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Data Element
CRX121
CRX.003.121
Definition | The amount billed at the claim detail level as submitted by the provider. For encounter records, Type of Claim = 3, C, or W, this field should be populated with the amount that the provider billed the managed care plan. For sub-capitated encounters from a sub-capitated entity that is not a sub-capitated network provider, report the amount that the provider billed the sub-capitated entity at the claim line detail level. Report a null value in this field if the provider is a sub-capitated network provider. For sub-capitated encounters from a sub-capitated network provider, if the sub-capitated network provider directly employs the provider that renders the service to the enrollee, report a null value in this field. |
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Size | S9(11)V99 |
FLF Start Position | 179 |
FLF Stop Position | 191 |
Segment Key Field Identifier | Not Applicable |
Coding Requirements | 1. Value must be between -99999999999.99 and 99999999999.99 |
Valid Value Code Set | Valid Value Code | Valid Value Name | Valid Value Description | Effective Start Date | Effective End Date |
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DE Number | System DE Number | DE Name | File Segment Number | File Segment Name |
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COT174 | COT.003.174 | BILLED-AMT | COT00003 | CLAIM-LINE-RECORD-OT |