English	French	Notes	Complete/Exclude
PSC Category: 			
Item:			
Unit Cost :			
Actual Unit Cost: 			
Serial #:			
Patient Category: 			
Type of Transaction: 			
Special Category: 			
Appliance/Repair: 			
Item Remarks: 			
Brief Description: 			
Extended Description:			
(Example, PO number), or Bank Authorization Number (6 digit number).			
ERROR** This transaction was not posted to 2319, please contact your IRM..			
Ready to Reconcile and Close-Out Transaction			
You may now Close-out and Post this Transaction. Please answer Yes or No.			
Transaction NOT Closed-Out!			
** No Item selected..			
2R~UNIT COST;			
4R~UNIT OF ISSUE;7;11////C			
DO YOU WANT TO ADD A DUPLICATE ITEM?			
***** NOT CLOSED-OUT !!!!			
**** NOT CLOSED-OUT!! ****			
**** TRANSACTION NOT CLOSED-OUT!! ****			
Enter Next Transaction to Close-out, or <RETURN> to continue.			
INCOMPLETE RECORD..file 664..entry..			
...PLEASE CONTACT YOUR IRM or CANCEL THIS ENTRY!!!			
UNKNOWN 2319 RECORD TO UPDATE, 2319 NOT UPDATED!			
This Transaction has already been CLOSED!			
This Transaction has been CANCELED!			
Updated 			
 10-2319 record for this Veteran			
Would You like to Edit another Entry (Y/N) 			
NOT DELIVERED/ACCEPTED			
RMPR FCP MANAGER			
SUB TOTAL: 			
NO ITEMS ON FILE			
AMIS: 			
NO CODE FOR THIS ITEM			
PSAS HCPCS CODE: 			
UNIT COST: 			
ITEM COST: 			
SPEC/LEG			
Enter '^' to Quit Display, <Return> to Continue : 			
This report lists Open Purchase Card Transactions created in the			
Prosthetics Package.			
This report is sorted by Transaction Date and Initiator.			
The PC # column is the abbreviated Purchase Card Transaction Number,			
Example:  644-PC546, would display as 546.			
OPEN 2421PC TRANSACTIONS			
Item Cost			
 Open 2421PC Transactions     			
...now posting to file 660...			
**** POSTING TO 2319 FOR ITEM..			
PLEASE RUN CLOSE-OUT OPTION AGAIN...			
Select Transaction or Patient Name: 			
<REQUEST QUEUED>			
<REQUEST NOT QUEUED>			
OMB Number 2900-0188			
Estimated Burden: 4 minutes			
***ORIGINAL COPY AND COMMERCIAL INVOICE MUST BE SUBMITTED***			
TO THE VAMC PROSTHETIC ACTIVITY LISTED BELOW			
Prosthetic Authorization for Items or Services			
1. Name and Address of Vendor			
2. Name and Address of VA Facility			
NO STATE ON FILE			
3. Veterans Name (Last, First, MI)			
4. Date of Authorization			
5. Veterans Address			
6. Date Required			
9. Authority For Issuance  CFR 17.115			
CHARGE MEDICAL APPROPRIATION			
7. Claim Number			
10. Statistical Data			
11. FOB Point			
13. Delivery Time			
14. Delivery To: 			
15. DESCRIPTION OF ITEMS OR SERVICES AUTHORIZED			
ITEM NUMBER			
DESCRIPTION/NOMENCLATURE			
***SEE ATTACHED CONTINUATION SHEET FOR ITEM DESCRIPTION(S)***			
CONTINUATION OF PURCHASE CARD 			
16. Contract Number: 			
Discount $			
Shipping: 			
17. Signature of			
19. Signature and Title of			
Requesting Official			
Contracting/Accountable Officer			
Order and Receipt Action			
21. Order Number			
22. Date of Order			
23. Date Item Received			
24. Date Delivered			
25. The articles or services listed herein have been received, or rendered			
ordered in the quantity and quality specified orginally or as shown by			
authenticated changes, except as noted.			
Signature of Veteran or VA Official			
VOUCHER AUDIT BLOCK (For use by VA Facility only)			
Bank Authorization Number: 			
Acct. Symbol 			
ADP Form 10-2421PC  APR 1991			
52.224-2 PRIVACY ACT (APR 1984)			
(a)  The Contractor agrees to---			
(1) Comply with the Privacy Act of 1974 (the Act) and the agency rules and			
regulations issued under the Act in the design, development, or operation 			
of any system of records on individuals to accomplish an agency function when			
the contract specifically identifies---			
(i)  The systems of records: and			
(ii) The design, development, or operation work that the contractor is to			
(2) Include the Privacy Act notification contained in this contract in every			
solicitation and resulting subcontract and in every subcontract awarded without			
a solicitation, when the work statement in the proposed subcontract required the			
redesign, development, or operation of a system of records on individuals that			
is subject to the Act; and			
(3) Include this clause, including this subparagraph (3), in all subcontracts			
awarded under this contract which requires the design, development, or opera-			
tion of such a system of records.			
(b)  In the event of violations of the Act, a civil action may be brought ag-			
ainst the agency involved when the violation concerns the design, development or			
operation of a system of records on individuals to accomplish an agency function,			
and criminal penalties may be imposed upon the officers or employees of the ag-			
ency when the violation concerns the operation of a system of records on indivi-			
duals to accomplish an agency function. For purposes of the Act, when the con-			
tract is for the operation of a system of records on individuals to accomplish			
an agency function, the Contractor is considered to be an employee of the agen-			
Operation of a system of records,			
 as used in this clause, means per-			
formance of any of the activities associated with maintaining the system of re-			
cords, including the collection, use, and dissemination of records.			
Record,			
 as used in this clause, means any item, collection, or grouping			
of information about an individual that is maintained by an agency, including,			
but not limited to, education, financial transactions, medical history, and			
criminal or employment history and that contains the person's name, or the iden-			
tifying number, symbol, or other identifying particular assigned to the indivi-			
dual, such as a fingerprint or voiceprint or a photograph.			
System of records on individuals			
 as used in this clause, means a			
group of any records under the control of any agency from which information is			
retrieved by the name of the individual or by some identifying number, symbol,			
or other identifying particular assigned to the individual.			
MR. 			
MS. 			
In reply refer to: 			
Accounting Symbol 			
This is to notify you that the items listed below were ordered			
for you on 			
.  Delivery of this equipment is expected			
on or about 			
in 30 days from the order date.			
If you do not receive it within 5 days of the expected date,			
please contact 			
, of my staff, at 			
17;16;8////^S X=$G(RMTYPE);9////^S X=$G(RMCAT);10////^S X=$G(RMSPE);1R~BRIEF DESCRIPTION OF ITEM (for Vendor);			
17;8TYPE OF TRANSACTION;9PATIENT CATEGORY;S RMPRDIS=+$P(^RMPR(664,DA(1),1,DA,0),U,10);S Y=$S(RMPRDIS=4:			
);@2;3QTY;2;4UNIT OF ISSUE;11////C;			
;@1;10SPECIAL CATEGORY;S Y=			
Enter the IFCAP Site used with the Purchase Card Module			
The following site you select will be used on all your			
Purchase Card Transactions in IFCAP only.			
Prosthetics PIP Extract			
G.RMPR SERVER			
The Prosthetics PIP Inventory Data was transmitted to PSAS HQ today.			
The dates used for Days On-Hand, and Days Average Usage Rate calculations			
The server was activated by 			
No HQ mail address is defined in your PROSTHETICS SITE			
  PARAMETERS file for the PIP report.  The PIP report			
  will not be run.  Please contact your system administrator			
  or enter a NOIS in Forum for the NVS Team.			
VHACOPSASPIPReport@med.va.gov			
No Records to Print !!			
GRAND TOTAL $ VALUE ISSUED (Used) = 			
GRAND TOTAL $ VALUE ON-HAND (Used) = 			
GRAND TOTAL $ VALUE ISSUED (New)  = 			
GRAND TOTAL $ VALUE ON-HAND (New)  = 			
PROSTHETIC INVENTORY ITEM DETAIL REPORT			
 calendar days ]			
HCPCS     PSAS/ITEM			
HCPCS    DESCRIPTION			
NPPD LINE			
NPPD GROUP			
V.A.(Used)  Total| COM. (New)  Total| Total |Days Ave  |  Stock On-Hand| Days   |Total $ Value On-Hand			
Issue     $ Value| Issue     $ Value| Issue |Usage Rate|  Used    New  | On-Hand|   Used        New			
INVENTORY REPORT			
RMPRSEL(			
Select inventory report level of detail			
Ending date should not precede start date			
Select NPPD line(s) within the above group			
NPPD Lines for Group: 			
Choose HCPCS selection option			
Select HCPCS 			
You need at least 132 columns for this report.			
Please use a device capable of this requirement.			
100:WHEELCHAIRS AND ACCESSORIES			
200:ARTIFICIAL LEGS			
300:ARTIFICIAL ARMS AND TERMINAL DEVICES			
400:BRACES AND ORTHOTICS			
600:NEUROSENSORY AIDS			
800:OXYGEN AND RESPIRATORY			
900:MEDICAL EQUIPMENT			
910:ALL OTHER SUPPLIES AND EQUIPMENT			
920:HOME DIALYSIS PROGRAM			
930:ADAPTIVE EQUIPMENT			
960:SURGICAL IMPLANTS			
Processing report.......			
NPPD_GROUP			
NPPD_LINE			
HCPC_CODE			
HCPC_ITEM			
ISSUE COST			
INVENTORY_IEN			
HCPC_IEN			
PIP DETAIL ITEM REPORT			
PIP HCPCS SUMMARY REPORT			
PIP NPPD LINE SUMMARY REPORT			
PIP NPPD GROUP SUMMARY REPORT			
          GRAND TOTAL $ VALUE ISSUED (Used) = $			
          GRAND TOTAL $ VALUE ON-HAND (Used) = $			
          GRAND TOTAL $ VALUE ISSUED (New)  = $			
          GRAND TOTAL $ VALUE ON-HAND (New)  = $			
HCPCS   DESCRIPTION			
NPPD LINE          			
NPPD GROUP         			
    V.A.(Used)  Total| COM. (New)  Total| Total |Days Ave  |  Stock On-Hand| Days   |Total $ Value On-Hand			
PROSTHETIC INVENTORY HCPCS SUMMARY REPORT			
PROSTHETIC INVENTORY NPPD GROUP/LINE REPORT			
GRAND TOTAL $ VALUE ON-HAND = 			
PROSTHETIC INVENTORY NPPD GROUP REPORT			
ENTIRE SUMMARY			
..Duplicate HCPCS			
STOCK ITEM REPORT			
RMPRI(			
Processing report......			
*** ISSUE and STOCK CONTROL RECORD - PROSTHETICS STOCK ITEMS ***			
*** Dollar Value of HCPCS Issued			
*** Dollar Value of Item Issued			
No Item Statistics for HCPCS: 			
...for this date range !!!			
NO DATA AT THIS DATE RANGE!!!!			
Enter 'ALL' for all Locations or 'RETURN' to select individual Locations: 			
Select Location 			
..Duplicate Location			
PROSTHETIC INVENTORY LOCATION SUMMARY			
Processing report.....			
*** PROSTHETICS INVENTORY BALANCE BY LOCATION ***			
NO DATA !!!!			
Enter 'ALL' for all HCPCS or 'RETURN' to select individual HCPCS: 			
*** PROSTHETICS INVENTORY BALANCE BY HCPCS ***			
NO DATA !!!!!			
Enter 'ALL' for all Lab Employees or 'RETURN' to select individual names: 			
Select EMPLOYEE 			
..Duplicate employee name			
PROS LAB ITEM SUMMARY			
PROSTHETICS LAB ITEM SUMMARY BY EMPLOYEE			
TIME SPENT(hr)			
No Lab data for Employee: 			
 ....for this date range !!!			
NO DATA FOR THIS DATE RANGE!!!			
Adding Item to a Location.....			
Enter Pros Location: 			
Record in use. Try again later...			
Select HCPCS to ADD 			
** No HCPCS Selected or Unable to Select Inactive HCPCS...			
Enter Item to Add: 			
22R;23R~TOTAL COST OF QUANTITY;24;25R;26;27			
Added/Updated by 			
Delete an Inventory Location.....			
This option now requires the electronic signatures of 2 users			
holding the RMPRMANAGER key to be entered before a location			
Are you sure you want to DELETE this LOCATION (Y/N) 			
Nothing Deleted..			
Location is deleted!!!!			
Pease ask another user with the RMPRMANAGER key to			
enter their user name and electronic signature.			
Enter user name of 2nd manager:			
The 2nd manager must be different to the manager logged on.			
The 2nd manager does not have the correct security key set up.			
The above location contains 			
 types of items			
with a total quantity of 			
 and cost of $			
Editing an Inventory Item in a Location.....			
Location has been edited from '			
Select HCPCS to EDIT: 			
** No HCPCS selected...			
Enter PSAS Item to Edit: 			
29;22R;23R~TOTAL COST OF QUANTITY;24;25R;26;27			
This will DELETE all HCPCS and ITEMS under this LOCATION...			
Ordering ITEM from Supply or Vendor....			
Select HCPCS to ORDER: 			
Enter Item to ORDER: 			
Quantity to Order			
*** Item was not ordered....			
Enter quantity 1 to 99999..			
Order from supply or vendor			
 was ordered....			
*** Receiving Item from Supply, Vendor or Veteran...			
Enter Receiving Location: 			
Select HCPCS to RECEIVE: 			
Enter Item to RECEIVE: 			
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