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Last active June 22, 2023 20:02
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Financial Status Report Calculations
{
"personalIdentification": {
"ssn": "1234",
"fileNumber": "5678",
"fsrReason": "Compromise, Waiver"
},
"personalData": {
"veteranFullName": {
"first": "Greg",
"middle": "A",
"last": "Anderson"
},
"address": {
"addresslineOne": "1200 Park Ave",
"addresslineTwo": "c/o Pixar",
"addresslineThree": "",
"city": "Emeryville",
"stateOrProvince": "CA",
"zipOrPostalCode": "94608",
"countryName": "US"
},
"telephoneNumber": "(510) 922-4444",
"dateOfBirth": "04/05/1933",
"married": true,
"spouseFullName": {
"first": "Angela",
"middle": "",
"last": "Mitchell"
},
"agesOfOtherDependents": [
"12",
"17"
],
"employmentHistory": [
{
"veteranOrSpouse": "VETERAN",
"occupationName": "Full time",
"from": "01/2021",
"to": "",
"present": true,
"employerName": "Test",
"employerAddress": {
"addresslineOne": "",
"addresslineTwo": "",
"addresslineThree": "",
"city": "",
"stateOrProvince": "",
"zipOrPostalCode": "",
"countryName": ""
}
},
{
"veteranOrSpouse": "VETERAN",
"occupationName": "Full time",
"from": "01/2021",
"to": "12/2021",
"present": false,
"employerName": "I quit",
"employerAddress": {
"addresslineOne": "",
"addresslineTwo": "",
"addresslineThree": "",
"city": "",
"stateOrProvince": "",
"zipOrPostalCode": "",
"countryName": ""
}
},
{
"veteranOrSpouse": "SPOUSE",
"occupationName": "Full time",
"from": "06/2018",
"to": "",
"present": true,
"employerName": "Spouse Current",
"employerAddress": {
"addresslineOne": "",
"addresslineTwo": "",
"addresslineThree": "",
"city": "",
"stateOrProvince": "",
"zipOrPostalCode": "",
"countryName": ""
}
},
{
"veteranOrSpouse": "SPOUSE",
"occupationName": "Full time",
"from": "03/2015",
"to": "06/2018",
"present": false,
"employerName": "Spouse Previous",
"employerAddress": {
"addresslineOne": "",
"addresslineTwo": "",
"addresslineThree": "",
"city": "",
"stateOrProvince": "",
"zipOrPostalCode": "",
"countryName": ""
}
}
]
},
"income": [
{
"veteranOrSpouse": "VETERAN",
"monthlyGrossSalary": "123.00",
"deductions": {
"taxes": "1.00",
"retirement": "0.00",
"socialSecurity": "0.00",
"otherDeductions": {
"name": "",
"amount": "0.00"
}
},
"totalDeductions": "1.00",
"netTakeHomePay": "122.00",
"otherIncome": {
"name": "Disability Compensation, Education, Social Security, Alimony",
"amount": "3672.20"
},
"totalMonthlyNetIncome": "3794.20"
},
{
"veteranOrSpouse": "SPOUSE",
"monthlyGrossSalary": "0.00",
"deductions": {
"taxes": "0.00",
"retirement": "0.00",
"socialSecurity": "0.00",
"otherDeductions": {
"name": "",
"amount": "0.00"
}
},
"totalDeductions": "0.00",
"netTakeHomePay": "0.00",
"otherIncome": {
"name": "Disability Compensation, Education, Child care income, Alimony payment",
"amount": "3301.32"
},
"totalMonthlyNetIncome": "3301.32"
}
],
"expenses": {
"rentOrMortgage": "1200.53",
"food": "1000.54",
"utilities": "662.98",
"otherLivingExpenses": {
"name": "Clothing, Veteran added",
"amount": "110.00"
},
"expensesInstallmentContractsAndOtherDebts": "12000.64",
"totalMonthlyExpenses": "14974.69"
},
"discretionaryIncome": {
"netMonthlyIncomeLessExpenses": "-4604.60",
"amountCanBePaidTowardDebt": "10.51"
},
"assets": {
"cashInBank": "200.00",
"cashOnHand": "100.00",
"automobiles": [
{
"make": "Dodge",
"model": "RAM",
"year": "2020",
"resaleValue": "75000.45"
},
{
"make": "Dodge",
"model": "Charger",
"year": "2020",
"resaleValue": "40000.54"
}
],
"trailersBoatsCampers": "15000.23",
"usSavingsBonds": "100.00",
"stocksAndOtherBonds": "400.00",
"realEstateOwned": "800000.81",
"otherAssets": [
{
"name": "Collectibles, or collection(s)",
"amount": "12344"
},
{
"name": "Antiques",
"amount": "44"
},
{
"name": "Fine art",
"amount": "122"
}
],
"totalAssets": "943312.03"
},
"installmentContractsAndOtherDebts": [
{
"purpose": "Credit card payments",
"creditorName": "Creditor One",
"originalAmount": "50000.54",
"unpaidBalance": "15000.56",
"amountDueMonthly": "800.10",
"dateStarted": "03/2017",
"amountPastDue": "125.43",
"creditorAddress": {
"addresslineOne": "",
"addresslineTwo": "",
"addresslineThree": "",
"city": "",
"stateOrProvince": "",
"zipOrPostalCode": "",
"countryName": ""
}
},
{
"purpose": "Car payment/lease",
"creditorName": "Creditor Two",
"originalAmount": "100000.43",
"unpaidBalance": "50000.26",
"amountDueMonthly": "1200.54",
"dateStarted": "05/2019",
"amountPastDue": "0",
"creditorAddress": {
"addresslineOne": "",
"addresslineTwo": "",
"addresslineThree": "",
"city": "",
"stateOrProvince": "",
"zipOrPostalCode": "",
"countryName": ""
}
},
{
"purpose": "Credit card payment",
"creditorName": "",
"originalAmount": "",
"unpaidBalance": "300000",
"amountDueMonthly": "10000",
"amountPastDue": "7000",
"creditorAddress": {
"addresslineOne": "",
"addresslineTwo": "",
"addresslineThree": "",
"city": "",
"stateOrProvince": "",
"zipOrPostalCode": "",
"countryName": ""
}
}
],
"totalOfInstallmentContractsAndOtherDebts": {
"originalAmount": "150000.97",
"unpaidBalance": "365000.82",
"amountDueMonthly": "12000.64",
"amountPastDue": "7125.43"
},
"additionalData": {
"bankruptcy": {
"hasBeenAdjudicatedBankrupt": true,
"dateDischarged": "10/2004",
"courtLocation": "Tampa, FL",
"docketNumber": "123456"
},
"additionalComments": "Supporting personal statement...\nIndividual expense amount: Clothing ($10.00), Veteran added ($100.00)"
},
"applicantCertifications": {
"veteranSignature": "Greg A Anderson",
"veteranDateSigned": "06/22/2023"
},
"selectedDebtsAndCopays": [
{
"id": "f4385298-08a6-42f8-a86f-50e97033fb85",
"pSSeqNum": "506.00",
"pSTotSeqNum": "588.00",
"pSFacilityNum": "534",
"pSFacPhoneNum": null,
"pSTotStatement": "27.00",
"pSStatementVal": "0000018255H",
"pSStatementDate": "11152019",
"pSStatementDateOutput": "11/15/2019",
"pSProcessDate": "11112019",
"pSProcessDateOutput": "11/11/2019",
"pHPatientLstNme": "JONES",
"pHPatientFstNme": "TRAVIS",
"pHPatientMidNme": "D",
"pHAddress1": "1885 SHORE DR S APT 327",
"pHAddress2": null,
"pHAddress3": null,
"pHCity": "SAVANNAH",
"pHState": "FL",
"pHZipCde": "314104413",
"pHZipCdeOutput": "31410-4413",
"pHCtryNme": null,
"pHAmtDue": "15.00",
"pHAmtDueOutput": "15.00  ",
"pHPrevBal": "135.00",
"pHPrevBalOutput": "135.00  ",
"pHTotCharges": "15.00",
"pHTotChargesOutput": "15.00  ",
"pHTotCredits": "-135.00",
"pHTotCreditsOutput": "135.00- ",
"pHNewBalance": "15.00",
"pHNewBalanceOutput": "15.00  ",
"pHSpecialNotes": "To pay your statement online, go to www.pay.gov or call 1-888-827-4817.",
"pHroParaCdes": "304050556065708085",
"pHNumOfLines": "10.00",
"pHDfnNumber": "346310.00",
"pHCernerStatementNumber": "1005154223.00",
"pHCernerPatientId": "1005154223",
"pHCernerAccountNumber": "1005154223",
"pHIcnNumber": "1012845638V677813",
"pHAccountNumber": "0.00",
"pHLargeFontIndcator": "0.00",
"details": [
{
"pDDatePosted": "10072019",
"pDDatePostedOutput": "10/07/2019",
"pDTransDesc": "OUTPATIENT CARE(NSC)",
"pDTransDescOutput": "OUTPATIENT CARE",
"pDTransAmt": "-15.00",
"pDTransAmtOutput": "15.00- ",
"pDRefNo": "534-K90HEWN"
},
{
"pDDatePosted": "10072019",
"pDDatePostedOutput": "10/07/2019",
"pDTransDesc": "OUTPATIENT CARE(NSC)",
"pDTransDescOutput": "OUTPATIENT CARE",
"pDTransAmt": "-15.00",
"pDTransAmtOutput": "15.00- ",
"pDRefNo": "534-K90HEWN"
},
{
"pDDatePosted": "10072019",
"pDDatePostedOutput": "10/07/2019",
"pDTransDesc": "OUTPATIENT CARE(NSC)",
"pDTransDescOutput": "OUTPATIENT CARE",
"pDTransAmt": "-15.00",
"pDTransAmtOutput": "15.00- ",
"pDRefNo": "534-K90HEWN"
},
{
"pDDatePosted": "10072019",
"pDDatePostedOutput": "10/07/2019",
"pDTransDesc": "OUTPATIENT CARE(NSC)",
"pDTransDescOutput": "OUTPATIENT CARE",
"pDTransAmt": "-15.00",
"pDTransAmtOutput": "15.00- ",
"pDRefNo": "534-K90HEWN"
},
{
"pDDatePosted": "10072019",
"pDDatePostedOutput": "10/07/2019",
"pDTransDesc": "OUTPATIENT CARE(NSC)",
"pDTransDescOutput": "OUTPATIENT CARE",
"pDTransAmt": "-15.00",
"pDTransAmtOutput": "15.00- ",
"pDRefNo": "534-K90HEWN"
},
{
"pDDatePosted": "10072019",
"pDDatePostedOutput": "10/07/2019",
"pDTransDesc": "OUTPATIENT CARE(NSC)",
"pDTransDescOutput": "OUTPATIENT CARE",
"pDTransAmt": "-15.00",
"pDTransAmtOutput": "15.00- ",
"pDRefNo": "534-K90HEWN"
},
{
"pDDatePosted": "10072019",
"pDDatePostedOutput": "10/07/2019",
"pDTransDesc": "OUTPATIENT CARE(NSC)",
"pDTransDescOutput": "OUTPATIENT CARE",
"pDTransAmt": "-15.00",
"pDTransAmtOutput": "15.00- ",
"pDRefNo": "534-K90HEWN"
},
{
"pDDatePosted": "10072019",
"pDDatePostedOutput": "10/07/2019",
"pDTransDesc": "OUTPATIENT CARE(NSC)",
"pDTransDescOutput": "OUTPATIENT CARE",
"pDTransAmt": "-15.00",
"pDTransAmtOutput": "15.00- ",
"pDRefNo": "534-K90HEWN"
},
{
"pDDatePosted": "10072019",
"pDDatePostedOutput": "10/07/2019",
"pDTransDesc": "OUTPATIENT CARE(NSC)",
"pDTransDescOutput": "OUTPATIENT CARE",
"pDTransAmt": "-15.00",
"pDTransAmtOutput": "15.00- ",
"pDRefNo": "534-K90HEWN"
},
{
"pDDatePosted": "10152019",
"pDDatePostedOutput": "10/15/2019",
"pDTransDesc": "OUTPATIENT CARE(NSC) VISIT DATE: 09/07/2018",
"pDTransDescOutput": "OUTPATIENT CARE VISIT DATE: 09/07/2018",
"pDTransAmt": "15.00",
"pDTransAmtOutput": "15.00  ",
"pDRefNo": "534-K009FK8"
}
],
"station": {
"facilitYNum": "534",
"visNNum": "07",
"facilitYDesc": "RALPH H. JOHNSON VA MEDICAL CENTER (534)",
"cyclENum": "012",
"remiTToFlag": "L",
"maiLInsertFlag": "0",
"staTAddress1": "ACCOUNTS RECEIVABLE (04AR)",
"staTAddress2": "109 BEE ST",
"staTAddress3": null,
"city": "CHARLESTON",
"state": "SC",
"ziPCde": "294015703",
"ziPCdeOutput": "29401-5703",
"baRCde": "*294015703090*",
"teLNumFlag": "P",
"teLNum": "1-866-258-2772",
"teLNum2": null,
"contacTInfo": null,
"dM2TelNum": null,
"contacTInfo2": null,
"toPTelNum": null,
"lbXFedexAddress1": null,
"lbXFedexAddress2": null,
"lbXFedexAddress3": null,
"lbXFedexCity": null,
"lbXFedexState": null,
"lbXFedexZipCde": null,
"lbXFedexBarCde": null,
"lbXFedexContact": null,
"lbXFedexContactTelNum": null,
"facilityName": "Bob Stump Department of Veterans Affairs Medical Center"
},
"debtType": "COPAY",
"resolutionOption": "compromise",
"resolutionComment": "10.51"
},
{
"id": "b381cc7b-ea3a-49dc-a982-7146416ed373",
"pSSeqNum": "1162.00",
"pSTotSeqNum": "1.00",
"pSFacilityNum": "757",
"pSFacPhoneNum": null,
"pSTotStatement": "11.00",
"pSStatementVal": "0000040520F",
"pSStatementDate": "06052021",
"pSStatementDateOutput": "06/05/2021",
"pSProcessDate": "06092021",
"pSProcessDateOutput": "06/09/2021",
"pHPatientLstNme": "JONES",
"pHPatientFstNme": "TRAVIS",
"pHPatientMidNme": "D",
"pHAddress1": "1885 SHORE DR S APT 327",
"pHAddress2": null,
"pHAddress3": null,
"pHCity": "SOUTH PASADENA",
"pHState": "FL",
"pHZipCde": "337074743",
"pHZipCdeOutput": "33707-4743",
"pHCtryNme": "US",
"pHAmtDue": "46.00",
"pHAmtDueOutput": "46.00  ",
"pHPrevBal": "30.00",
"pHPrevBalOutput": "30.00  ",
"pHTotCharges": "46.00",
"pHTotChargesOutput": "46.00  ",
"pHTotCredits": "-30.00",
"pHTotCreditsOutput": "30.00- ",
"pHNewBalance": "46.00",
"pHNewBalanceOutput": "46.00  ",
"pHSpecialNotes": null,
"pHroParaCdes": "254050556065708085",
"pHNumOfLines": "7.00",
"pHDfnNumber": "0.00",
"pHCernerStatementNumber": "1005154223.00",
"pHCernerPatientId": "1005154223",
"pHCernerAccountNumber": "1005154223",
"pHIcnNumber": "1012845638V677813",
"pHAccountNumber": "0.00",
"pHLargeFontIndcator": "0.00",
"details": [
{
"pDDatePosted": "03092020",
"pDDatePostedOutput": "03/09/2020",
"pDTransDesc": "OUTPATIENT CARE(NSC) VISIT DATE: 01/14/2020",
"pDTransDescOutput": "OUTPATIENT CARE VISIT DATE: 01/14/2020",
"pDTransAmt": "15.00",
"pDTransAmtOutput": "15.00  ",
"pDRefNo": "516-K00R4FL"
},
{
"pDDatePosted": "03092020",
"pDDatePostedOutput": "03/09/2020",
"pDTransDesc": "OUTPATIENT CARE(NSC)",
"pDTransDescOutput": "OUTPATIENT CARE",
"pDTransAmt": "-15.00",
"pDTransAmtOutput": "15.00- ",
"pDRefNo": "516-K00R4FL"
},
{
"pDDatePosted": "03242020",
"pDDatePostedOutput": "03/24/2020",
"pDTransDesc": "COPAY RX:100020337B FD:01/23/2020",
"pDTransDescOutput": "COPAY RX#100020337B FILL DATE: 01/23/2020",
"pDTransAmt": "5.00",
"pDTransAmtOutput": "5.00  ",
"pDRefNo": "516-K00RSNZ"
},
{
"pDDatePosted": null,
"pDDatePostedOutput": "",
"pDTransDesc": "DRUG:LISINOPRIL 5MG TAB DAYS:30 QTY:30",
"pDTransDescOutput": "   DRUG:LISINOPRIL 5MG TAB DAYS:30 QTY:30",
"pDTransAmt": "0.00",
"pDTransAmtOutput": ".00  ",
"pDRefNo": null
},
{
"pDDatePosted": null,
"pDDatePostedOutput": "",
"pDTransDesc": "PHY:SANTOS,LOUISE CHG:$5.00",
"pDTransDescOutput": "   PHY:SANTOS,LOUISE CHG:$5.00",
"pDTransAmt": "0.00",
"pDTransAmtOutput": ".00  ",
"pDRefNo": null
},
{
"pDDatePosted": "03242020",
"pDDatePostedOutput": "03/24/2020",
"pDTransDesc": "RX CO-PAYMENT/NSC VET",
"pDTransDescOutput": "PAYMENT POSTED ON 03/24/2020",
"pDTransAmt": "-5.00",
"pDTransAmtOutput": "5.00- ",
"pDRefNo": "516-K00RSNZ"
},
{
"pDDatePosted": "04032020",
"pDDatePostedOutput": "04/03/2020",
"pDTransDesc": "COPAY RX:100030241 FD:03/30/2020",
"pDTransDescOutput": "COPAY RX#100030241 FILL DATE: 03/30/2020",
"pDTransAmt": "15.00",
"pDTransAmtOutput": "15.00  ",
"pDRefNo": "516-K00S829"
},
{
"pDDatePosted": null,
"pDDatePostedOutput": "",
"pDTransDesc": "DRUG:ATENOLOL 25MG TAB DAYS:90 QTY:90",
"pDTransDescOutput": "   DRUG:ATENOLOL 25MG TAB DAYS:90 QTY:90",
"pDTransAmt": "0.00",
"pDTransAmtOutput": ".00  ",
"pDRefNo": null
},
{
"pDDatePosted": null,
"pDDatePostedOutput": "",
"pDTransDesc": "PHY:GUTHRIE,BROOKE L CHG:$15.00",
"pDTransDescOutput": "   PHY:GUTHRIE,BROOKE L CHG:$15.00",
"pDTransAmt": "0.00",
"pDTransAmtOutput": ".00  ",
"pDRefNo": null
},
{
"pDDatePosted": "04272020",
"pDDatePostedOutput": "04/27/2020",
"pDTransDesc": "COPAY RX:100020336 FD:04/23/2020",
"pDTransDescOutput": "COPAY RX#100020336 FILL DATE: 04/23/2020",
"pDTransAmt": "15.00",
"pDTransAmtOutput": "15.00  ",
"pDRefNo": "516-K00SZBK"
},
{
"pDDatePosted": null,
"pDDatePostedOutput": "",
"pDTransDesc": "DRUG:AMLODIPINE BESYLATE 10MG TAB DAYS:90",
"pDTransDescOutput": "   DRUG:AMLODIPINE BESYLATE 10MG TAB DAYS:90",
"pDTransAmt": "0.00",
"pDTransAmtOutput": ".00  ",
"pDRefNo": null
},
{
"pDDatePosted": null,
"pDDatePostedOutput": "",
"pDTransDesc": "QTY:90 PHY:GUTHRIE,BROOKE L CHG:$15.00",
"pDTransDescOutput": "   QTY:90 PHY:GUTHRIE,BROOKE L CHG:$15.00",
"pDTransAmt": "0.00",
"pDTransAmtOutput": ".00  ",
"pDRefNo": null
},
{
"pDDatePosted": "04282020",
"pDDatePostedOutput": "04/28/2020",
"pDTransDesc": "COPAY RX:100011847 FD:04/23/2020",
"pDTransDescOutput": "COPAY RX#100011847 FILL DATE: 04/23/2020",
"pDTransAmt": "8.00",
"pDTransAmtOutput": "8.00  ",
"pDRefNo": "516-K00SZBK"
},
{
"pDDatePosted": null,
"pDDatePostedOutput": "",
"pDTransDesc": "DRUG:MICONAZOLE NITRATE 2% TOP TINCTURE DAYS:30",
"pDTransDescOutput": "   DRUG:MICONAZOLE NITRATE 2% TOP TINCTURE DAYS:30",
"pDTransAmt": "0.00",
"pDTransAmtOutput": ".00  ",
"pDRefNo": null
},
{
"pDDatePosted": null,
"pDDatePostedOutput": "",
"pDTransDesc": "QTY:60 PHY:GUTHRIE,BROOKE L CHG:$8.00",
"pDTransDescOutput": "   QTY:60 PHY:GUTHRIE,BROOKE L CHG:$8.00",
"pDTransAmt": "0.00",
"pDTransAmtOutput": ".00  ",
"pDRefNo": null
},
{
"pDDatePosted": "05262020",
"pDDatePostedOutput": "05/26/2020",
"pDTransDesc": "OUTPATIENT CARE(NSC) VISIT DATE: 04/15/2020",
"pDTransDescOutput": "OUTPATIENT CARE VISIT DATE: 04/15/2020",
"pDTransAmt": "50.00",
"pDTransAmtOutput": "50.00  ",
"pDRefNo": "516-K00TXGK"
},
{
"pDDatePosted": "05262020",
"pDDatePostedOutput": "05/26/2020",
"pDTransDesc": "OUTPATIENT CARE(NSC)",
"pDTransDescOutput": "OUTPATIENT CARE",
"pDTransAmt": "-50.00",
"pDTransAmtOutput": "50.00- ",
"pDRefNo": "516-K00TXGK"
},
{
"pDDatePosted": "06302020",
"pDDatePostedOutput": "06/30/2020",
"pDTransDesc": "COPAY RX:100030241 FD:06/30/2020",
"pDTransDescOutput": "COPAY RX#100030241 FILL DATE: 06/30/2020",
"pDTransAmt": "15.00",
"pDTransAmtOutput": "15.00  ",
"pDRefNo": "516-K00UY3W"
},
{
"pDDatePosted": null,
"pDDatePostedOutput": "",
"pDTransDesc": "DRUG:ATENOLOL 25MG TAB DAYS:90 QTY:90",
"pDTransDescOutput": "   DRUG:ATENOLOL 25MG TAB DAYS:90 QTY:90",
"pDTransAmt": "0.00",
"pDTransAmtOutput": ".00  ",
"pDRefNo": null
},
{
"pDDatePosted": null,
"pDDatePostedOutput": "",
"pDTransDesc": "PHY:GUTHRIE,BROOKE L CHG:$15.00",
"pDTransDescOutput": "   PHY:GUTHRIE,BROOKE L CHG:$15.00",
"pDTransAmt": "0.00",
"pDTransAmtOutput": ".00  ",
"pDRefNo": null
},
{
"pDDatePosted": "07092020",
"pDDatePostedOutput": "07/09/2020",
"pDTransDesc": "OUTPATIENT CARE(NSC) VISIT DATE: 06/08/2020",
"pDTransDescOutput": "OUTPATIENT CARE VISIT DATE: 06/08/2020",
"pDTransAmt": "50.00",
"pDTransAmtOutput": "50.00  ",
"pDRefNo": "516-K00V8T8"
},
{
"pDDatePosted": "07092020",
"pDDatePostedOutput": "07/09/2020",
"pDTransDesc": "OUTPATIENT CARE(NSC)",
"pDTransDescOutput": "OUTPATIENT CARE",
"pDTransAmt": "-50.00",
"pDTransAmtOutput": "50.00- ",
"pDRefNo": "516-K00V8T8"
},
{
"pDDatePosted": "07092020",
"pDDatePostedOutput": "07/09/2020",
"pDTransDesc": "COMMENT: K00ULWR PD $50.00 DOS 060820",
"pDTransDescOutput": "   COMMENT: K00ULWR PD $50.00 DOS 060820",
"pDTransAmt": "0.00",
"pDTransAmtOutput": ".00  ",
"pDRefNo": "516-K00V8T8"
},
{
"pDDatePosted": "08132020",
"pDDatePostedOutput": "08/13/2020",
"pDTransDesc": "COPAY RX:100020336 FD:08/11/2020",
"pDTransDescOutput": "COPAY RX#100020336 FILL DATE: 08/11/2020",
"pDTransAmt": "15.00",
"pDTransAmtOutput": "15.00  ",
"pDRefNo": "516-K00WDZQ"
},
{
"pDDatePosted": null,
"pDDatePostedOutput": "",
"pDTransDesc": "DRUG:AMLODIPINE BESYLATE 10MG TAB DAYS:90",
"pDTransDescOutput": "   DRUG:AMLODIPINE BESYLATE 10MG TAB DAYS:90",
"pDTransAmt": "0.00",
"pDTransAmtOutput": ".00  ",
"pDRefNo": null
},
{
"pDDatePosted": null,
"pDDatePostedOutput": "",
"pDTransDesc": "QTY:90 PHY:GUTHRIE,BROOKE L CHG:$15.00",
"pDTransDescOutput": "   QTY:90 PHY:GUTHRIE,BROOKE L CHG:$15.00",
"pDTransAmt": "0.00",
"pDTransAmtOutput": ".00  ",
"pDRefNo": null
},
{
"pDDatePosted": "09222020",
"pDDatePostedOutput": "09/22/2020",
"pDTransDesc": "OUTPATIENT CARE(NSC) VISIT DATE: 08/20/2020",
"pDTransDescOutput": "OUTPATIENT CARE VISIT DATE: 08/20/2020",
"pDTransAmt": "50.00",
"pDTransAmtOutput": "50.00  ",
"pDRefNo": "516-K00XUY2"
},
{
"pDDatePosted": "09222020",
"pDDatePostedOutput": "09/22/2020",
"pDTransDesc": "OUTPATIENT CARE(NSC)",
"pDTransDescOutput": "OUTPATIENT CARE",
"pDTransAmt": "-50.00",
"pDTransAmtOutput": "50.00- ",
"pDRefNo": "516-K00XUY2"
},
{
"pDDatePosted": "09222020",
"pDDatePostedOutput": "09/22/2020",
"pDTransDesc": "COMMENT: K00X41A PD $50.00 DOS 082020",
"pDTransDescOutput": "   COMMENT: K00X41A PD $50.00 DOS 082020",
"pDTransAmt": "0.00",
"pDTransAmtOutput": ".00  ",
"pDRefNo": "516-K00XUY2"
},
{
"pDDatePosted": "10072020",
"pDDatePostedOutput": "10/07/2020",
"pDTransDesc": "COPAY RX:100030241 FD:10/05/2020",
"pDTransDescOutput": "COPAY RX#100030241 FILL DATE: 10/05/2020",
"pDTransAmt": "15.00",
"pDTransAmtOutput": "15.00  ",
"pDRefNo": "516-K10J56V"
},
{
"pDDatePosted": null,
"pDDatePostedOutput": "",
"pDTransDesc": "DRUG:ATENOLOL 25MG TAB DAYS:90 QTY:90",
"pDTransDescOutput": "   DRUG:ATENOLOL 25MG TAB DAYS:90 QTY:90",
"pDTransAmt": "0.00",
"pDTransAmtOutput": ".00  ",
"pDRefNo": null
},
{
"pDDatePosted": null,
"pDDatePostedOutput": "",
"pDTransDesc": "PHY:GUTHRIE,BROOKE L CHG:$15.00",
"pDTransDescOutput": "   PHY:GUTHRIE,BROOKE L CHG:$15.00",
"pDTransAmt": "0.00",
"pDTransAmtOutput": ".00  ",
"pDRefNo": null
},
{
"pDDatePosted": "10292020",
"pDDatePostedOutput": "10/29/2020",
"pDTransDesc": "COPAY RX:100045030 FD:10/27/2020",
"pDTransDescOutput": "COPAY RX#100045030 FILL DATE: 10/27/2020",
"pDTransAmt": "24.00",
"pDTransAmtOutput": "24.00  ",
"pDRefNo": "516-K10J56V"
},
{
"pDDatePosted": null,
"pDDatePostedOutput": "",
"pDTransDesc": "DRUG:NIACIN (SLO-NIACIN) 250MG TAB,SA DAYS:90",
"pDTransDescOutput": "   DRUG:NIACIN (SLO-NIACIN) 250MG TAB,SA DAYS:90",
"pDTransAmt": "0.00",
"pDTransAmtOutput": ".00  ",
"pDRefNo": null
},
{
"pDDatePosted": null,
"pDDatePostedOutput": "",
"pDTransDesc": "QTY:90 PHY:VELAZQUEZ SANCHEZ,VANESSA",
"pDTransDescOutput": "   QTY:90 PHY:VELAZQUEZ SANCHEZ,VANESSA",
"pDTransAmt": "0.00",
"pDTransAmtOutput": ".00  ",
"pDRefNo": null
},
{
"pDDatePosted": null,
"pDDatePostedOutput": "",
"pDTransDesc": "CHG:$24.00",
"pDTransDescOutput": "   CHG:$24.00",
"pDTransAmt": "0.00",
"pDTransAmtOutput": ".00  ",
"pDRefNo": null
},
{
"pDDatePosted": "10292020",
"pDDatePostedOutput": "10/29/2020",
"pDTransDesc": "COPAY RX:100045028 FD:10/27/2020",
"pDTransDescOutput": "COPAY RX#100045028 FILL DATE: 10/27/2020",
"pDTransAmt": "8.00",
"pDTransAmtOutput": "8.00  ",
"pDRefNo": "516-K10J56V"
},
{
"pDDatePosted": null,
"pDDatePostedOutput": "",
"pDTransDesc": "DRUG:CARBAMIDE PEROXIDE 6.5% OTIC SOLN DAYS:14",
"pDTransDescOutput": "   DRUG:CARBAMIDE PEROXIDE 6.5% OTIC SOLN DAYS:14",
"pDTransAmt": "0.00",
"pDTransAmtOutput": ".00  ",
"pDRefNo": null
},
{
"pDDatePosted": null,
"pDDatePostedOutput": "",
"pDTransDesc": "QTY:45 PHY:VELAZQUEZ SANCHEZ,VANESSA CHG:$8.00",
"pDTransDescOutput": "   QTY:45 PHY:VELAZQUEZ SANCHEZ,VANESSA CHG:$8.00",
"pDTransAmt": "0.00",
"pDTransAmtOutput": ".00  ",
"pDRefNo": null
},
{
"pDDatePosted": "10292020",
"pDDatePostedOutput": "10/29/2020",
"pDTransDesc": "COPAY RX:100045029 FD:10/27/2020",
"pDTransDescOutput": "COPAY RX#100045029 FILL DATE: 10/27/2020",
"pDTransAmt": "8.00",
"pDTransAmtOutput": "8.00  ",
"pDRefNo": "516-K10J56V"
},
{
"pDDatePosted": null,
"pDDatePostedOutput": "",
"pDTransDesc": "DRUG:MICONAZOLE NITRATE 2% TOP TINCTURE DAYS:30",
"pDTransDescOutput": "   DRUG:MICONAZOLE NITRATE 2% TOP TINCTURE DAYS:30",
"pDTransAmt": "0.00",
"pDTransAmtOutput": ".00  ",
"pDRefNo": null
},
{
"pDDatePosted": null,
"pDDatePostedOutput": "",
"pDTransDesc": "QTY:90 PHY:VELAZQUEZ SANCHEZ,VANESSA CHG:$8.00",
"pDTransDescOutput": "   QTY:90 PHY:VELAZQUEZ SANCHEZ,VANESSA CHG:$8.00",
"pDTransAmt": "0.00",
"pDTransAmtOutput": ".00  ",
"pDRefNo": null
},
{
"pDDatePosted": "11192020",
"pDDatePostedOutput": "11/19/2020",
"pDTransDesc": "PAYMENT (Int:0.12 Adm:1.64)",
"pDTransDescOutput": "PAYMENT POSTED ON 11/19/2020",
"pDTransAmt": "-16.76",
"pDTransAmtOutput": "16.76- ",
"pDRefNo": "516-K00JZPJ"
},
{
"pDDatePosted": "11192020",
"pDDatePostedOutput": "11/19/2020",
"pDTransDesc": "PAYMENT (Int:0.26 Adm:0.00)",
"pDTransDescOutput": "PAYMENT POSTED ON 11/19/2020",
"pDTransAmt": "-15.26",
"pDTransAmtOutput": "15.26- ",
"pDRefNo": "516-K00N8XA"
},
{
"pDDatePosted": "11192020",
"pDDatePostedOutput": "11/19/2020",
"pDTransDesc": "PAYMENT",
"pDTransDescOutput": "PAYMENT POSTED ON 11/19/2020",
"pDTransAmt": "-15.00",
"pDTransAmtOutput": "15.00- ",
"pDRefNo": "516-K00QKJJ"
},
{
"pDDatePosted": "11192020",
"pDDatePostedOutput": "11/19/2020",
"pDTransDesc": "PAYMENT",
"pDTransDescOutput": "PAYMENT POSTED ON 11/19/2020",
"pDTransAmt": "-15.00",
"pDTransAmtOutput": "15.00- ",
"pDRefNo": "516-K00S829"
},
{
"pDDatePosted": "11192020",
"pDDatePostedOutput": "11/19/2020",
"pDTransDesc": "PAYMENT",
"pDTransDescOutput": "PAYMENT POSTED ON 11/19/2020",
"pDTransAmt": "-23.00",
"pDTransAmtOutput": "23.00- ",
"pDRefNo": "516-K00SZBK"
},
{
"pDDatePosted": "11192020",
"pDDatePostedOutput": "11/19/2020",
"pDTransDesc": "PAYMENT",
"pDTransDescOutput": "PAYMENT POSTED ON 11/19/2020",
"pDTransAmt": "-15.00",
"pDTransAmtOutput": "15.00- ",
"pDRefNo": "516-K00UY3W"
},
{
"pDDatePosted": "11192020",
"pDDatePostedOutput": "11/19/2020",
"pDTransDesc": "PAYMENT",
"pDTransDescOutput": "PAYMENT POSTED ON 11/19/2020",
"pDTransAmt": "-15.00",
"pDTransAmtOutput": "15.00- ",
"pDRefNo": "516-K00WDZQ"
},
{
"pDDatePosted": "11192020",
"pDDatePostedOutput": "11/19/2020",
"pDTransDesc": "PAYMENT",
"pDTransDescOutput": "PAYMENT POSTED ON 11/19/2020",
"pDTransAmt": "-55.00",
"pDTransAmtOutput": "55.00- ",
"pDRefNo": "516-K10J56V"
},
{
"pDDatePosted": "11232020",
"pDDatePostedOutput": "11/23/2020",
"pDTransDesc": "OUTPATIENT CARE(NSC) VISIT DATE: 10/27/2020",
"pDTransDescOutput": "OUTPATIENT CARE VISIT DATE: 10/27/2020",
"pDTransAmt": "15.00",
"pDTransAmtOutput": "15.00  ",
"pDRefNo": "516-K10LD3I"
},
{
"pDDatePosted": "11232020",
"pDDatePostedOutput": "11/23/2020",
"pDTransDesc": "OUTPATIENT CARE(NSC)",
"pDTransDescOutput": "OUTPATIENT CARE",
"pDTransAmt": "-15.00",
"pDTransAmtOutput": "15.00- ",
"pDRefNo": "516-K10LD3I"
},
{
"pDDatePosted": "11232020",
"pDDatePostedOutput": "11/23/2020",
"pDTransDesc": "COMMENT: K10KM1P PD $15.00 DOS:10/27/20",
"pDTransDescOutput": "   COMMENT: K10KM1P PD $15.00 DOS:10/27/20",
"pDTransAmt": "0.00",
"pDTransAmtOutput": ".00  ",
"pDRefNo": "516-K10LD3I"
},
{
"pDDatePosted": "12012020",
"pDDatePostedOutput": "12/01/2020",
"pDTransDesc": "COPAY RX:100046632 FD:11/18/2020",
"pDTransDescOutput": "COPAY RX#100046632 FILL DATE: 11/18/2020",
"pDTransAmt": "15.00",
"pDTransAmtOutput": "15.00  ",
"pDRefNo": "516-K10LT59"
},
{
"pDDatePosted": null,
"pDDatePostedOutput": "",
"pDTransDesc": "DRUG:AMLODIPINE BESYLATE 10MG TAB DAYS:90",
"pDTransDescOutput": "   DRUG:AMLODIPINE BESYLATE 10MG TAB DAYS:90",
"pDTransAmt": "0.00",
"pDTransAmtOutput": ".00  ",
"pDRefNo": null
},
{
"pDDatePosted": null,
"pDDatePostedOutput": "",
"pDTransDesc": "QTY:90 PHY:VELAZQUEZ SANCHEZ,VANESSA",
"pDTransDescOutput": "   QTY:90 PHY:VELAZQUEZ SANCHEZ,VANESSA",
"pDTransAmt": "0.00",
"pDTransAmtOutput": ".00  ",
"pDRefNo": null
},
{
"pDDatePosted": null,
"pDDatePostedOutput": "",
"pDTransDesc": "CHG:$15.00",
"pDTransDescOutput": "   CHG:$15.00",
"pDTransAmt": "0.00",
"pDTransAmtOutput": ".00  ",
"pDRefNo": null
},
{
"pDDatePosted": "12162020",
"pDDatePostedOutput": "12/16/2020",
"pDTransDesc": "COPAY RX:100030241A FD:12/12/2020",
"pDTransDescOutput": "COPAY RX#100030241A FILL DATE: 12/12/2020",
"pDTransAmt": "15.00",
"pDTransAmtOutput": "15.00  ",
"pDRefNo": "516-K10MUDV"
},
{
"pDDatePosted": null,
"pDDatePostedOutput": "",
"pDTransDesc": "DRUG:ATENOLOL 25MG TAB DAYS:90 QTY:90",
"pDTransDescOutput": "   DRUG:ATENOLOL 25MG TAB DAYS:90 QTY:90",
"pDTransAmt": "0.00",
"pDTransAmtOutput": ".00  ",
"pDRefNo": null
},
{
"pDDatePosted": null,
"pDDatePostedOutput": "",
"pDTransDesc": "PHY:VELAZQUEZ SANCHEZ,VANESSA CHG:$15.00",
"pDTransDescOutput": "   PHY:VELAZQUEZ SANCHEZ,VANESSA CHG:$15.00",
"pDTransAmt": "0.00",
"pDTransAmtOutput": ".00  ",
"pDRefNo": null
},
{
"pDDatePosted": "12212020",
"pDDatePostedOutput": "12/21/2020",
"pDTransDesc": "OUTPATIENT CARE(NSC) VISIT DATE: 11/13/2020",
"pDTransDescOutput": "OUTPATIENT CARE VISIT DATE: 11/13/2020",
"pDTransAmt": "15.00",
"pDTransAmtOutput": "15.00  ",
"pDRefNo": "516-K10N4AR"
},
{
"pDDatePosted": "12212020",
"pDDatePostedOutput": "12/21/2020",
"pDTransDesc": "OUTPATIENT CARE(NSC)",
"pDTransDescOutput": "OUTPATIENT CARE",
"pDTransAmt": "-15.00",
"pDTransAmtOutput": "15.00- ",
"pDRefNo": "516-K10N4AR"
},
{
"pDDatePosted": null,
"pDDatePostedOutput": "",
"pDTransDesc": "INTEREST/ADM. CHARGE (Int:0.32 Adm:1.64 Other:0.00",
"pDTransDescOutput": "INTEREST/ADM. CHARGE (Int:0.32 Adm:1.64 Other:0.00",
"pDTransAmt": "1.96",
"pDTransAmtOutput": "1.96  ",
"pDRefNo": null
}
],
"station": {
"facilitYNum": "649",
"visNNum": "22",
"facilitYDesc": "PRESCOTT VA MEDICAL CENTER (649)",
"cyclENum": "016",
"remiTToFlag": "L",
"maiLInsertFlag": "0",
"staTAddress1": "500 N US HIGHWAY 89",
"staTAddress2": "AGENT CASHIER (04C)",
"staTAddress3": null,
"city": "PRESCOTT",
"state": "AZ",
"ziPCde": "863135001",
"ziPCdeOutput": "86313-5001",
"baRCde": "*863135001003*",
"teLNumFlag": "S",
"teLNum": "1-866-802-6819",
"teLNum2": null,
"contacTInfo": null,
"dM2TelNum": null,
"contacTInfo2": null,
"toPTelNum": null,
"lbXFedexAddress1": null,
"lbXFedexAddress2": null,
"lbXFedexAddress3": null,
"lbXFedexCity": null,
"lbXFedexState": null,
"lbXFedexZipCde": null,
"lbXFedexBarCde": null,
"lbXFedexContact": null,
"lbXFedexContactTelNum": null,
"facilityName": "Ralph H. Johnson Department of Veterans Affairs Medical Center"
},
"debtType": "COPAY",
"resolutionOption": "waiver",
"resolutionComment": "",
"resolutionWaiverCheck": true
}
]
}

Summary of Findings

Income

The total monthly net income for the veteran and spouse is as follows:

  • Veteran's Income: $3794.20
  • Spouse's Income: $3301.32
  • Total Income: $7095.52

Expenses

The total monthly expenses amount to:

  • Total Expenses: $14974.69

Net Monthly Income

The net monthly income (total income - total expenses) is:

  • Net Monthly Income: -$7879.17

Please note that a negative net monthly income indicates that the total expenses exceed the total income.

Income

Veteran

  • Monthly gross salary: $123.00
  • Total deductions: $1.00
  • Net take home pay: $122.00
  • Other income: $3672.20
  • Total monthly net income: $3794.20

Spouse

  • Monthly gross salary: $0.00
  • Total deductions: $0.00
  • Net take home pay: $0.00
  • Other income: $3301.32
  • Total monthly net income: $3301.32

Expenses

  • Rent or Mortgage: $1200.53
  • Food: $1000.54
  • Utilities: $662.98
  • Other living expenses: $110.00
  • Expenses installment contracts and other debts: $12000.64
  • Total monthly expenses: $14974.69

Discretionary Income

  • Incorrectly stated net monthly income less expenses: -$4604.60
  • Actual net monthly income less expenses: -$7879.17

Please note, the Amount that can be paid toward debt is incorrect because the user is already in the negative:

  • Amount can be paid toward debt: $10.51

Assets

  • Cash in bank: $200.00
  • Cash on hand: $100.00
  • Automobiles:
    • Dodge RAM (2020), Resale value: $75000.45
    • Dodge Charger (2020), Resale value: $40000.54
  • Trailers, boats, campers: $15000.23
  • US savings bonds: $100.00
  • Stocks and other bonds: $400.00
  • Real estate owned: $800000.81
  • Other assets:
    • Collectibles, or collection(s): $12344
    • Antiques: $44
    • Fine art: $122
  • Total assets: $943312.03
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