Field Name |
Description |
Type of Data Used to Determine Provider Population: |
Required. Select an option to indicate the type of data used to determine estimates. |
Values represent a single month's worth of data |
Select check box to indicate that values represent one month's worth of data. Unselect to indicate that the values represent 12 months' worth of data. |
Enrolled in Medicaid |
Required. Default value is "0". Maximum length of 7 digits. |
No health insurance |
Required. Default value is "0". Maximum length of 7 digits. |
American Indian/Alaska Native |
Required. Default value is "0". Maximum length of 7 digits. |
Underinsured in FQHC/RHC or deputized facility |
Required. Default value is "0". Maximum length of 7 digits. |
Total VFC |
Equals the sum of all values in the corresponding column for VFC Vaccine Eligibility Categories. |
Insured (private pay/health ins. covers vaccines) |
Required. Default value is "0". Maximum length of 7 digits. |
Children's Health Insurance Program (CHIP) |
Required. Default value is "0". Maximum length of 7 digits. |
Total Non-VFC |
Equals the sum of all values in the corresponding column for non-VFC Vaccine Eligibility Categories. |
Total Patients |
Equals the sum of the Total VFC and Total non-VFC values in the corresponding column. |
Row Total |
Equals the sum of all values in the corresponding row. |
|
Pressing Previous will take you to the previous screen. |
|
Pressing Continue will take you to the next screen. |
