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Professional Component Charge

CLM_INSTNL_PRFNL_AMT

FOR INPATIENT AND OUTPATIENT CLAIMS, THE AMOUNT OF PHYSICIAN AND OTHER PROFESSIONAL CHARGES COVERED UNDER MEDICARE PART B (E.G. IF COMPUTING INTERIM PAYMENT THESE CHARGES ARE DEDUCTED)

Field Metadata

FHIR Resource
ExplanationOfBenefit
FHIRPath 
ExplanationOfBenefit.adjudication.where(
  category.coding.where(
    system = 'https://bluebutton.cms.gov/fhir/CodeSystem/Adjudication' and
      code = 'CLM_INSTNL_PRFNL_AMT'
  ).exists()
).amount.value
Coverage / Claim Type
  • Inpatient
  • Outpatient
  • SNF
Source View
V2_MDCR_CLM_INSTNL
Source Column
CLM_INSTNL_PRFNL_AMT
Sources
  • NCH
Profiles
  • CMS

Example 

93.22

Mappings

CCLF
  • CCLFA.CLM_INSTNL_PRFNL_AMT
CCW
  • NCH_PROFNL_CMPNT_CHRG_AMT

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