CLP Claim Level Data

To supply information common to all services of a claim

Position: CLP-01 · Element: 1028 · Name: Claim Submitter's Identifier · Type: String (AN) · Requirement: Mandatory · Min: 1 · Max: 38 · Repeat: -

Identifier used to track a claim from creation by the health care provider through payment.

Position: CLP-02 · Element: 1029 · Name: Claim Status Code · Type: Identifier (ID) · Requirement: Mandatory · Min: 1 · Max: 2 · Repeat: -

Code identifying the status of an entire claim as assigned by the payor.

Position: CLP-03 · Element: 782 · Name: Monetary Amount · Type: Decimal number (R) · Requirement: Mandatory · Min: 1 · Max: 15 · Repeat: -

Monetary amount.

CLP03 is the amount paid this claim.

Position: CLP-04 · Element: 782 · Name: Monetary Amount · Type: Decimal number (R) · Requirement: Mandatory · Min: 1 · Max: 15 · Repeat: -

Monetary amount.

CLP04 is the amount of submitted charges this claim.

Position: CLP-05 · Element: 782 · Name: Monetary Amount · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 15 · Repeat: -

Monetary amount.

CLP05 is the patient responsibility amount.

Position: CLP-06 · Element: 1032 · Name: Claim Filing Indicator Code · Type: Identifier (ID) · Requirement: Optional · Min: 1 · Max: 2 · Repeat: -

Code identifying the type of health insurance or program.