Agency Check Audit Report FDI010 (Output)

The Agency Check Audit Report FDI010 (Output) produces two listings of benefit data where the serial number was issued or voided between the selected From and To dates.  The detail listing is by serial number and the summary listing is by State WIC ID. The Excel output is generated on demand. The report is generated when the OK button is clicked on the Generate Agency Check Audit Report screen.

The format of the detail report is as follows:

• Column A = Check Serial Number

• Column B = Clinic Name

• Column C = State WIC ID

• Column D = Household ID

• Column E = Household Size

• Column F = Address

• Column G = City

• Column H = Zip Code

• Column I = County

• Column J = Annual Income Amount

• Column K = Issuing Clinic

• Column L = Date of Birth

• Column M = Gender

• Column N = Medical Assistance Flag

• Column O = Certification Start Date

• Column P = Issue Date

• Column Q = Staff ID

• Column R = Void Flag

• Column S = Void Date

The format of the summary report is as follows:

• Column A = Clinic Name

• Column B = State WIC ID

• Column C = Household ID

• Column D = Household Size

• Column E = Address

• Column F = City

• Column G = Zip Code

• Column H = County

• Column I = Annual Income Amount

• Column J = Date of Birth

• Column K = Gender

• Column L = Medical Assistance Flag

• Column M = Certification Start Date

• Column N = Issue Date

• Column O = Staff ID

• Column P = Void Flag

• Column Q = Void Date

"FDI010"

"Agency Check Audit Report - Detail/Summary"

Data Elements - Detail Report

This section describes the data elements that print on the detail system output. Because of space constraints, the layout may be slightly different and/or all characters may not print within the space allotted.

Column A (Check Serial Number)

Origin of Data Element

This value is the SerialNo column of the FoodInstrument table for the selected records.

Format

This is an eight-character value.

Column B (Clinic Name)

Origin of Data Element

This value is the ServiceSiteName column of the ServiceSite table for the clinic the participant is currently assigned to. The AgencyID and ServiceSiteID columns of the Member table are used to get the name from the ServiceSite table.

Format

This is a fifty-character value.

Column C (State WIC ID)

Origin of Data Element

This value is the StateWICID column of the FoodInstrumentSet table for the selected records.

Format

This is an eight-character value.

Column D (Household ID)

Origin of Data Element

This value is the HouseholdID column of the Member table for the selected records.

Format

This is an eight-character value.

Column E (Household Size)

Origin of Data Element

This value is the HouseholdSize column of the Household table for the selected records.

Format

This is a two-digit value.

Column F (Address)

Origin of Data Element

This value is the MailAddress column of the Household table for the selected records.

Format

This is a fifty-character value.

Column G (City)

Origin of Data Element

This value is the MailCity column of the Household table for the selected records.

Format

This is a thirty-character value.

Column H (Zip Code)

Origin of Data Element

This value is the MailZip column of the Household table for the selected records.

Format

This is a five-character value.

Column I (County)

Origin of Data Element

This value is the Name column of the County table for the selected records.

Format

This is a thirty-character value.

Column J (Annual Income Amount)

Origin of Data Element

This value is the AnnualIncome column of the IncomeContact table. The system will look for the most current income contact where the screen date is less than or equal to the issued date of the benefit and the income contact includes an adjunctive eligibility of Medicaid.

Format

This is a eight-digit value.

Column K (Issuing Clinic)

Origin of Data Element

This value is the ServiceSiteName column of the ServiceSite table for the clinic that issued the benefit. The AgencyID and ServiceSiteID columns of the FoodInstrumentSet table are used to get the name from the ServiceSite table.

Format

This is a fifty-character value.

Column L (Date of Birth)

Origin of Data Element

This value is the DateOfBirth column of the Member table for the selected records.

Format

This is a date value formatted as MM/DD/CCYY.

Column M (Gender)

Origin of Data Element

This value is the Gender column of the Member table for the selected records.

Format

This is a one-character value.

Column N (Medical Assistance Flag)

Origin of Data Element

This value is a "Y/N" flag that indicates whether or not the participant had an income contact where the screen date is less than or equal to the issued date of the benefit and the income contact includes an adjunctive eligibility of Medicaid.

Format

This is a one-character value.

Column O (Certification Start Date)

Origin of Data Element

This value is the min CertEffectiveDate of the CertContact table for the participant.

Format

This is a date value formatted as MM/DD/CCYY.

Column P (Issue Date)

Origin of Data Element

This value is the IssuedDate of the FoodInstrumentSet table for the selected records.

Format

This is a date value formatted as MM/DD/CCYY.

Column Q (Staff ID)

Origin of Data Element

This value is the CreateUserID of the FoodInstrumentSet table for the participant.

Format

This is a twenty-character value.

Column R (Void Flag)

Origin of Data Element

This value is a "Y/N" flag that indicates whether or not the benefit was voided. If the VoidedDate of the FoodInstrument table is null, the value is "N". Otherwise, he value is "Y".

Format

This is a one-character value.

Column S (Void Date)

Origin of Data Element

This value is the VoidedDate of the FoodInstrument table for the selected records.

Format

This is a date value formatted as MM/DD/CCYY.

Data Elements - Summary Report

This section describes the data elements that print on the summary system output. Because of space constraints, the layout may be slightly different and/or all characters may not print within the space allotted.

Column A (Clinic Name)

Origin of Data Element

This value is the ServiceSiteName column of the ServiceSite table for the clinic the participant is currently assigned to. The AgencyID and ServiceSiteID columns of the Member table are used to get the name from the ServiceSite table.

Format

This is a fifty-character value.

Column B (State WIC ID)

Origin of Data Element

This value is the StateWICID column of the FoodInstrumentSet table for the selected records.

Format

This is an eight-character value.

Column C (Household ID)

Origin of Data Element

This value is the HouseholdID column of the Member table for the selected records.

Format

This is an eight-character value.

Column D (Household Size)

Origin of Data Element

This value is the HouseholdSize column of the Household table for the selected records.

Format

This is a two-digit value.

Column E (Address)

Origin of Data Element

This value is the MailAddress column of the Household table for the selected records.

Format

This is a fifty-character value.

Column F (City)

Origin of Data Element

This value is the MailCity column of the Household table for the selected records.

Format

This is a thirty-character value.

Column G (Zip Code)

Origin of Data Element

This value is the MailZip column of the Household table for the selected records.

Format

This is a five-character value.

Column H (County)

Origin of Data Element

This value is the Name column of the County table for the selected records.

Format

This is a thirty-character value.

Column I (Annual Income Amount)

Origin of Data Element

This value is the AnnualIncome column of the IncomeContact table. The system will look for the most current income contact where the screen date is less than or equal to the issued date of the benefit and the income contact includes an adjunctive eligibility of Medicaid.

Format

This is a eight-digit value.

Column J (Date of Birth)

Origin of Data Element

This value is the DateOfBirth column of the Member table for the selected records.

Format

This is a date value formatted as MM/DD/CCYY.

Column K (Gender)

Origin of Data Element

This value is the Gender column of the Member table for the selected records.

Format

This is a one-character value.

Column L (Medical Assistance Flag)

Origin of Data Element

This value is a "Y/N" flag that indicates whether or not the participant had an income contact where the screen date is less than or equal to the issued date of the benefit and the income contact includes an adjunctive eligibility of Medicaid.

Format

This is a one-character value.

Column M (Certification Start Date)

Origin of Data Element

This value is the min CertEffectiveDate of the CertContact table for the participant.

Format

This is a date value formatted as MM/DD/CCYY.

Column N (Issue Date)

Origin of Data Element

This value is the IssuedDate of the FoodInstrumentSet table for the selected records.

Format

This is a date value formatted as MM/DD/CCYY.

Column O (Staff ID)

Origin of Data Element

This value is the CreateUserID of the FoodInstrumentSet table for the participant.

Format

This is a twenty-character value.

Column P (Void Flag)

Origin of Data Element

This value is a "Y/N" flag that indicates whether or not the benefit was voided. If the VoidedDate of the FoodInstrument table is null, the value is "N". Otherwise, he value is "Y".

Format

This is a one-character value.

Column Q (Void Date)

Origin of Data Element

This value is the VoidedDate of the FoodInstrument table for the selected records.

Format

This is a date value formatted as MM/DD/CCYY.

Filter Criteria

Base of Data

For the detail report, all benefits that were issued or voided during the selected time frame are included in the report. For the summary report, all participants that were issued benefits or had a benefit voided during the selected time frame are included in the report. The following selection criteria must be met for both the detail and summary report.

• The AgencyID column of the FoodInstrumentSet table equals the agency selected.

• One of the following is true.

• The IssuedDate column of the FoodInstrumentSet table is between the selected From and To dates, inclusive.

• The VoidedDate column of the FoodInstrument table is between the selected From and To dates, inclusive.

Sort Order - Detail Report

Check Serial Number

The report will be sorted by Check Serial Number.

Sort Order - Summary Report

State WIC ID

The report will be sorted by State WIC ID.