|
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 |
SEQ_GRP_ITM_TYPE_C_NAME |
VARCHAR |
No |
|
|
|
Stores the type of value stored in I CLM 18766, 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 |
SEQ_GRP_ITM_CODE |
VARCHAR |
No |
|
|
|
Stores the value or code for the type stored in I CLM 18765, to be used in claim sequencing. |
|
|