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Provider Obligation To Accept as Full Amount

CLM_LINE_OTAF_AMT

AN AMOUNT IDENTIFYING A PROVIDER'S OBLIGATED TO ACCEPT IN FULL (OTAF) FROM MEDICARE AS PAYMENT. A BENEFICIARY CANNOT BE CHARGED FOR ANY AMOUNT EXCEEDING THE OTAF TOTAL.

Field Metadata

FHIR Resource
ExplanationOfBenefit
FHIRPath 
ExplanationOfBenefit.item.adjudication.where(
  category.coding.where(
    system = 'https://bluebutton.cms.gov/fhir/CodeSystem/Adjudication'
  ) and
    category.coding.where(code = 'CLM_LINE_OTAF_AMT')
).amount.value
Coverage / Claim Type
  • Carrier
  • DME
  • Outpatient
  • SNF
Source View
V2_MDCR_CLM_LINE
Source Column
CLM_LINE_OTAF_AMT
Sources
  • FISS
  • MCS
  • NCH
  • VMS
Profiles
  • CMS

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