SVC_LN_INFO_3

Description:

All values associated with a claim are stored in the Claim External Value record. The SVC_LN_INFO_3 table holds information about the service lines on the claim.

Primary Key

Column Name	Ordinal Position
RECORD_ID	1
LINE	2

Column Information

	Name	Type	Discontinued?
1	RECORD_ID	NUMERIC	No
	The unique identifier for the claim value record
2	LINE	INTEGER	No
	The line number for the information associated with this record. Multiple pieces of information can be associated with this record.
3	LN_INGRED_COST_PAID	NUMERIC	No
	Drug ingredient cost paid.
4	LN_DISP_FEE_PAID	NUMERIC	No
	Dispensing fee paid.
5	LN_PAT_PAY_AMT	NUMERIC	No
	Patient pay amount.
6	LN_COPAY_AMT	NUMERIC	No
	Amount of patient copay.
7	LN_COINS_AMT	NUMERIC	No
	Amount of patient coinsurance.
8	LN_DEDUCT_AMT	NUMERIC	No
	Amount of patient deductible.
9	LN_REGLTRY_FEE_AMT	NUMERIC	No
	Flat sales tax amount paid.
10	LN_PCT_TAX_AMT	NUMERIC	No
	Percentage tax amount paid.
11	LN_INCENTIVE_AMT	NUMERIC	No
	Incentive amount paid.
12	LN_OTHR_AMT_RECOGZ	NUMERIC	No
	Total amount recognized by the processor of any payment from another source.
13	LN_NET_AMT_DUE	NUMERIC	No
	Net amount paid to provider by the payer.
14	LN_DENT_PROS_QUAL	VARCHAR	No
	This item holds a code indicating if the date for a prior crown/prosthesis is estimated or exact.
15	LN_DENT_PROS_DATE	DATETIME	No
	The date a prior crown/prosthesis was previously placed.
16	SVC_DENIED_STATUS_IDENT	VARCHAR	No
	This stores the external identifier for the denial status of this line.
17	PRCS_IND_CD	VARCHAR	No
	Claim line level processing indicator code.
18	PRCS_IND_CD_DESC	VARCHAR	No
	Claim line level processing indicator code description.
19	LN_OPR_TAXONOMY	VARCHAR	No
	Stores the Line Operating Provider Taxonomy Code.
20	LN_APPLIANCE_REPLACEMENT_DATE	DATETIME	No
	The date when an orthodontic appliance was replaced.
21	LN_TREATMENT_START_DATE	DATETIME	No
	The date of the initial treatment for a dental service.
22	LN_TREATMENT_COMPLETION_DATE	DATETIME	No
	The date of the completed treatment for a dental service.
23	LN_FILL_STATUS	VARCHAR	No
	Stores information on whether the prescription was completely or partially filled.
24	LN_ORD_TAXONOMY	VARCHAR	No
	Stores the National Uniform Claim Committee (NUCC) taxonomy code associated with the line-level operating provider
25	LN_APPLIANCE_PLACEMENT_DATE	DATETIME	No
	The date when the orthodontic appliance was placed.
26	LN_LIN_QUALIFIER	VARCHAR	No
	Qualifier code to identify drug code set or the type/source of the descriptive number used in Product/Service ID.
27	LN_PRESC_PROV_NPI	VARCHAR	No
	This column holds the National Provider Identifier (NPI) of the provider that prescribed the medication on this service.
28	LN_PRESC_PROV_TAXONOMY	VARCHAR	No
	This column holds the NUCC Taxonomy Code of the provider that prescribed the medication on this service.
29	LN_SERV_PROV_NPI	VARCHAR	No
	This item holds the National Provider Identifier (NPI) of the pharmacy that filled the prescription.
30	LN_SERV_PROV_TAXONOMY	VARCHAR	No
	This column holds the NUCC Taxonomy Code of the pharmacy that filled the prescription.
31	LN_DX_PTR_RANK	VARCHAR	No
	The comma-delimited list of diagnoses ranks for each diagnosis on a service. Each position here corresponds to the same comma-delimited position of the column LN_DX_PTR from the SVC_LN_INFO table. The rank here specifies the ranking of diagnoses for the specific service. This can be different than the rank of the same diagnoses at the header-level or even the same diagnoses for a different service.
32	LN_PCP_REF_LAST_NM	VARCHAR	No
	This item stores the line's PCP referring provider's last name.
33	LN_PCP_REF_FIRST_NM	VARCHAR	No
	This item stores the line's PCP referring provider's first name.
34	LN_PCP_REF_MID_NM	VARCHAR	No
	This item stores the line's PCP referring provider's middle name.
35	LN_PCP_REF_SUFFIX_NM	VARCHAR	No
	This item stores the line's PCP referring provider's suffix.
36	LN_PCP_REF_NPI	VARCHAR	No
	This item stores the line's PCP referring provider's NPI.
37	RX_DATE	DATETIME	No
	The date when the prescription was written.
38	SUB_CLAR_CODE	VARCHAR	No
	The code indicating that the pharmacist is clarifying the submission.
39	RX_ORIGIN_CODE	VARCHAR	No
	The code indicating the origin of the prescription.
40	RX_PHARM_SRV_TYPE	VARCHAR	No
	The type of service being performed by a pharmacy when different contractual terms exist between a payer and the pharmacy, or when benefits are based upon the type of service performed.
41	RX_PROD_DESC	VARCHAR	No
	The description of the product being submitted on the prescription claim.
42	OTHER_CVG_CODE	VARCHAR	No
	The code indicating whether or not the patient has other insurance coverage.
43	RX_SERVICE_LEVEL	VARCHAR	No
	The code indicating the type of service the provider rendered.
44	QTY_PRESCRIBED	NUMERIC	No
	The quantity of prescription drug expressed in metric decimal units.
45	REASON_SVC_CODE	VARCHAR	No
	The code identifying the type of utilization conflict detected or the reason for the pharmacist's professional service.
46	PROF_SRVC_CODE	VARCHAR	No
	The code identifying pharmacist intervention when a conflict code has been identified or service has been rendered.
47	RES_SVC_CODE	VARCHAR	No
	The code describing a pharmacist's action in response to a professional conflict.
48	LEVEL_OF_EFFORT	VARCHAR	No
	The code indicating the level of effort as determined by the complexity of decision-making or resources utilized by a pharmacist to perform a professional service.
49	DOSAGE_FORM_DESC_CD	VARCHAR	No
	The dosage form of the complete compound mixture.
50	DISP_UNIT_FORM_INDICATOR	VARCHAR	No
	The NCPDP standard product billing codes.
51	ADMIN_ROUTE	VARCHAR	No
	An override to the "default" route referenced for the product. For a multi-ingredient compound, it is the route of the complete compound mixture.
52	INGREDIENT_COMPOUND_CNT	INTEGER	No
	The count of compound product IDs (both active and inactive) in the compound mixture submitted.
53	USUAL_CUSTOMARY_CHG	INTEGER	No
	The amount charged to cash customers for the prescription exclusive of sales tax or other amounts claimed.
54	COST_BASIS	VARCHAR	No
	The code indicating the method used to calculate the ingredient cost.
55	INGREDIENT_COST_SUBMITTED	NUMERIC	No
	The product component cost of the dispensed prescription.
56	DISP_FEE_SUBMITTED	NUMERIC	No
	The dispensing fee submitted by the pharmacy.
57	PROF_FEE_SUBMITTED	NUMERIC	No
	The amount submitted by the provider for professional services rendered.
58	INGREDIENT_AMT_SUBMITTED	NUMERIC	No
	The amount representing the fee that is submitted by the pharmacy for contractually agreed upon services.
59	OTHER_AMT_SUBMITTED	NUMERIC	No
	The amount representing the additional incurred costs for a dispensed prescription or service.
60	GROSS_AMOUNT_DUE	NUMERIC	No
	The total gross amount submitted on the claim.
61	LN_PICK_UP_CNTY	VARCHAR	No
	County in which the ambulance pick-up occured.
62	LN_DROP_OFF_CNTY	VARCHAR	No
	Stores the Line Ambulance Drop-Off Location County
63	LN_START_LOCAL_DTTM	DATETIME (Local)	No
	Stores the line service start time.
64	LN_END_LOCAL_DTTM	DATETIME (Local)	No
	Stores the end time for the service.
65	LN_ELAPSED_TIME	VARCHAR	No
	Stores the time between the start and end time for the service.
66	SECTION_340B	VARCHAR	No
	Section 340B Program Participant - if drug was dispensed under 340B program (yes/no)
67	ACTIVITY_TCN	VARCHAR	No
	This item stores the Activity ID of a single activity line on the claim.
68	ACTIVITY_VAT_PERCENT	NUMERIC	No
	This item stores the VAT percent for a single activity line on the claim.
69	ACTIVITY_CODE	VARCHAR	No
	This item stores the Activity code of a single activity line on the claim.
70	ACTIVITY_START_DATE	DATETIME	No
	This item stores the activity start date of a single activity line on the claim.
71	LN_SERV_PROV_NAME	VARCHAR	No
	The freetext name of the service provider.
72	REVENUE_APC_CODE	VARCHAR	No
	The provider-assigned revenue code for each cost center for which a separate charge is billed.
73	LINE_PRIMARY_PAYER_CODE	VARCHAR	No
	The code specifying a federal non-Medicare program or other source that has primary responsibility for the payment of the Medicare beneficiary's medical bills relating to the service line on the claim. The presence of this code indicates that some other payer besides Medicare covered at least some portion of the charges.
74	LINE_HCPCS_BETOS_CODE	VARCHAR	No
	The Berenson-Eggers Type of Service (BETOS) classification assigned to the Healthcare Common Procedure Coding System (HCPCS) code for the service line.
75	LINE_FEDERAL_SERVICE_CODE	VARCHAR	No
	Code indicating the type of service, as defined in the CMS Medicare Carrier Manual, for this line item on the non-institutional claim.