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Updated:10/16/2008

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AMT
Service Supplemental Amount .
Pos: 110 Max: 12
Detail - Optional
Loop: 2110 Elements: 2
.

To indicate the total monetary amount

Element Summary:

                     
  _Ref_ Id _________Element Name__________ Req Type Min/Max    
  AMT01 522 Amount Qualifier Code M ID 1/3    
      Description: Code to qualify amount
        Code Name_______________________________
      T Tax
      B6 Allowed - Actual
          Description: Amount considered for payment under the provisions of the contract
      DY Per Day Limit
      KH Deduction Amount
      NE Net Billed
          Description: Amount billed, less allowable payments from other sources
      T2 Total Claim Before Taxes
          Description: The total monies requested for a single claim before any taxes were included
      ZK Federal Medicare or Medicaid Payment Mandate - Category 1
      ZL Federal Medicare or Medicaid Payment Mandate - Category 2
      ZM Federal Medicare or Medicaid Payment Mandate - Category 3
      ZN Federal Medicare or Medicaid Payment Mandate - Category 4
      ZO Federal Medicare or Medicaid Payment Mandate - Category 5
  AMT02 782 Monetary Amount M R 1/18    
      Description: Monetary amount


Transaction Set

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Copyright © 1996-2008  Management Systems Consulting, Inc.
Last modified: May 16, 2008