CLAIM_INFO3
Description:
This table contains claims information from Claim Information (CLM) records for Hospital and Professional Billing.

Primary Key
Column Name Ordinal Position
CLAIM_ID 1

Column Information
Name Type Discontinued?
1 CLAIM_ID NUMERIC No
The unique identifier for the Claim Info record.
2 KIDMED_IMMUNI_C_NAME VARCHAR No
The last immunization date for the KidMed visit.
May contain organization-specific values: Yes
Category Entries:
Yes, Status Current
No, Medically contraindicated
No, Parent Refusal
No, Off Schedule
3 KIDMED_SUSPECTED_YN VARCHAR No
Whether there are suspected conditions, for the KidMed visit.
May contain organization-specific values: No
Category Entries:
Yes
No
4 KIDMED_R1_PROV_FST VARCHAR No
The referred-to provider's last name for the first referral for the KidMed visit.
5 KIDMED_R1_PROV_LAST VARCHAR No
The referred-to provider's first name for the first referral for the KidMed visit.
6 KIDMED_R1_PROV_PH VARCHAR No
The referred-to provider's phone number for the first referral for the KidMed visit.
7 KIDMED_R1_APPT_DT DATETIME No
The appointment date for the first referral for the KidMed visit.
8 KIDMED_R1_REASON VARCHAR No
The appointment reason for the first referral for the KidMed visit.
9 KIDMED_R1_TYPE_C_NAME VARCHAR No
The appointment type for the first referral for the KidMed visit.
May contain organization-specific values: Yes
Category Entries:
Referral Offsite
Referral In-house
10 KIDMED_R2_PROV_FST VARCHAR No
The referred-to provider's last name for the second referral for the KidMed visit.
11 KIDMED_R2_PROV_LAST VARCHAR No
The referred-to provider's first name for the second referral for the KidMed visit.
12 KIDMED_R2_PROV_PH VARCHAR No
The referred-to provider's phone number for the second referral for the KidMed visit.
13 KIDMED_R2_APPT_DT DATETIME No
The appointment date for the second referral for the KidMed visit.
14 KIDMED_R2_REASON VARCHAR No
The appointment reason for the second referral for the KidMed visit.
15 KIDMED_R2_TYPE_C_NAME VARCHAR No
The appointment type for the second referral for the KidMed visit.
The category values for this column were already listed for column: KIDMED_R1_TYPE_C_NAME
16 KIDMED_R3_PROV_FST VARCHAR No
The referred-to provider's last name for the third referral for the KidMed visit.
17 KIDMED_R3_PROV_LAST VARCHAR No
The referred-to provider's first name for the third referral for the KidMed visit.
18 KIDMED_R3_PROV_PH VARCHAR No
The referred-to provider's phone number for the third referral for the KidMed visit.
19 KIDMED_R3_APPT_DT DATETIME No
The appointment date for the third referral for the KidMed visit.
20 KIDMED_R3_REASON VARCHAR No
The appointment reason for the third referral for the KidMed visit.
21 KIDMED_R3_TYPE_C_NAME VARCHAR No
The appointment type for the third referral for the KidMed visit.
The category values for this column were already listed for column: KIDMED_R1_TYPE_C_NAME
22 SPARCS_START_DATETIME DATETIME (Local) No
The start date and time of the patient's presence in the operating room.
23 SPARCS_END_DATETIME DATETIME (Local) No
The end date and time of the patient's presence in the operating room.
24 SPARCS_ANESTHESIA_C_NAME VARCHAR No
Type of anesthesia administered during the stay.
May contain organization-specific values: Yes
Category Entries:
Local Anesthesia
General Anesthesia
Regional Anesthesia
Other
No Anesthesia
25 SPARCS_EXEMPT_UI_C_NAME VARCHAR No
The code which identifies a discharge from a unit within the facility that is exempt from Diagnosis Related Group (DRG) reimbursement.
May contain organization-specific values: Yes
Category Entries:
Alcohol Rehabilitation
Alternate Level of Care
Comprehensive Psychiatric Emergency Program Observation
Drug Rehabilitation
Epilepsy
All Services at Hospital are Exempt
Medical Rehabilitation
Non-DRG Billable Claim
Psychiatric
HIV-AIDS
Traumatic Brain Injury
Ventilator Dependent
26 AMBL_PICK_CNTRY_C_NAME VARCHAR No
Stores the ambulance pick-up location address country.
May contain organization-specific values: Yes
27 AMBL_DROP_CNTRY_C_NAME VARCHAR No
Stores the ambulance drop-off location address country.
The category values for this column were already listed for column: AMBL_PICK_CNTRY_C_NAME
28 CLIENT_IND_C_NAME VARCHAR No
Whether the patient is a new or existing client.
May contain organization-specific values: Yes
No Entries Defined
29 INCOME_AMT NUMERIC No
The patient's annual income.
30 NUM_PEOPLE_SUPPORTD INTEGER No
This item is used to store the number of people financially supported by the patient.
31 ML_PRIM_BRTH_CTRL_C_NAME VARCHAR No
This item is used to store the primary method of male birth control being used by the patient.
May contain organization-specific values: Yes
No Entries Defined
32 PRACTITNR_LVL_CD_C_NAME VARCHAR No
This item is used to store the medical practitioner level code of the practitioner that's seeing the patient.
May contain organization-specific values: Yes
No Entries Defined
33 PAYMENT_C_NAME VARCHAR No
This item is used to store whether the patient made a full, partial, or no payment for the visit.
May contain organization-specific values: Yes
No Entries Defined
34 FAM_PLANNG_ELIG_DT DATETIME No
The date the patient became eligible for family planning insurance.
35 INSURANCE_TYPE_C_NAME VARCHAR No
The family planning insurance type used by the patient.
May contain organization-specific values: Yes
36 WK_COMP_EMPR_ID VARCHAR No
The ID of the employer record for this Workers' Comp claim.
37 WK_COMP_EMPR_ID_EMPLOYER_NAME VARCHAR No
The name of the employer.
38 CLINICAL_TRIAL_NUM VARCHAR No
The National Clinical Trial (NCT) number.
39 RESUB_REASON_C_NAME VARCHAR No
Record the reason for the claim resubmission.
May contain organization-specific values: Yes
No Entries Defined
40 CVR_LST_CT_TEST_C_NAME VARCHAR No
Whether there was a last chlamydia test, for contraceptive vaginal ring (CVR).
May contain organization-specific values: Yes
Category Entries:
Never
Unknown
Date
41 CVR_LST_CT_TEST_DT DATETIME No
Date of the last chlamydia test, for contraceptive vaginal ring (CVR).
42 CVR_LST_PAP_TEST_C_NAME VARCHAR No
Whether there was a last pap test, for contraceptive vaginal ring (CVR).
May contain organization-specific values: Yes
Category Entries:
Never
Unknown
Date
43 CVR_LST_PAP_TEST_DT DATETIME No
Date of the last pap test, for contraceptive vaginal ring (CVR).
44 CVR_INS_ENRL_ASST_C_NAME VARCHAR No
How the patient enrolled in assistance, for contraceptive vaginal ring (CVR).
May contain organization-specific values: Yes
Category Entries:
Onsite
Referral
45 CVR_PREG_INT_SCR_C_NAME VARCHAR No
Whether the patient plans to have a pregnancy intention screening, for contraceptive vaginal ring (CVR).
May contain organization-specific values: Yes
Category Entries:
Yes, Near Future
No, Maybe Later
Unsure
Never
46 DME_LAST_CERT_DT DATETIME No
Last certification date for the durable medical equipment (DME).
47 HDH_EXAM_CODE_C_NAME VARCHAR No
The exam code for Health and Developmental History.
May contain organization-specific values: No
Category Entries:
Completed/Normal
ABN/Treated Abnormal by Screening Provider
ABN/Referred Abnormal
Not Required
Not Performed
48 OVRIDE_OHIP_MASTER_NUM VARCHAR No
The override master number for Ontario Health Insurance Plan (OHIP).
49 OVRIDE_DON_REC_OHIP_NUM VARCHAR No
The recipient's Ontario Health Insurance Plan (OHIP) number for donor claims.
50 WK_COMP_EMPR_CITY VARCHAR No
Employer city for an accident claim.
51 WK_COMP_STATE_C_NAME VARCHAR No
Employer state for an accident claim.
May contain organization-specific values: Yes
52 WK_COMP_EMPR_ZIP VARCHAR No
Employer zip for an accident claim.
53 WK_COMP_CNTRY_C_NAME VARCHAR No
Employer country for an accident claim.
The category values for this column were already listed for column: AMBL_PICK_CNTRY_C_NAME
54 WK_COMP_EMPR_PHONE VARCHAR No
Employer phone number for an accident claim.
55 PAT_ROLE_IN_ACCIDENT_C_NAME VARCHAR No
The patient's role for an automobile accident claim.
May contain organization-specific values: Yes
Category Entries:
Driver
Passenger
Pedestrian
Cyclist
Other
56 DRIVER_NAME VARCHAR No
Driver's name, for an auto accident.
57 DRIVER_CITY VARCHAR No
Driver's city, for an auto accident.
58 DRIVER_STATE_C_NAME VARCHAR No
Driver's state, for an auto accident.
The category values for this column were already listed for column: WK_COMP_STATE_C_NAME
59 DRIVER_ZIP VARCHAR No
Driver's ZIP code, for an auto accident.
60 DRIVER_COUNTRY_C_NAME VARCHAR No
Driver's country, for an auto accident.
The category values for this column were already listed for column: AMBL_PICK_CNTRY_C_NAME
61 DRIVER_PHONE VARCHAR No
Driver's phone number, for an auto accident.
62 VEHICLE_REG_NUM VARCHAR No
The vehicle registration number of the car involved in an auto accident.
63 PAY_TO_CODE_C_NAME VARCHAR No
Override for the Alberta Health Services (AHS) pay-to code.
May contain organization-specific values: Yes
Category Entries:
Business Arrangement
Contract Holder
Service Provider
Service Recipient
Other
64 PAY_TO_PHN NUMERIC No
The Alberta Health Services (AHS) pay-to patient health number.
65 OTHER_PAYEE_ACCT_ID NUMERIC No
This item stores the other payee guarantor account number for AHS.
66 AMBULANCE_PICK_CD_C_NAME VARCHAR No
Emergency Medical Services (EMS) code for the ambulance pick-up location, for Alberta Blue Cross.
May contain organization-specific values: Yes
No Entries Defined
67 AMBULANCE_DROP_CD_C_NAME VARCHAR No
Emergency Medical Services (EMS) code for the ambulance drop-off location, for Alberta Blue Cross.
May contain organization-specific values: Yes
No Entries Defined
68 PRIOR_INV_NUM VARCHAR No
The previous invoice number for Alberta Health Services (AHS) professional claims.
69 INJURY_REASON_C_NAME VARCHAR No
The cause of the injury.
May contain organization-specific values: Yes
No Entries Defined
70 INJURY_ACTIVITY_C_NAME VARCHAR No
The main activity of the injured person, or the type of situation the injured person was in, at the time of injury.
May contain organization-specific values: Yes
No Entries Defined
71 INJURY_MECHANISM_C_NAME VARCHAR No
The activity, contact, or influence that caused the injury to occur.
May contain organization-specific values: Yes
No Entries Defined
72 INJURY_SEVERITY_C_NAME VARCHAR No
How seriously the patient appears to be injured.
May contain organization-specific values: Yes
No Entries Defined
73 TXPORT_MEANS_C_NAME VARCHAR No
Indicates the type of transportation being used by the injured person at the time of the traffic accident.
May contain organization-specific values: Yes
No Entries Defined
74 INJURY_MUNICIP_C_NAME VARCHAR No
The municipality where the injury took place.
May contain organization-specific values: Yes
No Entries Defined
75 ACCIDENT_LONGITUDE VARCHAR No
The longitude of where the auto accident took place.
76 ACCIDENT_LATITUDE VARCHAR No
The latitude of where the auto accident took place.
77 CNTRPARTY_VEHICLE_C_NAME VARCHAR No
The type of vehicle which caused the auto accident.
May contain organization-specific values: Yes
No Entries Defined
78 TRAFFIC_SITUATION_C_NAME VARCHAR No
Indicates the accident-causing traffic situation.
May contain organization-specific values: Yes
No Entries Defined
79 USED_PROTECTION_C_NAME VARCHAR No
Indicates whether the injured person used protection, such as a helmet or seat belt, at the time of the injury.
May contain organization-specific values: No
Category Entries:
Yes
No
Unknown
80 PRODUCT_USED_C_NAME VARCHAR No
Indicates the machinery or equipment being used at the time of the work-related injury.
May contain organization-specific values: Yes
No Entries Defined
81 PLAYGROUND_TYPE_C_NAME VARCHAR No
Type of playground the accident occurred on.
May contain organization-specific values: Yes
No Entries Defined
82 INJURY_PRODUCT_TYPE_C_NAME VARCHAR No
Type of product involved in the injury.
May contain organization-specific values: Yes
No Entries Defined
83 PRODUCT_NAME VARCHAR No
Name of the product involved in the injury.
84 PRODUCT_DEFECTIVE_C_NAME VARCHAR No
Whether the product that led to injury was defective.
The category values for this column were already listed for column: USED_PROTECTION_C_NAME
85 PRODUCT_DESC VARCHAR No
A description of the product involved in the injury.
86 EMPR_IND_C_NAME VARCHAR No
Indicates the industry of the injured person’s employer.
May contain organization-specific values: Yes
No Entries Defined
87 ACCIDENT_COUNTRY_C_NAME VARCHAR No
Country where the accident occurred.
The category values for this column were already listed for column: AMBL_PICK_CNTRY_C_NAME
88 ACCIDENT_DISTRICT_C_NAME VARCHAR No
District where the accident occurred.
May contain organization-specific values: Yes
89 ACDNT_HOUSE_NUMBER VARCHAR No
House number where the accident occurred.
90 FIRST_DEPT_REFERRED_TO VARCHAR No
Referral 1: referred-to department name
91 SECOND_DEPT_REFERRED_TO VARCHAR No
Referral 2: referred-to department name
92 WK_COMP_EMPR_ID_CMT VARCHAR No
Enter the employer responsible for this workers' compensation claim.