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Provider Payment Amount

CLM_PRVDR_PMT_AMT

AN AMOUNT IDENTIFYING THE TOTAL PAYMENT MADE TO A PROVIDER/SUPPLIER FOR SERVICES RENDERED ON AN INDIVIDUAL CLAIM.

Field Metadata

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

Example 

11.11

Mappings

CCW
  • CLM_OP_PRVDR_PMT_AMT
  • NCH_CLM_PRVDR_PMT_AMT

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