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["ChangeIndicator","ProviderID","LocationID","ProviderTypeID","FirstName","MiddleInitial","LastName","Suffix","TitleCode","PrimaryDegree","Degree2","Degree3","ProvNPI","ProvSSN","ProvGender","ProvDOB","BoardName1","Board1CertEffdt","Board1CertExpdt","BoardCertNumber1","BoardCertPrvValidDte1","BoardCertValidDte1","BoardCertVerifMethod1","BoardCertStatus1","BoardName2","Board2CertEffdt","Board2CertExpdt","BoardCertNumber2","BoardCertPrvValidDte2","BoardCertValidDte2","BoardCertVerifMethod2","BoardCertStatus2","BoardName3","Board3CertEffdt","Board3CertExpdt","BoardCertNumber3","BoardCertPrvValidDte3","BoardCertValidDte3","BoardCertVerifMethod3","BoardCertStatus3","MedicaidID","MedicaidEffDt","MedicaidExpDt","MedicareID","MedicareEffDt","MedicareExpDt","StateLicense1","License1State","License1EffDt","License1ExpDt","StateLicensePrvValidDte1","StateLicenseValidationDte1","StateLicenseVerifMethod1","StateLicenseStatus1","StateLicense2","License2State","License2EffDt","License2ExpDt","StateLicensePrvValidDte2","StateLicenseValidationDte2","StateLicenseVerifMethod2","StateLicenseStatus2","StateLicense3","License3State","License3EffDt","License3ExpDt","StateLicensePrvValidDte3","StateLicenseValidationDte3","StateLicenseVerifMethod3","StateLicenseStatus3","StateLicense4","License4State","License4EffDt","License4ExpDt","StateLicensePrvValidDte4","StateLicenseValidationDte4","StateLicenseVerifMethod4","StateLicenseStatus4","FederalDEA","FedDEAEffDt","FedDEAExpDt","FedDEAPrevValidDte","FedDEAValidDte","FedDEAVerifMethod","FedDEAStatus","FedDEAState","FederalDEA2","FedDEAEffDt2","FedDEAExpDt2","FedDEAPrevValidDte2","FedDEAValidDte2","FedDEAVerifMethod2","FedDEAStatus2","FedDEAState2","FederalDEA3","FedDEAEffDt3","FedDEAExpDt3","FedDEAPrevValidDte3","FedDEAValidDte3","FedDEAVerifMethod3","FedDEAStatus3","FedDEAState3","FederalDEA4","FedDEAEffDt4","FedDEAExpDt4","FedDEAPrevValidDte4","FedDEAValidDte4","FedDEAVerifMethod4","FedDEAStatus4","FedDEAState4","StateDEA1","DEA1State","DEA1ExpDt","StateDEAPrevValidDte1","StateDEAValidDate1","StateDEAVerifMethod1","StateDEAStatus1","StateDEA2","DEA2State","DEA2ExpDt","StateDEAPrevValidDte2","StateDEAValidDate2","StateDEAVerifMethod2","StateDEAStatus2","StateDEA3","DEA3State","DEA3ExpDt","StateDEAPrevValidDte3","StateDEAValidDate3","StateDEAVerifMethod3","StateDEAStatus3","StateDEA4","DEA4State","DEA4ExpDt","StateDEAPrevValidDte4","StateDEAValidDate4","StateDEAVerifMethod4","StateDEAStatus4","Suboxone","SuboxoneState","SuboxoneEffDt","SuboxoneExpDt","SuboxonePrevValidDte","SuboxoneValidDte","SuboxoneVerifMethod","SuboxoneStatus","Language1","Language2","Language3","Language4","Language5","MedSchoolName","MedSchoolBegYR","MedSchoolEndYR","MedSchoolDegree","MedSchoolSpecialty","ResidencyName","ResidencyBegYR","ResidencyEndYR","ResidencyDegree","ResidencySpecialty","ResidencyName2","ResidencyBegYR2","ResidencyEndYR2","ResidencyDegree2","ResidencySpecialty2","FellowshipName","FellowshipBegYR","FellowshipEndYR","FellowshipDegree","FellowshipSpecialty","InternshipName","InternshipBegYR","InternshipEndYR","InternshipDegree","InternshipSpecialty","MalpracticeCarrier","MalpracticePolicy","MalpracticeEffDt","MalpracticeExpDt","MalpracticeCovAmt","MalpracticeAggAmt","MalpracticeVerificationSource","MalpracticeVerificationStatus","ProviderEffDt","ProviderExpDt","MailAddr1","MailAddr2","MailCity","MailState","MailZip","MailZip4","MailPhone","MailPhoneExt","MailFax","MailContact","ProviderEmail","ProviderTaxID","TaxIDType","GroupName","GroupNPI","GroupTaxonomy","GroupTaxonomy2","GroupTaxonomy3","BillName","BillAddr1","BillAddr2","BillCity","BillState","BillZip","BillZip4","BillPhone","BillPhoneExt","BillFax","BillContact","BillContactEmail","PrimaryLocFlg","HandicapFlg","ServAddrEffDt","ServAddrExpDt","ServName","DBAName","ServAddr1","ServAddr2","ServCity","ServState","ServZip","ServZip4","ServPhone","ServPhoneExt","ServFax","ServContact","ServContactEmail","MonBeg","MonEnd","TuesBeg","TuesEnd","WedBeg","WedEnd","ThursBeg","ThursEnd","FriBeg","FriEnd","SatBeg","SatEnd","SunBeg","SunEnd","NewPatientFlg","HospName1","HospPrivFlg1","Hosp1PrivAddr1","Hosp1PrivAddr2","Hosp1PrivCity","Hosp1PrivState","Hosp1PrivZip","Hosp1PrivZip4","Hosp1AHCAID","HospName2","HospPrivFlg2","Hosp2PrivAddr1","Hosp2PrivAddr2","Hosp2PrivCity","Hosp2PrivState","Hosp2PrivZip","Hosp2PrivZip4","Hosp2AHCAID","HospName3","HospPrivFlg3","Hosp3PrivAddr1","Hosp3PrivAddr2","Hosp3PrivCity","Hosp3PrivState","Hosp3PrivZip","Hosp3PrivZip4","Hosp3AHCAID","LowAge","HighAge","DelegatedFlg","DelegatedName","MinorityOwnOperate","SmallBusFlg","WomanOwnedFlg","SmallDisadvFlg","VeteranOwnedFlg","DisadvVetFlg","HubZoneFlg","HistBlackCollege","NAICSCode","ADASurveyFlg","ADASurveyDte","SpcNSurveyFlg","SpcNSurveyDte","ECFMGFlag","ECFMGNumber","ECFMGIssued","ECFMGExpDte","PagerNumber","AnswerServiceNumber","CellPhoneNumber","InitialCredDt","PreviousCredDt","RecredDueDt","CurrCredDt","ReviewType","ProcessStatus","AppReceivedDt","AttestationDt","AppReceivedCompleteDt","SiteVisitCompleteDt","SiteVisitResult","Decision ","DecisionMadeBy","DecisionDate","ProviderCAQHNumber","ProviderCAQHAttestationDt","ACStatus_JC","ACFROM_JC","ACTO_JC","DateVeri_JC","Previous_DateVeri_JC","ACStatus_CARF","ACFROM_CARF","ACTO_CARF","DateVeri_CARF","Previous_DateVeri_CARF","ACStatus_COA","ACFROM_COA","ACTO_COA","DateVeri_COA","Previous_DateVeri_COA","ACStatus_DNV","ACFROM_DNV","ACTO_DNV","DateVeri_DNV","Previous_DateVeri_DNV","ACStatus_IMQ","ACFROM_IMQ","ACTO_IMQ","DateVeri_IMQ","Previous_DateVeri_IMQ","FacilityName","FacilityProviderType","Plan01 ","Plan02","Plan03","Plan04","Plan05","Plan06","Plan07","Plan08","Plan09","Plan10","Plan11 ","Plan12","Plan13","Plan14","Plan15","Plan16","Plan17","Plan18","Plan19","Plan20","Plan21 ","Plan22","Plan23","Plan24","Plan25","Plan26","Plan27","Plan28","Plan29","Plan30","Plan31 ","Plan32","Plan33","Plan34","Plan35","Plan36","Plan37","Plan38","Plan39","Plan40","Plan41 ","Plan42","Plan43","Plan44","Plan45","Plan46","Plan47","Plan48","Plan49","Plan50","EHRFlag","SSACode","MedicareBeds","MedicaidBeds","GroupDBAName","GroupAltName","ContractStart","AHCAHospitalID","Ethnicity","Plan1ParLevel","Plan1EffDate","Plan1ExpDate","Plan2ParLevel","Plan2EffDate","Plan2ExpDate","Plan3ParLevel","Plan3EffDate","Plan3ExpDate","Plan4ParLevel","Plan4EffDate","Plan4ExpDate","Plan5ParLevel","Plan5EffDate","Plan5ExpDate","Plan6ParLevel","Plan6EffDate","Plan6ExpDate","Plan7ParLevel","Plan7EffDate","Plan7ExpDate","Plan8ParLevel","Plan8EffDate","Plan8ExpDate","Plan9ParLevel","Plan9EffDate","Plan9ExpDate","Plan10ParLevel","Plan10EffDate","Plan10ExpDate","Plan11ParLevel","Plan11EffDate","Plan11ExpDate","Plan12ParLevel","Plan12EffDate","Plan12ExpDate","Plan13ParLevel","Plan13EffDate","Plan13ExpDate","Plan14ParLevel","Plan14EffDate","Plan14ExpDate","Plan15ParLevel","Plan15EffDate","Plan15ExpDate","Plan16ParLevel","Plan16EffDate","Plan16ExpDate","Plan17ParLevel","Plan17EffDate","Plan17ExpDate","Plan18ParLevel","Plan18EffDate","Plan18ExpDate","Plan19ParLevel","Plan19EffDate","Plan19ExpDate","Plan20ParLevel","Plan20EffDate","Plan20ExpDate","Plan21ParLevel","Plan21EffDate","Plan21ExpDate","Plan22ParLevel","Plan22EffDate","Plan22ExpDate","Plan23ParLevel","Plan23EffDate","Plan23ExpDate","Plan24ParLevel","Plan24EffDate","Plan24ExpDate","Plan25ParLevel","Plan25EffDate","Plan25ExpDate","Plan26ParLevel","Plan26EffDate","Plan26ExpDate","Plan27ParLevel","Plan27EffDate","Plan27ExpDate","Plan28ParLevel","Plan28EffDate","Plan28ExpDate","Plan29ParLevel","Plan29EffDate","Plan29ExpDate","Plan30ParLevel","Plan30EffDate","Plan30ExpDate","Plan31ParLevel","Plan31EffDate","Plan31ExpDate","Plan32ParLevel","Plan32EffDate","Plan32ExpDate","Plan33ParLevel","Plan33EffDate","Plan33ExpDate","Plan34ParLevel","Plan34EffDate","Plan34ExpDate","Plan35ParLevel","Plan35EffDate","Plan35ExpDate","Plan36ParLevel","Plan36EffDate","Plan36ExpDate","Plan37ParLevel","Plan37EffDate","Plan37ExpDate","Plan38ParLevel","Plan38EffDate","Plan38ExpDate","Plan39ParLevel","Plan39EffDate","Plan39ExpDate","Plan40ParLevel","Plan40EffDate","Plan40ExpDate","Plan41ParLevel","Plan41EffDate","Plan41ExpDate","Plan42ParLevel","Plan42EffDate","Plan42ExpDate","Plan43ParLevel","Plan43EffDate","Plan43ExpDate","Plan44ParLevel","Plan44EffDate","Plan44ExpDate","Plan45ParLevel","Plan45EffDate","Plan45ExpDate","Plan46ParLevel","Plan46EffDate","Plan46ExpDate","Plan47ParLevel","Plan47EffDate","Plan47ExpDate","Plan48ParLevel","Plan48EffDate","Plan48ExpDate","Plan49ParLevel","Plan49EffDate","Plan49ExpDate","Plan50ParLevel","Plan50EffDate","Plan50ExpDate","ProviderSpecialty1","ProviderSpecialty2","ProviderSpecialty3","ProviderSpecialty4","ProviderSpecialty5","ProviderSpecialty6","ProviderSpecialty7","ProviderSpecialty8","ProviderSpecialty9","ProviderSpecialty10","ProviderSpecialty11","ProviderSpecialty12","FacilitySpecialty1","FacilitySpecialty2","FacilitySpecialty3","FacilitySpecialty4","FacilitySpecialty5","FacilitySpecialty6","FacilitySpecialty7","FacilitySpecialty8","FacilitySpecialty9","FacilitySpecialty10","FacilitySpecialty11","FacilitySpecialty12","FacilitySpecialty13","FacilitySpecialty14","FacilitySpecialty15","FacilitySpecialty16","FacilitySpecialty17","FacilitySpecialty18","FacilitySpecialty19","FacilitySpecialty20","FacilitySpecialty21","FacilitySpecialty22","FacilitySpecialty23","FacilitySpecialty24","FacilitySpecialty25","FacilitySpecialty26","FacilitySpecialty27","FacilitySpecialty28","FacilitySpecialty29","FacilitySpecialty30","FacilitySpecialty31","FacilitySpecialty32","FacilitySpecialty33","FacilitySpecialty34","FacilitySpecialty35","FacilitySpecialty36","FacilitySpecialty37","FacilitySpecialty38","FacilitySpecialty39","FacilitySpecialty40","FacilitySpecialty41","FacilitySpecialty42","FacilitySpecialty43","FacilitySpecialty44","FacilitySpecialty45","FacilitySpecialty46","FacilitySpecialty47","FacilitySpecialty48","FacilitySpecialty49","FacilitySpecialty50","SiteMedicaid","SiteNPI","SiteNPI2","SiteNPI3","SiteNPI4","SiteNPI5","ProvTaxonomy1","ProvTaxonomy2","ProvTaxonomy3","ProvTaxonomy4","ProvTaxonomy5","ProvTaxonomy6","ProvTaxonomy7","ProvTaxonomy8","ProvTaxonomy9","ProvTaxonomy10","ProvTaxonomy11","ProvTaxonomy12","ProvTaxonomy13","ProvTaxonomy14","ProvTaxonomy15","ProvTaxonomy16","ProvTaxonomy17","ProvTaxonomy18","ProvTaxonomy19","ProvTaxonomy20","ProvTaxonomy21","ProvTaxonomy22","ProvTaxonomy23","ProvTaxonomy24","ProvTaxonomy25","ProvTaxonomy26","ProvTaxonomy27","ProvTaxonomy28","ProvTaxonomy29","ProvTaxonomy30","ProvTaxonomy31","ProvTaxonomy32","ProvTaxonomy33","ProvTaxonomy34","ProvTaxonomy35","ProvTaxonomy36","ProvTaxonomy37","ProvTaxonomy38","ProvTaxonomy39","ProvTaxonomy40","ProvTaxonomy41","ProvTaxonomy42","ProvTaxonomy43","ProvTaxonomy44","ProvTaxonomy45","ProvTaxonomy46","ProvTaxonomy47","ProvTaxonomy48","ProvTaxonomy49","ProvTaxonomy50","WebsiteURL","CulturalCompetencyTraining","CulturalGenderStrengths","AnthemID","DirectoryFlg","TelehealthFlg","TotalBedCount","StandardEthnicity","OMBRace","OMBEthnicity ","PromiseID","PromiseSvcLoc","PromiseffDt","PromiseExpDt"]

{"sheet":"EXPORT","index":1,"n_rows":0,"n_cols":0,"rows_kept":0,"cut":false,"hidden":false,"merged":[]}

{"sheet":"SPI_GUIDE_LAYOUT","index":2,"n_rows":684,"n_cols":9,"rows_kept":684,"cut":false,"hidden":false,"merged":[]}
["Column on Layout","Field Number","Field Name","Req","Type","Size","Provider Type","Special Formatting/Valid Values","Field Description"]
["A",1,"ChangeIndicator","C","A",1,"All","Valid Values: F","Change status of record.\n\nRecord should always be populated with ‘F’"]
["B",2,"ProviderID","C","A",20,"All",null,"Unique identifier for the provider within the submitters system.  The Unique Provider ID assigned by the entity to this provider."]
["C",3,"LocationID","O","A",20,"All",null,"Location ID for this record assigned by the submitting entity"]
["D",4,"ProviderTypeID","C","A",1,"All","Valid Values: I, G, F, R, P","Provider type represented by this record:\nI-individual practitioner;\nG-group entity – group provider entity containing credentialed practitioners under this taxid that are par;\nF-facility type provider - hospital, ancillary;\nR-roster providers attached to a facility;\nP-paraprofessional providers practicing under another provider;"]
["E",5,"FirstName","C","A",25,"I, R, P",null,"Provider first name only.  Should not contain middle name or middle initial. Should contain no punctuation except a dash for hyphenated first name "]
["F",6,"MiddleInitial","O","A",1,"I, R, P",null,"Provider middle initial only"]
["G",7,"LastName","C","A",25,"I, R, P",null,"Provider last name only.  Should not contain any degree or suffix (ex: Jr, III, LLP, LLC).  Should contain no punctuation except a dash for hyphenated last names."]
["H",8,"Suffix","O","A",4,"I, R, P",null,"Provider Name Suffix.  Examples include Jr, Sr, III etc. \"Null\" = No Value.  Should contain no punctuation."]
["I",9,"TitleCode","O","A",4,"I, R, P","See Title Code List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Provider's professional credentials; ex: APRN, LCSW, MD"]
["J",10,"PrimaryDegree","C","N",25,"I, R, P","See Primary Degree List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Identifies the primary degree related to the specialization that the provider practices under.  (NOTE: License LEVEL)"]
["K",11,"Degree2","O","N",25,"I, R, P","See Primary Degree List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Identifies the secondary degree related to the specialization that the provider practices under."]
["L",12,"Degree3","O","N",25,"I, R, P","See Primary Degree List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Identifies the third degree related to the specialization that the provider practices under."]
["M",13,"ProvNPI","C","A",10,"All",null,"Individual Practitioner NPI.  Do not place a group or facility NPI number in this field.  10 digit number and must include leading zeroes."]
["N",14,"ProvSSN","R","A",12,"I, R, P","Numbers only; no dashes","Social Security Number; must be 9 digits"]
["O",15,"ProvGender","R","A",1,"I, R, P","M, F, U or blank","Gender"]
["P",16,"ProvDOB","R","A",10,"I, R, P","Format mm/dd/ccyy","Date of birth"]
["Q",17,"BoardName1","O","A",100,"All","See Board Certification List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Code for 1st certifying board name.  Up to 3 board certifications can be provided."]
["R",18,"Board1CertEffdt","O","A",10,"All","Format mm/dd/ccyy","Board 1 certification effective date.  If only the year is known use 01/01/CCYY."]
["S",19,"Board1CertExpdt","O","A",10,"All","Format mm/dd/ccyy","Board 1 certification expiration date.  If only the year is known use 01/01/CCYY.  Enter 12/31/9999 (2029 is the no expiration date.) if no termination date.  If blank then it is considered lifetime.  "]
["T",20,"BoardCertNumber1","O","A",35,"All",null,"Board Certification Number"]
["U",21,"BoardCertPrvValidDte1","O","A",10,"All","Format mm/dd/ccyy","Board certification previous validation date.  If only the year is known use 01/01/CCYY"]
["V",22,"BoardCertValidDte1","O","A",10,"All","Format mm/dd/ccyy","Board certification current validation date.  If only the year is known use 01/01/CCYY"]
["W",23,"BoardCertVerifMethod1","O","A",50,"All","See PSV Verification Method List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Board certification verification method during PSV (primary source verification)"]
["X",24,"BoardCertStatus1","O","A",25,"All","See Certification Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Lic certification status"]
["Y",25,"BoardName2","O","A",100,"All","See Board Certification List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Code for 2nd certifying board name.  Up to 3 board certifications can be provided."]
["Z",26,"Board2CertEffdt","O","A",10,"All","Format mm/dd/ccyy","Board 2 certification effective date.  If only the year is known use 01/01/CCYY."]
["AA",27,"Board2CertExpdt","O","A",10,"All","Format mm/dd/ccyy","Board 2 certification expiration date.  If only the year is known use 01/01/CCYY.  Enter 12/31/9999 if no termination date."]
["AB",28,"BoardCertNumber2","O","A",35,"All",null,"Board Certification Number"]
["AC",29,"BoardCertPrvValidDte2","O","A",10,"All","Format mm/dd/ccyy","Board certification previous validation date.  If only the year is known use 01/01/CCYY"]
["AD",30,"BoardCertValidDte2","O","A",10,"All","Format mm/dd/ccyy","Board certification current validation date.  If only the year is known use 01/01/CCYY"]
["AE",31,"BoardCertVerifMethod2","O","A",50,"All","See PSV Verification Method List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Board certification verification method during PSV (primary source verification)"]
["AF",32,"BoardCertStatus2","O","A",25,"All","See Certification Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Board certification status"]
["AG",33,"BoardName3","O","A",100,"All","See Board Certification List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Code for 3rd certifying board name.  Up to 3 board certifications can be provided."]
["AH",34,"Board3CertEffdt","O","A",10,"All","Format mm/dd/ccyy","Board 3 certification effective date.  If only the year is known use 01/01/CCYY."]
["AI",35,"Board3CertExpdt","O","A",10,"All","Format mm/dd/ccyy","Board 3 certification expiration date.  If only the year is known use 01/01/CCYY.  Enter 12/31/9999 if no termination date."]
["AJ",36,"BoardCertNumber3","O","A",35,"All",null,"Board Certification Number"]
["AK",37,"BoardCertPrvValidDte3","O","A",10,"All","Format mm/dd/ccyy","Board certification previous validation date.  If only the year is known use 01/01/CCYY"]
["AL",38,"BoardCertValidDte3","O","A",10,"All","Format mm/dd/ccyy","Board certification current validation date.  If only the year is known use 01/01/CCYY"]
["AM",39,"BoardCertVerifMethod3","O","A",50,"All","See PSV Verification Method List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Board certification verification method during PSV (primary source verification)"]
["AN",40,"BoardCertStatus3","O","A",25,"All","See Certification Status List in Appendix for approved values\r***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Board certification status"]
["AO",41,"MedicaidID","O","A",30,"All",null,"Medicaid ID"]
["AP",42,"MedicaidEffDt","O","A",10,"All","Format mm/dd/ccyy","Provider's Medicaid start date formatted as mm/dd/ccyy"]
["AQ",43,"MedicaidExpDt","O","A",10,"All","Format mm/dd/ccyy","Provider's Medicaid term date formatted as mm/dd/ccyy"]
["AR",44,"MedicareID","O","A",30,"All",null,"Medicare ID"]
["AS",45,"MedicareEffDt","O","A",10,"All","Format mm/dd/ccyy","Provider's Medicare start date formatted as mm/dd/ccyy"]
["AT",46,"MedicareExpDt","O","A",10,"All","Format mm/dd/ccyy","Provider's Medicare term date formatted as mm/dd/ccyy"]
["AU",47,"StateLicense1","R","A",30,"All",null,"Provider's primary state medical license number.  Up to 4 state license numbers can be provided"]
["AV",48,"License1State","R","A",2,"All",null,"State of provider's 1st medical license.  Must use 2 character postal abbreviation for State."]
["AW",49,"License1EffDt","R","A",10,"All","Format mm/dd/ccyy","State license 1 effective date.  If only the year is known use 01/01/CCYY."]
["AX",50,"License1ExpDt","R","A",10,"All","Format mm/dd/ccyy","State license 1 expiration date.  If only the year is known use 01/01/CCYY.  Enter 12/31/9999 if no termination date."]
["AY",51,"StateLicensePrvValidDte1","O","A",10,"All","Format mm/dd/ccyy","State license previous validation date.  If only the year is known use 01/01/CCYY"]
["AZ",52,"StateLicenseValidationDte1","O","A",10,"All","Format mm/dd/ccyy","State license current validation date.  If only the year is known use 01/01/CCYY"]
["BA",53,"StateLicenseVerifMethod1","O","A",50,"All","See PSV Verification Method List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","State license verification method"]
["BB",54,"StateLicenseStatus1","O","A",25,"All","See Certification Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","State license status"]
["BC",55,"StateLicense2","O","A",30,"All",null,"Provider's 2nd state medical license number.  Up to 4 state license numbers can be provided"]
["BD",56,"License2State","O","A",2,"All",null,"State of provider's 2nd medical license.  Must use 2 character postal abbreviation for State."]
["BE",57,"License2EffDt","O","A",10,"All","Format mm/dd/ccyy","State license 2 effective date.  If only the year is known use 01/01/CCYY."]
["BF",58,"License2ExpDt","O","A",10,"All","Format mm/dd/ccyy","State license 2 expiration date.  If only the year is known use 01/01/CCYY.  Enter 12/31/9999 if no termination date."]
["BG",59,"StateLicensePrvValidDte2","O","A",10,"All","Format mm/dd/ccyy","State license previous validation date.  If only the year is known use 01/01/CCYY"]
["BH",60,"StateLicenseValidationDte2","O","A",10,"All","Format mm/dd/ccyy","State license current validation date.  If only the year is known use 01/01/CCYY"]
["BI",61,"StateLicenseVerifMethod2","O","A",50,"All","See PSV Verification Method List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","State license verification method"]
["BJ",62,"StateLicenseStatus2","O","A",25,"All","See Certification Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","State license status"]
["BK",63,"StateLicense3","O","A",30,"All",null,"Provider's 3rd state medical license number.  Up to 4 state license numbers can be provided"]
["BL",64,"License3State","O","A",2,"All",null,"State of provider's 3rd medical license.  Must use 2 character postal abbreviation for State."]
["BM",65,"License3EffDt","O","A",10,"All","Format mm/dd/ccyy","State license 3 effective date.  If only the year is known use 01/01/CCYY."]
["BN",66,"License3ExpDt","O","A",10,"All","Format mm/dd/ccyy","State license 3 expiration date.  If only the year is known use 01/01/CCYY.  Enter 12/31/9999 if no termination date."]
["BO",67,"StateLicensePrvValidDte3","O","A",10,"All","Format mm/dd/ccyy","State license previous validation date.  If only the year is known use 01/01/CCYY"]
["BP",68,"StateLicenseValidationDte3","O","A",10,"All","Format mm/dd/ccyy","State license current validation date.  If only the year is known use 01/01/CCYY"]
["BQ",69,"StateLicenseVerifMethod3","O","A",50,"All","See PSV Verification Method List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","State license verification method"]
["BR",70,"StateLicenseStatus3","O","A",25,"All","See Certification Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","State license status"]
["BS",71,"StateLicense4","O","A",30,"All",null,"Provider's 4th state medical license number.  Up to 4 state license numbers can be provided"]
["BT",72,"License4State","O","A",2,"All",null,"State of provider's 4th medical license.  Must use 2 character postal abbreviation for State."]
["BU",73,"License4EffDt","O","A",10,"All","Format mm/dd/ccyy","State license 4 effective date.  If only the year is known use 01/01/CCYY."]
["BV",74,"License4ExpDt","O","A",10,"All","Format mm/dd/ccyy","State license 4 expiration date.  If only the year is known use 01/01/CCYY.  Enter 12/31/9999 if no termination date."]
["BW",75,"StateLicensePrvValidDte4","O","A",10,"All","Format mm/dd/ccyy","State license previous validation date.  If only the year is known use 01/01/CCYY"]
["BX",76,"StateLicenseValidationDte4","O","A",10,"All","Format mm/dd/ccyy","State license current validation date.  If only the year is known use 01/01/CCYY"]
["BY",77,"StateLicenseVerifMethod4","O","A",50,"All","See PSV Verification Method List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","State license verification method"]
["BZ",78,"StateLicenseStatus4","O","A",25,"All","See Certification Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","State license status"]
["CA",79,"FederalDEA","O","A",9,"All",null,"Federal DEA number assigned to the provider allowing them to write prescriptions for controlled substances.  Format - 9 digit Alphanumeric. First 2 digits are alpha, last 7 digits are numeric. \"Null\" = No Value"]
["CB",80,"FedDEAEffDt","O","A",10,"All","Format mm/dd/ccyy","Federal DEA effective date.  If only the year is known use 01/01/CCYY."]
["CC",81,"FedDEAExpDt","O","A",10,"All","Format mm/dd/ccyy","Federal DEA expiration date.  If only the year is known use 01/01/CCYY.  Enter 12/31/9999 if no termination date."]
["CD",82,"FedDEAPrevValidDte","O","A",10,"All","Format mm/dd/ccyy","Federal DEA previous validation date.  If only the year is known use 01/01/CCYY"]
["CE",83,"FedDEAValidDte","O","A",10,"All","Format mm/dd/ccyy","Federal DEA current validation date.  If only the year is known use 01/01/CCYY"]
["CF",84,"FedDEAVerifMethod","O","A",50,"All","See PSV Verification Method List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Federal DEA verification method"]
["CG",85,"FedDEAStatus","O","A",25,"All","See Certification Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Federal DEA status"]
["CH",86,"FedDEAState","O","A",2,"All",null,"Federal DEA1 State "]
["CI",87,"FederalDEA2","O","A",9,"All",null,"Federal DEA number assigned to the provider allowing them to write prescriptions for controlled substances.  Format - 9 digit Alphanumeric. First 2 digits are alpha, last 7 digits are numeric. \"Null\" = No Value"]
["CJ",88,"FedDEAEffDt2","O","A",10,"All","Format mm/dd/ccyy","Federal DEA2 effective date.  If only the year is known use 01/01/CCYY."]
["CK",89,"FedDEAExpDt2","O","A",10,"All","Format mm/dd/ccyy","Federal DEA2 expiration date.  If only the year is known use 01/01/CCYY.  Enter 12/31/9999 if no termination date."]
["CL",90,"FedDEAPrevValidDte2","O","A",10,"All","Format mm/dd/ccyy","Federal DEA2 previous validation date.  If only the year is known use 01/01/CCYY"]
["CM",91,"FedDEAValidDte2","O","A",10,"All","Format mm/dd/ccyy","Federal DEA2 current validation date.  If only the year is known use 01/01/CCYY"]
["CN",92,"FedDEAVerifMethod2","O","A",50,"All","See PSV Verification Method List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Federal DEA2 verification method"]
["CO",93,"FedDEAStatus2","O","A",25,"All","See Certification Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Federal DEA2 status"]
["CP",94,"FedDEAState2","O","A",2,"All",null,"Federal DEA2 State "]
["CQ",95,"FederalDEA3","O","A",9,"All",null,"Federal DEA number assigned to the provider allowing them to write prescriptions for controlled substances.  Format - 9 digit Alphanumeric. First 2 digits are alpha, last 7 digits are numeric. \"Null\" = No Value"]
["CR",96,"FedDEAEffDt3","O","A",10,"All","Format mm/dd/ccyy","Federal DEA3 effective date.  If only the year is known use 01/01/CCYY."]
["CS",97,"FedDEAExpDt3","O","A",10,"All","Format mm/dd/ccyy","Federal DEA3 expiration date.  If only the year is known use 01/01/CCYY.  Enter 12/31/9999 if no termination date."]
["CT",98,"FedDEAPrevValidDte3","O","A",10,"All","Format mm/dd/ccyy","Federal DEA3 previous validation date.  If only the year is known use 01/01/CCYY"]
["CU",99,"FedDEAValidDte3","O","A",10,"All","Format mm/dd/ccyy","Federal DEA3 current validation date.  If only the year is known use 01/01/CCYY"]
["CV",100,"FedDEAVerifMethod3","O","A",50,"All","See PSV Verification Method List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Federal DEA3 verification method"]
["CW",101,"FedDEAStatus3","O","A",25,"All","See Certification Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Federal DEA3 status"]
["CX",102,"FedDEAState3","O","A",2,"All",null,"Federal DEA3 State "]
["CY",103,"FederalDEA4","O","A",9,"All",null,"Federal DEA number assigned to the provider allowing them to write prescriptions for controlled substances.  Format - 9 digit Alphanumeric. First 2 digits are alpha, last 7 digits are numeric. \"Null\" = No Value"]
["CZ",104,"FedDEAEffDt4","O","A",10,"All","Format mm/dd/ccyy","Federal DEA4 effective date.  If only the year is known use 01/01/CCYY."]
["DA",105,"FedDEAExpDt4","O","A",10,"All","Format mm/dd/ccyy","Federal DEA4 expiration date.  If only the year is known use 01/01/CCYY.  Enter 12/31/9999 if no termination date."]
["DB",106,"FedDEAPrevValidDte4","O","A",10,"All","Format mm/dd/ccyy","Federal DEA4 previous validation date.  If only the year is known use 01/01/CCYY"]
["DC",107,"FedDEAValidDte4","O","A",10,"All","Format mm/dd/ccyy","Federal DEA4 current validation date.  If only the year is known use 01/01/CCYY"]
["DD",108,"FedDEAVerifMethod4","O","A",50,"All","See PSV Verification Method List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Federal DEA4 verification method"]
["DE",109,"FedDEAStatus4","O","A",25,"All","See Certification Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Federal DEA4 status"]
["DF",110,"FedDEAState4","O","A",2,"All",null,"Federal DEA4 State "]
["DG",111,"StateDEA1","O","A",30,"All",null,"1st State DEA Number.  Up to 4 state DEA numbers can be provided."]
["DH",112,"DEA1State","O","A",2,"All",null,"State of provider's 1st State DEA license.  Must use 2 character postal abbreviation for State."]
["DI",113,"DEA1ExpDt","O","A",10,"All","Format mm/dd/ccyy","1st State DEA number expiration date.   If only the year is known use 01/01/CCYY.  Enter 12/31/9999 if no termination date."]
["DJ",114,"StateDEAPrevValidDte1","O","A",10,"All","Format mm/dd/ccyy","State DEA previous validation date.  If only the year is known use 01/01/CCYY"]
["DK",115,"StateDEAValidDate1","O","A",10,"All","Format mm/dd/ccyy","State DEA current validation date.  If only the year is known use 01/01/CCYY"]
["DL",116,"StateDEAVerifMethod1","O","A",50,"All","See PSV Verification Method List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","State DEA verification method"]
["DM",117,"StateDEAStatus1","O","A",25,"All","See Certification Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","State DEA status"]
["DN",118,"StateDEA2","O","A",30,"All",null,"2nd State DEA Number.  Up to 4 state DEA numbers can be provided."]
["DO",119,"DEA2State","O","A",2,"All",null,"State of provider's 2nd State DEA license.  Must use 2 character postal abbreviation for State."]
["DP",120,"DEA2ExpDt","O","A",10,"All","Format mm/dd/ccyy","2nd State DEA number expiration date.  I If only the year is known use 01/01/CCYY.  Enter 12/31/9999 if no termination date."]
["DQ",121,"StateDEAPrevValidDte2","O","A",10,"All","Format mm/dd/ccyy","State DEA previous validation date.  If only the year is known use 01/01/CCYY"]
["DR",122,"StateDEAValidDate2","O","A",10,"All","Format mm/dd/ccyy","State DEA current validation date.  If only the year is known use 01/01/CCYY"]
["DS",123,"StateDEAVerifMethod2","O","A",50,"All","See PSV Verification Method List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","State DEA verification method"]
["DT",124,"StateDEAStatus2","O","A",25,"All","See Certification Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","State DEA status"]
["DU",125,"StateDEA3","O","A",30,"All",null,"3rd State DEA Number.  Up to 4 state DEA numbers can be provided."]
["DV",126,"DEA3State","O","A",2,"All",null,"State of provider's 3rd State DEA license.  Must use 2 character postal abbreviation for State."]
["DW",127,"DEA3ExpDt","O","A",10,"All","Format mm/dd/ccyy","3rd State DEA number expiration date.  I If only the year is known use 01/01/CCYY.  Enter 12/31/9999 if no termination date."]
["DX",128,"StateDEAPrevValidDte3","O","A",10,"All","Format mm/dd/ccyy","State DEA previous validation date.  If only the year is known use 01/01/CCYY"]
["DY",129,"StateDEAValidDate3","O","A",10,"All","Format mm/dd/ccyy","State DEA current validation date.  If only the year is known use 01/01/CCYY"]
["DZ",130,"StateDEAVerifMethod3","O","A",50,"All","See PSV Verification Method List in Appendix for approved values in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","State DEA verification method"]
["EA",131,"StateDEAStatus3","O","A",25,"All","See Certification Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","State DEA status"]
["EB",132,"StateDEA4","O","A",30,"All",null,"4th State DEA Number.  Up to 4 state DEA numbers can be provided."]
["EC",133,"DEA4State","O","A",2,"All",null,"State of provider's 4th State DEA license.  Must use 2 character postal abbreviation for State."]
["ED",134,"DEA4ExpDt","O","A",10,"All","Format mm/dd/ccyy","4th State DEA number expiration date.  If only the year is known use 01/01/CCYY.  Enter 12/31/9999 if no termination date."]
["EE",135,"StateDEAPrevValidDte4","O","A",10,"All","Format mm/dd/ccyy","State DEA previous validation date.  If only the year is known use 01/01/CCYY"]
["EF",136,"StateDEAValidDate4","O","A",10,"All","Format mm/dd/ccyy","State DEA current validation date.  If only the year is known use 01/01/CCYY"]
["EG",137,"StateDEAVerifMethod4","O","A",50,"All","See PSV Verification Method List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","State DEA verification method"]
["EH",138,"StateDEAStatus4","O","A",25,"All","See Certification Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","State DEA status"]
["EI",139,"Suboxone","O","A",20,"All",null,"Provider's suboxone license number"]
["EJ",140,"SuboxoneState","O","A",2,"All",null,"State issuing provider's suboxone license.  Must use 2 character postal abbreviation for State."]
["EK",141,"SuboxoneEffDt","O","A",10,"All","Format mm/dd/ccyy","Suboxone license effective date.  If only the year is known use 01/01/CCYY."]
["EL",142,"SuboxoneExpDt","O","A",10,"All","Format mm/dd/ccyy","Suboxone license expiration date.   If only the year is known use 01/01/CCYY.  Enter 12/31/9999 if no termination date."]
["EM",143,"SuboxonePrevValidDte","O","A",10,"All","Format mm/dd/ccyy","Suboxone previous validation date.  If only the year is known use 01/01/CCYY"]
["EN",144,"SuboxoneValidDte","O","A",10,"All","Format mm/dd/ccyy","Suboxone current validation date.  If only the year is known use 01/01/CCYY"]
["EO",145,"SuboxoneVerifMethod","O","A",50,"All","See PSV Verification Method List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Suboxone verification method"]
["EP",146,"SuboxoneStatus","O","A",25,"All","See Certification Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Suboxone status"]
["EQ",147,"Language1","O","A",50,"All","See Language Code List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Provider's first language after English"]
["ER",148,"Language2","O","A",50,"All","See Language Code List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Provider's second language after English"]
["ES",149,"Language3","O","A",50,"All","See Language Code List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Provider's third language after English"]
["ET",150,"Language4","O","A",50,"All","See Language Code List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Provider's fourth language after English"]
["EU",151,"Language5","O","A",50,"All","See Language Code List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Provider's fifth language after English"]
["EV",152,"MedSchoolName","O","A",100,"I, R, P",null,"Medical school name"]
["EW",153,"MedSchoolBegYR","O","A",10,"I, R, P","Format mm/dd/ccyy","Medical school begin year"]
["EX",154,"MedSchoolEndYR","O","A",10,"I, R, P","Format mm/dd/ccyy","Medical school graduation year"]
["EY",155,"MedSchoolDegree","O","A",50,"I, R, P","See Education Degree Code List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Medical school degree"]
["EZ",156,"MedSchoolSpecialty","O","A",75,"I, R, P",null,"Medical school field of study"]
["FA",157,"ResidencyName","O","A",100,"I, R, P",null,"Residency name"]
["FB",158,"ResidencyBegYR","O","A",10,"I, R, P","Format mm/dd/ccyy","Residency begin year"]
["FC",159,"ResidencyEndYR","O","A",10,"I, R, P","Format mm/dd/ccyy","Residency completion year"]
["FD",160,"ResidencyDegree","O","A",50,"I, R, P","See Education Degree Code List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Residency degree"]
["FE",161,"ResidencySpecialty","O","A",75,"I, R, P",null,"Residency field of study"]
["FF",162,"ResidencyName2","O","A",100,"I, R, P",null,"Residency name"]
["FG",163,"ResidencyBegYR2","O","A",10,"I, R, P","Format mm/dd/ccyy","Residency begin year"]
["FH",164,"ResidencyEndYR2","O","A",10,"I, R, P","Format mm/dd/ccyy","Residency completion year"]
["FI",165,"ResidencyDegree2","O","A",50,"I, R, P","See Education Degree Code List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Residency degree"]
["FJ",166,"ResidencySpecialty2","O","A",75,"I, R, P",null,"Residency field of study"]
["FK",167,"FellowshipName","O","A",100,"I, R, P",null,"Fellowship name"]
["FL",168,"FellowshipBegYR","O","A",10,"I, R, P","Format mm/dd/ccyy","Fellowship begin year"]
["FM",169,"FellowshipEndYR","O","A",10,"I, R, P","Format mm/dd/ccyy","Fellowship completion year"]
["FN",170,"FellowshipDegree","O","A",50,"I, R, P","See Education Degree Code List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Fellowship degree"]
["FO",171,"FellowshipSpecialty","O","A",75,"I, R, P",null,"Fellowship field of study"]
["FP",172,"InternshipName","O","A",100,"I, R, P",null,"Internship name"]
["FQ",173,"InternshipBegYR","O","A",10,"I, R, P","Format mm/dd/ccyy","Internship begin year"]
["FR",174,"InternshipEndYR","O","A",10,"I, R, P","Format mm/dd/ccyy","Internship completion year"]
["FS",175,"InternshipDegree","O","A",50,"I, R, P","See Education Degree Code List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Internship degree"]
["FT",176,"InternshipSpecialty","O","A",75,"I, R, P",null,"Internship field of study"]
["FU",177,"MalpracticeCarrier","O","A",100,"All",null,"Malpractice insurance carrier"]
["FV",178,"MalpracticePolicy","O","A",30,"All",null,"Malpractice insurance policy number"]
["FW",179,"MalpracticeEffDt","O","A",10,"All","Format mm/dd/ccyy","Malpractice insurance effective date"]
["FX",180,"MalpracticeExpDt","O","A",10,"All","Format mm/dd/ccyy","Malpractice insurance expiration date"]
["FY",181,"MalpracticeCovAmt","O","N",12,"All",null,"Malpractice coverage amount per claim"]
["FZ",182,"MalpracticeAggAmt","O","N",12,"All",null,"Malpractice aggregate amount"]
["GA",183,"MalpracticeVerificationSource","O","A",50,"All","See PSV Verification Method List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Malpractice verification method"]
["GB",184,"MalpracticeVerificationStatus","O","A",25,"All","See Certification Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Malpractice status"]
["GC",185,"ProviderEffDt","R","A",10,"All","Format mm/dd/ccyy","Provider's effective date"]
["GD",186,"ProviderExpDt","R","A",10,"All","Format mm/dd/ccyy","Provider's expiration date; if not terminated send 12/31/9999"]
["GE",187,"MailAddr1","R","A",55,"All",null,"Provider's mailing address line 1.  Should not contain any punctuation.  Ex: 1234 Main Street"]
["GF",188,"MailAddr2","O","A",55,"All",null,"Provider's mailing address line 2. Contains suite, floor, room, etc. information.  Should not contain any punctuation. Ex: Suite 101, Building C, etc."]
["GG",189,"MailCity","R","A",30,"All",null,"Provider's mailing city. Should contain no punctuation."]
["GH",190,"MailState","R","A",2,"All",null,"Provider's mailing state.  2 character postal abbreviation for the state"]
["GI",191,"MailZip","R","A",5,"All",null,"Provider's mailing zip.  Format 99999 and should include leading zeroes"]
["GJ",192,"MailZip4","O","A",4,"All",null,"Provider's mailing zip +4 extension.  Format 9999 and should include leading zeroes"]
["GK",193,"MailPhone","R","A",10,"All",null,"Phone number associated with provider's mailing address, including area code.  Format is 9999999999; no dashes or parenthesis."]
["GL",194,"MailPhoneExt","O","A",6,"All",null,"Phone number extension associated with provider's mailing address.  Numbers only."]
["GM",195,"MailFax","O","A",10,"All",null,"Fax number associated with provider's mailing address, including area code.  Format is 9999999999; no dashes or parenthesis."]
["GN",196,"MailContact","O","A",50,"All",null,"Name of contact for mailing address.  Includes first and last name."]
["GO",197,"ProviderEmail","O","A",60,"All",null,"Provider's email address"]
["GP",198,"ProviderTaxID","C","A",9,"All",null,"Federal tax ID number assigned by the IRS.  This can be a social security number or federal tax identification number.  This is the tax ID associated with the practice address on this record.  Format is 999999999 and must include leading zeroes; no dashes.  All nine digits must be populated"]
["GQ",199,"TaxIDType","R","A",1,"All","E or S","Identifies TIN as employer identification number (E) or social security number (S)"]
["GR",200,"GroupName","R","A",100,"All",null,"Name of provider's group or facility.  Should contain no punctuation except dash, ampersand or apostrophe."]
["GS",201,"GroupNPI","R","N",10,"All",null,"Group/Facility NPI.  Do not place an individual NPI number in this field UNLESS ProviderTypeID='P\"/paraprofessional.\n10 digit number and must include leading zeroes."]
["GT",202,"GroupTaxonomy","O","A",10,"N/A"," Do not use","Primary Taxonomy code associated with the Group/Facility NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["GU",203,"GroupTaxonomy2","O","A",10,"N/A","Do not use","2nd Taxonomy code associated with the Group/Facility's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["GV",204,"GroupTaxonomy3","O","A",10,"N/A","Do not use","3rd Taxonomy code associated with the Group/Facility's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["GW",205,"BillName","C","A",100,"All",null,"Billing vendor's name.  Should contain no punctuation except a dash for hyphenated names or an ampersand or apostrophe.  If no billing name is provided then practice vendor name or provider name will be used in that order."]
["GX",206,"BillAddr1","C","A",55,"All",null,"Provider's billing address line 1.  Should not contain any punctuation.  Ex: 1234 Main Street"]
["GY",207,"BillAddr2","O","A",55,"All",null,"Provider's billing address line 2.  Contains suite, floor, room, etc. information.  Should not contain any punctuation. Ex: Suite 101, Building C, etc."]
["GZ",208,"BillCity","C","A",30,"All",null,"Provider's billing city. Should contain no punctuation."]
["HA",209,"BillState","C","A",2,"All",null,"Provider's billing state.  2 character postal abbreviation for the state"]
["HB",210,"BillZip","C","A",5,"All",null,"Provider's billing zip.  Format 99999 and should include leading zeroes"]
["HC",211,"BillZip4","O","A",4,"All",null,"Provider's billing zip +4 extension.  Format 9999 and should include leading zeroes"]
["HD",212,"BillPhone","R","A",10,"All",null,"Phone number associated with provider's billing address, including area code.  Format is 9999999999; no dashes or parenthesis."]
["HE",213,"BillPhoneExt","O","A",6,"All",null,"Phone number extension associated with provider's billing address.  Numbers only."]
["HF",214,"BillFax","O","A",10,"All",null,"Fax number associated with provider's billing address, including area code.  Format is 9999999999; no dashes or parenthesis."]
["HG",215,"BillContact","O","A",25,"All",null,"Name of contact for billing address.  Includes first and last name."]
["HH",216,"BillContactEmail","O","A",60,"All",null,"Billing contact's email address"]
["HI",217,"PrimaryLocFlg","R","A",1,"All","Y or N","Indicates if address is the primary service location for provider. Provider can have only 1 primary service location"]
["HJ",218,"HandicapFlg","R","A",1,"All","Y, N, U or blank","Indicates whether the service location has wheelchair accessibility.  Y=Yes and N=No."]
["HK",219,"ServAddrEffDt","R","A",10,"All","Format mm/dd/ccyy","Service address effective date"]
["HL",220,"ServAddrExpDt","R","A",10,"All","Format mm/dd/ccyy","Service address expiration date; if not terminated send 12/31/9999"]
["HM",221,"ServName","C","A",100,"All",null,"Service vendor's name only.  Should contain no punctuation except a dash for hyphenated name or an ampersand or apostrophe.  If no service name is provided then billing vendor name or provider name will be used in that order."]
["HN",222,"DBAName","O","A",50,"All",null,"Vendor DBA (Doing Business As) Name"]
["HO",223,"ServAddr1","C","A",55,"All",null,"Provider's service address line 1.  Should not contain any punctuation.  Ex: 1234 Main Street"]
["HP",224,"ServAddr2","O","A",55,"All",null,"Provider's service address line 2.  Contains suite, floor, room, etc. information.  Should not contain any punctuation. Ex: Suite 101, Building C, etc."]
["HQ",225,"ServCity","C","A",30,"All",null,"Provider's service city. Should contain no punctuation."]
["HR",226,"ServState","C","A",2,"All",null,"Provider's service state.  2 character postal abbreviation for the state"]
["HS",227,"ServZip","C","A",5,"All",null,"Provider's service zip.  Format 99999 and should include leading zeroes"]
["HT",228,"ServZip4","O","A",4,"All",null,"Provider's service zip +4 extension.  Format 9999 and should include leading zeroes"]
["HU",229,"ServPhone","C","A",10,"All",null,"Phone number associated with provider's service address, including area code.  Format is 9999999999; no dashes or parenthesis."]
["HV",230,"ServPhoneExt","O","A",6,"All",null,"Phone number extension associated with provider's service address.  Numbers only."]
["HW",231,"ServFax","O","A",10,"All",null,"Fax number associated with provider's service address, including area code.  Format is 9999999999; no dashes or parenthesis."]
["HX",232,"ServContact","O","A",25,"All",null,"Name of contact for service address.  Includes first and last name."]
["HY",233,"ServContactEmail","O","A",60,"All",null,"Service address contact's email address"]
["HZ",234,"MonBeg","O","A",5,"All","Format XHHMM","Monday start time format XHHMM where X=AM/PM indicator; HH=hour 01-12; MM=minutes 00-59"]
["IA",235,"MonEnd","O","A",5,"All","Format XHHMM","Monday end time format XHHMM where X=AM/PM indicator; HH=hour 01-12; MM=minutes 00-59"]
["IB",236,"TuesBeg","O","A",5,"All","Format XHHMM","Tuesday start time format XHHMM where X=AM/PM indicator; HH=hour 01-12; MM=minutes 00-59"]
["IC",237,"TuesEnd","O","A",5,"All","Format XHHMM","Tuesday end time format XHHMM where X=AM/PM indicator; HH=hour 01-12; MM=minutes 00-59"]
["ID",238,"WedBeg","O","A",5,"All","Format XHHMM","Wednesday start time format XHHMM where X=AM/PM indicator; HH=hour 01-12; MM=minutes 00-59"]
["IE",239,"WedEnd","O","A",5,"All","Format XHHMM","Wednesday end time format XHHMM where X=AM/PM indicator; HH=hour 01-12; MM=minutes 00-59"]
["IF",240,"ThursBeg","O","A",5,"All","Format XHHMM","Thursday start time format XHHMM where X=AM/PM indicator; HH=hour 01-12; MM=minutes 00-59"]
["IG",241,"ThursEnd","O","A",5,"All","Format XHHMM","Thursday end time format XHHMM where X=AM/PM indicator; HH=hour 01-12; MM=minutes 00-59"]
["IH",242,"FriBeg","O","A",5,"All","Format XHHMM","Friday start time format XHHMM where X=AM/PM indicator; HH=hour 01-12; MM=minutes 00-59"]
["II",243,"FriEnd","O","A",5,"All","Format XHHMM","Friday end time format XHHMM where X=AM/PM indicator; HH=hour 01-12; MM=minutes 00-59"]
["IJ",244,"SatBeg","O","A",5,"All","Format XHHMM","Saturday start time format XHHMM where X=AM/PM indicator; HH=hour 01-12; MM=minutes 00-59"]
["IK",245,"SatEnd","O","A",5,"All","Format XHHMM","Saturday end time format XHHMM where X=AM/PM indicator; HH=hour 01-12; MM=minutes 00-59"]
["IL",246,"SunBeg","O","A",5,"All","Format XHHMM","Sunday start time format XHHMM where X=AM/PM indicator; HH=hour 01-12; MM=minutes 00-59"]
["IM",247,"SunEnd","O","A",5,"All","Format XHHMM","Sunday end time format XHHMM where X=AM/PM indicator; HH=hour 01-12; MM=minutes 00-59"]
["IN",248,"NewPatientFlg","R","A",1,"All","Y or N","Accepting new patients at this location.  Y=accepting patients; N=not accepting"]
["IO",249,"HospName1","O","A",100,"I, R, P",null,"Name of the 1st facility where the provider has privileges"]
["IP",250,"HospPrivFlg1","O","A",25,"I, R, P","See Hospital Privileges List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Type of privileges at 1st facility "]
["IQ",251,"Hosp1PrivAddr1","O","A",55,"I, R, P",null,"Hospital 1 Privilege Address 1"]
["IR",252,"Hosp1PrivAddr2","O","A",55,"I, R, P",null,"Hospital 1 Privilege Address 2"]
["IS",253,"Hosp1PrivCity","O","A",30,"I, R, P",null,"Hospital 1 Privilege City"]
["IT",254,"Hosp1PrivState","O","A",2,"I, R, P",null,"Hospital 1 Privilege State"]
["IU",255,"Hosp1PrivZip","O","A",5,"I, R, P",null,"Hospital 1 Privilege Zip"]
["IV",256,"Hosp1PrivZip4","O","A",4,"I, R, P",null,"Hospital 1 Privilege Zip4"]
["IW",257,"Hosp1AHCAID","O","N",8,"I, R, P",null,"Hospital 1 Privilege AHCA ID"]
["IX",258,"HospName2","O","A",100,"I, R, P",null,"Name of the 2nd facility where the provider has privileges"]
["IY",259,"HospPrivFlg2","O","A",25,"I, R, P","See Hospital Privileges List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Type of privileges at 2nd facility "]
["IZ",260,"Hosp2PrivAddr1","O","A",55,"I, R, P",null,"Hospital 2 Privilege Address 1"]
["JA",261,"Hosp2PrivAddr2","O","A",55,"I, R, P",null,"Hospital 2 Privilege Address 2"]
["JB",262,"Hosp2PrivCity","O","A",30,"I, R, P",null,"Hospital 2 Privilege City"]
["JC",263,"Hosp2PrivState","O","A",2,"I, R, P",null,"Hospital 2 Privilege State"]
["JD",264,"Hosp2PrivZip","O","A",5,"I, R, P",null,"Hospital 2 Privilege Zip"]
["JE",265,"Hosp2PrivZip4","O","A",4,"I, R, P",null,"Hospital 2 Privilege Zip4"]
["JF",266,"Hosp2AHCAID","O","N",8,"I, R, P",null,"Hospital 2 Privilege AHCA ID"]
["JG",267,"HospName3","O","A",100,"I, R, P",null,"Name of the 3rd facility where the provider has privileges"]
["JH",268,"HospPrivFlg3","O","A",25,"I, R, P","See Hospital Privileges List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Type of privileges at 3rd facility "]
["JI",269,"Hosp3PrivAddr1","O","A",55,"I, R, P",null,"Hospital 3 Privilege Address 1"]
["JJ",270,"Hosp3PrivAddr2","O","A",55,"I, R, P",null,"Hospital 3 Privilege Address 2"]
["JK",271,"Hosp3PrivCity","O","A",30,"I, R, P",null,"Hospital 3 Privilege City"]
["JL",272,"Hosp3PrivState","O","A",2,"I, R, P",null,"Hospital 3 Privilege State"]
["JM",273,"Hosp3PrivZip","O","A",5,"I, R, P",null,"Hospital 3 Privilege Zip"]
["JN",274,"Hosp3PrivZip4","O","A",4,"I, R, P",null,"Hospital 3 Privilege Zip4"]
["JO",275,"Hosp3AHCAID","O","N",8,"I, R, P",null,"Hospital 3 Privilege AHCA ID"]
["JP",276,"LowAge","R","N",2,"All",null,"Minimum age a provider is willing to see.  Numbers 0-9 only"]
["JQ",277,"HighAge","R","N",2,"All",null,"Maximum age a provider is willing to see.   Numbers 0-9 only"]
["JR",278,"DelegatedFlg","O","A",1,"All","Y, N or blank","Delegated provider flag"]
["JS",279,"DelegatedName","O","A",75,"All",null,"Delegated agency name"]
["JT",280,"MinorityOwnOperate","O","A",1,"All","Y, N or blank","Minority Owned Business Flag"]
["JU",281,"SmallBusFlg","O","A",1,"All","Y, N or blank","Small business flag. Answer Y if provider's practice meets the standards set by the Small Business Administration"]
["JV",282,"WomanOwnedFlg","O","A",1,"All","Y, N or blank","Woman Owned Small Business flag.  Answer Y if at least 51% of provider's practice is owned by one or more woman"]
["JW",283,"SmallDisadvFlg","O","A",1,"All","Y, N or blank","Small Disadvantaged business flag.  Answer Y if at least 51% of provider's practice is owned by a disadvantaged person and that person provides daily management and control"]
["JX",284,"VeteranOwnedFlg","O","A",1,"All","Y, N or blank","Veteran owned small business flag.  Answer Y if at least 51% of provider's practice is owned by one or more veterans that provide daily management and control"]
["JY",285,"DisadvVetFlg","O","A",1,"All","Y, N or blank","Service-Disabled Veteran owned small business flag.  Answer Y if provider's practice is owned and controlled by a service disabled veteran under section 101 (16) of title 38, United States Code"]
["JZ",286,"HubZoneFlg","O","A",1,"All","Y, N or blank","HubZone Small business flag.  Answer Y if provider's practice can be found in a qualified Hubzone concern."]
["KA",287,"HistBlackCollege","O","A",1,"All","Y, N or blank","Historically Black College/Minority Institution flag.  Answer Y if provider's practice meets the requirements determined by Secretary of Education 34 CFR 608.2"]
["KB",288,"NAICSCode","O","A",6,"All",null,"NAICS Code; North American Industrial Classification System Code for this practice"]
["KC",289,"ADASurveyFlg","O","A",1,"I,G, F","Y, N or blank","ADA Survey flag.  Answer 'Y' if ADA survey was approved for practice location."]
["KD",290,"ADASurveyDte","O","A",10,"I,G, F","Format mm/dd/ccyy","ADA Survey completion date.  If only the year is known use 01/01/CCYY."]
["KE",291,"SpcNSurveyFlg","O","A",1,"I,G, F","Y, N or blank","Special Needs Survey flag.  Answer 'Y' if Special Needs survey was received for practice location."]
["KF",292,"SpcNSurveyDte","O","A",10,"I,G, F","Format mm/dd/ccyy","Special Needs Survey completion date.  If only the year is known use 01/01/CCYY."]
["KG",293,"ECFMGFlag","O","A",1,"All","Y, N or blank","ECFMG flag. Answer 'Y' if provider has ECFMG number"]
["KH",294,"ECFMGNumber","O","A",8,"All",null,"ECFMG Number"]
["KI",295,"ECFMGIssued","O","A",10,"All","Format mm/dd/ccyy","ECFMG Issue Date in MM/DD/CCYY format.  If only the year is known use 01/01/CCYY"]
["KJ",296,"ECFMGExpDte","O","A",11,"All","Format mm/dd/ccyy","ECFMG Expiration Date in MM/DD/CCYY format.  If only the year is known use 01/01/CCYY"]
["KK",297,"PagerNumber","O","A",10,"All",null,"Provider's pager number, including area code.  Format is 9999999999; no dashes or parenthesis."]
["KL",298,"AnswerServiceNumber","O","A",10,"All",null,"Answering Service Phone number for provider, including area code.  Format is 9999999999; no dashes or parenthesis."]
["KM",299,"CellPhoneNumber","O","A",10,"All",null,"Provider's cell phone number, including area code.  Format is 9999999999; no dashes or parenthesis."]
["KN",300,"InitialCredDt","R","A",10,"All","Format mm/dd/ccyy","Provider's initial credentialing date"]
["KO",301,"PreviousCredDt","R","A",10,"All","Format mm/dd/ccyy","Date provider was last credentialed"]
["KP",302,"RecredDueDt","R","A",10,"All","Format mm/dd/ccyy","Date provider is due for recredentialing (usually 2-3 years from current credential date)"]
["KQ",303,"CurrCredDt","R","A",10,"I, F","Format mm/dd/ccyy","Current credential date; Most recent credentialing date for provider"]
["KR",304,"ReviewType","R","A",50,"I, F","See Review Type List\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Credentialing review type"]
["KS",305,"ProcessStatus","R","A",50,"I, F","See Process Status List\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Credentialing process status"]
["KT",306,"AppReceivedDt","O","A",10,"I, F","Format mm/dd/ccyy","Credentialing application received date"]
["KU",307,"AttestationDt","O","A",10,"I, F","Format mm/dd/ccyy","Credentialing attestation date"]
["KV",308,"AppReceivedCompleteDt","O","A",10,"I, F","Format mm/dd/ccyy","Credentialing application received complete date"]
["KW",309,"SiteVisitCompleteDt","O","A",10,"F","Format mm/dd/ccyy","Credentialing site visit complete date"]
["KX",310,"SiteVisitResult","O","A",50,"F",null,"Credentialing site visit result"]
["KY",311,"Decision ","O","A",50,"I, F",null,"Credentialing Decision"]
["KZ",312,"DecisionMadeBy","O","A",50,"I, F",null,"Credentialing Decision Made by"]
["LA",313,"DecisionDate","O","A",10,"I, F","Format mm/dd/ccyy","Credentialing Decision Date"]
["LB",314,"ProviderCAQHNumber","O","A",17,"I",null,"CAQH number"]
["LC",315,"ProviderCAQHAttestationDt","O","A",10,"I","Format mm/dd/ccyy","CAQH attestation date"]
["LD",316,"ACStatus_JC","O","A",1,"F","1=Yes or blank","Accreditation Status-Expected Value (1) or NULL for JCAH or TJC (Joint Commission/JCAHO)"]
["LE",317,"ACFROM_JC","O","A",10,"F","Format mm/dd/ccyy","Accreditation From Date"]
["LF",318,"ACTO_JC","O","A",10,"F","Format mm/dd/ccyy","Accreditation To Date"]
["LG",319,"DateVeri_JC","O","A",10,"F","Format mm/dd/ccyy","Accreditation Date Verified"]
["LH",320,"Previous_DateVeri_JC","O","A",10,"F","Format mm/dd/ccyy","Date Accreditation was previously verified"]
["LI",321,"ACStatus_CARF","O","A",1,"F","1=Yes or blank","Accreditation Status-Expected Value (1) or NULL for CARF or CAR1 (Commission on Accreditation of Rehab Facilities)"]
["LJ",322,"ACFROM_CARF","O","A",10,"F","Format mm/dd/ccyy","Accreditation From Date"]
["LK",323,"ACTO_CARF","O","A",10,"F","Format mm/dd/ccyy","Accreditation To Date"]
["LL",324,"DateVeri_CARF","O","A",10,"F","Format mm/dd/ccyy","Accreditation Date Verified"]
["LM",325,"Previous_DateVeri_CARF","O","A",10,"F","Format mm/dd/ccyy","Date Accreditation was previously verified"]
["LN",326,"ACStatus_COA","O","A",1,"F","1=Yes or blank","Accreditation Status-Expected Value (1) or NULL for COA (Council on Accreditation)"]
["LO",327,"ACFROM_COA","O","A",10,"F","Format mm/dd/ccyy","Accreditation From Date"]
["LP",328,"ACTO_COA","O","A",10,"F","Format mm/dd/ccyy","Accreditation To Date"]
["LQ",329,"DateVeri_COA","O","A",10,"F","Format mm/dd/ccyy","Accreditation Date Verified"]
["LR",330,"Previous_DateVeri_COA","O","A",10,"F","Format mm/dd/ccyy","Date Accreditation was previously verified"]
["LS",331,"ACStatus_DNV","O","A",1,"F","1=Yes or blank","Accreditation Status-Expected Value (1) or NULL for DNV or DHAP(DNV/NIAHO Hospital Accreditation Program)"]
["LT",332,"ACFROM_DNV","O","A",10,"F","Format mm/dd/ccyy","Accreditation From Date"]
["LU",333,"ACTO_DNV","O","A",10,"F","Format mm/dd/ccyy","Accreditation To Date"]
["LV",334,"DateVeri_DNV","O","A",10,"F","Format mm/dd/ccyy","Accreditation Date Verified"]
["LW",335,"Previous_DateVeri_DNV","O","A",10,"F","Format mm/dd/ccyy","Date Accreditation was previously verified"]
["LX",336,"ACStatus_IMQ","O","A",1,"F","1=Yes or blank","Accreditation Status-Expected Value (1) or NULL for IMQ (Institute for Medical Quality)"]
["LY",337,"ACFROM_IMQ","O","A",10,"F","Format mm/dd/ccyy","Accreditation From Date"]
["LZ",338,"ACTO_IMQ","O","A",10,"F","Format mm/dd/ccyy","Accreditation To Date"]
["MA",339,"DateVeri_IMQ","O","A",10,"F","Format mm/dd/ccyy","Accreditation Date Verified"]
["MB",340,"Previous_DateVeri_IMQ","O","A",10,"F","Format mm/dd/ccyy","Date Accreditation was previously verified"]
["MC",341,"FacilityName","C","A",100,"R, F",null,"Facility's full name.  Should contain no punctuation except a dash for hyphenated name."]
["MD",342,"FacilityProviderType","C","A",50,"F","See Facility Type List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility provider type"]
["ME",343,"Plan01 ","C","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:\nPopulate a ‘Y’ in this field for ALL providers"]
["MF",344,"Plan02","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["MG",345,"Plan03","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["MH",346,"Plan04","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["MI",347,"Plan05","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["MJ",348,"Plan06","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["MK",349,"Plan07","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["ML",350,"Plan08","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["MM",351,"Plan09","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["MN",352,"Plan10","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["MO",353,"Plan11 ","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["MP",354,"Plan12","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["MQ",355,"Plan13","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["MR",356,"Plan14","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["MS",357,"Plan15","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["MT",358,"Plan16","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["MU",359,"Plan17","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["MV",360,"Plan18","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["MW",361,"Plan19","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["MX",362,"Plan20","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["MY",363,"Plan21 ","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["MZ",364,"Plan22","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["NA",365,"Plan23","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["NB",366,"Plan24","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["NC",367,"Plan25","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["ND",368,"Plan26","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["NE",369,"Plan27","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["NF",370,"Plan28","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["NG",371,"Plan29","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["NH",372,"Plan30","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["NI",373,"Plan31 ","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["NJ",374,"Plan32","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["NK",375,"Plan33","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["NL",376,"Plan34","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["NM",377,"Plan35","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["NN",378,"Plan36","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["NO",379,"Plan37","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["NP",380,"Plan38","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["NQ",381,"Plan39","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["NR",382,"Plan40","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["NS",383,"Plan41 ","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["NT",384,"Plan42","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["NU",385,"Plan43","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["NV",386,"Plan44","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["NW",387,"Plan45","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["NX",388,"Plan46","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["NY",389,"Plan47","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["NZ",390,"Plan48","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["OA",391,"Plan49","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["OB",392,"Plan50","O","A",1,"All","Y=Yes or N=No","Provider participates in plan/benefit:  "]
["OC",393,"EHRFlag","O","A",1,"All","Y, N or blank","Electronic Health Record flag"]
["OD",394,"SSACode","O","A",5,"All",null,"State/County service location codes"]
["OE",395,"MedicareBeds","O","N",4,"All",null,"Number of Medicare beds"]
["OF",396,"MedicaidBeds","O","N",4,"All",null,"Number of Medicaid beds"]
["OG",397,"GroupDBAName","O","A",50,"I, R, P, G",null,"Group DBA Name"]
["OH",398,"GroupAltName","O","A",100,"I, R, P, G",null,"Group Alternate Name"]
["OI",399,"ContractStart","O","A",10,"All","Format mm/dd/ccyy","Provider's contract start date formatted as mm/dd/ccyy"]
["OJ",400,"AHCAHospitalID","O","N",8,"F",null,"AHCA Hospital ID (required for facility)"]
["OK",401,"Ethnicity","O","A",25,"I, R, P","See Ethnicity List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Practitioner Race Code"]
["OL",402,"Plan1ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 1 - Provider participation level"]
["OM",403,"Plan1EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 1 - Contract Effective Date (Plan Affiliation Date)"]
["ON",404,"Plan1ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 1 - Contract Termination Date (Plan Affiliation Date)"]
["OO",405,"Plan2ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 2 - Provider participation level"]
["OP",406,"Plan2EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 2 - Contract Effective Date "]
["OQ",407,"Plan2ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 2 - Contract Termination Date "]
["OR",408,"Plan3ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 3 - Provider participation level"]
["OS",409,"Plan3EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 3 - Contract Effective Date "]
["OT",410,"Plan3ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 3 - Contract Termination Date "]
["OU",411,"Plan4ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 4 - Provider participation level"]
["OV",412,"Plan4EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 4 - Contract Effective Date "]
["OW",413,"Plan4ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 4 - Contract Termination Date "]
["OX",414,"Plan5ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 5 - Provider participation level"]
["OY",415,"Plan5EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 5 - Contract Effective Date "]
["OZ",416,"Plan5ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 5 - Contract Termination Date "]
["PA",417,"Plan6ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 6 - Provider participation level"]
["PB",418,"Plan6EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 6 - Contract Effective Date "]
["PC",419,"Plan6ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 6 - Contract Termination Date "]
["PD",420,"Plan7ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 7 - Provider participation level"]
["PE",421,"Plan7EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 7 - Contract Effective Date "]
["PF",422,"Plan7ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 7 - Contract Termination Date "]
["PG",423,"Plan8ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 8 - Provider participation level"]
["PH",424,"Plan8EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 8 - Contract Effective Date "]
["PI",425,"Plan8ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 8 - Contract Termination Date "]
["PJ",426,"Plan9ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 9 - Provider participation level"]
["PK",427,"Plan9EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 9 - Contract Effective Date "]
["PL",428,"Plan9ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 9 - Contract Termination Date "]
["PM",429,"Plan10ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 10 - Provider participation level"]
["PN",430,"Plan10EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 10 - Contract Effective Date "]
["PO",431,"Plan10ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 10 - Contract Termination Date "]
["PP",432,"Plan11ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 11 - Provider participation level"]
["PQ",433,"Plan11EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 11 - Contract Effective Date "]
["PR",434,"Plan11ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 11 - Contract Termination Date "]
["PS",435,"Plan12ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 12 - Provider participation level"]
["PT",436,"Plan12EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 12 - Contract Effective Date "]
["PU",437,"Plan12ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 12 - Contract Termination Date "]
["PV",438,"Plan13ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 13 - Provider participation level"]
["PW",439,"Plan13EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 13 - Contract Effective Date "]
["PX",440,"Plan13ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 13 - Contract Termination Date "]
["PY",441,"Plan14ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 14 - Provider participation level"]
["PZ",442,"Plan14EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 14 - Contract Effective Date "]
["QA",443,"Plan14ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 14 - Contract Termination Date "]
["QB",444,"Plan15ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 15 - Provider participation level"]
["QC",445,"Plan15EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 15 - Contract Effective Date "]
["QD",446,"Plan15ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 15 - Contract Termination Date "]
["QE",447,"Plan16ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 16 - Provider participation level"]
["QF",448,"Plan16EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 16 - Contract Effective Date "]
["QG",449,"Plan16ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 16 - Contract Termination Date "]
["QH",450,"Plan17ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 17 - Provider participation level"]
["QI",451,"Plan17EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 17 - Contract Effective Date "]
["QJ",452,"Plan17ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 17 - Contract Termination Date "]
["QK",453,"Plan18ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 18 - Provider participation level"]
["QL",454,"Plan18EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 18 - Contract Effective Date "]
["QM",455,"Plan18ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 18 - Contract Termination Date "]
["QN",456,"Plan19ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 19 - Provider participation level"]
["QO",457,"Plan19EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 19 - Contract Effective Date "]
["QP",458,"Plan19ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 19 - Contract Termination Date "]
["QQ",459,"Plan20ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 20 - Provider participation level"]
["QR",460,"Plan20EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 20 - Contract Effective Date "]
["QS",461,"Plan20ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 20 - Contract Termination Date "]
["QT",462,"Plan21ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 21 - Provider participation level"]
["QU",463,"Plan21EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 21 - Contract Effective Date "]
["QV",464,"Plan21ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 21 - Contract Termination Date "]
["QW",465,"Plan22ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 22 - Provider participation level"]
["QX",466,"Plan22EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 22 - Contract Effective Date "]
["QY",467,"Plan22ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 22 - Contract Termination Date "]
["QZ",468,"Plan23ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 23 - Provider participation level"]
["RA",469,"Plan23EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 23 - Contract Effective Date "]
["RB",470,"Plan23ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 23 - Contract Termination Date "]
["RC",471,"Plan24ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 24 - Provider participation level"]
["RD",472,"Plan24EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 24 - Contract Effective Date "]
["RE",473,"Plan24ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 24 - Contract Termination Date "]
["RF",474,"Plan25ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 25 - Provider participation level"]
["RG",475,"Plan25EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 25 - Contract Effective Date "]
["RH",476,"Plan25ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 25 - Contract Termination Date "]
["RI",477,"Plan26ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 26 - Provider participation level"]
["RJ",478,"Plan26EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 26 - Contract Effective Date "]
["RK",479,"Plan26ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 26 - Contract Termination Date "]
["RL",480,"Plan27ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 27 - Provider participation level"]
["RM",481,"Plan27EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 27 - Contract Effective Date "]
["RN",482,"Plan27ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 27 - Contract Termination Date "]
["RO",483,"Plan28ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 28 - Provider participation level"]
["RP",484,"Plan28EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 28 - Contract Effective Date "]
["RQ",485,"Plan28ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 28 - Contract Termination Date "]
["RR",486,"Plan29ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 29 - Provider participation level"]
["RS",487,"Plan29EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 29 - Contract Effective Date "]
["RT",488,"Plan29ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 29 - Contract Termination Date "]
["RU",489,"Plan30ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 30 - Provider participation level"]
["RV",490,"Plan30EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 30 - Contract Effective Date "]
["RW",491,"Plan30ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 30 - Contract Termination Date "]
["RX",492,"Plan31ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 31 - Provider participation level"]
["RY",493,"Plan31EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 31 - Contract Effective Date "]
["RZ",494,"Plan31ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 31 - Contract Termination Date "]
["SA",495,"Plan32ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 32 - Provider participation level"]
["SB",496,"Plan32EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 32 - Contract Effective Date "]
["SC",497,"Plan32ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 32 - Contract Termination Date "]
["SD",498,"Plan33ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 33 - Provider participation level"]
["SE",499,"Plan33EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 33 - Contract Effective Date "]
["SF",500,"Plan33ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 33 - Contract Termination Date "]
["SG",501,"Plan34ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 34 - Provider participation level"]
["SH",502,"Plan34EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 34 - Contract Effective Date "]
["SI",503,"Plan34ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 34 - Contract Termination Date "]
["SJ",504,"Plan35ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 35 - Provider participation level"]
["SK",505,"Plan35EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 35 - Contract Effective Date "]
["SL",506,"Plan35ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 35 - Contract Termination Date "]
["SM",507,"Plan36ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 36 - Provider participation level"]
["SN",508,"Plan36EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 36 - Contract Effective Date "]
["SO",509,"Plan36ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 36 - Contract Termination Date "]
["SP",510,"Plan37ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 37 - Provider participation level"]
["SQ",511,"Plan37EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 37 - Contract Effective Date "]
["SR",512,"Plan37ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 37 - Contract Termination Date "]
["SS",513,"Plan38ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 38 - Provider participation level"]
["ST",514,"Plan38EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 38 - Contract Effective Date "]
["SU",515,"Plan38ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 38 - Contract Termination Date "]
["SV",516,"Plan39ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 39 - Provider participation level"]
["SW",517,"Plan39EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 39 - Contract Effective Date "]
["SX",518,"Plan39ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 39 - Contract Termination Date "]
["SY",519,"Plan40ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 40 - Provider participation level"]
["SZ",520,"Plan40EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 40 - Contract Effective Date "]
["TA",521,"Plan40ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 40 - Contract Termination Date "]
["TB",522,"Plan41ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 41 - Provider participation level"]
["TC",523,"Plan41EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 41 - Contract Effective Date "]
["TD",524,"Plan41ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 41 - Contract Termination Date "]
["TE",525,"Plan42ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 42 - Provider participation level"]
["TF",526,"Plan42EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 42 - Contract Effective Date "]
["TG",527,"Plan42ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 42 - Contract Termination Date "]
["TH",528,"Plan43ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 43 - Provider participation level"]
["TI",529,"Plan43EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 43 - Contract Effective Date "]
["TJ",530,"Plan43ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 43 - Contract Termination Date "]
["TK",531,"Plan44ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 44 - Provider participation level"]
["TL",532,"Plan44EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 44 - Contract Effective Date "]
["TM",533,"Plan44ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 44 - Contract Termination Date "]
["TN",534,"Plan45ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 45 - Provider participation level"]
["TO",535,"Plan45EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 45 - Contract Effective Date "]
["TP",536,"Plan45ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 45 - Contract Termination Date "]
["TQ",537,"Plan46ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 46 - Provider participation level"]
["TR",538,"Plan46EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 46 - Contract Effective Date "]
["TS",539,"Plan46ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 46 - Contract Termination Date "]
["TT",540,"Plan47ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 47 - Provider participation level"]
["TU",541,"Plan47EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 47 - Contract Effective Date "]
["TV",542,"Plan47ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 47 - Contract Termination Date "]
["TW",543,"Plan48ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 48 - Provider participation level"]
["TX",544,"Plan48EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 48 - Contract Effective Date "]
["TY",545,"Plan48ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 48 - Contract Termination Date "]
["TZ",546,"Plan49ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 49 - Provider participation level"]
["UA",547,"Plan49EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 49 - Contract Effective Date "]
["UB",548,"Plan49ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 49 - Contract Termination Date "]
["UC",549,"Plan50ParLevel","O","A",25,"All","See Participation Status List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Plan 50 - Provider participation level"]
["UD",550,"Plan50EffDate","O","A",10,"All","Format mm/dd/ccyy","Plan 50 - Contract Effective Date "]
["UE",551,"Plan50ExpDate","O","A",10,"All","Format mm/dd/ccyy","Plan 50 - Contract Termination Date "]
["UF",552,"ProviderSpecialty1","R","A",100,"I, R, P","See Practitioner Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Code representing the provider's 1st area of specialization. "]
["UG",553,"ProviderSpecialty2","O","A",100,"I, R, P","See Practitioner Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Code representing the provider's 2nd area of specialization.  "]
["UH",554,"ProviderSpecialty3","O","A",100,"I, R, P","See Practitioner Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Code representing the provider's 3rd area of specialization.  "]
["UI",555,"ProviderSpecialty4","O","A",100,"I, R, P","See Practitioner Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Code representing the provider's 4th area of specialization. "]
["UJ",556,"ProviderSpecialty5","O","A",100,"I, R, P","See Practitioner Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Code representing the provider's 5th area of specialization.  "]
["UK",557,"ProviderSpecialty6","O","A",100,"I, R, P","See Practitioner Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Provider Specialization 6"]
["UL",558,"ProviderSpecialty7","O","A",100,"I, R, P","See Practitioner Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Provider Specialization 7"]
["UM",559,"ProviderSpecialty8","O","A",100,"I, R, P","See Practitioner Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Provider Specialization 8"]
["UN",560,"ProviderSpecialty9","O","A",100,"I, R, P","See Practitioner Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Provider Specialization 9"]
["UO",561,"ProviderSpecialty10","O","A",100,"I, R, P","See Practitioner Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Provider Specialization 10"]
["UP",562,"ProviderSpecialty11","O","A",100,"I, R, P","See Practitioner Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Provider Specialization 11"]
["UQ",563,"ProviderSpecialty12","O","A",100,"I, R, P","See Practitioner Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Provider Specialization 12"]
["UR",564,"FacilitySpecialty1","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 1"]
["US",565,"FacilitySpecialty2","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 2"]
["UT",566,"FacilitySpecialty3","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 3"]
["UU",567,"FacilitySpecialty4","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 4"]
["UV",568,"FacilitySpecialty5","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 5"]
["UW",569,"FacilitySpecialty6","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 6"]
["UX",570,"FacilitySpecialty7","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 7"]
["UY",571,"FacilitySpecialty8","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 8"]
["UZ",572,"FacilitySpecialty9","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 9"]
["VA",573,"FacilitySpecialty10","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 10"]
["VB",574,"FacilitySpecialty11","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 11"]
["VC",575,"FacilitySpecialty12","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 12"]
["VD",576,"FacilitySpecialty13","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 13"]
["VE",577,"FacilitySpecialty14","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 14"]
["VF",578,"FacilitySpecialty15","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 15"]
["VG",579,"FacilitySpecialty16","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 16"]
["VH",580,"FacilitySpecialty17","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 17"]
["VI",581,"FacilitySpecialty18","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 18"]
["VJ",582,"FacilitySpecialty19","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 19"]
["VK",583,"FacilitySpecialty20","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 20"]
["VL",584,"FacilitySpecialty21","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 21"]
["VM",585,"FacilitySpecialty22","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 22"]
["VN",586,"FacilitySpecialty23","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 23"]
["VO",587,"FacilitySpecialty24","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 24"]
["VP",588,"FacilitySpecialty25","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 25"]
["VQ",589,"FacilitySpecialty26","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 26"]
["VR",590,"FacilitySpecialty27","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 27"]
["VS",591,"FacilitySpecialty28","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 28"]
["VT",592,"FacilitySpecialty29","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 29"]
["VU",593,"FacilitySpecialty30","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 30"]
["VV",594,"FacilitySpecialty31","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 31"]
["VW",595,"FacilitySpecialty32","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 32"]
["VX",596,"FacilitySpecialty33","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 33"]
["VY",597,"FacilitySpecialty34","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 34"]
["VZ",598,"FacilitySpecialty35","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 35"]
["WA",599,"FacilitySpecialty36","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 36"]
["WB",600,"FacilitySpecialty37","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 37"]
["WC",601,"FacilitySpecialty38","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 38"]
["WD",602,"FacilitySpecialty39","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 39"]
["WE",603,"FacilitySpecialty40","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 40"]
["WF",604,"FacilitySpecialty41","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 41"]
["WG",605,"FacilitySpecialty42","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 42"]
["WH",606,"FacilitySpecialty43","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 43"]
["WI",607,"FacilitySpecialty44","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 44"]
["WJ",608,"FacilitySpecialty45","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 45"]
["WK",609,"FacilitySpecialty46","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 46"]
["WL",610,"FacilitySpecialty47","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 47"]
["WM",611,"FacilitySpecialty48","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 48"]
["WN",612,"FacilitySpecialty49","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 49"]
["WO",613,"FacilitySpecialty50","O","A",100,"F, G","See Facility Specialty List in Appendix for approved values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Facility program code 50"]
["WP",614,"SiteMedicaid","O","A",30,"All",null,"Site location Medicaid ID"]
["WQ",615,"SiteNPI","O","A",10,"N/A","Do not use","Site location NPI"]
["WR",616,"SiteNPI2","O","A",10,"N/A","Do not use","Site location 2nd NPI"]
["WS",617,"SiteNPI3","O","A",10,"N/A","Do not use","Site location 3rd NPI"]
["WT",618,"SiteNPI4","O","A",10,"N/A","Do not use","Site location 4th NPI"]
["WU",619,"SiteNPI5","O","A",10,"N/A","Do not use","Site location 5th NPI"]
["WV",620,"ProvTaxonomy1","O","A",10,"All",null,"Primary Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["WW",621,"ProvTaxonomy2","O","A",10,"All",null,"2nd Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["WX",622,"ProvTaxonomy3","O","A",10,"All",null,"3rd Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["WY",623,"ProvTaxonomy4","O","A",10,"All",null,"Primary Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["WZ",624,"ProvTaxonomy5","O","A",10,"All",null,"2nd Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["XA",625,"ProvTaxonomy6","O","A",10,"All",null,"3rd Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["XB",626,"ProvTaxonomy7","O","A",10,"All",null,"4th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["XC",627,"ProvTaxonomy8","O","A",10,"All",null,"5th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["XD",628,"ProvTaxonomy9","O","A",10,"All",null,"6th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["XE",629,"ProvTaxonomy10","O","A",10,"All",null,"7th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["XF",630,"ProvTaxonomy11","O","A",10,"All",null,"8th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["XG",631,"ProvTaxonomy12","O","A",10,"All",null,"9th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["XH",632,"ProvTaxonomy13","O","A",10,"All",null,"10th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["XI",633,"ProvTaxonomy14","O","A",10,"All",null,"11th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["XJ",634,"ProvTaxonomy15","O","A",10,"All",null,"12th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["XK",635,"ProvTaxonomy16","O","A",10,"All",null,"13th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["XL",636,"ProvTaxonomy17","O","A",10,"All",null,"14th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["XM",637,"ProvTaxonomy18","O","A",10,"All",null,"15th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["XN",638,"ProvTaxonomy19","O","A",10,"All",null,"16th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["XO",639,"ProvTaxonomy20","O","A",10,"All",null,"17th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["XP",640,"ProvTaxonomy21","O","A",10,"All",null,"18th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["XQ",641,"ProvTaxonomy22","O","A",10,"All",null,"19th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["XR",642,"ProvTaxonomy23","O","A",10,"All",null,"20th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["XS",643,"ProvTaxonomy24","O","A",10,"All",null,"21st Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["XT",644,"ProvTaxonomy25","O","A",10,"All",null,"22nd Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["XU",645,"ProvTaxonomy26","O","A",10,"All",null,"23rd Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["XV",646,"ProvTaxonomy27","O","A",10,"All",null,"24th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["XW",647,"ProvTaxonomy28","O","A",10,"All",null,"25th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["XX",648,"ProvTaxonomy29","O","A",10,"All",null,"26th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["XY",649,"ProvTaxonomy30","O","A",10,"All",null,"27th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["XZ",650,"ProvTaxonomy31","O","A",10,"All",null,"28th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["YA",651,"ProvTaxonomy32","O","A",10,"All",null,"29th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["YB",652,"ProvTaxonomy33","O","A",10,"All",null,"30th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["YC",653,"ProvTaxonomy34","O","A",10,"All",null,"31st Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["YD",654,"ProvTaxonomy35","O","A",10,"All",null,"32nd Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["YE",655,"ProvTaxonomy36","O","A",10,"All",null,"33rd Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["YF",656,"ProvTaxonomy37","O","A",10,"All",null,"34th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["YG",657,"ProvTaxonomy38","O","A",10,"All",null,"35th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["YH",658,"ProvTaxonomy39","O","A",10,"All",null,"36th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["YI",659,"ProvTaxonomy40","O","A",10,"All",null,"37th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["YJ",660,"ProvTaxonomy41","O","A",10,"All",null,"38th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["YK",661,"ProvTaxonomy42","O","A",10,"All",null,"39th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["YL",662,"ProvTaxonomy43","O","A",10,"All",null,"40th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["YM",663,"ProvTaxonomy44","O","A",10,"All",null,"41st Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["YN",664,"ProvTaxonomy45","O","A",10,"All",null,"42nd Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["YO",665,"ProvTaxonomy46","O","A",10,"All",null,"43rd Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["YP",666,"ProvTaxonomy47","O","A",10,"All",null,"44th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["YQ",667,"ProvTaxonomy48","O","A",10,"All",null,"45th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["YR",668,"ProvTaxonomy49","O","A",10,"All",null,"46th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["YS",669,"ProvTaxonomy50","O","A",10,"All",null,"47th Taxonomy code associated with the Provider's NPI.  Must be valid NUCC (National Uniform Claim Committee) taxonomy code.  Include any leading zeroes."]
["YT",670,"WebsiteURL","O","A",100,"All",null,"Provider's Website URL Address"]
["YU",671,"CulturalCompetencyTraining","O","A",1,"All","Y/N","Has provider completed cultural competency training for this location?  For facilities/groups, Y=indicates training has been conducted for their staff; for individuals, Y=provider has received this training"]
["YV",672,"CulturalGenderStrengths","O","A",200,"All",null,"Provider notes here whether there are any cultural or gender based strengths or special competencies/programs.  Field may contain multiple items separated by semicolon (;)"]
["YW",673,"AnthemID","O","N",15,"All",null,"Anthem system ID, if applicable"]
["YX",674,"DirectoryFlg","O","A",1,"All",null,"Should provider appear in the directory?  Y=indicates provider should appear in directory, including online directories and N=provider should not be listed in directory"]
["YY",675,"TelehealthFlg","O","A",1,"All",null,"Telehealth visits provided.  Y=indicates provider does provide telehealth consultations and N=provider does not or did not provide that information."]
["YZ",676,"TotalBedCount","O","N",3,"F",null,"Total of all beds provided at facility location"]
["ZA",677,"StandardEthnicity","O","A",25,"I","Ethnicity Code Approved Values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Industry standard Ethnicity Code"]
["ZB",678,"OMBRace","O","A",50,"I","Office Management and Budget Race Code Approved Values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Office of Management and Budget race code definition"]
["ZC",679,"OMBEthnicity ","O","A",50,"I","Ethnicity Code Approved Values\n***PLEASE REFER TO WORD DOCUMENT FOR APPROVED VALUES","Office of Management and Budget ethnicity code definition"]
["ZD",680,"PromiseID","O","A",9,"All"]
["ZE",681,"PromiseSvcLoc","O","A",4,"All"]
["ZF",682,"PromiseffDt","O","A",8,"All",null,"Promise ID start date formatted as mm/dd/ccyy"]
["ZG",683,"PromiseExpDt","O","A",8,"All",null,"Provider's Medicaid term date formatted as mm/dd/ccyy"]