GLOBAL MAP DATA DICTIONARY #161 -- FEE BASIS PATIENT FILE                                                         9/29/25    PAGE 1
STORED IN ^FBAAA(  *** NO DATA STORED YET ***   SITE: WWW.BMIRWIN.COM   UCI: VISTA,VISTA                           (VERSION 3.5)   
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CONTAINS ALL AUTHORIZATIONS FOR FEE BASIS SERVICES.  
 
Per VHA Directive 10-93-142, this file definition should not be modified.  


CROSS
REFERENCED BY: FROM DATE(AC), VENDOR(ACV), FEE ID CARD NUMBER(AE), FROM DATE(AENR01), TO DATE(AENR02), FEE PROGRAM(AENR03), 
               TREATMENT TYPE CODE(AENR095), AUSTIN DELETE FLAG(AENR102), PRINT AUTHORIZATION (Y/N)(AF), 
               POTENTIAL COST RECOVERY CASE(AIC), FROM DATE(AIC1), FEE ID CARD NUMBER(AOLD), ARCH ELIGIBILITY DATE(ARCH), 
               ARCH ELIGIBILITY DETERMINATION(ARCHSRC), FROM DATE(ATST), NAME(B), FEE ID CARD NUMBER(C)

INDEXED BY:    CONTRACT (ACN)


^FBAAA(D0,0)= (#.01) NAME [1P:2] ^ 
^FBAAA(D0,1,0)=^161.01ID^^  (#1) AUTHORIZATION
^FBAAA(D0,1,D1,0)= (#.01) FROM DATE [1D] ^ (#.02) TO DATE [2D] ^ (#.03) FEE PROGRAM [3P:161.8] ^ (#.04) VENDOR [4P:161.2] ^ 
                ==>(#101) PRIMARY SERVICE AREA [5P:4] ^  ^ (#.07) PURPOSE OF VISIT CODE [7P:161.82] ^ (#.08) DX LINE 1 [8F] ^ 
                ==>(#.055) ASSOCIATED 7078/583 [9V] ^  ^  ^  ^ (#.095) TREATMENT TYPE CODE [13S] ^ (#2) TYPE OF CARE [14S] ^ 
                ==>(#.06) DISCHARGE TYPE [15S] ^  ^  ^ (#.065) PATIENT TYPE CODE [18S] ^ (#.096) ACCIDENT RELATED (Y/N) [19F] ^ 
                ==>(#.097) POTENTIAL COST RECOVERY CASE [20F] ^ (#104) REFERRING PROVIDER [21P:200] ^ (#105) CONTRACT 
                ==>[22P:161.43] ^ 
^FBAAA(D0,1,D1,1)=  ^ (#3) DATE PRINTED [2D] ^ 
^FBAAA(D0,1,D1,2,0)=^161.06^^  (#.021) AUTHORIZATION REMARKS
^FBAAA(D0,1,D1,2,D2,0)= (#.01) AUTHORIZATION REMARKS [1W] ^ 
^FBAAA(D0,1,D1,3)= (#.085) DX LINE 2 [1F] ^ (#.086) DX LINE 3 [2F] ^ 
^FBAAA(D0,1,D1,100)= (#100) CLERK [1P:200] ^ 
^FBAAA(D0,1,D1,ADEL)= (#102) AUSTIN DELETE FLAG [1F] ^ (#103) DATE DELETE MRA TRANSMITTED [2D] ^ 
^FBAAA(D0,1,D1,C)= (#1) PRINT AUTHORIZATION (Y/N) [1F] ^ (#.087) ICD DIAGNOSIS [2P:80] ^ 
^FBAAA(D0,1,D1,LOG1,0)=^161.192D^^  (#292) USER AUDIT
^FBAAA(D0,1,D1,LOG1,D2,0)= (#.01) DATE/TIME EDITED [1D] ^ (#1) EDITED BY [2P:200] ^ (#2) COMMENTS [3F] ^ 
^FBAAA(D0,1,D1,LOG2,0)=^161.193D^^  (#293) DATA AUDIT
^FBAAA(D0,1,D1,LOG2,D2,0)= (#.01) CHANGED DATE/TIME [1D] ^ (#1) FIELD [2F] ^ (#2) OLD VALUE [3F] ^ (#3) NEW VALUE [4F] ^ (#4) 
                        ==>CHANGED BY [5P:200] ^ 
^FBAAA(D0,2,0)=^161.02D^^  (#2) REPORT OF CONTACT
^FBAAA(D0,2,D1,0)= (#.01) DATE OF CONTACT [1D] ^ (#1) VENDOR/PROVIDER [2F] ^ (#1.5) VENDOR/PROVIDER TELEPHONE NO. [3F] ^ (#3) DX 
                ==>[4F] ^ (#5) INPUT DATE [5D] ^ (#3.5) TYPE OF CONTACT [6S] ^ 
^FBAAA(D0,2,D1,1,0)=^161.04^^  (#2) NARRATIVE
^FBAAA(D0,2,D1,1,D2,0)= (#.01) NARRATIVE [1W] ^ 
^FBAAA(D0,2,D1,100)= (#100) CLERK [1P:200] ^ 
^FBAAA(D0,4)= (#.5) FEE ID CARD NUMBER [1F] ^ (#.6) FEE ID CARD ISSUE DATE [2D] ^ (#.7) REASON FOR CARD NUMBER CHANGE [3F] ^ 
           ==>(#.65) FEE ID CARD EXPIRATION DATE [4D] ^ 
^FBAAA(D0,ARCHFEE,0)=^161.011D^^  (#11) ARCH ELIGIBILITY
^FBAAA(D0,ARCHFEE,D1,0)= (#.01) ARCH ELIGIBILITY DATE [1D] ^ (#2) ARCH ELIGIBILITY [2S] ^ (#3) ARCH ELIGIBILITY DETERMINATION 
                      ==>[3P:200] ^ (#4) JUSTIFICATION [4P:161.35] ^ (#5) VERIFICATION OF MILEAGE [5F] ^ 


INPUT TEMPLATE(S):
^DIE(1057)= FB UNAUTHORIZED EDIT    
^DIE(1047)= FB UNAUTHORIZED UPDATE    
^DIE(1058)= FB UNAUTHORIZED UPDATE1    
^DIE(1015)= FBAA AUTHORIZATION    Compiled: ^FBCTAU
^DIE(1018)= FBAA REPORT OF CONTACT    
^DIE(1035)= FBNH EDIT AUTHORIZATION    
^DIE(1033)= FBNH ENTER AUTHORIZATION    

PRINT TEMPLATE(S):

SORT TEMPLATE(S):

FORM(S)/BLOCK(S):