|
Name |
Type |
Discontinued? |
|
1 |
CLAIM_PRINT_ID |
NUMERIC |
No |
|
|
|
The unique identifier for the claim print database 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 |
EOB_CAS_CLM_CVG_ID |
NUMERIC |
No |
|
|
|
The coverage record ID for the claim-level explanation of benefits adjustment. |
|
|
4 |
EOB_CLM_CAS_GRP_C_NAME |
VARCHAR |
No |
|
|
|
The claim-level explanation of benefits adjustment group code. |
May contain organization-specific values: Yes |
Category Entries: |
Patient Responsibility |
Contractual Obligation |
Payor Initiated |
Correction and Reversal |
Other Adjustment |
|
|
5 |
EOB_CLM_CAS_RMT_CD |
VARCHAR |
No |
|
|
|
The claim-level explanation of benefits adjustment reason code. |
|
|
6 |
EOB_CLM_CAS_AMT |
NUMERIC |
No |
|
|
|
The claim-level explanation of benefits adjustment amount. |
|
|
7 |
EOB_CLM_CAS_QTY |
INTEGER |
No |
|
|
|
The claim-level explanation of benefits adjustment quantity. |
|
|