Data Elements

Field IDField_NameField_Description
200772ldate(CA)LOCUS Date
200669notes180-Day Review Notes
201126safeAbility to keep self safe
200783dim6bAccept./Engagmnt - Prnt/Prim. Care Taker Score
200782dim6aAcceptance and Engagement - Child/Adolescent Score
201872RACTIONAction Code
030010RACTIONAction Code
201408RACTIONAction Code
200640addlinfoAdd'l Information to Consider
201561adateAdmission Date
101039adateAdmission Date
030050ax1sdAdmission Diagnosis
030060adsrccdAdmission Source Code
030840atimeAdmission Time
201701atimeAdmission Time (HH:MM)
030080adtypcdAdmission Type Code
201508AdvDirAdvance Directive
201106AdvDirAdvance Directives (y/n)
201578AGE1Age At First Use (1)
201584AGE2Age At First Use (2)
201590AGE3Age At First Use (3)
201702ALCSAgency Licensing and Certification Site ID
200650orgnpiAgency National Provider Identifier
201409RORGAgency Reporting Unit ID
201874RORGAgency Reporting Unit ID
030020RORGAgency Reporting Unit ID
200923txorgAgency Transferred to
201562ALTLNAlternative Last Name
200123incomeAnnual Gross Income
200676apprenddtApproved End Date
200675apprstdtApproved Start Date
201600AGEGRPASAM Age Group
201599ANTOUTASAM Anticipated Outcome
201595ADATEASAM Assessment Date
201601DIM1ASAM Dimension 1
201602DIM2ASAM Dimension 2
201603DIM3ASAM Dimension 3
201604DIM4ASAM Dimension 4
201605DIM5ASAM Dimension 5
201606DIM6ASAM Dimension 6
201544asamlvlASAM Level
201596ALVLIASAM Level Indicated
201597ALVRASAM Level Received
201598DIFREAASAM Reason For Difference
200627intkstfAssessment Clinician Name (LName, FName)
200272faccdAssessment Facility Code
200955agy1Assigned Agency
200957agy2Assigned Agency
200674asauthAssigned Authorization Number
030200certAuthorization Number
201123ffsupptAvailability of support friends/family
101003batdtBatch Date
201406BATFILEBatch File
101004batnoBatch Number
201547bdateBegin Date
201548btimeBegin Time
201516BHPABehavioral Health Provider Agency
200312bookdtBooking Date
201525COTYPCall Out Type
201127stressCapacity to handle stress/change
200952causeCause Number
200974causeCause Number
200651certtypCertification Type Code (Authorization)
201515ChildPetsChild/Pets in home needing care
201101declineChoose not to do crisis plan (y/n)
200668tpr4Client Has a History of Chronic MH Needs…
200665tpr1Client's Condition Continues to Meet Admission…
200661tpr5Client's Condition Continues to Meet Continued…
201527presprobClient's Presenting Problem at Intake
200921cjustClinical Justification for Difference
200920lrecClinician Level of Care Recommendation
200657staffnpiClinician National Provider Identifier
201125cognitiveCognitive Functioning
200775dim3Co-Morbidity Score
200659cdateCompleted Date
030210cmpdxpt1Composite Diagnosis Code Pointer 1
030220cmpdxpt2Composite Diagnosis Code Pointer 2
030230cmpdxpt3Composite Diagnosis Code Pointer 3
030240cmpdxpt4Composite Diagnosis Code Pointer 4
200919cscoreComposite Score
200183addr1Consumer Address Line 1
200184addr2Consumer Address Line 2
200185cityConsumer City
030190PNOLDConsumer ID to be Voided
200186phone1Consumer Phone Num 1
200187phone2Consumer Phone Num 2
030250psta1Consumer Phone Status 1
030260psta2Consumer Phone Status 2
200189ptype1Consumer Phone Type 1
200190ptype2Consumer Phone Type 2
200192stateConsumer State
200193zipConsumer ZIP Code (#########)
200667tpr3Continued Service is Court Ordered
200663tpr7Continued Service is Court Ordered by LRA/CR
200664tpr8Continued Treatment is Deemed Medically…
200704aquadvalCo-Occurring Disorder Assessment Quadrant Value
200702edsCo-Occurring Disorder EDS Screening Score
200701idsCo-Occurring Disorder IDS Screening Score
200703sdsCo-Occurring Disorder SDS Screening Score
201519coOccurIssCo-Occurring Issues
200130COUNTCounty of Residence
200130countyCounty of Residence
201559svccntyCounty of Service
200257cptCPT Code
201550outcCrisis Outcome
200267dothersDangerous to Others
200269propertyDangerous to Property
200266dselfDangerous to Self
030270cadateDate Crisis Plan Entered
030270ctdateDate Crisis Plan Entered
201582DLU1Date Last Used (1)
201588DLU2Date Last Used (2)
201594DLU3Date Last Used (3)
200643autdtDate of Authorization Request
101014dobDate of Birth
201415DAYSOUTDays Outstanding
200128gradeDegree (Grade Level)
201801DREASDelay Reason
201506OtherDescDescription of other potential risk factors
200973detctyDetention County
201575DIAG2Diagnosis 2
030310diag2Diagnosis 2
201576DIAG2DTDiagnosis 2 Date
030320diag3Diagnosis 3
030330diag4Diagnosis 4
030340diag5Diagnosis 5
030350diag6Diagnosis 6
030360diag7Diagnosis 7
030370diag8Diagnosis 8
200646diagdtDiagnosis Date
030390ddateDischarge Date
201781DCDATEDischarge Date
030410ax2pdxDischarge Diagnosis 1
030430ax2sdxDischarge Diagnosis 2
030850dtimeDischarge Time
201782DCTimeDischarge Time (HH:MM)
201303CASENODispatch Case Number
201306COUNTYDispatch County
030880ddateDispatch Date
201301DISPDTDispatch Date
201304DISPLODispatch Location
201305DISPSTDispatch Staff Type
201302DISPTMDispatch Time
030890dtimeDispatch Time
201524CODISPDisposition of Call Out
200607reasdelDocumented Reason for Assessment Delay
200658ddateDue Date
030290durDuration of Stay
201149EDATEEffective Date
030440edateEffective Date
200141modateEffective Date
200949edateEffective Date
201884EligCr1Eligibility Criteria 1
201885EligCr2Eligibility Criteria 2
201886EligCr3Eligibility Criteria 3
201887EligCr4Eligibility Criteria 4
201882EligTypEligibility Type
101053estaEmployment Status
201555emsdoEMS Drop Off
201150TDATEEnd Date
201878EndDateEnd Date for Eligibility YYYY-MM-DD
200666tpr2Ending Episode of Care…Would Not Be…
200779dim6Engagement Score
030460CDATEEpisode End (Close) Date
030460cdateEpisode End Date
030470episEpisode ID
030480ADATEEpisode Start (Admit) Date
030480adateEpisode Start Date
030490epistypeEpisode Type
201786EPISTYPEEpisode Type
201784EPISTYPEEpisode Type
030520eflagEPSDT Indicator
201412ERRCODEError Code
201414ERRDATEError Create Date
201413ERRMSGError Message
030530eth1Ethnicity 1
030540eth2Ethnicity 2
030550eth3Ethnicity 3
201401ebp01Evidence Based Practice 1
201402ebp02Evidence Based Practice 2
201403ebp03Evidence Based Practice 3
201404ebp04Evidence Based Practice 4
201405ebp05Evidence Based Practice 5
201888ResPlcExpected Residential Placement
200608authtypExpedited Authorization Flag
201574EXPFLExpedited Flag
201520RiskDescExplanation of Risk Factors checked above
200606extreqExtension Requested by
200272faccdFacility Code
201560factypFacility Type - Stabilization or Triage
201504HxFamilyFamily History (Suicide/psychiatric disorders)
200937faiadtFirst Accepted Intake Appointment Date
200938faiatmFirst Accepted Intake Appointment Time
200940footdFirst Offered Appointment Reason
200934foiadtFirst Offered Intake Appointment Date
200935foiatmFirst Offered Intake Appointment Time
200943fradtFRA Accepted Date
200944fratmFRA Accepted Time
200946nofraFRA not occurred reason codes
200941frodtFRA Offered Date
200942frotmFRA Offered Time
200933frascdFRAS Outside 28-Days Reason Codes
201579FREQ1Frequency of Use (1)
201585FREQ2Frequency of Use (2)
201591FREQ3Frequency of Use (3)
201513NatSupNameFriend/Natural Support Name
201514NatSupPhonFriend/Natural Support Phone
200774dim2Functional Status Score
200947gdateGAINS Date
201540medicalGeneral Medical Conditions
101020firstGiven Name
201151t1Global Alert Text 1
201152t2Global Alert Text 2
201153t3Global Alert Text 3
201154t4Global Alert Text 4
201155t5Global Alert Text 5
200268gravelyGravely Disabled
200647adlguidGUID of Additional Authorization Request Info.
200126posHealth Care Service Location
201783HCAUSEHearing Cause Number (Court Docket)
101077countyHearing County
101076hdateHearing Date
200270houtcHearing Outcome
030570shdateHire Date
010121horgHispanic Origin
201503HxAggressHistory of agression
201132HxTraumaHistory of trauma/victimization
201107AdinfoIf AD, what info is important…
030580impk1Impairment Kind 1
030590impk2Impairment Kind 2
030600impk3Impairment Kind 3
201128impulseImpulse control/judgement
030610initauthInitial Authorized Days
030030RORGInpatient Facility Reporting Unit ID
200604iaidateIntake Assessment Initiated Date
200315jailintkIntake Completed in Jail Code
200929nointcdIntake Not Occurred Reason Code
200624sitefaxIntake Staff Site Fax Number
101058countyInvestigation County
101059bdateInvestigation Date
201573EDATEInvestigation End Date
101060outcInvestigation Outcome
101061btimeInvestigation Start Time
200311jailcdJail Code
201554lawdoLaw Enforcement Drop-off
201511LglGrdCntcLegal Guardian Contact Info
201510LglGrdNameLegal Guardian Name
201509LegalGuardLegal Guardian Y/N
200247lstatLegal Status
200622sitestMain Site Address Line 2
200625sitecityMain Site City
200623sitetelMain Site Telephone Number
200626sitezipMain Site ZIP Code
200962x7Maintain health and safety
201564MARSTMarital Status
201411PNMaster Client Number
030620PNMaster Client Number
201876PNMaster Client Number
200316macijMedicaid Application Completed Code
201518MedIssuesMedical Issues
201517MedPCPMedical Primary Care Provider
201139MedNonComMedication non-compliance
201581METH1Method (1)
201587METH2Method (2)
201593METH3Method (3)
200199miMiddle Initial
201563MILSVCMilitary Service
101063minMinutes of Service
201133MultResMultiple residential placements
201571NUENeedle Use Ever
200601nomailNo Mail Flag
201572NSTYPNo Show Type
200925ntxreasNot Transferred to Agency Reason Codes
201873RSNIDNSBHO Reporting ID
200660nocompNumber of Completed Reviews
200124peopleNumber of Dependents
201890NumDepNumber of Dependents Dependent on income 99
200645orgeinOrganization Employer Identification Number
200650orgnpiOrganization National Provider Identification
200964otherOther conditions
200972other2Other conditions - second line
200602pgnameParent/Guardian Name
200956x2Participate in and follow…
200954x1Participate in and follow…
030640psigsrcPatient Signature Source Code
030650pstatcdPatient Status Code
201580PEAK1Peak Use (1)
201586PEAK2Peak Use (2)
201592PEAK3Peak Use (3)
201551prinvPeer Involved
201135PhysDisPhysical disability/other medical condition
200126posPlace of Service
030670detainPlacement (Rpt Unit)
200918plevelPlacement Grid Level
201883PovLvlPoverty Level
201512PwrAttPower of Attorney
101024planPreferred Language
200654priorautPrevious Authorization Number
030690CLINPCODEPrimary Clinician
200310icrirPrimary Intervention Reason
030710diagPrincipal Diagnosis
030710ax1pdPrincipal Diagnosis
030710princdiaPrincipal Diagnosis/Primary Qualifying Diagnosis
200709priorPrior Authorization or Referral Number
101026priorPriority Code
200705mod1Procedure Modifier 1
200706mod2Procedure Modifier 2
200707mod3Procedure Modifier 3
200708mod4Procedure Modifier 4
200656eautperProposed End of Authorization Period
200655sautperProposed Start of Authorization Period
030910prvtpProvider Type
101018P1IDProviderOne Client ID
201541peprob1Psychosocial/Environmental Problems - Primary
201542peprob2Psychosocial/Environmental Problems - Secondary
201543peprob3Psychosocial/Environmental Problems - Tertiary
200310icrirReason for Referral
201407TxIDRecord Type
200776dim4aRecovery Environment - Level of Stress Score
200777dim4bRecovery Environment - Level of Support Score
030720refidReference Identification
030680referralReferral From/Referral Source
200309icrrsReferral Source
201556refhospReferring Hospital
200960x5Refrain from drugs/alcohol
200963x8Refrain from possessing firearms
200961x6Refrain from threats or acts of harm
200677rmessReject Message
200673rejectcdReject Reason
200313exitdtRelease Date
030750roicdRelease of Information Code
030670detainReporting Unit Ordered To
200958x3Reside at approved residence
200129lsitResidence (Living Situation)
200781dim5Resiliency and Treatment History Score
201416RESREASResolve Reason
200672actcdReview Action Code
200670staffidReviewd By
200771revidReviewer ID
101087revokRevoke Initiated
200271rvkotRevoked - Reason other than above
030740rightsRights Read
200773dim1Risk of Harm Score
200926forguidRLGUID of First Offered/Referral
200924rfsguidRLGUID of Request For Service
200930rfsguidRLGUID of Request For Service
200939rsaguidRLGUID of Request for Svc - Addl. Info.
030750roicodeROI Code
030750roicdROI Code
200314rsnhistRSN History Code
030760RSNIDRSN Report Unit
201136RunningRunning Away
201568SCHLASchool Attendance
200948saiScreen Assessment Indicator
201536sedca5SED Capacity - Functioning at School Work
201533sedca2SED Capacity - Functioning in Community
201532sedca1SED Capacity - Functioning in Self-Care
201534sedca3SED Capacity - Functioning in Social Relationships
201535sedca4SED Capacity - Functioning in the Family
201538sedsy2SED Symptoms - Danger to self, others, or property
201537sedsy1SED Symptoms - Psychotic Symptoms
201539sedsy3SED Symptoms - Trauma Symptoms
201121selfcareSelf-Care Skills
201502SelfHarmSelf-harm behavior
201569SELFHSelf-Help Count
200970svccityService City
201549countyService County
101067sdateService Date
200968svcaddr1Service Street Address
200969svcaddr2Service Street Address 2
200652svctypService Type Code
200971svczipService ZIP
101068sexorSexual Orientation
201530smi3SMI - Dysfunction in Role Performance
201528smi1SMI - Inability to Live Without Supervision
201531smi4SMI - Risk of Deterioration
201529smi2SMI - Risk of Serious Harm to Others
201567SMOKESmoking Status
201124socialSocial Behaviors
101033ssSocial Security Number
201122lsitstabStability of living situation
200966fnameStaff First Name
200976stfsexStaff Gender
030770staffidStaff ID
200977lang1Staff Language 1
200978lang2Staff Language 2
200979lang3Staff Language 3
200980lang4Staff Language 4
200981lang5Staff Language 5
200965lnameStaff Last Name
200657staffnpiStaff National Provider Identification
201526PhoneStaff Phone
200967prvtpStaff Provider Type
030780pwacs1Staff Specialty 1
031260pwacs2Staff Specialty 2
031270pwacs3Staff Specialty 3
031280pwacs4Staff Specialty 4
031290pwacs5Staff Specialty 5
031300pwacs6Staff Specialty 6
031310pwacs7Staff Specialty 7
031320pwacs8Staff Specialty 8
031330pwacs9Staff Specialty 9
201877StartDateStart Date for Eligibility YYYY-MM-DD
201505StressorsStressors/triggering events
101027suborgSubmitting Reporting Unit ID
200649idSubscriber Supplemental ID-Reference ID
200648idqualSubscriber Supplemental ID-Reference ID Qualifier
201577SUB1Substance (1)
201583SUB2Substance (2)
201589SUB3Substance (3)
201522HxIntervSuccessful Hx Interventions for Managing Crises
201501HxSuicideSuicidal (history of prior suicide attempts)
200959x4Take prescribed meds
030800stdateTermination Date
200950tdateTermination Date
200644auttmTime of Authorization Request
200671reviewtimeTimestamp of the Authorization Review
030810authextTotal Authorized Extension Days
101073RCODETransaction ID
201871RCODETransaction ID
200778dim5Treatment and Recovery History Score
200662tpr6Treatment Plan Includes Discharge…
201410RLGUIDUnique Identifier
030001RLGUIDUnique Identifier
201875RLGUIDUnique Identifier
201570USENEUsed Needle Recently
201879VdateVerification Date YYYY-MM-DD
201880VincomeVerified Income Amount 999999.99
201881VIncSrcVerified Income Source
201523IntervStraWhat intervention strategies prior to I/P care?
201521ProtectFxWhat protective factors are present?
201108healthWhat safety/health concerns