Arizona

Organization(s)
Arizona Department of Health Services/Bureau of Public Health Statistics/Section of Cost Reporting and Discharge Data Review
Organizational Website
http://www.azdhs.gov/preparedness/public-health-statistics/index.php
Organization Type
State government data organization
Organization Contact Name
Donna J. Courtney
Organization Contact Email
donna.courtney@azdhs.gov
Sent Survey
Responded to Survey
State Mandate
Yes
Hospital Data Collection- Inpatient Data
Mandatory
Hospital Data Collection- Emergency Department
Mandatory
PUF- Inpatient Data
Mandatory
PUF- Emergency Department
Mandatory
URL for Data Dictionary
http://www.azdhs.gov/plan/crr/ddr/hospa1/pdf/ddma.pdf
Legislation/Law/Statute
Arizona Revised Statute A.R.S. §36.125.05.
Rule/Regulation/Code
Arizona Administrative Code A.A.C. R9-11-401 & 402 (inpatient) A.A.C. R9-11-501 & 502 (emergency department)
States that make hospital-level data available
Yes
Cost of PUF
$900 per set (one type of data, six months of discharges); Researcher - $300 per set (one type of data, six months of discharges).
PUF elements support AHRQ QI release
Yes
UB 04 Format- for inpatient
Electronic submission crosswalks to UB-04
Name
Yes
Date of Birth
Yes
Race/Ethnicity
B
Gender
Yes
ST Address
Yes
Zipcode
Yes
Medical Record No.
Yes
Patient SSN
Yes
Newborn Birthweight
Yes
Mom's Medical Record # (Newborn)
No
Mom's Madien Name
No
Other
Hlth cert/claims as ID's
POA
Yes
DNR
Yes
Collect Physician Name (First, Middle, Last)
Yes
Collect NPI
Yes
Collect Physician State License Number
Yes
Attending Physician
Yes
Operating Physician
Yes
Other Physician
Yes