| Name | Description | Type | Additional information |
|---|---|---|---|
| ID | integer |
None. |
|
| BILLING_NPI | integer |
None. |
|
| BILLING_PRVDR_NAME | string |
None. |
|
| SERVC_NPI | integer |
None. |
|
| SERVC_PRVDR_NAME | string |
None. |
|
| TAX_ID | string |
None. |
|
| PRVDR_CONTACT_NAME | string |
None. |
|
| PRVDR_PHONE | string |
None. |
|
| PRVDR_TYPE | string |
None. |
|
| STREET1 | string |
None. |
|
| STREET3 | string |
None. |
|
| STREET2 | string |
None. |
|
| Address | string |
None. |
|
| CITY_TOWN_NAME | string |
None. |
|
| STATE_PRVNC_CODE | string |
None. |
|
| POSTAL_CODE | integer |
None. |
|
| CREATE_USER | integer |
None. |
|
| REMARKS | string |
None. |
|
| OPRTNL_FLAG | string |
None. |
|
| SDMEDX_ID | integer |
None. |
|
| TODATE | date |
None. |
|
| FROMDATE | date |
None. |
|
| PRVDR_FOR | integer |
None. |
|
| HH_CLINIC_ID | string |
None. |
|
| PCP_CLINIC_ID | string |
None. |
|
| COST_STLMNT_FLAG | string |
None. |
|
| ASA_CENSUS_FLAG | string |
None. |
|
| FACIS_ID | integer |
None. |
|
| PR_CLINIC_ID | string |
None. |
|
| Report_Month | integer |
None. |
|
| Report_Year | integer |
None. |
|
| Type | string |
None. |