|
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. |
|
|