@vbasoftware/vbapi-vbasoftware-typescript-axios 1.20230208.2 → 1.20230225.1

This diff represents the content of publicly available package versions that have been released to one of the supported registries. The information contained in this diff is provided for informational purposes only and reflects changes between package versions as they appear in their respective public registries.
@@ -21,73 +21,73 @@
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  */
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  export interface ClaimDetail {
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  /**
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- *
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+ * References the Claim.Claim_Number value on the parent record. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
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  * @type {number}
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  * @memberof ClaimDetail
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  */
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  'claim_Number': number;
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  /**
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- *
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+ * In combination with Adjustment_Seq, creates a unique sequence for each service line on this claim.
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  * @type {string}
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  * @memberof ClaimDetail
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  */
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  'claim_Seq': string;
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  /**
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- *
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+ * In combination with Claim_Seq, creates a unique sequence for each service line on this claim. Used to note adjustments, cascading, etc. when utlized.
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  * @type {string}
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  * @memberof ClaimDetail
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  */
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  'adjustment_Seq': string;
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  /**
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- *
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+ * No longer in use.
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  * @type {string}
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  * @memberof ClaimDetail
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  */
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  'ansI_Code'?: string | null;
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  /**
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- *
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+ * The APC code applied to this service if identified for calculation during adjudication.
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  * @type {string}
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  * @memberof ClaimDetail
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  */
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  'apC_Code'?: string | null;
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  /**
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- *
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+ * For reference purposes, this hold the individual service line funding payor/account. If multiple payor/accounts are found on different service lines for the same claim, adjudication spits out an error.
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  * @type {number}
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  * @memberof ClaimDetail
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  */
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  'account_Key'?: number | null;
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  /**
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- *
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+ * Notes if this line was adjusted as part of an individual claim adjustment process. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
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  * @type {boolean}
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  * @memberof ClaimDetail
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  */
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  'adjusted_Line': boolean;
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  /**
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- *
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+ * No longer in use. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
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  * @type {number}
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  * @memberof ClaimDetail
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  */
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  'admin_Amt': number;
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  /**
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- *
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+ * The Auth Number for services that require authorization. References Auth.Auth_Number.
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  * @type {string}
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  * @memberof ClaimDetail
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  */
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  'auth_Number'?: string | null;
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  /**
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- *
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+ * If an Auth Penalty is applied during adjudication, that is housed here.
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  * @type {number}
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  * @memberof ClaimDetail
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  */
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  'auth_Penalty'?: number | null;
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  /**
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- *
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+ * Notes that this service lines required authorization.
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  * @type {string}
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  * @memberof ClaimDetail
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  */
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  'auth_Required'?: string | null;
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  /**
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- *
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+ * This is the benefit code assigned to this service line based on the Plan assigned on the Claim header. References BenefitCodes.Benefit_Code.
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  * @type {string}
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  * @memberof ClaimDetail
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  */
@@ -97,675 +97,681 @@ export interface ClaimDetail {
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  * @type {number}
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  * @memberof ClaimDetail
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  */
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+ 'benefit_Rate_Applied'?: number | null;
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+ /**
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+ * The billed charges assigned by the provider for this service. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
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+ * @type {number}
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+ * @memberof ClaimDetail
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+ */
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  'billed_Price': number;
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  /**
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- *
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+ * Pharmacy claim information submitted via file submission and used in reporting and interfaces.
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  * @type {string}
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  * @memberof ClaimDetail
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  */
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  'brand_Indicator'?: string | null;
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  /**
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- *
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+ * For dental claims, notes if this surface had services rendered. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
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  * @type {boolean}
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  * @memberof ClaimDetail
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  */
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  'buccal': boolean;
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  /**
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- *
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+ * No longer in use.
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  * @type {string}
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  * @memberof ClaimDetail
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  */
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  'cliA_Number'?: string | null;
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  /**
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- *
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+ * Holds the Other Insurance calculated amount that would affect the payable amount for this service (calculated from COB_Hold, COB_Mem_Resp, COB_Savings, and COB_Savings_Used). Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
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  * @type {number}
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  * @memberof ClaimDetail
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  */
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  'coB_Amt': number;
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  /**
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- *
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+ * Used in COB calculations (Dupe or Non-Dupe) to determine the COB_Amt to be applied.
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  * @type {number}
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  * @memberof ClaimDetail
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  */
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  'coB_Hold'?: number | null;
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  /**
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- *
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+ * Used in COB calculations (Dupe or Non-Dupe) to determine the COB_Amt to be applied.
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  * @type {number}
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  * @memberof ClaimDetail
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  */
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  'coB_Mem_Resp'?: number | null;
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  /**
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- *
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+ * Used in COB calculations (Dupe or Non-Dupe) to determine the COB_Amt to be applied.
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  * @type {number}
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  * @memberof ClaimDetail
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  */
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  'coB_Savings'?: number | null;
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  /**
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- *
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+ * Used in COB calculations (Dupe or Non-Dupe) to determine the COB_Amt to be applied.
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  * @type {number}
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  * @memberof ClaimDetail
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  */
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  'coB_Savings_Used'?: number | null;
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  /**
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- *
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+ * Used for Flex Claims to indicate the calendar year this claim applies.
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  * @type {string}
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  * @memberof ClaimDetail
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  */
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  'calendar_Year'?: string | null;
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  /**
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- *
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+ * Notes if this service line is captiated. If the Claim.Capitation_Claim value is flagged, it overrides this value and notes the entire claim and all service lines as capitated. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
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  * @type {boolean}
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  * @memberof ClaimDetail
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  */
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  'capitation_Claim': boolean;
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  /**
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- *
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+ * No longer in use.
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  * @type {number}
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  * @memberof ClaimDetail
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  */
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  'check_ID'?: number | null;
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  /**
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- *
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+ * The co-insurance amount applied by adjudication based on benefit definition. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
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  * @type {number}
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  * @memberof ClaimDetail
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  */
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  'co_Ins_Amt': number;
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  /**
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- *
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+ * The co-pay amount applied by adjudication based on benefit definition. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
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  * @type {number}
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  * @memberof ClaimDetail
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  */
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  'co_Pay_Amt': number;
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  /**
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- *
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+ * For currency calculations, this holds the destination currency.
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  * @type {string}
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  * @memberof ClaimDetail
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  */
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  'currency_ID'?: string | null;
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  /**
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- *
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+ * Pharmacy claim information submitted via file submission and used in reporting and interfaces.
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  * @type {number}
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  * @memberof ClaimDetail
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  */
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  'days_Supply'?: number | null;
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  /**
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- *
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+ * If the service is eligiblity for deductible credits, they would be stored here.
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  * @type {number}
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  * @memberof ClaimDetail
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  */
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  'ded_Credit_Amt'?: number | null;
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  /**
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- *
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+ * The deductible amount applied by adjudication based on benefit definition. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
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  * @type {number}
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  * @memberof ClaimDetail
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  */
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  'deductible_Amt': number;
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  /**
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- *
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+ * The diagnosis pointer for this service line indicating which Diagnostic Codes from the Claim are applicable to this service.
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  * @type {string}
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  * @memberof ClaimDetail
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  */
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  'diagnosis_Code'?: string | null;
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  /**
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- *
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+ * The difference between Billed and Allowed is stored as the Discount Amount. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
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  * @type {number}
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  * @memberof ClaimDetail
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  */
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  'discount_Amt': number;
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  /**
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- *
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+ * Pharmacy claim information submitted via file submission and used in reporting and interfaces.
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  * @type {number}
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  * @memberof ClaimDetail
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  */
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  'dispense_As_Written'?: number | null;
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  /**
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- *
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+ * For dental claims, notes if this surface had services rendered. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
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  * @type {boolean}
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  * @memberof ClaimDetail
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  */
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  'distal': boolean;
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  /**
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- *
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+ * For RX claims or medical claims that hold a drug code. References DrugCode.Drug_Code.
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  * @type {string}
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  * @memberof ClaimDetail
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  */
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  'drug_Code'?: string | null;
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  /**
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- *
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+ * Pharmacy claim information submitted via file submission and used in reporting and interfaces.
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  * @type {number}
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  * @memberof ClaimDetail
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  */
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  'drug_Quantity'?: number | null;
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  /**
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- *
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+ * Date when the record was first added to the system.
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  * @type {string}
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  * @memberof ClaimDetail
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  */
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  'entry_Date'?: string;
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  /**
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- *
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+ * User that first added the record to the system.
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  * @type {string}
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  * @memberof ClaimDetail
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  */
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  'entry_User'?: string | null;
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  /**
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- *
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+ * A place for both user assigned reason codes applicable to this claim or for adjudication to automatically assign ex code. References ExplanationCodes.Ex_Code.
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  * @type {string}
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  * @memberof ClaimDetail
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  */
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  'ex_Code'?: string | null;
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  /**
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- *
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+ * A place for both user assigned reason codes applicable to this claim or for adjudication to automatically assign ex code. References ExplanationCodes.Ex_Code.
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  * @type {string}
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  * @memberof ClaimDetail
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  */
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  'ex_Code2'?: string | null;
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  /**
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- *
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+ * A place for both user assigned reason codes applicable to this claim or for adjudication to automatically assign ex code. References ExplanationCodes.Ex_Code.
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  * @type {string}
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  * @memberof ClaimDetail
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  */
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  'ex_Code3'?: string | null;
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  /**
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- *
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+ * The FICA tax amount for disability claims. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
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  * @type {number}
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  * @memberof ClaimDetail
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  */
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  'fica': number;
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  /**
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- *
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+ * For dental claims, notes if this surface had services rendered. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
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  * @type {boolean}
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  * @memberof ClaimDetail
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  */
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  'facial': boolean;
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  /**
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- *
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+ * Based on taxable amount and various configurations, this holds the Federal \"To Tax\" amount for disability claim.
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  * @type {number}
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  * @memberof ClaimDetail
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  */
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  'federal_Amount_To_Tax'?: number | null;
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  /**
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- *
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+ * The calculated Federal tax amount based on the \"To Tax\" amount. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
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  * @type {number}
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  * @memberof ClaimDetail
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  */
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  'federal_Tax': number;
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  /**
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- *
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+ * A flat federal tax amount applied in addition to the calculated tax amount.
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  * @type {number}
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  * @memberof ClaimDetail
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  */
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  'federal_Tax_Flat'?: number | null;
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  /**
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- *
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+ * Pharmacy claim information submitted via file submission and used in reporting and interfaces.
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  * @type {string}
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  * @memberof ClaimDetail
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  */
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  'fill_Date'?: string | null;
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  /**
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- *
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+ * Manually entered description of this flex claim.
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  * @type {string}
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  * @memberof ClaimDetail
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  */
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  'flex_Description'?: string | null;
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  /**
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- *
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+ * Pharmacy claim information submitted via file submission and used in reporting and interfaces.
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  * @type {string}
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  * @memberof ClaimDetail
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  */
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  'formulary_Indicator'?: string | null;
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  /**
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- *
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+ * For dental claims, notes if this surface had services rendered. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
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  * @type {boolean}
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  * @memberof ClaimDetail
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  */
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  'incisal': boolean;
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  /**
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- *
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+ * If interest is calculated on a claim, it is stored here and applied to payable amount. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
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  * @type {number}
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  * @memberof ClaimDetail
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  */
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  'interest': number;
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  /**
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- *
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+ * For dental claims, notes if this surface had services rendered. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
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  * @type {boolean}
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  * @memberof ClaimDetail
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  */
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  'labial': boolean;
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  /**
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- *
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+ * The Life Benefit to be applied for Life claims processing.
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  * @type {string}
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  * @memberof ClaimDetail
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  */
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  'life_Benefit'?: string | null;
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  /**
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- *
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+ * The Life Benefit calculated volume based on benefit definition.
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  * @type {number}
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  * @memberof ClaimDetail
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  */
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  'life_Benefit_Volume'?: number | null;
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  /**
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- *
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+ * Number added manually to claims and from 837 files and sent outbound on 835 files.
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  * @type {string}
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  * @memberof ClaimDetail
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  */
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  'line_Control_Number'?: string | null;
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  /**
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- *
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+ * For dental claims, notes if this surface had services rendered. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
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  * @type {boolean}
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  * @memberof ClaimDetail
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  */
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  'lingual': boolean;
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  /**
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- *
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+ * If a locality tax is applicable it would be housed here.
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  * @type {number}
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  * @memberof ClaimDetail
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  */
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  'local_Tax'?: number | null;
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  /**
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- *
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+ * Pharmacy claim information submitted via file submission and used in reporting and interfaces.
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  * @type {string}
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  * @memberof ClaimDetail
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  */
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  'mail_Order_Indicator'?: string | null;
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  /**
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- *
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+ * Based on taxable amount and various configurations, this holds the Medicare \"To Tax\" amount for disability claim.
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  * @type {number}
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  * @memberof ClaimDetail
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  */
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  'medicare_Amount_To_Tax'?: number | null;
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  /**
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- *
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+ * The calculated Medicare tax amount based on the \"To Tax\" amount.
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  * @type {number}
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  * @memberof ClaimDetail
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  */
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  'medicare_Tax'?: number | null;
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  /**
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- *
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+ * For dental claims, notes if this surface had services rendered. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
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  * @type {boolean}
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  * @memberof ClaimDetail
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  */
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  'mesial': boolean;
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  /**
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- *
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+ * The modifier applied to this service.
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  * @type {string}
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  * @memberof ClaimDetail
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  */
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  'modifier'?: string | null;
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  /**
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- *
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+ * The modifier applied to this service.
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  * @type {string}
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  * @memberof ClaimDetail
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  */
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  'modifier_2'?: string | null;
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  /**
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- *
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+ * The modifier applied to this service.
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  * @type {string}
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  * @memberof ClaimDetail
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  */
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  'modifier_3'?: string | null;
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  /**
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- *
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+ * The modifier applied to this service.
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  * @type {string}
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  * @memberof ClaimDetail
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  */
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  'modifier_4'?: string | null;
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  /**
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- *
420
+ * For not covered services, or partially not covered services, this reflects that deduction. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
415
421
  * @type {number}
416
422
  * @memberof ClaimDetail
417
423
  */
418
424
  'not_Covered_Amt': number;
419
425
  /**
420
- *
426
+ * For dental claims, notes if this surface had services rendered. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
421
427
  * @type {boolean}
422
428
  * @memberof ClaimDetail
423
429
  */
424
430
  'occlusal': boolean;
425
431
  /**
426
- *
432
+ * For dental claims this holds the oral cavity designation sent on the 837D.
427
433
  * @type {string}
428
434
  * @memberof ClaimDetail
429
435
  */
430
436
  'oral_Cavity_Designation_Code_1'?: string | null;
431
437
  /**
432
- *
438
+ * For dental claims this holds the oral cavity designation sent on the 837D.
433
439
  * @type {string}
434
440
  * @memberof ClaimDetail
435
441
  */
436
442
  'oral_Cavity_Designation_Code_2'?: string | null;
437
443
  /**
438
- *
444
+ * For dental claims this holds the oral cavity designation sent on the 837D.
439
445
  * @type {string}
440
446
  * @memberof ClaimDetail
441
447
  */
442
448
  'oral_Cavity_Designation_Code_3'?: string | null;
443
449
  /**
444
- *
450
+ * For dental claims this holds the oral cavity designation sent on the 837D.
445
451
  * @type {string}
446
452
  * @memberof ClaimDetail
447
453
  */
448
454
  'oral_Cavity_Designation_Code_4'?: string | null;
449
455
  /**
450
- *
456
+ * For dental claims this holds the oral cavity designation sent on the 837D.
451
457
  * @type {string}
452
458
  * @memberof ClaimDetail
453
459
  */
454
460
  'oral_Cavity_Designation_Code_5'?: string | null;
455
461
  /**
456
- *
462
+ * Pharmacy claim information submitted via file submission and used in reporting and interfaces.
457
463
  * @type {number}
458
464
  * @memberof ClaimDetail
459
465
  */
460
466
  'other_Deduction_Amount'?: number | null;
461
467
  /**
462
- *
468
+ * Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
463
469
  * @type {boolean}
464
470
  * @memberof ClaimDetail
465
471
  */
466
472
  'override_COB_Amt': boolean;
467
473
  /**
468
- *
474
+ * Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
469
475
  * @type {boolean}
470
476
  * @memberof ClaimDetail
471
477
  */
472
478
  'override_Co_Ins_Amt': boolean;
473
479
  /**
474
- *
480
+ * Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
475
481
  * @type {boolean}
476
482
  * @memberof ClaimDetail
477
483
  */
478
484
  'override_Co_Pay_Amt': boolean;
479
485
  /**
480
- *
486
+ * Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
481
487
  * @type {boolean}
482
488
  * @memberof ClaimDetail
483
489
  */
484
490
  'override_Ded_Credit_Amt': boolean;
485
491
  /**
486
- *
492
+ * Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
487
493
  * @type {boolean}
488
494
  * @memberof ClaimDetail
489
495
  */
490
496
  'override_Deductible_Amt': boolean;
491
497
  /**
492
- *
498
+ * Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
493
499
  * @type {boolean}
494
500
  * @memberof ClaimDetail
495
501
  */
496
502
  'override_Federal_Tax': boolean;
497
503
  /**
498
- *
504
+ * Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
499
505
  * @type {boolean}
500
506
  * @memberof ClaimDetail
501
507
  */
502
508
  'override_Local_Tax': boolean;
503
509
  /**
504
- *
510
+ * Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
505
511
  * @type {boolean}
506
512
  * @memberof ClaimDetail
507
513
  */
508
514
  'override_Medicare_Tax': boolean;
509
515
  /**
510
- *
516
+ * Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
511
517
  * @type {boolean}
512
518
  * @memberof ClaimDetail
513
519
  */
514
520
  'override_Not_Covered_Amt': boolean;
515
521
  /**
516
- *
522
+ * Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
517
523
  * @type {boolean}
518
524
  * @memberof ClaimDetail
519
525
  */
520
526
  'override_Plan_Price': boolean;
521
527
  /**
522
- *
528
+ * Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
523
529
  * @type {boolean}
524
530
  * @memberof ClaimDetail
525
531
  */
526
532
  'override_Social_Security': boolean;
527
533
  /**
528
- *
534
+ * Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
529
535
  * @type {boolean}
530
536
  * @memberof ClaimDetail
531
537
  */
532
538
  'override_State_Tax': boolean;
533
539
  /**
534
- *
540
+ * Notes that the associated amount field was manually overrided by an application user or automated process that would skip adjudication calculations for this amount. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
535
541
  * @type {boolean}
536
542
  * @memberof ClaimDetail
537
543
  */
538
544
  'override_With_Hold_Amt': boolean;
539
545
  /**
540
- *
546
+ * Information field used in custom processing and reporting.
541
547
  * @type {number}
542
548
  * @memberof ClaimDetail
543
549
  */
544
550
  'ppO_Price_Plan_Price_Diff'?: number | null;
545
551
  /**
546
- *
552
+ * The final paid amount for this service line based on allowed amount (Plan_Price) minus all applicable deductions. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
547
553
  * @type {number}
548
554
  * @memberof ClaimDetail
549
555
  */
550
556
  'paid_Amt': number;
551
557
  /**
552
- *
558
+ * The partial loss amount for disability claims. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
553
559
  * @type {number}
554
560
  * @memberof ClaimDetail
555
561
  */
556
562
  'partial_Loss': number;
557
563
  /**
558
- *
564
+ * For reference purposes, this hold the individual service line funding payor/account. If multiple payor/accounts are found on different service lines for the same claim, adjudication spits out an error.
559
565
  * @type {string}
560
566
  * @memberof ClaimDetail
561
567
  */
562
568
  'payor_ID'?: string | null;
563
569
  /**
564
- *
570
+ * Pharmacy claim information submitted via file submission and used in reporting and interfaces.
565
571
  * @type {string}
566
572
  * @memberof ClaimDetail
567
573
  */
568
574
  'pharmacy_Name'?: string | null;
569
575
  /**
570
- *
576
+ * The place of service for the services being rendered on this service line.
571
577
  * @type {string}
572
578
  * @memberof ClaimDetail
573
579
  */
574
580
  'place_Of_Service'?: string | null;
575
581
  /**
576
- *
582
+ * The allowed amount for this service based on fee schedule, pricing, repricing, etc. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
577
583
  * @type {number}
578
584
  * @memberof ClaimDetail
579
585
  */
580
586
  'plan_Price': number;
581
587
  /**
582
- *
588
+ * The premium deduction amount for disability claims. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
583
589
  * @type {number}
584
590
  * @memberof ClaimDetail
585
591
  */
586
592
  'premium_Deduction': number;
587
593
  /**
588
- *
594
+ * Pharmacy claim information submitted via file submission and used in reporting and interfaces.
589
595
  * @type {string}
590
596
  * @memberof ClaimDetail
591
597
  */
592
598
  'prescriber_ID'?: string | null;
593
599
  /**
594
- *
600
+ * Pharmacy claim information submitted via file submission and used in reporting and interfaces.
595
601
  * @type {string}
596
602
  * @memberof ClaimDetail
597
603
  */
598
604
  'prescription_Date'?: string | null;
599
605
  /**
600
- *
606
+ * Pharmacy claim information submitted via file submission and used in reporting and interfaces.
601
607
  * @type {string}
602
608
  * @memberof ClaimDetail
603
609
  */
604
610
  'prescription_Number'?: string | null;
605
611
  /**
606
- *
612
+ * For reprice claims (typically submitted via 837), this notes the reprice method used to reprice this service line.
607
613
  * @type {string}
608
614
  * @memberof ClaimDetail
609
615
  */
610
616
  'pricing_Method'?: string | null;
611
617
  /**
612
- *
618
+ * The rate associated with the reprice method (Pricing_Method).
613
619
  * @type {number}
614
620
  * @memberof ClaimDetail
615
621
  */
616
622
  'pricing_Rate'?: number | null;
617
623
  /**
618
- *
624
+ * For life claims, this holds the principal amount for reporting. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
619
625
  * @type {number}
620
626
  * @memberof ClaimDetail
621
627
  */
622
628
  'principal': number;
623
629
  /**
624
- *
630
+ * The service being rendered on this claim.
625
631
  * @type {string}
626
632
  * @memberof ClaimDetail
627
633
  */
628
634
  'procedure_Code'?: string | null;
629
635
  /**
630
- *
636
+ * The secondary service being rendered on this claim.
631
637
  * @type {string}
632
638
  * @memberof ClaimDetail
633
639
  */
634
640
  'procedure_Code2'?: string | null;
635
641
  /**
636
- *
642
+ * QPA (Qualified Payment Amount) values received in upcoming EDI transactions for the NSA (No Surprise Act) mandate.
637
643
  * @type {number}
638
644
  * @memberof ClaimDetail
639
645
  */
640
646
  'qualifying_Payment_Amount'?: number | null;
641
647
  /**
642
- *
648
+ * No longer in use.
643
649
  * @type {number}
644
650
  * @memberof ClaimDetail
645
651
  */
646
652
  'reason_Code'?: number | null;
647
653
  /**
648
- *
654
+ * Pharmacy claim information submitted via file submission and used in reporting and interfaces.
649
655
  * @type {number}
650
656
  * @memberof ClaimDetail
651
657
  */
652
658
  'refill_Indicator'?: number | null;
653
659
  /**
654
- *
660
+ * Holds the submitted reprice savings amount for services that include this amount in the pricing calculation.
655
661
  * @type {number}
656
662
  * @memberof ClaimDetail
657
663
  */
658
664
  'repriced_Savings_Amount'?: number | null;
659
665
  /**
660
- *
666
+ * For dental claims, notes if this surface had services rendered. Note: The database will apply a default value of `False` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `False` to meet the API requirements and ensure that the functionality occurs as expected.
661
667
  * @type {boolean}
662
668
  * @memberof ClaimDetail
663
669
  */
664
670
  'root': boolean;
665
671
  /**
666
- *
672
+ * The start date of the services being rendered.
667
673
  * @type {string}
668
674
  * @memberof ClaimDetail
669
675
  */
670
676
  'service_Date'?: string | null;
671
677
  /**
672
- *
678
+ * The end date of the services being rendered.
673
679
  * @type {string}
674
680
  * @memberof ClaimDetail
675
681
  */
676
682
  'service_Thru'?: string | null;
677
683
  /**
678
- *
684
+ * Based on taxable amount and various configurations, this holds the Social Security \"To Tax\" amount for disability claim.
679
685
  * @type {number}
680
686
  * @memberof ClaimDetail
681
687
  */
682
688
  'socSec_Amount_To_Tax'?: number | null;
683
689
  /**
684
- *
690
+ * The calculated Social Security tax amount based on the \"To Tax\" amount. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
685
691
  * @type {number}
686
692
  * @memberof ClaimDetail
687
693
  */
688
694
  'social_Security': number;
689
695
  /**
690
- *
696
+ * Based on taxable amount and various configurations, this holds the State \"To Tax\" amount for disability claim.
691
697
  * @type {number}
692
698
  * @memberof ClaimDetail
693
699
  */
694
700
  'state_Amount_To_Tax'?: number | null;
695
701
  /**
696
- *
702
+ * The calculated State tax amount based on the \"To Tax\" amount. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
697
703
  * @type {number}
698
704
  * @memberof ClaimDetail
699
705
  */
700
706
  'state_Tax': number;
701
707
  /**
702
- *
708
+ * A flat state tax amount applied in addition to the calculated tax amount.
703
709
  * @type {number}
704
710
  * @memberof ClaimDetail
705
711
  */
706
712
  'state_Tax_Flat'?: number | null;
707
713
  /**
708
- *
714
+ * When state taxes are calculated, this indicates the state the tax amount was calculated against.
709
715
  * @type {string}
710
716
  * @memberof ClaimDetail
711
717
  */
712
718
  'state_Tax_State'?: string | null;
713
719
  /**
714
- *
720
+ * Holds the individaul status of this service line based on Ex Codes. A - Payable, D - Denied, E - Pended.
715
721
  * @type {string}
716
722
  * @memberof ClaimDetail
717
723
  */
718
724
  'status_Code'?: string | null;
719
725
  /**
720
- *
726
+ * The units applied to this service.
721
727
  * @type {number}
722
728
  * @memberof ClaimDetail
723
729
  */
724
730
  'svc_Count'?: number | null;
725
731
  /**
726
- *
732
+ * This holds the starting taxable amount based on pre-tax and pre-gross deductions applied to this service.
727
733
  * @type {number}
728
734
  * @memberof ClaimDetail
729
735
  */
730
736
  'taxable_Amount'?: number | null;
731
737
  /**
732
- *
738
+ * For dental claims, this identifies the tooth, quadrant or arch being worked for this service.
733
739
  * @type {number}
734
740
  * @memberof ClaimDetail
735
741
  */
736
742
  'tooth_Number'?: number | null;
737
743
  /**
738
- *
744
+ * No longer in use. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
739
745
  * @type {number}
740
746
  * @memberof ClaimDetail
741
747
  */
742
748
  'ucR_Price': number;
743
749
  /**
744
- *
750
+ * Pharmacy claim information submitted via file submission and used in reporting and interfaces.
745
751
  * @type {number}
746
752
  * @memberof ClaimDetail
747
753
  */
748
754
  'unit_Dose'?: number | null;
749
755
  /**
750
- *
756
+ * Pharmacy claim information submitted via file submission and used in reporting and interfaces.
751
757
  * @type {string}
752
758
  * @memberof ClaimDetail
753
759
  */
754
760
  'unit_Of_Measure'?: string | null;
755
761
  /**
756
- *
762
+ * Date when the record was last updated in the system.
757
763
  * @type {string}
758
764
  * @memberof ClaimDetail
759
765
  */
760
766
  'update_Date'?: string;
761
767
  /**
762
- *
768
+ * User that last updated the record in the system.
763
769
  * @type {string}
764
770
  * @memberof ClaimDetail
765
771
  */
766
772
  'update_User'?: string | null;
767
773
  /**
768
- *
774
+ * For plans that allow withhold, this amount is used to track that amount. Note: The database will apply a default value of `0` for this field if a value is not provided. This field is also marked as NOT NULL in the database and therefore required by the API. If you do not have a value for this field, supply the database default value of `0` to meet the API requirements and ensure that the functionality occurs as expected.
769
775
  * @type {number}
770
776
  * @memberof ClaimDetail
771
777
  */