Report Record Number
Provider Control Type Code
Provider Number
Report Status Code
Initial Report Switch
Last Report Switch
Transmittal Number
Fiscal Intermediary Number
Automated Desk Review Vendor Code
Utilization Code
Special Indicator
National Provider Identifier
Fiscal Year Begin Date
Fiscal Year End Date
HCRIS Process Date
Fiscal Intermediary Create Date
Notice of Program Reimbursement Date
Fiscal Intermediary Receipt Date