|
Name |
Type |
Discontinued? |
|
| 1 |
INVOICE_ID |
NUMERIC |
No |
|
|
|
|
| 2 |
LINE |
INTEGER |
No |
|
|
|
| The line number for the information associated with this record. Multiple pieces of information can be associated with this record. |
|
|
| 3 |
EDIT_EOB_CLM_CVG_ID |
NUMERIC |
No |
|
|
|
| The edited explanation of benefits coverage at the claim level. |
|
|
| 4 |
EDIT_EOB_GRP_CLM_C_NAME |
VARCHAR |
No |
|
|
|
| The edited explanation of benefits group code at the claim level. |
| May contain organization-specific values: Yes |
| Category Entries: |
| Patient Responsibility |
| Contractual Obligation |
| Payor Initiated |
| Correction and Reversal |
| Other Adjustment |
|
|
| 5 |
EDIT_EOB_RMT_CD_CLM |
VARCHAR |
No |
|
|
|
| The edited explanation of benefits remit code at the claim level. |
|
|
| 6 |
EDIT_EOB_AMT_CLM |
NUMERIC |
No |
|
|
|
| The edited explanation of benefits amount at the claim level. |
|
|
| 7 |
EDIT_EOB_QTY_CLM |
INTEGER |
No |
|
|
|
| The edited explanation of benefits quantity at the claim level. |
|
|