9.1 KiB
9.1 KiB
1 | APPLICABLE_MANUFACTURER_OR_APPLICABLE_GPO_NAME | APPLICABLE_MANUFACTURER_OR_APPLICABLE_GPO_ID | CONSOLIDATED_REPORT_INDICATOR | RESUBMISSION_FILE_INDICATOR | COVERED_RECIPIENT_TYPE | NON_COVERED_RECIPIENT_ENTITY_NAME | COVERED_RECIPIENT_TEACHING_HOSPITAL_NAME | COVERED_RECIPIENT_TEACHING_HOSPITAL_TAX_ID_NUMBER | COVERED_RECIPIENT_FIRST_NAME | COVERED_RECIPIENT_MIDDLE_NAME | COVERED_RECIPIENT_LAST_NAME | COVERED_RECIPIENT_NAME_SUFFIX | RECIPIENT_BUSINESS_STREET_ADDRESS_LINE_1 | RECIPIENT_BUSINESS_STREET_ADDRESS_LINE_2 | RECIPIENT_CITY | RECIPIENT_STATE | RECIPIENT_ZIP_CODE | RECIPIENT_COUNTRY | RECIPIENT_PROVINCE | RECIPIENT_POSTAL_CODE | RECIPIENT_EMAIL_ADDRESS | COVERED_RECIPIENT_NPI | COVERED_RECIPIENT_PRIMARY_TYPE | COVERED_RECIPIENT_SPECIALTY | COVERED_RECIPIENT_LICENSE_STATE_AND_LICENSE_NUMBER_1 | COVERED_RECIPIENT_LICENSE_STATE_AND_LICENSE_NUMBER_2 | COVERED_RECIPIENT_LICENSE_STATE_AND_LICENSE_NUMBER_3 | COVERED_RECIPIENT_LICENSE_STATE_AND_LICENSE_NUMBER_4 | COVERED_RECIPIENT_LICENSE_STATE_AND_LICENSE_NUMBER_5 | RELATED_PRODUCT_INDICATOR | COVERED_OR_NONCOVERED_INDICATOR_1 | INDICATE_DRUG_OR_BIOLOGICAL_OR_DEVICE_OR_MEDICAL_SUPPLY_1 | PRODUCT_CATEGORY_OR_THERAPEUTIC_AREA_1 | NAME_OF_DRUG_OR_BIOLOGICAL_OR_DEVICE_OR_MEDICAL_SUPPLY_1 | ASSOCIATED_DRUG_OR_BIOLOGICAL_NDC_1 | PRIMARY_DEVICE_IDENTIFIER_1 | COVERED_OR_NONCOVERED_INDICATOR_2 | INDICATE_DRUG_OR_BIOLOGICAL_OR_DEVICE_OR_MEDICAL_SUPPLY_2 | PRODUCT_CATEGORY_OR_THERAPEUTIC_AREA_2 | NAME_OF_DRUG_OR_BIOLOGICAL_OR_DEVICE_OR_MEDICAL_SUPPLY_2 | ASSOCIATED_DRUG_OR_BIOLOGICAL_NDC_2 | PRIMARY_DEVICE_IDENTIFIER_2 | COVERED_OR_NONCOVERED_INDICATOR_3 | INDICATE_DRUG_OR_BIOLOGICAL_OR_DEVICE_OR_MEDICAL_SUPPLY_3 | PRODUCT_CATEGORY_OR_THERAPEUTIC_AREA_3 | NAME_OF_DRUG_OR_BIOLOGICAL_OR_DEVICE_OR_MEDICAL_SUPPLY_3 | ASSOCIATED_DRUG_OR_BIOLOGICAL_NDC_3 | PRIMARY_DEVICE_IDENTIFIER_3 | COVERED_OR_NONCOVERED_INDICATOR_4 | INDICATE_DRUG_OR_BIOLOGICAL_OR_DEVICE_OR_MEDICAL_SUPPLY_4 | PRODUCT_CATEGORY_OR_THERAPEUTIC_AREA_4 | NAME_OF_DRUG_OR_BIOLOGICAL_OR_DEVICE_OR_MEDICAL_SUPPLY_4 | ASSOCIATED_DRUG_OR_BIOLOGICAL_NDC_4 | PRIMARY_DEVICE_IDENTIFIER_4 | COVERED_OR_NONCOVERED_INDICATOR_5 | INDICATE_DRUG_OR_BIOLOGICAL_OR_DEVICE_OR_MEDICAL_SUPPLY_5 | PRODUCT_CATEGORY_OR_THERAPEUTIC_AREA_5 | NAME_OF_DRUG_OR_BIOLOGICAL_OR_DEVICE_OR_MEDICAL_SUPPLY_5 | ASSOCIATED_DRUG_OR_BIOLOGICAL_NDC_5 | PRIMARY_DEVICE_IDENTIFIER_5 | APPLICABLE_MANUFACTURER_OR_APPLICABLE_GPO_MAKING_PAYMENT_NAME | APPLICABLE_MANUFACTURER_OR_APPLICABLE_GPO_MAKING_PAYMENT_REGISTRATION_ID | HOME_SYSTEM_PAYMENT_ID | RESUBMITTED_PAYMENT_RECORD_ID | PREVIOUSLY_DELETED_INDICATOR | PREVIOUSLY_DELETED_PAYMENT_RECORD_ID | TOTAL_AMOUNT_OF_RESEARCH_PAYMENT_U_S_DOLLARS | DATE_OF_PAYMENT | FORM_OF_PAYMENT_OR_TRANSFER_OF_VALUE | EXPENDITURE_CATEGORY | PRE_CLINICAL_RESEARCH_INDICATOR | DELAY_IN_PUBLICATION_OF_RESEARCH_PAYMENT_INDICATOR | NAME_OF_STUDY | CONTEXT_OF_RESEARCH | CLINICALTRIALS_GOV_IDENTIFIER | RESEARCH_INFORMATION_LINK | PRINCIPAL_INVESTIGATOR_COVERED_RECIPIENT_INDICATOR | PRINCIPAL1_INVESTIGATOR_COVERED_RECIPIENT_TYPE | PRINCIPAL1_INVESTIGATOR_FIRST_NAME | PRINCIPAL1_INVESTIGATOR_MIDDLE_NAME | PRINCIPAL1_INVESTIGATOR_LAST_NAME | PRINCIPAL1_INVESTIGATOR_NAME_SUFFIX | PRINCIPAL1_INVESTIGATOR_BUSINESS_STREET_ADDRESS_LINE_1 | PRINCIPAL1_INVESTIGATOR_BUSINESS_STREET_ADDRESS_LINE_2 | PRINCIPAL1_INVESTIGATOR_CITY | PRINCIPAL1_INVESTIGATOR_STATE | PRINCIPAL1_INVESTIGATOR_ZIP_CODE | PRINCIPAL1_INVESTIGATOR_COUNTRY | PRINCIPAL1_INVESTIGATOR_PROVINCE | PRINCIPAL1_INVESTIGATOR_POSTAL_CODE | PRINCIPAL1_INVESTIGATOR_PRIMARY_TYPE | PRINCIPAL1_INVESTIGATOR_NPI | PRINCIPAL1_INVESTIGATOR_SPECIALTY | PRINCIPAL1_INVESTIGATOR_LICENSE_STATE_AND_LICENSE_NUMBER_1 | PRINCIPAL1_INVESTIGATOR_LICENSE_STATE_AND_LICENSE_NUMBER_2 | PRINCIPAL1_INVESTIGATOR_LICENSE_STATE_AND_LICENSE_NUMBER_3 | PRINCIPAL1_INVESTIGATOR_LICENSE_STATE_AND_LICENSE_NUMBER_4 | PRINCIPAL1_INVESTIGATOR_LICENSE_STATE_AND_LICENSE_NUMBER_5 | PRINCIPAL2_INVESTIGATOR_COVERED_RECIPIENT_TYPE | PRINCIPAL2_INVESTIGATOR_FIRST_NAME | PRINCIPAL2_INVESTIGATOR_MIDDLE_NAME | PRINCIPAL2_INVESTIGATOR_LAST_NAME | PRINCIPAL2_INVESTIGATOR_NAME_SUFFIX | PRINCIPAL2_INVESTIGATOR_BUSINESS_STREET_ADDRESS_LINE_1 | PRINCIPAL2_INVESTIGATOR_BUSINESS_STREET_ADDRESS_LINE_2 | PRINCIPAL2_INVESTIGATOR_CITY | PRINCIPAL2_INVESTIGATOR_STATE | PRINCIPAL2_INVESTIGATOR_ZIP_CODE | PRINCIPAL2_INVESTIGATOR_COUNTRY | PRINCIPAL2_INVESTIGATOR_PROVINCE | PRINCIPAL2_INVESTIGATOR_POSTAL_CODE | PRINCIPAL2_INVESTIGATOR_PRIMARY_TYPE | PRINCIPAL2_INVESTIGATOR_NPI | PRINCIPAL2_INVESTIGATOR_SPECIALTY | PRINCIPAL2_INVESTIGATOR_LICENSE_STATE_AND_LICENSE_NUMBER_1 | PRINCIPAL2_INVESTIGATOR_LICENSE_STATE_AND_LICENSE_NUMBER_2 | PRINCIPAL2_INVESTIGATOR_LICENSE_STATE_AND_LICENSE_NUMBER_3 | PRINCIPAL2_INVESTIGATOR_LICENSE_STATE_AND_LICENSE_NUMBER_4 | PRINCIPAL2_INVESTIGATOR_LICENSE_STATE_AND_LICENSE_NUMBER_5 | PRINCIPAL3_INVESTIGATOR_COVERED_RECIPIENT_TYPE | PRINCIPAL3_INVESTIGATOR_FIRST_NAME | PRINCIPAL3_INVESTIGATOR_MIDDLE_NAME | PRINCIPAL3_INVESTIGATOR_LAST_NAME | PRINCIPAL3_INVESTIGATOR_NAME_SUFFIX | PRINCIPAL3_INVESTIGATOR_BUSINESS_STREET_ADDRESS_LINE_1 | PRINCIPAL3_INVESTIGATOR_BUSINESS_STREET_ADDRESS_LINE_2 | PRINCIPAL3_INVESTIGATOR_CITY | PRINCIPAL3_INVESTIGATOR_STATE | PRINCIPAL3_INVESTIGATOR_ZIP_CODE | PRINCIPAL3_INVESTIGATOR_COUNTRY | PRINCIPAL3_INVESTIGATOR_PROVINCE | PRINCIPAL3_INVESTIGATOR_POSTAL_CODE | PRINCIPAL3_INVESTIGATOR_PRIMARY_TYPE | PRINCIPAL3_INVESTIGATOR_NPI | PRINCIPAL3_INVESTIGATOR_SPECIALTY | PRINCIPAL3_INVESTIGATOR_LICENSE_STATE_AND_LICENSE_NUMBER_1 | PRINCIPAL3_INVESTIGATOR_LICENSE_STATE_AND_LICENSE_NUMBER_2 | PRINCIPAL3_INVESTIGATOR_LICENSE_STATE_AND_LICENSE_NUMBER_3 | PRINCIPAL3_INVESTIGATOR_LICENSE_STATE_AND_LICENSE_NUMBER_4 | PRINCIPAL3_INVESTIGATOR_LICENSE_STATE_AND_LICENSE_NUMBER_5 | PRINCIPAL4_INVESTIGATOR_COVERED_RECIPIENT_TYPE | PRINCIPAL4_INVESTIGATOR_FIRST_NAME | PRINCIPAL4_INVESTIGATOR_MIDDLE_NAME | PRINCIPAL4_INVESTIGATOR_LAST_NAME | PRINCIPAL4_INVESTIGATOR_NAME_SUFFIX | PRINCIPAL4_INVESTIGATOR_BUSINESS_STREET_ADDRESS_LINE_1 | PRINCIPAL4_INVESTIGATOR_BUSINESS_STREET_ADDRESS_LINE_2 | PRINCIPAL4_INVESTIGATOR_CITY | PRINCIPAL4_INVESTIGATOR_STATE | PRINCIPAL4_INVESTIGATOR_ZIP_CODE | PRINCIPAL4_INVESTIGATOR_COUNTRY | PRINCIPAL4_INVESTIGATOR_PROVINCE | PRINCIPAL4_INVESTIGATOR_POSTAL_CODE | PRINCIPAL4_INVESTIGATOR_PRIMARY_TYPE | PRINCIPAL4_INVESTIGATOR_NPI | PRINCIPAL4_INVESTIGATOR_SPECIALTY | PRINCIPAL4_INVESTIGATOR_LICENSE_STATE_AND_LICENSE_NUMBER_1 | PRINCIPAL4_INVESTIGATOR_LICENSE_STATE_AND_LICENSE_NUMBER_2 | PRINCIPAL4_INVESTIGATOR_LICENSE_STATE_AND_LICENSE_NUMBER_3 | PRINCIPAL4_INVESTIGATOR_LICENSE_STATE_AND_LICENSE_NUMBER_4 | PRINCIPAL4_INVESTIGATOR_LICENSE_STATE_AND_LICENSE_NUMBER_5 | PRINCIPAL5_INVESTIGATOR_COVERED_RECIPIENT_TYPE | PRINCIPAL5_INVESTIGATOR_FIRST_NAME | PRINCIPAL5_INVESTIGATOR_MIDDLE_NAME | PRINCIPAL5_INVESTIGATOR_LAST_NAME | PRINCIPAL5_INVESTIGATOR_NAME_SUFFIX | PRINCIPAL5_INVESTIGATOR_BUSINESS_STREET_ADDRESS_LINE_1 | PRINCIPAL5_INVESTIGATOR_BUSINESS_STREET_ADDRESS_LINE_2 | PRINCIPAL5_INVESTIGATOR_CITY | PRINCIPAL5_INVESTIGATOR_STATE | PRINCIPAL5_INVESTIGATOR_ZIP_CODE | PRINCIPAL5_INVESTIGATOR_COUNTRY | PRINCIPAL5_INVESTIGATOR_PROVINCE | PRINCIPAL5_INVESTIGATOR_POSTAL_CODE | PRINCIPAL5_INVESTIGATOR_PRIMARY_TYPE | PRINCIPAL5_INVESTIGATOR_NPI | PRINCIPAL5_INVESTIGATOR_SPECIALTY | PRINCIPAL5_INVESTIGATOR_LICENSE_STATE_AND_LICENSE_NUMBER_1 | PRINCIPAL5_INVESTIGATOR_LICENSE_STATE_AND_LICENSE_NUMBER_2 | PRINCIPAL5_INVESTIGATOR_LICENSE_STATE_AND_LICENSE_NUMBER_3 | PRINCIPAL5_INVESTIGATOR_LICENSE_STATE_AND_LICENSE_NUMBER_4 | PRINCIPAL5_INVESTIGATOR_LICENSE_STATE_AND_LICENSE_NUMBER_5 |
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2 | ABCDE Manufacturer | 1000000001 | N | N | 1 | Jennifer | L | Zebrowski | 2455 Covered Harvest St | Chester | MA | 10111 | US | jennifer.zebrowski@generalhospital.com | 121232333 | 3 | 207Q00000X | MA-67667623 | MA-565454 | Y | 1 | 1 | Endocrinology | Triptorelin | 9999-9999-99 | 1 | 1 | Endocrinology | Triptorelin pamoate | 3333-4444-09 | 1 | 1 | Endocrinology | Trastuzumab | 2222-2222-88 | 1 | 2 | Endocrinology | Neurotech Vital Device | 1 | 2 | Endocrinology | Sham Device | ABCDE Manufacturer | 1000000001 | 98761234 | N | 76767.22 | 20211014 | 1 | N | 3 | A Comparison of the TIMI | GRACE and HEART Scores | NCT01398631 | Y | 1 | Barbara | M | Backus | 680 Centre St | Brocton | MA | 230211034 | US | 2 | 4545451234 | 207R00000X | MA-1245662 | MA-1665578 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
3 | ABCDE Manufacturer | 1000000011 | N | N | 2 | St Bernards Hospital | 131334213 | 2345 Library Rd | Birmingham | AL | 35233 | US | admin@bernardhospital.com | Y | 1 | 1 | Hematology | Digoxin | 12345-678-90 | 1 | 1 | Hematology | Metformin | 33322-4455-88 | 1 | 1 | Hematology | Aspirin | 2233-4455-98 | 1 | 2 | Hematology | <A0>Percutaneous Coronary Stenting | 1 | 2 | Hematology | <A0>drug eluting coronary stent | ABCDE Manufacturer | 1000000001 | 98761211 | N | 1253.55 | 20211016 | 1 | 2-100 | N | 3 | Evaluation of BTVS | BTVS trials | Y | 1 | John | Miller | Jr. | 1111 North St | Baltimore | MD | 21213 | US | 1 | 9999999999 | 207RH0003X | MD-11111111 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
4 | ABCDE Manufacturer | 1000000001 | N | N | 10 | John | G | Doe | 1234 Waverly Crossing Lane | Chatilly | VA | 20151 | US | Joh_Doe@xyz.com | 431212423 | 104 | 367500000X | VA-334453 | Y | 1 | 2 | SURGICAL KIT | SURGICAL KIT | D443332UU33 | 1 | 2 | SURGICAL KIT-IMPLANT | SURGICAL KIT-IMPLANT | UV3999833UD333 | ABCDE Manufacturer | 1000000001 | Home-5 | N | 6664.87 | 20211018 | 1 | N | 3 | A Comparison of the Surgery | GRACE and HEART Scores | NCT01398631 | Y | 1 | Barbara | M | Backus | 680 Centre St | Brocton | MA | 23021 | US | 2 | 4545451234 | 207R00000X | MA-1245662 | MA-1665578 | 10 | Allen | Smith | 123 ABC Road | Fairfax | VA | 22033 | US | 101 | 112234532 | 364SX0204X | VA-55446 |