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Part A/B Coinsurance Liability Amount

CLM_MDCR_COINSRNC_AMT

An amount identifying the portion applied toward the coinsurance a beneficiary is responsible for.

Field Metadata

FHIR Resource
ExplanationOfBenefit
FHIRPath
ExplanationOfBenefit.total.where(
  category.coding.where(
    system = 'http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication' and
      code = 'coinsurance'
  ).exists() and
    category.coding.where(
      system = 'https://bluebutton.cms.gov/fhir/CodeSystem/Adjudication' and
        code = 'CLM_MDCR_COINSRNC_AMT'
    ).exists()
).amount.value
Coverage / Claim Type
  • Inpatient
  • Outpatient
  • SNF
Source View
V2_MDCR_CLM
Source Column
CLM_MDCR_COINSRNC_AMT
Sources
  • FISS
  • NCH
  • VMS
Profiles
  • Regular
  • CMS

Example

9.82

Mappings

CCLF
  • CCLFA.CLM_MDCR_COINSRNC_AMT
CCW
  • NCH_BENE_PTA_COINSRNC_LBLTY_AM
  • NCH_BENE_PTB_COINSRNC_AMT

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