|
| The quantity qualifier code for the claim supplemental quantity information. This is a standard code that indicates what the quantity represents. |
| May contain organization-specific values: No |
| Category Entries: |
| Covered actual |
| Co-insured - Actual |
| Life-time reserve - Actual |
| Life-time reserve - Estimated |
| Number of non-covered days |
| Non-covered - Estimated |
| Not replaced blood units |
| Outlier days |
| Prescription |
| Visits |
| Federal medicare or medicaid payment mandate category 1 |
| Federal medicare or medicaid payment mandate category 2 |
| Federal medicare or medicaid payment mandate category 3 |
| Federal medicare or medicaid payment mandate category 4 |
| Federal medicare or medicaid payment mandate category 5 |