PR_EST_AP_CLAIM_PROC
Description:
This table stores service line information for managed care estimates.

Primary Key
Column Name Ordinal Position
ESTIMATE_ID 1
LINE 2

Column Information
Name Type Discontinued?
1 ESTIMATE_ID NUMERIC No
The unique identifier for the patient estimate 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 CONTEXT_LINE INTEGER No
The LINE in the PR_EST_AP_CLAIM table that stores the claim information that this service line is associated with.
4 PROC_ID_PROC_NAME VARCHAR No
The name of each procedure.
5 PROC_MODS VARCHAR No
The modifiers associated with the service line.
6 PROC_QTY INTEGER No
The procedure quantity associated with the service line.
7 CHG_AMT NUMERIC No
The billed amount associated with the service line.
8 SYS_CHG_AMT NUMERIC No
The system-calculated billed amount associated with the service line detail.
9 ALLOW_AMT NUMERIC No
The allowed amount associated with the service line.
10 SYS_ALLOW_AMT NUMERIC No
The system-calculated allowed amount associated with the service line detail.
11 SELF_PAY_AMT NUMERIC No
The self-pay amount associated with the service line.
12 SYS_SELF_PAY_AMT NUMERIC No
The system-calculated self-pay amount associated with the service line detail.
13 MC_ADDL_LINE INTEGER No
The LINE in the PR_EST_ADDL_INFO table that stores additional information about the service line.
14 TX_ID NUMERIC No
The AP Claims transaction (ETR) ID associated with this estimate procedure line.
15 AUTH_REQUIRED_YN VARCHAR No
Identifies if an authorization is required for the procedure line to be covered.
May contain organization-specific values: No
Category Entries:
No
Yes
16 DRG_ID VARCHAR No
The Diagnosis Related Group (DRG) associated with the service line detail.
17 DRG_ID_DRG_NAME VARCHAR No
The name of the Diagnoses Related Group name.
18 MC_NETWORK_LEVELS_C_NAME VARCHAR No
Indicates if the service is priced to be In or Out of network.
May contain organization-specific values: Yes
Category Entries:
In
Out
Out of Area
N/A
19 MC_CLICKED_ON_YN VARCHAR No
Signals if the line was clicked on by the member
The category values for this column were already listed for column: AUTH_REQUIRED_YN
20 MC_IS_ANCHOR_YN VARCHAR No
This indicates whether the associated procedure is what the member searched for in Cost Calc (Aka. Anchor)
The category values for this column were already listed for column: AUTH_REQUIRED_YN
21 REV_CODE_ID NUMERIC No
The revenue code associated with the service line detail.
22 REV_CODE_ID_REVENUE_CODE_NAME VARCHAR No
The name of the revenue code.