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Payment Code

CLM_PMT_80_100_CD

The code indicating that the amount shown in the payment field on the non-institutional line item represents either 80% or 100% of the allowed charges less any deductible, or 100% limitation of liability only.

Field Metadata

FHIR Resource
ExplanationOfBenefit
FHIRPath
ExplanationOfBenefit.item.extension.where(
  url = 'https://bluebutton.cms.gov/fhir/StructureDefinition/CLM-PMT-80-100-CD'
).value.code
Coverage / Claim Type
  • Carrier
  • DME
Source View
V2_MDCR_CLM_LINE_PRFNL
Source Column
CLM_PMT_80_100_CD
Reference Table
https://bluebutton.cms.gov/fhir/CodeSystem/CLM-PMT-80-100-CD
Sources
  • MCS
  • NCH
Profiles
  • CMS

Example

3

Mappings

CCW
  • LINE_PMT_80_100_CD

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