CLP_EOB_PAID_CLM
Description:
This table holds the claim level secondary information for a non-primary claim. It contains the paid amount and other secondary amounts other than claim adjustments (CAS).

Primary Key
Column Name Ordinal Position
CLAIM_PRINT_ID 1
LINE 2

Column Information
Name Type Discontinued?
1 CLAIM_PRINT_ID NUMERIC No
The unique identifier for the claim print record.
2 LINE INTEGER No
The line number of one of the multiple values associated with a specific group of data within this record.
3 EOB_CLM_CVG_ID NUMERIC No
The claim-level explanation of benefits coverage ID. This only populates for secondary claims.
4 EOB_CLM_PAID NUMERIC No
This item holds the claim level paid amount.
5 EOB_CLM_CONTRACT NUMERIC No
The claim-level contract amount.
6 EOB_CLM_PAT_REMAIN NUMERIC No
This item holds the claim level remaining patient reliability amount.
7 EOB_CLM_NONCOVERED NUMERIC No
This item holds the claim level non-covered amount.
8 EOB_CLM_MIA_01 INTEGER No
This is the covered days count.
9 EOB_CLM_MIA_02 NUMERIC No
This is the other coverage monetary amount.
10 EOB_CLM_MIA_03 INTEGER No
This is the other coverage lifetime psychiatric days count.
11 EOB_CLM_MIA_04 NUMERIC No
This is the other coverage Diagnosis Related Group amount.
12 EOB_CLM_MIA_05 VARCHAR No
This is the other coverage remark code.
13 EOB_CLM_MIA_06 NUMERIC No
This is the other coverage disproportionate share amount.
14 EOB_CLM_MIA_07 NUMERIC No
This is the other coverage Medicare Secondary Payer pass-through amount.
15 EOB_CLM_MIA_08 NUMERIC No
This is the other coverage Prospective Payment System capital amount.
16 EOB_CLM_MIA_09 NUMERIC No
This is the other coverage Prospective Payment System capital federal specific Diagnosis Related Group amount.
17 EOB_CLM_MIA_10 NUMERIC No
This is the other coverage Prospective Payment System capital hospital specific Diagnosis Related Group amount.
18 EOB_CLM_MIA_11 NUMERIC No
This is the other coverage Prospective Payment System capital Disproportionate Share Hospital Diagnosis Related Group amount.
19 EOB_CLM_MIA_12 NUMERIC No
This is the other coverage old capital amount.
20 EOB_CLM_MIA_13 NUMERIC No
This is the other coverage Prospective Payment System capital Indirect Medical Education amount.
21 EOB_CLM_MIA_14 NUMERIC No
This is the other coverage Prospective Payment System operating hospital specific Diagnosis Related Group amount.
22 EOB_CLM_MIA_15 INTEGER No
This is the other coverage cost report day count.
23 EOB_CLM_MIA_16 NUMERIC No
This is the other coverage Prospective Payment System federal specific Diagnosis Related Group amount.
24 EOB_CLM_MIA_17 NUMERIC No
This is the other coverage Prospective Payment System capital outlier amount.
25 EOB_CLM_MIA_18 NUMERIC No
This is the other coverage claim indirect teaching amount.
26 EOB_CLM_MIA_19 NUMERIC No
This is the other coverage non-payable professional component billed amount.
27 EOB_CLM_MIA_20 VARCHAR No
This is the other coverage remark code.
28 EOB_CLM_MIA_21 VARCHAR No
This is the other coverage remark code.
29 EOB_CLM_MIA_22 VARCHAR No
This is the other coverage remark code.
30 EOB_CLM_MIA_23 VARCHAR No
This is the other coverage remark code.
31 EOB_CLM_MIA_24 NUMERIC No
This is the other coverage Prospective Payment System capital exception amount.
32 EOB_CLM_MOA_01 NUMERIC No
This is the other coverage Medicare Outpatient Adjudication reimbursement rate.
33 EOB_CLM_MOA_02 NUMERIC No
This is the other coverage Medicare Outpatient Adjudication Healthcare Common Procedure Coding System payable amount.
34 EOB_CLM_MOA_03 VARCHAR No
This is the other coverage Medicare Outpatient Adjudication remark code.
35 EOB_CLM_MOA_04 VARCHAR No
This is the other coverage Medicare Outpatient Adjudication remark code.
36 EOB_CLM_MOA_05 VARCHAR No
This is the other coverage Medicare Outpatient Adjudication remark code.
37 EOB_CLM_MOA_06 VARCHAR No
This is the other coverage Medicare Outpatient Adjudication remark code.
38 EOB_CLM_MOA_07 VARCHAR No
This is the other coverage Medicare Outpatient Adjudication remark code.
39 EOB_CLM_MOA_08 NUMERIC No
This is the other coverage Medicare Outpatient Adjudication End Stage Renal Disease payment amount.
40 EOB_CLM_MOA_09 NUMERIC No
This is the other coverage Medicare Outpatient Adjudication non-payable professional component billed amount.
41 EOB_CLM_DATE DATETIME No
The claim-level explanation of benefits adjudication date. This only populates for secondary claims.
42 EOB_CLM_AMT_D8 NUMERIC No
The Coordination of Benefits (COB) discount amount associated with the claim. This only populates for American National Standards Institute (ANSI) 4010 version electronic claims.
43 EOB_CLM_AMT_DY NUMERIC No
The Coordination of Benefits (COB) per day amount associated with the claim. This only populates for American National Standards Institute (ANSI) 4010 version electronic claims.
44 EOB_CLM_AMT_F5 NUMERIC No
The Coordination of Benefits (COB) patient paid amount associated with the claim. This only populates for American National Standards Institute (ANSI) 4010 version electronic claims.
45 EOB_CLM_AMT_T NUMERIC No
The Coordination of Benefits (COB) tax amount associated with the claim. This only populates for American National Standards Institute (ANSI) 4010 version electronic claims.
46 EOB_CLM_AMT_T2 NUMERIC No
The Coordination of Benefits (COB) total before taxes amount associated with the claim. This only populates for American National Standards Institute (ANSI) 4010 version electronic claims.
47 EOB_COINS_DAYS INTEGER No
This item holds the coinsurance days pulled forward from a valid payment.