File FEE_BASIS_INVOICE(162.5) Data List

NUMBER	INVOICE DATE RECEIVED	SUSPEND CODE	FEE PROGRAM	PAYMENT TYPE CODE	REJECT STATUS	REJECT REASON	OLD BATCH NUMBER	INTERFACE REJECT	REJECT CODE	VOID PAYMENT	REASON FOR VOIDED PAYMENT	SUPERVISOR WHO VOIDED	DESCRIPTION OF SUSPENSION	DATE FINALIZED	VENDOR	BATCH NUMBER	PURPOSE OF VISIT	PATIENT TYPE CODE	PRIMARY SERVICE FACILITY	DISCHARGE DRG	DRG WEIGHT	RESUBMISSION	NVH PRICER AMOUNT	VETERAN	ICD1	POA1	ICD2	POA2	ICD3	POA3	ICD4	POA4	ICD5	POA5	ICD6	POA6	ICD7	POA7	ICD8	POA8	ICD9	POA9	ICD10	POA10	ICD11	POA11	ICD12	POA12	ICD13	POA13	ICD14	POA14	ICD15	POA15	ICD16	POA16	ICD17	POA17	ICD18	POA18	ICD19	POA19	ICD20	POA20	ICD21	POA21	ICD22	POA22	ICD23	POA23	ICD24	POA24	ICD25	POA25	ADMITTING DIAGNOSIS	ASSOCIATED 7078/583	PROC1	PROC2	PROC3	PROC4	PROC5	PROC6	PROC7	PROC8	PROC9	PROC10	PROC11	PROC12	PROC13	PROC14	PROC15	PROC16	PROC17	PROC18	PROC19	PROC20	PROC21	PROC22	PROC23	PROC24	PROC25	DATE PAID	VENDOR INVOICE DATE	PROMPT PAY TYPE	CHECK NUMBER	CANCELLATION DATE	TREATMENT FROM DATE	REASON CODE	CANCELLATION ACTIVITY	DISBURSED AMOUNT	INTEREST AMOUNT	COVERED DAYS	PATIENT CONTROL NUMBER	FPPS CLAIM ID	FPPS LINE ITEM	ADJUSTMENT	REMITTANCE REMARK	TREATMENT TO DATE	DISCHARGE TYPE CODE	BILLED CHARGES	PAYMENT BY MEDICARE/FED AGENCY	CONTRACT	ROUTING NUMBER	ACCOUNT NUMBER	FINANCIAL INSTITUTION	ATTENDING PROV NAME	ATTENDING PROV NPI	ATTENDING PROV TAXONOMY CODE	OPERATING PROV NAME	OPERATING PROV NPI	RENDERING PROV NAME	AMOUNT CLAIMED	RENDERING PROV NPI	RENDERING PROV TAXONOMY CODE	SERVICING PROV NAME	SERVICING PROV NPI	REFERRING PROV NAME	REFERRING PROV NPI	LINE ITEM RENDERING PROV	AMOUNT PAID	SERVICING FACILITY ADDRESS	SERVICING FACILITY CITY	SERVICING FACILITY STATE	SERVICING FACILITY ZIP	UNIQUE CLAIM IDENTIFIER	DoD INVOICE NUMBER	IPAC VENDOR AGREEMENT	AUTHORIZATION NUMBER	CLAIM LEVEL ALLOWED AMOUNT	AMOUNT SUSPENDED	PAYMENT METHODOLOGY	ATTACHMENT ID