|
Name |
Type |
Discontinued? |
|
| 1 |
CLAIM_PRINT_ID |
NUMERIC |
No |
|
|
|
| The unique identifier for the claim record associated with a single hospital account or liability bucket. |
|
|
| 2 |
CONTACT_DATE_REAL |
FLOAT |
No |
|
|
|
| The contact date for the creation of the record in internal format. (There is only one contact date per claim print record.) |
|
|
| 3 |
LINE |
INTEGER |
No |
|
|
|
| The line number for the information associated with this record. Multiple pieces of information can be associated with this record. |
|
|
| 4 |
UB_MIN_SERVICE |
DATETIME |
No |
|
|
|
| The minimum service date for the claim print record. |
|
|
| 5 |
UB_MAX_SERVICE |
DATETIME |
No |
|
|
|
| The maximum service date for the claim print record. |
|
|
| 6 |
UB_CHARGES |
NUMERIC |
No |
|
|
|
| The uniform billing charges on the claim |
|
|
| 7 |
UB_MODIFIER |
VARCHAR |
No |
|
|
|
| The modifier for the claim print record. |
|
|
| 8 |
UB_CPT_CODE |
VARCHAR |
No |
|
|
|
| The uniform billing current procedural terminology code on the claim print record. |
|
|
| 9 |
HSP_ACCOUNT_ID |
NUMERIC |
No |
|
|
|
| The unique ID of the hospital account associated with this claim print record. |
|
|
| 10 |
CM_PHY_OWN_ID |
VARCHAR |
No |
|
|
|
| ID of the physical deployment owner for this record. Physical owners will be where the data is hosted, either on the cross-over server or the owner deployment. |
|
|
| 11 |
REV_CODE_EXT |
VARCHAR |
No |
|
|
|
| The external uniform billing revenue code. |
|
|
| 12 |
UB_REV_CD_DESC |
VARCHAR |
No |
|
|
|
| The description of the uniform billing line. |
|
|
| 13 |
UB_HIPPS_CD |
VARCHAR |
No |
|
|
|
| The uniform billing line health insurance prospective payment system code. |
|
|
| 14 |
UB_QTY |
VARCHAR |
No |
|
|
|
| The uniform billing line quality. |
|
|
| 15 |
UB_NON_CVD_AMT |
NUMERIC |
No |
|
|
|
| The non-covered amount for the uniform billing line. |
|
|
| 16 |
UB_LMRP_CD |
VARCHAR |
No |
|
|
|
| The uniform billing local coverage determination code. |
|
|
| 17 |
UB_HCPCS_RATE |
VARCHAR |
No |
|
|
|
| The uniform billing healthcare common procedure coding system code and modifier or rate. |
|
|
| 18 |
UB_CODE_TYPE_C_NAME |
VARCHAR |
No |
|
|
|
| The code type for the uniform billing claim line. If there is no code type this field will be blank. |
| May contain organization-specific values: Yes |
| Category Entries: |
| CPT(R) |
| HCPCS |
| ADA |
| ASA |
| SKS |
| THL |
| CBV |
| VT |
| ZA |
| CCSD |
|
|
| 19 |
UB_PRIOR_AUTH |
VARCHAR |
No |
|
|
|
| The prior authorization number for the uniform billing line. |
|
|
| 20 |
UB_RFL_NUM |
VARCHAR |
No |
|
|
|
| The uniform billing line referral number. |
|
|
| 21 |
UB_REND_PROV_ID_PROV_NAME |
VARCHAR |
No |
|
|
|
| The name of the service provider. This item may be hidden in a public view of the CLARITY_SER table. |
|
|
| 22 |
UB_LINE_SRC_C_NAME |
VARCHAR |
No |
|
|
|
| The category of the line source for the uniform billing line. |
| May contain organization-specific values: No |
| Category Entries: |
| Charge |
| Coding |
| Combined |
| SNF HIPPS |
| IRF HIPPS |
| Extension |
| Edited |
|
|
| 23 |
UB_REIMB_AMT |
NUMERIC |
No |
|
|
|
| The reimbursement amount for the uniform billing line. |
|
|
| 24 |
UB_REIMB_CNTRCT_AMT |
NUMERIC |
No |
|
|
|
| The reimbursement contract amount for the uniform billing line. |
|
|
| 25 |
UB_SVC_DATE |
DATETIME |
No |
|
|
|
| The service date of the uniform billing service line. |
|
|
| 26 |
UB_MOLDX_TEST_CODE |
VARCHAR |
No |
|
|
|
| The auxiliary procedure code for a uniform billing line. |
|
|
| 27 |
UB_AUXPX_CD_TYPE_C_NAME |
VARCHAR |
No |
|
|
|
| The type of auxiliary procedure code when one is applicable to a uniform billing line. |
| May contain organization-specific values: No |
| Category Entries: |
| Laboratory Test Code |
| Molecular Diagnostic Test Code |
|
|
| 28 |
UB_AUTH_ID |
NUMERIC |
No |
|
|
|
| Stores the hospital billing charge level linked authorization ID. |
|
|
| 29 |
UB_REF_PROV_ID_PROV_NAME |
VARCHAR |
No |
|
|
|
| The name of the service provider. This item may be hidden in a public view of the CLARITY_SER table. |
|
|