|
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_CVG_ID |
NUMERIC |
No |
|
|
|
| The edited explanation of benefits coverage. |
|
|
| 4 |
EDIT_EOB_CLM_LN |
INTEGER |
No |
|
|
|
| The edited explanation of benefits line. |
|
|
| 5 |
EDIT_EOB_GRP_LN_C_NAME |
VARCHAR |
No |
|
|
|
| The edited explanation of benefits line group code. |
| May contain organization-specific values: Yes |
| Category Entries: |
| Patient Responsibility |
| Contractual Obligation |
| Payor Initiated |
| Correction and Reversal |
| Other Adjustment |
|
|
| 6 |
EDIT_EOB_RMT_CD_LN |
VARCHAR |
No |
|
|
|
| The edited explanation of benefits line remittance code. |
|
|
| 7 |
EDIT_EOB_AMT_LN |
NUMERIC |
No |
|
|
|
| The edited explanation of benefits line level service adjustment. |
|
|
| 8 |
EDIT_EOB_QTY_LN |
INTEGER |
No |
|
|
|
| The edited explanation of benefits line quantity. |
|
|