| 1 | English French  Notes   Complete/Exclude
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| 2 | Patient is in an 'EXEMPT' status and requires property information.                     
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| 3 | Patient's deductible expenses cannot exceed income.                     
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| 4 | Patient has more than one spouse for this means test.                   
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| 5 | Since assets exceed the threshold, the                  
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| 6 |  test can                       
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| 7 | be sent to adjudication.  If the                        
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| 8 |  test is not                    
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| 9 | adjudicated, the patient will be placed in                      
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| 10 | GMT Copay Required                      
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| 11 | MT Copay Required                       
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| 12 | Non-exempt                      
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| 13 | Do you wish to send this case to adjudication                   
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| 14 | PRINT 10-10F                    
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| 15 | THIS OUTPUT REQUIRES 132 COLUMN OUTPUT TO THE PRINTER.                  
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| 16 | CANNOT QUEUE TO HOME DEVICE!                    
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| 17 | Print 10-10F                    
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| 18 |  to CONTINUE,                   
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| 19 | to EDIT,                        
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| 20 |  for screen N, or                       
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| 21 |  to EXIT:                       
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| 22 | Enter <RET> to continue to the next available screen.                   
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| 23 | Enter an available item number from                     
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| 24 |  to edit.                       
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| 25 | The items should be separated by commas or a range of numbers                   
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| 26 | separated by a dash, or a combination of commas and dashes.                     
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| 27 | To edit a specific column, enter 'V'                    
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| 28 |  in front of the selected items.                        
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| 29 | Enter 'ALL' to edit all available items on the screen.                  
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| 30 | Enter '^N' to jump to a select screen.  Enter '^' to exit.                      
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| 31 | AVAILABLE SCREENS                       
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| 32 | IOINHI;IOINLOW                  
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| 33 | ANNUAL INCOME FOR                       
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| 34 | Means Test Signed?:                     
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| 35 | Patient Requires a Means Test                   
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| 36 | Patient's Means Test is Pending Adjudication for                        
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| 37 | Means Test Not Required                 
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| 38 | Patient's status is                     
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| 39 |  based on primary means test                    
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| 40 | Has                     
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| 41 |  agreed to pay the deductible                   
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| 42 | Primary Means Test                      
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| 43 | Required from                   
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| 44 | Last Applied                    
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| 45 |  (NO LONGER REQUIRED:                   
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| 46 | proceed with                    
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| 47 |  the means test at this time                    
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| 48 | *** Patient Requires a Means Test ***                   
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| 49 | Primary Means Test Required from                        
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| 50 | Patient's Test dated                    
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| 51 |  The test                       
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| 52 | date is greater than 365 days old.  Please update.                      
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| 53 | Cannot copy information.  Either there is no prior year income                  
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| 54 | or there is income already on file for this year.                       
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| 55 | Previous year data contains a negative amount.  Data cannot be copied.                  
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| 56 | Patient:                        
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| 57 | Date of Test:                   
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| 58 | Total Dependents:                       
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| 59 | Type Of Test:                   
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| 60 | Status:                 
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| 61 | Date/Time Completed:                    
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| 62 | Primary Test For Year:                  
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| 63 | Source Of Test:                 
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| 64 | Income:                 
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| 65 | Completed By:                   
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| 66 | Net Worth:                      
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| 67 | Date/Time Category Changed:                     
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| 68 | Deductible Expenses:                    
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| 69 | Category Changed By:                    
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| 70 | Agreed to Pay Deduct.:                  
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| 71 | Adjudicated Date/Time:                  
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| 72 | Declines Income Info:                   
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| 73 | No Longer Required Date:                        
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| 74 | No Longer Applicable Date:                      
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| 75 | MT Threshold:                   
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| 76 | Hardship Review Date:                   
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| 77 | GMT Threshold:                  
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| 78 | Date Vet Signed Test:                   
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| 79 | Income Data Purged:                     
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| 80 | Means Test Signed?:                     
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| 81 | Refused to Sign:                        
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| 82 | Date IVM MT Completed:                  
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| 83 | Hardship Approved By:                   
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| 84 | OTHER VAMC                      
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| 85 | Hardship Review Site:                   
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| 86 | Hardship Reason:                        
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| 87 | COMMENT(S):                     
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| 88 | Date Range Selection                    
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| 89 |    Past dates are not allowed.                  
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| 90 | Division Selection                      
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| 91 | Clinic Selection                        
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| 92 | LOCAL INCOME TEST                       
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| 93 |  TEST INCOME INFORMATION IS NOT AVAILABLE **                    
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| 94 | ** MEANS TEST IS NO LONGER REQUIRED INCOME INFORMATION MAY NOT BE ACCURATE **                   
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| 95 | ** COPAY TEST IS NO LONGER APPLICABLE INCOME INFORMATION MAY NOT BE ACCURATE **                 
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| 96 | DETAILED MEANS TEST INCOME INFORMATION COULD NOT BE CONVERTED FOR THE                   
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| 97 | FOLLOWING RELATIONS ASSOCIATED WITH THIS MEANS TEST:                    
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| 98 | NET WORTH                       
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| 99 | TO COLLECT THE NEW DETAILED DEPENDENT DEMOGRAPHIC AND INCOME INFORMATION                        
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| 100 | THE MEANS TEST WOULD HAVE TO BE EDITED.                 
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| 101 | Variables DGCAT, DGINT, DGNWT, DGTHA, DGTYC and DGMTS must be defined!                  
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| 102 | Variables DFN, DGND, DGDET and DGMTDT must be defined!                  
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| 103 | DECLINES TO GIVE INCOME INFO                    
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| 104 | DG(408.32,                      
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| 105 | NJ13,2                  
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| 106 | DEDUCTIBLE EXPENSES                     
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| 107 | NJ2,0                   
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| 108 | TOTAL DEPENDENTS                        
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| 109 | COMPLETED BY                    
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| 110 | DATE/TIME COMPLETED                     
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| 111 | SITE CONDUCTING TEST                    
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| 112 | AGREED TO PAY DEDUCTIBLE                        
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| 113 | NJ8,2                   
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| 114 | THRESHOLD A                     
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| 115 | THRESHOLD B                     
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| 116 | GMT THRESHOLD                   
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| 117 | PREVIOUS YEARS THRESHOLD                        
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| 118 | HARDSHIP REVIEW DATE                    
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| 119 | APPROVED BY                     
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| 120 | HARDSHIP EFFECTIVE DATE                 
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| 121 | SITE GRANTING HARDSHIP                  
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| 122 | HARDSHIP REASON                 
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| 123 | PERMANENTLY INCAPABLE OF SELF-SUPPORT                   
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| 124 | DID THE CHILD LIVE WITH YOU                     
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| 125 | DID YOU CONTRIBUTE TO THE CHILD'S SUPPORT                       
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| 126 | DID CHILD HAVE ANY INCOME                       
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| 127 | WAS THE CHILD'S INCOME AVAILABLE TO YOU                 
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| 128 | Variables DGDR and DGVIR0 must be defined!                      
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| 129 | NJ8,2X                  
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| 130 | MEDICAL EXPENSES                        
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| 131 | FUNERAL AND BURIAL EXPENSES                     
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| 132 | VETERAN'S EDUCATIONAL EXPENSES                  
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| 133 | Variable DGDR and DGPRTY must be defined!                       
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| 134 | NJ10,2X                 
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| 135 | SOCIAL SECURITY (NOT SSI)                       
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| 136 | U.S. CIVIL SERVICE                      
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| 137 | U.S. RAILROAD RETIREMENT                        
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| 138 | MILITARY RETIREMENT                     
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| 139 | UNEMPLOYMENT COMPENSATION                       
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| 140 | OTHER RETIREMENT                        
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| 141 | NJ9,2X                  
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| 142 | TOTAL INCOME FROM EMPLOYMENT                    
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| 143 | INTEREST, DIVIDEND, OR ANNUITY                  
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| 144 | WORKERS COMP. OR BLACK LUNG                     
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| 145 | ALL OTHER INCOME                        
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| 146 | Variables DFN and DGDR must be defined!                 
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| 147 | WAS YOUR MARITAL STATUS EITHER MARRIED OR SEPARATED ON DEC 31ST LAST YEAR                       
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| 148 | DID YOU LIVE WITH YOUR SPOUSE LAST YEAR                 
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| 149 | NJ8,2XR                 
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| 150 | IF YOU DID NOT LIVE WITH SPOUSE, AMOUNT CONTRIBUTED TO SPOUSE LAST YEAR                 
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| 151 | DID YOU HAVE ANY DEPENDENT CHILDREN                     
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| 152 | CASH, AMOUNTS IN BANK ACCOUNTS                  
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| 153 | STOCKS AND BONDS                        
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| 154 | REAL PROPERTY                   
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| 155 | OTHER PROPERTY OR ASSETS                        
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| 156 | DA))'>0                 
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| 157 | DA)                     
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| 158 | TE VALUE                        
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| 159 | ` BULLETIN WILL NOT BE TRIGGERED)                       
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| 160 | -1^MISSING DFN                  
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| 161 | -1^Missing DFN                  
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| 162 | UNABLE TO GENERATE RELEASE NOTES!!                      
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| 163 | GENERATING FOR VERSION                  
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| 164 | MAS VERSION                     
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| 165 |  RELEASE NOTES                  
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| 166 |  NOT VALID                      
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| 167 | Did you receive Nose or Throat Radium Treatments in the military?                       
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| 168 | Did you serve as an aviator in the military before Jan 31, 1955?                        
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| 169 | Did you have submarine training in the military before Jan 1, 1965?                     
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| 170 | DGNT VERIFY                     
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| 171 | Do you want to verify now?                      
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| 172 | Nose and throat radium treatment verified by:                   
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| 173 | Has the veteran been diagnosed with Cancer of the Head and/or Neck?                     
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| 174 | Enter the sort type                     
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| 175 | Current N/T Radium Treatment Pending Verification report.                       
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| 176 | **** No records to report. ****                 
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| 177 | Total Patients Pending                  
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| 178 | Documentation                   
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| 179 | REPORT STOPPED AT USER REQUEST                  
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| 180 | Total Patients Pending Verification:                    
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| 181 | N/T RADIUM TREATMENT PENDING VERIFICATION REPORT                        
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| 182 | Avi                     
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| 183 | Sub                     
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| 184 | Date/Time Entered                       
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| 185 | YES,PENDING BOTH DOCUMENTATION AND DIAGNOSIS                    
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| 186 | YES,PENDING DOCUMENTATION                       
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| 187 | YES,PENDING DIAGNOSIS                   
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| 188 | YES,VERIFIED                    
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| 189 | Enter date of ASIH:                     
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| 190 | You have entered a future date...to prevent the printing                        
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| 191 | of a negative report, remember to task this request for                 
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| 192 | the appropriate date.                   
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| 193 | ASIH LIST FOR                   
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| 194 | *** THERE ARE NO PATIENTS OUT ON ASIH FOR                       
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| 195 | Enter <RET> to continue or ^ to Quit                    
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| 196 | DISCRETIONARY WORKLOAD OPTIONS ARE NO LONGER AVAILABLE!                 
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| 197 | Do you wish (I)npatient,(O)utpatient,or (B)oth reports: BOTH//                  
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| 198 | DGODOP1,^DGODNP1                        
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| 199 | Enter I,O,B, or ^ to QUIT                       
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| 200 | Purge single (M)onth or (A)ll or (^ to quit): MONTH//                   
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| 201 | MONTH/YR                        
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| 202 | RUN DATE                        
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| 203 | Nothing purged, all your data is current                        
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| 204 | Select MONTH/YEAR to PURGE:                     
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| 205 | SELECT ENTRY FROM LIST IN MONTH/YEAR FORMAT.                    
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| 206 | IF JANUARY 1988 WAS LISTED YOU WOULD ENTER 01/88                        
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| 207 | ARE YOU SURE YOU WISH TO PURGE YOUR FILE                        
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| 208 | INPATIENT DISCHARGES BY MEANS TEST CATEGORY                     
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| 209 | REPORT REQUIRES 132 COLUMN OUTPUT                       
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| 210 | QUEUE ON DEVICE:                        
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| 211 | CANNOT QUEUE TO YOUR OWN DEVICE                 
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| 212 | CONTINUE DIRECTLY TO YOUR I/O DEVICE//                  
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| 213 | If you say YES execution will begin immediately and your default i/o device will hang during compilation, NO or ^ will end                      
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| 214 | Requested Start Time:                   
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| 215 | DISCRETIONARY WORK REPORT-                      
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| 216 | From DATE:                      
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| 217 | To DATE:                        
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| 218 | TO DATE IS LESS THAN FROM DATE, TRY AGAIN                       
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| 219 | SC 50-100%^A&A/HB/WW1/POW/MEX^SC<50%^NSC/PEN^NSC^DOM^                   
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| 220 | Elapsed time for this run:                      
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| 221 | INPATIENT DISCHARGES REPORT                     
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| 222 | DATE RANGE: FROM                        
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| 223 | MEANS TEST CLASSIFICATION                       
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| 224 | FACILITY:                       
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| 225 | TOTAL DISCHARGES:                       
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| 226 | Patients remaining  on                  
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| 227 | VETERAN ELIGIBILITY                     
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| 228 | NON-VETERAN ELIGIBILITY                 
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| 229 | Hit RETURN to continue                  
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| 230 | SUBTOTAL %                      
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| 231 | Inpatient Workload Summary                      
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| 232 | TOTAL %                 
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| 233 | TOTAL VISITS:                   
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| 234 | Outpatient Workload Summary                     
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| 235 | Admitted on                     
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| 236 | Died while an inpatient on                      
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| 237 | Died on                         
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| 238 | Unscheduled visit on                    
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| 239 | Inpatient List                  
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| 240 | SORT BY                 
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| 241 | START WITH                      
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| 242 | WARD LOCATION                   
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| 243 | Enter all or part of a ward name.  If the FROM and TO wards are pure                    
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| 244 | numbers (no alphas), no wards with an alpha suffix will appear on the sort.                     
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| 245 | GO TO                   
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| 246 | End must be after beginning                     
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| 247 | PRINT WITH WARD BREAKOUT                        
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| 248 | PRINT WITH DRG BREAKOUT                 
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| 249 | INPATIENT LIST                  
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| 250 | Patient name                    
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| 251 | Admit/Tran Ward                 
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| 252 | LOS   AA Pass   UA ASIH                 
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| 253 | Avg                     
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| 254 | Int-                    
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| 255 | Affil                   
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| 256 | Days to                 
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| 257 | Trim                    
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| 258 | Nat/Loc                 
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| 259 | WARD LOCATION:                  
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| 260 | DIVISION(S):                    
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| 261 | '+' Before the Patient name indicates patient is currently ASIH, '!' Indicates patient chose not to be in Facility Directory                    
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| 262 | LEGEND:  '####' - Stay exceeds high trim,  '**' - Stay exceeds 69% of high trim,  '@' Stay exceeds 49% of high trim                     
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| 263 | Press '^' to QUIT or Return to Continue                 
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| 264 | BAD 'CN' CROSS REFERENCE FOR WARD                       
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| 265 | , PATIENT NUMBER                        
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| 266 | No DRG can be calculated                        
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| 267 | Rm:                     
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| 268 | Spec:                   
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| 269 | Sort this report by (W)ard or (P)rovider?  WARD//                       
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| 270 | Enter W to sort this report of inpatients by WARD                       
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| 271 | or P to sort the report by PROVIDER.                    
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| 272 | Which provider?                         
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| 273 | (P)rimary Care, (A)ttending, or (E)ITHER? EITHER//                      
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| 274 | Enter P to sort this report of inpatients by PRIMARY CARE PHYSICIAN                     
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| 275 | A to sort the report by ATTENDING PHYSICIAN, or                 
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| 276 | E to print the report where the provider was EITHER                     
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| 277 | Attending or Primary Care                       
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| 278 | Sub-sort by (N)ame of Patient or (R)oom  NAME//                         
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| 279 | SECONDARY SORT ORDER:                   
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| 280 | Enter N to sort this report of inpatients by NAME                       
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| 281 | or R to sort the report by ROOM NUMBER.                 
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| 282 | Note: ROOM NUMBER = First set of numbers that appear in ROOM-BED                        
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| 283 | WOULD YOU LIKE THE INPATIENT ROSTER DOUBLE SPACED                       
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| 284 | Enter 'Y'es to double space this report, 'N'o to single space                   
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| 285 | HOW MANY COPIES OF THE INPATIENT ROSTER WOULD YOU LIKE? 1//                     
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| 286 | Enter a number from 1 to 10 indicating the number of copies you want printed.                   
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| 287 | THIS REPORT REQUIRES 132 COLUMN OUTPUT                  
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| 288 | VAUTD#^VAUTW#^DGPVAR^DGHOW^DGCPYS^DGDS^DGSUBS                   
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| 289 | INPATIENT ROSTER                        
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| 290 | ROOM-BED                        
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| 291 | '!' Before the Patient name indicates the patient chose not to be listed in the Facility Directory                      
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| 292 | Display report for (D)ATE RANGE or (C)URRENT DATE:  CURRENT//                   
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| 293 | You may display report for :                    
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| 294 | Include Service Connected Inpatients                    
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| 295 | VAUTD#^DGBEG^DGBEG1^DGEND^DGEND1^DGL^DGSC                       
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| 296 | Enter the beginning date:                       
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| 297 | The ending date can not be before the beginning date                    
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| 298 | C for CURRENT DATE - Report will display only those patients that                       
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| 299 | are inpatients in hospital today.                       
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| 300 | D for DATE RANGE - to display all patients that were admitted                   
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| 301 | to the hospital during that period.                     
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| 302 | Choose (Y)es or (N)o:                   
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| 303 | ####################    ####################    ####################    
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| 304 | ####################    ####################    ####################    
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| 305 | ####################    ####################    ####################    
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| 306 | ####################    ####################    ####################    
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| 307 | ####################    ####################    ####################    
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