PR_EST_PX_BEN_ADDL_INFO
Description:
Contains additional benefit related information for each procedure in a price estimate.

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 ADDL_LINE_NUM INTEGER No
The line number of the additional information charge line group.
4 FILE_ORD_NUM INTEGER No
The coverage level associated with the corresponding coverage (I PES 168).
5 SERVICE_TYPE_ID VARCHAR No
The service type associated with the benefits on an estimate line.
6 SERVICE_TYPE_ID_SERVICE_TYPE_NAME VARCHAR No
The name of this benefit service type.
7 PAYER_BEN_CAT VARCHAR No
The benefit category identifier supplied by the payer. This is used instead of a service type in estimates adjudicated by the payer. It should only be set on an estimate reference benefits.
8 DEDUCTIBLE_AMT NUMERIC No
This is the deductible amount of an estimate line.
9 COPAY_AMT NUMERIC No
This is the copay amount of an estimate line.
10 COINS_AMT NUMERIC No
This is the coinsurance amount of an estimate line.
11 SELFPAY_EXCESS_AMT NUMERIC No
This is the additional self-pay amount as a result of insurance limits.
12 MOOP_AMT NUMERIC No
This is the maximum out-of-pocket amount for an estimate line.
13 ANNUAL_LIMIT NUMERIC No
This is the annual insurance limit amount of an estimate line.
14 LIFETIME_LIMIT NUMERIC No
This is the lifetime insurance limit amount of an estimate line.
15 ROLLOVER_AMT NUMERIC No
This is the rollover period amount of an estimate line.
16 NET_LEVEL_C_NAME VARCHAR No
This is the network level used to calculate benefits of an estimate line.
May contain organization-specific values: Yes
Category Entries:
In
Out
Out of Area
N/A
17 VISIT_MOOP_AMT NUMERIC No
This is the visit maximum out-of-pocket amount for an estimate line.
18 VISIT_LIMIT NUMERIC No
This is the amount of an estimate line applied to a visit insurance limit.
19 PROV_TOTAL NUMERIC No
The total the Provider is estimated pay for an estimate line.
20 NONCVRD_AMT NUMERIC No
Amount not covered by a member's benefits for an estimate line.
21 AMT_EXCEEDED NUMERIC No
The amount that exceeded the benefit amount from the estimate line.
22 BEN_BKT_ID NUMERIC No
The ID of the bucket that the estimate line contributes to.
23 BEN_BKT_ID_BUCKET_NAME VARCHAR No
The name of the bucket.
24 BEN_BKT_LIMIT NUMERIC No
The maximum amount the bucket can hold.
25 BEN_BKT_ADDL_AMT NUMERIC No
Additional amount added to the bucket from the estimate line.
26 BEN_BKT_REMAIN NUMERIC No
Amount left in the bucket after adding the additional amount from the estimate line.
27 LTC_MONTHLY_AMT NUMERIC No
This is the Monthly Patient Pay Amount of an estimate line