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[]
[null,null,"Provincial Travel Nurse Team (PTNT) - Mileage, Parking and Other Expense Claim Form"]
[]
[null,"Mileage and Parking reimbursements for employees are paid via Electronic Funds Transfer to the same bank account as their payroll deposits"]
[]
[null,null,null,"Start Date","End Date"]
[null,null,null,"(MM/DD/YY)","(MM/DD/YY)"]
[null,"Travel Dates"]
[null,"Program",null,null,"Email Address \nIf no email address is provided, you WILL NOT receive notification of payment",null,"Name ",null,null,"Employee Number",null,"Position"]
[null,"Provincial Travel Nurse Team"]
[null,"Complete Home Address\nIncluding City/Town & Postal Code",null,null,"Previous Complete Home Address \nProvide if there was a change in address\nIncluding City/Town & Postal Code",null,null,"Employee Signature\nBy typing your name in the field below, you are stating that you are aware of this claim being submitted by you as the Claimant",null,null,"Date Form Filled\n(MM/DD/YY)",null,"Phone #\nXXX-XXX-XXXX"]
[]
[]
[null,null,"TOTAL CLAIM",{"$f":"L34+J54+G90+F75","v":0},null,null,"Please email receipts (can be photo utilizing smallest picture setting on your phone) in chronological order and form to ptntclaims@sharedhealthmb.ca"]
[]
[null,"MILEAGE"]
[null,"Location\n(Pick fr Drop Down List)","Facility Assignment\n(Pick fr Drop Down List)\n*Location must be chosen first*","Date\n(MM/DD/YY)","Trip Information ",null,null,null,"Round Trip","Rate\n","Input Total KM Traveled","Total","Cost Centre","Expense Code"]
[null,null,null,null,"From \n(Home or any other Address)",null,"Destination \n(Home or Assigned Facility)",null,"(Y/N)"]
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[null,null,null,null,null,null,null,null,null,{"$f":"IF(ISERROR(VLOOKUP(B29,Inputs!$O$2:$P$7,2,0)),\"\",VLOOKUP(B29,Inputs!$O$2:$P$7,2,0))","v":""},null,"",{"$f":"IF(ISERROR(VLOOKUP(C29,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP(C29,'Cost Centre'!$A:$B,2,0))","v":""},""]
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[null,null,null,null,null,null,null,null,null,{"$f":"IF(ISERROR(VLOOKUP(B32,Inputs!$O$2:$P$7,2,0)),\"\",VLOOKUP(B32,Inputs!$O$2:$P$7,2,0))","v":""},null,"",{"$f":"IF(ISERROR(VLOOKUP(C32,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP(C32,'Cost Centre'!$A:$B,2,0))","v":""},""]
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[null,null,null,null,null,null,null,null,"Total",null,{"$f":"SUM(K29:K33)","v":0},{"$f":"SUM(L19:L33)","v":0}]
[]
[null,"PER DIEM - TRAVEL DAY ONLY"]
[null,"Location\n(Pick fr Drop Down List)","Facility Assignment\n(Pick fr Drop Down List)\n*Location must be chosen first*","Date\n(MM/DD/YY)","Time Traveled",null,"PLEASE REFER TO TABLE TO FOR RATES BASED ON LOCATION",null,null,"Total","Cost Centre","Expense Code"]
[null,null,null,null,"Departure Time\n(24-hour format)","Arrival Time\n(24-hour format)","Breakfast\n(Pick fr Drop Down List)","Lunch\n(Pick fr Drop Down List)","Dinner\n(Pick fr Drop Down List)"]
[null,null,null,null,null,null,null,null,null,{"$f":"SUM(G39:I39)","v":0},{"$f":"IF(ISERROR(VLOOKUP(C39,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP(C39,'Cost Centre'!$A:$B,2,0))","v":""},{"$f":"IF(K39=\"\",\"\",\"562300005\")","v":""}]
[null,null,null,null,null,null,null,null,null,{"$f":"SUM(G40:I40)","v":0},{"$f":"IF(ISERROR(VLOOKUP(C40,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP(C40,'Cost Centre'!$A:$B,2,0))","v":""},{"$f":"IF(K40=\"\",\"\",\"562300005\")","v":""}]
[null,null,null,null,null,null,null,null,null,0,{"$f":"IF(ISERROR(VLOOKUP(C41,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP(C41,'Cost Centre'!$A:$B,2,0))","v":""},{"$f":"IF(K41=\"\",\"\",\"562300005\")","v":""}]
[null,null,null,null,null,null,null,null,null,0,{"$f":"IF(ISERROR(VLOOKUP(C42,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP(C42,'Cost Centre'!$A:$B,2,0))","v":""},""]
[null,null,null,null,null,null,null,null,null,0,{"$f":"IF(ISERROR(VLOOKUP(C43,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP(C43,'Cost Centre'!$A:$B,2,0))","v":""},""]
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[null,null,null,null,null,null,null,null,null,0,{"$f":"IF(ISERROR(VLOOKUP(C46,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP(C46,'Cost Centre'!$A:$B,2,0))","v":""},""]
[null,null,null,null,null,null,null,null,null,0,{"$f":"IF(ISERROR(VLOOKUP(C47,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP(C47,'Cost Centre'!$A:$B,2,0))","v":""},""]
[null,null,null,null,null,null,null,null,null,0,{"$f":"IF(ISERROR(VLOOKUP(C48,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP(C48,'Cost Centre'!$A:$B,2,0))","v":""},""]
[null,null,null,null,null,null,null,null,null,0,{"$f":"IF(ISERROR(VLOOKUP(C49,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP(C49,'Cost Centre'!$A:$B,2,0))","v":""},""]
[null,null,null,null,null,null,null,null,null,0,{"$f":"IF(ISERROR(VLOOKUP(C50,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP(C50,'Cost Centre'!$A:$B,2,0))","v":""},""]
[null,null,null,null,null,null,null,null,null,0,{"$f":"IF(ISERROR(VLOOKUP(C51,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP(C51,'Cost Centre'!$A:$B,2,0))","v":""},""]
[null,null,null,null,null,null,null,null,null,0,{"$f":"IF(ISERROR(VLOOKUP(C52,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP(C52,'Cost Centre'!$A:$B,2,0))","v":""},""]
[null,null,null,null,null,null,null,null,null,0,{"$f":"IF(ISERROR(VLOOKUP(C53,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP(C53,'Cost Centre'!$A:$B,2,0))","v":""},""]
[null,null,null,null,null,"Total",{"$f":"SUM(G39:G53)","v":0},{"$f":"SUM(H39:H53)","v":0},{"$f":"SUM(I39:I53)","v":0},{"$f":"SUM(J39:J53)","v":0}]
[]
[]
[]
[null,"PER DIEM - CLINICAL DAY OR AWAY FOR 24 HRS OR MORE"]
[null,"Location\n(Pick fr Drop Down List)","Facility Assignment\n(Pick fr Drop Down List)\n*Location must be chosen first*","Claim Type\n(Pick fr Drop Down List)","Date\n(MM/DD/YY)","Total","Cost Centre","Expense Code"]
[]
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[null,null,null,null,null,{"$f":"IF(ISERROR(VLOOKUP($B62,Inputs!$O$8:$P$12,2,0)),\"\",VLOOKUP($B62,Inputs!$O$8:$P$12,2,0))","v":""},{"$f":"IF(ISERROR(VLOOKUP($C62,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP($C62,'Cost Centre'!$A:$B,2,0))","v":""},""]
[null,null,null,null,null,{"$f":"IF(ISERROR(VLOOKUP($B63,Inputs!$O$8:$P$12,2,0)),\"\",VLOOKUP($B63,Inputs!$O$8:$P$12,2,0))","v":""},{"$f":"IF(ISERROR(VLOOKUP($C63,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP($C63,'Cost Centre'!$A:$B,2,0))","v":""},""]
[null,null,null,null,null,{"$f":"IF(ISERROR(VLOOKUP($B64,Inputs!$O$8:$P$12,2,0)),\"\",VLOOKUP($B64,Inputs!$O$8:$P$12,2,0))","v":""},{"$f":"IF(ISERROR(VLOOKUP($C64,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP($C64,'Cost Centre'!$A:$B,2,0))","v":""},""]
[null,null,null,null,null,{"$f":"IF(ISERROR(VLOOKUP($B65,Inputs!$O$8:$P$12,2,0)),\"\",VLOOKUP($B65,Inputs!$O$8:$P$12,2,0))","v":""},{"$f":"IF(ISERROR(VLOOKUP($C65,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP($C65,'Cost Centre'!$A:$B,2,0))","v":""},""]
[null,null,null,null,null,{"$f":"IF(ISERROR(VLOOKUP($B66,Inputs!$O$8:$P$12,2,0)),\"\",VLOOKUP($B66,Inputs!$O$8:$P$12,2,0))","v":""},{"$f":"IF(ISERROR(VLOOKUP($C66,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP($C66,'Cost Centre'!$A:$B,2,0))","v":""},""]
[null,null,null,null,null,{"$f":"IF(ISERROR(VLOOKUP($B67,Inputs!$O$8:$P$12,2,0)),\"\",VLOOKUP($B67,Inputs!$O$8:$P$12,2,0))","v":""},{"$f":"IF(ISERROR(VLOOKUP($C67,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP($C67,'Cost Centre'!$A:$B,2,0))","v":""},""]
[null,null,null,null,null,{"$f":"IF(ISERROR(VLOOKUP($B68,Inputs!$O$8:$P$12,2,0)),\"\",VLOOKUP($B68,Inputs!$O$8:$P$12,2,0))","v":""},{"$f":"IF(ISERROR(VLOOKUP($C68,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP($C68,'Cost Centre'!$A:$B,2,0))","v":""},""]
[null,null,null,null,null,{"$f":"IF(ISERROR(VLOOKUP($B69,Inputs!$O$8:$P$12,2,0)),\"\",VLOOKUP($B69,Inputs!$O$8:$P$12,2,0))","v":""},{"$f":"IF(ISERROR(VLOOKUP($C69,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP($C69,'Cost Centre'!$A:$B,2,0))","v":""},""]
[null,null,null,null,null,{"$f":"IF(ISERROR(VLOOKUP($B70,Inputs!$O$8:$P$12,2,0)),\"\",VLOOKUP($B70,Inputs!$O$8:$P$12,2,0))","v":""},{"$f":"IF(ISERROR(VLOOKUP($C70,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP($C70,'Cost Centre'!$A:$B,2,0))","v":""},""]
[null,null,null,null,null,{"$f":"IF(ISERROR(VLOOKUP($B71,Inputs!$O$8:$P$12,2,0)),\"\",VLOOKUP($B71,Inputs!$O$8:$P$12,2,0))","v":""},{"$f":"IF(ISERROR(VLOOKUP($C71,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP($C71,'Cost Centre'!$A:$B,2,0))","v":""},""]
[null,null,null,null,null,{"$f":"IF(ISERROR(VLOOKUP($B72,Inputs!$O$8:$P$12,2,0)),\"\",VLOOKUP($B72,Inputs!$O$8:$P$12,2,0))","v":""},{"$f":"IF(ISERROR(VLOOKUP($C72,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP($C72,'Cost Centre'!$A:$B,2,0))","v":""},""]
[null,null,null,null,null,{"$f":"IF(ISERROR(VLOOKUP($B73,Inputs!$O$8:$P$12,2,0)),\"\",VLOOKUP($B73,Inputs!$O$8:$P$12,2,0))","v":""},{"$f":"IF(ISERROR(VLOOKUP($C73,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP($C73,'Cost Centre'!$A:$B,2,0))","v":""},""]
[null,null,null,null,null,{"$f":"IF(ISERROR(VLOOKUP($B74,Inputs!$O$8:$P$12,2,0)),\"\",VLOOKUP($B74,Inputs!$O$8:$P$12,2,0))","v":""},{"$f":"IF(ISERROR(VLOOKUP($C74,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP($C74,'Cost Centre'!$A:$B,2,0))","v":""},""]
[null,null,null,null,"Total",{"$f":"SUM(F61:F74)","v":0}]
[]
[]
[null,"OTHER EXPENSES"]
[null,"Location\n(Pick fr Drop Down List)","Facility Assignment\n(Pick fr Drop Down List)\n*Location must be chosen first*","Date\n(MM/DD/YY)","Claim Type","Claim Type - Other\nPlease specify","Total","Cost Centre","Expense Code"]
[]
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[null,null,null,null,null,null,null,{"$f":"IF(ISERROR(VLOOKUP($C82,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP($C82,'Cost Centre'!$A:$B,2,0))","v":""},{"$f":"IF(H82=\"\",\"\",\"562300000\")","v":""}]
[null,null,null,null,null,null,null,{"$f":"IF(ISERROR(VLOOKUP($C83,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP($C83,'Cost Centre'!$A:$B,2,0))","v":""},""]
[null,null,null,null,null,null,null,{"$f":"IF(ISERROR(VLOOKUP($C84,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP($C84,'Cost Centre'!$A:$B,2,0))","v":""},""]
[null,null,null,null,null,null,null,{"$f":"IF(ISERROR(VLOOKUP($C85,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP($C85,'Cost Centre'!$A:$B,2,0))","v":""},""]
[null,null,null,null,null,null,null,{"$f":"IF(ISERROR(VLOOKUP($C86,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP($C86,'Cost Centre'!$A:$B,2,0))","v":""},""]
[null,null,null,null,null,null,null,{"$f":"IF(ISERROR(VLOOKUP($C87,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP($C87,'Cost Centre'!$A:$B,2,0))","v":""},""]
[null,null,null,null,null,null,null,{"$f":"IF(ISERROR(VLOOKUP($C88,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP($C88,'Cost Centre'!$A:$B,2,0))","v":""},""]
[null,null,null,null,null,null,null,{"$f":"IF(ISERROR(VLOOKUP($C89,'Cost Centre'!$A:$B,2,0)),\"\",VLOOKUP($C89,'Cost Centre'!$A:$B,2,0))","v":""},""]
[null,null,null,null,"Total",null,{"$f":"SUM(G81:G89)","v":0}]
[]
[]
[null,"Coding Summary- FOR FINANCE ONLY** NO ENTRY BY NURSE IN THIS SECTION"]
[null,"Cost Centre","Facility Name",562312000,562300005,562300000,"Total"]
[null,null,null,"Staff Travel Provincial","Travel Operations Meals","Travel Exp- Staff"]
[]
[null,80600933,"SHM - PrvFlPool",{"$f":"SUMIF($M$17:$M$33,B97,$L$17:$L$33)","v":0},{"$f":"SUMIF($K$37:$K$53,B97,$J$37:$J$53)+SUMIF($G$59:$G$74,B97,$F$59:$F$74)","v":0},{"$f":"SUMIF($H$79:$H$89,B97,$G$79:$G$89)","v":0},{"$f":"SUM(D97:F97)","v":0}]
[null,80800001,"NR Thompson Psychiatry",0,{"$f":"SUMIF($K$37:$K$53,B98,$J$37:$J$53)+SUMIF($G$59:$G$74,B98,$F$59:$F$74)","v":0},0,{"$f":"SUM(D98:F98)","v":0}]
[null,80800002,"NR Thompson Obstetrics/L&D",0,0,0,0]
[null,80800003,"NR Thompson Med/Surg/Peds",0,0,0,0]
[null,80800004,"NR Thompson Emergency Dept",0,0,0,0]
[null,80800005,"NR Thompson Dialysis",0,0,0,0]
[null,80800006,"NR Thompson Operating Room",0,0,0,0]
[null,80800007,"NR FlinFlon CancerCare",0,0,0,0]
[null,80800008,"NR Thompson Northern Spirit Manor",0,0,0,0]
[null,80800009,"NR The Pas Amb Care Clinic",0,0,0,0]
[null,80800010,"NR The Pas Dialysis",0,0,0,0]
[null,80800011,"NR The Pas Medicine",0,0,0,0]
[null,80800012,"NR The Pas Obstetrics / L&D",0,0,0,0]
[null,80800013,"NR The Pas Operating Room",0,0,0,0]
[null,80800014,"NR The Pas Emergency Dept",0,0,0,0]
[null,80800015,"NR The Pas Psychiatry",0,0,0,0]
[null,80800016,"NR The Pas St. Paul's PCH",0,0,0,0]
[null,80800017,"NR The Pas HC",0,0,0,0]
[null,80800018,"NR FlinFlon CancerCare",0,0,0,0]
[null,80800019,"NR FlinFlon Dialysis",0,0,0,0]
[null,80800020,"NR FlinFlon Medicine/Emergency",0,0,0,0]
[null,80800021,"NR FlinFlon Medicine/Emergency",0,0,0,0]
[null,80800022,"NR FlinFlon NorthernLightsMan",0,0,0,0]
[null,80800023,"NR FlinFlon PersonalCareHome",0,0,0,0]
[null,80800024,"NR Flin Flon Home Care",0,0,0,0]
[null,80800026,"NR Snow Lake Emergency Dept",0,0,0,0]
[null,80800027,"NR Gillam Emergency Dept",0,0,0,0]
[null,80800028,"NR Gillam Emergency Dept",0,0,0,0]
[null,80800029,"NR Lynn Lake Medicine / Emerg",0,0,0,0]
[null,80800030,"NR Lynn Lake Medicine / Emerg",0,0,0,0]
[null,80800031,"NR Leaf Rapids Emergency Dept",0,0,0,0]
[null,80800032,"IE PineFalls Dialysis",0,0,0,0]
[null,80800033,"IE PineFalls Emergency/Medicine",{"$f":"SUMIF($M$17:$M$33,B129,$L$17:$L$33)","v":0},0,{"$f":"SUMIF($H$79:$H$89,B129,$G$79:$G$89)","v":0},0]
[null,80800035,"IE Ashern Emergency",0,0,0,0]
[null,80800036,"IE Ashern Medicine",0,0,0,0]
[null,80800037,"IE Ashern Dialysis",0,0,0,0]
[null,80800038,"IE Beausejour Medicine/Emerg",0,0,0,0]
[null,80800040,"IE Stonewall Medicine/Emerg",0,0,0,0]
[null,80800042,"IE Selkirk Emergency",0,0,0,0]
[null,80800043,"IE Selkirk Dialysis",0,0,0,0]
[null,80800044,"PM Dauphin Emerg",0,0,0,0]
[null,80800045,"PM Dauphin Hemodialysis",0,0,0,0]
[null,80800046,"PM Dauphin OR/PostAnaesthesia",0,0,0,0]
[null,80800047,"PM Dauphin Surgery",0,0,0,0]
[null,80800048,"PM Dauphin Medicine",0,0,0,0]
[null,80800049,"PM Dauphin Special Care Unit",0,0,0,0]
[null,80800050,"PM Dauphin Oncology",0,0,0,0]
[null,80800051,"PM Parkland Mental Health Center",0,0,0,0]
[null,80800052,"PM Dauphin PCH",0,0,0,0]
[null,80800053,"PM Swan River PCH",0,0,0,0]
[null,80800054,"PM Swan Valley Lodge PCH",0,0,0,0]
[null,80800055,"PM Benito PCH",0,0,0,0]
[null,80800056,"PM Minnedosa Medicine/ Emerg",0,0,0,0]
[null,80800058,"PM Brandon Medicine ",0,0,0,0]
[null,80800059,"PM Brandon Emergency Dept",0,0,0,0]
[null,80800060,"PM Gilb PlainsPersonalCareHome",0,0,0,0]
[null,80800061,"PM Birtle Personal Care Home",0,0,0,0]
[null,80800062,"SS Portage Cancer Care",0,0,0,0]
[null,80800063,"SS Portage Dialysis",0,0,0,0]
[null,80800064,"SS Portage Emergency Depart",0,0,0,0]
[null,80800065,"SS Portage Medicine/Pediatrics",0,0,0,0]
[null,80800066,"SS Portage Operating Room",0,0,0,0]
[null,80800067,"SS Portage PostAnaethesia",0,0,0,0]
[null,80800068,"SS Portage Rehab",0,0,0,0]
[null,80800069,"SS Portage Surgery",{"$f":"SUMIF($M$17:$M$33,B161,$L$17:$L$33)","v":0},0,{"$f":"SUMIF($H$79:$H$89,B161,$G$79:$G$89)","v":0},0]
[null,80800070,"SS Portage Obstetrics",0,{"$f":"SUMIF($K$37:$K$53,B162,$J$37:$J$53)+SUMIF($G$59:$G$74,B162,$F$59:$F$74)","v":0},0,{"$f":"SUM(D162:F162)","v":0}]
[null,80800071,"SS BoundTrails Cancer Care",0,0,0,0]
[null,80800072,"SS BoundTrails Dialysis",0,0,0,0]
[null,80800073,"SS BoundTrails Emergency Dept",0,0,0,0]
[null,80800074,"SS BoundTrails Medicine ",0,0,0,0]
[null,80800075,"SS BoundTrails Operating Room",0,0,0,0]
[null,80800076,"SS BoundTrails PostAnaesthesia",0,0,0,0]
[null,80800077,"SS BoundTrails Rehab",0,0,0,0]
[null,80800078,"SS BoundTrails Surgery",0,0,0,0]
[null,80800079,"SS BoundTrails Obsetrics",0,0,0,0]
[null,80800081,"NR The Pas Cancer Care",0,0,0,0]
[null,80800082,"PM Brandon Surgery",0,0,0,0]
[null,80800083,"IE Eriksdale PCH",0,0,0,0]
[null,80800084,"IE Selkirk Medicine",0,0,0,0]
[null,80800085,"IE Selkirk Observation",0,0,0,0]
[null,80800086,"NR Thompson RAAM Eaglewood",0,0,0,0]
[null,80800087,"PM Glenboro Med/Emerg",0,0,0,0]
[null,80800088,"SS Carmen Memorial Hospital Medicine",0,0,0,0]
[null,80800089,"SS Carman Operating Room",0,0,0,0]
[null,80800090,"SS Carman Same Day Surgery",0,0,0,0]
[null,80800091,"SS Carman Emergency Dept",0,0,0,0]
[null,80800092,"SS Carman Post Anesthesia Care",0,0,0,0]
[null,80800093,"NRHA Thompson CCC",0,0,0,0]
[null,80800094,"PM Glenboro PCH",0,0,0,0]
[null,80800095,"IE Selkirk MedX",0,0,0,0]
[null,80800096,"IE Whitemouth PCH",{"$f":"SUMIF($M$17:$M$33,B187,$L$17:$L$33)","v":0},{"$f":"SUMIF($K$37:$K$53,B187,$J$37:$J$53)+SUMIF($G$59:$G$74,B187,$F$59:$F$74)","v":0},{"$f":"SUMIF($H$79:$H$89,B187,$G$79:$G$89)","v":0},{"$f":"SUM(D187:F187)","v":0}]
[null,80800097,"IE Pinawa Medicine",0,0,0,0]
[null,80800098,"SS Notre Dame Med/Emerg",0,0,0,0]
[null,80800099,"SS Rock Lake Med/Surg",0,0,0,0]
[null,80800100,"IE Berens River Dialysis",0,0,0,0]
[null,80800101,"IE Hodgson Dialysis",0,0,0,0]
[null,80800104,"PM Brandon Dialysis",0,0,0,0]
[null,80800105,"PM Neepawa Chemo",0,0,0,0]
[null,80800106,"PM Neepawa Medicine/Surgery",0,0,0,0]
[null,80800107,"PM Neepawa PCH",0,0,0,0]
[null,80800108,"PM Westman Nursing Home PCH",0,0,0,0]
[null,80800102,"IE Sunnywood PCH Pine Falls",{"$f":"SUMIF($M$17:$M$33,B198,$L$17:$L$33)","v":0},{"$f":"SUMIF($K$37:$K$53,B198,$J$37:$J$53)+SUMIF($G$59:$G$74,B198,$F$59:$F$74)","v":0},{"$f":"SUMIF($H$79:$H$89,B198,$G$79:$G$89)","v":0},{"$f":"SUM(D198:F198)","v":0}]
[null,80800109,"IE Ashern PCH",0,0,0,0]
[null,80800110,"IE East Gate Loge PCH Beausejour",0,0,0,0]
[null,null,"Total",{"$f":"SUM(D97:D197)","v":0},{"$f":"SUM(E97:E197)","v":0},0,0,{"$f":"G201=D14","v":true}]

{"sheet":"Instructions","index":1,"n_rows":76,"n_cols":1,"rows_kept":76,"cut":false,"hidden":true,"merged":[]}
["Instructions on How to Complete the Expense Claim Form"]
[]
["Incomplete forms will be returned to employees unprocessed."]
[]
["Who has to complete a Expense Claim Form?"]
["All Shared Health employees requesting reimbursement for expenses incurred while on Shared Health business."]
[]
["Employee information (all must be filled out):"]
["Travel Dates"]
["Email Address"]
["Name"]
["Position"]
["Employee Number "]
["Home Address (check box if it's a new address)"]
["Signature (By typing your name in the above field, you are stating that you are aware of this claim being submitted by you as the Claimant)"]
["Date"]
["Phone #"]
[]
["Note: Employees are required to provide a void cheque for direct deposit with their first claim, no cheques will be issued. If you wish to receive notification of payment you must supply your email address with your void cheque"]
[]
["APPROVAL REQUIRED "]
["Authorized by - Employee’s Manager with signing authority."]
["Date - Date signed by Manager."]
["Authorized Signature - Signature of Manager"]
[]
["MILEAGE SECTION"]
[]
["Location - Choose one location from drop down list"]
[]
["Facility Assignment - Choose one location from drop down list"]
[]
["Date – Date travel took place"]
[]
["Trip Information- ALL mileage for the day should be documented in this column.   Identify starting address (location), each destination traveled to and the reason for the trip. \n If traveling from home to a location other than your base site, home should be the starting address.  Note: travel from home directly to base site should not be listed."]
[]
["Total Trip Km - total number of all kms driven between locations.  "]
[]
["Rate (Auto-populates based on Location chose) - km rate identified in your collective agreement or as per set Corporate kilometer rate for non-union employees. Use the control button to select the appropriate mileage rate."]
[" - Below the 53rd parallel for travel south of Grand Rapids"]
[" - Above the 53rd parallel for travel north of Grand Rapids"]
["- Employee with a car allowance - this is to be used by employees receiving a car allowance who are traveling outside of the city only. Travel within the city is considered covered by you allowance."]
[]
["PER DIEM - TRAVEL DAY ONLY SECTION"]
[]
["Location - Choose one location from drop down list"]
[]
["Facility Assignment - Choose one location from drop down list"]
[]
["Date – Date travel took place"]
[]
["Time Traveled - Enter Arrival and Departure Time"]
[]
["Breakfast/Lunch/Dinner - Choose amount from drop down list if entitled for reimbursement for time traveled"]
[]
[]
["PER DIEM - CLINICAL DAY OR AWAY FOR 24 HRS OR MORE SECTION"]
[]
["Location - Choose one location from drop down list"]
[]
["Facility Assignment - Choose one location from drop down list"]
[]
["Claim Type - Chose either Clinical Day or Away for 24 hours or more from drop down if entitled for reimbursement"]
[]
["Date – Date travel took place"]
[]
["OTHER EXPENSES SECTION"]
[]
["Location - Choose one location from drop down list"]
[]
["Facility Assignment - Choose one location from drop down list"]
[]
["Date – Date travel took place"]
[]
["Claim Type -  Chose from drop down list"]
[]
["Claim Type - Other Please specify - If chose 'Other' please provide detail on expense claim type"]

{"sheet":"Inputs","index":2,"n_rows":50,"n_cols":20,"rows_kept":50,"cut":false,"hidden":false,"merged":[]}
["SDO",null,"NRHA",null,"IERHA",null,"PMH",null,"PTNT Above 53rd",null,"PTNT Above 53rd",null,"SHSS",null,"Rate",null,null,"Other"]
["NRHA",null,"NR Flin Flon Home Care",null,"IE Ashern Dialysis",null,"PM Benito PCH",null,"SHM - PrvFlPool",null,"SHM - PrvFlPool",null,"SS Portage Cancer Care",null,"IERHA",0.46,null,"Accomondations"]
["IERHA",null,"NR FlinFlon CancerCare",null,"IE Ashern Emergency",null,"PM Birtle Personal Care Home",null,null,null,null,null,"SS Portage Dialysis",null,"PMH",0.46,null,"Airfare"]
["PMH",null,"NR FlinFlon Dialysis",null,"IE Ashern Medicine",null,"PM Brandon Emergency Dept",null,null,null,null,null,"SS Portage Emergency Depart",null,"SHSS",0.46,null,"Baggage Claim"]
["SHSS",null,"NR FlinFlon Medicine/Emergency",null,"IE Beausejour Medicine/Emerg",null,"PM Brandon Medicine ",null,null,null,null,null,"SS Portage Medicine/Pediatrics",null,"NRHA",0.504,null,"Parking"]
["PTNT_Above_53rd",null,"NR FlinFlon NorthernLightsMan",null,"IE Eriksdale PCH",null,"PM Brandon Surgery",null,null,null,null,null,"SS Portage Operating Room",null,"PTNT_Above_53rd",0.504,null,"Taxi/Uber"]
["PTNT_Below_53rd",null,"NR FlinFlon PersonalCareHome",null,"IE PineFalls Dialysis",null,"PM Dauphin Emerg",null,null,null,null,null,"SS Portage PostAnaethesia",null,"PTNT_Below_53rd",0.46,null,"Car Rental"]
[null,null,"NR Gillam Emergency Dept",null,"IE PineFalls Emergency/Medicine",null,"PM Dauphin Hemodialysis",null,null,null,null,null,"SS Portage Rehab",null,"Rate",null,null,"Car Rental Gas"]
[null,null,"NR Leaf Rapids Emergency Dept",null,"IE Selkirk Dialysis",null,"PM Dauphin Medicine",null,null,null,null,null,"SS Portage Surgery",null,"IERHA",60,null,"Other"]
[null,null,"NR Lynn Lake Medicine / Emerg",null,"IE Selkirk Emergency",null,"PM Dauphin Oncology",null,null,null,null,null,"SS Portage Obstetrics",null,"PMH",60]
[null,null,"NR Snow Lake Emergency Dept",null,"IE Selkirk Medicine",null,"PM Dauphin OR/PostAnaesthesia",null,null,null,null,null,"SS BoundTrails Cancer Care",null,"SHSS",60]
[null,null,"NR The Pas Amb Care Clinic",null,"IE Selkirk MedX",null,"PM Dauphin PCH",null,null,null,null,null,"SS BoundTrails Dialysis",null,"NRHA",65]
[null,null,"NR The Pas Cancer Care",null,"IE Selkirk Observation",null,"PM Dauphin Special Care Unit",null,null,null,null,null,"SS BoundTrails Emergency Dept",null,null,"  "]
[null,null,"NR The Pas Dialysis",null,"IE Stonewall Medicine/Emerg",null,"PM Dauphin Surgery",null,null,null,null,null,"SS BoundTrails Medicine "]
[null,null,"NR The Pas Emergency Dept",null,"IE Pinawa Medicine",null,"PM Gilb PlainsPersonalCareHome",null,null,null,null,null,"SS BoundTrails Operating Room",null,null,"Location","Breakfast","Lunch","Dinner","Incidentials"]
[null,null,"NR The Pas HC",null,"IE Whitemouth PCH",null,"PM Glenboro Med/Emerg",null,null,null,null,null,"SS BoundTrails PostAnaesthesia",null,null,"Below 53rd",10,14,26,10]
[null,null,"NR The Pas Medicine",null,"IE Berens River Dialysis",null,"PM Glenboro PCH",null,null,null,null,null,"SS BoundTrails Rehab",null,null,"Above 53rd",12,15,28,10]
[null,null,"NR The Pas Obstetrics / L&D",null,"IE Hodgson Dialysis",null,"PM Minnedosa Medicine/ Emerg",null,null,null,null,null,"SS BoundTrails Surgery"]
[null,null,"NR The Pas Operating Room",null,"PM Westman Nursing Home PCH",null,"PM Parkland Mental Health Center",null,null,null,null,null,"SS BoundTrails Obsetrics"]
[null,null,"NR The Pas Psychiatry",null,"IE Sunnywood PCH Pine Falls",null,"PM Swan River PCH",null,null,null,null,null,"SS Carmen Memorial Hospital Medicine"]
[null,null,"NR The Pas St. Paul's PCH",null,"IE Ashern PCH",null,"PM Swan Valley Lodge PCH",null,null,null,null,null,"SS Carman Operating Room",null,null,"2024-01-01",4.1666666666666664E-2,null,"Y"]
[null,null,"NR Thompson Dialysis",null,"IE East Gate Loge PCH Beausejour",null,"PM Brandon Dialysis",null,null,null,null,null,"SS Carman Same Day Surgery",null,null,"2030-12-31",1,null,"N"]
[null,null,"NR Thompson Emergency Dept",null,null,null,"PM Neepawa Chemo",null,null,null,null,null,"SS Notre Dame Med/Surg"]
[null,null,"NR Thompson Med/Surg/Peds",null,null,null,"PM Neepawa Medicine/Surgery",null,null,null,null,null,"SS Rock Lake Med/Surg"]
[null,null,"NR Thompson Northern Spirit Manor",null,null,null,"PM Neepawa PCH",null,null,null,null,null,"SS Carman Emergency Dept"]
[null,null,"NR Thompson Obstetrics/L&D",null,null,null,"PM Westman Nursing Home PCH",null,null,null,null,null,"SS Carman Post Anesthesia Care",null,null,"General Duty Nurse (N2)"]
[null,null,"NR Thompson Operating Room",null,null,null,null,null,null,null,null,null,null,null,null,"Licensed Practical Nurse"]
[null,null,"NR Thompson Psychiatry",null,null,null,null,null,null,null,null,null,null,null,null,"Registered Psychiatric Nurse (N2)"]
[null,null,"NR Thompson RAAM Eaglewood"]
[null,null,"NR Thompson CCC"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Location","Breakfast","Lunch","Dinner","Incidentials"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"IERHA",10,14,26,10]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"PMH",10,14,26,10]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"SHSS",10,14,26,10]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"NRHA",12,15,28,10]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Clinical Day"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Away for 24 Hours or more"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Educational Day"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Location"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"IERHA","Below 53rdB","Below 53rdL","Below 53rdD"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"PMH","Below 53rdB","Below 53rdL","Below 53rdD"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"SHSS","Below 53rdB","Below 53rdL","Below 53rdD"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"NRHA","Above 53rdB","Above 53rdL","Below 53rdD"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Below 53rdB","Below 53rdL","Below 53rdD"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,10,14,26]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Above 53rdB","Above 53rdL","Below 53rdD"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,12,15,28]

{"sheet":"Sheet1","index":3,"n_rows":15,"n_cols":10,"rows_kept":15,"cut":false,"hidden":true,"merged":[]}
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,"Location","Breakfast","Lunch","Dinner"]
[null,null,null,null,null,null,"IERHA",10,14,26]
[null,null,null,null,null,null,"PMH",10,14,26]
[null,null,null,null,null,null,"SH-SS",10,14,26]
[null,null,null,null,null,null,"NRHA",12,15,28]

{"sheet":"Per Diem","index":4,"n_rows":0,"n_cols":0,"rows_kept":0,"cut":false,"hidden":true,"merged":[]}

{"sheet":"Allowable Claim Items","index":5,"n_rows":0,"n_cols":0,"rows_kept":0,"cut":false,"hidden":true,"merged":[]}

{"sheet":"Cost Centre","index":6,"n_rows":106,"n_cols":4,"rows_kept":106,"cut":false,"hidden":false,"merged":[]}
[]
["ESP Long Name","Cost Ctr","SDO","ESP Long Name"]
["SHM - PrvFlPool",80600933,"PTNT","SHM - PrvFlPool"]
["NR Thompson Psychiatry",80800001,"NRHA","NR Thompson Psychiatry"]
["NR Thompson Obstetrics/L&D",80800002,"NRHA","NR Thompson Obstetrics/L&D"]
["NR Thompson Med/Surg/Peds",80800003,"NRHA","NR Thompson Med/Surg/Peds"]
["NR Thompson Emergency Dept",80800004,"NRHA","NR Thompson Emergency Dept"]
["NR Thompson Dialysis",80800005,"NRHA","NR Thompson Dialysis"]
["NR Thompson Operating Room",80800006,"NRHA","NR Thompson Operating Room"]
["NR FlinFlon CancerCare",80800007,"NRHA","NR FlinFlon CancerCare"]
["NR Thompson Northern Spirit Manor",80800008,"NRHA","NR Thompson Northern Spirit Manor"]
["NR The Pas Amb Care Clinic",80800009,"NRHA","NR The Pas Amb Care Clinic"]
["NR The Pas Dialysis",80800010,"NRHA","NR The Pas Dialysis"]
["NR The Pas Medicine",80800011,"NRHA","NR The Pas Medicine"]
["NR The Pas Obstetrics / L&D",80800012,"NRHA","NR The Pas Obstetrics / L&D"]
["NR The Pas Operating Room",80800013,"NRHA","NR The Pas Operating Room"]
["NR The Pas Emergency Dept",80800014,"NRHA","NR The Pas Emergency Dept"]
["NR The Pas Psychiatry",80800015,"NRHA","NR The Pas Psychiatry"]
["NR The Pas St. Paul's PCH",80800016,"NRHA","NR The Pas St. Paul's PCH"]
["NR The Pas HC",80800017,"NRHA","NR The Pas HC"]
["NR FlinFlon CancerCare",80800018,"NRHA","NR FlinFlon CancerCare"]
["NR FlinFlon Dialysis",80800019,"NRHA","NR FlinFlon Dialysis"]
["NR FlinFlon Medicine/Emergency",80800020,"NRHA","NR FlinFlon Medicine/Emergency"]
["NR FlinFlon Medicine/Emergency",80800021,"NRHA","NR FlinFlon Medicine/Emergency"]
["NR FlinFlon NorthernLightsMan",80800022,"NRHA","NR FlinFlon NorthernLightsMan"]
["NR FlinFlon PersonalCareHome",80800023,"NRHA","NR FlinFlon PersonalCareHome"]
["NR Flin Flon Home Care",80800024,"NRHA","NR Flin Flon Home Care"]
["NR Snow Lake Emergency Dept",80800026,"NRHA","NR Snow Lake Emergency Dept"]
["NR Gillam Emergency Dept",80800027,"NRHA","NR Gillam Emergency Dept"]
["NR Gillam Emergency Dept",80800028,"NRHA","NR Gillam Emergency Dept"]
["NR Lynn Lake Medicine / Emerg",80800029,"NRHA","NR Lynn Lake Medicine / Emerg"]
["NR Lynn Lake Medicine / Emerg",80800030,"NRHA","NR Lynn Lake Medicine / Emerg"]
["NR Leaf Rapids Emergency Dept",80800031,"NRHA","NR Leaf Rapids Emergency Dept"]
["IE PineFalls Dialysis",80800032,"IERHA","IE PineFalls Dialysis"]
["IE PineFalls Emergency/Medicine",80800033,"IERHA","IE PineFalls Emergency/Medicine"]
["IE Ashern Emergency",80800035,"IERHA","IE Ashern Emergency"]
["IE Ashern Medicine",80800036,"IERHA","IE Ashern Medicine"]
["IE Ashern Dialysis",80800037,"IERHA","IE Ashern Dialysis"]
["IE Beausejour Medicine/Emerg",80800038,"IERHA","IE Beausejour Medicine/Emerg"]
["IE Stonewall Medicine/Emerg",80800040,"IERHA","IE Stonewall Medicine/Emerg"]
["IE Selkirk Emergency",80800042,"IERHA","IE Selkirk Emergency"]
["IE Selkirk Dialysis",80800043,"IERHA","IE Selkirk Dialysis"]
["PM Dauphin Emerg",80800044,"PMH","PM Dauphin Emerg"]
["PM Dauphin Hemodialysis",80800045,"PMH","PM Dauphin Hemodialysis"]
["PM Dauphin OR/PostAnaesthesia",80800046,"PMH","PM Dauphin OR/PostAnaesthesia"]
["PM Dauphin Surgery",80800047,"PMH","PM Dauphin Surgery"]
["PM Dauphin Medicine",80800048,"PMH","PM Dauphin Medicine"]
["PM Dauphin Special Care Unit",80800049,"PMH","PM Dauphin Special Care Unit"]
["PM Dauphin Oncology",80800050,"PMH","PM Dauphin Oncology"]
["PM Parkland Mental Health Center",80800051,"PMH","PM Parkland Mental Health Center"]
["PM Dauphin PCH",80800052,"PMH","PM Dauphin PCH"]
["PM Swan River PCH",80800053,"PMH","PM Swan River PCH"]
["PM Swan Valley Lodge PCH",80800054,"PMH","PM Swan Valley Lodge PCH"]
["PM Benito PCH",80800055,"PMH","PM Benito PCH"]
["PM Minnedosa Medicine/ Emerg",80800056,"PMH","PM Minnedosa Medicine/ Emerg"]
["PM Brandon Medicine ",80800058,"PMH","PM Brandon Medicine "]
["PM Brandon Emergency Dept",80800059,"PMH","PM Brandon Emergency Dept"]
["PM Gilb PlainsPersonalCareHome",80800060,"PMH","PM Gilb PlainsPersonalCareHome"]
["PM Birtle Personal Care Home",80800061,"PMH","PM Birtle Personal Care Home"]
["SS Portage Cancer Care",80800062,"SH-SS","SS Portage Cancer Care"]
["SS Portage Dialysis",80800063,"SH-SS","SS Portage Dialysis"]
["SS Portage Emergency Depart",80800064,"SH-SS","SS Portage Emergency Depart"]
["SS Portage Medicine/Pediatrics",80800065,"SH-SS","SS Portage Medicine/Pediatrics"]
["SS Portage Operating Room",80800066,"SH-SS","SS Portage Operating Room"]
["SS Portage PostAnaethesia",80800067,"SH-SS","SS Portage PostAnaethesia"]
["SS Portage Rehab",80800068,"SH-SS","SS Portage Rehab"]
["SS Portage Surgery",80800069,"SH-SS","SS Portage Surgery"]
["SS Portage Obstetrics",80800070,"SH-SS","SS Portage Obstetrics"]
["SS BoundTrails Cancer Care",80800071,"SH-SS","SS BoundTrails Cancer Care"]
["SS BoundTrails Dialysis",80800072,"SH-SS","SS BoundTrails Dialysis"]
["SS BoundTrails Emergency Dept",80800073,"SH-SS","SS BoundTrails Emergency Dept"]
["SS BoundTrails Medicine ",80800074,"SH-SS","SS BoundTrails Medicine "]
["SS BoundTrails Operating Room",80800075,"SH-SS","SS BoundTrails Operating Room"]
["SS BoundTrails PostAnaesthesia",80800076,"SH-SS","SS BoundTrails PostAnaesthesia"]
["SS BoundTrails Rehab",80800077,"SH-SS","SS BoundTrails Rehab"]
["SS BoundTrails Surgery",80800078,"SH-SS","SS BoundTrails Surgery"]
["SS BoundTrails Obsetrics",80800079,"SH-SS","SS BoundTrails Obsetrics"]
["NR The Pas Cancer Care",80800081,"NRHA","NR The Pas Cancer Care"]
["PM Brandon Surgery",80800082,"PMH","PM Brandon Surgery"]
["IE Eriksdale PCH",80800083,"IERHA","IE Eriksdale PCH"]
["IE Selkirk Medicine",80800084,"IERHA","IE Selkirk Medicine"]
["IE Selkirk Observation",80800085,"IERHA","IE Selkirk Observation"]
["NR Thompson RAAM Eaglewood",80800086,"NRHA","NR Thompson RAAM Eaglewood"]
["PM Glenboro Med/Emerg",80800087,"PMH","PM Glenboro Med/Emerg"]
["SS Carmen Memorial Hospital Medicine",80800088,"SH-SS","SS Carmen Memorial Hospital Medicine"]
["SS Carman Operating Room",80800089,"SH-SS","SS Carman Operating Room"]
["SS Carman Same Day Surgery",80800090,"SH-SS","SS Carman Same Day Surgery"]
["SS Carman Emergency Dept",80800091,"SH-SS","SS Carman Emergency Dept"]
["SS Carman Post Anesthesia Care",80800092,"SH-SS","SS Carman Post Anesthesia Care"]
["NRHA Thompson CCC",80800093,"NRHA","NR Thompson CCC"]
["PM Glenboro PCH",80800094,"PMH","PM Glenboro PCH"]
["IE Selkirk MedX",80800095,"IERHA","IE Selkirk MedX"]
["IE Whitemouth PCH",80800096,"IERHA","IE Whitemouth PCH"]
["IE Pinawa Medicine",80800097,"IERHA","IE Pinawa Medicine"]
["SS Notre Dame Med/Emerg",80800098,"SH-SS","SS Notre Dame Med/Emerg"]
["SS Rock Lake Med/Surg",80800099,"SH-SS","SS Rock Lake Med/Surg"]
["IE Berens River Dialysis",80800100,"IERHA","IE Berens River Dialysis"]
["IE Hodgson Dialysis",80800101,"IERHA","IE Hodgson Dialysis"]
["PM Brandon Dialysis",80800104,"PMH","PM Brandon Dialysis"]
["PM Neepawa Chemo",80800105,"PMH","PM Neepawa Chemo"]
["PM Neepawa Medicine/Surgery",80800106,"PMH","PM Neepawa Medicine/Surgery"]
["PM Neepawa PCH",80800107,"PMH","PM Neepawa PCH"]
["PM Westman Nursing Home PCH",80800108,"PMH","PM Westman Nursing Home PCH"]
["IE Sunnywood PCH Pine Falls",80800102,"IERHA","IE Sunnywood PCH Pine Falls"]
["IE Ashern PCH",80800109,"IERHA","IE Ashern PCH"]
["IE East Gate Loge PCH Beausejour",80800110,"IERHA","IE East Gate Loge PCH Beausejour"]

{"sheet":"Expense Code","index":7,"n_rows":9,"n_cols":2,"rows_kept":9,"cut":false,"hidden":true,"merged":[]}
[]
[]
[562310000,"Staff Travel Local"]
[562312000,"Staff Travel Provincial"]
[562314000,"Staff Travel (Outside Manitoba)"]
[562320002,"Staff Travel Service Recipient-Related Parking"]
[562300005,"Travel Operations Meals"]
[562310002,"Staff Travel Local - MNU Mileage Allowance"]
[562300000,"TRAVEL EXP - STAFF"]

{"sheet":"Follow-up","index":8,"n_rows":15,"n_cols":4,"rows_kept":15,"cut":false,"hidden":true,"merged":[]}
[]
[null,"Item","Change","Status"]
[null,1,"Larger font and wrap text","Complete"]
[null,2,"For the Employee Signature, please change to have the employee type in their name and format the font to be in a legible script font.  Can add a comment something like “By typing your name in the above field, you are stating that you are aware of this claim being submitted by you as the Claimant.”","Complete"]
[null,3,"In the Mileage section, is it possible to interchange the columns, so that input for Trip information will be the starting point like Home or any other Address, and the Facility assignment will be destination (Facility assigned to). Perhaps change names to something like From and To Destination respectively.","Please Review"]
[null,4,"Formula in Mileage Total is not picking up all the cells – missing cells L21 to L30 in the formula","Complete"]
[null,5,"Drop downs in the Per Diem – Travel Day do not appear to be working.  Also “Page 1” is appearing in the form in this section ","Changed to Normal View from Page Break View; Location and Facility needs to be selected for drop down to populate -  Complete"]
[null,6,"Can the following be added in the drop down list for Other:","Complete"]
[null,null,"Taxi/Uber"]
[null,null,"Car Rental"]
[null,null,"Car Rental Gas"]
[null,7,"For the “Other” selection in this section, there should be a cell to populate what the actual charge is.","Need more information"]
[null,8,"Shared Health logo should be at the top of the page – perhaps in the header","Complete"]
[null,9,"AP was hoping there would be a summary section that would summarize the coding and charges be cost centre and expense code.  Not sure how to build a formula to do that though.  It would mean that AP would have to manually calculate the totals by cost centre/expense code or enter each line separately.  More work for AP, but that may have to be the way it is as we don’t want to eliminate any of the built in features in the new claim.  Open to discuss.","Complete"]
[null,10,"Approver sign the form","Complete"]