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Paid to Beneficiary Amount

CLM_BENE_PD_AMT

AN AMOUNT PAID TO A BENEFICIARY FOR A SUBMITTED CLAIM.

Field Metadata

FHIR Resource
ExplanationOfBenefit
FHIRPath 
ExplanationOfBenefit.total.where(
  category.coding.where(
    system = 'https://bluebutton.cms.gov/fhir/CodeSystem/Adjudication'
  ).exists() and
    category.coding.where(code = 'CLM_BENE_PD_AMT').exists()
).amount.value
Coverage / Claim Type
  • Carrier
  • DME
Source View
V2_MDCR_CLM
Source Column
CLM_BENE_PD_AMT
Sources
  • MCS
  • NCH
  • VMS
Profiles
  • Regular
  • CMS

Example 

1.5

Notes

This refers to the processed field. This field may be populated for institutional processing claims, as it is the equivalent of CLM_MDCR_INSTNL_BENE_PD_AMT

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