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All Payer Claims: Data Element Comparison

Selected Items
Action Name Data Element ID Version State/Organization
Copay Amount PC040 2010-03-16 Maine
Copay Amount PC040 v1.2 Maine
Data Element: Copay Amount PC040 - 2010-03-16
(Maine)
Copay Amount PC040 - v1.2
(Maine)
[Shared]Data Element ID PC040 PC040
[Unshared]Definition The preset, fixed dollar amount for which the individual is This field contains the pre-set, fixed dollar amount payable by a member, often on a per visit/service basis. This is a money field containing dollars and cents with an implied decimal point. This field may contain a negative value.
[Shared] State / Source Maine
Maine
[Unshared]Data Type decimal NUMBER
[Shared]Length 10 10
[Shared]Field Name COPAY COPAY
[Unshared]DATE AVAIL '1/1/2003 Not Supplied
[Unshared]Date Required Not Supplied '2003-01-31
[Unshared]Warnings Not Supplied Not all payers can distinguish between the mutually exclusive fields of copay, coinsurance amount and deductible. To determine the total out of pocket/member responsibility for this service you must sum all three fields. (PC040, PC041, PC042) Payers must verify submissions with less than 25% of the records containing a member payment (coinsurance amount, deductible amount, copay).
Data Element: Copay Amount PC040 - 2010-03-16
(Maine)
Copay Amount PC040 - v1.2
(Maine)
There are no enumerated permissible values for these data elements.
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