type: Text
[Shared] Length: 15
[Unshared] Name: Medical / Healthcare Home ID
[Shared] Type: Text
[Shared] Length: 15
[Unshared] Name: Medical / Healthcare Home ID
[Shared] Type: Text
[Shared] Length: 15
PV055
[Shared] Name: PCP Flag
[Unshared] Type: Text
[Shared] Length: 1
Codes:
1
Yes
2
No
3
Unknown
4
Other
5
Not Applicable
[Shared] Name: PCP Flag
[Unshared] Type: Lookup Table - Integer
[Shared] Length: 1
Codes:
1
Yes
2
No
3
Unknown
4
Other
5
Not Applicable
[Shared] Name: PCP Flag
[Unshared] Type: Lookup Table - Integer
[Shared] Length: 1
Codes:
1
Yes
2
No
3
Unknown
4
Other
5
Not Applicable
PV056
[Shared] Name: Provider Affiliation
[Shared] Type: Text
[Shared] Length: 30
[Shared] Name: Provider Affiliation
[Shared] Type: Text
[Shared] Length: 30
[Shared] Name: Provider Affiliation
[Shared] Type: Text
[Shared] Length: 30
PV057
[Shared] Name: Provider Telephone
[Unshared] Type: Text
[Shared] Length: 10
[Shared] Name: Provider Telephone
[Unshared] Type: Numeric
[Shared] Length: 10
[Shared] Name: Provider Telephone
[Unshared] Type: Numeric
[Shared] Length: 10
PV058
[Shared] Name: Delegated Provider Record Flag
[Unshared] Type: Text
[Shared] Length: 1
Codes:
1
Yes
2
No
3
Unknown
4
Other
5
Not Applicable
[Shared] Name: Delegated Provider Record Flag
[Unshared] Type: Lookup Table - Integer
[Shared] Length: 1
Codes:
1
Yes
2
No
3
Unknown
4
Other
5
Not Applicable
[Shared] Name: Delegated Provider Record Flag
[Unshared] Type: Lookup Table - Integer
[Shared] Length: 1
Codes:
1
Yes
2
No
3
Unknown
4
Other
5
Not Applicable
PV059
[Shared] Name: Filler
[Shared] Type: Filler
[Unshared] Length: 2
[Shared] Name: Filler
[Shared] Type: Filler
[Unshared] Length: 0
[Shared] Name: Filler
[Shared] Type: Filler
[Unshared] Length: 0
PV060
[Shared] Name: Office Type
[Unshared] Type: Text
[Shared] Length: 1
Codes:
0
Other
1
Facility
2
Doctors office
3
Clinic
4
Walk in Clinic
5
Laboratory
[Shared] Name: Office Type
[Unshared] Type: Lookup Table - Integer
[Shared] Length: 1
Codes:
0
Other
1
Facility
2
Doctors office
3
Clinic
4
Walk in Clinic
5
Laboratory
[Shared] Name: Office Type
[Unshared] Type: Lookup Table - Integer
[Shared] Length: 1
Codes:
0
Other
1
Facility
2
Doctors office
3
Clinic
4
Walk in Clinic
5
Laboratory
PV061
[Shared] Name: Prescribing Provider
[Unshared] Type: Text
[Shared] Length: 1
Codes:
1
Yes
2
No
3
Unknown
4
Other
5
Not Applicable
[Shared] Name: Prescribing Provider
[Unshared] Type: Lookup Table - Integer
[Shared] Length: 1
Codes:
1
Yes
2
No
3
Unknown
4
Other
5
Not Applicable
[Shared] Name: Prescribing Provider
[Unshared] Type: Lookup Table - Integer
[Shared] Length: 1
Codes:
1
Yes
2
No
3
Unknown
4
Other
5
Not Applicable
PV062
[Shared] Name: Provider Affiliation Start Date
[Unshared] Type: Date
[Shared] Length: 8
[Shared] Name: Provider Affiliation Start Date
[Unshared] Type: Full Date - Integer
[Shared] Length: 8
[Shared] Name: Provider Affiliation Start Date
[Unshared] Type: Full Date - Integer
[Shared] Length: 8
PV063
[Shared] Name: Provider Affiliation End Date
[Unshared] Type: Date
[Shared] Length: 8
[Shared] Name: Provider Affiliation End Date
[Unshared] Type: Full Date - Integer
[Shared] Length: 8
[Shared] Name: Provider Affiliation End Date
[Unshared] Type: Full Date - Integer
[Shared] Length: 8
PV064
[Shared] Name: PPO Indicator
[Unshared] Type: Text
[Shared] Length: 1
Codes:
1
Yes
2
No
3
Unknown
4
Other
5
Not Applicable
[Shared] Name: PPO Indicator
[Unshared] Type: Lookup Table - Integer
[Shared] Length: 1
Codes:
1
Yes
2
No
3
Unknown
4
Other
5
Not Applicable
[Shared] Name: PPO Indicator
[Unshared] Type: Lookup Table - Integer
[Shared] Length: 1
Codes:
1
Yes
2
No
3
Unknown
4
Other
5
Not Applicable
PV065
Data Element: PV065
not present in this file submission.
[Unshared] Name: Filler
[Unshared] Type: Filler
[Unshared] Length: 0
Codes:
 
 
 
 
 
 
 
 
 
 
 
 
 
 
[Unshared] Name: Disbursement Code
[Unshared] Type: Lookup Table - Integer
[Unshared] Length: 1
Codes:
0
Pay
1
State Agency
2
Muni-Med
3
Non-Billing
4
EHR Incentive provider only-No Pay
5
EHR incentive provider expenditure only
6
Health Safety Net
PV066
Data Element: PV066
not present in this file submission.
[Unshared] Name: Filler
[Unshared] Type: Filler
[Unshared] Length: 0