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 type of claim

Code identifying the type of provider or claim

Code indicating a Yes or No condition or response

CLM06 is provider signature on file indicator. A "Y" value indicates the provider signature is on file; an "N" value indicates the provider signatue is not on file.

Code indicating whether the provider accepts assignment

Code indicating a Yes or No condition or response

CLM08 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

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

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

Code indicating a Yes or No condition or response

CLM13 is CHAMPUS nonavailability indicator. A "Y" value indicates a statement of non-availability is on file; an "N" value indicates statment of nonavailability is not on file or not necessary.

Code specifying the level of service rendered

Code indicating a Yes or No condition or response

CLM15 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, claim review organization or repricing organization

Code indicating a Yes or No condition or response

CLM18 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

Code indicating the reason why a request was delayed