|
Name |
Type |
Discontinued? |
|
| 1 |
CLAIM_ID |
NUMERIC |
No |
|
|
|
| The unique identifier (.1 item) for the claim info 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 |
PSEQ_GRP_ITM_TYPE_C_NAME |
VARCHAR |
No |
|
|
|
| Stores the type of value stored in I CLM 18768 from the previously received claim information, to be used in claim sequencing. |
| May contain organization-specific values: No |
| Category Entries: |
| Paid Date |
| Received Date |
| Quantity |
| Days Supply |
| Adjustment Type |
| Claim Type |
| Service Start Date |
| Service End Date |
| Payer Claim Id |
| Primary Procedure |
| Primary Diagnosis |
| NDC |
| Line of Business |
| Benefit Plan |
| Claim Processed Date |
| Date Filled |
| Quantity Dispensed |
| Performed Start Date |
| Performed End Date |
| Denial Reason |
| Processing Status |
| Source File Date |
| Adjustment To Claim Header Id |
| Reversal To Claim Header Id |
|
|
| 4 |
PSEQ_GRP_ITM_CODE |
VARCHAR |
No |
|
|
|
| Stores the value or code for the type stored in I CLM 18767 from the previously received claim information, to be used in claim sequencing. |
|
|