| Field ID | Field Name | Field Description |
| 200772 | ldate | (CA)LOCUS Date |
| 200669 | notes | 180-Day Review Notes |
| 200632 | bqual2 | 2+ I/P admits due to MH dx during prev. 2-yrs |
| 201126 | safe | Ability to keep self safe |
| 200783 | dim6b | Accept./Engagmnt - Prnt/Prim. Care Taker Score |
| 200782 | dim6a | Acceptance and Engagement - Child/Adolescent Score |
| 030010 | RACTION | Action Code |
| 200640 | addlinfo | Add'l Information to Consider |
| 101039 | adate | Admission Date |
| 030050 | ax1sd | Admission Diagnosis |
| 030060 | adsrccd | Admission Source Code |
| 030840 | atime | Admission Time |
| 030080 | adtypcd | Admission Type Code |
| 201106 | AdvDir | Advance Directives (y/n) |
| 200650 | orgnpi | Agency National Provider Identifier |
| 030020 | RORG | Agency Reporting Unit ID |
| 200923 | txorg | Agency Transferred to |
| 200123 | income | Annual Gross Income |
| 200676 | apprenddt | Approved End Date |
| 200675 | apprstdt | Approved Start Date |
| 201140 | assaultive | Assaultiveness towards others |
| 200627 | intkstf | Assessment Clinician Name (LName, FName) |
| 200272 | faccd | Assessment Facility Code |
| 200957 | agy2 | Assigned Agency |
| 200955 | agy1 | Assigned Agency |
| 200674 | asauth | Assigned Authorization Number |
| 030200 | cert | Authorization Number |
| 201123 | ffsuppt | Availability of support friends/family |
| 101003 | batdt | Batch Date |
| 101004 | batno | Batch Number |
| 200312 | bookdt | Booking Date |
| 201127 | stress | Capacity to handle stress/change |
| 200974 | cause | Cause Number |
| 200952 | cause | Cause Number |
| 200651 | certtyp | Certification Type Code (Authorization) |
| 200145 | cgas | CGAS |
| 200636 | bqual6 | Child Age<6 - Atypical Behavioral Patterns… |
| 200637 | bqual7 | Child Age<6 - Atypical Emotional Response… |
| 200635 | bqual5 | Child Only-At risk of escalating symptoms due… |
| 201101 | decline | Choose not to do crisis plan (y/n) |
| 200668 | tpr4 | Client Has a History of Chronic MH Needs… |
| 200665 | tpr1 | Client's Condition Continues to Meet Admission… |
| 200661 | tpr5 | Client's Condition Continues to Meet Continued… |
| 200641 | presprob | Client's Presenting Problem at Access |
| 200921 | cjust1 | Clinical Justification for Difference |
| 200920 | lrec | Clinician Level of Care Recommendation |
| 200657 | staffnpi | Clinician National Provider Identifier |
| 201125 | cognitive | Cognitive Functioning |
| 200775 | dim3 | Co-Morbidity Score |
| 200659 | cdate | Completed Date |
| 030210 | cmpdxpt1 | Composite Diagnosis Code Pointer 1 |
| 030220 | cmpdxpt2 | Composite Diagnosis Code Pointer 2 |
| 030230 | cmpdxpt3 | Composite Diagnosis Code Pointer 3 |
| 030240 | cmpdxpt4 | Composite Diagnosis Code Pointer 4 |
| 200919 | cscore | Composite Score |
| 030870 | cons | Consultation |
| 031000 | cd_sys | Consultation - CD System |
| 030930 | cdmhp | Consultation - CDMHP |
| 030940 | child | Consultation - Child |
| 031010 | crime | Consultation - Criminal Justice System |
| 030990 | dd_sys | Consultation - DD System |
| 030960 | ethnic | Consultation - Ethnic Minority |
| 030970 | family | Consultation - Family and Natural Supports |
| 030980 | hospital | Consultation - Hospital ER |
| 030950 | older | Consultation - Older Adult System |
| 031030 | ocmhp | Consultation - Other CMH Professional |
| 031020 | pro_out | Consultation - Other Professional - Outside ICRS |
| 031040 | pro_in | Consultation - Other Professional - Within ICRS |
| 031060 | pcp | Consultation - Primary Care Provider |
| 030920 | psych | Consultation - Psychiatrist |
| 031340 | school | Consultation - School |
| 200183 | addr1 | Consumer Address Line 1 |
| 200184 | addr2 | Consumer Address Line 2 |
| 200185 | city | Consumer City |
| 030190 | PNOLD | Consumer ID to be Voided |
| 200186 | phone1 | Consumer Phone Num 1 |
| 200187 | phone2 | Consumer Phone Num 2 |
| 030250 | psta1 | Consumer Phone Status 1 |
| 030260 | psta2 | Consumer Phone Status 2 |
| 200189 | ptype1 | Consumer Phone Type 1 |
| 200190 | ptype2 | Consumer Phone Type 2 |
| 200192 | state | Consumer State |
| 200193 | zip | Consumer ZIP Code |
| 200667 | tpr3 | Continued Service is Court Ordered |
| 200663 | tpr7 | Continued Service is Court Ordered by LRA/CR |
| 200664 | tpr8 | Continued Treatment is Deemed Medically… |
| 200704 | aquadval | Co-Occurring Disorder Assessment Quadrant Value |
| 200702 | eds | Co-Occurring Disorder EDS Screening Score |
| 200701 | ids | Co-Occurring Disorder IDS Screening Score |
| 200703 | sds | Co-Occurring Disorder SDS Screening Score |
| 200951 | count | County |
| 200130 | county | County of Residence |
| 200257 | cpt | CPT Code |
| 201143 | Criminal | Criminal Behavior |
| 200267 | dothers | Dangerous to Others |
| 200269 | property | Dangerous to Property |
| 200266 | dself | Dangerous to Self |
| 030270 | cadate | Date Crisis Plan Entered |
| 030270 | ctdate | Date Crisis Plan Entered |
| 200643 | autdt | Date of Authorization Request |
| 101014 | dob | Date of Birth |
| 200147 | dc03 | DC03 |
| 200973 | detcty | Detention County |
| 200922 | deter | Determination |
| 200611 | ax1pri | Diagnosis - Axis I - Primary |
| 200612 | ax1sec | Diagnosis - Axis I - Secondary |
| 200613 | ax1ter | Diagnosis - Axis I - Tertiary |
| 200206 | axis1a | Diagnosis - Axis I Primary |
| 200207 | axis1b | Diagnosis - Axis I Secondary |
| 200614 | ax2pri | Diagnosis - Axis II - Primary |
| 200615 | ax2sec | Diagnosis - Axis II - Secondary |
| 200616 | ax2ter | Diagnosis - Axis II - Tertiary |
| 200208 | axis2a | Diagnosis - Axis II Primary |
| 200209 | axis2b | Diagnosis - Axis II Secondary |
| 200617 | ax3 | Diagnosis - Axis III |
| 200618 | ax4pri | Diagnosis - Axis IV - Primary |
| 200619 | ax4sec | Diagnosis - Axis IV - Secondary |
| 200620 | ax4ter | Diagnosis - Axis IV - Tertiary |
| 200621 | ax5 | Diagnosis - Axis V |
| 030310 | diag2 | Diagnosis 2 |
| 030320 | diag3 | Diagnosis 3 |
| 030330 | diag4 | Diagnosis 4 |
| 030340 | diag5 | Diagnosis 5 |
| 030350 | diag6 | Diagnosis 6 |
| 030360 | diag7 | Diagnosis 7 |
| 030370 | diag8 | Diagnosis 8 |
| 200646 | diagdt | Diagnosis Date |
| 030390 | ddate | Discharge Date |
| 030410 | ax2pdx | Discharge Diagnosis 1 |
| 030430 | ax2sdx | Discharge Diagnosis 2 |
| 030850 | dtime | Discharge Time |
| 030880 | ddate | Dispatch Date |
| 030890 | dtime | Dispatch Time |
| 200711 | dispo | Disposition |
| 200710 | dispdt | Disposition Date |
| 200607 | reasdel | Documented Reason for Assessment Delay |
| 200658 | ddate | Due Date |
| 030290 | dur | Duration of Stay |
| 101051 | educ | Education |
| 201149 | EDATE | Effective Date |
| 030440 | edate | Effective Date |
| 200949 | edate | Effective Date |
| 200141 | modate | Effective Date |
| 031240 | edate10 | Effective Date (10th) |
| 031070 | edate01 | Effective Date (1st) |
| 031080 | edate02 | Effective Date (2nd) |
| 031100 | edate03 | Effective Date (3rd) |
| 031120 | edate04 | Effective Date (4th) |
| 031140 | edate05 | Effective Date (5th) |
| 031160 | edate06 | Effective Date (6th) |
| 031180 | edate07 | Effective Date (7th) |
| 031200 | edate08 | Effective Date (8th) |
| 031220 | edate09 | Effective Date (9th) |
| 101053 | esta | Employment Status |
| 201150 | TDATE | End Date |
| 200666 | tpr2 | Ending Episode of Care…Would Not Be… |
| 200779 | dim6 | Engagement Score |
| 030460 | cdate | Episode End (Close) Date |
| 030500 | cdate | Episode End Date |
| 030460 | cdate | Episode End Date |
| 030470 | epis | Episode ID |
| 030480 | adate | Episode Start (Admit) Date |
| 030510 | adate | Episode Start Date |
| 030480 | adate | Episode Start Date |
| 030490 | epistype | Episode Type |
| 030520 | eflag | EPSDT Indicator |
| 030530 | eth1 | Ethnicity 1 |
| 030540 | eth2 | Ethnicity 2 |
| 030550 | eth3 | Ethnicity 3 |
| 200608 | authtyp | Expedited Authorization Flag |
| 200606 | extreq | Extension Requested by |
| 200272 | faccd | Facility Code |
| 200937 | faiadt | First Accepted Intake Appointment Date |
| 200938 | faiatm | First Accepted Intake Appointment Time |
| 200940 | footd | First Offered Appointment Reason |
| 200934 | foiadt | First Offered Intake Appointment Date |
| 200935 | foiatm | First Offered Intake Appointment Time |
| 200943 | fradt | FRA Accepted Date |
| 200944 | fratm | FRA Accepted Time |
| 200946 | nofra | FRA not occurred reason codes |
| 200941 | frodt | FRA Offered Date |
| 200942 | frotm | FRA Offered Time |
| 200933 | frascd | FRAS Outside 28-Days Reason Codes |
| 200774 | dim2 | Functional Status Score |
| 200135 | gaf | GAF |
| 200947 | gdate | GAINS Date |
| 101019 | sex | Gender |
| 101020 | first | Given Name |
| 201151 | t1 | Global Alert Text 1 |
| 201152 | t2 | Global Alert Text 2 |
| 201153 | t3 | Global Alert Text 3 |
| 201154 | t4 | Global Alert Text 4 |
| 201155 | t5 | Global Alert Text 5 |
| 200128 | grade | Grade Level |
| 200268 | gravely | Gravely Disabled |
| 200647 | adlguid | GUID of Additional Authorization Request Info. |
| 201130 | halluc | Hallucinations/Delusions |
| 200126 | pos | Health Care Service Location |
| 101077 | county | Hearing County |
| 101076 | hdate | Hearing Date |
| 200270 | houtc | Hearing Outcome |
| 200631 | bqual1 | High Risk Behavior Previous 90-days |
| 030570 | shdate | Hire Date |
| 010121 | horg | Hispanic Origin |
| 201131 | HxPsyHosp | History of psychiatric hospitalization |
| 201132 | HxTrauma | History of trauma/victimization |
| 201137 | Homeless | Homelessness |
| 201107 | Adinfo | If AD, what info is important… |
| 030580 | impk1 | Impairment Kind 1 |
| 030590 | impk2 | Impairment Kind 2 |
| 030600 | impk3 | Impairment Kind 3 |
| 201128 | impulse | Impulse control/judgement |
| 030610 | initauth | Initial Authorized Days |
| 030030 | RORG | Inpatient Facility Reporting Unit ID |
| 201129 | insight | Insight |
| 200604 | iaidate | Intake Assessment Initiated Date |
| 200315 | jailintk | Intake Completed in Jail Code |
| 200929 | nointcd | Intake Not Occurred Reason Code |
| 200624 | sitefax | Intake Staff Site Fax Number |
| 101058 | county | Investigation County |
| 101059 | bdate | Investigation Date |
| 101060 | outc | Investigation Outcome |
| 200310 | icrir | Investigation Reason |
| 101061 | btime | Investigation Start Time |
| 200311 | jailcd | Jail Code |
| 200247 | lstat | Legal Status |
| 200953 | len | Length |
| 200609 | level | Level |
| 200129 | lsit | Living Situation |
| 200622 | sitest | Main Site Address Line 2 |
| 200625 | sitecity | Main Site City |
| 200623 | sitetel | Main Site Telephone Number |
| 200626 | sitezip | Main Site ZIP Code |
| 200962 | x7 | Maintain health and safety |
| 030620 | PN | Master Client Number |
| 200316 | macij | Medicaid Application Completed Code |
| 201139 | MedNonCom | Medication non-compliance |
| 200199 | mi | Middle Initial |
| 030900 | tmin | Minutes Dispatch to Begin Time |
| 101063 | min | Minutes of Service |
| 201133 | MultRes | Multiple residential placements |
| 200601 | nomail | No Mail Flag |
| 200925 | ntxreas | Not Transferred to Agency Reason Codes |
| 200660 | nocomp | Number of Completed Reviews |
| 200124 | people | Number of Dependents |
| 200645 | orgein | Organization Employer Identification Number |
| 200650 | orgnpi | Organization National Provider Identification |
| 201144 | Other | Other |
| 200964 | other | Other conditions |
| 200972 | other2 | Other conditions - second line |
| 030860 | out1 | Outreach |
| 200602 | pgname | Parent/Guardian Name |
| 200956 | x2 | Participate in and follow… |
| 200954 | x1 | Participate in and follow… |
| 030640 | psigsrc | Patient Signature Source Code |
| 030650 | pstatcd | Patient Status Code |
| 201135 | PhysDis | Physical disability/other medical condition |
| 101018 | pic | PIC |
| 200126 | pos | Place of Service |
| 030670 | detain | Placement (Rpt Unit) |
| 200918 | plevel | Placement Grid Level |
| 101024 | plan | Preferred Language |
| 200654 | prioraut | Previous Authorization Number |
| 030690 | clinpcode | Primary Clinician |
| 031250 | clinpcde10 | Primary Clinician (10th) |
| 030690 | clinpcode1 | Primary Clinician (1st) |
| 031090 | clinpcode2 | Primary Clinician (2nd) |
| 031110 | clinpcode3 | Primary Clinician (3rd) |
| 031130 | clinpcode4 | Primary Clinician (4th) |
| 031150 | clinpcode5 | Primary Clinician (5th) |
| 031170 | clinpcode6 | Primary Clinician (6th) |
| 031190 | clinpcode7 | Primary Clinician (7th) |
| 031210 | clinpcode8 | Primary Clinician (8th) |
| 031230 | clinpcode9 | Primary Clinician (9th) |
| 030700 | primary | Primary Indicator |
| 030710 | ax1pd | Principal Diagnosis |
| 030710 | princdia | Principal Diagnosis |
| 030710 | diag | Principal Diagnosis |
| 200709 | prior | Prior Authorization or Referral Number |
| 200634 | bqual4 | Prior Public O/P MH Tx during prev. 90-days |
| 101026 | prior | Priority Code |
| 200705 | mod1 | Procedure Modifier 1 |
| 200706 | mod2 | Procedure Modifier 2 |
| 200707 | mod3 | Procedure Modifier 3 |
| 200708 | mod4 | Procedure Modifier 4 |
| 201141 | Property | Property destruction |
| 200656 | eautper | Proposed End of Authorization Period |
| 200655 | sautper | Proposed Start of Authorization Period |
| 030910 | prvtp | Provider Type |
| 101018 | pic | ProviderOne Client ID |
| 200633 | bqual3 | Psych. Res. Tx LOS>=6mos or D/C now from psych I/P |
| 200144 | race | Race |
| 201146 | Strategy | Recommended Strategy |
| 200776 | dim4a | Recovery Environment - Level of Stress Score |
| 200777 | dim4b | Recovery Environment - Level of Support Score |
| 030720 | refid | Reference Identification |
| 030680 | referral | Referral From/Referral Source |
| 200309 | icrrs | Referral Source |
| 200960 | x5 | Refrain from drugs/alcohol |
| 200963 | x8 | Refrain from possessing firearms |
| 200961 | x6 | Refrain from threats or acts of harm |
| 200673 | rejectcd | Reject Reason |
| 200313 | exitdt | Release Date |
| 030750 | roicd | Release of Information Code |
| 030670 | detain | Reporting Unit Ordered To |
| 200958 | x3 | Reside at approved residence |
| 200781 | dim5 | Resiliency and Treatment History Score |
| 200672 | actcd | Review Action Code |
| 200670 | staffid | Reviewd By |
| 200771 | revid | Reviewer ID |
| 101087 | revok | Revoke Initiated |
| 200271 | rvkot | Revoked - Reason other than above |
| 030740 | rights | Rights Read |
| 200773 | dim1 | Risk of Harm Score |
| 200926 | forguid | RLGUID of First Offered/Referral |
| 200930 | rfsguid | RLGUID of Request For Service |
| 200924 | rfsguid | RLGUID of Request For Service |
| 200939 | rsaguid | RLGUID of Request for Svc - Addl. Info. |
| 030750 | roicode | ROI Code |
| 030750 | roicd | ROI Code |
| 200314 | rsnhist | RSN History Code |
| 030760 | RSNID | RSN Report Unit |
| 201136 | Running | Running Away |
| 200948 | sai | Screen Assessment Indicator |
| 201121 | selfcare | Self-Care Skills |
| 201134 | separat | Separation from family/natural support |
| 200970 | svccity | Service City |
| 101067 | sdate | Service Date |
| 200968 | svcaddr1 | Service Street Address |
| 200969 | svcaddr2 | Service Street Address 2 |
| 200652 | svctyp | Service Type Code |
| 200982 | units | Service Units |
| 200971 | svczip | Service ZIP |
| 201142 | SexAggr | Sexual Aggression |
| 101068 | sexor | Sexual Orientation |
| 201124 | social | Social Behaviors |
| 101033 | ss | Social Security Number |
| 201122 | lsitstab | Stability of living situation |
| 200966 | fname | Staff First Name |
| 200976 | stfsex | Staff Gender |
| 030770 | staffid | Staff ID |
| 200977 | lang1 | Staff Language 1 |
| 200978 | lang2 | Staff Language 2 |
| 200979 | lang3 | Staff Language 3 |
| 200980 | lang4 | Staff Language 4 |
| 200981 | lang5 | Staff Language 5 |
| 200965 | lname | Staff Last Name |
| 200657 | staffnpi | Staff National Provider Identification |
| 200967 | prvtp | Staff Provider Type |
| 030780 | pwacs1 | Staff Specialty 1 |
| 031260 | pwacs2 | Staff Specialty 2 |
| 031270 | pwacs3 | Staff Specialty 3 |
| 031280 | pwacs4 | Staff Specialty 4 |
| 031290 | pwacs5 | Staff Specialty 5 |
| 031300 | pwacs6 | Staff Specialty 6 |
| 031310 | pwacs7 | Staff Specialty 7 |
| 031320 | pwacs8 | Staff Specialty 8 |
| 031330 | pwacs9 | Staff Specialty 9 |
| 101027 | suborg | Submitting Reporting Unit ID |
| 200649 | id | Subscriber Supplemental ID-Reference ID |
| 200648 | idqual | Subscriber Supplemental ID-Reference ID Qualifier |
| 201138 | SubAbuse | Substance Abuse |
| 101071 | last | Surname |
| 200959 | x4 | Take prescribed meds |
| 200950 | tdate | Termination Date |
| 030800 | stdate | Termination Date |
| 201148 | threats | Threats/Actual Incidents to harm self |
| 200644 | auttm | Time of Authorization Request |
| 200671 | reviewtime | Timestamp of the Authorization Review |
| 030810 | authext | Total Authorized Extension Days |
| 101073 | RCODE | Transaction ID |
| 200778 | dim5 | Treatment and Recovery History Score |
| 200662 | tpr6 | Treatment Plan Includes Discharge… |
| 030001 | RLGUID | Unique Identifier |
| 201108 | health | What safety/health concerns |
