|
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_LN_CVG_ID |
NUMERIC |
No |
|
|
|
| The coverage record ID for the line-level explanation of benefits adjustment. |
|
|
| 4 |
EOB_CAS_CLM_LINE |
INTEGER |
No |
|
|
|
| The service line number for the line-level explanation of benefits adjustment. |
|
|
| 5 |
EOB_LN_CAS_GRP_C_NAME |
VARCHAR |
No |
|
|
|
| The line-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 |
|
|
| 6 |
EOB_LN_CAS_RMT_CODE |
VARCHAR |
No |
|
|
|
| The line-level explanation of benefits adjustment reason code. |
|
|
| 7 |
EOB_LN_CAS_AMT |
NUMERIC |
No |
|
|
|
| The line-level explanation of benefits adjustment amount. |
|
|
| 8 |
EOB_LN_CAS_QTY |
INTEGER |
No |
|
|
|
| The line-level explanation of benefits adjustment quantity. |
|
|