EOB to JSON Field Mapping
This table shows some values from the EOB and their corresponding JSON fields. It also explains how some of those fields are calculated.
| EOB Field | JSON Field | Notes |
|---|---|---|
| PT RESP | RemittanceAdvices[n].ClaimPayments[n].PatientResponsibility | Deductible + CoInsurance + CoPay(PR-49) |
| Billed Claim Totals | RemittanceAdvices[n].ClaimPayments[n].TotalClaimCharges | Sum of all Billed Line Items(Services) |
| Allowed Claim Totals | RemittanceAdvices[n].ClaimPayments[n].AllowedActualPayment | Sum of AllowedActualpayment Value of JSON Fields |
| PROV PD Claim Totals | RemittanceAdvices[n].PaymentDetails.TotalActualProviderPayment | Sum of TotalActualProviderPayment Value of JSON Fields |
| COINS Claim Totals | RemittanceAdvices[n].ClaimPayments[n].CoinsuredQuantityActual | Sum of CoinsuredQuantityActual Value of JSON Fields |
| GRP/RC-AMT Claim Totals | RemittanceAdvices[n].ClaimPayments[n].ServicePayments[n].Adjustments[n].Adjustments.Amount | Sum of all Adjustment Amounts in JSON Fields |
| Deductible Claim Totals | Field Deductible not available in JSON Output | Billed Total - Coins Total - Adjustments Total - Provider Paid Amount Total |