308 lines
10 KiB
Plaintext
308 lines
10 KiB
Plaintext
English French Notes Complete/Exclude
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Select FRAME SIZE/TEMPLE LENGTH:
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ENTER THE NAME OF THE FRAMES MANUFACTURER ; 3 TO 30 CHARACTERS ALLOWED
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MAS Disability Code(s):
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Disability%
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Service Connected?
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Is a non-existent code ; Check the MAS disability codes on this patient.
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Enter `^`to exit, or `return` to continue:
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Enter `return` to continue
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YOU MUST ENTER `RETURN` TO FINISH VIEWING MAS DISABILITY CODES
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MAS Disability Codes continued:
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Press `RETURN` to continue.
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Last Movement Actions
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No Movements Recorded for this Patient
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Trans. Type:
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Type of Movement:
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Clinic Enrollments
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No Clinic Enrollments for this Patient
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OPT or AC
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Pending Appointments
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No Pending Appointments for this Patient
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Appt. Date
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Suspense Processing
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INITIAL ACTION DATE
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Chronological list of notes posted to the request...
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No notes have been posted to this request
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Initial Action Note
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Completion Note
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Other Action Note
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posted by
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RMPREO LINK 2319
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Old suspense record, no completion note available.
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VENDOR PHONE:
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Can Not Edit This Suspense Record!
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STOCK ISSUE
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Initial Action Note Already Posted!
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nothing noted
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Can Not Forward.
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Completion Note Already Posted!
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Select Service To Forward Consult:
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Not Forwarded! No Service Selected .
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Must Have Note to Forward. Consult Not Forwarded.
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See Completion Note, this was forwarded to another service.
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not noted
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ERROR, DID NOT FORWARD!
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Consult Forwarded.
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See Completion Note for Initial Action Taken.
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No Initial Action Taken...
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This has already been completed, cannot cancel!
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This will CANCEL/DELETE this Suspense Request.
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Are you sure you want to CANCEL/DELETE this Suspense Request? (Y/N)
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Suspense Not Cancelled!
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DELETED/CANCELLED!
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Someone else is editing this record
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Only CPRS Suspense Can Be Cloned!
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Could NOT CLONE DUE TO BAD DATA!
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Done... Please select a device to print the new SUSPENSE Record.
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Nothing to Display, Manual Suspense.
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RMPR DETAILED DISPLAY
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Select PROSTHETICS SITE PARAMETER SITE NAME
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PIP ROLL-UP
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PIP REPORT
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Prosthetics Data Extract
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The National Data Server has been activated today by Prosthetics HQ.
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Data has been collected for the date range
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Disability Code information will be transmitted.
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PSAS National Extract From
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RMPRXMZ(
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Total Number of Unique SSN's for this site:
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PSAS Summary National Extract From
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Extract From
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Prosthetics National Data Extract
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Message Numbers Created
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Summary
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RMPRM(
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Prosthetics Data Extract Open Obligations
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Data has been collected for all open obligations.
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Select FORM LETTER TYPE:
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Would you like a header on this letter
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Answer `YES` for a header, `NO` for no header
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Enter `return` to continue:
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You may only enter `return` here..
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PRINT PROSTHETICS FL 10-90
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REQUEST FOR QUOTATION
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FROM: Prosthetics Service
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Prosthetics Service
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Vendor Phone #:
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SSN:
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Your firm is being considered for the following:
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An estimate on the above-listed item(s) is requested.
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YOUR QUOTATION
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DOES NOT CONSTITUTE A PURCHASE ORDER.
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Upon completion of the esti-
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mate, return the original to the Veterans Affairs facility indicated
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above and retain a copy for your files.
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If approved, a purchase order will be prepared and forwarded to you.
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VENDOR'S ESTIMATE
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(To be completed by Vendor)
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Article or Service
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|Quantity| Unit |Unit Cost|Total Cost|
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Contract number (if applicable) |
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Signature & Title of Company Official|
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| Note:List Terms/Discounts if Applicable
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FL 10-90 ADP
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Push return to continue
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CONTINUATION OF REQUEST FOR QUOTATION
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SSN:
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CONTINUATION OF ITEM LIST:
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PROSTHETICS GENERIC CODE SHEETS
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AMIS is Already Running!
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PROSTHETICS ORTHOTIC/RESTORATION GENERIC CODE SHEETS
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Would you like to Delete this Transaction
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Would you like to Edit this Transaction
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1R;12R;4R;7R;2R;62R;63;14R~UNIT COST;5R;10;9;21
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Do you wish to POST this entry
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Do you wish to Delete this entry
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Enter HOME/LIAISON VISIT DATE OPENED
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VISIT HAS NOT BEEN CLOSED OUT
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Select HOME/LIAISON VISIT DATE OPENED:
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MSH|^~\&|PROSTHETICS|
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unable to file order
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Request Failed to Suspense
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RMPR SUSP
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RMPR LOAN DEL
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RMPR LOAN CREATE
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RMPR LOAN RET
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RMPR LOAN DISP
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RMPR LOAN FOLLOW-UP
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RMPR LOAN PRINT ALL
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RMPR LOAN EDIT
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RMPR LOAN STAT
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RMPR LOAN MENU
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ENTRIES FOR
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NO. - DESCRIPTION
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NO OUTSTANDING 2237 ENTRIES.
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ELIG/REF
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Select Item to Edit
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Deliver To information is Missing!! 2421 is incomplete
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REQUIRED ITEM INFORMATION IS MISSING
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Do you want to delete the 2421 Request
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Do You want to delete the 2421 Request
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This report lists open purchasing transactions created in the
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Prosthetic Package. It will not include manual transactions done
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in the IFCAP 1358 module.
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OPEN 1358 TRANSACTIONS
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ITEM COST
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This Transaction has been Closed!
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This Transaction has already been Canceled!
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An X in the Item column is an error and must be reported to your Application Coordinator!
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Enter 'W' for WHEELCHAIR, 'O' for BRACE, 'B' for BLIND AIDS, 'A' for ART. LIMBS
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Select PSC ITEM CATEGORY:
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You will not be able to exceed an item repair cost of more than $
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BLIND AID
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ARTIFICIAL LIMB
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Transaction NOT Closed-out, IFCAP Failed to Post for the Following Reason.
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Enter Date to Start NPPD Calculations From:
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DETAIL & NEW SUMMARY
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Prosthetic NPPD
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NO UPDATE!
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NEW TO REPAIR
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REPAIR TO NEW
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Line is null, something wrong with file 661.1 :
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HCPCS DES
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PICKUP/DEL
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Ave Com
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SP LEG
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ELG REF
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$ELG REF
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STATION SUMMARY (REPAIR ACTIVITIES)
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Elg Ref $
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SPEC LEG
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Total Disability:
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HEARING AID, LOCAL REPAIRS
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WHEELCHAIRS AND ACCESSORIES
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ARTIFICIAL LEGS
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ARTIFICIAL ARMS AND TERMINAL DEVICES
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BRACES AND ORTHOTICS
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NEUROSENSORY AIDS
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HOME DIALYSIS EQUIPMENT
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MEDICAL EQUIPMENT
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ALL OTHER
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AUTO & VAN EQUIP
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WHEELCHAIRS AND ACCESSORIES
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ARTIFICIAL LEGS
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ARTIFICIAL ARMS AND TERMINAL DEVICES
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BRACES AND ORTHOTICS
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SHOES/ORTHOTICS
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NEUROSENSORY AIDS
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HOME DIALYSIS EQUIPMENT
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MEDICAL EQUIPMENT
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OXYGEN & RESPIRATORY
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AUTO & VAN EQUIP
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ERROR, STOPPING!
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STATION SUMMARY (NEW ACTIVITIES)
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Unique SSN:
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OXYGEN AND RESPIRATORY
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ALL OTHER SUPPLIES AND EQUIPMENT
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HOME DIALYSIS PROGRAM
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ADAPTIVE EQUIPMENT
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SURGICAL IMPLANTS
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OXYGEN AND RESPIRATORY
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ALL OTHER SUPPLIES AND EQUIPMENT
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HOME DIALYSIS PROGRAM
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ADAPTIVE EQUIPMENT
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SURGICAL IMPLANTS
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Sort Options
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2 or 5 = USED INVENTORY ONLY (NEW REPORT)
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1 or 4 = NEW ITEM COSTS, USED INVENTORY (VA) COST AS ZERO,
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(PREVIOUS BRIEF/DETAILED NPPD REPORT)
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3 or 6 = NEW AND USED COST, BOTH DOLLAR AMOUNTS TOTALED (NEW REPORT)
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USED INVENTORY ONLY
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NEW ITEM COSTS, USED INVENTORY (VA) COST AS ZERO
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NEW AND USED COST, BOTH DOLLAR AMOUNTS TOTALED
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2. ARTIFICIAL LEGS
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3. ARTIFICIAL ARMS AND TERMINAL DEVICES
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8. OXYGEN AND RESPIRATORY
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9. MEDICAL EQUIPMENT
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10. ALL OTHER SUPPLIES AND EQUIPMENT
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11. HOME DIALYSIS PROGRAM
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12. ADAPTIVE EQUIPMENT
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14. SURGICAL IMPLANTS
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REPAIR TO NEW
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Create Date Patient HCPCS Item Vendor PA
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Changed From Line
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To NPPD Line:
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Local Record #:
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Nothing Changed, Someone Was Editing Record. Local Record #:
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Prosthetics Auto-Fix
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Prosthetic 2529-3 NPPD
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REPORT OF 2529-3 REPAIR PROSTHETICS ACTIVITIES
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STATION SUMMARY (2529-3 REPAIR ACTIVITIES)
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2529-3 WHEELCHAIRS AND ACCESSORIES
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2529-3 ARTIFICIAL LEGS
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2529-3 ARTIFICIAL ARMS AND TERMINAL DEVICES
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2529-3 BRACES AND ORTHOTICS
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2529-3 NEUROSENSORY AIDS
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2529-3 HOME DIALYSIS EQUIPMENT
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2529-3 MEDICAL EQUIPMENT
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2529-3 ALL OTHER
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2529-3 AUTO & VAN EQUIP
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REPORT OF 2529-3 NEW PROSTHETICS ACTIVITIES
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STATION SUMMARY (2529-3 NEW ACTIVITIES)
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2529-3 WHEELCHAIRS AND ACCESSORIES
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2529-3 ARTIFICIAL LEGS
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2529-3 ARTIFICIAL ARMS AND TERMINAL DEVICES
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2529-3 BRACES AND ORTHOTICS
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2529-3 NEUROSENSORY AIDS
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2529-3 OXYGEN AND RESPIRATORY
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2529-3 MEDICAL EQUIPMENT
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2529-3 ALL OTHER SUPPLIES AND EQUIPMENT
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2529-3 HOME DIALYSIS PROGRAM
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2529-3 ADAPTIVE EQUIPMENT
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2529-3 SURGICAL IMPLANTS
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2529-3 OXYGEN AND RESPIRATORY
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2529-3 ALL OTHER SUPPLIES AND EQUIPMENT
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2529-3 HOME DIALYSIS PROGRAM
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2529-3 ADAPTIVE EQUIPMENT
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2529-3 SURGICAL IMPLANTS
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2529-3 Form Type Only
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This Represents Prosthetic Lab Transactions
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2529-3 LAB DETAIL
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2529-3 LAB BRIEF
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1. 2529-3 WHEELCHAIRS AND ACCESSORIES
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2. 2529-3 ARTIFICIAL LEGS
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3. 2529-3 ARTIFICIAL ARMS AND TERMINAL DEVICES
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4. 2529-3 BRACES AND ORTHOTICS
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6. 2529-3 NEUROSENSORY AIDS
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8. 2529-3 OXYGEN AND RESPIRATORY
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9. 2529-3 MEDICAL EQUIPMENT
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10. 2529-3 ALL OTHER SUPPLIES AND EQUIPMENT
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11. 2529-3 HOME DIALYSIS PROGRAM
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12. 2529-3 ADAPTIVE EQUIPMENT
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14. 2529-3 SURGICAL IMPLANTS
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Select 2529-3 NPPD Group
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Select 2529-3 NPPD Line
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Please Enter the 2319 Date or the Patient's Name:
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Would You like to Delete this 2319 Entry (Y/N)
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OPEN STOCK ISSUES
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Would you like Approve Multiple Purchases
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Would you like to Approve this Request
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Request not Approved
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***WORKING COPY***
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CONTINUATION OF 2421
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17. Signature and Title of
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Approved For
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Voucher Auditor
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Acct. Symbol
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ADP Form 10-2421 APR 1991
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****DUPLICATE COPY****
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In Reply Refer to:
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With reference to your request of
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, authority is granted to repair
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the appliance described below for the above-named veteran.
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DESCRIPTION OF APPLIANCE OR REPAIR
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The total cost, not including mailing cost, will not exceed
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When repairs are completed, please attach the original of this letter to
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the original copy of your invoice covering repair charges. Your invoice,
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in original and one copy should then be forwarded to this office for
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Please retain the duplicate copy of this letter for your files.
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ADP FORM 10-55
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PROSTHETICS PRINT OF 10-55
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<REQUEST DID NOT QUEUE!>
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#################### #################### ####################
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#################### #################### ####################
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#################### #################### ####################
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#################### #################### ####################
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#################### #################### ####################
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