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

Monetary amount.

CLM02 is the total amount of all submitted charges of service segments for this claim.

Code identifying the type of health insurance or program.

Code identifying the type of provider or claim

Code identifying the type of facility referenced

Code identifying the type of facility where services were performed; the first position of the uniform bill type or place of service from health care financing administration claim form or place of treatment from the dental claim form

Code specifying the frequency of the claim; this is the third position of the Uniform Billing Claim Form Bill Type

Code indicating a Yes or No condition or response.

CLM08 is provider signature on file indicator. A ``Y'' value indicates the provider signature is on file. A ``N'' value indicates the provider signature is not on file.

Code indicating whether the provider accepts assignment

Code indicating a Yes or No condition or response.

CLM10 is assignment of benefits indicator. A ``Y'' value indicates insured or authorized person authorizes benefits to be assigned to the provider. An ``N'' value indicates benefits have not been assigned to the provider.

Code indicating whether the provider has on file a signed statement by the patient authorizing the release of medical data to other organizations in order to adjudicate the claim

Code indicating how the patient or subscriber authorization signatures were obtained and how they are being retained by the provider

Code identifying an accompanying cause of an illness or an accident

Code identifying an accompanying cause of an illness or an accident

Code identifying an accompanying cause of an illness or an accident

Code (Standard State/Province) as defined by appropriate government agency.

CLM16 and CLM17 apply only to auto accidents when CLM13, CLM14, or CLM15 is equal to AA.

Code identifying the country.

Code indicating the Special Program under which the services rendered to the patient were performed

Code indicating a Yes or No condition or response.

CLM19 is CHAMPUS non-availability indicator. A ``Y'' value indicates a statement of non-availability is on file. An ``N'' value indicates statement of non-availability is not on file or not necessary.

Code specifying the level of service rendered

Code indicating a Yes or No condition or response.

CLM21 is charges itemized by service indicator. A ``Y'' value indicates charges are itemized by service. An ``N'' value indicates charges are summarized by service.

Code indicating the type of agreement under which the provider is submitting this claim

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

Code indicating a Yes or No condition or response.

CLM24 is explanation of benefit (EOB) indicator. A ``Y'' value indicates that a paper EOB is requested. An ``N'' value indicates that no paper EOB is requested.

Code identifying reason for claim submission