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1 | CCRS.zip\CCRS\ccra-2.5.0.zip\ccra-2.5.0-1582193c50aced3fa6ab803711ab119c7d5c9158\artifacts\Build_2\Sprint_4\docs | Sample CCN Obligation Numbers.xlsx | Mon Apr 9 15:28:51 2018 UTC |
2 | CCRS.zip\CCRS\ccra-2.5.0.zip\ccra-2.5.0-1582193c50aced3fa6ab803711ab119c7d5c9158\artifacts\Build_2\Sprint_4\docs | Sample CCN Obligation Numbers.xlsx | Fri Jun 15 15:22:04 2018 UTC |
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1 | SHEET: Fee Stdz | ||
2 | Sample CCN Obligatio n Numbers under a Co nsolidated Obligatio n Structur e, | ||
3 | Category o f Care,Cat egory of C are Subset ,Obligatio n Number, | ||
4 | Hospitaliz ations,Con tract/Non Contracted Hospital izations ( Authorized ),741Y9101 0 | ||
5 | , | ||
6 | Hospitaliz ations,Sta te Contrac t Hospital izations ( Authorized ),741Y9102 0, | ||
7 | Unauthoriz ed Care,Mi ll Bill/Un authorized Inpatient Care,741Y 91030, | ||
8 | Mill Bill/ Unauthoriz ed Outpati ent Care,7 41Y91040, | ||
9 | Medical Em ergency Tr ansportati on (1725) Ambulance, 741Y91050, | ||
10 | Non-Instit utional Ca re,ADHC (A dult Day H ealth Care ),741Y9106 0, | ||
11 | Home Maker Health Ai d / Respit e Care Ser vices,741Y 91070, | ||
12 | Home Hospi ce,741Y910 80, | ||
13 | Home Infus ion_TPN/IV ,741Y91090 , | ||
14 | Home Skill ed Care (R N/PT/OT) ( includes B owel & Bla dder),741Y 91100, | ||
15 | Non-Instit utional Ca re,Veteran Directed Home and C ommunity B ased Servi ces Progra m (VD-HCBS ),741Y9111 0, | ||
16 | Medical/ S urgical Auth orized Out patient Me dical/Surg ical Autho rized-Incl udes all a ncillary s ervices & profession al fees no t identifi ed elsewhe re, i.e. l ab, x-rays , office v isits,Outp atient -Me dical/Surg ical Autho rized-incl udes all a ncillary s ervices & profession al fees no t identifi ed elsewhe re i.e. la bs, x-rays , office v isits, pha rmacy, Rad iation, On cology, et c... ,741Y 91120 | ||
17 | , | ||
18 | Dialysis,D ialysis VA National Contract S ervices,74 1Y91130, | ||
19 | Dialysis V A Locally Provided S ervices,74 1Y91140, | ||
20 | Dental,Fee Dental Se rvices,741 Y91150 | ||
21 | , | ||
22 | Contract N ursing Hom e,Contract Nursing H ome,741Y91 160 | ||
23 | , | ||
24 | VADOD Shar ing,VA DOD (Inpatien t/Outpatie nt),741Y91 170, | ||
25 | Behavioral Health,Al cohol and Drug Treat ment and R ehabilitat ion,741Y91 180, | ||
26 | , | ||
27 | Note - the se assume that the f irst refer ral won't affect cur rent year funds and will be do ne in FY19 . Also OCC Finance w ill not ac tually cre ate the ob ligations until CCN is live., | ||
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