File FEE_BASIS_UNAUTHORIZED_CLAIMS(162.7) Data List
| DATE CLAIM RECEIVED |
FEE PROGRAM |
VENDOR |
DISPOSITION |
DISPOSITION REMARKS |
APPEAL DISPOSITION REMARKS |
COVA DISPOSITION REMARKS |
DATE OF DISPOSITION |
AUTHORIZED FROM DATE |
AUTHORIZED TO DATE |
AMOUNT APPROVED |
REASON FOR DISAPPROVAL |
*DISPOSITON DESCRIPTION |
*REASON FOR PENDING |
PRINT LETTER? |
DATE LETTER SENT |
DATE REQ INFO SENT |
VETERAN |
MASTER CLAIM |
REOPEN CLAIM DATE |
DATE OF ORIGINAL DISPOSITION |
CLAIM SUBMITTED BY |
STATUS |
DATE OF CURRENT STATUS |
EXPIRATION DATE OF CLAIM |
EXTENSIONS |
ENTERED/LAST EDITED BY |
DATE ENTERED/LAST EDITED |
DISCHARGE TYPE |
USER AUDIT |
DATA AUDIT |
TREATMENT FROM DATE |
AUTHORIZATION |
38 U.S.C. 1725 |
FPPS CLAIM ID |
TREATMENT TO DATE |
DIAGNOSIS |
ICD DIAGNOSIS |
NOTICE OF DISAGREEMENT RECV'D |
STATEMENT OF THE CASE ISSUED |
DATE SUBSTANTIVE APPEAL RECV'D |
DATE APPEAL DISPOSITIONED |
DATE APPEALED TO COVA |
DATE COVA APPEAL DISPOSITIONED |
PRIMARY SERVICE FACILITY |
DATE VALID CLAIM RECEIVED |
AMOUNT CLAIMED |
PATIENT TYPE CODE |