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Claim Line Reported Gap Discount Amount

CLM_LINE_RPTD_GAP_DSCNT_AMT

The reported amount that the sponsor advanced at point-of-sale for the gap discount for applicable drugs.

Field Metadata

FHIR Resource
ExplanationOfBenefit
FHIRPath 
ExplanationOfBenefit.item.adjudication.where(
  category.coding.system = 'https://bluebutton.cms.gov/fhir/CodeSystem/Adjudication' and
    category.coding.code = 'CLM_LINE_RPTD_GAP_DSCNT_AMT'
).amount.value
Coverage / Claim Type
  • Pharmacy
Source View
V2_MDCR_CLM_LINE_RX
Source Column
CLM_LINE_RPTD_GAP_DSCNT_AMT
Sources
  • DDPS
Profiles
  • CMS

Example 

10

Mappings

CCW
  • RPTD_GAP_DSCNT_NUM

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