FileMan FileNo | FileMan Filename | Package |
---|---|---|
161.23 | FEE BASIS CNH AUTHORIZATION RATE | Fee Basis |
Package | Total | FileMan Files |
---|---|---|
Fee Basis | 2 | VA FORM 10-7078(#162.4)[.03] FEE BASIS PATIENT(#161)[.04] |
Field # | Name | Loc | Type | Details |
---|---|---|---|---|
.01 | FROM DATE | 0;1 | DATE | ************************REQUIRED FIELD************************
|
.02 | TO DATE | 0;2 | DATE | ************************REQUIRED FIELD************************
|
.03 | ASSOCIATED 7078 | 0;3 | POINTER TO VA FORM 10-7078 FILE (#162.4) | ************************REQUIRED FIELD************************ VA FORM 10-7078(#162.4)
|
.04 | PATIENT | 0;4 | POINTER TO FEE BASIS PATIENT FILE (#161) | ************************REQUIRED FIELD************************ FEE BASIS PATIENT(#161)
|
.05 | PER DIEM RATE | 0;5 | NUMBER | ************************REQUIRED FIELD************************
|
.06 | CONTRACT | 0;6 | FREE TEXT |
|