|
Name |
Type |
Discontinued? |
|
1 |
IMAGE_ID |
VARCHAR |
No |
|
|
|
This is the ID for the remittance image record with related remit claim references. |
|
|
2 |
PROV_IDENTIFIER |
VARCHAR |
No |
|
|
|
This is the provider number for the remittance record. |
|
|
3 |
FACILITY_TYPE |
VARCHAR |
No |
|
|
|
This is the code identifying the type of facility where services were provided for the claim reimbursed by the remittance record. |
|
|
4 |
FP_DATE |
DATETIME |
No |
|
|
|
This is the last day of the provider’s fiscal year. |
|
|
5 |
TOT_CLAIM_COUNT |
INTEGER |
No |
|
|
|
This is total number of claims. |
|
|
6 |
TOT_CLAIM_AMT |
NUMERIC |
No |
|
|
|
This is the total reported charges for all claims. |
|
|
7 |
TOT_COV_AMT |
NUMERIC |
No |
|
|
|
This is the monetary amount for the total covered charges. This is submitted charges less the non-covered charges. |
|
|
8 |
TOT_NONCOV_AMT |
NUMERIC |
No |
|
|
|
This is the amount for the total of non-covered charges. |
|
|
9 |
TOT_DEN_AMT |
NUMERIC |
No |
|
|
|
This is the monetary amount for the total of denied charges. |
|
|
10 |
TOT_PROV_AMT |
NUMERIC |
No |
|
|
|
This is the monetary amount for the total provider payment. The total provider payment amount includes the total of all interest paid. The amount can be less than zero. |
|
|
11 |
TOT_INT_AMT |
NUMERIC |
No |
|
|
|
This is the total amount of interest paid. |
|
|
12 |
TOT_CONT_AMT |
NUMERIC |
No |
|
|
|
This is the amount for the total contractual adjustment. |
|
|
13 |
TOT_GRAM_AMT |
NUMERIC |
No |
|
|
|
This is the amount for the total Gramm-Rudman adjustment. |
|
|
14 |
TOT_MSP_AMT |
NUMERIC |
No |
|
|
|
This is the total Medicare Secondary Payer (MSP) primary payor amount. |
|
|
15 |
TOT_BLOOD_AMT |
NUMERIC |
No |
|
|
|
This is the total blood deductible amount in dollars. |
|
|
16 |
TOT_NONLAB_AMT |
NUMERIC |
No |
|
|
|
This is the summary of non-lab charges. |
|
|
17 |
TOT_COINS_AMT |
NUMERIC |
No |
|
|
|
This is the total coinsurance amount. |
|
|
18 |
HCPCS_AMT |
NUMERIC |
No |
|
|
|
This is the Health Care Financing Administration Common Procedural Coding System (HCPCS) reported charges. |
|
|
19 |
HCPCS_PAYABLE |
NUMERIC |
No |
|
|
|
This is the total Health Care Financing Administration Common Procedural Coding System (HCPCS) payable amount. |
|
|
20 |
TOTAL_DEDUCT_AMT |
NUMERIC |
No |
|
|
|
This is the total deductible amount. |
|
|
21 |
TOT_PROF_AMT |
NUMERIC |
No |
|
|
|
This is the total professional component amount. |
|
|
22 |
PAT_MSP_LIABILITY |
NUMERIC |
No |
|
|
|
This is the total Medicare Secondary Payer (MSP) patient liability met. |
|
|
23 |
PAT_REIMB_AMT |
NUMERIC |
No |
|
|
|
This is the total patient reimbursement amount. |
|
|
24 |
PIP_CLAIM_CNT |
INTEGER |
No |
|
|
|
This is the total periodic interim payment (PIP) number of claims. |
|
|
25 |
PIP_ADJ_AMT |
NUMERIC |
No |
|
|
|
This is the total periodic interim payment (PIP) adjustment. |
|
|