AP_CLAIM_PX_AMT_LV
Description:
This table contains the allowed amount adjudication levels for AP Claim procedures.
To link this table’s service line information back to a claim header, join this table to AP_CLAIM_PROC_IDS on the TX_ID column. If you need to report on claim service lines specific to Cost Sharing Reduction (CSR), join this table instead to AP_CLAIM_PROC_IDS_CSR on the TX_ID column.

Primary Key
Column Name Ordinal Position
TX_ID 1
LINE 2

Column Information
Name Type Discontinued?
1 TX_ID NUMERIC No
The unique ID of the AP Claim procedure transaction.
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 ALLOW_AMT_ADJ_LVLS VARCHAR No
The allowed amount adjudication levels for the procedure. Information from this caret (^) delimited string is parsed out in subsequent columns.
4 ALWD_AMT_LVL_PMT_LV VARCHAR No
The level of payment for the allowed amount of the service line on the AP Claim.
5 ALWD_AMT_LVL_CVD VARCHAR No
The covered amount of the allowed amount for the service line of the AP Claim.
6 ALWD_AMT_LVL_LM_TYP INTEGER No
The limit type of the allowed amount of the service line on the AP Claim.
7 ALWD_AMT_PMT_MECH INTEGER No
The payment mechanism for the allowed amount of the service line on the AP Claim.
8 ALWD_AMT_LVL_PRICE VARCHAR No
The price of the service line allowed amount on the AP Claim.
9 ALWD_AMT_LVL_RATE VARCHAR No
The rate used in determining the allowed amount of the service line on the AP Claim.
10 ALWD_AMT_LVL_HMU VARCHAR No
The conversion factor table used to price a service line using RVU pricing.
11 ALWD_AMT_LVL_HMU_TABLE_NAME VARCHAR No
The name for the conversion factor table.
12 ALWD_AMT_LVL_TOS INTEGER No
The type of service used to get the conversion factor in Relative Value Unit (RVU) pricing.
13 ALWD_AMT_LVL_UNITS VARCHAR No
The total number of time units used to determine the price of an anesthesia procedure on an AP Claim.
14 ALWD_AMT_LVL_DSCNT VARCHAR No
Discount percentage used in calculating the allowed amount of the service line on the AP Claim.
15 ALWD_AMT_LVL_MULT VARCHAR No
The multiplier or conversion factor value used in calculating the allowed amount of the service line on the AP Claim.
16 ALWD_AMT_RVU_VALUE VARCHAR No
The Relative Value Unit (RVU) value of the procedure on the service line of the AP Claim. This is only stored in level 1.
17 ALWD_AMT_LPP_CMMT VARCHAR No
The comment added by the pricing programming point, which was used to determine the allowed amount of the service line on the AP Claim.
18 ALWD_AMT_LVL_FSM NUMERIC No
The ID of the fee schedule map used to determine the allowed amount of the service line on the AP Claim.
19 ALWD_AMT_LVL_FSM_FEE_SCHEDULE_MAP_NAME VARCHAR No
The name for the fee schedule map record.
20 ALWD_AMT_LVL_ZIP VARCHAR No
When a fee schedule map is used to determine the allowed amount of the service line on the AP claim, this column contains the ZIP Code where the service was performed.
21 ALWD_AMT_LVL_UNSUPP_LPP_YN VARCHAR No
Set to "Y" if the pricing programming point is not supported, resulting in the execution of the pricing programming point being skipped. Set to "N" otherwise.
22 ALWD_AMT_LVL_FEE_SCHED1_PRICE VARCHAR No
The rate associated with the first fee schedule used to determine the allowed amount of the service line on the AP Claim.
23 ALWD_AMT_LVL_FEE_SCHED2_PRICE VARCHAR No
The rate associated with the second fee schedule used to determine the allowed amount of the service line on the AP Claim.
24 ALWD_AMT_SVC_PAYMENT_MECH_C INTEGER No
The payment mechanism used as a result of either minimum of options or maximum of options to determine the allowed amount of the service line on the AP Claim.
25 ALWD_AMT_LVL_IS_STOP_LOSS_YN VARCHAR No
Set to "Y" if the level of payment for the allowed amount of the service line on the AP Claim is a stop loss level, "N" otherwise.