|
Name |
Type |
Discontinued? |
|
| 1 |
CLAIM_ID |
NUMERIC |
No |
|
|
|
| The unique identifier for the claim record. |
|
|
| 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 |
OTH_PAY_INFO_TY_C_NAME |
VARCHAR |
No |
|
|
|
| This is the type of information of other payors. |
| May contain organization-specific values: No |
| Category Entries: |
| Primary Payor Claim Check or Remittance Date |
|
|
| 4 |
OTH_PAY_INFO_VAL |
VARCHAR |
No |
|
|
|
| This is the value of the information of type mentioned in the corresponding line of Claim Information item 1120 (CLM 1120). |
|
|