CLM_VALUES

Description: |
All values associated with a claim are stored in the Claim External Value record. The CLM_VALUES table holds claim-level values set by the system during claims processing or by user edits.

Primary Key

Column Name | Ordinal Position |
--- | --- | ---
RECORD_ID | 1 |

Column Information

| Name | Type | Discontinued? |
--- | --- | --- | --- | ---
1 | RECORD_ID | NUMERIC | No |
This column stores the unique identifier for the claim record.
2 | BIL_PROV_TYP_QUAL | VARCHAR | No |
The value indicating whether the billing provider on the claim is a person or a non-person.
3 | BIL_PROV_NAM_LAST | VARCHAR | No |
The billing provider's last name (if a person) or the organization name (if a non-person).
4 | BIL_PROV_NAM_FIRST | VARCHAR | No |
The billing provider's first name. It is only populated when the billing provider is a person.
5 | BIL_PROV_NAM_MID | VARCHAR | No |
The billing provider's middle name. It is only populated when the billing provider is a person.
6 | BIL_PROV_NAM_SUF | VARCHAR | No |
The suffix to the billing provider's name (e.g., Jr, III). It is only populated when the billing provider is a person.
7 | BIL_PROV_NPI | VARCHAR | No |
The billing provider's National Provider Identifier (NPI).
8 | BIL_PROV_TAXONOMY | VARCHAR | No |
The billing provider's taxonomy code.
9 | BIL_PROV_TAXID_QUAL | VARCHAR | No |
The qualifier for the billing provider's tax ID defining the type of ID reported as the tax ID.
10 | BIL_PROV_TAXID | VARCHAR | No |
The billing provider's tax ID. For individuals, this ID could be the SSN or tax ID.
11 | BIL_PROV_UPIN | VARCHAR | No |
The billing provider's unique physician identification number (UPIN). It is only populated when the provider is a person.
12 | BIL_PROV_LIC_NUM | VARCHAR | No |
The billing provider's license number. It is only populated when the billing provider is a person.
13 | BIL_PROV_ADDR_1 | VARCHAR | No |
The first line of the billing provider's street address.
14 | BIL_PROV_ADDR_2 | VARCHAR | No |
The second line of the billing provider's street address.
15 | BIL_PROV_CITY | VARCHAR | No |
The billing provider's city.
16 | BIL_PROV_STATE | VARCHAR | No |
The billing provider's state.
17 | BIL_PROV_ZIP | VARCHAR | No |
The billing provider's ZIP Code.
18 | BIL_PROV_CNTRY | VARCHAR | No |
The billing provider's country. It is only populated if the address is outside the United States.
19 | BIL_PROV_CNTRY_SUB | VARCHAR | No |
The billing provider's country subdivision (e.g., state, province). It is only populated if the address is outside the United States.
20 | CLM_CVG_SEQ_CD | VARCHAR | No |
The code identifying the filing order for the claim (e.g., primary, secondary, tertiary).
21 | CLM_CVG_PYR_NAM | VARCHAR | No |
The payer name.
22 | CLM_CVG_GRP_NUM | VARCHAR | No |
The group number entered in the coverage record.
23 | CLM_CVG_GRP_NAM | VARCHAR | No |
The group name entered in the coverage record.
24 | CLM_CVG_INS_TYP | VARCHAR | No |
The insurance type code for the claim.
25 | CLM_CVG_FILING_IND | VARCHAR | No |
The indicator identifying the type of claim.
26 | CLM_CVG_PYR_ID_TYP | VARCHAR | No |
The qualifier that describes the type of ID used to identify the payer.
27 | CLM_CVG_PYR_ID | VARCHAR | No |
The primary ID for the payer.
28 | CLM_CVG_ACPT_ASGN | VARCHAR | No |
The indicator that the provider accepts assignment from the payer.
29 | CLM_CVG_AUTH_PMT | VARCHAR | No |
The indicator that the insured assigns benefits to the provider.
30 | CLM_CVG_REL_INFO | VARCHAR | No |
The indicator that the insured has authorized the release of information to the payer.
31 | PYR_ADDR_1 | VARCHAR | No |
The first line of the payer's street address.
32 | PYR_ADDR_2 | VARCHAR | No |
The second line of the payer's street address.
33 | PYR_CITY | VARCHAR | No |
The payer's city.
34 | PYR_STATE | VARCHAR | No |
The payer's state.
35 | PYR_ZIP | VARCHAR | No |
The payer's ZIP Code.
36 | PYR_CNTRY | VARCHAR | No |
The payer's country. It is only populated if the address is outside the United States.
37 | PYR_CNTRY_SUB | VARCHAR | No |
The payer's country subdivision (e.g., state, province). It is only populated if the address is outside the United States.
38 | PAT_NAM_LAST | VARCHAR | No |
The patient's last name.
39 | PAT_NAM_FIRST | VARCHAR | No |
The patient's first name.
40 | PAT_NAM_MID | VARCHAR | No |
The patient's middle name.
41 | PAT_NAM_SUF | VARCHAR | No |
The suffix to the patient's name (e.g., Jr, III).
42 | PAT_MRN | VARCHAR | No |
The patient's medical record number.
43 | PAT_CVG_MEM_ID | VARCHAR | No |
The coverage member ID for the patient.
44 | PAT_REL_TO_INS | VARCHAR | No |
The patient's relationship to the coverage subscriber.
45 | PAT_BIRTH_DATE | DATETIME | No |
The patient's birthdate.
46 | PAT_SEX | VARCHAR | No |
The patient's gender.
47 | PAT_SIG_ON_FILE | VARCHAR | No |
The indicator that the patient has signed the necessary release forms and the forms are on file at the provider.
48 | PAT_SIG_SRC | VARCHAR | No |
The indicator that the release forms were signed on the patient's behalf.
49 | PAT_DEATH_DATE | DATETIME | No |
The date of the patient's death.
50 | PAT_WT | NUMERIC | No |
The patient's weight (in pounds) when needed for the claim.
51 | PAT_PREG_IND | VARCHAR | No |
The indicator that the patient is pregnant.
52 | PAT_WK_COMP_NUM | VARCHAR | No |
The identification number used for workers' comp claims.
53 | PAT_MAR_STAT | VARCHAR | No |
The patient's marital status.
54 | PAT_EMPY_STAT | VARCHAR | No |
The patient's employment status.
55 | PAT_PH | VARCHAR | No |
The patient's phone number.
56 | PAT_ADDR_1 | VARCHAR | No |
The first line of the patient's street address.
57 | PAT_ADDR_2 | VARCHAR | No |
The second line of the patient's street address.
58 | PAT_CITY | VARCHAR | No |
The patient's city.
59 | PAT_STATE | VARCHAR | No |
The patient's state.
60 | PAT_ZIP | VARCHAR | No |
The patient's ZIP Code.
61 | PAT_CNTRY | VARCHAR | No |
The patient's country. It is only populated if the address is outside the United States.
62 | PAT_CNTRY_SUB | VARCHAR | No |
The patient's country subdivision (e.g., state, province). It is only populated if the address is outside the United States.
63 | INV_NUM | VARCHAR | No |
The invoice number that uniquely identifies the claim in the billing system.
64 | ICN | VARCHAR | No |
The payer's internal control number (ICN) that uniquely identifies the claim in the payer's system.
65 | TTL_CHG_AMT | NUMERIC | No |
The total charge amount for the claim.
66 | BILL_TYP_FAC_CD | VARCHAR | No |
The facility code portion of the bill type (first and second digits).
67 | BILL_TYP_FREQ_CD | VARCHAR | No |
The frequency code portion of the bill type (third digit).
68 | MOMS_MRN | VARCHAR | No |
The mother's medical record number when the patient is a newborn.
69 | PAYTO_ADDR_TYP_QUAL | VARCHAR | No |
The indicator that the pay-to address entity on the claim is a person or a non-person.