To convey provider level adjustment information for debit or credit transactions such as, accelerated payments, cost report settlements for a fiscal year and timeliness report penalties unrelated to a specific claim or service
Reference number or identification number as defined for a particular Transaction Set, or as specified by the Reference Number Qualifier.
PLB01 is the provider number assigned by the payer.
Date (YYMMDD).
PLB02 is the last day of the providers fiscal year.
Reference number or identification number as defined for a particular Transaction Set, or as specified by the Reference Number Qualifier.
PLB03 is the adjustment information as defined by payer.
Monetary amount.
PLB04 is the adjustment amount.
Reference number or identification number as defined for a particular Transaction Set, or as specified by the Reference Number Qualifier.
PLB05 is the adjustment information as defined by payer.
Monetary amount.
PLB06 is the adjustment amount.
Reference number or identification number as defined for a particular Transaction Set, or as specified by the Reference Number Qualifier.
PLB07 is adjustment information as defined by payer.
Monetary amount.
PLB08 is the adjustment amount.
Reference number or identification number as defined for a particular Transaction Set, or as specified by the Reference Number Qualifier.
PLB09 is adjustment information as defined by payer.
Monetary amount.
PLB10 is the adjustment amount.
Reference number or identification number as defined for a particular Transaction Set, or as specified by the Reference Number Qualifier.
PLB11 is adjustment information as defined by payer.
Monetary amount.
PLB12 is the adjustment amount.
Reference number or identification number as defined for a particular Transaction Set, or as specified by the Reference Number Qualifier.
PLB13 is adjustment information as defined by payer.
Monetary amount.
PLB14 is the adjustment amount.
