NATIONAL PRACTITIONER DATA BANK (NPDB)

CODE LISTS

Version 2.07
April 2019

U.S. Department of Health and Human Services

Health Resources and Services Administration
Bureau of Health Workforce
Division of Practitioner Data Bank
Parklawn Building, Room 11SWH03
5600 Fishers Lane
Rockville, Maryland 20857
Code Lists Version 2.07

Document Change History

The table below identifies changes that have been incorporated into each baseline of this document.

Table 1 - Document Change History

Date Version # Change Description

4/2009 1.00 Initial Version.
New codes go into effect June 15, 2009. The following code lists have been
updated:
AAR Adverse Action Classification Codes - Individual Subjects.
● Clinical Privileges - Actions: Added codes 1615, 1637, 1638, 1642, 1643, 1644,
1655, 1656.
● Clinical Privileges - Revisions to Actions: Added codes 1610, 1615, 1630, 1632,
1637, 1638, 1639, 1640, 1642, 1643, 1644, 1645, 1655, 1656, 1682, 1696.
● Exclusion or Debarment - Revisions to Actions: Added code 1514.
● Federal Licensure - Revisions to Actions: Added codes 1110, 1125, 1135, 1140,
1147, 1179, 1189, 1199, 1283, 1297.
● Government Administrative - Actions: Added code 1525.
● Government Administrative - Revisions to Actions: Added codes 1510, 1512,
1517, 1520, 1530, 1532, 1550, 1551, 1555, 1560, 1562, 1565, 1589, 1597.
● Health Plan - Actions: Added codes 1931, 1951, 1952; Retired code 1950.
● Health Plan - Revisions to Actions: Added codes 1920, 1930, 1931, 1932, 1941,
1942, 1989, 1997.
● Professional Society - Actions: Added code 1735.
● Professional Society - Revisions to Actions: Added codes 1710, 1730, 1735,
1745, 1796.
● State Licensure - Revisions to Actions: Added codes 1110, 1125, 1135, 1138,
1139, 1140, 1147, 1173, 1189, 1199, 1283, 1297.
● State Licensure - Revisions to Nurse Multi-State Privilege Actions: Added
codes 1310, 1325, 1335, 1340, 1347, 1373, 1389, 1399, 1483, 1497.

AAR Adverse Action Classification Codes - Organization Subjects.

● Exclusion or Debarment - Revisions to Actions: Added code 3519.
● Federal or State Licensure - Actions: Added codes 3138, 3204, 3205, 3206,
3207, 3210, 3212, 3220, 3225, 3230, 3233, 3239; Change description on code
3143.
● Federal or State Licensure - Revisions to Actions: Added codes 3111, 3136,
3138, 3141, 3143, 3202, 3203, 3204, 3205, 3206, 3207, 3210, 3212, 3220, 3225,
3230, 3233, 3239, 3284, 3297.
● Government Administrative - Actions: Added code 3525.
● Government Administrative - Revisions to Actions: Added codes 3202, 3203,
3205, 3206, 3207, 3210, 3212, 3230, 3232, 3510, 3512, 3517, 3520, 3540, 3542,
3551, 3589, 3597.
● Health Plan - Actions: Added codes 3591, 3592; Retired code 3950.
● Health Plan - Revisions to Actions: Added codes 3920, 3930, 3932, 3989, 3997.

April 2019 i
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Date Version # Change Description

4/2009 1.00 AAR Adverse Action Classification Codes - Retired.
● Codes 1950 and 3950 were retired.

AAR Basis for Action Codes - Individual Subjects

● Clinical Privileges Actions: Added codes 17, 18, 24, 25, 50, 70, 79, AH, D4,
D5, D6, D7, D8, E6; Retired code 10.
● Exclusion or Debarment Actions: Added codes 50, 84.
● Federal or State Licensure Actions: Added codes 17, 18, 23, 24, 25, 35, 36, 37,
50, 84, D4, D5, D6, D7, D8, E6; Retired code 10.
● Government Administrative Actions: Added codes 17, 18, 24, 25, 50, 52, 84,
D4, D5, D6, D7, D8, E6; Retired code 10.
● Health Plan Actions: Added codes 17, 18, 24, 25, 50, D4, D5, D6, D7, D8, E6;
Change description on code A9; Retired code 10.
● Professional Society Actions: Added codes 17, 18, 24, 25, 50, 70, 79, AH, D4,
D5, D6, D7, D8, E6; Retired code 10.

AAR Basis for Action Codes - Organization Subjects.

● Exclusion or Debarment Actions: Added codes 50, 84.
● Federal or State Licensure Actions: Added codes 17, 18, 50, 57, 84, A5, AE,
AF, AG, E6, G1, G2, H7, H8, H9.
● Government Administrative Actions: Added codes 17, 18, 50, 52, 84, E6.
● Health Plan Actions: Added codes 17, 18, 50, 84, E6.

AAR Basis for Action Codes - Retired.

● Code 10, Unprofessional Conduct was retired.

Occupation/Field of Licensure Codes.

● Added codes 502, 503, 504, 540, 607, 759; Changed description on code 501,
758.

8/2009 1.01 New changes go into effect August 31, 2009. The following code lists have been
updated:
Error Codes.
● Code RQ was added.

Void Reason Codes.

● Table was added.

8/2009 1.02 New changes go into effect August 31, 2009. The following code list has been
updated:
Error Codes.
● Changed description for code PD.

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Date Version # Change Description

TBD 1.03 Below is a summary of changes to the Code Lists version 1.03. This version
contains changes that are based on the anticipated final regulations to implement
Section 1921 of the Social Security Act, as amended by section 5(b) of the Medicare
and Medicaid Patient and Program Protection Act of 1987 (MMPPPA), and as
amended by the Omnibus Budget Reconciliation Act of 1990. There may be
additional changes to this document as a result of final federal review process.
This version will be effective on the date as published in the Federal Register. This
Code Lists version 1.03 will replace version 1.02. The changes in this draft version
are indicated below:
The following code lists have been updated:
Adverse Action Classification Codes - Individual Subjects.
● Federal and State Licensure Actions: modified descriptions for codes 1149 and
1189.
● State Licensure Actions: added codes 1338 and 1339.

Adverse Action Classification Codes - Organization Subjects.

● State Licensure Actions: added code 3238.
● Accreditation Actions: added codes 3850, 3855, 3859, 3864, 3860, and 3862.

Basis for Action Codes - Organization Subjects.

● Accreditation Actions: added codes 91 and 92.
Error Codes.
● Added codes AM, CC, CD, CE, CF, Q1, Q4, Q5, Q6, Q7, Q8, Q9, QA, QB, QC,
QD, QE, QF.

AAR Type of Negative Finding Codes.

● Added list of negative finding codes for Peer Review Organization reports.

AAR Basis for Finding Codes.

● Added list of basis for finding codes for Peer Review Organization reports.

AAR Type of Action Codes.

● Added descriptions for codes 7, Peer Review Organization and 8, Accreditation.

April 2019 iii

Code Lists Version 2.07

Date Version # Change Description

1/2010 1.04 New changes go into effect January 25, 2010. The following code lists have been
updated:
Error Codes.
● Code RM was added.

AAR Basis for Action Codes - Individual Subjects.

● Government Administrative Actions: added code 21.

AAR Basis for Action Codes - Organization Subjects.

● Government Administrative Actions: added code 21.

AAR Basis for Action Codes - Retired.

● Code 52 was retired.

3/1/2010 1.05 Below is a summary of changes to the Code Lists version 1.05. This version
contains changes that are based on the final rule for Section 1921 of the Social
Security Act, as amended by section 5(b) of the Medicare and Medicaid Patient and
Program Protection Act of 1987 (MMPPPA), and as amended by the Omnibus
Budget Reconciliation Act of 1990. The final rule was published in the Federal
Register January 28, 2010. Effective March 1, 2010, the Data Banks accepts reports
and queries to the NPDB under Section 1921.
This version will be effective on March 1, 2010. This Code Lists version 1.05 will
replace version 1.04. The changes in this version are indicated below:
● Announcement of final rule.

Basis for Action Codes - Organization Subjects.

● Accreditation Actions: added code 92 and removed code 91.

AAR Type of Negative Finding Codes.

● Added code 1841 for Revision to Action Reports.

4/12/2010 1.06 This Code Lists version 1.06 will replace version 1.05. The change in this version is
indicated below:
AAR Type of Action Codes
● Expanded the description for code 1(SL) to include Section 1921 actions.

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Code Lists Version 2.07

Date Version # Change Description

6/14/2010 1.07 This Code Lists version 1.07 will replace version 1.06. The changes in this version
are indicated below:
Error Codes.
● Added code J7.
● Changed description for code B5.

8/30/2010 1.08 This Code Lists version 1.08 will replace version 1.07. The changes in this version
are indicated below:
QRXS Client Program Status Codes.
● Added codes C61, C62.
● Changed description for code C64.

QRXS Web Service Status Codes.

Added new code list.

April 2019 v
Code Lists Version 2.07

Date Version # Change Description

11/8/2010 1.09 This Code Lists version 1.09 will replace version 1.08. Formatting changes were
made throughout the document. The following code lists have been updated:
Error Codes.
● Added code MY.
● Updated the URLs in codes RE, RF, and RG.

QRXS Client Program Status Codes and QRXS Web Service Status Codes
● Updated the URLs in codes C16 and C17 and in the table footer notes.
Occupation/Field of Licensure Codes.
● Added codes 134, 550.

1/24/2011 1.10 This Code Lists version 1.10 will replace version 1.09. The changes in this version
are indicated below:
ITP Client Program Status Codes
● Updated the description for code C25.

QRXS Client Program Status Codes

● Updated the description for code C02.

4/4/2011 1.11 This Code Lists version 1.11 will replace version 1.10. The changes in this version
are indicated below:
AAR Adverse Action Classification Codes - Organization Subjects.
● Federal or State Licensure Actions - modified the description for code 3238.

Error Codes.
● Added code IC.

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Date Version # Change Description

6/6/2011 1.12 This Code Lists version 1.12 will replace version 1.11. The changes in this version
are indicated below:
AAR Basis for Action Codes - Individual Subjects.
● Federal or State Licensure Actions - added code I1.

AAR Basis for Action Codes - Organization Subjects.

● Federal or State Licensure Actions - added code I1.

Error Codes.
● Added codes MZ, SM, SN, SO, UA, UF, UJ, UM, UN, UP, US, and UZ.
● Modified existing codes S3, S4, and S8.

8/22/2011 1.13 This Code Lists version 1.13 will replace version 1.12. The changes in this version
are indicated below:
AAR Adverse Action Codes - Individual Subjects.
● State Licensure Actions - added code 1150.
Error Codes.
● Modified existing code AA.
Changed PDS references to Continuous Query throughout entire document.

11/7/2011 1.14 This Code Lists version 1.14 will replace version 1.13. The changes in this version
are indicated below:
Error Codes.
● Modified existing codes 54 and 56.

1/24/2012 1.15 This Code Lists version 1.15 will replace version 1.14. The changes in this version
are indicated below:
Error Codes.
● Modified existing code AA.

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Code Lists Version 2.07

Date Version # Change Description

4/2/2012 1.16 This Code Lists version 1.16 will replace version 1.15. The changes in this version
are indicated below:
Error Codes.
● Added ITP client program status codes C68, C69.
● Added QRXS client program status codes C68, C69.
● Added QRXS Web Service status codes C68, C69.

8/27/2012 1.17 This Code Lists version 1.17 will replace version 1.16. The changes in this version
are indicated below:
Statutory Authority Codes
● Inserted Tables 191 and 192, Statutory Authority QRXS Codes and Statutory
Authority ITP Codes, respectively.

10/10/201 2.00 This Code Lists version 2.00 will replace version 1.17. The changes in this version
2 are indicated below:
Error Codes.
● Added code RR.

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Date Version # Change Description

3/2013 2.01 This version contains changes that are based on the final rule for merging the NPDB
and HIPDB into one Data Bank, which was published in the Federal Register April
5, 2013. This Code Lists version 2.01 will be effective on May 6, 2013, and will
replace version 2.00. The changes in this version are indicated below:
AAR Adverse Action Codes – Individual Subjects
● Government Administrative – Initial and Revision tables split table between
“Actions Related to Certification Agreements or Contracts for Participation in a
Federal or State Health Care Program” and “Other Adjudicated Actions or
Decisions by a Federal or State Agency”
o Initial Government Administrative Action Classification Codes
Retired Codes: 1520, 1530, 1532
● Added Codes: 1521, 1531, 1533, 1536, 1539, 1556, 1579, 1588
o Revision Government Administrative Action Classification Codes
● Added Codes: 1536, 1539, 1556, 1579, 1588, 1599
● The following code numbers were split and given new codes:
1590, 1592, 1595, 1596, 1597
o New codes for “Actions Related to Certification
Agreements or Contracts for Participation in a Federal
or State Health Care Program”, respectively: 1580,
1581, 1582, 1583, 1584

o New codes for “Other Adjudicated Actions or Decisions

by a Federal or State Agency”, respectively: 1590, 1591,
1592, 1593, 1594
AAR Adverse Action Codes – Organization Subjects
● Government Administrative – Initial and Revision tables split between “Actions
Related to Certification Agreements or Contracts for Participation in a Federal or
State Health Care Program” and “Other Adjudicated Actions or Decisions by a
Federal or State Agency”
o Initial Government Administrative Action Classification Codes
● Retired Codes: 3230, 3520
● Added Codes: 3521, 3531, 3538, 3539, 3579, 3588, 3599
o Revision Government Administrative Action Classification Codes
● Retired Codes: 3230, 3520
● Added Codes: 3231, 3521, 3538, 3539, 3579, 3588, 3599
● The following code numbers were split and given new codes:
3590, 3592, 3595, 3596, 3597
o New codes for “Actions Related to Certification
Agreements or Contracts for Participation in a Federal
or State Health Care Program”, respectively: 3580,
3581, 3582, 3583, 3584
o New codes for “Other Adjudicated Actions or Decisions
by a Federal or State Agency”, respectively: 3590, 3591,
3592, 3593, 3594

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Code Lists Version 2.07

Date Version # Change Description

4/2013 2.02 This version contains changes that are based on the final rule for merging the NPDB
and HIPDB into one Data Bank, which was published in the Federal Register April
5, 2013. This Code Lists version 2.02 will be effective on May 6, 2013, and will
replace version 2.01. The changes in this version are indicated below:
AAR Adverse Action Codes – Individual Subjects
● Government Administrative –
Retired Codes: 1550, 1560, 1562, 1565, 1589
o Initial Government Administrative Action Classification Codes
● Actions Related to Certification Agreements or Contracts for
Participation in a Federal or State Health Care Program
o Removed code 1588, 1589
o Added code 1599, 1598
● Other Adjudicated Actions or Decisions by a Federal or State
Agency
o Removed code 1550, 1560, 1562, 1565, 1599
o Added code 1552, 1561, 1563, 1566, 1588
o Revision Government Administrative Action Classification Codes
● Actions Related to Certification Agreements or Contracts for
Participation in a Federal or State Health Care Program
o Removed codes 1580, 1581, 1582, 1583, 1584, 1588,
1589
o Added codes 1590, 1592, 1595, 1596, 1597, 1598, 1599

● Other Adjudicated Actions or Decisions by a Federal or State

Agency
o Removed code 1550, 1560, 1562, 1565, 1590, 1591,
1592, 1593, 1594, 1599
o Added codes 1552, 1561, 1563, 1566, 1580, 1581, 1582,
1583, 1584, 1588
AAR Adverse Action Codes – Organization Subjects
● Government Administrative –
Retired Codes: 3232, 3589
o Initial Government Administrative Action Classification Codes
● Actions Related to Certification Agreements or Contracts for
Participation in a Federal or State Health Care Program
o Removed code 3232, 3588, 3589
o Added code 3234, 3598, 3599
● Other Adjudicated Actions or Decisions by a Federal or State
Agency
o Removed code 3599
o Added code 3588

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Date Version # Change Description

4/2013 2.02 o Revision Government Administrative Action Classification Codes
● Actions Related to Certification Agreements or Contracts for
Participation in a Federal or State Health Care Program
o Removed codes 3232, 3580, 3581, 3582, 3583, 3584,
3588, 3589
o Added codes 3234, 3590, 3592, 3595, 3596, 3597, 3598,
3599
● Other Adjudicated Actions or Decisions by a Federal or State
Agency
o Removed code 3590, 3591, 3592, 3593, 3594, 3599
Added codes 3580, 3581, 3582, 3583, 3584, 3588

7/2014 2.03 This Code Lists version 2.03 will replace version 2.02. The changes in this version
are indicated below:
● Removed Table 196 – Statutory Authority ITP Codes
● Removed Table 198 - ITP Client Program Status Codes
● Removed codes 01,87, 88, 89, 90, 91, B7, C3, RM, and SI from the Error Codes
table.
● Modified Table 142, Code A.

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Date Version # Change Description

11/17/2014 2.04 This Code Lists version 2.04 will replace version 2.03. The changes in this version
are indicated below:
AAR Adverse Action Codes – Individual Subjects:
● Tables 16 and 17:
o Added codes 1151, 1179
● Table 18:
o Removed codes 1348, 1349
● Table 19:
o Added codes 1338, 1339

Error Codes Table 196:

● Added codes PN and H4

Occupation/Field of Licensure Codes, Tables 150-170:

● Retired and replaced the following codes:
o Retired code 134 and replaced with existing code 130
o Retired code 148 and replaced with existing code 150
o Retired code 654 and replaced with existing code 660
o Retired code 657 and replaced with existing code 661
o Retired code 402 and replaced with new codes 662, 664, 665, 667
o Retired code 260 and replaced with existing code 270
o Retired code 060 and replaced with existing code 050
o Retired code 645 and replaced with existing code 642
o Retired code 502 and replaced with existing code 501
o Retired code 504 and replaced with existing code 503
o Retired code 540 and replaced with existing code 530
o Retired code 550 and replaced with existing code 530
o Retired code 752 and replaced with existing code 758
o Retired code 755 and replaced with existing code 758
o Retired code 759 and replaced with existing code 758
o Retired code 812 and replaced with existing code 810

● Updated the description of codes 015, 025, 100, 150, 660, 270, 642, 501, 503,
530, 758, 810

● Updated the title of Table 155

● Added new codes 142, 176, 613, 604, 605, 652, 653, 662, 664, 665, 667,
668, 211, 281, 637, 076, 649, 374, 658, 471, 551

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Date Version # Change Description

10/2016 2.05 This Code Lists version 2.05 will replace version 2.04. The changes in this version
are indicated below:
• Tables 16, 17
o Added code 1179
• Tables 19,20
o Added code 1351
• Tables 149, 194:
o Added code RQ
• Updated the URL to https://www.npdb.hrsa.gov

6/30/2018 2.06 This Code Lists version 2.06 will replace version 2.05. The changes in this version
are indicated below:
● Added Dispute Status Codes – See Table 206
o Added a new value for Dispute Status – Q – Reconsideration Requested.
The rest of the codes in this table are unchanged.
● Added Error Codes MI and IP for new MMPR field (Total Number of
Claimants Included in Settlement) – See Table 198.
● Added the following tables to list existing codes. These codes have not
changed in this version. The codes will be maintained here instead of in the
XML schema definition (XSD) files:
o Added AAR Automatic Reinstatement Codes – See Table 119.
o Added JOCR Jurisdiction Codes – See Table 124.
o Added AAR Type of Action Codes (Old Format) – See Table 118.
o Added MMPR Report Type Codes – See Table 136.
o Added MMPR Relationship of Entity Codes – See Table 146.
o Added MMPR Relationship of Entity Codes (Old Format) – See
Table 147.
o Added MMPR Payment Result Of Codes – See Table 148.
o Added MMPR Payment Result Of Codes (Old Format) – See Table
149.
o Added MMPR Payment Type Codes – See Table 150.
o Added MMPR Patient Type Codes – See Table 151.
o Added Gender Codes – See Table 205.

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Date Version # Change Description

4/5/2019 2.07 This Code Lists version 2.07 will replace version 2.06. The changes in this version
are indicated below:
● Converted Nursing Multi-State Licensure Adverse Action Classification
Codes (AACCs) to generic Multi-State Licensure AACCs – See Tables 18
and 19, and accompanying Footnote 3.
● Removed “(NPDB Only)” text from Adverse Action Classification Codes
1138, 1139, 1150, 1338 and 1339 - See Tables 16, 17, and 18.
● Clarified footnotes 1 and 2 for State Licensure Adverse Action Classification
Codes (Tables 16-19).
● Added new Adverse Action Classification Code 1155 (“Withdrawal of
Renewal Application While Under Investigation”) to the Federal and State
Licensure action codes – See Tables 6, 7, 16, and 17.
● Emergency Medical Technician (EMT) Field of Licensure (FOL) Code
Changes:
o Updated descriptions of the existing EMT FOL codes.
o Added FOL code 240 – Emergency Medical Responder.
o See Table 167.
● Added MMPR Payment Result Of Code “O” (“Other”) – See Table 148.
● Error Codes changes:
o Updated Error Code “38” to apply to both missing and invalid
“payment result of” MMPR data.
o Added Error Code “N0” to indicate when Payment Result of
Description should be provided or when it should not be provided.
o Updated description of Error Code “AI” to refer to more generic
Multi-State licensure.
o Added new Error Codes “AN” and “AO” to reflect new restrictions
on the automatic reinstatement field.
o Added AH error code for the restriction on multiple adverse action
classification codes for multi-state license actions
o See Table 208.

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Table of Contents

Table 1 - Document Change History ........................................................................................................................................................ i

AAR Adverse Action Classification Codes - Individual Subjects ................................................................................1
Clinical Privileges Actions .......................................................................................................................................1
Table 2 - Clinical Privileges - Actions ..................................................................................................................................................... 1
Table 3 - Clinical Privileges - Revisions to Actions (No Basis for Action Codes Required) ................................................................... 1
Exclusion or Debarment Actions .............................................................................................................................2
Table 4 - Exclusion or Debarment - Actions............................................................................................................................................ 2
Table 5 - Exclusion or Debarment - Revisions to Actions (No Basis for Action Codes Required) ......................................................... 2
Federal Licensure Actions ......................................................................................................................................3
Table 6 - Licensure - Actions ................................................................................................................................................................... 3
Table 7 - Licensure - Revisions to Actions (No Basis for Action Codes Required) ................................................................................ 3
Government Administrative Actions ........................................................................................................................4
Table 8 - Government Administrative - Actions Related to Certification Agreements or Contracts for Participation in a Federal or
State Health Care Program....................................................................................................................................................................... 4
Table 9 - Government Administrative - Other Adjudicated Actions or Decisions by a Federal or State Agency .................................... 4
Table 10 - Government Administrative - Revisions to Actions (No Basis for Action Code Required) - Actions Related to Certification
Agreements or Contracts for Participation in a Federal or State Health Care Program............................................................................ 4
Table 11 - Government Administrative - Revisions to Actions (No Basis for Action Code Required) - Other Adjudicated Actions or
Decisions by a Federal or State Agency................................................................................................................................................... 5
Health Plan Actions .................................................................................................................................................6
Table 12 - Health Plan Action - Actions .................................................................................................................................................. 6
Table 13 - Health Plan Action - Revisions to Actions (No Basis for Action Code Required) ................................................................. 6
Professional Society Actions...................................................................................................................................6
Table 14 - Professional Society - Actions ................................................................................................................................................ 6
Table 15 - Professional Society - Revisions to Actions (No Basis for Action Code Required) ............................................................... 6
State Licensure Actions ..........................................................................................................................................7
Table 16 - Licensure - Actions ................................................................................................................................................................. 7
Table 17 - Licensure - Revisions to Actions (No Basis for Action Codes Required) .............................................................................. 7
Table 18 - Licensure - Multi-State Privilege Actions3 ............................................................................................................................. 8
Table 19 - Licensure - Revisions to Multi-State Privilege Actions (No Basis for Action Codes Required)3 ........................................... 8
AAR Adverse Action Classification Codes (Old Format) ............................................................................................9
Table 20 - AAR Adverse Action Classification Codes (Old Format) ...................................................................................................... 9
Table 21 - AAR Adverse Action Classification Codes - Old Format (continued) ................................................................................. 10
AAR Adverse Action Classification Codes - Organization Subjects ........................................................................ 11
Accreditation Actions ........................................................................................................................................... 11
Table 22 - Accreditation Actions ........................................................................................................................................................... 11
Table 23 - Accreditation Revisions to Actions (No Basis for Action Codes Required) ......................................................................... 11
Exclusion or Debarment Actions .......................................................................................................................... 11

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Table 24 - Exclusion or Debarment Actions .......................................................................................................................................... 11

Table 25 - Exclusion or Debarment Revisions to Actions (No Basis for Action Code Required) ......................................................... 11
Federal or State Licensure Actions ...................................................................................................................... 12
Table 26 - Licensure Actions ................................................................................................................................................................. 12
Table 27 - Licensure Revisions to Actions (No Basis for Action Codes Required) ............................................................................... 12
Government Administrative Actions ..................................................................................................................... 13
Table 28 - Government Administrative Actions - Actions Related to Certification Agreements or Contracts for Participation in a
Federal or State Health Care Program.................................................................................................................................................... 13
Table 29 - Government Administrative - Other Adjudicated Actions or Decisions by a Federal or State Agency ................................ 13
Table 30 - Government Administrative - Revisions to Actions (No Basis for Action Code Required) - Actions Related to Certification
Agreements or Contracts for Participation in a Federal or State Health Care Program.......................................................................... 13
Table 31 - Government Administrative - Revisions to Actions (No Basis for Action Code Required) - Other Adjudicated Actions or
Decisions by a Federal or State Agency................................................................................................................................................. 14
Health Plan Actions .............................................................................................................................................. 15
Table 32 - Health Plan Action - Actions ................................................................................................................................................ 15
Table 33 - Health Plan Action - Revisions to Actions (No Basis for Action Code Required) ............................................................... 15
AAR Adverse Action Classification Codes - Retired ............................................................................................... 16
Table 34 - AAR Adverse Action Classification Codes - Retired ........................................................................................................... 16
AAR Type of Negative Finding Codes - Individual Subjects ................................................................................... 17
Peer Review Organization ................................................................................................................................... 17
Table 35 - Initial Actions ....................................................................................................................................................................... 17
Table 36 - Revision to Actions .............................................................................................................................................................. 17
AAR Basis for Action Codes - Individual Subjects .................................................................................................. 18
Clinical Privileges Actions .................................................................................................................................... 18
Table 37 - Non-Compliance With Requirements ................................................................................................................................... 18
Table 38 - Criminal Conviction or Adjudication ................................................................................................................................... 18
Table 39 - Confidentiality, Consent or Disclosure Violations ............................................................................................................... 18
Table 40 - Misconduct or Abuse ............................................................................................................................................................ 18
Table 41 - Fraud, Deception, or Misrepresentation ................................................................................................................................ 19
Table 42 - Unsafe Practice or Substandard Care .................................................................................................................................... 19
Table 43 - Improper Supervision or Allowing Unlicensed Practice ....................................................................................................... 19
Table 44 - Improper Prescribing, Dispensing, Administering Medication/Drug Violation.................................................................... 19
Table 45 - Other ..................................................................................................................................................................................... 19
Exclusion or Debarment Actions .......................................................................................................................... 20
Table 46 - Criminal Conviction ............................................................................................................................................................. 20
Table 47 - Other ..................................................................................................................................................................................... 20
Federal or State Licensure Actions ...................................................................................................................... 21
Table 48 - Non-Compliance With Requirements ................................................................................................................................... 21
Table 49 - Criminal Conviction or Adjudication ................................................................................................................................... 21
Table 50 - Confidentiality, Consent or Disclosure Violations ............................................................................................................... 21
Table 51 - Misconduct or Abuse ............................................................................................................................................................ 21
Table 52 - Fraud, Deception, or Misrepresentation ................................................................................................................................ 22

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Table 53 - Unsafe Practice or Substandard Care .................................................................................................................................... 22

Table 54 - Improper Supervision or Allowing Unlicensed Practice ....................................................................................................... 22
Table 55 - Improper Prescribing, Dispensing, Administering Medication/Drug Violation.................................................................... 22
Table 56 - Other ..................................................................................................................................................................................... 22
Government Administrative Actions ..................................................................................................................... 23
Table 57 - Non-Compliance With Requirements ................................................................................................................................... 23
Table 58 - Criminal Conviction or Adjudication ................................................................................................................................... 23
Table 59 - Confidentiality, Consent or Disclosure Violations ............................................................................................................... 23
Table 60 - Misconduct or Abuse ............................................................................................................................................................ 23
Table 61 - Fraud, Deception, or Misrepresentation ................................................................................................................................ 24
Table 62 - Unsafe Practice or Substandard Care .................................................................................................................................... 24
Table 63 - Improper Supervision or Allowing Unlicensed Practice ....................................................................................................... 24
Table 64 - Improper Prescribing, Dispensing, Administering Medication/Drug Violation.................................................................... 24
Table 65 - Other ..................................................................................................................................................................................... 24
Health Plan Actions .............................................................................................................................................. 25
Table 66 - Non-Compliance With Requirements ................................................................................................................................... 25
Table 67 - Criminal Conviction or Adjudication ................................................................................................................................... 25
Table 68 - Confidentiality, Consent or Disclosure Violations ............................................................................................................... 25
Table 69 - Misconduct or Abuse ............................................................................................................................................................ 25
Table 70 - Fraud, Deception, or Misrepresentation ................................................................................................................................ 26
Table 71 - Unsafe Practice or Substandard Care .................................................................................................................................... 26
Table 72 - Improper Supervision or Allowing Unlicensed Practice ....................................................................................................... 26
Table 73 - Improper Prescribing, Dispensing, Administering Medication/Drug Violation.................................................................... 26
Table 74 - Other ..................................................................................................................................................................................... 26
Professional Society Actions................................................................................................................................ 27
Table 75 - Non-Compliance With Requirements ................................................................................................................................... 27
Table 76 - Criminal Conviction or Adjudication ................................................................................................................................... 27
Table 77 - Confidentiality, Consent or Disclosure Violations ............................................................................................................... 27
Table 78 - Misconduct or Abuse ............................................................................................................................................................ 27
Table 79 - Fraud, Deception, or Misrepresentation ................................................................................................................................ 27
Table 80 - Unsafe Practice or Substandard Care .................................................................................................................................... 28
Table 81 - Improper Supervision or Allowing Unlicensed Practice ....................................................................................................... 28
Table 82 - Improper Prescribing, Dispensing, Administering Medication/Drug Violation.................................................................... 28
Table 83 - Other ..................................................................................................................................................................................... 28
AAR Basis for Action Codes - Organization Subjects ............................................................................................. 29
Accreditation Actions ........................................................................................................................................... 29
Table 84 - Non-Compliance With Federal, State or Contractual Requirements .................................................................................... 29
Table 85 - Other ..................................................................................................................................................................................... 29
Exclusion or Debarment Actions .......................................................................................................................... 29
Table 86 - Criminal Conviction ............................................................................................................................................................. 29
Table 87 - Other ..................................................................................................................................................................................... 29

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Federal or State Licensure Actions ...................................................................................................................... 30

Table 88 - Non-Compliance With Requirements ................................................................................................................................... 30
Table 89 - Criminal Conviction or Adjudication ................................................................................................................................... 30
Table 90 - Confidentiality, Consent or Disclosure Violations ............................................................................................................... 30
Table 91 - Conflict of Interest ................................................................................................................................................................ 30
Table 92 - Fraud, Deception, or Misrepresentation ................................................................................................................................ 31
Table 93 - Substandard Care or Patient Neglect/Abuse ......................................................................................................................... 31
Table 94 - Improper Supervision or Allowing Unlicensed Practice ....................................................................................................... 31
Table 95 - Improper Prescribing, Dispensing, Administering Medication/Drug Violation.................................................................... 31
Table 96 - Other ..................................................................................................................................................................................... 31
Government Administrative Actions ..................................................................................................................... 32
Table 97 - Non-Compliance With Requirements ................................................................................................................................... 32
Table 98 - Criminal Conviction or Adjudication ................................................................................................................................... 32
Table 99 - Confidentiality, Consent or Disclosure Violations ............................................................................................................... 32
Table 100 - Conflict of Interest .............................................................................................................................................................. 32
Table 101 - Fraud, Deception, or Misrepresentation .............................................................................................................................. 32
Table 102 - Substandard Care or Patient Neglect/Abuse ....................................................................................................................... 33
Table 103 - Improper Prescribing, Dispensing, Administering Medication/Drug Violation.................................................................. 33
Table 104 - Other ................................................................................................................................................................................... 33
Health Plan Actions .............................................................................................................................................. 34
Table 105 - Non-Compliance With Requirements ................................................................................................................................. 34
Table 106 - Criminal Conviction or Adjudication ................................................................................................................................. 34
Table 107 - Confidentiality, Consent or Disclosure Violations ............................................................................................................. 34
Table 108 - Conflict of Interest .............................................................................................................................................................. 34
Table 109 - Fraud, Deception or Misrepresentation ............................................................................................................................... 34
Table 110 - Substandard Care or Patient Neglect/Abuse ....................................................................................................................... 35
Table 111 - Improper Prescribing, Dispensing, Administering Medication/Drug Violation.................................................................. 35
Table 112 - Other ................................................................................................................................................................................... 35
AAR Basis for Action Codes - Retired ..................................................................................................................... 36
Table 113 - AAR Basis for Action Codes - Retired ............................................................................................................................... 36
AAR Basis for Finding Codes - Individual Subjects ................................................................................................. 37
Peer Review Organization ................................................................................................................................... 37
Table 114 - Fraud, Deception or Misrepresentation ............................................................................................................................... 37
Table 115 - Unsafe Practice or Substandard Care .................................................................................................................................. 37
Table 116 - Other ................................................................................................................................................................................... 37
AAR Type of Action Codes ...................................................................................................................................... 38
Table 117 - AAR Type of Action Codes................................................................................................................................................ 38
AAR Type of Action Codes (Old Format) ................................................................................................................ 39
Table 118 - AAR Type of Action Codes (Old Format).......................................................................................................................... 39
AAR Automatic Reinstatement Codes..................................................................................................................... 40
Table 119 - AAR Automatic Reinstatement Codes ............................................................................................................................... 40

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Nature of Relationship Codes .................................................................................................................................. 41

Individual Subjects ............................................................................................................................................... 41
Table 120 - Individual Subjects ............................................................................................................................................................. 41
Organization Subjects .......................................................................................................................................... 41
Table 121 - Organization Subjects ......................................................................................................................................................... 41
JOCR Act or Omission Codes ................................................................................................................................. 42
Table 122 - JOCR Act or Omission Codes ............................................................................................................................................ 42
JOCR Type of Action Codes ................................................................................................................................... 43
Table 123 - JOCR Type of Action Codes .............................................................................................................................................. 43
JOCR Jurisdiction Codes ........................................................................................................................................ 43
Table 124 - JOCR Jurisdiction Codes .................................................................................................................................................... 43
MMPR Act or Omission Codes (Old Format MMPR) .............................................................................................. 44
Table 125 - Diagnosis ............................................................................................................................................................................ 44
Table 126 - Anesthesia........................................................................................................................................................................... 44
Table 127 - Surgery ............................................................................................................................................................................... 44
Table 128 - Medication .......................................................................................................................................................................... 44
Table 129 - Intravenous and Blood Products ......................................................................................................................................... 44
Table 130 - Obstetrics ............................................................................................................................................................................ 44
Table 131 - Treatment ............................................................................................................................................................................ 44
Table 132 - Monitoring .......................................................................................................................................................................... 44
Table 133 - Biomedical Equipment/Product .......................................................................................................................................... 45
Table 134 - Miscellaneous ..................................................................................................................................................................... 45
MMPR Nature of Allegation Codes .......................................................................................................................... 46
Table 135 - MMPR Nature of Allegation Codes.................................................................................................................................... 46
MMPR Report Type Codes ..................................................................................................................................... 46
Table 136 - MMPR Report Type Codes ................................................................................................................................................ 46
MMPR Outcome Codes ........................................................................................................................................... 47
Table 137 - MMPR Outcome Codes ...................................................................................................................................................... 47
MMPR Specific Allegation Codes ............................................................................................................................ 48
Table 138 - Failure to Take Appropriate Action .................................................................................................................................... 48
Table 139 - Delay In Performance ......................................................................................................................................................... 48
Table 140 - Error/Improper Performance............................................................................................................................................... 48
Table 141 - Unnecessary/Contraindicated Procedure ............................................................................................................................ 48
Table 142 - Communication/Supervision .............................................................................................................................................. 48
Table 143 - Continuity of Care/Care Management ................................................................................................................................ 48
Table 144 - Behavior/Legal ................................................................................................................................................................... 48
Table 145 - Other ................................................................................................................................................................................... 49
MMPR Relationship of Entity Codes ....................................................................................................................... 49
Table 146 - MMPR Relationship of Entity Codes ................................................................................................................................. 49
MMPR Relationship of Entity Codes (Old Format) .................................................................................................. 49

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Table 147 - MMPR Relationship of Entity Codes (Old Format) ........................................................................................................... 49

MMPR Payment Result Of Codes ........................................................................................................................... 50
Table 148 - MMPR Payment Result Of Codes ...................................................................................................................................... 50
MMPR Payment Result Of Codes (Old Format) ..................................................................................................... 50
Table 149 - MMPR Payment Result Of Codes (Old Format) ................................................................................................................ 50
MMPR Payment Type Codes .................................................................................................................................. 51
Table 150 - MMPR Payment Type Codes ............................................................................................................................................. 51
MMPR Patient Type Codes ..................................................................................................................................... 51
Table 151 - MMPR Patient Type Codes ................................................................................................................................................ 51
Report Transaction Type Codes .............................................................................................................................. 52
Table 152 - Report Transaction Type Codes.......................................................................................................................................... 52
Void Reason Codes ................................................................................................................................................. 53
Table 153 - Void Reason Codes............................................................................................................................................................. 53
Subject Source Codes ............................................................................................................................................. 53
Table 154 - Subject Source Codes ......................................................................................................................................................... 53
Transaction Codes................................................................................................................................................... 54
Table 155 - Transaction Codes .............................................................................................................................................................. 54
Query Purpose Codes ............................................................................................................................................. 55
Table 156 - Query Purpose Codes ......................................................................................................................................................... 55
Continuous Query Enrollment Purpose Codes ....................................................................................................... 55
Table 157 - Continuous Query Enrollment Purpose Codes ................................................................................................................... 55
Continuous Query Enrollment Status Codes ........................................................................................................... 55
Table 158 - Continuous Query Enrollment Status Codes....................................................................................................................... 55
Continuous Query Report Disclosure Reason Codes ............................................................................................. 56
Table 159 - Continuous Query Report Disclosure Reason Codes .......................................................................................................... 56
Occupation/Field of Licensure Codes...................................................................................................................... 58
Table 160 – Physician ............................................................................................................................................................................ 58
Table 161 – Nurse – Advanced, Registered, Vocational or Practical..................................................................................................... 58
Table 162 – Nurse Aide, Home Health Aide and Other Aide ................................................................................................................ 58
Table 163 – Dental Service Practitioner ................................................................................................................................................ 58
Table 164 – Chiropractor ....................................................................................................................................................................... 58
Table 165 – Behavioral Health Occupations.......................................................................................................................................... 58
Table 166 – Dietitian/Nutritionist .......................................................................................................................................................... 58
Table 167 – Emergency Medical Technician (EMT) ............................................................................................................................. 58
Table 168 – Eye and Vision Service Practitioner................................................................................................................................... 58
Table 169 – Pharmacy Service Practitioner ........................................................................................................................................... 58
Table 170 – Physician Assistant ............................................................................................................................................................ 58
Table 171 – Podiatric Service Practitioner ............................................................................................................................................. 59
Table 172 – Psychologist/Psychological Assistant ................................................................................................................................ 59
Table 173 – Rehabilitative, Respiratory and Restorative Service Practitioner ....................................................................................... 59

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Table 174 – Social Worker .................................................................................................................................................................... 59

Table 175 – Speech, Language and Hearing Service Practitioner.......................................................................................................... 59
Table 176 – Technologist/Technician .................................................................................................................................................... 59
Table 177 – Other Health Care Practitioner ........................................................................................................................................... 59
Table 178 – Health Care Facility Administrator1 ................................................................................................................................... 59
Table 179 – Other Occupation1 .............................................................................................................................................................. 59
Occupation/Field of Licensure Codes – Retired ...................................................................................................... 60
Table 180 – Occupation/Field of Licensure Codes – Retired................................................................................................................. 60
Specialty Codes ....................................................................................................................................................... 61
Table 181 - Physician Specialties .......................................................................................................................................................... 61
Table 182 - Dental Specialties ............................................................................................................................................................... 61
Entity Status Codes ................................................................................................................................................. 62
Table 183 - Entity Status Codes ............................................................................................................................................................. 62
State Abbreviations and U.S. Territories ................................................................................................................. 63
Table 184 – States .................................................................................................................................................................................. 63
Table 185 - Territories ........................................................................................................................................................................... 63
Table 186 - Armed Forces ..................................................................................................................................................................... 63
APO/FPO Postal Codes ....................................................................................................................................... 64
Table 187 - AE - Europe ........................................................................................................................................................................ 64
Table 188 - AA - Americas .................................................................................................................................................................... 64
Table 189 - AP - Pacific......................................................................................................................................................................... 64
Type of Organization Codes .................................................................................................................................... 65
Table 190 - Group or Practice ................................................................................................................................................................ 65
Table 191 - Home Health Agency/ Organization ................................................................................................................................... 65
Table 192 - Hospice/Hospice Care Provider .......................................................................................................................................... 65
Table 193 - Hospital .............................................................................................................................................................................. 65
Table 194 - Hospital Unit ...................................................................................................................................................................... 65
Table 195 - Laboratory/CLIA Laboratory.............................................................................................................................................. 65
Table 196 - Nursing Facility/Skilled Nursing Facility ........................................................................................................................... 65
Table 197 - Research Center/Facility ..................................................................................................................................................... 65
Table 198 - Ambulance Service/Transportation Company .................................................................................................................... 65
Table 199 - Health Insurance Company/Provider .................................................................................................................................. 65
Table 200 - Other Health Care Facility .................................................................................................................................................. 65
Table 201 - Managed Care Organization ............................................................................................................................................... 65
Table 202 - Health Care Supplier/Manufacturer .................................................................................................................................... 65
Table 203 - Other ................................................................................................................................................................................... 65
Report Change Notification Disclosure Type Codes ............................................................................................... 66
Table 204 - Report Change Notification Disclosure Type Codes .......................................................................................................... 66
Gender Codes ......................................................................................................................................................... 68
Table 205 - Gender Codes ..................................................................................................................................................................... 68
Dispute Status Codes .............................................................................................................................................. 68
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Table 206 - Dispute Status Codes .......................................................................................................................................................... 68

Statutory Authority Codes ........................................................................................................................................ 68
Table 207 – Statutory Authority QRXS Codes ...................................................................................................................................... 68
Error Codes ............................................................................................................................................................. 69
Table 208 - Error Codes......................................................................................................................................................................... 69
QRXS Client Program Status Codes ....................................................................................................................... 85
Table 209 - QRXS Client Program Status Codes................................................................................................................................... 85
QRXS Web Service Status Codes .......................................................................................................................... 87
Table 210 - QRXS Web Service Status Codes....................................................................................................................................... 87

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AAR Adverse Action Classification Codes - Individual Subjects
Clinical Privileges Actions

Table 2 - Clinical Privileges - Actions

Code Description
1610 Revocation of Clinical Privileges
1615 Termination of Panel Membership or Employment (Professional Review Action)
1630 Suspension of Clinical Privileges
1632 Summary or Emergency Suspension of Clinical Privileges
1634 Voluntary Limitation, Restriction, or Reduction of Clinical Privilege(s) While Under, or to Avoid, Investigation Relating
to Professional Competence or Conduct
Voluntary Surrender of Clinical Privilege(s), While Under, or to Avoid, Investigation Relating to Professional
1635
Competence or Conduct
1637 Involuntary Resignation
1638 Voluntary Leave of Absence, While Under, or to Avoid, Investigation
1639 Summary or Emergency Limitation, Restriction, or Reduction of Clinical Privileges
1640 Reduction of Clinical Privileges
1642 Limitation or Restriction on Certain Procedure(s) or Practice Area(s)
1643 Limitation or Restriction: Mandatory Concurring Consultation Prior to Procedures
1644 Limitation or Restriction: Mandatory Proctoring or Monitoring During Procedures
1645 Other Restriction/Limitation of Clinical Privileges, Specify, _________________
1650 Denial of Clinical Privileges
1655 Withdrawal of Renewal Application While Under Investigation
1656 Practitioner Allowed Privileges to Expire While Under Investigation

Table 3 - Clinical Privileges - Revisions to Actions (No Basis for Action Codes Required)
Code Description
1610 Revocation of Clinical Privileges
1615 Termination of Panel Membership or Employment (Professional Review Action)
1630 Suspension of Clinical Privileges
1632 Summary or Emergency Suspension of Clinical Privileges
1634 Voluntary Limitation, Restriction, or Reduction of Clinical Privilege(s) While Under, or to Avoid, Investigation Relating
to Professional Competence or Conduct
1635 Voluntary Surrender of Clinical Privilege(s), While Under, or to Avoid, Investigation Relating to Professional
Competence or Conduct
1637 Involuntary Resignation
1638 Voluntary Leave of Absence, While Under, or to Avoid, Investigation
1639 Summary or Emergency Limitation, Restriction, or Reduction of Clinical Privileges
1640 Reduction of Clinical Privileges
1642 Limitation or Restriction on Certain Procedure(s) or Practice Area(s)
1643 Limitation or Restriction: Mandatory Concurring Consultation Prior to Procedures
1644 Limitation or Restriction: Mandatory Proctoring or Monitoring During Procedures
1645 Other Restriction/Limitation of Clinical Privileges, Specify, _________________
1655 Withdrawal of Renewal Application While Under Investigation
1656 Practitioner Allowed Privileges to Expire While Under Investigation
1680 Clinical Privileges Restored or Reinstated, Complete
1681 Clinical Privileges Restored or Reinstated, Conditional
1682 Clinical Privileges Restored or Reinstated, Partial
1689 Clinical Privileges Restoration or Reinstatement Denied
1690 Reduction of Previous Action
1695 Extension of Previous Action
1696 Modification of Previous Action

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 Code Lists Version 2.07

Exclusion or Debarment Actions

Table 4 - Exclusion or Debarment - Actions

Code Description
1500 Debarment From Federal Programs
1505 Exclusion From a Federal Health Care Program
1507 Exclusion From a State Health Care Program
1
1508 Exclusion From Medicare, Medicaid and All Other Federal Health Care Programs
1
1509 Exclusion From Medicare and State Health Care Programs

Table 5 - Exclusion or Debarment - Revisions to Actions (No Basis for Action Codes Required)
Code Description
1514 Modification of Previous Action
1515 Reinstatement
1516 Reinstatement Denied

1
These codes are for the HHS Office of Inspector General (OIG) use only. In cases in which the HHS OIG submits
an Exclusion or Debarment action, the HHS OIG may not select multiple Adverse Action Classification Codes when
reporting either of the following two codes: Exclusion from Medicare, Medicaid and all other Federal Health Care
Programs, or Exclusion from Medicare and State Health Care Programs. Additional actions should be submitted in
separate reports.

All other reporters of Exclusion or Debarment actions may select any available Adverse Action Classification Code alone
or in combination, except for the two codes noted above.

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Code Lists Version 2.07

Federal Licensure Actions

Table 6 - Licensure - Actions

Code Description
1110 Revocation of License
1125 Probation of License
1135 Suspension of License
1140 Reprimand or Censure
1145 Voluntary Surrender of License
1146 Voluntary Limitation or Restriction on License
1147 Limitation or Restriction on License
1148 Denial of License Renewal
1
1149 Denial of Initial License
1155 Withdrawal of Renewal Application While Under Investigation
1
1173 Publicly Available Fine/Monetary Penalty
1189 Publicly Available Negative Action or Finding Specify, ____
1199 Other Licensure Action - Not Classified, Specify, ____________________

Table 7 - Licensure - Revisions to Actions (No Basis for Action Codes Required)
Code Description
1110 Revocation of License
1125 Probation of License
1135 Suspension of License
1140 Reprimand or Censure
1145 Voluntary Surrender of License
1146 Voluntary Limitation or Restriction on License
1147 Limitation or Restriction on License
1155 Withdrawal of Renewal Application While Under Investigation
1
1173 Publicly Available Fine/Monetary Penalty
1
1189 Publicly Available Negative Action or Finding, Specify, ____
1199 Other Licensure Action - Not Classified, Specify, ____________________
1280 License Restored or Reinstated, Complete
1282 License Restored or Reinstated, Conditional
1283 License Restored or Reinstated, Partial
1285 License Restoration or Reinstatement Denied
1295 Reduction of Previous Licensure Action
1296 Extension of Previous Licensure Action
1297 Modification of Previous Licensure Action

1
In cases in which the Drug Enforcement Administration (DEA) submits a Federal Licensure action on a health care
practitioner, the DEA may not select multiple Adverse Action Classification Codes when reporting any one of the
following codes: 1149 Denial of Initial License, 1173 Publicly Available Fine/Monetary Penalty, or 1189 Publicly
Available Negative Action or Finding. Additional actions should be submitted in separate reports.
When reporting on a subject other than a practitioner, the DEA may select any Federal Licensure Adverse Action
Classification Code singly or in combination.
All other reporters submitting a Federal Licensure action may select any available Adverse Action Classification Code
alone or in combination for any type of subject.

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Code Lists Version 2.07

Government Administrative Actions

Table 8 - Government Administrative - Actions Related to Certification Agreements or Contracts for Participation in a
Federal or State Health Care Program
Code Description
1510 Termination of Medicare or Other Federal Health Care Program Participation
Voluntary Termination of Medicare or Other Federal Health Care Program Participation After Notification of
1512
Investigation or Disciplinary Action
1513 Nonrenewal of Medicare or Other Federal Health Care Program Participation Agreement for Cause
Voluntary Termination of Medicaid or Other State Health Care Program Participation After Notification of
1517
Investigation or Disciplinary Action
1518 Nonrenewal of Medicaid or Other State Health Care Program Participation Agreement for Cause
1525 Denial of Initial Application
1531 Civil Money Penalty Imposed by a Federal or State Health Care Program
1533 Administrative Fine/Monetary Penalty Imposed by a Federal or State Health Care Program
1551 Termination of Medicaid or Other State Health Care Program Participation
1555 Employment Disqualification Based on Finding in State Nurse Aide Registry
1556 Negative Finding or Listing in a State Health Care Practitioner Registry
1579 Other Action Imposed by Medicaid or Other State Health Care Program- Not Classified, Specify,
1598 Other Action Imposed by Medicare or Other Federal Health Care Program- Not Classified, Specify,
1599 Other Certification Action – Not Classified, Specify, ____________________

Table 9 - Government Administrative - Other Adjudicated Actions or Decisions by a Federal or State Agency
Code Description
1521 Contract Termination
1536 Administrative Fine/Monetary Penalty
1539 Civil Money Penalty
1552 Disqualification of Clinical Investigator From Receiving Investigational Products
1561 Personnel Action - Employee Termination
1563 Personnel Action - Employee Suspension
1566 Personnel Action - Not Classified, Specify, _____
1588 Other Adjudicated Action or Decision – Not Classified, Specify, _____

Table 10 - Government Administrative - Revisions to Actions (No Basis for Action Code Required) - Actions Related
to Certification Agreements or Contracts for Participation in a Federal or State Health Care Program
Code Description
1510 Termination of Medicare or Other Federal Health Care Program Participation
Voluntary Termination of Medicare or Other Federal Health Care Program Participation After Notification of
1512
Investigation or Disciplinary Action
Voluntary Termination of Medicaid or Other State Health Care Program Participation After Notification of
1517
Investigation or Disciplinary Action
1531 Civil Money Penalty Imposed by a Federal or State Health Care Program
1533 Administrative Fine/Monetary Penalty Imposed by a Federal or State Health Care Program
1551 Termination of Medicaid or Other State Health Care Program Participation
1555 Employment Disqualification Based on Finding in State Nurse Aide Registry
1556 Negative Finding or Listing in a State Health Care Practitioner Registry
1579 Other Action Imposed by Medicaid or Other State Health Care Program- Not Classified, Specify,
1590 Reinstatement
1592 Reinstatement Denied
1595 Reduction of Previous Action
1596 Extension of Previous Action
1597 Modification of Previous Action
1598 Other Action Imposed by Medicare or Other Federal Health Care Program- Not Classified, Specify,
1599 Other Certification Action – Not Classified, Specify

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Code Lists Version 2.07
Table 11 - Government Administrative - Revisions to Actions (No Basis for Action Code Required) - Other Adjudicated
Actions or Decisions by a Federal or State Agency
Code Description
1521 Contract Termination
1536 Administrative Fine/Monetary Penalty
1539 Civil Money Penalty
1552 Disqualification of Clinical Investigator From Receiving Investigational Products
1561 Personnel Action - Employee Termination
1563 Personnel Action - Employee Suspension
1566 Personnel Action - Not Classified, Specify, _____
1580 Reinstatement
1581 Reinstatement Denied
1582 Reduction of Previous Action
1583 Extension of Previous Action
1584 Modification of Previous Action
1588 Other Adjudicated Action or Decision – Not Classified, Specify, _____

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Code Lists Version 2.07

Health Plan Actions

Table 12 - Health Plan Action - Actions

Code Description
1920 Contract Termination
1930 Suspension of Contract
1931 Contract Restriction
1932 Administrative Fine/Monetary Penalty
1941 Employment Termination
1942 Employment Suspension
1951 Denial of Initial Contract Application
1952 Denial of Contract Renewal
1989 Other Health Plan Action, Specify, ___________________

Table 13 - Health Plan Action - Revisions to Actions (No Basis for Action Code Required)
Code Description
1920 Contract Termination
1930 Suspension of Contract
1931 Contract Restriction
1932 Administrative Fine/Monetary Penalty
1941 Employment Termination
1942 Employment Suspension
1989 Other Health Plan Action, Specify, ___________________
1990 Reinstatement
1992 Reinstatement Denied
1995 Reduction of Previous Action
1996 Extension of Previous Action
1997 Modification of Previous Action

Professional Society Actions

Table 14 - Professional Society - Actions

Code Description
1710 Revocation of Professional Society Membership
1730 Suspension of Professional Society Membership
1735 Disciplinary Probation Affecting Membership Rights or Privileges
1745 Other Restriction/Limitation on Professional Society Membership, Specify, ____________________
1750 Denial of Professional Society Membership (Subsequent)

Table 15 - Professional Society - Revisions to Actions (No Basis for Action Code Required)
Code Description
1710 Revocation of Professional Society Membership
1730 Suspension of Professional Society Membership
1735 Disciplinary Probation Affecting Membership Rights or Privileges
1745 Other Restriction/Limitation on Professional Society Membership, Specify, ____________________
1780 Membership Reinstated, Complete
1781 Membership Reinstated, Conditional
1789 Membership Reinstatement Denied
1790 Reduction of Previous Action
1795 Extension of Previous Action
1796 Modification of Previous Action

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Code Lists Version 2.07

State Licensure Actions

Table 16 - Licensure - Actions

Code Description
1110 Revocation of License
1125 Probation of License
1135 Suspension of License
1,2
1138 Summary or Emergency Limitation or Restriction on License
1,2
1139 Summary or Emergency Suspension of License
1140 Reprimand or Censure
1145 Voluntary Surrender of License
1146 Voluntary Limitation or Restriction on License
1147 Limitation or Restriction on License
1148 Denial of License Renewal
1149 Denial of Initial License
1150 Interim Action - Voluntary Agreement to Refrain from Practice or to Suspend License Pending Completion of an
Investigation
1151 Cease and Desist
1155 Withdrawal of Renewal Application While Under Investigation
1173 Publicly Available Fine/Monetary Penalty
1179 Prescriptive/Dispensing Authority Action - Not Classified, Specify, ____________________
1
1189 Publicly Available Negative Action or Finding Specify, ____
1199 Other Licensure Action - Not Classified, Specify, ____________________

Table 17 - Licensure - Revisions to Actions (No Basis for Action Codes Required)
Code Description
1110 Revocation of License
1125 Probation of License
1135 Suspension of License
1,2
1138 Summary or Emergency Limitation or Restriction on License
1,2
1139 Summary or Emergency Suspension of License
1140 Reprimand or Censure
1145 Voluntary Surrender of License
1146 Voluntary Limitation or Restriction on License
1147 Limitation or Restriction on License
1150 Interim Action - Voluntary Agreement to Refrain from Practice or to Suspend License Pending Completion of an
Investigation
1151 Cease and Desist
1155 Withdrawal of Renewal Application While Under Investigation
1173 Publicly Available Fine/Monetary Penalty
1179 Prescriptive/Dispensing Authority Action - Not Classified, Specify, ____________________
1
1189 Publicly Available Negative Action or Finding Specify, ____
1199 Other Licensure Action - Not Classified, Specify, ____________________
1280 License Restored or Reinstated, Complete
1282 License Restored or Reinstated, Conditional
1283 License Restored or Reinstated, Partial
1285 License Restoration or Reinstatement Denied
1295 Reduction of Previous Licensure Action
1296 Extension of Previous Licensure Action
1297 Modification of Previous Licensure Action

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 Code Lists Version 2.07
State Licensure Actions (continued)

3
Table 18 - Licensure - Multi-State Privilege Actions
Code Description
1310 Revocation of Multi-State Licensure Privilege
1325 Probation of Multi-State Licensure Privilege
1335 Suspension of Multi-State Licensure Privilege
1338 Summary or Emergency Limitation or Restriction of Multi-State Licensure Privilege
1339 Summary or Emergency Suspension of Multi-State Licensure Privilege
1340 Reprimand or Censure of Multi-State Licensure Privilege
1345 Voluntary Surrender of Multi-State Licensure Privilege
1346 Voluntary Limitation or Restriction on Practice Authorized by Multi-State Licensure Privilege
1347 Limitation or Restriction on Multi-State Licensure Privilege
1351 Cease and Desist – Multi-State Licensing Privilege
1373 Publicly Available Fine/Monetary Penalty Concerning Practicing under Multi-State Licensure Privilege
1389 Publicly Available Negative Action or Finding Concerning Practicing under Multi-State Licensure Privilege, Specify,
________
1399 Other Action Against Practitioner Practicing Under Multi-State Licensure Privilege - Not Classified, Specify, ___

3
Table 19 - Licensure - Revisions to Multi-State Privilege Actions (No Basis for Action Codes Required)
Code Description
1310 Revocation of Multi-State Licensure Privilege
1325 Probation of Multi-State Licensure Privilege
1335 Suspension of Multi-State Licensure Privilege
1338 Summary or Emergency Limitation or Restriction of Multi-State Licensure Privilege
1339 Summary or Emergency Suspension of Multi-State Licensure Privilege
1340 Reprimand or Censure of Multi-State Licensure Privilege
1345 Voluntary Surrender of Multi-State Licensure Privilege
1346 Voluntary Limitation or Restriction on Practice Authorized by Multi-State Licensure Privilege
1347 Limitation or Restriction on Multi-State Licensure Privilege
1351 Cease and Desist – Multi-State Licensing Privilege
1373 Publicly Available Fine/Monetary Penalty Concerning Practicing under Multi-State Licensure Privilege
1389 Publicly Available Negative Action or Finding Concerning Practicing under Multi-State Licensure Privilege, Specify,
________
1399 Other Action Against Practitioner Practicing Under Multi-State Licensure Privilege – Not Classified, Specify, ___
1480 Multi-State Licensure Privilege Restored or Reinstated, Complete
1482 Multi-State Licensure Privilege Restored or Reinstated, Conditional
1483 Multi-State Licensure Privilege Restored or Reinstated, Partial
1485 Multi-State Licensure Privilege Restoration or Reinstatement Denied
1495 Reduction of Previous Multi-State Licensure Privilege Action
1496 Extension of Previous Multi-State Licensure Privilege Action
1497 Modification of Previous Multi-State Licensure Privilege Action

1
For State Licensure Actions against practitioners you may not select multiple Adverse Action Classification Codes
when reporting any one of the following codes: 1138 Summary or Emergency Limitation or Restriction on License, 1139
Summary or Emergency Suspension of License, 1149 Denial of Initial License, or 1189 Publicly Available Negative
Action or Finding. Additional actions should be submitted in separate reports. You may select all other Adverse Action
Classification Codes available, in any combination, up to the five allowable codes.
2
Codes 1138 and 1139 against physicians and dentists must be based on the professional competence or conduct of
the subject.
3
Multi-State licensure privilege codes are only valid for actions against practitioners when such actions are being taken by a
remote state subject to a multi-state Licensure Compact. These codes cannot be used by the state which issued the license,
nor can they be used in conjunction with any Licensure Actions.

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Code Lists Version 2.07
AAR Adverse Action Classification Codes (Old Format)
(For Initial Reports submitted through August 14, 2000 using an earlier reporting format.)
Table 20 - AAR Adverse Action Classification Codes Code Description
(Old Format) 61020 Clinic Priv Revoked: Mental Disorder
61030 Clinic Priv Revoked: Allowing Unlicensed Person to
Code Description Practice
10000 License Revoked 61050 Clinic Priv Revoked: Disciplinary Action in Another State
10100 License Revoked: Alcohol and Other Substance Abuse 61080 Clinic Priv Revoked: Physical Impairment
10200 License Revoked: 61090 Clinic Priv Revoked: Other
Incompetence/Malpractice/Negligence 63000 Clinic Privileges Suspended
10300 License Revoked: Narcotics Violations 63001 Privs Suspended: Alcohol and Other Substance Abuse
10400 License Revoked: Felony 63002 Privs Suspended: Incompetence/Malpractice/Negligence
10500 License Revoked: Fraud 63003 Privs Suspended: Narcotics Violations
11000 License Revoked: Unprofessional Conduct 63004 Privs Suspended: Felony
12000 License Revoked: Mental Disorder 63005 Privs Suspended: Fraud
13000 License Revoked: Allowing Unlicensed Person to 63010 Privs Suspended: Unprofessional Conduct
Practice 63020 Privs Suspended: Mental Disorder
15000 License Revoked: Disciplinary Action in Another State 63030 Privs Suspended: Allowing Unlicensed Person to
18000 License Revoked: Other Reason - Not Classified Practice
20000 License Probation 63050 Privs Suspended: Disciplinary Action in Another State
20100 License Probation: Alcohol and Other Substance Abuse 63080 Privs Suspended: Physical Impairment
20200 License Probation: 63090 Privs Suspended: Other
Incompetence/Malpractice/Negligence 63500 Voluntary Surrender of Privileges
20300 License Probation: Narcotics Violations 63501 Vol Surr of Priv: Alcohol and Other Substance Abuse
20400 License Probation: Felony 63502 Vol Surr of Priv: Incompetence/Malpractice/Negligence
20500 License Probation: Fraud 63503 Vol Surr of Priv: Narcotics Violations
21000 License Probation: Unprofessional Conduct 63504 Vol Surr of Priv: Felony
22000 License Probation: Mental Disorder 63505 Vol Surr of Priv: Fraud
23000 License Probation: Allowing Unlicensed Person to 63510 Vol Surr of Priv: Unprofessional Conduct
Practice 63520 Vol Surr of Priv: Mental Disorder
25000 License Probation: Disciplinary Action in Another State 63530 Vol Surr of Priv: Allowing Unlicensed Person to Practice
28000 License Probation: Other Reason - Not Classified 63550 Vol Surr of Priv: Disciplinary Action in Another State
30000 License Suspended 63580 Vol Surr of Priv: Physical Impairment
30100 License Suspended: Alcohol and Other Substance 63590 Vol Surr of Priv: Other
Abuse 64000 Clinical Privileges Reduced
30200 License Suspended: 64001 Clinic Priv Reduced: Alcohol and Other Substance
Incompetence/Malpractice/Negligence Abuse
30300 License Suspended: Narcotics Violations 64002 Clinic Priv Reduced:
30400 License Suspended: Felony Incompetence/Malpractice/Negligence
30500 License Suspended: Fraud 64003 Clinic Priv Reduced: Narcotics Violations
31000 License Suspended: Unprofessional Conduct 64005 Clinic Priv Reduced: Fraud
32000 License Suspended: Mental Disorder 64010 Clinic Priv Reduced: Unprofessional Conduct
33000 License Suspended: Allowing Unlicensed Person to 64020 Clinic Priv Reduced: Mental Disorder
Practice 64030 Clinic Priv Reduced: Allowing Unlicensed Person to
35000 License Suspended: Disciplinary Action in Another State Practice
38000 License Suspended: Other Reason - Not Classified 64050 Clinic Priv Reduced: Disciplinary Action in Another State
40000 License-Miscellaneous 64080 Clinic Priv Reduced: Physical Impairment
40100 License-Misc.: License Restored or Reinstated 64090 Clinic Priv Reduced: Other
40200 License-Misc.: Reinstatement Denied 64500 Other Clinical Privileges Restriction
40600 License-Misc.: Reprimand 64501 Other Priv Restrict: Alcohol and Other Substance Abuse
41000 License-Misc.: Other Misc. Action (Inc. Censure & 64502 Other Priv Restrict:
Surrender) Incompetence/Malpractice/Negligence
41200 License-Misc.: License Denied (Renewal Only) 64503 Other Priv Restrict: Narcotics Violations
60000 Code/Clinical Privileges 64504 Other Priv Restrict: Felony
61000 Clinic Privileges Revoked 64505 Other Priv Restrict: Fraud
61001 Clinic Priv Revoked: Alcohol and Other Substance 64510 Other Priv Restrict: Unprofessional Conduct
Abuse 64520 Other Priv Restric: Mental Disorder
61002 Clinic Priv Revoked: Other Priv Restrict: Allowing Unlicensed Person to
Incompetence/Malpractice/Negligence 64530
Practice
61003 Clinic Priv Revoked: Narcotics Violations 64550 Other Priv Restrict: Disciplinary Action in Another State
61004 Clinic Priv Revoked: Felony 64580 Other Priv Restrict: Physical Impairment
61005 Clinic Priv Revoked: Fraud 64590 Other Priv Restrict: Other (Inc. Probation Restricting
61010 Clinic Priv Revoked: Unprofessional Conduct Priv)

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Code Lists Version 2.07

AAR Adverse Action Classification Codes - Old Format (continued)

Code Description
Table 21 - AAR Adverse Action Classification Codes - 73030 Prof Soc. Suspended: Allowing Unlicensed Person to
Old Format (continued) Practice
Code Description 73050 Prof Soc. Suspended: Disciplinary Action in Another
State
65000 Clinical Privileges Denial
73080 Prof Soc. Suspended: Physical Impairment
65001 Denial-Privs: Alcohol and Other Substance Abuse
73090 Prof Soc. Suspended: Other
65002 Denial-Privs: Incompetence/Malpractice/Negligence
74500 Other Restrictions - Professional Society Membership
65003 Denial-Privs: Narcotics Violations
74501 Prof Soc Other Rest: Alcohol and Other Substance
65004 Denial-Privs: Felony
Abuse
65005 Denial-Privs: Fraud
74502 Prof Soc Other Rest:
65010 Denial-Privs: Unprofessional Conduct
Incompetence/Malpractice/Negligence
65020 Denial-Privs: Mental Disorder
74503 Prof Soc Other Rest: Narcotics Violations
65030 Denial-Privs: Allowing Unlicensed Person to Practice
74504 Prof Soc Other Rest: Felony
65050 Denial-Privs: Disciplinary Action Taken in Another State
74505 Prof Soc Other Rest: Fraud
65080 Denial-Privs: Physical Impairment
74510 Prof Soc Other Rest: Unprofessional Conduct
65090 Denial-Privs: Other
74520 Prof Soc Other Rest: Mental Disorder
68000 Revision-Privs: Reinstatement, Complete
74530 Prof Soc Other Rest: Allowing Unlicensed Person to
68100 Revision-Privs: Reinstatement, Conditional Practice
68900 Revision-Privs: Reinstatement Denied 74550 Prof Soc Other Rest: Disciplinary Action in Another
69000 Revision-Privs: Reduction of Previous Action State
69500 Revision-Privs: Extension of Previous Action 74580 Prof Soc Other Rest: Physical Impairment
69900 Revision-Privs: Reversal of Action Due to Appeal or 74590 Prof Soc Other Rest: Other (Inc Probation Restricting
Review Privs)
71000 Professional Society Membership Revoked 75000 Denial-Professional Society Membership
71001 Prof Society Revoked: Alcohol and Other Substance 75001 Denial-Prof Society: Alcohol and Other Substance
Abuse Abuse
71002 Prof Society Revoked: 75002 Denial-Prof Society:
Incompetence/Malpractice/Negligence Incompetence/Malpractice/Negligence
71003 Prof Society Revoked: Narcotics Violations 75003 Denial-Prof Society: Narcotics Violations
71004 Prof Society Revoked: Felony 75004 Denial-Prof Society: Felony
71005 Prof Society Revoked: Fraud 75005 Denial-Prof Society: Fraud
71010 Prof Society Revoked: Unprofessional Conduct 75010 Denial-Prof Society: Unprofessional Conduct
71020 Prof Society Revoked: Mental Disorder 75020 Denial-Prof Society: Mental Disorder
71030 Prof Society Revoked: Allowing Unlicensed Person to 75030 Denial-Prof Society: Allowing Unlicensed Person to
Practice Practice
71050 Prof Society Revoked: Disciplinary Action in Another 75050 Denial-Prof Society: Disciplinary Action in Another State
State 75080 Denial-Prof Society: Physical Impairment
71080 Prof Society Revoked: Physical Impairment 75090 Denial-Prof Society: Other
71090 Prof Society Revoked: Other 78000 Revision-Prof Society: Reinstatement, Complete
78100 Revision-Prof Society: Reinstatement, Conditional
73000 Professional Society Membership Suspended 78900 Revision-Prof Society: Reinstatement Denied
73001 Prof Soc. Suspended: Alcohol and Other Substance 79000 Revision-Prof Society: Reduction of Previous Action
Abuse
79500 Revision-Prof Society: Extension of Previous Action
73002 Prof Soc. Suspended:
79900 Revision-Prof Society: Reversal of Previous Action
Incompetence/Malpractice/Negligence
73003 Prof Soc. Suspended: Narcotics Violations
73004 Prof Soc. Suspended: Felony
73005 Prof Soc. Suspended: Fraud
73010 Prof Soc. Suspended: Unprofessional Conduct
73020 Prof Soc. Suspended: Mental Disorder

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AAR Adverse Action Classification Codes - Organization Subjects

Accreditation Actions

Table 22 - Accreditation Actions

Code Description
3850 Accreditation Award Revoked
3855 Non-Accreditation/Denial of Accreditation
3864 Accreditation Restoration or Reinstatement Denied
3859 Other Private Accreditation Action - Not Classified, Specify, _________________

Table 23 - Accreditation Revisions to Actions (No Basis for Action Codes Required)
Code Description
3860 Accreditation
3862 Accreditation Restored or Reinstated, Conditional

Exclusion or Debarment Actions

Table 24 - Exclusion or Debarment Actions

Code Description
3500 Debarment From Federal Programs
3505 Exclusion From a Federal Health Care Program
3507 Exclusion From a State Health Care Program
1
3508 Exclusion From Medicare, Medicaid and All Other Federal Health Care Programs
1
3509 Exclusion From Medicare and State Health Care Programs

Table 25 - Exclusion or Debarment Revisions to Actions (No Basis for Action Code Required)
Code Description
3515 Reinstatement
3516 Reinstatement Denied
3519 Modification of Previous Action

1
These codes are for the HHS Office of Inspector General (OIG) use only. In cases in which the HHS OIG submits
an Exclusion or Debarment action, the HHS OIG may not select multiple Adverse Action Classification Codes when
reporting either of the following two codes: Exclusion from Medicare, Medicaid and all other Federal Health Care
Programs, or Exclusion from Medicare and State Health Care Programs. Additional actions should be submitted in
separate reports.
All other reporters of Exclusion or Debarment actions may select any available Adverse Action Classification Code alone
or in combination except for the two codes noted above.

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Code Lists Version 2.07

Federal or State Licensure Actions

Table 26 - Licensure Actions

Code Description
3111 Revocation of License or Certificate
3136 Suspension of License or Certificate
3138 Reprimand or Censure
3141 Voluntary Surrender of License or Certificate
3143 Conditional, Provisional, or Probationary License or Certificate
3144 Denial of License or Certificate Renewal
3145 Denial of Initial License or Certificate
3202 Directed Plan of Correction
3203 On-Site Monitoring
3204 Monitoring
3205 Directed In-Service Training
3206 Appointment of Temporary Management
3207 Restrictions on Admissions or Services
3210 Closure of Facility
3212 Transfer of Residents to Other Facilities Without Closure of the Facility
3220 Receivership
3225 Liquidation
3230 Civil Money Penalty
3233 Publicly Available Fine/Monetary Penalty
3238 Summary or Emergency Action, Specify
3239 Other Licensure Action - Not Classified, Specify, _________________

Table 27 - Licensure Revisions to Actions (No Basis for Action Codes Required)
Code Description
3111 Revocation of License or Certificate
3136 Suspension of License or Certificate
3138 Reprimand or Censure
3141 Voluntary Surrender of License or Certificate
3143 Conditional, Provisional, or Probationary License or Certificate
3202 Directed Plan of Correction
3203 On-Site Monitoring
3204 Monitoring
3205 Directed In-Service Training
3206 Appointment of Temporary Management
3207 Restrictions on Admissions or Services
3210 Closure of Facility
3212 Transfer of Residents to Other Facilities Without Closure of the Facility
3220 Receivership
3225 Liquidation
3230 Civil Money Penalty
3233 Publicly Available Fine/Monetary Penalty
3238 Summary or Emergency Action, Specify
3239 Other Licensure Action - Not Classified, Specify, _________________
3281 License or Certificate Restored or Reinstated, Complete
3283 License or Certificate Restored or Reinstated, Conditional
3284 License or Certificate Restored or Reinstated, Partial
3286 License or Certificate Restoration or Reinstatement Denied
3295 Reduction of Previous Licensure Action
3296 Extension of Previous Licensure Action
3297 Modification of Previous Licensure Action

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Government Administrative Actions

Table 28 - Government Administrative Actions - Actions Related to Certification Agreements or Contracts for
Participation in a Federal or State Health Care Program
Code Description
3202 Directed Plan of Correction
3203 On-Site Monitoring
3205 Directed In-Service Training
3206 Appointment of Temporary Management
3207 Restrictions on Admissions or Services
3210 Closure of Facility
3212 Transfer of Residents to Other Facilities Without Closure of the Facility
3231 Civil Money Penalty Imposed by a Federal or State Health Care Program
3234 Administrative Fine/Monetary Penalty Imposed by a Federal or State Health Care Program
3510 Termination of Medicare or Other Federal Health Care Program Participation
3512 Voluntary Termination of Medicare or Other Federal Health Care Program Participation After Notification of
Investigation or Disciplinary Action
3513 Nonrenewal of Medicare or Other Federal Health Care Program Participation Agreement for Cause
3517 Voluntary Termination of Medicaid or Other State Health Care Program Participation After Notification of
Investigation or Disciplinary Action
3518 Nonrenewal of Medicaid or Other State Health Care Program Participation Agreement for Cause
3525 Denial of Initial Application
3540 Marketing Activities Suspended or Restricted
3542 Beneficiary Enrollment Suspended
3551 Termination of Medicaid or Other State Health Care Program Participation
3579 Other Action Imposed by Medicaid or Other State Health Care Program- Not Classified, Specify,
3598 Other Action Imposed by Medicare or Other Federal Health Care Program- Not Classified, Specify,
3599 Other Certification Action - Not Classified, Specify, ______________

Table 29 - Government Administrative - Other Adjudicated Actions or Decisions by a Federal or State Agency
Code Description
3521 Contract Termination
3538 Administrative Fine/Monetary Penalty
3539 Civil Money Penalty
3588 Other Adjudicated Action or Decision Not Classified, Specify, _____

Table 30 - Government Administrative - Revisions to Actions (No Basis for Action Code Required) - Actions Related
to Certification Agreements or Contracts for Participation in a Federal or State Health Care Program
Code Description
3202 Directed Plan of Correction
3203 On-Site Monitoring
3205 Directed In-Service Training
3206 Appointment of Temporary Management
3207 Restrictions on Admissions or Services
3210 Closure of Facility
3212 Transfer of Residents to Other Facilities Without Closure of the Facility
3231 Civil Money Penalty Imposed by a Federal or State Health Care Program
3234 Administrative Fine/Monetary Penalty Imposed by a Federal or State Health Care Program
3510 Termination of Medicare or Other Federal Health Care Program Participation
3512 Voluntary Termination of Medicare or Other Federal Health Care Program Participation After Notification of
Investigation or Disciplinary Action
3517 Voluntary Termination of Medicaid or Other State Health Care Program Participation After Notification of
Investigation or Disciplinary Action

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Code Lists Version 2.07
Code Description
3540 Marketing Activities Suspended or Restricted
3542 Beneficiary Enrollment Suspended
3551 Termination of Medicaid or Other State Health Care Program Participation
3579 Other Action Imposed by Medicaid or Other State Health Care Program- Not Classified, Specify,
3590 Reinstatement
3592 Reinstatement Denied
3595 Reduction of Previous Action
3596 Extension of Previous Action
3597 Modification of Previous Action
3598 Other Action Imposed by Medicare or Other Federal Health Care Program- Not Classified, Specify,
3599 Other Certification Action - Not Classified, Specify, ______________

Table 31 - Government Administrative - Revisions to Actions (No Basis for Action Code Required) - Other Adjudicated
Actions or Decisions by a Federal or State Agency
Code Description
3521 Contract Termination
3538 Administrative Fine/Monetary Penalty
3539 Civil Money Penalty
3580 Reinstatement
3581 Reinstatement Denied
3582 Reduction of Previous Action
3583 Extension of Previous Action
3584 Modification of Previous Action
3588 Other Adjudicated Action or Decision Not Classified, Specify, _____

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Code Lists Version 2.07

Health Plan Actions

Table 32 - Health Plan Action - Actions

Code Description
3920 Contract Termination
3930 Suspension of Contract
3932 Administrative Fine/Monetary Penalty
3951 Denial of Initial Contract Application
3952 Denial of Contract Renewal
3989 Other Health Plan Action, Specify, ____________________

Table 33 - Health Plan Action - Revisions to Actions (No Basis for Action Code Required)
Code Description
3920 Contract Termination
3930 Suspension of Contract
3932 Administrative Fine/Monetary Penalty
3989 Other Health Plan Action, Specify, ____________________
3990 Reinstatement
3992 Reinstatement Denied
3995 Reduction of Previous Action
3996 Extension of Previous Action
3997 Modification of Previous Action

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Code Lists Version 2.07

AAR Adverse Action Classification Codes - Retired

Table 34 - AAR Adverse Action Classification Codes - Retired

Code Description
1172 Administrative Fine/Monetary Penalty
1520 Contract Termination
1530 Civil Money Penalty
1532 Administrative Fine/Monetary Penalty
1550 Disqualification of Clinical Investigator From Receiving Investigational Products
1560 Personnel Action - Employee Termination
1562 Personnel Action - Employee Suspension
1565 Personnel Action - Not Classified
1589 Other Action - Not Classified, Specify
1636 Voluntary Acceptance of Restrictions on Privileges
1699 Reversal of Previous Action Due to Appeal or Review
1799 Reversal of Previous Action Due to Appeal or Review
1831 Recommendation to Exclude from Participating in Medicare, Medicaid
1950 Denial of Contract Application or Renewal
3232 Administrative Fine/Monetary Penalty
3520 Contract Termination
3589 Other Action - Not Classified, Specify
3950 Denial of Contract Application or Renewal

Retired codes are not available for submission on new reports but may appear on existing reports.

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Code Lists Version 2.07
AAR Type of Negative Finding Codes - Individual Subjects
Peer Review Organization

Table 35 - Initial Actions

Code Description
1830 Recommendation to Sanction
1889 Other Finding - Not Classified, Specify, ____________________

Table 36 - Revision to Actions

Code Description
1840 Withdrawal of Recommendation to Sanction
1841 Withdrawal of Recommendation to Exclude from Participating in Medicare, Medicaid

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Code Lists Version 2.07

AAR Basis for Action Codes - Individual Subjects

Clinical Privileges Actions

Table 37 - Non-Compliance With Requirements

Code Description
A8 Clinical Privileges Restricted, Suspended or Revoked by Another Hospital or Health Care Facility
AA Failure to Comply With Corrective Action Plan
AH Failure to Comply With Terms of Probation or other Previously Imposed Requirements
50 Failure to Maintain Adequate or Accurate Records
45 Failure to Maintain Records or Provide Medical, Financial or Other Required Information
39 License Revocation, Suspension or Other Disciplinary Action Taken by a Federal, State or Local Licensing
Authority
29 Practicing Beyond the Scope of Practice
AB Practicing Beyond the Scope of Privileges
24 Practicing With an Expired License
25 Practicing Without a License
A4 Practicing Without a Valid License
A7 Surrendered License to Practice
70 Violation of By-Laws, Protocols or Guidelines
79 Violation of Code of Ethics

Table 38 - Criminal Conviction or Adjudication

Code Description
19 Criminal Conviction
18 Deferred Adjudication
B1 Nolo Contendere Plea

Table 39 - Confidentiality, Consent or Disclosure Violations

Code Description
C3 Breach of Confidentiality
C2 Failure to Comply With Patient Consultation Requirements
C1 Failure to Obtain Informed Consent

Table 40 - Misconduct or Abuse

Code Description
D4 Abusive Conduct Toward Staff
D7 Conduct Evidencing Ethical Unfitness
D6 Conduct Evidencing Moral Unfitness
71 Conflict of Interest
D5 Disruptive Conduct
16 Misappropriation of Patient Property or Other Property
D2 Non-Sexual Dual Relationship or Boundary Violation
14 Patient Abuse
D1 Sexual Misconduct
D8 Other Unprofessional Conduct, Specify______________

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Code Lists Version 2.07

Clinical Privileges Actions (continued)

Table 41 - Fraud, Deception, or Misrepresentation

Code Description
E6 Failure to Disclose
E3 Filing False Reports or Falsifying Records
05 Fraud - Unspecified
E4 Fraud, Deceit or Material Omission in Obtaining License or Credentials
55 Improper or Abusive Billing Practices
E1 Insurance Fraud (Medicare, Medicaid or Other Insurance)
81 Misrepresentation of Credentials
56 Submitting False Claims

Table 42 - Unsafe Practice or Substandard Care

Code Description
F8 Failure to Consult or Delay in Seeking Consultation With Supervisor/Proctor
53 Failure to Provide Medically Reasonable and/or Necessary Items or Services
F1 Immediate Threat to Health or Safety
17 Inadequate or Improper Infection Control Practices
FA Inappropriate Refusal to Treat
11 Incompetence
12 Malpractice
13 Negligence
F9 Patient Abandonment
15 Patient Neglect
F6 Substandard or Inadequate Care
F7 Substandard or Inadequate Skill Level
F5 Unable to Practice Safely
F2 Unable to Practice Safely by Reason of Alcohol or Other Substance Abuse
F4 Unable to Practice Safely by Reason of Physical Illness or Impairment
F3 Unable to Practice Safely by Reason of Psychological Impairment or Mental Disorder

Table 43 - Improper Supervision or Allowing Unlicensed Practice

Code Description
G2 Allowing or Aiding Unlicensed Practice
G1 Improper or Inadequate Supervision or Delegation

Table 44 - Improper Prescribing, Dispensing, Administering Medication/Drug Violation

Code Description
H6 Diversion of Controlled Substance
H5 Error in Prescribing, Dispensing or Administering Medication
H1 Narcotics Violation or Other Violation of Drug Statutes
H4 Unauthorized Administration of Medication
H3 Unauthorized Dispensing of Medication
H2 Unauthorized Prescribing of Medication

Table 45 - Other
Code Description
99 Other - Not Classified, Specify______________

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Code Lists Version 2.07

Exclusion or Debarment Actions

Table 46 - Criminal Conviction

Code Description
66 Conviction Relating to Controlled Substances
64 Conviction Relating to Fraud
65 Conviction Relating to Obstruction of an Investigation
63 Conviction Relating to Patient Abuse or Neglect
69 Criminal Conviction - Not Classified
61 Felony Conviction Relating to Controlled Substance Violations
60 Felony Conviction Relating to Health Care Fraud
62 Program-Related Conviction

Table 47 - Other
Code Description
71 Conflict of Interest
72 Corporate Integrity Agreement Breach
44 Default on Health Education Loan or Scholarship Obligations
41 Entities Owned or Controlled by a Sanctioned Individual
40 Exclusion or Suspension From a Federal or State Health Care Program
46 Failure to Grant Immediate Access
50 Failure to Maintain Adequate or Accurate Records
45 Failure to Maintain Records or Provide Medical, Financial or Other Required Information
51 Failure to Perform Contractual Obligations
53 Failure to Provide Medically Reasonable and/or Necessary Items or Services
47 Failure to Take Corrective Action
57 Fraud, Kickbacks or Other Prohibited Activities
54 Furnishing Unnecessary or Substandard Items or Services
58 Imposition of Civil Money Penalty or Assessment
55 Improper or Abusive Billing Practices
42 Individuals Controlling Sanctioned Entities
39 License Revocation, Suspension or Other Disciplinary Action Taken by a Federal, State or Local Licensing
Authority
H1 Narcotics Violation or Other Violation of Drug Statutes
59 Peer Review Organization Recommendation
73 Settlement Agreement Breach
56 Submitting False Claims
A7 Surrendered License to Practice
A6 Violation of Federal or State Statutes, Regulations or Rules
84 Violation of State Health Code
99 Other - Not Classified, Specify, ___________________

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Code Lists Version 2.07

Federal or State Licensure Actions

Table 48 - Non-Compliance With Requirements

Code Description
44 Default on Health Education Loan or Scholarship Obligations
35 Drug Screening Violation
A2 Failure to Comply With Continuing Education or Competency Requirements
31 Failure to Comply With Health and Safety Requirements
23 Failure to Cooperate With Board Investigation
50 Failure to Maintain Adequate or Accurate Records
45 Failure to Maintain Records or Provide Medical, Financial or Other Required Information
A3 Failure to Meet Licensing Board Reporting Requirements
A1 Failure to Meet the Initial Requirements of a License
37 Failure to Pay Child Support/Delinquent Child Support
39 License Revocation, Suspension or Other Disciplinary Action Taken by a Federal, State or Local Licensing
Authority
29 Practicing Beyond the Scope of Practice
24 Practicing With an Expired License
25 Practicing Without a License
A4 Practicing Without a Valid License
A6 Violation of Federal or State Statutes, Regulations or Rules
36 Violation of Federal or State Tax Code
84 Violation of State Health Code
A5 Violation of or Failure to Comply With Licensing Board Order

Table 49 - Criminal Conviction or Adjudication

Code Description
19 Criminal Conviction
18 Deferred Adjudication
B1 Nolo Contendere Plea
I1 Diverted Conviction

Table 50 - Confidentiality, Consent or Disclosure Violations

Code Description
C3 Breach of Confidentiality
C2 Failure to Comply With Patient Consultation Requirements
C1 Failure to Obtain Informed Consent

Table 51 - Misconduct or Abuse

Code Description
D4 Abusive Conduct Toward Staff
D7 Conduct Evidencing Ethical Unfitness
D6 Conduct Evidencing Moral Unfitness
71 Conflict of Interest
D5 Disruptive Conduct
D3 Exploiting a Patient for Financial Gain
16 Misappropriation of Patient Property or Other Property
D2 Non-Sexual Dual Relationship or Boundary Violation
14 Patient Abuse
D1 Sexual Misconduct
D8 Other Unprofessional Conduct, Specify______________

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Code Lists Version 2.07
Federal or State Licensure Actions (continued)

Table 52 - Fraud, Deception, or Misrepresentation

Code Description
E6 Failure to Disclose
E3 Filing False Reports or Falsifying Records
05 Fraud - Unspecified
E4 Fraud, Deceit or Material Omission in Obtaining License or Credentials
55 Improper or Abusive Billing Practices
E1 Insurance Fraud (Medicare, Medicaid or Other Insurance)
E5 Misleading, False or Deceptive Advertising or Marketing
81 Misrepresentation of Credentials
E2 Providing or Ordering Unnecessary Tests or Services
56 Submitting False Claims

Table 53 - Unsafe Practice or Substandard Care

Code Description
F8 Failure to Consult or Delay in Seeking Consultation With Supervisor/Proctor
53 Failure to Provide Medically Reasonable and/or Necessary Items or Services
F1 Immediate Threat to Health or Safety
17 Inadequate or Improper Infection Control Practices
FA Inappropriate Refusal to Treat
11 Incompetence
12 Malpractice
13 Negligence
F9 Patient Abandonment
15 Patient Neglect
F6 Substandard or Inadequate Care
F7 Substandard or Inadequate Skill Level
F5 Unable to Practice Safely
F2 Unable to Practice Safely by Reason of Alcohol or Other Substance Abuse
F4 Unable to Practice Safely by Reason of Physical Illness or Impairment
F3 Unable to Practice Safely by Reason of Psychological Impairment or Mental Disorder

Table 54 - Improper Supervision or Allowing Unlicensed Practice

Code Description
G2 Allowing or Aiding Unlicensed Practice
G1 Improper or Inadequate Supervision or Delegation

Table 55 - Improper Prescribing, Dispensing, Administering Medication/Drug Violation

Code Description
H6 Diversion of Controlled Substance
H5 Error in Prescribing, Dispensing or Administering Medication
H1 Narcotics Violation or Other Violation of Drug Statutes
H4 Unauthorized Administration of Medication
H3 Unauthorized Dispensing of Medication
H2 Unauthorized Prescribing of Medication

Table 56 - Other
Code Description
99 Other - Not Classified, Specify, ___________________

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Government Administrative Actions

Table 57 - Non-Compliance With Requirements

Code Description
A8 Clinical Privileges Restricted, Suspended or Revoked by Another Hospital or Health Care Facility
82 Debarment from Federal or State Program
44 Default on Health Education Loan or Scholarship Obligations
43 Employing or Contracting With Individuals or Entities Excluded From a Federal or State Health Care Program
40 Exclusion or Suspension From a Federal or State Health Care Program
50 Failure to Maintain Adequate or Accurate Records
45 Failure to Maintain Records or Provide Medical, Financial or Other Required Information
51 Failure to Perform Contractual Obligations
21 Failure to Repay Overpayment
39 License Revocation, Suspension or Other Disciplinary Action Taken by a Federal, State or Local Licensing
Authority
24 Practicing With an Expired License
25 Practicing Without a License
A4 Practicing Without a Valid License
A7 Surrendered License to Practice
A6 Violation of Federal or State Statutes, Regulations or Rules
84 Violation of State Health Code
A5 Violation of or Failure to Comply With Licensing Board Order

Table 58 - Criminal Conviction or Adjudication

Code Description
19 Criminal Conviction
18 Deferred Adjudication
B1 Nolo Contendere Plea

Table 59 - Confidentiality, Consent or Disclosure Violations

Code Description
C3 Breach of Confidentiality
C2 Failure to Comply With Patient Consultation Requirements
C1 Failure to Obtain Informed Consent

Table 60 - Misconduct or Abuse

Code Description
D4 Abusive Conduct Toward Staff
D7 Conduct Evidencing Ethical Unfitness
D6 Conduct Evidencing Moral Unfitness
71 Conflict of Interest
D5 Disruptive Conduct
16 Misappropriation of Patient Property or Other Property
D2 Non-Sexual Dual Relationship or Boundary Violation
14 Patient Abuse
D1 Sexual Misconduct
D8 Other Unprofessional Conduct, Specify______________

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Government Administrative Actions (continued)

Table 61 - Fraud, Deception, or Misrepresentation

Code Description
E6 Failure to Disclose
E3 Filing False Reports or Falsifying Records
05 Fraud - Unspecified
E4 Fraud, Deceit or Material Omission in Obtaining License or Credentials
55 Improper or Abusive Billing Practices
E1 Insurance Fraud (Medicare, Medicaid or Other Insurance)
E5 Misleading, False or Deceptive Advertising or Marketing
81 Misrepresentation of Credentials
E2 Providing or Ordering Unnecessary Tests or Services
56 Submitting False Claims

Table 62 - Unsafe Practice or Substandard Care

Code Description
F8 Failure to Consult or Delay in Seeking Consultation With Supervisor/Proctor
53 Failure to Provide Medically Reasonable and/or Necessary Items or Services
F1 Immediate Threat to Health or Safety
17 Inadequate or Improper Infection Control Practices
FA Inappropriate Refusal to Treat
11 Incompetence
12 Malpractice
13 Negligence
F9 Patient Abandonment
15 Patient Neglect
F6 Substandard or Inadequate Care
F7 Substandard or Inadequate Skill Level
F5 Unable to Practice Safely
F2 Unable to Practice Safely by Reason of Alcohol or Other Substance Abuse
F4 Unable to Practice Safely by Reason of Physical Illness or Impairment
F3 Unable to Practice Safely by Reason of Psychological Impairment or Mental Disorder

Table 63 - Improper Supervision or Allowing Unlicensed Practice

Code Description
G2 Allowing or Aiding Unlicensed Practice
G1 Improper or Inadequate Supervision or Delegation

Table 64 - Improper Prescribing, Dispensing, Administering Medication/Drug Violation

Code Description
H6 Diversion of Controlled Substance
H5 Error in Prescribing, Dispensing or Administering Medication
H1 Narcotics Violation or Other Violation of Drug Statutes
H4 Unauthorized Administration of Medication
H3 Unauthorized Dispensing of Medication
H2 Unauthorized Prescribing of Medication

Table 65 - Other
Code Description
99 Other - Not Classified, Specify, ___________________

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Health Plan Actions

Table 66 - Non-Compliance With Requirements

Code Description
A8 Clinical Privileges Restricted, Suspended or Revoked by Another Hospital or Health Care Facility
82 Debarment From Federal or State Program
43 Employing or Contracting With Individuals or Entities Excluded From a Federal or State Health Care Program
40 Exclusion or Suspension From a Federal or State Health Care Program
AA Failure to Comply With Corrective Action Plan
50 Failure to Maintain Adequate or Accurate Records
45 Failure to Maintain Records or Provide Medical, Financial or Other Required Information
A9 Failure to Meet or Comply With Contractual Obligations, Participation Requirements, or Credentialing Standards
39 License Revocation, Suspension or Other Disciplinary Action Taken by a Federal, State or Local Licensing
Authority
29 Practicing Beyond the Scope of Practice
24 Practicing With an Expired License
25 Practicing Without a License
A4 Practicing Without a Valid License
A7 Surrendered License to Practice

Table 67 - Criminal Conviction or Adjudication

Code Description
19 Criminal Conviction
18 Deferred Adjudication
B1 Nolo Contendere Plea

Table 68 - Confidentiality, Consent or Disclosure Violations

Code Description
C3 Breach of Confidentiality
C2 Failure to Comply With Patient Consultation Requirements
C1 Failure to Obtain Informed Consent

Table 69 - Misconduct or Abuse

Code Description
D4 Abusive Conduct Toward Staff
D7 Conduct Evidencing Ethical Unfitness
D6 Conduct Evidencing Moral Unfitness
71 Conflict of Interest
D5 Disruptive Conduct
16 Misappropriation of Patient Property or Other Property
D2 Non-Sexual Dual Relationship or Boundary Violation
14 Patient Abuse
D1 Sexual Misconduct
D8 Other Unprofessional Conduct, Specify

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Health Plan Actions (continued)

Table 70 - Fraud, Deception, or Misrepresentation

Code Description
E6 Failure to Disclose
E3 Filing False Reports or Falsifying Records
05 Fraud - Unspecified
E4 Fraud, Deceit or Material Omission in Obtaining License or Credentials
55 Improper or Abusive Billing Practices
E1 Insurance Fraud (Medicare, Medicaid or Other Insurance)
E5 Misleading, False or Deceptive Advertising or Marketing
81 Misrepresentation of Credentials
E2 Providing or Ordering Unnecessary Tests or Services
56 Submitting False Claims

Table 71 - Unsafe Practice or Substandard Care

Code Description
FB Excessive Malpractice Cases/Extensive Malpractice History
F8 Failure to Consult or Delay in Seeking Consultation With Supervisor/Proctor
53 Failure to Provide Medically Reasonable and/or Necessary Items or Services
F1 Immediate Threat to Health or Safety
17 Inadequate or Improper Infection Control Practices
FA Inappropriate Refusal to Treat
11 Incompetence
12 Malpractice
13 Negligence
F9 Patient Abandonment
15 Patient Neglect
F6 Substandard or Inadequate Care
F7 Substandard or Inadequate Skill Level
F5 Unable to Practice Safely
F2 Unable to Practice Safely by Reason of Alcohol or Other Substance Abuse
F4 Unable to Practice Safely by Reason of Physical Illness or Impairment
F3 Unable to Practice Safely by Reason of Psychological Impairment or Mental Disorder

Table 72 - Improper Supervision or Allowing Unlicensed Practice

Code Description
G2 Allowing or Aiding Unlicensed Practice
G1 Improper or Inadequate Supervision or Delegation

Table 73 - Improper Prescribing, Dispensing, Administering Medication/Drug Violation

Code Description
H6 Diversion of Controlled Substance
H5 Error in Prescribing, Dispensing or Administering Medication
H1 Narcotics Violation or Other Violation of Drug Statutes
H4 Unauthorized Administration of Medication
H3 Unauthorized Dispensing of Medication
H2 Unauthorized Prescribing of Medication

Table 74 - Other
Code Description
99 Other - Not Classified, Specify, ___________________

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Professional Society Actions

Table 75 - Non-Compliance With Requirements

Code Description
A8 Clinical Privileges Restricted, Suspended or Revoked by Another Hospital or Health Care Facility
AA Failure to Comply With Corrective Action Plan
AH Failure to Comply With Terms of Probation or other Previously Imposed Requirements
50 Failure to Maintain Adequate or Accurate Records
45 Failure to Maintain Records or Provide Medical, Financial or Other Required Information
39 License Revocation, Suspension or Other Disciplinary Action Taken by a Federal, State or Local Licensing Authority
29 Practicing Beyond the Scope of Practice
AB Practicing Beyond the Scope of Privileges
24 Practicing With an Expired License
25 Practicing Without a License
A4 Practicing Without a Valid License
A7 Surrendered License to Practice
70 Violation of By-Laws, Protocols or Guidelines
79 Violation of Code of Ethics

Table 76 - Criminal Conviction or Adjudication

Code Description
19 Criminal Conviction
18 Deferred Adjudication
B1 Nolo Contendere Plea

Table 77 - Confidentiality, Consent or Disclosure Violations

Code Description
C3 Breach of Confidentiality
C2 Failure to Comply With Patient Consultation Requirements
C1 Failure to Obtain Informed Consent

Table 78 - Misconduct or Abuse

Code Description
D4 Abusive Conduct Toward Staff
D7 Conduct Evidencing Ethical Unfitness
D6 Conduct Evidencing Moral Unfitness
71 Conflict of Interest
D5 Disruptive Conduct
16 Misappropriation of Patient Property or Other Property
D2 Non-Sexual Dual Relationship or Boundary Violation
14 Patient Abuse
D1 Sexual Misconduct
D8 Other Unprofessional Conduct, Specify______________

Table 79 - Fraud, Deception, or Misrepresentation

Code Description
E6 Failure to Disclose
E3 Filing False Reports or Falsifying Records
05 Fraud - Unspecified
E4 Fraud, Deceit or Material Omission in Obtaining License or Credentials
55 Improper or Abusive Billing Practices

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Code Description
E1 Insurance Fraud (Medicare, Medicaid or Other Insurance)
81 Misrepresentation of Credentials
56 Submitting False Claims

Table 80 - Unsafe Practice or Substandard Care

Code Description
F8 Failure to Consult or Delay in Seeking Consultation With Supervisor/Proctor
53 Failure to Provide Medically Reasonable and/or Necessary Items or Services
F1 Immediate Threat to Health or Safety
17 Inadequate or Improper Infection Control Practices
FA Inappropriate Refusal to Treat
11 Incompetence
12 Malpractice
13 Negligence
F9 Patient Abandonment
15 Patient Neglect
F6 Substandard or Inadequate Care
F7 Substandard or Inadequate Skill Level
F5 Unable to Practice Safely
F2 Unable to Practice Safely by Reason of Alcohol or Other Substance Abuse
F4 Unable to Practice Safely by Reason of Physical Illness or Impairment
F3 Unable to Practice Safely by Reason of Psychological Impairment or Mental Disorder

Table 81 - Improper Supervision or Allowing Unlicensed Practice

Code Description
G2 Allowing or Aiding Unlicensed Practice
G1 Improper or Inadequate Supervision or Delegation

Table 82 - Improper Prescribing, Dispensing, Administering Medication/Drug Violation

Code Description
H6 Diversion of Controlled Substance
H5 Error in Prescribing, Dispensing or Administering Medication
H1 Narcotics Violation or Other Violation of Drug Statutes
H4 Unauthorized Administration of Medication
H3 Unauthorized Dispensing of Medication
H2 Unauthorized Prescribing of Medication

Table 83 - Other
Code Description
99 Other - Not Classified, Specify, ___________________

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AAR Basis for Action Codes - Organization Subjects

Accreditation Actions

Table 84 - Non-Compliance With Federal, State or Contractual Requirements

Code Description
92 Noncompliance With Private Accreditation Standards That Indicate a Risk to the Safety of Patients or Quality of
Health Care Services

Table 85 - Other
Code Description
99 Other - Not Classified, Specify, ___________________

Exclusion or Debarment Actions

Table 86 - Criminal Conviction

Code Description
66 Conviction Relating to Controlled Substances
64 Conviction Relating to Fraud
65 Conviction Relating to Obstruction of an Investigation
63 Conviction Relating to Patient Abuse or Neglect
69 Criminal Conviction - Not Classified
61 Felony Conviction Relating to Controlled Substance Violations
60 Felony Conviction Relating to Health Care Fraud
62 Program-Related Conviction

Table 87 - Other
Code Description
71 Conflict of Interest
72 Corporate Integrity Agreement Breach
44 Default on Health Education Loan or Scholarship Obligations
41 Entities Owned or Controlled by a Sanctioned Individual
40 Exclusion or Suspension From a Federal or State Health Care Program
46 Failure to Grant Immediate Access
50 Failure to Maintain Adequate or Accurate Records
45 Failure to Maintain Records or Provide Medical, Financial or Other Required Information
51 Failure to Perform Contractual Obligations
53 Failure to Provide Medically Reasonable and/or Necessary Items or Services
47 Failure to Take Corrective Action
57 Fraud, Kickbacks or Other Prohibited Activities
54 Furnishing Unnecessary or Substandard Items or Services
58 Imposition of Civil Money Penalty or Assessment
55 Improper or Abusive Billing Practices
42 Individuals Controlling Sanctioned Entities
39 License Revocation, Suspension or Other Disciplinary Action Taken by a Federal, State or Local Licensing
Authority
H1 Narcotics Violation or Other Violation of Drug Statutes
59 Peer Review Organization Recommendation
73 Settlement Agreement Breach
56 Submitting False Claims
A7 Surrendered License to Practice
A6 Violation of Federal or State Statutes, Regulations or Rules

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Code Description
84 Violation of State Health Code
99 Other - Not Classified, Specify, ___________________

Federal or State Licensure Actions

Table 88 - Non-Compliance With Requirements

Code Description
40 Exclusion or Suspension From a Federal or State Health Care Program
31 Failure to Comply With Health and Safety Requirements
50 Failure to Maintain Adequate or Accurate Records
AC Failure to Maintain Equipment/Missing or Inadequate Equipment
45 Failure to Maintain Records or Provide Medical, Financial or Other Required Information
AG Failure to Maintain Supplies/Missing or Inadequate Supplies
A3 Failure to Meet Licensing Board Reporting Requirements
A1 Failure to Meet the Initial Requirements of a License
47 Failure to Take Corrective Action
34 Financial Insolvency
32 Lack of Appropriately Qualified Professionals
39 License Revocation, Suspension or Other Disciplinary Action Taken by a Federal, State or Local Licensing
Authority
AF Operating Beyond Scope of License
AE Operating Without a License or Permits or on a Lapsed License
A6 Violation of Federal or State Statutes, Regulations or Rules
84 Violation of State Health Code
A5 Violation of or Failure to Comply With Licensing Board Order

Table 89 - Criminal Conviction or Adjudication

Code Description
19 Criminal Conviction
18 Deferred Adjudication
B1 Nolo Contendere Plea
I1 Diverted Conviction

Table 90 - Confidentiality, Consent or Disclosure Violations

Code Description
C3 Breach of Confidentiality
C2 Failure to Comply With Patient Consultation Requirements
C1 Failure to Obtain Informed Consent

Table 91 - Conflict of Interest

Code Description
71 Conflict of Interest

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Federal or State Licensure Actions (continued)

Table 92 - Fraud, Deception, or Misrepresentation

Code Description
E6 Failure to Disclose
E3 Filing False Reports or Falsifying Records
05 Fraud - Unspecified
E4 Fraud, Deceit or Material Omission in Obtaining License or Credentials
57 Fraud, Kickbacks or Prohibited Activities
55 Improper or Abusive Billing Practices
E1 Insurance Fraud (Medicare, Medicaid or Other Insurance)
E5 Misleading, False or Deceptive Advertising or Marketing
E2 Providing or Ordering Unnecessary Tests or Services
56 Submitting False Claims

Table 93 - Substandard Care or Patient Neglect/Abuse

Code Description
53 Failure to Provide Medically Reasonable and/or Necessary Items or Services
17 Inadequate or Improper Infection Control Practices
FA Inappropriate Refusal to Treat
F9 Patient Abandonment
14 Patient Abuse
15 Patient Neglect
F6 Substandard or Inadequate Care

Table 94 - Improper Supervision or Allowing Unlicensed Practice

Code Description
G2 Allowing or Aiding Unlicensed Practice
G1 Improper or Inadequate Supervision or Delegation

Table 95 - Improper Prescribing, Dispensing, Administering Medication/Drug Violation

Code Description
H5 Error in Prescribing, Dispensing or Administering Medication
H8 Expired Drugs in Inventory
H7 Inadequate Security for Controlled Substances
H9 Misbranding Drug Labels/Lack of Required Labeling on Drugs
H1 Narcotics Violation or Other Violation of Drug Statutes
H4 Unauthorized Administration of Medication
H3 Unauthorized Dispensing of Medication
H2 Unauthorized Prescribing of Medication

Table 96 - Other
Code Description
99 Other - Not Classified, Specify, ___________________

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Government Administrative Actions

Table 97 - Non-Compliance With Requirements

Code Description
82 Debarment From Federal or State Program
43 Employing or Contracting With Individuals or Entities Excluded From a Federal or State Health Care Program
40 Exclusion or Suspension From a Federal or State Health Care Program
31 Failure to Comply With Health and Safety Requirements
49 Failure to Comply With the Composition of Enrollment Requirements
50 Failure to Maintain Adequate or Accurate Records
AC Failure to Maintain Equipment/Missing or Inadequate Equipment
45 Failure to Maintain Records or Provide Medical, Financial or Other Required Information
48 Failure to Obtain a Surety Bond
51 Failure to Perform Contractual Obligations
21 Failure to Repay Overpayment
47 Failure to Take Corrective Action
34 Financial Insolvency
32 Lack of Appropriately Qualified Professionals
39 License Revocation, Suspension or Other Disciplinary Action Taken by a Federal, State or Local Licensing
Authority
A6 Violation of Federal or State Statutes, Regulations or Rules
84 Violation of State Health Code

Table 98 - Criminal Conviction or Adjudication

Code Description
19 Criminal Conviction
18 Deferred Adjudication
B1 Nolo Contendere Plea

Table 99 - Confidentiality, Consent or Disclosure Violations

Code Description
C3 Breach of Confidentiality
C2 Failure to Comply With Patient Consultation Requirements
C1 Failure to Obtain Informed Consent

Table 100 - Conflict of Interest

Code Description
71 Conflict of Interest

Table 101 - Fraud, Deception, or Misrepresentation

Code Description
E6 Failure to Disclose
E3 Filing False Reports or Falsifying Records
05 Fraud - Unspecified
E4 Fraud, Deceit or Material Omission in Obtaining License or Credentials
55 Improper or Abusive Billing Practices
E1 Insurance Fraud (Medicare, Medicaid or Other Insurance)
E5 Misleading, False or Deceptive Advertising or Marketing
E2 Providing or Ordering Unnecessary Tests or Services
56 Submitting False Claims

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Government Administrative Actions (continued)

Table 102 - Substandard Care or Patient Neglect/Abuse

Code Description
53 Failure to Provide Medically Reasonable and/or Necessary Items or Services
17 Inadequate or Improper Infection Control Practices
FA Inappropriate Refusal to Treat
FC Negligent Credentialing
F9 Patient Abandonment
14 Patient Abuse
15 Patient Neglect
F6 Substandard or Inadequate Care

Table 103 - Improper Prescribing, Dispensing, Administering Medication/Drug Violation

Code Description
H5 Error in Prescribing, Dispensing or Administering Medication
H1 Narcotics Violation or Other Violation of Drug Statutes
H4 Unauthorized Administration of Medication
H3 Unauthorized Dispensing of Medication
H2 Unauthorized Prescribing of Medication

Table 104 - Other

Code Description
99 Other - Not Classified, Specify, ___________________

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Health Plan Actions

Table 105 - Non-Compliance With Requirements

Code Description
82 Debarment From Federal or State Program
43 Employing or Contracting With Individuals or Entities Excluded From a Federal or State Health Care Program
40 Exclusion or Suspension From a Federal or State Health Care Program
31 Failure to Comply With Health and Safety Requirements
50 Failure to Maintain Adequate or Accurate Records
AC Failure to Maintain Equipment/Missing or Inadequate Equipment
45 Failure to Maintain Records or Provide Medical, Financial or Other Required Information
51 Failure to Perform Contractual Obligations
47 Failure to Take Corrective Action
34 Financial Insolvency
32 Lack of Appropriately Qualified Professionals
39 License Revocation, Suspension or Other Disciplinary Action Taken by a Federal, State or Local Licensing
Authority
A6 Violation of Federal or State Statutes, Regulations or Rules
84 Violation of State Health Code

Table 106 - Criminal Conviction or Adjudication

Code Description
19 Criminal Conviction
18 Deferred Adjudication
B1 Nolo Contendere Plea

Table 107 - Confidentiality, Consent or Disclosure Violations

Code Description
C3 Breach of Confidentiality
C2 Failure to Comply With Patient Consultation Requirements
C1 Failure to Obtain Informed Consent

Table 108 - Conflict of Interest

Code Description
71 Conflict of Interest

Table 109 - Fraud, Deception or Misrepresentation

Code Description
E6 Failure to Disclose
E3 Filing False Reports or Falsifying Records
05 Fraud - Unspecified
E4 Fraud, Deceit or Material Omission in Obtaining License or Credentials
55 Improper or Abusive Billing Practices
E1 Insurance Fraud (Medicare, Medicaid or Other Insurance)
E5 Misleading, False or Deceptive Advertising or Marketing
E2 Providing or Ordering Unnecessary Tests or Services
56 Submitting False Claims

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Health Plan Actions (continued)

Table 110 - Substandard Care or Patient Neglect/Abuse

Code Description
53 Failure to Provide Medically Reasonable and/or Necessary Items or Services
17 Inadequate or Improper Infection Control Practices
FA Inappropriate Refusal to Treat
FC Negligent Credentialing
F9 Patient Abandonment
14 Patient Abuse
15 Patient Neglect
F6 Substandard or Inadequate Care

Table 111 - Improper Prescribing, Dispensing, Administering Medication/Drug Violation

Code Description
H5 Error in Prescribing, Dispensing or Administering Medication
H1 Narcotics Violation or Other Violation of Drug Statutes
H4 Unauthorized Administration of Medication
H3 Unauthorized Dispensing of Medication
H2 Unauthorized Prescribing of Medication

Table 112 - Other

Code Description
99 Other - Not Classified, Specify, ___________________

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AAR Basis for Action Codes - Retired

Table 113 - AAR Basis for Action Codes - Retired

Code Description
22 Advertising or Marketing Services or Products That Are Discriminatory, Misleading, False, or
Deceptive
01 Alcohol and/or Other Substance Abuse
30 Allowing Unlicensed Person to Practice
52 Failure to Repay Overpayment
09 Fraud in Obtaining License or Credentials
83 Hospital Privileges Restricted, Suspended or Revoked
06 Insurance Fraud - Medicare or Other Federal Government Program
07 Insurance Fraud - Medicaid or Other State Government Program
08 Insurance Fraud - Non-Government or Private Insurance
20 Mental Disorder
03 Narcotics Violations
80 Physical Impairment
AD Surrendered Clinical Privileges
10 Unprofessional Conduct
77 Violation of Americans With Disabilities Act or Applicable Federal and State Laws
78 Violation of Civil Rights Act or Applicable Federal and State Laws
75 Violation of Drug-Free Workplace Act
74 Violation of Federal or State Antitrust Statute
76 Violation of Immigration and Nationality Act Employment Provisions

Retired codes are not available for submission on new reports but may appear on existing reports.

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AAR Basis for Finding Codes - Individual Subjects

Peer Review Organization

Table 114 - Fraud, Deception or Misrepresentation

Code Description
55 Improper or Abusive Billing Practices
56 Submitting False Claims

Table 115 - Unsafe Practice or Substandard Care

Code Description
53 Failure to Provide Medically Reasonable and/or Necessary Items or Services
54 Furnishing Unnecessary or Substandard Items or Services

Table 116 - Other

Code Description
99 Other - Not Classified, Specify, ___________________

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AAR Type of Action Codes

Table 117 - AAR Type of Action Codes

Code Type Description

1 (SL) Licensure (State State licensure actions are adverse actions taken by State licensing and
Licensure) certification authorities related to the license, certification, or registration of
health care practitioners, providers, and suppliers. State licensing actions
include State professional and health care facility licensing sanctions. State
licensing actions against physicians and dentists that are based upon the
subject's professional competence or conduct are reportable to the NPDB
under provisions of Title IV of the Health Care Quality Improvement Act of
1986, as amended, and 45 CFR Part 60. Section 1921 of the Social Security
Act 45 CFR Part 60, expands the reporting requirements of the NPDB to
include all licensure actions taken against all healthcare practitioners, as well
as healthcare entities: not just physicians and dentists. All State licensing
actions against health care practitioners, providers, and suppliers are
reportable to the NPDB under Section 1128E of the Social Security Act and
45 CFR Part 60.
2 (FL) Licensure (Federal Federal licensure actions are adverse actions taken by Federal licensing and
Licensure) certification authorities related to the license, certification, or registration of
health care providers, practitioners, and suppliers. Federal licensure actions
include Federal CLIA certification actions; Federal DEA registration actions;
and Federal FDA licensing, certification, and registration actions. These
actions are reportable to the NPDB under Section 1128E of the Social
Security Act and 45 CFR Part 60. DEA registration actions against health care
practitioners also are reportable to the NPDB under Title IV of the Health Care
Quality Improvement Act of 1986, as amended, and 45 CFR Part 60.
3 (CP) Clinical Privilege Clinical Privilege actions are adverse actions taken by hospitals and other
(Includes Panel health care entities related to the authorization of health care practitioners to
Membership) provide health care services, including actions related to a practitioner's
membership on the medical staff or panel, and based upon the subject's
professional competence or conduct. These actions are reportable to the
NPDB under Title IV of the Health Care Quality Improvement Act of 1986, as
amended, and 45 CFR Part 60.
4 (HP) Health Plan Health plan actions are adverse actions that are taken by a health plan
against a health care practitioner, provider or supplier and that are reportable
to the NPDB under Section 1128E of the Social Security Act and 45 CFR part
60. These actions must meet the regulatory definition of "other adjudicated
actions," which requires that they: 1) be formal or official actions; 2) include
the availability of a due process mechanism; and 3) be based on acts or
omissions that affect or could affect the payment, provision or delivery of a
health care item or service. The definition specifically excludes clinical
privileging actions or paneling decisions (which normally are the result of a
formal peer review process). However, quality actions that include the
availability of due process are reportable. An example of a reportable health
plan action would be the termination of a practitioner's contract to provide
health care services, as long as it meets the three specified criteria.

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Code Type Description
5 (ED) Exclusion or The exclusion or debarment of a health care practitioner, provider, or supplier
Debarment from participating in and/or contracting with a Federal or State health care
program is reportable to the NPDB under Section 1128E of the Social
Security Act and 45 CFR Part 60. Exclusion of a practitioner from the
Medicare and Medicaid programs is reportable to the NPDB under a
Memorandum of Understanding with the Office of Inspector General, and the
Centers for Medicare & Medicaid Services, U.S. Department of Health and
Human Services.
6 (PS) Professional Society Professional Society actions are adverse actions taken by associations of
health care practitioners that follow formal peer review processes for the
purpose of furthering quality health care and that are based upon the subject's
professional competence or conduct. These actions are reportable to the
NPDB under the provisions of Title IV of the Health Care Quality Improvement
Act of 1986, as amended, and 45 CFR Part 60.
7 (PR) Peer Review Peer review organization actions include any recommendation by a peer
Organization review organization to sanction a health care practitioner. These actions are
reportable to the NPDB under the provisions of Section 1921 of the Social
Security Act and 45 CFR Part 60.
8 (AC) Accreditation Private accreditation organization actions include final determinations of
denial or termination of an accreditation status from a private accreditation
entity that indicates a risk to the safety of a patient(s) or quality of health care
services. These actions are taken against health care entities that have
received or are attempting to receive accreditation. These actions are
reportable to the NPDB under the provisions of 45 CFR Part 60.
9 (GA) Government Government Administrative actions are reportable to the NPDB under Section
Administrative 1921 of the Social Security Act, and Section 1128E of the Social Security Act
and 45 CFR Part 60. State actions are reportable under Section 1921 of the
Social Security Act and Federal actions are reportable under Section 1128E
of the Social Security Act. They encompass adverse actions reportable to
NPDB that are not classified elsewhere. This category includes any publicly
available negative action or finding by Government agencies (Federal or
State) that certify health care practitioners, providers, and suppliers for
participation in a Government health care program. In addition, other
Government Administrative actions include any other adjudicated action or
decision by an authorized Government agency (Federal or State) against a
health care practitioner, provider, or supplier. These adjudicated actions or
decisions may include, for example, personnel actions, employment
disqualifications, and contract terminations.

AAR Type of Action Codes (Old Format)

Table 118 - AAR Type of Action Codes (Old Format)

Code Type
L Licensure
C Clinical Privileges
S Society Membership

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AAR Automatic Reinstatement Codes

Table 119 - AAR Automatic Reinstatement Codes

Code Description

Y Reinstatement is automatic at completion of adverse action period.

N Reinstatement is not automatic.

C Reinstatement is automatic, with conditions.

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Nature of Relationship Codes

Individual Subjects

Table 120 - Individual Subjects

Code Description
100 Subject is Owner/Partner of Affiliate or Associate
150 Subject is Manager/Supervisor/Director of Affiliate or Associate
200 Subject is Employee of Affiliate or Associate
250 Subject is Contractor to Affiliate or Associate
300 Subject is Member of Affiliate or Associate’s Network
350 Subject has Clinical Privileges With Affiliate or Associate
400 Subject is Supplier to Affiliate or Associate
450 Subject is Customer of Affiliate or Associate
700 Subject is in Joint Venture With Affiliate or Associate
999 Other Relationship - Not Classified, Specify, ____________________

Organization Subjects

Table 121 - Organization Subjects

Code Description
250 Subject is Contractor to Affiliate or Associate
300 Subject is Member of Affiliate or Associate’s Network
400 Subject is Supplier to Affiliate or Associate
450 Subject is Customer of Affiliate or Associate
500 Subject is Parent Organization of Affiliate or Associate
600 Subject is Subsidiary of Affiliate or Associate
700 Subject is in Joint Venture With Affiliate or Associate
999 Other Relationship - Not Classified, Specify, ____________________

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JOCR Act or Omission Codes

Table 122 - JOCR Act or Omission Codes

Code Description
200 Fraudulent Billing/Cost Reporting
205 Billing for Services Not Rendered/Supplies Not Provided
207 Misrepresentation of Services/ Supplies Provided
210 Duplicate Billing
220 Unbundling of Services
222 Upcoding of Services
230 Fraudulent Cost Reporting
240 Medicare/Medicaid Secondary Payor Fraud
250 Submitting Claims After Sanctions
260 Overcharging
270 Failure to Pay Non-Assigned Claim
300 Patient Abuse
305 Theft or Misappropriation of Patient Property
310 Billing for Medically Unnecessary Services
320 Poor Quality of Care
350 Failure to Provide Medically Necessary Care
400 Licensed Practitioner Impersonation/ Allowing Unlicensed Persons to Practice
500 Procurement Fraud
525 Research Fraud
550 Medical Record Falsification
551 Creating Medical Record for Patient Who Does Not Exist
552 Alteration/Misrepresentation of Medical Record
600 Anti-Competition Violation/Deceptive Advertising
700 Controlled Substances Violation
710 Mislabeling Drugs
720 Generic Substitutions
730 Prescription Splitting
735 Prescription Shorting
740 Drug Diversion
750 Forged/Altered Prescription Drugs
760 Illegal Prescription of Controlled Substance
770 Counterfeiting Drugs
780 Illegal Drug Use/Possession
790 Illegal Drug Trafficking
810 Kickbacks
820 Self-Referral Violations
999 Other Act/Omission - Not Classified, Specify, ___________________

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JOCR Type of Action Codes

Table 123 - JOCR Type of Action Codes

Code Type Description

10 Criminal Conviction Federal or State criminal convictions against health care
(Guilty Plea or Trial) practitioners, providers, and suppliers. Convictions must be
related to the delivery of a health care item or service.
Convictions include guilty pleas and findings of guilt by either
a judge or a jury. These actions are reportable to the HIPDB
under Section 1128E of the Social Security Act and 45 CFR
Part 61.
20 Deferred Conviction/Pre- Federal or State court actions in which a healthcare
Trial Diversion practitioner, provider, or supplier has entered into participation
in a first offender, or other program or arrangement where the
conviction has been deferred or held in abeyance. These
actions must be related to the delivery of a health care item or
service. These actions are reportable to the HIPDB under
Section 1128E of the Social Security Act and 45 CFR Part 61.
30 Nolo Contendere (No Acceptance by a Federal or State court of a nolo contendere or
Contest) Plea no contest plea by a health care practitioner, provider, or
supplier in a matter related to the delivery of a health care item
or service. These actions are reportable to the HIPDB under
Section 1128E of the Social Security Act and 45 CFR Part 61.
40 Civil Judgment Civil judgments against health care practitioners, providers,
and suppliers in Federal or State courts. Judgments must be
related to the delivery of a health care item or service. This
reporting requirement does not include settlements in which no
findings of liability have been made. These actions are
reportable to the HIPDB under Section 1128E of the Social
Security Act and 45 CFR Part 61.
50 Injunction Civil actions taken against health care practitioners, providers,
and suppliers that seek to stop a specific activity, such as the
continued production or distribution of a violative product or the
provision of a service. The action must be related to the
delivery of a health care item or service. These actions are
reportable to the HIPDB under Section 1128E of the Social
Security Act and 45 CFR Part 61.

JOCR Jurisdiction Codes

Table 124 - JOCR Jurisdiction Codes

Code Type
S State/Local Court
F Federal Court

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MMPR Act or Omission Codes (Old Format MMPR)

1
(For Initial Reports submitted through January 30, 2004 using an earlier reporting format)
Table 125 - Diagnosis Table 129 - Intravenous and Blood Products
Code Description Code Description
010 Failure to Diagnose (i.e., Concluding That Patient Has 410 Failure to Monitor
No Disease or Condition Worthy of Follow-Up or 420 Wrong Solution
Observation) 430 Improper Performance
020 Wrong Diagnosis or Misdiagnosis (i.e., Original 440 IV Related-Not Otherwise Classified
Diagnosis is Incorrect) 450 Failure to Ensure Contamination Free
030 Improper Performance of Test 460 Wrong Type
040 Unnecessary Diagnostic Test 470 Improper Administration
050 Delay in Diagnosis 480 Failure to Obtain Consent/Lack of Informed Consent
060 Failure to Obtain Consent/Lack of Informed Consent 490 Blood Product Related-Not Otherwise Classified
090 Diagnosis Related-Not Otherwise Classified

Table 130 - Obstetrics

Table 126 - Anesthesia
Code Description
Code Description 505 Failure to Manage Pregnancy
110 Failure to Complete Patient Assessment 510 Improper Choice of Delivery Method
120 Failure to Monitor 520 Improperly Performed Vaginal Delivery
130 Failure to Test Equipment 525 Improperly Performed C-Section
140 Improper Choice of Anesthesia Agent or Equipment 530 Delay in Delivery (Induction or Surgery)
150 Improper Technique/Induction 540 Failure to Obtain Consent/Lack of Informed Consent
160 Improper Equipment Use 550 Improperly Managed Labor-Not Otherwise Classified
170 Improper Intubation 555 Failure to Identify/Treat Fetal Distress
180 Improper Positioning 560 Delay in Treatment of Fetal Distress (i.e., Identified but
185 Failure to Obtain Consent/Lack of Informed Consent Treated in Untimely Manner)
190 Anesthesia Related-Not Otherwise Classified 570 Retained Foreign Body/Vaginal/Uterine
575 Abandonment
580 Wrongful Life/Birth
Table 127 - Surgery 590 Obstetrics Related-Not Otherwise Classified
Code Description
210 Failure to Perform Surgery
Table 131 - Treatment
220 Improper Positioning
230 Retained Foreign Body Code Description
240 Wrong Body Part 610 Failure to Treat
250 Improper Performance of Surgery 620 Wrong Treatment/Procedure Performed
260 Unnecessary Surgery 630 Failure to Instruct Patient on Self-Care
270 Delay in Surgery 640 Improper Performance of Treatment/Procedure
280 Improper Management of Surgical Patient 650 Improper Management of Course of Treatment
285 Failure to Obtain Consent/Lack of Informed Consent 660 Unnecessary Treatment
290 Surgery Related-Not Otherwise Classified 665 Delay in Treatment
670 Premature End of Treatment (Also Abandonment)
675 Failure to Supervise Treatment/Procedure
Table 128 - Medication 680 Failure to Obtain Consent/Lack of Informed Consent
Code Description 685 Failure to Refer or Seek Consultation
305 Failure to Order Appropriate Medication 690 Treatment Related-Not Otherwise Classified
310 Wrong Medication Ordered
315 Wrong Dosage Ordered of Correct Medication
Table 132 - Monitoring
320 Failure to Instruct on Medication
325 Improper Management of Medication Regimen Code Description
330 Failure to Obtain Consent/Lack of Informed Consent 710 Failure to Monitor
340 Medication Error-Not Otherwise Classified 720 Failure to Respond to Patient
350 Failure to Medicate 730 Failure to Report on Patient Condition
355 Wrong Medication Administered 790 Monitoring Related-Not Otherwise Classified
360 Wrong Dosage Administered
365 Wrong Patient
370 Wrong Route
380 Improper Technique
390 Medication Administration Related-Not Otherwise
Classified

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Table 133 - Biomedical Equipment/Product Table 134 - Miscellaneous

Code Description Code Description
810 Failure to Inspect/Monitor 910 Inappropriate Behavior of Clinician (e.g., Sexual
820 Improper Maintenance Misconduct Allegation, Assault)
830 Improper Use 920 Failure to Protect Third Parties (e.g., Failure to
840 Failure to Respond to Warning Warn/Protect From Violent Patient Behavior)
850 Failure to Instruct Patient on Use of Equipment/Product 930 Breach of Confidentiality/Privacy
860 Malfunction/Failure 940 Failure to Maintain Appropriate Infection Control
890 Biomedical Equipment/Product Related-Not Otherwise 950 Failure to Follow Institutional Policy or Procedure
Classified 960 Other (Provide Detailed Description)
990 Failure to Review Provider Performance

1
Codes other than those listed above may be returned to the user. These additional codes are no longer
accepted by the NPDB and should be interpreted as ‘UNKNOWN’.

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MMPR Nature of Allegation Codes

Table 135 - MMPR Nature of Allegation Codes

Code Description
001 Diagnosis Related
010 Anesthesia Related
020 Surgery Related
030 Medication Related
040 IV & Blood Products Related
050 Obstetrics Related
060 Treatment Related
070 Monitoring Related
080 Equipment/Product Related
090 Other Miscellaneous
100 Behavioral Health Related

MMPR Report Type Codes

Table 136 - MMPR Report Type Codes

Code Description
I Initial
C Correction

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MMPR Outcome Codes

Table 137 - MMPR Outcome Codes

Code Description
01 Emotional injury only
02 Insignificant injury
03 Minor temporary injury
04 Major temporary injury
05 Minor permanent injury
06 Significant permanent injury
07 Major permanent injury
08 Grave Permanent Injury, such as quadriplegic or brain damage,
requiring lifelong dependent care
09 Death
10 Cannot be determined from available records

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MMPR Specific Allegation Codes

Code Description
Table 138 - Failure to Take Appropriate Action 332 Wrong Equipment
Code Description 333 Wrong Patient
100 Failure to Use Aseptic Technique 334 Wrong Procedure or Treatment
101 Failure to Diagnose Table 141 - Unnecessary/Contraindicated Procedure
102 Failure to Delay a Case When Indicated
103 Failure to Identify Fetal Distress Code Description
104 Failure to Treat Fetal Distress 400 Contraindicated Procedure
105 Failure to Medicate 401 Surgical or Procedural Clearance Contraindicated
106 Failure to Monitor 402 Unnecessary Procedure
107 Failure to Order Appropriate Medication 403 Unnecessary Test
108 Failure to Order Appropriate Test 404 Unnecessary Treatment
109 Failure to Perform Preoperative Evaluation
110 Failure to Perform Procedure
111 Failure to Perform Resuscitation Table 142 - Communication/Supervision
112 Failure to Recognize a Complication Code Description
113 Failure to Treat 500 Communication Problem Between Practitioners
501 Failure to Instruct or Communicate with Patient or
Table 139 - Delay In Performance Family
502 Failure to Report on Patient Condition
Code Description 503 Failure to Respond to Patient
200 Delay in Diagnosis 504 Failure to Supervise
201 Delay in Performance 505 Improper Supervision
202 Delay in Treatment
203 Delay in Treatment of Identified Fetal Distress
Table 143 - Continuity of Care/Care Management

Table 140 - Error/Improper Performance Code Description

600 Failure/Delay in Admission to Hospital or Institution
Code Description 601 Failure/Delay in Referral or Consultation
300 Administration of Blood or Fluids Problem 602 Premature Discharge from Institution
301 Agent Use or Selection Error 603 Altered, Misplaced or Prematurely Destroyed Records
302 Complementary or Alternative Medication Problem
303 Equipment Utilization Problem
304 Improper Choice of Delivery Method Table 144 - Behavior/Legal
305 Improper Management Code Description
306 Improper Performance 700 Abandonment
307 Improperly Performed C-Section 701 Assault and Battery
308 Improperly Performed Vaginal Delivery 702 Breach of Contract or Warranty
309 Improperly Performed Resuscitation 703 Breach of Patient Confidentiality
310 Improperly Performed Test 704 Equipment Malfunction
311 Improper Technique 705 Failure to Conform with Regulation, Statute, or Rule
312 Intubation Problem 706 Failure to Ensure Patient Safety
313 Laboratory Error 707 Failure to Obtain Consent or Lack of Informed Consent
314 Pathology Error 708 Failure to Protect a Third Party
315 Medication Administered via Wrong Route 709 Failure to Test Equipment
316 Patient History, Exam, or Workup Problem 710 False Imprisonment
317 Problems With Patient Monitoring in Recovery 711 Improper Conduct
318 Patient Monitoring Problem 712 Inadequate Utilization Review
319 Patient Positioning Problem 713 Negligent Credentialing
320 Problem with Appliance, Prostheses, Orthotic, 714 Practitioner with Communicable Disease
Restorative, Splint, Device, etc. 715 Product Liability
321 Radiology or Imaging Error 716 Religious Issues
322 Surgical or Other Foreign Body Retained 717 Sexual Misconduct
323 Wrong Diagnosis or Misdiagnosis 718 Third Party Claimant
324 Wrong Dosage Administered 719 Vicarious Liability
325 Wrong Dosage Dispensed 720 Wrongful Life/Birth
326 Wrong Dosage Ordered of Correct Medication
327 Wrong Medication Administered
328 Wrong Medication Dispensed
329 Wrong Medication Ordered
330 Wrong Body Part
331 Wrong Blood Type

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Table 145 - Other
These codes were adapted from code lists developed
Code Description
by The Risk Management Foundation of the Harvard
899 Cannot Be Determined from Available Records
999 Allegation - Not Otherwise Classified,
Medical Institutions and the Physician Insurers
Specify___________________________ Association of America.

MMPR Relationship of Entity Codes

Table 146 - MMPR Relationship of Entity Codes

Code Description

P Insurance company – Primary Insurer

E Insurance company – Excess Insurer

S Self-Insured Organization

G Insurance Guaranty Fund

M State Medical Malpractice Payment Fund as the Primary Payer for This Practitioner

O State Medical Malpractice Payment Fund as a Secondary Payer for This Practitioner

MMPR Relationship of Entity Codes (Old Format)

Table 147 - MMPR Relationship of Entity Codes (Old Format)

Code Description

I Insurance company

S Self-Insured Organization

O Other – Guaranty Fund

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MMPR Payment Result Of Codes

Table 148 - MMPR Payment Result Of Codes

Code Description

J Judgment

S Settlement

B Payment Prior to Settlement

O Other

MMPR Payment Result Of Codes (Old Format)

Table 149 - MMPR Payment Result Of Codes (Old Format)

Code Description

J Judgment

S Settlement

B Payment Prior to Settlement

U Unknown

O Other

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MMPR Payment Type Codes

Table 150 - MMPR Payment Type Codes

Code Description

S A Single Final Payment

M One of Multiple Payments

U Unknown Payment Type (Responses only - do not submit reports with this payment type)

MMPR Patient Type Codes

Table 151 - MMPR Patient Type Codes

Code Description

I Inpatient

O Outpatient

B Both

U Unknown

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Report Transaction Type Codes

Table 152 - Report Transaction Type Codes

Code Description

I Initial: The first record of an adverse action that is submitted to and processed by the NPDB. An
Initial Report is the current version of the report until a Revision to Action, Correction, Void, or
Notice of Appeal is submitted.

C Correction: A report that corrects an error or omission in an existing report. The Correction will
supersede the contents of the current version of a report in the NPDB. It should be submitted
as soon as possible after a reporting error or omission is discovered. Corrections may be
submitted as often as necessary.

V Void: The retraction of a report in its entirety from the NPDB. The report is removed from the
subject’s disclosable record.

R Revision to Action: A new action that relates to and modifies a previously reported adverse
action, (e.g., reinstatement of a license, extension of an exclusion from a Government program,
restrictions of clinical privileges lifted, previously stayed license revocation imposed). A
correction of a Revision to Action Report may be submitted via the IQRS or QRXS

O Correction of Revision to Action: A report that corrects a previously submitted Revision to

Action Report. This correction will supersede the contents of the current version of the Revision
to Action Report in the NPDB. It should be submitted as soon as possible after a reporting error
or omission is discovered. Corrections may be submitted as often as necessary.

A Notice of Appeal: A report notifying the NPDB that a subject has formally appealed a previously
reported adverse action. Under Section 1921 and Section 1128E, reporting entities must submit
a Notice of Appeal whenever a previously reported adverse action is on appeal. A Notice of
Appeal is separate and distinct from a subject's dispute of an NPDB report. There is no legal
requirement for this type of report to be submitted to the NPDB under Title IV.

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Void Reason Codes

Table 153 - Void Reason Codes

Code Description
V0 The report was erroneously submitted (e.g., wrong practitioner named;
duplicate report, payment not delivered; action never finalized).
V1 The report was not required to be filed; the action does not meet the legal
reporting criteria.
V2 The action was reversed because the original action should never have been
taken (e.g., overturned on appeal).

Subject Source Codes

Table 154 - Subject Source Codes

Code Description
Q You received the previous version of this report via a query.
R Your entity submitted the previous version of this report.
P You received the previous version of this report via a Continuous Query
enrollment that has since been canceled.

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Transaction Codes

Table 155 - Transaction Codes

Code Description
PE Continuous Query Enrollment
PU Continuous Query Update
PN Continuous Query Renewal
PC Continuous Query Cancellation
PI Continuous Query Status Request
PD Continuous Query Report Disclosure
1L Single Query - Individual Subject
1C Single Query - Organization Subject
1A Multiple-Name Query - Individual Subject
1J Multiple-Name Query - Organization Subject
A2 AAR Initial Report
A4 AAR Correction Report
A5 AAR Void Report - Organization Subject
A6 AAR Void Report - Individual Subject
A7 AAR Revision to Action Report
A8 AAR Notice of Appeal - Organization Subject
A9 AAR Notice of Appeal - Individual Subject
J2 JOCR Initial Report
J4 JOCR Correction Report
J5 JOCR Void Report - Organization Subject
J6 JOCR Void Report - Individual Subject
J7 JOCR Revision to Action Report
J8 JOCR Notice of Appeal - Organization Subject
J9 JOCR Notice of Appeal - Individual Subject
M2 MMPR Initial Report
M4 MMPR Correction Report
M6 MMPR Void Report
90 User Account Password Change
91 User Account Password Reset (Only Permitted By Entity Administrator)
DB Data Bank Correspondence

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Query Purpose Codes

Table 156 - Query Purpose Codes

Code Description
P Privileging or Employment
R Professional Review
M Mandatory Two-Year Review (For Use by Hospitals)
S Licensing
F Fraud and Abuse Investigation
G Certification to Participate in a Government Program
I Claims Processing

Continuous Query Enrollment Purpose Codes

Table 157 - Continuous Query Enrollment Purpose Codes

Code Description
P Privileging or Employment
R Professional Review
M Mandatory Two-Year Review
S Licensing
F Fraud and Abuse Investigation
G Certification to Participate in a Government Program
I Claims Processing

Continuous Query Enrollment Status Codes

Table 158 - Continuous Query Enrollment Status Codes

Code Description
E Enrolled
N Not Enrolled
S Suspended
C Previously Enrolled
P Pending

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Continuous Query Report Disclosure Reason Codes

Table 159 - Continuous Query Report Disclosure Reason Codes

Code Description
IR The reporting entity identified in this disclosure has submitted Initial Report {1}.
RR The reporting entity identified in this disclosure has submitted Revision to Action Report {1}.
CR The reporting entity identified in this disclosure has submitted correction(s) to report {1}.
CA The reporting entity identified in this disclosure has submitted correction(s) to report {1}.
DA The subject of report {1} has filed a dispute with the NPDB concerning information contained in
the report. The reporting entity identified in this disclosure and the subject of the report are
responsible for settling the dispute.
DW The subject of report {1} has withdrawn the dispute originally associated with this report.
SA The subject of report {1} has added a statement to the report to explain or comment on the
action reported.
SW The subject of report {1} has withdrawn the statement previously associated with this report.
NA The reporting entity identified in this disclosure has indicated that the action described in report
{1} is being appealed.
RE The subject of report {1} has requested that this dispute be reviewed by the Secretary of the
U.S. Department of Health and Human Services.
RW The subject of report {1} has withdrawn the request for review of this dispute by the Secretary of
the U.S. Department of Health and Human Services.
RD The Secretary of the U.S. Department of Health and Human Services has reviewed the facts of
the dispute and has made a determination regarding report {1}.
VR Report {1} and all information in it have been expunged from the NPDB and should not be used.
Please destroy all copies of this report.
OC On behalf of the reporting entity identified in this disclosure, the NPDB corrected report {1}. The
following data fields have been modified: {2}.
OA On behalf of the reporting entity identified in this disclosure, the NPDB corrected report {1}. The
following data fields have been modified: {2}.
RC On behalf of the reporting entity identified in this disclosure, the NPDB corrected report {1} as
directed by the Secretary of the U.S. Department of Health and Human Services. For further
information, see the Secretary’s comments included in this disclosure.
RA On behalf of the reporting entity identified in this disclosure, the NPDB corrected report {1} as
directed by the Secretary of the U.S. Department of Health and Human Services. For further
information, see the Secretary’s comments included in this disclosure.
OV On behalf of the reporting entity identified in this disclosure, the NPDB voided report {1}
because it was determined to be a duplicate report. Please destroy all copies of report {1}. The
original report remains in the NPDB.

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Code Description
RV On behalf of the reporting entity identified in this disclosure, the NPDB voided report {1} as
directed by the Secretary of the U.S. Department of Health and Human Services. The
referenced report and all information in it have been expunged from the NPDB and should not
be used. Please destroy all copies of this report.
BI Correction Report {1} should have been submitted as a Revision to Action since it modifies a
previously reported action. To correct this, the NPDB, on behalf of the reporting entity identified
in this disclosure, have re−submitted the original or previous Initial Report as {2}. Additionally,
the Correction Report {1} has been voided and re−submitted as Revision to Action {3}. Please
destroy all copies of report {1}.
BV Correction Report {1} should have been submitted as a Revision to Action since it modifies a
previously reported action. To correct this, the NPDB, on behalf of the reporting entity identified
in this disclosure, have re−submitted the original or previous Initial Report as {2}. Additionally,
the Correction Report {1} has been voided and re−submitted as Revision to Action {3}. Please
destroy all copies of report {1}.
BR Correction Report {1} should have been submitted as a Revision to Action since it modifies a
previously reported action. To correct this, the NPDB, on behalf of the reporting entity identified
in this disclosure, have re−submitted the original or previous Initial Report as {2}. Additionally,
the Correction Report {1} has been voided and re−submitted as Revision to Action {3}. Please
destroy all copies of report {1}.
AV On behalf of the reporting entity identified in this disclosure, the NPDB converted report {1} to
Revision to Action Report {2}. This action should have been reported as a Revision to Action
since it modifies the previously reported action {3}. Please destroy all copies of report {1}.
AR On behalf of the reporting entity identified in this disclosure, the NPDB converted report {1} to
Revision to Action Report {2}. This action should have been reported as a Revision to Action
since it modifies the previously reported action {3}. Please destroy all copies of report {1}.
NM Report {1} no longer matches the enrolled subject profile for {2}. Please disregard and destroy
all previous versions of this report and any copies.
ND Report {1} is no longer disclosable to your entity. Please disregard and destroy all previous
versions of this report and any copies.
EC Initial Enrollment Disclosure
UC Enrollment Update Disclosure
RQ At the request of the subject, report {1} was reviewed by the Secretary of the U.S. Department
of Health and Human Services and a decision was reached. The subject has requested that the
Secretary reconsider the original decision.
Note(s):
The descriptions listed herein contain placeholder references ({1}, {2}, and {3}) and each will be replaced with an
actual report DCN when a notification is generated by the NPDB.

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Occupation/Field of Licensure Codes

Table 160 – Physician Table 165 – Behavioral Health Occupations
Code Description Code Description
010 Physician (MD) 621 Counselor, Mental Health
015 Physician Resident (MD) 651 Professional Counselor
020 Osteopathic Physician (DO) 660 Addictions Counselor
025 Osteopathic Physician Resident (DO) 652 Sex Offender Counselor
653 Pastoral Counselor
661 Marriage and Family Therapist
662 Art Therapist
Table 161 – Nurse – Advanced, Registered, Vocational 664 Recreation Therapist
or Practical 665 Dance Therapist
Code Description 667 Music Therapist
100 Registered Nurse 668 Other Behavioral Health Occupation - Not
110 Nurse Anesthetist Classified, Specify, __________
120 Nurse Midwife
130 Nurse Practitioner Table 166 – Dietitian/Nutritionist
140 Licensed Practical or Vocational Nurse
141 Clinical Nurse Specialist Code Description
142 Other Nurse Occupation - Not Classified, Specify, 200 Dietitian
__________ 210 Nutritionist
211 Other Dietitian/Nutritionist Occupation - Not
Classified, Specify, __________
Table 162 – Nurse Aide, Home Health Aide and Other
Aide
Code Description Table 167 – Emergency Medical Technician (EMT)
150 Nurse Aide/Nursing Assistant
160 Home Health Aide (Homemaker) Code Description
165 Health Care Aide/Direct Care Worker 240 Emergency Medical Responder
175 Certified or Qualified Medication Aide 250 Emergency Medical Technician
176 Other Aide Occupation - Not Classified, Specify, 270 Emergency Medical Technician, Advanced
__________ 280 Paramedic
281 Other Emergency Medical Technician - Not
Classified, Specify, __________
Table 163 – Dental Service Practitioner
Code Description Table 168 – Eye and Vision Service Practitioner
030 Dentist
035 Dental Resident Code Description
606 Dental Assistant 630 Ocularist
607 Dental Therapist/Dental Health Aide 633 Optician
609 Dental Hygienist 636 Optometrist
612 Denturist 637 Other Eye and Vision Service Occupation - Not
613 Other Dental Occupation - Not Classified, Specify, Classified, Specify, __________
__________
Table 169 – Pharmacy Service Practitioner
Table 164 – Chiropractor Code Description
Code Description 050 Pharmacist
603 Chiropractor 055 Pharmacy Intern
604 Chiropractic Assistant 070 Pharmacy Assistant
605 Other Chiropractic Occupation - Not Classified, 075 Pharmacy Technician
Specify, __________ 076 Other Pharmacy Service Occupation - Not
Classified, Specify, __________

Table 170 – Physician Assistant

Code Description
642 Physician Assistant

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Table 176 – Technologist/Technician
Table 171 – Podiatric Service Practitioner
Code Description
Code Description 501 Medical or Clinical Lab Technician/Technologist
350 Podiatrist 503 Surgical Technologist/Assistant
648 Podiatric Assistant 505 Cytotechnologist
649 Other Podiatric Service Occupation - Not Classified, 510 Nuclear Medicine Technologist
Specify, __________ 520 Radiation Therapy Technologist
530 Radiologic Technician/Technologist
551 Other Technologist/Technician - Not Classified,
Specify, __________
Table 172 – Psychologist/Psychological Assistant
Code Description
371 Psychologist
Table 177 – Other Health Care Practitioner
372 School Psychologist Code Description
373 Psychological Assistant, Associate, Examiner 600 Acupuncturist
374 Other Psychologist/Psychological Assistant 601 Athletic Trainer
Occupation - Not Classified, Specify, __________ 615 Homeopath
618 Medical Assistant
624 Midwife, Lay (Non-Nurse)
Table 173 – Rehabilitative, Respiratory and Restorative 627 Naturopath
639 Orthotics/Prosthetics Fitter
Service Practitioner
647 Perfusionist
Code Description 170 Psychiatric Technician
405 Massage Therapist 699 Other Health Care Practitioner - Not Classified,
410 Occupational Therapist Specify, __________
420 Occupational Therapy Assistant
430 Physical Therapist 1
Table 178 – Health Care Facility Administrator
440 Physical Therapy Assistant
450 Rehabilitation Therapist Code Description
663 Respiratory Therapist 758 Health Care Facility Administrator
666 Respiratory Therapy Technician
658 Other Rehabilitative, Respiratory and Restorative 1
Service Occupation - Not Classified, Specify, Table 179 – Other Occupation
__________
Code Description
850 Accountant
Table 174 – Social Worker 853 Bookkeeper
822 Business Manager
Code Description 830 Business Owner
300 Social Worker 820 Corporate Officer
810 Insurance Agent/Broker
Table 175 – Speech, Language and Hearing Service 800 Researcher, Clinical
840 Salesperson
Practitioner
899 Other Occupation - Not Classified, Specify,
Code Description __________
400 Audiologist
1
460 Speech/Language Pathologist Health Care Facility Administrator and Other
470 Hearing Aid (or Instrument) Specialist, Dealer, Occupation codes are not available for Clinical
Dispenser or Fitter Privilege and Professional Society actions and Peer
471 Other Speech, Language and Hearing Service Review Organization findings.
Occupation - Not Classified, Specify, __________

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Occupation/Field of Licensure Codes – Retired

Table 180 – Occupation/Field of Licensure Codes – Retired

Code Description
060 Pharmacist, Nuclear
134 Doctor of Nursing Practice
135 Advanced Practice Nurse
148 Certified Nurse Aide/Certified Nursing Assistant
260 EMT, Cardiac/Critical Care
370 Psychologist, Clinical
402 Art/Recreation Therapist
500 Medical Technologist
502 Medical or Clinical Laboratory Technician
504 Surgical Assistant
540 X-Ray Technician or Operator
550 Limited X-Ray Machine Operator (LXMO)
645 Physician Assistant, Osteopathic
654 Professional Counselor, Alcohol
657 Professional Counselor, Family/Marriage
752 Adult Care Facility Administrator
755 Hospital Administrator
759 Assisted Living Facility Administrator
812 Insurance Broker

Retired Codes are not available for submission on new reports or queries but may appear on existing reports.

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Specialty Codes

Table 181 - Physician Specialties Table 182 - Dental Specialties

Code Description Code Description
01 Allergy and Immunology D1 General Dentistry (No Specialty)
03 Aerospace Medicine D2 Dental: Public Health
05 Anesthesiology D3 Endodontics
10 Cardiovascular Diseases D4 Oral and Maxillofacial Surgery
13 Child Psychiatry D5 Oral and Maxillofacial Pathology
20 Dermatology D6 Orthodontics and Dentofacial Orthopedics
23 Diagnostic Radiology D7 Pediatric Dentistry
25 Emergency Medicine D8 Periodontics
29 Forensic Pathology D9 Prosthodontics
30 Gastroenterology DA Oral and Maxillofacial Radiology
33 General Practice/Family Practice DB Unknown
35 General Preventive Medicine
37 Hospitalist
39 Internal Medicine
40 Neurology
43 Neurology, Clinical Neurophysiology
45 Nuclear Medicine
50 Obstetrics & Gynecology
53 Occupational Medicine
55 Ophthalmology
59 Otolaryngology
60 Pediatrics
63 Psychiatry
65 Public Health
67 Clinical Pharmacology
69 Physical Medicine & Rehabilitation
70 Pulmonary Diseases
73 Anatomic/Clinical Pathology
75 Radiology
76 Radiation Oncology
80 Colon and Rectal Surgery
81 General Surgery
82 Neurological Surgery
83 Orthopedic Surgery
84 Plastic Surgery
85 Thoracic Surgery
86 Urological Surgery
98 Other Specialty - Not Classified
99 Unspecified

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Entity Status Codes

Table 183 - Entity Status Codes

Code Type Description

A Original Reporting Entity The entity that filed the report may have changed its name or address
is Active on file with the NPDB. The most recent entity contact information
reported to the NPDB and the date on which it was reported is
provided.
S Original Reporting Entity The entity that filed the report is no longer an active registrant with the
is Inactive but has a NPDB. The most recent information for the registered successor
Successor entity is provided.
D Original Reporting Entity The entity that filed the report is no longer an active registrant with the
is Inactive with no NPDB. The most recent entity contact information reported to the
Successor NPDB and the date on which it was reported is provided. The NPDB
have no additional information regarding this entity.
N Original Reporting Entity The entity that filed the report is no longer an active registrant with the
is Inactive and its NPDB. The most recent information for the registered successor
Successor is Inactive entity is provided, but that entity is also no longer an active registrant
with the NPDB. The NPDB has no additional information regarding
this entity.

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State Abbreviations and U.S. Territories

Table 184 – States
Code Description Code Description Code Description
AL Alabama MS Mississippi WV West Virginia
AK Alaska MO Missouri WI Wisconsin
AZ Arizona MT Montana WY Wyoming
AR Arkansas NE Nebraska
CA California NV Nevada
CO Colorado NH New Hampshire
CT Connecticut NJ New Jersey Table 185 - Territories
DE Delaware NM New Mexico Code Description
DC District of Columbia NY New York AS American Samoa
FL Florida NC North Carolina FM Federated States of Micronesia
GA Georgia ND North Dakota GU Guam
HI Hawaii OH Ohio MP Northern Marianas
ID Idaho OK Oklahoma PW Palau
IL Illinois OR Oregon PR Puerto Rico
IN Indiana PA Pennsylvania VI Virgin Islands
IA Iowa RI Rhode Island
KS Kansas SC South Carolina
KY Kentucky SD South Dakota
LA Louisiana TN Tennessee Table 186 - Armed Forces
ME Maine TX Texas
Code Description
MD Maryland UT Utah
AA Central and South America
MA Massachusetts VT Vermont
AE Europe
MI Michigan VA Virginia
AP Pacific
MN Minnesota WA Washington

Please adhere to the following guidelines when entering foreign or military addresses:

Addresses for United States Territories:

● Enter Territory abbreviation in "State" field.

Addresses outside the United States or its territories:

● Leave the "State" field blank.
● Enter the city and/or province in the "City" field.
● Enter the Country Code in the "ZIP" fields - maximum 5 characters in first field, maximum 4 characters in the second field.
● Enter the country in the "Country" field.

Military Addresses:
● Enter APO in the "City" field.
● Enter AE, AA in the "State" field.
● Enter the ZIP code in the "ZIP" field.

Following State Codes are not valid for State of Licensure:

● AA Central and South America (Armed Forces)
● AE Europe (Armed Forces)
● AP Pacific (Armed Forces)

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APO/FPO Postal Codes

Table 187 - AE - Europe

First 3 digits of ZIP Code Geographic Area
090-092 Germany
094 United Kingdom
095 Atlantic Ocean/ Mediterranean Sea Ships
096 Italy, Spain
097 Other Europe
098 Middle East, Africa

Table 188 - AA - Americas

First 3 digits of ZIP Code Geographic Area
340 Central, South Americas

Table 189 - AP - Pacific

First 3 digits of ZIP Code Geographic Area
962 Korea
963 Japan
964 Philippines
965 Other Pacific and Alaska
966 Pacific and Indian Ocean Ships

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Type of Organization Codes

Table 190 - Group or Practice Table 199 - Health Insurance Company/Provider

Code Description Code Description
361 Chiropractic Group/Practice 320 Health Insurance Company/Provider
362 Dental Group/Practice
365 Medical Group/Practice
366 Mental Health/Substance Abuse Group/Practice Table 200 - Other Health Care Facility
363 Optician/Optometric Group/Practice Code Description
367 Physical/Occupational Therapy Group/Practice 381 Adult Day Care Facility
364 Podiatric Group/Practice 392 Ambulatory Clinic/Center
391 Ambulatory Surgical Center
Table 191 - Home Health Agency/ Organization 398 End Stage Renal Disease Facility
Health Center/Federally Qualified Health
394
Code Description Center/Community Health Center
393 Home Health Agency/Organization Intermediate Care Facility for Intellectually
383
Disabled/Substance
397 Mammography Service Provider
Table 192 - Hospice/Hospice Care Provider Mental Health Center/Community Mental Health
395
Center
Code Description
Outpatient Rehabilitation Facility/
382 Hospice/Hospice Care Provider 388
Comprehensive Outpatient Rehabilitation Facility
399 Radiology/Imaging Center
Table 193 - Hospital 386 Residential Treatment Facility/ Program
396 Rural Health Clinic
Code Description
304 Federal Hospital
301 General/Acute Care Hospital Table 201 - Managed Care Organization
302 Psychiatric Hospital
Code Description
303 Rehabilitation Hospital
331 Health Maintenance Organization
335 Preferred Provider Organization
Table 194 - Hospital Unit 336 Provider Sponsored Organization
338 Religious, Fraternal Benefit Society Plan
Code Description
307 Psychiatric Unit
308 Rehabilitation Unit Table 202 - Health Care Supplier/Manufacturer
Code Description
1
Table 195 - Laboratory/CLIA Laboratory 347 Biological Products Manufacturer
342 Blood Bank
Code Description 1
343 Durable Medical Equipment Supplier
310 Laboratory/CLIA Laboratory 1
344 Eyewear Equipment Supplier
1
351 Fiscal/Billing/Management Agent
Table 196 - Nursing Facility/Skilled Nursing Facility 1
353 Nursing/Health Care Staffing Service
Code Description 1
348 Organ Procurement Organization
389 Nursing Facility/Skilled Nursing Facility 345 Pharmacy
1
346 Pharmaceutical Manufacturer
1
Table 197 - Research Center/Facility 349 Portable X-Ray Supplier
1
Code Description 352 Purchasing Service
370 Research Center/Facility
Table 203 - Other
Table 198 - Ambulance Service/Transportation Code Description
Company Other Type - Not Classified, Specify,
999
Code Description ______________
390 Ambulance Service/Transportation Company 1 These organization type codes are not available for
Accreditation action and Peer Review Organization
findings.

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Report Change Notification Disclosure Type Codes

Table 204 - Report Change Notification Disclosure Type Codes

Code Description

IR The reporting entity identified in this disclosure has submitted Initial Report {1}.

RR The reporting entity identified in this disclosure has submitted Revision to Action Report {1}.

CR The reporting entity identified in this disclosure has submitted correction(s) to report {1}.

CA The reporting entity identified in this disclosure has submitted correction(s) to report {1}.

DA The subject of report {1} has filed a dispute with the NPDB concerning information contained in
the report. The reporting entity identified in this disclosure and the subject of the report are
responsible for settling the dispute.

DW The subject of report {1} has withdrawn the dispute originally associated with this report.

SA The subject of report {1} has added a statement to the report to explain or comment on the
action reported.

SW The subject of report {1} has withdrawn the statement previously associated with this report.

NA The reporting entity identified in this disclosure has indicated that the action described in report
{1} is being appealed.

RE The subject of report {1} has requested that this dispute be reviewed by the Secretary of the
U.S. Department of Health and Human Services.

RW The subject of report {1} has withdrawn the request for review of this dispute by the Secretary
of the U.S. Department of Health and Human Services.

RD The Secretary of the U.S. Department of Health and Human Services has reviewed the facts of
the dispute and has made a determination regarding report {1}.

VR Report {1} and all information in it have been expunged from the NPDB and should not be
used. Please destroy all copies of this report.

OC On behalf of the reporting entity identified in this disclosure, the NPDB corrected report {1}.
The following data fields have been modified: {2}.

OA On behalf of the reporting entity identified in this disclosure, the NPDB corrected report {1}.
The following data fields have been modified: {2}.

RC On behalf of the reporting entity identified in this disclosure, the NPDB corrected report {1} as
directed by the Secretary of the U.S. Department of Health and Human Services. For further
information, see the Secretary’s comments included in this disclosure.

RA On behalf of the reporting entity identified in this disclosure, the NPDB corrected report {1} as
directed by the Secretary of the U.S. Department of Health and Human Services. For further
information, see the Secretary’s comments included in this disclosure.

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Code Description

OV On behalf of the reporting entity identified in this disclosure, the NPDB voided report {1}
because it was determined to be a duplicate report. Please destroy all copies of report {1}.
The original report remains in the NPDB.

RV On behalf of the reporting entity identified in this disclosure, the NPDB voided report {1} as
directed by the Secretary of the U.S. Department of Health and Human Services. The
referenced report and all information in it have been expunged from the NPDB and should not
be used. Please destroy all copies of this report.

BI Correction Report {1} should have been submitted as a Revision to Action since it modifies a
previously reported action. To correct this, the NPDB, on behalf of the reporting entity
identified in this disclosure, have re−submitted the original or previous Initial Report as {2}.
Additionally, the Correction Report {1} has been voided and re−submitted as Revision to Action
{3}. Please destroy all copies of report {1}.

BV Correction Report {1} should have been submitted as a Revision to Action since it modifies a
previously reported action. To correct this, the NPDB, on behalf of the reporting entity
identified in this disclosure, have re−submitted the original or previous Initial Report as {2}.
Additionally, the Correction Report {1} has been voided and re−submitted as Revision to Action
{3}. Please destroy all copies of report {1}.

BR Correction Report {1} should have been submitted as a Revision to Action since it modifies a
previously reported action. To correct this, the NPDB, on behalf of the reporting entity
identified in this disclosure, have re−submitted the original or previous Initial Report as {2}.
Additionally, the Correction Report {1} has been voided and re−submitted as Revision to Action
{3}. Please destroy all copies of report {1}.

AV On behalf of the reporting entity identified in this disclosure, the NPDB converted report {1} to
Revision to Action Report {2}. This action should have been reported as a Revision to Action
since it modifies the previously reported action {3}. Please destroy all copies of report {1}.

AR On behalf of the reporting entity identified in this disclosure, the NPDB converted report {1} to
Revision to Action Report {2}. This action should have been reported as a Revision to Action
since it modifies the previously reported action {3}. Please destroy all copies of report {1}.

ND Report {1} is no longer disclosable to your entity. Please disregard and destroy all previous
versions of this report and any copies.

RQ At the request of the subject, report {1} was reviewed by the Secretary of the U.S. Department
of Health and Human Services and a decision was reached. The subject has requested that
the Secretary reconsider the original decision.
Note(s):
The descriptions listed herein contain placeholder references ({1}, {2}, and {3}) and each will be replaced with an
actual report DCN when a notification is generated by the NPDB.

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Gender Codes

Table 205 - Gender Codes

Code Description

M Male

F Female

U Unknown

Dispute Status Codes

Table 206 - Dispute Status Codes

Code Description

N Report is not in dispute.

Y The subject of the referenced report has filed a dispute with the NPDB concerning information
contained in the report.

S The subject of the referenced report has requested that this dispute be reviewed by the Secretary of
the U.S. Department of Health and Human Services.

R The Secretary of the U.S. Department of Health and Human Services has reviewed the facts of the
dispute and has reached a decision.

Q At the request of the subject, the referenced report was reviewed by the Secretary of the U.S.
Department of Health and Human Services and a decision was reached. The subject has requested
that the Secretary reconsider the original decision.

Statutory Authority Codes

Table 207 – Statutory Authority QRXS Codes

Code Description

IV Report is maintained under the provisions of Title IV of Public Law 99-660.

1921 Report is maintained under the provisions of Section 1921.

1128E Report is maintained under the provisions of Section 1128E.

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Error Codes

Table 208 - Error Codes

Code Description

03 File is not compliant with the current format version.

05 SQL error.

06 Invalid transaction code entered.

07 Invalid Data Bank ID.

08 Invalid password.

09 This entity does not have the privilege to perform this transaction.

11 Entity registration has expired.

12 Agent registration has expired.

13 This agent does not have the authority to act for entity.

15 Entity name or Data Bank ID is missing or illegible.

16 All or part of the entity address is missing or invalid.

18 Invalid entity type code.

20 All or part of a subject's name is missing or invalid. Subject First Name and Last Name are required.

22 Invalid subject type.

23 Incomplete subject Occupation/Field of Licensure information. For each license number you provide,
you must also provide a valid, two-letter abbreviation for the U.S. State from where the license was
issued, and a valid, three-digit Occupation/Field of Licensure code.

24 Invalid Occupation/Field of Licensure code.

25 All or part of school information is missing or illegible: professional school information must include both
the name of the professional health care school attended and the year the subject graduated. If the
subject did not graduate, provide the last year he or she attended the school-this will be presented on
the response as the subject year of graduation.

26 Invalid Drug Enforcement Administration number.

27 Invalid Social Security Number.

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Code Description

28 Missing, invalid, or illegible date of birth. Date of birth must be at least 15 years before today's date and
after 1900.

29 Invalid gender code.

30 Adverse Action Report data is missing or illegible: required information is missing in section C of the
Adverse Action Report you submitted. Each of the fields in this section must be completed legibly.
Please submit a new, fully completed adverse action report to the NPDB. Do not reference Data Bank
Control Number of this rejection notice on your new report. If this rejected report was an initial report,
you must submit a new initial report; if a correction or void was rejected, you must resubmit your
correction or void as if this rejected report was never submitted to the NPDB.

31 Invalid Adverse Action Classification code.

32 Invalid Adverse Action type code: the type of Adverse Action taken (licensure, clinical privileges, or
professional society membership) was not indicated in field 3 of your Adverse Action Report form, or
more than one type was marked. Please submit a new, fully completed Adverse Action Report to the
NPDB, indicating the type of adverse action your organization is reporting. Do not reference the
document control number of this rejection notice on your new report. If this rejected report was an initial
report, you must submit a new initial report; if a correction or void was rejected, you must resubmit your
correction or void as if this rejected report was never submitted to the NPDB.

33 Invalid Omission code.

34 Medical Malpractice Payment Report data is missing or illegible: required information is missing or
illegible in section C of the Medical Malpractice Payment Report you submitted. Each of the unshaded
fields in this section must be completed legibly. Please submit a new, fully completed Medical
Malpractice Payment Report to the NPDB. Do not reference the Data Bank Control Number of this
rejection notice on your new report. If this rejected report was an initial report, you must submit a new
initial report; if a correction or void was rejected, you must resubmit your correction or void as if this
rejected report was never submitted to the NPDB.

35 Invalid Hospital data. A valid Name, City, and State are required for each hospital provided.

36 Missing or invalid relation of entity to subject.

37 Invalid payment type.

38 Missing or invalid payment result.

39 All or part of certification is missing: you must provide your printed name, your title (except for individual
subject self-queries), your daytime telephone number, your signature, and the date you signed the form.
Please submit a new, fully completed form to the NPDB.

40 All or part of notarization is missing: to be legal and valid, a notarized form must include the notary
public's signature; the date that the practitioner appeared before the notary; the date the notary's
commission expires; and the notary's stamp, seal, or notary number. Please submit a new, fully
completed and notarized form to the NPDB.

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Code Description

41 Missing or invalid credit card information. The NPDB accepts VISA, MasterCard, Discover or American
Express. The NPDB does not accept cash, checks or money orders.

42 Your registered entity does not have a valid EFT account on file.

43 Expired credit card: please contact your credit card company for further information.

44 Rejected credit card: the bank that issued your credit card has denied these charges. No further
information was made available to the NPDB regarding the reason for this rejection. Please contact
your credit card company for further information.

45 Duplicate report.

46 Data Bank Control Number of report to be voided or corrected is missing or invalid.

47 Query data is missing.

48 Invalid Query Purpose code.

49 Time to dispute a report has expired.

50 Valid Data Bank Control Number of report to be corrected or voided was not provided.

51 Cannot dispute a changed/voided report.

52 Attempted to correct or void a report that has been previously voided or replaced by a corrected
version.

53 Report is already in dispute.

54 Report is already in Report Review.

55 Report is not in dispute: cannot withdraw dispute.

56 Report is not in Report Review: cannot withdraw dispute.

57 Control character (non-alphanumeric) found in file.

58 Possible data entry error found.

59 Credit card bill authorization error.

60 File is not in the appropriate format. Check to ensure that the file is not zipped or in binary format (e.g.,
MS Word or Corel WordPerfect) prior to resubmission.

61 Query file with this name has already been processed.

62 Cannot access drive.

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Code Description

63 Damaged diskette.

64 Bad sector(s) on disk.

65 Warning detection error.

66 No files found on disk.

67 I/O error.

68 Missing, invalid, or illegible date of omission. Date of omission must not be later than today's date and
not earlier than 1900.

69 Graduation year is inconsistent with year of birth: the subject's date of birth and year of graduation must
be at least 15 years apart.

70 Length of action is missing or contains more than two digits.

71 Invalid Agent Identification Number.

72 Entity does not have active status.

73 Agent does not have active status.

74 Possible @ sign in data.

75 Invalid entity phone number.

76 Invalid entity phone extension.

77 Invalid certification phone number.

78 Invalid certification phone extension.

79 Invalid subject deceased flag.

80 Invalid subject identification number.

81 Invalid subject address.

82 Invalid payment on Medical Malpractice Payment Report.

83 Invalid Medical Malpractice Payment Report data.

84 Invalid report category code.

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Code Description

85 Credit card authorization unavailable: the NPDB experienced communications problems with our credit
card authorization service when we attempted to bill your account for the enclosed query. As a result,
the charges were not fully authorized and we are unable to process the query. Your credit card account
may show a temporary hold for these charges that will expire within 10 days of the process date shown
above. If, for any reason, you are billed for the enclosed query file, please contact the NPDB Customer
Service Center immediately at 1-800-767-6732. Please create a new query file for the subject names
you need to have processed and transmit it to the NPDB. We regret any inconvenience that this may
cause.

93 Invalid user account.

94 Invalid date of judgment or sentence. The date must be a valid date and must not occur in the future.

99 Billing problem - transaction on hold.

A1 Invalid type of adverse action.

A2 The Name of Agency or Program That Took the Adverse Action is missing or invalid.

A3 Invalid or duplicate Adverse Action Classification code.

A4 Invalid entry for total amount of monetary penalty, assessment, restitution and/or fine.

A5 Invalid entry for date of action, date of finding, or date action became effective.

A6 Invalid length of action.

A7 Invalid entry in automatic reinstatement field.

A8 Missing narrative description of subject’s act(s) or omission(s) or other reasons for action(s) taken and
description of action(s) taken by the reporting entity.

A9 Invalid entries in the publicly available or professional competence or conduct field.

AA This submission could not be processed for the following reason(s). Invalid combination of Adverse
Action Classification codes. State Licensure actions taken against health care practitioners may not
contain multiple codes when one of the following codes is reported: 1138, 1139, 1149, 1150, or 1189.
DEA/Federal Licensure actions taken by the DEA against health care practitioners may not contain
multiple codes when one of the following codes is reported: 1149, 1173, or 1189. Exclusion/Debarment
actions taken by the HHS Office of Inspector General may not contain multiple codes when one of the
following codes is reported: 1508, 1509, 3508, or 3509. Additional actions should be submitted in
separate reports.

AB Duplicate Type of Negative Finding code.

AC Length of action information should not be included in the report for the selected Adverse Action
Classification codes.

AD Name of Agency or Program that took the Adverse Action is not allowed for this report type.

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Code Description

AE The QRXS does not accept transactions related to Adverse Action Reports in legacy format.

AF This agent does not have authority to perform this action for this entity.

AG Invalid date of action or date of finding. For a Revision to Action report, the date of action or date of
finding must be the same as or later than the date of action or date of finding on the initial report.

AH Invalid combination of Adverse Action Classification codes. State Licensure actions taken against a
multi-state license may not contain multiple codes when one of the following codes is reported: 1338 or
1339. Additional actions should be submitted in separate reports.

AI Status codes in Licensure Actions and Multi-State Licensure Privilege Actions cannot be selected
together.

AM Invalid combination of Adverse Action Classification codes. State Licensure actions taken against
organizations may not contain multiple codes when code 3238 is reported. Additional actions should be
submitted in separate reports.

AN Automatic reinstatement field is only allowed when a specific length of action is specified.

AO Automatic reinstatement field is not allowed with the specified Adverse Action Classification code(s).

B1 Incomplete individual subject Occupation/Field of Licensure.

B2 Incomplete or invalid subject Occupation/Field of Licensure information. For each License provided, a
valid, two-letter abbreviation for the U.S. State from where the license was issued and a valid, three-
digit Occupation/Field of Licensure code must be provided. License Numbers must contain at least one
digit. If the subject does not have a license, specify No License and do not provide a License Number.
An Occupation/Field of Licensure Description is required if the Occupation/Field of Licensure code is
"Other", and not allowed otherwise.

B3 The specialty code selected is either invalid or incompatible with the occupation/field of licensure code
selected. Physician specialty codes should only be used for physicians (occupation/field of licensure
codes 010, 015, 020 and 025). Dental specialty codes should only be used for dentists
(occupation/field of licensure codes 030 and 035).

B4 Invalid organization subject license number.

B5 Incomplete or invalid subject Licensure information. For each License provided, a valid, two-letter
abbreviation for the U.S. State from where the license was issued must be provided. License numbers
must contain at least one digit. If the subject does not have a license, specify No License and do not
provide a License Number.

B6 Invalid organization subject license number State field.

B8 Act or Omission code missing or invalid.

B9 Missing Judgment or Conviction Report information.

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Code Description

BA Specialty code is a required field for this occupation/field of licensure selection.

BB The specialty code must not be specified for Clinical Privilege or Professional Society actions.

C0 Incomplete or invalid Organization Name or Type information. For each organization, you must provide
a valid Organization Name and Organization Type. An Other Description is required if the Organization
Type is 999, and not allowed otherwise.

C1 Missing or invalid sentence/judgment information.

C4 Invalid Food and Drug Administration number(s).

C5 Invalid National Provider Identifier(s).

C6 Invalid Federal Employer Identification Number(s).

C7 Invalid affiliation data. For each provided affiliate, a valid name is required. If an affiliate address is
provided, the city and state (or city and country) are required. An Other Description is required if the
Nature of Relationship code is 999, and not allowed otherwise.

C8 Invalid appeal information. Specify if the report is on appeal, and only provide an appeal date if the
report is on appeal.

C9 Incomplete information for statutory offenses and counts.

CC orgDefn not allowed for this report type.

CD CCB not allowed for this report type.

CE At least one SSN or FEIN must be provided for Organization Subject.

CF Negative Finding Date not allowed for this report type.

CG Invalid date of judgment or sentence. For a Revision to Action report, the date of judgment or sentence
must be the same as or later than the date of judgment or sentence on the initial report.

CV You may not void a report that has related Revision to Action reports. You must first void the Revision
to Action reports before voiding this report. You can view the related Revision to Action reports by
attempting to void this report using the IQRS (https://www.npdb.hrsa.gov).

D0 Invalid deceased date.

D2 Invalid health care entity definition entry.

D3 Invalid type of organization.

D4 Missing organization name.

D5 Missing or invalid Basis for Action code.

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Code Description

D6 Report is not valid under any NPDB statutory authority.

D7 This type of report does not accept notices of appeal.

D8 You do not have the statutory authority to submit a notice of appeal for this report.

D9 Professional school and year of graduation should not be present for non-practitioners.

DA Missing or invalid basis for action description.

E0 Missing basis code.

E1 No basis code should be present for revision to actions.

E4 Publicly available field should not be filled in.

E5 Missing competence or conduct basis entry.

E6 Competence or conduct entry not applicable to your report.

F2 The NPDB no longer accepts Adverse Action Reports submitted via disk. All Adverse Action Reports
submitted to the NPDB must be submitted through the Integrated Querying and Reporting Service
found on the World Wide Web at www.npdb.hrsa.gov.

F5 A revision to action transaction attempted to modify certain fields that must contain the same
information as the report being revised: 'Type of Action', 'Occupation/Field of Licensure' if you are filing
a report on an individual subject, as well as 'Competence/Conduct Basis' if you are filing a State
licensure report on an individual subject, or 'Health Care Entity Definition' if you are filing a State
licensure report on an organizational subject.

F6 The previous DCN did not match a report in the Data Bank.

F7 A transaction type was not found for the specified report.

F8 The previous DCN is not applicable for this type of report.

F9 A correction of revision to action transaction attempted to correct a non-revision to action report.

G1 Set A and set B mandatory fields not complete for individual query.

G2 Set A and set B mandatory fields not complete for organization query.

G3 Missing/invalid notary date

G4 Missing/invalid notary seal, stamp, or certificate.

G5 Missing/invalid notary signature.

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Code Description

G6 Missing/invalid subject appearance date.

G7 Missing/invalid subject signature.

G8 Invalid number of subjects in query.

G9 Invalid batch query. Individual and organization subjects may not be queried on in the same query
batch.

H4 This subject is a duplicate of a subject submitted as DCN <DCN of previously queried subject>

I1 Invalid Individual Taxpayer Identification Number(s).

I2 At least one ITIN or SSN must be provided for Individual Subject.

I3 At least one ITIN, SSN or FEIN must be provided for Organization Subject.

I4 Invalid Unique Physician Identification Number(s).

I5 Invalid Principal Officers and Owners information.

I6 Invalid Medicare Provider/Supplier Number(s).

I7 Invalid Clinical Laboratory Improvement Act Number(s).

I8 Invalid Entity Internal Report Reference.

I9 Invalid report type.

IC Insufficient credits available for transaction.

IN ITIN not allowed for this report type.

IP Total Number of Claimants Included in (Global) Settlement was specified, but the payment was not
specified as being the result of a settlement. Total Number of Claimants Included in (Global) Settlement
is only allowed if the payment is the result of a settlement.

J1 Credit Card Issuer Unavailable: The NPDB experienced communication problems in contacting your
financial institution when we attempted to bill your account for the enclosed query. Since your financial
institution was not contacted, your account should not have been charged for this query. If, for any
reason, you are billed for the enclosed file, please contact the NPDB Customer Service Center
immediately at 1-800-767-6732. Please create a new query file for the subject name(s) in the enclosed
query file and transmit it to the NPDB. Should you add additional subject names to your new query,
your new charges will be higher than your original charge because fees are levied on a per-name basis.
We regret any inconvenience that this may cause.

J2 Missing or invalid credit card information, the card holder name is missing or not valid.

J3 Missing or invalid credit card information, the credit card number is not a valid credit card number.

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Code Description

J4 Missing or invalid credit card information, the credit card expiration date is not valid.

J5 All or part of the credit card billing address is missing or invalid.

J6 Payment information is missing.

J7 Invalid Credit card and EFT data conflict.

K1 Professional School information is not allowed in judgment or conviction reports.

K2 An Act or Omission Description is required if the Act or Omission Code is 999, and not allowed
otherwise.

K3 Invalid Case Number.

K4 Invalid Type of Action.

K5 Missing or invalid Docket/Court File Number.

K6 Missing or invalid Jurisdiction.

K7 Missing or invalid Narrative description of act(s) or omission(s).

K8 Missing or invalid Prosecuting Agency or Civil Plaintiff.

K9 Missing or invalid Venue information. Venue name, city and state are all required.

KA Invalid Investigating Agency Name.

KB Invalid Investigating Agency Case Number.

KC Invalid Other Organization Name.

KD Hospital Affiliates are only valid for medical malpractice payment reports. Report this data in an Affiliate
record instead.

KE Type of Action on this correction or revision report must match the Type of Action of the previous report.

KF CLIA not allowed in organization judgment or conviction reports.

KG FDA not allowed in organization judgment or conviction reports.

M0 Specific allegation or date of event is missing or invalid, or description for an unclassified specific
allegation is missing.

M1 Missing or invalid Payment date. The date must be a valid date, must not be in the future, and must
occur after the date(s) of event(s) associated with the allegation(s) or incident(s).

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Code Description

M2 Description of judgment or settlement is missing or invalid.

M3 Number of practitioners for whom this payer has paid or will pay in this case must be a value between 1
and 999 inclusive.

M4 State fund payment flag or amount is invalid.

M5 Self-insured payment flag or amount is invalid.

M6 Patient age, gender or type is missing or invalid.

M7 Description of the medical condition with which the patient presented for treatment is missing or invalid.

M8 Description of the procedure performed is missing or invalid.

M9 Nature of allegation code is missing or invalid.

MA Outcome is missing or invalid.

MB Description of allegations and injuries or illnesses is missing or invalid.

MC Total amount paid or to be paid by this payer for this practitioner must be greater than or equal to the
amount of this payment by this payer for this practitioner.

MD Total amount paid or to be paid by this payer for all practitioners must be greater than or equal to total
amount paid or to be paid by this payer for this practitioner.

ME The NPDB no longer accepts initial Medical Malpractice Payment Reports in legacy format.

MF State fund payment flag and/or amount is invalid. Your entity's relationship to this practitioner (as
specified in this submission) does not allow the completion of the state fund payment fields.

MG Self-insured payment flag or amount is invalid. Your entity's relationship to this practitioner (as specified
in this submission) does not allow the completion of the self-insured organization and/or other insurance
company payment fields.

MH Judgment or Settlement Date is invalid.

MI Invalid Total Number of Claimants Included in (Global) Settlement.

MJ Invalid Adjudicative Body Case Number.

MK Invalid Adjudicative Body Name.

ML Invalid Court File Number.

MM Missing or invalid Amount of This Payment for This Practitioner.

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Code Description

MN Missing or invalid Total Amount Paid or to Be Paid by This Payer for This Practitioner.

MO Total amount paid or to be paid by this payer for this practitioner must be greater than or equal to the
state fund payment amount.

MP Missing or invalid Total Amount Paid or to Be Paid by This Payer for All Practitioners.

MQ Total amount paid or to be paid by this payer for this practitioner must be greater than or equal to the
self-insured payment amount.

MR ITIN not allowed in medical malpractice payment reports.

MS Licensure Specialty not allowed in medical malpractice payment reports.

MT Organization Type not allowed in medical malpractice payment reports.

MU NPI not allowed in medical malpractice payment reports.

MV FEIN not allowed in medical malpractice payment reports.

MW UPIN not allowed in medical malpractice payment reports.

MX Only information regarding hospital affiliations may be reported for medical malpractice payment
reports.

MY The date of this payment should not be before 09/01/1990.

MZ Description of the Act(s) or Omission(s) and injuries or illnesses is missing or invalid.

P1 Missing or invalid customer subject ID number.

N0 A payment result of description must be provided if payment result of is “Other” and is not allowed
otherwise.

P2 Too many data elements have been changed in this enrollment update which may change the identity
of the subject and cause erroneous matching results.

P3 Missing or invalid enrollment purpose code.

P4 Missing or invalid cancellation purpose code.

P5 A cancellation purpose description must be provided if the cancellation purpose is "Other" and is not
allowed otherwise.

P6 Purpose code only allowed for enrollment transactions.

P7 Invalid number of subjects: Number of subjects does not match the number of subjects in the file.

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Code Description

P8 Data Bank subject ID number is not allowed for enrollment transactions.

P9 Data Bank subject ID number does not correspond to the same enrolled subject as the customer
subject ID number.

PA Data Bank subject ID number does not correspond to an active enrolled subject.

PB Data Bank subject ID number or customer subject ID number must be provided.

PC Customer subject ID number does not correspond to an active enrolled subject.

PD Subject is currently being enrolled or updated. Retry your submission after receiving output from the
enrollment or most recent update.

PE Enrolled subject can only be renewed within two months before or one month after its renewal date.

PF The entity on whose behalf you are submitting this transaction has not enabled use of Continuous
Query.

PG Missing or invalid Data Bank subject ID number.

PH Only one Continuous Query update, cancellation or status request is allowed per submission file.

PI A maximum of 999 subjects may be submitted in a batch transaction.

PJ This Continuous Query renewal batch contains enrolled subjects with different expiration dates.

PM The Continuous Query subject is already up to date with the changes you submitted.

PN This enrollment contains subjects that match duplicate enrolled subjects: <name(s) and subject id(s) of
currently enrolled subject(s)>

Q1 Missing or invalid basis for finding.

Q4 Action taken date not allowed for this report type.

Q5 Action effective date not allowed for this report type.

Q6 Action length indefinite not allowed for this report type.

Q7 Action length permanent not allowed for this report type.

Q8 Action length not allowed for this report type.

Q9 Automatic reinstatement not allowed for this report type.

QA Amount not allowed for this report type.

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Code Description

QB Missing or invalid Type of Negative Finding code.

QC Missing or invalid negative finding description.

QD Missing or invalid negative finding date.

QE Missing or invalid basis for finding description.

QF Missing or invalid description of finding.

R1 All or part of certification information is missing.

R2 Invalid affiliate address.

R4 Invalid Organization Name.

R6 Invalid Customer Use data.

R9 You do not have the correct statutory authority to submit this report.

RE The DBID for your organization must be renewed before you can access the NPDB services. The
NPDB requires all registered entities to periodically renew their registration information. Re-registration
enables the NPDB to maintain accurate entity contact information and provides the entity with the
opportunity to review the legal requirements and verify their compliance for participation with NPDB.
The certifying official for your organization must review the NPDB regulations, available at
https://www.npdb.hrsa.gov/resources/aboutLegsAndRegs.jsp, as part of the renewal process. Once the
regulations have been reviewed, complete the on-line registration renewal form by logging in to the
IQRS and selecting Renew Registration on the registration confirmation screen. The completed form
must be signed and mailed to the NPDB for processing. If your organization has already mailed the
registration renewal to the NPDB, it will be processed within one business day of its receipt by the
NPDB. Data Bank Correspondence will be sent once the NPDB has successfully processed your
registration renewal form. If necessary, you may complete a new form by selecting Renew Registration
below. If you need further assistance, please contact the NPDB Customer Service Center at 1-800-
767-6732.

RF The DBID for your organization must be renewed before you can access the NPDB services. The
NPDB requires all registered entities to periodically renew their registration information. Re-registration
enables the NPDB to maintain accurate entity contact information and provides the entity with the
opportunity to review the legal requirements and verify their compliance for participation with NPDB.
The certifying official for your organization must review the NPDB regulations, available at
https://www.npdb.hrsa.gov/resources/aboutLegsAndRegs.jsp as part of the renewal process. Contact
the administrator of your organization so they can renew the registration. If you need further
assistance, please contact the NPDB Customer Service Center at 1-800-767-6732.

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Code Description

RG The DBID for the entity on whose behalf you are submitting the file must be renewed before the
submission file can be processed by the NPDB. The NPDB requires all registered entities to
periodically renew their registration information. Re-registration enables the NPDB to maintain accurate
entity contact information and provides the entity with the opportunity to review the legal requirements
and verify their compliance for participation with NPDB. As part of the renewal process, the certifying
official of the entity on whose behalf you are submitting the file must review the NPDB regulations,
available at https://www.npdb.hrsa.gov/resources/aboutLegsAndRegs.jsp. Once the certifying official
has reviewed these regulations, the entity administrator can complete the on-line registration renewal
form by logging in to the IQRS and selecting Renew Registration on the registration confirmation
screen. If you need further assistance, please contact the NPDB Customer Service Center at 1-800-
767-6732.

RH File is not compliant with the current format version of the latest Interface Control Document (ICD).
Please review the appropriate ICD specification for the type of transaction you wish to submit and
update your ICD transaction files.

RI The administrator account can not be used to submit report or query transactions. These transactions
must be submitted using a user account.

RJ The administrator account can not be used to submit query, report, or Continuous Query transactions.
These transactions must be submitted using a user account.

RQ Missing or invalid Void Reason Code.

RR Too much subject information has been changed. If you need to change subject information, first submit
a correction report and then submit this revision to action.

S0 The new password was based on a commonly used keyboard sequence. Passwords may not be a
simplistic or systematic sequence (e.g., abcd1234).

S1 The new password must be different from the old password.

S2 The new password must be between 8 and 14 characters long.

S3 The new password must contain at least one numeric character.

S4 The new password must contain at least one upper- and one lower-case character.

S5 The new password contains an illegal character.

S6 The new password was similar to your account user ID.

S7 The new password was similar to your account user ID with the characters reversed.

S8 The new password was the same as one you used previously.

S9 The new password did not contain enough different characters.

SA The new password was similar to a word in the dictionary.

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Code Description

SB The new password was similar to a word in the dictionary with the characters reversed.

SC Missing or invalid user account in the password change or reset request.

SD Only the administrator may reset a user's account password.

SE You may not change another user's account password.

SF The administrator password cannot be reset. A password change request may be submitted instead.

SG The new password must be provided in the password change request.

SH The password must be omitted in the password reset request. The NPDB will generate a new
password.

SM Your password contains too many repeated characters.

SN You may only change your password once per day.

SO Your password must contain at least one of these special characters: ! @ # $ ^ & * ( ) - _ = + [ ] { } | ; : , .
<>?

SJ Reserved for future use.

UA URLs and references to external sites are not allowed in the description of allegations and injuries.

UF URLs and references to external sites are not allowed in the description of finding.

UJ URLs and references to external sites are not allowed in the description of the judgment or settlement.

UM URLs and references to external sites are not allowed in the description of the medical condition.

UN URLs and references to external sites are not allowed in the narrative description.

UP URLs and references to external sites are not allowed in the description of the procedure performed.

US URLs and references to external sites are not allowed in the narrative description of acts or omissions.

UZ URLs and references to external sites are not allowed in the description of acts or omissions.

V1 Missing or invalid Vendor ID.

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QRXS Client Program Status Codes

Table 209 - QRXS Client Program Status Codes

Code Description
C00 Success, no errors.
C01 Error on NPDB server, reattempt transfer.
C02 Authentication failed; DBID, UserID, or Password are invalid, or the user account is inactive.*
C03 Password expired for DBID and UserID.*
C04 No filenames specified for upload.
C05 Error sending files to server, reattempt transfer.
C06 Client sent an invalid request.
C07 Inactive DBID.
C08 Maximum upload file size exceeded; reduce file size and reattempt transfer.
C09 All uploaded files are invalid.
C10 Unable to communicate with NPDB server, reattempt transfer.
C12 Database error on NPDB server, reattempt transfer.
C13 Not all of the files were processed successfully.
C16 The DBID for your organization must be renewed before you can access the NPDB’s services.
The NPDB requires all registered entities to periodically renew their registration information.
Re-registration enables the NPDB to maintain accurate entity contact information and provides
the entity with the opportunity to review the legal requirements and verify their compliance for
participation with NPDB. The certifying official for your organization must review the NPDB
statutory authorities, available at https://www.npdb.hrsa.gov/resources/aboutLegsAndRegs.jsp,
as part of the renewal process. Once the statutory authorities have been reviewed, complete
the on-line registration renewal form by logging in to the IQRS and selecting Renew
Registration on the registration confirmation screen. The completed form must be signed and
mailed to the NPDB for processing. If your organization has already mailed the registration
renewal to the NPDB, it will be processed within 1 business day of its receipt by the NPDB.
Data Bank Correspondence will be sent once the NPDB has successfully processed your
registration renewal form. If necessary, you may complete a new form by selecting Renew
Registration below. If you need further assistance, please contact the NPDB Customer Service
Center at 1-800-767-6732.
C17 The DBID for your organization must be renewed before you can access the NPDB’s services.
The NPDB requires all registered entities to periodically renew their registration information.
Re-registration enables the NPDB to maintain accurate entity contact information and provides
the entity with the opportunity to review the legal requirements and verify their compliance for
participation with NPDB. The certifying official for your organization must review the NPDB
statutory authorities, available at https://www.npdb.hrsa.gov/resources/aboutLegsAndRegs.jsp,
as part of the renewal process. Contact the Entity Data Bank Administrator of your organization
so they can renew the registration. If you need further assistance, please contact the NPDB
Customer Service Center at 1-800-767-6732.
C21 Client error, refer to log file for more information.
C22 Usage error, check command-line parameter.

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Code Description
C23 Error in reading Initialization file qrxs.properties, check that qrxs.properties file is in working
directory.
C24 Unable to open program log file, check that disk space is available.
C30 Error validating property in qrxs.properties, a property is missing or value is invalid.
C31 Error validating UploadListFile, upload file missing or a file listed in the upload file does not
exist.
C32 Error validating DownloadDir, directory does not exist.
C40 Error opening connection to NPDB server, check Internet connection and reattempt transfer.
C43 Error during client startup.**
C54 Error downloading response files, reattempt transfer.
C56 Error getting the list of response files downloaded, reattempt transfer.
C57 Your password has expired. You may login to the IQRS to reset your password or contact your
Entity Data Bank Administrator or the NPDB Customer Service Center.***
C58 Your account has been locked out. Contact your Entity Data Bank Administrator to reset the
password. If you are using an Entity Data Bank Administrator account, contact the NPDB
Customer Service Center to reset the password.
C59 Your account has been locked out. The number of invalid login attempts has exceeded the
allowable login limit. Contact your Entity Data Bank Administrator to reset the password. If you
are using an Entity Data Bank Administrator account, contact the NPDB Customer Service
Center to reset the password.
C60 Your password must be changed before other transactions can be submitted.
C61 Error changing the password.
C62 Error resetting the password.
C64 No more than one password change transaction can be submitted at one time. Reduce the
number of password change transactions to one, reattempt transfer.
C68 To ensure account security, your Entity Data Bank Administrator must authorize this
connection.
C69 To ensure account security, the account holder must contact the NPDB Customer Service
Center at 1-800-767-6732 to access the system.

* For detailed information on maintaining User IDs and passwords refer to

https://www.npdb.hrsa.gov/hcorg/howToManageUserIdsAndPasswords.jsp.
** Either two instances of the client program are running or one instance of the program was terminated
prematurely. If it is the latter, remove the qrxslock file from the program’s working directory and try again.
*** Under specific circumstances the IQRS password reset service is available to obtain a new password. Log in
to the IQRS with your expired password to begin. You must have an e-mail address stored in your user account
to use this service. You may also contact your Entity Data Bank Administrator to reset the password. If you are
using an Entity Data Bank Administrator account, you may also use the IQRS password reset service or contact
the NPDB Customer Service Center to reset the password.

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QRXS Web Service Status Codes

Table 210 - QRXS Web Service Status Codes

Code Description
C00 Success, no errors.
C01 Error on NPDB server, reattempt transfer.
C02 Authentication failed; invalid DBID, UserID, or Password.*
C03 Password expired for DBID and UserID.*
C05 Error sending files to server, reattempt transfer.
C06 Client sent an invalid request.
C07 Inactive DBID.
C08 Maximum upload file size exceeded; reduce file size and reattempt transfer.
C09 All uploaded files are invalid.
C10 Unable to communicate with NPDB server, reattempt transfer.
C12 Database error on NPDB server, reattempt transfer.
C13 Not all of the files were processed successfully.
C16 The DBID for your organization must be renewed before you can access the NPDB’s services.
The NPDB requires all registered entities to periodically renew their registration information.
Re-registration enables the NPDB to maintain accurate entity contact information and provides
the entity with the opportunity to review the legal requirements and verify their compliance for
participation with NPDB. The certifying official for your organization must review the NPDB
statutory authorities, available at https://www.npdb.hrsa.gov/resources/aboutLegsAndRegs.jsp,
as part of the renewal process. Once the statutory authorities have been reviewed, complete
the on-line registration renewal form by logging in to the IQRS and selecting Renew Registration
on the registration confirmation screen. The completed form must be signed and mailed to the
NPDB for processing. If your organization has already mailed the registration renewal to the
NPDB, it will be processed within 1 business day of its receipt by the NPDB. Data Bank
Correspondence will be sent once the NPDB has successfully processed your registration
renewal form. If necessary, you may complete a new form by selecting Renew Registration
below. If you need further assistance, please contact the NPDB Customer Service Center at 1-
800-767-6732.
C17 The DBID for your organization must be renewed before you can access the NPDB’s services.
The NPDB requires all registered entities to periodically renew their registration information.
Re-registration enables the NPDB to maintain accurate entity contact information and provides
the entity with the opportunity to review the legal requirements and verify their compliance for
participation with NPDB. The certifying official for your organization must review the NPDB
statutory authorities, available at https://www.npdb.hrsa.gov/resources/aboutLegsAndRegs.jsp,
as part of the renewal process. Contact the Entity Data Bank Administrator of your organization
so they can renew the registration. If you need further assistance, please contact the NPDB
Customer Service Center at 1-800-767-6732.
C40 Error opening connection to NPDB server, check Internet connection and reattempt transfer.
C54 Error downloading response files, reattempt transfer.

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Code Description
C57 Your password has expired. You may login to the IQRS to reset your password or contact your
Entity Data Bank Administrator or the NPDB Customer Service Center.***
C58 Your account has been locked out. Contact your Entity Data Bank Administrator to reset the
password. If you are using an Entity Data Bank Administrator account, contact the NPDB
Customer Service Center to reset the password.
C59 Your account has been locked out. The number of invalid login attempts has exceeded the
allowable login limit. Contact your Entity Data Bank Administrator to reset the password. If you
are using an Entity Data Bank Administrator account, contact the NPDB Customer Service
Center to reset the password.
C60 Your password must be changed before other transactions can be submitted.
C61 Error changing the password.
C62 Error resetting the password.
C64 No more than one password change transaction can be submitted at one time. Reduce the
number of password change transactions to one, reattempt transfer.
C68 To ensure account security, your Entity Data Bank Administrator must authorize this connection.
C69 To ensure account security, the account holder must contact the NPDB Customer Service
Center at 1-800-767-6732 to access the system.

* For detailed information on maintaining User IDs and passwords refer to

https://www.npdb.hrsa.gov/hcorg/howToManageUserIdsAndPasswords.jsp.
*** Under specific circumstances the IQRS password reset service is available to obtain a new password. Log in
to the IQRS with your expired password to begin. You must have an e-mail address stored in your user account
to use this service. You may also contact your Entity Data Bank Administrator to reset the password. If you are
using an Entity Data Bank Administrator account, you may also use the IQRS password reset service or contact
the NPDB Customer Service Center to reset the password.

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