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Total Contractual Amount Discrepancy

CLM_TOT_CNTRCTL_AMT

AN AMOUNT IDENTIFYING THE PORTION OF A CHARGE THAT EXCEEDS THE MAXIMUM ALLOWABLE AMOUNT OR A CONTRACTED FEE ARRANGEMENT FOR A SERVICE.

Field Metadata

FHIR Resource
ExplanationOfBenefit
FHIRPath 
ExplanationOfBenefit.adjudication.where(
  category.coding.where(
    system = 'https://bluebutton.cms.gov/fhir/CodeSystem/Adjudication'
  ) and
    category.coding.where(code = 'CLM_TOT_CNTRCTL_AMT')
).amount.value
Coverage / Claim Type
  • Inpatient
  • Outpatient
  • SNF
Source View
V2_MDCR_CLM
Source Column
CLM_TOT_CNTRCTL_AMT
Sources
  • FISS
Profiles
  • CMS

Example 

10.08

bluebutton.cms.gov

official website of the U.S. Department of Health and Human Services and the Centers for Medicare & Medicaid Services.

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