Official websites use .gov
A
.gov website belongs to an official government
organization in the United States.
Secure .gov websites use HTTPS
A
lock () or https:// means you've safely connected to
the .gov website. Share sensitive information only on official,
secure websites.
Data Element
CLT063
CLT.002.063
Definition | The total amount billed for this claim at the claim header level as submitted by the provider. For encounter records, when Type of Claim value is in [3, C, W], then value must equal amount the provider billed to the managed care plan. For sub-capitated encounters from a sub-capitated entity that is not a sub-capitated network provider, report the total amount that the provider billed the sub-capitated entity for the service. 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. |
---|---|
Size | S9(11)V99 |
FLF Start Position | 268 |
FLF Stop Position | 280 |
Segment Key Field Identifier | Not Applicable |
Coding Requirements | 1. Value must be between -99999999999.99 and 99999999999.99. 2. Value must be expressed as a number with 2-digit precision (e.g. 100.50 ). 3. Value must equal the sum of all Billed Amount instances for the associated claim. 4. Conditional 5. (individual line item payments) when populated and Payment Level Indicator (CLT.002.082) equals = '2' value must be greater than or equal to the sum of all claim line Revenue Charges (CLT.003.204). |
Valid Value Code Set | Valid Value Code | Valid Value Name | Valid Value Description | Effective Start Date | Effective End Date |
---|
DE Number | System DE Number | DE Name | File Segment Number | File Segment Name |
---|---|---|---|---|
CIP112 | CIP.002.112 | TOT-BILLED-AMT | CIP00002 | CLAIM-HEADER-RECORD-IP |
COT048 | COT.002.048 | TOT-BILLED-AMT | COT00002 | CLAIM-HEADER-RECORD-OT |
CRX039 | CRX.002.039 | TOT-BILLED-AMT | CRX00002 | CLAIM-HEADER-RECORD-RX |