Record 10

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All blank spaces are replaced with periods, out-of-band characters, with '#'. Long fields are shown truncated.

Record Type 1A1
Registry Type 232
FIN Coding System 393
Reserved 00 4.............16
NAACCR Record Version 1712019
NPI--Registry ID 20..........29
Registry ID 30..........39
Tumor Record Number 400141
Patient ID Number 426301301949
Patient System ID-Hosp 50........57
Reserved 01 58.....................................94
Addr at DX--City 95BARRON............................................144
Addr at DX--State 145WY146
Addr at DX--Postal Code 147555530000155
County at DX 156051158
Census Tract 1970/80/90 159......164
CensusBlockGroup 70/80/90 165.165
Census Cod Sys 1970/80/90 166.166
Census Tr Cert 1970/80/90 167.167
Census Tract 2000 168......173
Census Block Group 2000 174.174
Census Tr Certainty 2000 175.175
Marital Status at DX 1765176
Race 1 17701178
Race 2 179..180
Race 3 181..182
Race 4 183..184
Race 5 185..186
Race Coding Sys--Current 1877187
Race Coding Sys--Original 1885188
Spanish/Hispanic Origin 1890189
Computed Ethnicity 1900190
Computed Ethnicity Source 1910191
Sex 1921192
Age at Diagnosis 193063195
Date of Birth 19619400130203
Date of Birth Flag 204..205
Birthplace 206999208
Occupation Code--Census 209...211
Industry Code--Census 212...214
Occupation Source 215.215
Industry Source 216.216
Text--Usual Occupation 217RETIRED..................................................[etc., 100]316
Text--Usual Industry 317.........................................................[etc., 100]416
Occup/Ind Coding System 417.417
NHIA Derived Hisp Original 418.418
Race--NAPIIA (derived API) 419..420
IHS Link 421.421
GIS Coordinate Quality 422..423
RuralUrban Continuum 1993 424..425
RuralUrban Continuum 2003 426..427
Reserved 02 428TEST.RECORD.from.northcon12_u.0.1.8.12/18/2009.10:58:31..[etc., 100]527
Sequence Number--Central 52800529
Date of Diagnosis 53020030323537
Date of Diagnosis Flag 538..539
Primary Site 540C160543
Laterality 5440544
Histology (92-00) ICD-O-2 5458140548
Behavior (92-00) ICD-O-2 5493549
Histologic Type ICD-O-3 5508140553
Behavior Code ICD-O-3 5543554
Grade 5552555
Grade Path Value 556.556
Grade Path System 557.557
Site Coding Sys--Current 5584558
Site Coding Sys--Original 5594559
Morph Coding Sys--Current 5604560
Morph Coding Sys--Originl 5614561
Diagnostic Confirmation 5621562
Type of Reporting Source 5631563
Casefinding Source 564..565
Ambiguous Terminology DX 566.566
Date of Conclusive DX 567........574
Date Conclusive DX Flag 575..576
Mult Tum Rpt as One Prim 577..578
Date of Multiple Tumors 579........586
Date of Mult Tumors Flag 587..588
Multiplicity Counter 589..590
Reserved 03 591.........................................................[etc., 100]690
NPI--Reporting Facility 691..........700
Reporting Facility 7010001234561710
NPI--Archive FIN 711..........720
Archive FIN 721..........730
Accession Number--Hosp 731199500010739
Sequence Number--Hospital 74000741
Abstracted By 742DOE744
Date of 1st Contact 74520030323752
Date of 1st Contact Flag 753..754
Date of Inpatient Adm 755........762
Date of Inpt Adm Flag 763..764
Date of Inpatient Disch 765........772
Date of Inpt Disch Flag 773..774
Inpatient Status 775.775
Class of Case 77600777
Primary Payer at DX 778..779
RX Hosp--ASA Class 780.780
RX Hosp--Surg App 2010 781.781
RX Hosp--Surg Prim Site 7822.783
RX Hosp--Scope Reg LN Sur 784.784
RX Hosp--Surg Oth Reg/Dis 785.785
RX Hosp--Reg LN Removed 786..787
RX Hosp--Surg Timing 788.788
RX Hosp--Radiation 7890789
RX Hosp--Chemo 79000791
RX Hosp--Hormone 79200793
RX Hosp--BRM 79400795
RX Hosp--Other 7960796
RX Hosp--DX/Stg Proc 7972.798
RX Hosp--Palliative Proc 799.799
RX Hosp--Surg Site 98-02 800..801
RX Hosp--Scope Reg 98-02 802.802
RX Hosp--Surg Oth 98-02 803.803
Reserved 04 804.........................................................[etc., 100]903
SEER Summary Stage 2000 904.904
SEER Summary Stage 1977 9059905
EOD--Tumor Size 906999908
EOD--Extension 909..910
EOD--Extension Prost Path 911..912
EOD--Lymph Node Involv 913.913
Regional Nodes Positive 91499915
Regional Nodes Examined 91699917
EOD--Old 13 Digit 918.............930
EOD--Old 2 Digit 931..932
EOD--Old 4 Digit 933....936
Coding System for EOD 937.937
TNM Edition Number 93804939
TNM Path T 9401A1.943
TNM Path N 9441B..947
TNM Path M 948X...951
TNM Path Stage Group 9521B2.955
TNM Path Descriptor 956.956
TNM Path Staged By 957.957
TNM Clin T 9581A1.961
TNM Clin N 9621B..965
TNM Clin M 966X...969
TNM Clin Stage Group 9701B2.973
TNM Clin Descriptor 974.974
TNM Clin Staged By 975.975
Pediatric Stage 976..977
Pediatric Staging System 978..979
Pediatric Staged By 980.980
Tumor Marker 1 9819981
Tumor Marker 2 9829982
Tumor Marker 3 983.983
Lymph-vascular Invasion 984.984
CS Tumor Size 985...987
CS Extension 988...990
CS Tumor Size/Ext Eval 991.991
CS Lymph Nodes 992...994
CS Lymph Nodes Eval 995.995
CS Mets at DX 996..997
CS Mets Eval 998.998
CS Mets at Dx-Bone 999.999
CS Mets at Dx-Brain 1000.1000
CS Mets at Dx-Liver 1001.1001
CS Mets at Dx-Lung 1002.1002
CS Site-Specific Factor 1 1003...1005
CS Site-Specific Factor 2 1006...1008
CS Site-Specific Factor 3 1009...1011
CS Site-Specific Factor 4 1012...1014
CS Site-Specific Factor 5 1015...1017
CS Site-Specific Factor 6 1018...1020
CS Site-Specific Factor 7 1021...1023
CS Site-Specific Factor 8 1024...1026
CS Site-Specific Factor 9 1027...1029
CS Site-Specific Factor10 1030...1032
CS Site-Specific Factor11 1033...1035
CS Site-Specific Factor12 1036...1038
CS Site-Specific Factor13 1039...1041
CS Site-Specific Factor14 1042...1044
CS Site-Specific Factor15 1045...1047
CS Site-Specific Factor16 1048...1050
CS Site-Specific Factor17 1051...1053
CS Site-Specific Factor18 1054...1056
CS Site-Specific Factor19 1057...1059
CS Site-Specific Factor20 1060...1062
CS Site-Specific Factor21 1063...1065
CS Site-Specific Factor22 1066...1068
CS Site-Specific Factor23 1069...1071
CS Site-Specific Factor24 1072...1074
CS Site-Specific Factor25 1075...1077
CS PreRx Tumor Size 1078...1080
CS PreRx Extension 1081...1083
CS PreRx Tum Sz/Ext Eval 1084.1084
CS PreRx Lymph Nodes 1085...1087
CS PreRx Reg Nodes Eval 1088.1088
CS PreRx Mets at DX 1089..1090
CS PreRx Mets Eval 1091.1091
CS PostRx Tumor Size 1092...1094
CS PostRx Extension 1095...1097
CS PostRx Lymph Nodes 1098...1100
CS PostRx Mets at DX 1101..1102
Derived AJCC-6 T 1103..1104
Derived AJCC-6 T Descript 1105.1105
Derived AJCC-6 N 1106..1107
Derived AJCC-6 N Descript 1108.1108
Derived AJCC-6 M 1109..1110
Derived AJCC-6 M Descript 1111.1111
Derived AJCC-6 Stage Grp 1112..1113
Derived AJCC-7 T 1114...1116
Derived AJCC-7 T Descript 1117.1117
Derived AJCC-7 N 1118...1120
Derived AJCC-7 N Descript 1121.1121
Derived AJCC-7 M 1122...1124
Derived AJCC-7 M Descript 1125.1125
Derived AJCC-7 Stage Grp 1126...1128
Derived PreRx-7 T 1129...1131
Derived PreRx-7 T Descrip 1132.1132
Derived PreRx-7 N 1133...1135
Derived PreRx-7 N Descrip 1136.1136
Derived PreRx-7 M 1137...1139
Derived PreRx-7 M Descrip 1140.1140
Derived PreRx-7 Stage Grp 1141...1143
Derived PostRx-7 T 1144...1146
Derived PostRx-7 N 1147...1149
Derived PostRx-7 M 1150..1151
Derived PostRx-7 Stge Grp 1152...1154
Derived SS1977 1155.1155
Derived SS2000 1156.1156
Derived Neoadjuv Rx Flag 1157.1157
Derived AJCC--Flag 1158.1158
Derived SS1977--Flag 1159.1159
Derived SS2000--Flag 1160.1160
CS Version Input Current 1161......1166
CS Version Original 1167......1172
CS Version Derived 1173......1178
SEER Site-Specific Fact 1 1179.1179
SEER Site-Specific Fact 2 1180.1180
SEER Site-Specific Fact 3 1181.1181
SEER Site-Specific Fact 4 1182.1182
SEER Site-Specific Fact 5 1183.1183
SEER Site-Specific Fact 6 1184.1184
ICD Revision Comorbid 1185.1185
Comorbid/Complication 1 1186.....1190
Comorbid/Complication 2 1191.....1195
Comorbid/Complication 3 1196.....1200
Comorbid/Complication 4 1201.....1205
Comorbid/Complication 5 1206.....1210
Comorbid/Complication 6 1211.....1215
Comorbid/Complication 7 1216.....1220
Comorbid/Complication 8 1221.....1225
Comorbid/Complication 9 1226.....1230
Comorbid/Complication 10 1231.....1235
Reserved 05 1236.........................................................[etc., 200]1435
Date of Initial RX--SEER 1436200304201443
Date of Initial RX Flag 1444..1445
Date of 1st Crs RX--CoC 1446200304201453
Date of 1st Crs Rx Flag 1454..1455
RX Date--Surgery 1456200303231463
RX Date--Surgery Flag 1464..1465
RX Date--Most Defin Surg 1466........1473
RX Date Mst Defn Srg Flag 1474..1475
RX Date--Surgical Disch 1476........1483
RX Date Surg Disch Flag 1484..1485
RX Date--Radiation 1486200304201493
RX Date--Radiation Flag 1494..1495
RX Date--Radiation Ended 1496........1503
RX Date Rad Ended Flag 1504..1505
RX Date--Systemic 1506........1513
RX Date Systemic Flag 1514..1515
RX Date--Chemo 1516........1523
RX Date--Chemo Flag 1524111525
RX Date--Hormone 1526........1533
RX Date--Hormone Flag 1534111535
RX Date--BRM 1536........1543
RX Date--BRM Flag 1544111545
RX Date--Other 1546........1553
RX Date--Other Flag 1554111555
RX Date--DX/Stg Proc 1556200303231563
RX Date--Dx/Stg Proc Flag 1564..1565
RX Summ--Treatment Status 1566.1566
RX Summ--Surg Prim Site 1567001568
RX Summ--Scope Reg LN Sur 156901569
RX Summ--Surg Oth Reg/Dis 157001570
RX Summ--Reg LN Examined 1571001572
RX Summ--Surgical Approch 157301573
RX Summ--Surgical Margins 157481574
RX Summ--Reconstruct 1st 157501575
Reason for No Surgery 157611576
RX Summ--DX/Stg Proc 1577021578
RX Summ--Palliative Proc 1579.1579
RX Summ--Radiation 158011580
RX Summ--Rad to CNS 158191581
RX Summ--Surg/Rad Seq 158201582
RX Summ--Transplnt/Endocr 1583..1584
RX Summ--Chemo 1585001586
RX Summ--Hormone 1587001588
RX Summ--BRM 1589001590
RX Summ--Other 159101591
Reason for No Radiation 159201592
RX Coding System--Current 1593041594
First Course Calc Method 1595.1595
Rad--Regional Dose: CGY 1596.....1600
Rad--No of Treatment Vol 16010..1603
Rad--Treatment Volume 1604..1605
Rad--Location of RX 1606.1606
Rad--Regional RX Modality 1607..1608
Rad--Boost RX Modality 1609..1610
Rad--Boost Dose cGy 1611.....1615
RX Summ--Systemic/Sur Seq 1616.1616
RX Summ--Surgery Type 1617021618
Readm Same Hosp 30 Days 1619.1619
RX Summ--Surg Site 98-02 1620..1621
RX Summ--Scope Reg 98-02 1622.1622
RX Summ--Surg Oth 98-02 1623.1623
Reserved 06 1624.........................................................[etc., 100]1723
Subsq RX 2nd Course Date 1724........1731
Subsq RX 2ndCrs Date Flag 1732..1733
Subsq RX 2nd Course Surg 1734001735
Subsq RX 2nd--Scope LN SU 173601736
Subsq RX 2nd--Surg Oth 173701737
Subsq RX 2nd--Reg LN Rem 1738001739
Subsq RX 2nd Course Rad 174001740
Subsq RX 2nd Course Chemo 174101741
Subsq RX 2nd Course Horm 174201742
Subsq RX 2nd Course BRM 174301743
Subsq RX 2nd Course Oth 174401744
Subsq RX 3rd Course Date 1745........1752
Subsq RX 3rdCrs Date Flag 1753..1754
Subsq RX 3rd Course Surg 1755001756
Subsq RX 3rd--Scope LN Su 175701757
Subsq RX 3rd--Surg Oth 175801758
Subsq RX 3rd--Reg LN Rem 1759001760
Subsq RX 3rd Course Rad 176101761
Subsq RX 3rd Course Chemo 176201762
Subsq RX 3rd Course Horm 176301763
Subsq RX 3rd Course BRM 176401764
Subsq RX 3rd Course Oth 176501765
Subsq RX 4th Course Date 1766........1773
Subsq RX 4thCrs Date Flag 1774..1775
Subsq RX 4th Course Surg 1776001777
Subsq RX 4th--Scope LN Su 177801778
Subsq RX 4th--Surg Oth 177901779
Subsq RX 4th--Reg LN Rem 1780001781
Subsq RX 4th Course Rad 178201782
Subsq RX 4th Course Chemo 178301783
Subsq RX 4th Course Horm 178401784
Subsq RX 4th Course BRM 178501785
Subsq RX 4th Course Oth 178601786
Subsq RX--Reconstruct Del 178701787
Reserved 07 1788.........................................................[etc., 100]1887
Over-ride SS/NodesPos 1888.1888
Over-ride SS/TNM-N 1889.1889
Over-ride SS/TNM-M 1890.1890
Over-ride Acsn/Class/Seq 1891.1891
Over-ride HospSeq/DxConf 1892.1892
Over-ride CoC-Site/Type 1893.1893
Over-ride HospSeq/Site 1894.1894
Over-ride Site/TNM-StgGrp 1895.1895
Over-ride Age/Site/Morph 1896.1896
Over-ride SeqNo/DxConf 1897.1897
Over-ride Site/Lat/SeqNo 1898.1898
Over-ride Surg/DxConf 1899.1899
Over-ride Site/Type 1900.1900
Over-ride Histology 1901.1901
Over-ride Report Source 1902.1902
Over-ride Ill-define Site 1903.1903
Over-ride Leuk, Lymphoma 1904.1904
Over-ride Site/Behavior 1905.1905
Over-ride Site/EOD/DX Dt 1906.1906
Over-ride Site/Lat/EOD 1907.1907
Over-ride Site/Lat/Morph 1908.1908
Site (73-91) ICD-O-1 1909....1912
Histology (73-91) ICD-O-1 1913....1916
Behavior (73-91) ICD-O-1 1917.1917
Grade (73-91) ICD-O-1 1918.1918
ICD-O-2 Conversion Flag 191901919
CRC CHECKSUM 1920..........1929
SEER Coding Sys--Current 193051930
SEER Coding Sys--Original 1931.1931
CoC Coding Sys--Current 1932071933
CoC Coding Sys--Original 19340.1935
Vendor Name 1936ABS.......1945
SEER Type of Follow-Up 1946.1946
SEER Record Number 1947..1948
Diagnostic Proc 73-87 1949..1950
Date Case Initiated 1951........1958
Date Case Completed 1959200607261966
Date Case Completed--CoC 1967........1974
Date Case Last Changed 1975200607261982
Date Case Report Exported 1983........1990
Date Case Report Received 1991........1998
Date Case Report Loaded 1999........2006
Date Tumor Record Availbl 2007........2014
ICD-O-3 Conversion Flag 201512015
Reserved 08 2016.........................................................[etc., 100]2115
Date of Last Contact 2116200307072123
Date of Last Contact Flag 2124..2125
Vital Status 212602126
Cancer Status 212722127
Quality of Survival 212882128
Follow-Up Source 212912129
Next Follow-Up Source 2130.2130
Addr Current--City 2131..................................................2180
Addr Current--State 2181..2182
Addr Current--Postal Code 2183.........2191
County--Current 2192...2194
Unusual Follow-Up Method 2195.2195
Recurrence Date--1st 2196........2203
Recurrence Date--1st Flag 2204..2205
Recurrence Type--1st 2206702207
Follow-Up Contact--City 2208..................................................2257
Follow-Up Contact--State 2258..2259
Follow-Up Contact--Postal 2260.........2268
Cause of Death 226915102272
ICD Revision Number 227392273
Autopsy 227422274
Place of Death 22750822277
Follow-up Source Central 2278..2279
Date of Death--Canada 2280........2287
Date of Death--CanadaFlag 2288..2289
Reserved 09 2290..................................................2339
State/Requestor Items 2340........................................................[etc., 1000]3339
Name--Last 3340MORGAN..................................3379
Name--First 3380BENEDICT................................3419
Name--Middle 3420........................................3459
Name--Prefix 3460...3462
Name--Suffix 3463...3465
Name--Alias 3466........................................3505
Name--Maiden 3506........................................3545
Name--Spouse/Parent 3546............................................................3605
Medical Record Number 360608.77.79...3616
Military Record No Suffix 3617..3618
Social Security Number 36197630073493627
Addr at DX--No & Street 3628104.S.STATE.ST..............................................3687
Addr at DX--Supplementl 3688............................................................3747
Addr Current--No & Street 3748............................................................3807
Addr Current--Supplementl 3808............................................................3867
Telephone 386830755569853877
DC State File Number 3878......3883
Follow-Up Contact--Name 3884............................................................3943
Follow-Up Contact--No&St 3944............................................................4003
Follow-Up Contact--Suppl 4004............................................................4063
Latitude 4064..........4073
Longitude 4074...........4084
Reserved 10 4085.........................................................[etc., 200]4284
NPI--Following Registry 4285..........4294
Following Registry 4295..........4304
NPI--Inst Referred From 4305..........4314
Institution Referred From 431500000.....4324
NPI--Inst Referred To 4325..........4334
Institution Referred To 433500002345674344
Reserved 11 4345..................................................4394
NPI--Physician--Managing 4395..........4404
Physician--Managing 4405.5......4412
NPI--Physician--Follow-Up 4413..........4422
Physician--Follow-Up 4423.999998.4430
NPI--Physician--Primary Surg 4431..........4440
Physician--Primary Surg 4441........4448
NPI--Physician 3 4449..........4458
Physician 3 4459........4466
NPI--Physician 4 4467..........4476
Physician 4 4477........4484
Reserved 12 4485..................................................4534
Path Reporting Fac ID 1 4535.........................4559
Path Report Number 1 4560....................4579
Path Date Spec Collect 1 4580..............4593
Path Report Type 1 4594..4595
Path Ordering Fac No 1 4596.........................4620
Path Order Phys Lic No 1 4621....................4640
Path Reporting Fac ID 2 4641.........................4665
Path Report Number 2 4666....................4685
Path Date Spec Collect 2 4686..............4699
Path Report Type 2 4700..4701
Path Ordering Fac No 2 4702.........................4726
Path Order Phys Lic No 2 4727....................4746
Path Reporting Fac ID 3 4747.........................4771
Path Report Number 3 4772....................4791
Path Date Spec Collect 3 4792..............4805
Path Report Type 3 4806..4807
Path Ordering Fac No 3 4808.........................4832
Path Order Phys Lic No 3 4833....................4852
Path Reporting Fac ID 4 4853.........................4877
Path Report Number 4 4878....................4897
Path Date Spec Collect 4 4898..............4911
Path Report Type 4 4912..4913
Path Ordering Fac No 4 4914.........................4938
Path Order Phys Lic No 4 4939....................4958
Path Reporting Fac ID 5 4959.........................4983
Path Report Number 5 4984....................5003
Path Date Spec Collect 5 5004..............5017
Path Report Type 5 5018..5019
Path Ordering Fac No 5 5020.........................5044
Path Order Phys Lic No 5 5045....................5064
Reserved 13 5065.........................................................[etc., 500]5564
Text--DX Proc--PE 5565NA......................................................[etc., 1000]6564
Text--DX Proc--X-ray/Scan 65653/25/95.CT.CHEST/ABD:.POSSIBLE.MASS.AT.GE.JUNCTION.OR.PO[etc., 1000]7564
Text--DX Proc--Scopes 75653/23/95.EGD:MASS.LESION.GE.JUCNTION.MOST.LIKELY.CA.WITH.[etc., 1000]8564
Text--DX Proc--Lab Tests 8565NA......................................................[etc., 1000]9564
Text--DX Proc--Op 9565........................................................[etc., 1000]10564
Text--DX Proc--Path105653/23/95.#612-95.STOMACH.BX.SHOWED.ADENOCA.INFIL.MOD.DIFF[etc., 1000]11564
Text--Primary Site Title11565GE.JUNCTION..............................................[etc., 100]11664
Text--Histology Title11665ADENOCA.MOD.WELL.DIFF....................................[etc., 100]11764
Text--Staging11765TX.NX.MX.99.UNSTAGED....................................[etc., 1000]12764
RX Text--Surgery12765........................................................[etc., 1000]13764
RX Text--Radiation (Beam)137654/20-5/22/95.23F.30D.4137.CGY.TO.STOMACH.@.ST.JOE'S.....[etc., 1000]14764
RX Text--Radiation Other14765........................................................[etc., 1000]15764
RX Text--Chemo15765........................................................[etc., 1000]16764
RX Text--Hormone16765........................................................[etc., 1000]17764
RX Text--BRM17765........................................................[etc., 1000]18764
RX Text--Other18765........................................................[etc., 1000]19764
Text--Remarks197657/7/95.PT.EXPIRED.AT.ST.JOSEPH.HOSPITAL.W/PNEUMONIA,.PLE[etc., 1000]20764
Text--Place of Diagnosis20765............................................................20824
Reserved 1420825........................................................[etc., 2000]22824