REWARDS Extract Example

Business Subject Area

Table Name

Table Business Name

Table Description

Column Name

Column Business Name

Column Description

Data_object_id

Data_elem_id

Claims

CLM_LI_ORIGL_BILLD

Claim Line Original Billed

This table contains original information submitted for individual claim line items that have been updated during adjudication and pricing in the operational system.

ORIGL_SVC_PRCG_AMT

Line-Item Original Service Pricing Amount

The Service Pricing amount from the service amount column of the SEPC for this line item before format changes.

14188

27545

Claims

CLM_LI_ORIGL_BILLD

Claim Line Original Billed

This table contains original information submitted for individual claim line items that have been updated during adjudication and pricing in the operational system.

ORIGL_UNITS_CNT

Line-Item Original Number of Units

The number of units associated with this line before format changes.

14188

27546

Claims

CLM_LI_OTH_PAYR

Claim Line Other Payor

This table contains amounts paid by or amounts that are the responsibility of other payors for individual claim line items.

COB_SAVGS_AMT

COB/Medicare Savings Amount

The system generated calculation of the net savings for the secondary carrier based on the difference between what the primary carrier paid and the 'out-of-pocket' that was reimbursed between both carriers for the line-item.

14189

28889

Claims

CLM_LI_OTH_PAYR

Claim Line Other Payor

This table contains amounts paid by or amounts that are the responsibility of other payors for individual claim line items.

DBL_TRG_IND

??

Definition needed

14189

27960

Claims

CLM_LI_OTH_PAYR

Claim Line Other Payor

This table contains amounts paid by or amounts that are the responsibility of other payors for individual claim line items.

DW_CLM_KEY

DW Claim Key

A data warehouse assigned value to uniquely identify the claim.

14189

28746

Claims

CLM_LI_OTH_PAYR

Claim Line Other Payor

This table contains amounts paid by or amounts that are the responsibility of other payors for individual claim line items.

DW_CREAT_DT

Create Date

The date the row was created on the database.

14189

28766

Claims

CLM_LI_OTH_PAYR

Claim Line Other Payor

This table contains amounts paid by or amounts that are the responsibility of other payors for individual claim line items.

DW_REC_KEY

DW Record Key

A sequence number uniquely identify each row within a table. Maps 1 to 1 with a unique Key, including DW_open_dt

14189

16334

Claims

CLM_LI_OTH_PAYR

Claim Line Other Payor

This table contains amounts paid by or amounts that are the responsibility of other payors for individual claim line items.

DW_UPDT_DT

DW Update Date

Identifies the last date this record was updated in the data warehouse

14189

27059

Claims

CLM_LI_OTH_PAYR

Claim Line Other Payor

This table contains amounts paid by or amounts that are the responsibility of other payors for individual claim line items.

LI_NUM

Line Item Number

A sequential number assigned to each service line by the payer.

14189

28016

Claims

CLM_LI_OTH_PAYR

Claim Line Other Payor

This table contains amounts paid by or amounts that are the responsibility of other payors for individual claim line items.

OTH_PAYR_ALWD_AMT

Other Payer Allowed Amount

This column is only used when the COB calculation method is to the higher or lower of the two carriers allowable amounts. When utilized, this value is the primary carrier's allowable amount that will be used in the COB adjudication routine.

14189

27539