CLM_VALUES_3
Description:
All values associated with a claim are stored in the Claim External Value record. The CLM_VALUES_3 table holds claim level values set by the system during claims processing or by user edits.

Primary Key
Column Name Ordinal Position
RECORD_ID 1

Column Information
Name Type Discontinued?
1 RECORD_ID NUMERIC No
The unique identifier for the claim values record.
2 ASST_SURG_NAM_SUF VARCHAR No
The suffix to the assistant dental surgeon's name.
3 ASST_SURG_NPI VARCHAR No
The assistant dental surgeon's National Provider Identifier (NPI).
4 ASST_SURG_TAXONOMY VARCHAR No
The assistant dental surgeon's taxonomy code.
5 SVC_FAC_NAM VARCHAR No
The name of the external location where the services were performed.
6 SVC_FAC_NPI VARCHAR No
The NPI of the external location where the services were performed.
7 SVC_FAC_CNCT_NAM VARCHAR No
The contact name for the external location.
8 SVC_FAC_CNCT_PH VARCHAR No
The contact phone number for the external location.
9 SVC_FAC_CNCT_EXT VARCHAR No
The contact phone extension for the external location.
10 SVC_FAC_ADDR_1 VARCHAR No
The first line of the external location street address.
11 SVC_FAC_ADDR_2 VARCHAR No
The second line of the external location street address.
12 SVC_FAC_CITY VARCHAR No
The external location's city.
13 SVC_FAC_STATE VARCHAR No
The external location's state.
14 SVC_FAC_ZIP VARCHAR No
The external location's ZIP code.
15 SVC_FAC_CNTRY VARCHAR No
The external location's country. It is only populated if the address is outside the United States.
16 SVC_FAC_CNTRY_SUB VARCHAR No
The external location's country subdivision (state, province, etc). It is only populated if the address is outside the United States.
17 PICK_UP_ADDR_1 VARCHAR No
The first line of the ambulance pick-up location street address.
18 PICK_UP_ADDR_2 VARCHAR No
The second line of the ambulance pick-up location street address.
19 PICK_UP_CITY VARCHAR No
The ambulance pick-up location's city.
20 PICK_UP_STATE VARCHAR No
The ambulance pick-up location's state.
21 PICK_UP_ZIP VARCHAR No
The ambulance pick-up location's ZIP code.
22 PICK_UP_CNTRY VARCHAR No
The ambulance pick-up location's country. It is only populated if the address is outside the United States.
23 PICK_UP_CNTRY_SUB VARCHAR No
The ambulance pick-up location's country subdivision (e.g., state, province). It is only populated if the address is outside the United States.
24 DROP_OFF_NAM VARCHAR No
The name of the ambulance drop-off location.
25 DROP_OFF_ADDR_1 VARCHAR No
The first line of the ambulance drop-off location street address.
26 DROP_OFF_ADDR_2 VARCHAR No
The second line of the ambulance drop-off location street address.
27 DROP_OFF_CITY VARCHAR No
The ambulance drop-off location's city.
28 DROP_OFF_STATE VARCHAR No
The ambulance drop-off location's state.
29 DROP_OFF_ZIP VARCHAR No
The ambulance drop-off location's ZIP code.
30 DROP_OFF_CNTRY VARCHAR No
The ambulance drop-off location's country. It is only populated if the address is outside the United States.
31 DROP_OFF_CNTRY_SUB VARCHAR No
The ambulance drop-off location's country subdivision (e.g., state, province). It is only populated if the address is outside the United States.
32 CREATE_DT DATETIME No
The date the claim was created. It is used for paper institutional claims.
33 CLM_CVG_AMT_PAID NUMERIC No
The amount already paid by the payer of the current coverage.
34 PAT_PROP_CAS_ID_TYP VARCHAR No
The qualifier for the Property and Casualty Patient ID used on American National Standards Institute (ANSI) version 5010 claims.
35 PAT_PROP_CAS_ID VARCHAR No
This column stores the patient identifier for property and casualty claims used on American National Standards Institute (ANSI) version 5010 claims.
36 ADMSN_QUAL VARCHAR No
The qualifier to identify when the admission hour is reported along with the admission date.
37 REMARK VARCHAR No
The claim remark printed on institutional claims as the billing note.
38 CLM_CVG_AMT_DUE NUMERIC No
The amount due by the payer of the current coverage.
39 CLM_CVG_COMPLMT_ID VARCHAR No
The complementary payer ID for the payer of the current coverage.
40 CLM_CVG_REL_INFO_DT DATETIME No
The date on which the insured authorized the release of information to the payer.
41 LOCAL_USE_CMS VARCHAR No
The value to print in Reserved for Local Use Box 10d on the paper 1500 version 08/05 Centers for Medicare and Medicaid Services (CMS) claim form. On the 1500 version 02/12 form, this field was removed and no longer used.
42 DISABILITY_QUAL VARCHAR No
The qualifier for the disability date and time.
43 DISABILITY_TM_QUAL VARCHAR No
The disability time format qualifier.
44 CAS_SRC_CEV_ID NUMERIC No
The source claim values record to which this reason code claim values record is attached.
45 CAS_LVL_C_NAME VARCHAR No
The indicator that the claim values record includes claim-level or line-level explanation of benefits data.
May contain organization-specific values: No
Category Entries:
Claim Level
Service Line Level
Reusable
46 CAS_CVG_LN_NUM INTEGER No
The coverage line number in the source claim values record for claim-level explanation of benefits.
47 CAS_SVC_LN_NUM INTEGER No
The service line number in the source claim values record.
48 NCPDP_RECORD_TYPE VARCHAR No
The National Council for Prescription Drug Programs (NCPDP) transaction type being submitted.
49 TXST_TRANSMISSION_ACTION VARCHAR No
The indicator that the file being loaded is a replacement file, update file, or delete file.
50 TXST_SUBMISSION_NUMBER VARCHAR No
The number of times data set has been re-sent.