|
Name |
Type |
Discontinued? |
|
| 1 |
TX_ID |
NUMERIC |
No |
|
|
|
| The unique identifier for the transaction 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 |
BENEFIT_LEVEL |
VARCHAR |
No |
|
|
|
| The level used in adjudication benefits calculation. |
|
|
| 4 |
LIMIT_VARIABLE_ID |
NUMERIC |
No |
|
|
|
| The limit variable used by the level in adjudication benefits calculation. |
|
|
| 5 |
LIMIT_VARIABLE_ID_BEN_VAR_NAME |
VARCHAR |
No |
|
|
|
| The name of the benefit variable. |
|
|
| 6 |
BEN_LMT_VAR_SPEC_C_NAME |
VARCHAR |
No |
|
|
|
| The limit type of the limit variable used by the level in adjudication benefits calculation. |
| May contain organization-specific values: No |
| Category Entries: |
| By Procedure Unit |
| By Dollar Amount |
| By Co-insurance |
| By Visit |
|
|
| 7 |
LIMIT_AMOUNT |
NUMERIC |
No |
|
|
|
| The limit amount at the level in adjudication benefits calculation. |
|
|
| 8 |
LIMIT_REMAINING |
NUMERIC |
No |
|
|
|
| The limit amount remaining at the level in adjudication benefits calculation. |
|
|
| 9 |
PAYMENT_VARIABLE_ID |
NUMERIC |
No |
|
|
|
| The payment variable used by the level in adjudication benefits calculation. |
|
|
| 10 |
PAYMENT_VARIABLE_ID_BEN_VAR_NAME |
VARCHAR |
No |
|
|
|
| The name of the benefit variable. |
|
|
| 11 |
PAY_METHOD_EPP_C_NAME |
VARCHAR |
No |
|
|
|
| The payment type for the payment variable used by the level in adjudication benefits calculation. |
| May contain organization-specific values: No |
| Category Entries: |
| Percent of Price |
| Amount per Unit |
| Fixed Amount |
| Custom Calculation |
| No Patient Payment |
| Not Covered |
| Percent of Fee Schedule |
| Percent of Price with Exceptions Based on Fee Schedule |
|
|
| 12 |
PAYMENT_AMOUNT |
NUMERIC |
No |
|
|
|
| The payment amount for the payment variable used by the level in adjudication benefits calculation. |
|
|
| 13 |
COVERED_AMOUNT |
NUMERIC |
No |
|
|
|
| The covered amount used by the level in adjudication benefits calculation. |
|
|
| 14 |
COVERED_QUANTITY |
NUMERIC |
No |
|
|
|
| The covered quantity used by the level in adjudication benefits calculation. |
|
|