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
28	COINS_PERCENT	NUMERIC	No
	This is the coinsurance percentage for this procedure line.