|
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. |
|
|