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Purchase Price Amount

CLM_LINE_PRFNL_DME_PRICE_AMT

EFFECTIVE 5/92, THE AMOUNT REPRESENTING THE LOWER OF FEE SCHEDULE FOR PURCHASE OF NEW OR USED DME, OR ACTUAL CHARGE. IN CASE OF RENTAL DME, THIS AMOUNT REPRESENTS THE PURCHASE CAP; RENTAL PAYMENTS CAN ONLY BE MADE UNTIL THE CAP IS MET. THIS LINE ITEM FIELD IS APPLICABLE TO NON-INSTITUTIONAL CLAIMS INVOLVING DME, PROSTHETIC, ORTHOTIC AND SUPPLY ITEMS, IMMUNOSUPPRESSIVE DRUGS, PEN, ESRD AND OXYGEN ITEMS REFERRED TO AS DMEPOS. [NCH]

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_PRFNL_DME_PRICE_AMT'
    )
).amount.value
Coverage / Claim Type
  • Carrier
  • DME
Source View
V2_MDCR_CLM_LINE_PRFNL
Source Column
CLM_LINE_PRFNL_DME_PRICE_AMT
Sources
  • NCH
  • VMS

Example 

11.5

Mappings

CCW
  • LINE_DME_PRCHS_PRICE_AMT

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