EnrollEligCOB
Class BillingResponse

This class contains data sent by a Payer in response to a Billing Event detailing the components and reasons for any payments made or not made.

Attributes
«MO» MonetaryAmount accumulatedDeductibleAmount accumulatedDeductibleAmount

"Amount in dollars met by the patient/family in a deductible plan." - NCPDP Telecommunication (Field 512-FC, Data Dictionary 201104).

«MO» MonetaryAmount amountAppliedToDeductible amountAppliedToDeductible

"Amount to be collected from a patient that is included in Patient Pay Amount that is applied to a periodic deductible." - NCPDP Telecommunication (Field 517-FH, Data Dictionary 201104).

«MO» MonetaryAmount amountAttributableToSalesTax amountAttributableToSalesTax

"Amount to be collected from the patient that is included in Patient Pay Amount that is due to sales tax paid." - NCPDP Telecommunication (Field 523-FN, Data Dictionary 201104).

«MO» MonetaryAmount amountAttributedToBrandNonFormularySelection amountAttributedToBrandNonFormularySelection

"Amount to be collected from the patient that is included in Patient Pay Amount that is due to the patient’s selection of a Brand Non-Preferred Formulary product." - NCPDP Telecommunication (Field 136-UN, Data Dictionary 201104).

«MO» MonetaryAmount amountAttributedToBrandSelection amountAttributedToBrandSelection

"Amount to be collected from the patient that is included in Patient Pay Amount that is due to the patient’s selection of a Brand product." - NCPDP Telecommunication (Field 134-UK, Data Dictionary 201104).

«MO» MonetaryAmount amountAttributedToCoverageGap amountAttributedToCoverageGap

"Amount to be collected from the patient that is included in Patient Pay Amount that is due to the patient being in the coverage gap (for example Medicare Part D Coverage Gap (donut hole)). A coverage gap is defined as the period or amount during which the previous coverage ends and before an additional coverage begins." - NCPDP Telecommunication (Field 137-UP, Data Dictionary 201104).

«MO» MonetaryAmount amountAttributedToNonFormularySelection amountAttributedToNonFormularySelection

"Amount to be collected from the patient that is included in Patient Pay Amount that is due to the patient’s selection of a Non-Preferred Formulary product." - NCPDP Telecommunication (Field 135-UM, Data Dictionary 201104).

«MO» MonetaryAmount amountAttributedToProviderNetworkSelection amountAttributedToProviderNetworkSelection

"Amount to be collected from the patient that is included in Patient Pay Amount that is due to the patient’s provider network selection." - NCPDP Telecommunication (Field 133-UJ, Data Dictionary 201104).

«MO» MonetaryAmount amountExceedingBenefitMaximum amountExceedingBenefitMaximum

"Amount to be collected from the patient that is included in Patient Pay Amount that is due to the patient exceeding a periodic benefit maximum." - NCPDP Telecommunication (Field 520-FK, Data Dictionary 201104).

«MO» MonetaryAmount amountOfCoinsurance amountOfCoinsurance

"Amount to be collected from the patient that is included in Patient Pay Amount that is due to a per prescription coinsurance." - NCPDP Telecommunication (Field 572-4U, Data Dictionary 201104).

«MO» MonetaryAmount amountOfCopay amountOfCopay

"Amount to be collected from the patient that is included in Patient Pay Amount that is due to a per prescription copay." - NCPDP Telecommunication (Field 518-FI, Data Dictionary 201104).

«MO» MonetaryAmount amountOfProcessingFee amountOfProcessingFee

"Amount to be collected from the patient that is included in Patient Pay Amount that is due to the processing fee imposed by the processor." - NCPDP Telecommunication (Field 571-NZ, Data Dictionary 201104).

«CS» Code basisOfCalculationCoInsurance basisOfCalculationCoInsurance

"Code indicating how the Coinsurance reimbursement amount was calculated for Patient Pay Amount." - NCPDP Telecommunication (Field 573-4V, Data Dictionary 201104). Possible values include: Quantity Dispensed; Quantity Intended To Be Dispensed; Usual and Customary/Prorated; Waived Due To Partial Fill; Other.

«CS» Code basisOfCalculationCopay basisOfCalculationCopay

"Code indicating how the Copay reimbursement amount was calculated for Patient Pay Amount." - NCPDP Telecommunication (Field 347-HJ, Data Dictionary 201104). Possible values include: Quantity Dispensed; Quantity Intended To Be Dispensed; Usual and Customary/Prorated; Waived Due To Partial Fill; Other.

«CS» Code basisOfCalculationDispensingFee basisOfCalculationDispensingFee

"Code indicating how the reimbursement amount was calculated for Dispensing Fee Paid" - NCPDP Telecommunication (Field 346-HH, Data Dictionary 201104). Possible values include: Quantity Dispensed; Quantity Intended To Be Dispensed; Usual and Customary/Prorated; Waived Due To Partial Fill; Other.

«CS» Code basisOfCalculationFlatSalesTax basisOfCalculationFlatSalesTax

"Code indicating how the reimbursement amount was calculated for Flat Sales Tax Amount Paid" - NCPDP Telecommunication (Field 348-HK, Data Dictionary 201104). Possible values include: Quantity Dispensed; Quantity Intended To Be Dispensed.

«CS» Code basisOfCalculationPercentageSalesTax basisOfCalculationPercentageSalesTax

"Code indicating how the reimbursement amount was calculated for Percentage Sales Tax Amount Paid." - NCPDP Telecommunication (Field 349-HM, Data Dictionary 201104). Possible values include: Quantity Dispensed; Quantity Intended To Be Dispensed.

«CS» Code basisOfReimbursementDetermination basisOfReimbursementDetermination

"Code identifying how the reimbursement amount was calculated for "Ingredient Cost Paid." - NCPDP Telecommunication (Field 522-FM, Data Dictionary 201104). Possible values include: Default; AWP (Average Wholesale Price); Local Wholesaler; Direct; EAC (Estimated Acquisition Cost); Acquisition; MAC (Maximum Allowable Cost); Usual & Customary; 340B /Disproportionate Share Pricing/Public Health Service; ASP (Average Sales Price); AMP (Average Manufacturer Price); WAC (Wholesale Acquisition Cost); Special Patient Pricing; Other.

BenefitStage benefitStage benefitStage

Pointer to a record of the number and dollar amount of payments made in each Medicare Part D stage.

Integer benefitStageCount benefitStageCount

"Count of Benefit Stage Amount occurrences." - NCPDP Telecommunication (Field 392-MU, Data Dictionary 201104). Note that this property is marked as derived, since this number can be calculated from the number of Benefit Stage class instances.

«MO» MonetaryAmount dispensingFee dispensingFee

"Dispensing fee paid included in the Total Amount Paid" - NCPDP Telecommunication (Field 507-F7, Data Dictionary 201104).

«MO» MonetaryAmount dispensingFeeAmount dispensingFeeAmount

"Informational field used when Other Payer-Patient Responsibility Amount or Patient Pay Amount is used for reimbursement. Amount is equal to contracted or reimbursable dispensing fee for product being dispensed." - NCPDP Telecommunication (Field 149-U9, Data Dictionary 201104).

«MO» MonetaryAmount estimatedGenericSavings estimatedGenericSavings

"The amount, not included in the Total Amount Paid, that the patient would have saved if they had chosen the generic drug instead of the brand drug." - NCPDP Telecommunication (Field 577-G3, Data Dictionary 201104).

«MO» MonetaryAmount flatSalesTaxAmount flatSalesTaxAmount

"Flat sales tax paid which is included in the Total Amount Paid" - NCPDP Telecommunication (Field 558-AW, Data Dictionary 201104).

«MO» MonetaryAmount healthPlanFundedAssistanceAmount healthPlanFundedAssistanceAmount

"The amount from the health plan-funded assistance account for the patient that was applied to reduce Patient Pay Amount. This amount is used in Healthcare Reimbursement Account (HRA) benefits only. This field is always a negative amount or zero. The Health Plan-funded Assistance Amount is part of the patient pay amount calculation and is used to report back to the provider and patient the portion of Patient Pay Amount that was reduced due to this plan-funded assistance. NOTE: There is no credit card transaction involved in this type of Patient Spending Assistance, as in a Flexible Spending Account (FSA)." - NCPDP Telecommunication (Field 129-UD, Data Dictionary 201104).

«MO» MonetaryAmount incentiveAmount incentiveAmount

"Amount represents the contractually agreed upon incentive fee paid for specific services rendered. Amount is included in the Total Amount Paid." - NCPDP Telecommunication (Field 521-FL, Data Dictionary 201104).

«MO» MonetaryAmount ingredientCost ingredientCost

"Drug ingredient cost paid included in the Total Amount Paid." - NCPDP Telecommunication (Field 506-F6, Data Dictionary 201104).

«MO» MonetaryAmount ingredientCostAmount ingredientCostAmount

"Informational field used when Other Payer-Patient Responsibility Amount or Patient Pay Amount is used for reimbursement. Amount is equal to contracted or reimbursable amount for product being dispensed." - NCPDP Telecommunication (Field 148-U8, Data Dictionary 201104).

OtherAmount otherAmount otherAmount

Pointer to a set of additional costs associated with a dispensed prescription or service that were reimbursed. Examples of such costs include shipping, compound preparation, incentives, and taxes.

Integer otherAmountPaidCount otherAmountPaidCount

"Count of the other amount paid occurrences." - NCPDP Telecommunication (Field 563-J2, Data Dictionary 201104). Note that this property could potentially be calculated based on the number of instances of the Other Amount class.

«MO» MonetaryAmount otherPayerAmountRecognized otherPayerAmountRecognized

"Total amount recognized by the processor of any payment from another source." - NCPDP Telecommunication (Field 566-J5, Data Dictionary 201104).

«MO» MonetaryAmount patientPayAmount patientPayAmount

"Amount that is calculated by the processor and returned to the pharmacy as the TOTAL amount to be paid by the patient to the pharmacy; the patient’s total cost share, including copayments, amounts applied to deductible, over maximum amounts, penalties, etc." - NCPDP Telecommunication (Field 505-F5, Data Dictionary 201104).

«MO» MonetaryAmount patientSalesTaxAmount patientSalesTaxAmount

"Patient sales tax responsibility. This field is not a component of the Patient Pay Amount formula." - NCPDP Telecommunication (Field 575-EQ, Data Dictionary 201104).

«MO» MonetaryAmount percentageSalesTaxAmount percentageSalesTaxAmount

"Amount of percentage sales tax paid which is included in the Total Amount Paid" - NCPDP Telecommunication (Field 559-AX, Data Dictionary 201104).

«CS» Code percentageSalesTaxBasis percentageSalesTaxBasis

"Code indicating the percentage sales tax paid basis." - NCPDP Telecommunication (Field 561-AZ, Data Dictionary 201104). Possible values include: Ingredient Cost; Ingredient Cost plus Dispensing Fee; Not Specified.

«REAL» Decimal percentageSalesTaxRate percentageSalesTaxRate

"Percentage sales tax rate used to calculate Percentage Sales Tax Amount Paid" - NCPDP Telecommunication (Field 560-AY, Data Dictionary 201104).

«MO» MonetaryAmount planSalesTaxAmount planSalesTaxAmount

"Plan sales tax responsibility. This field is not a component of the Patient Pay Amount formula." - NCPDP Telecommunication (Field 574-2Y, Data Dictionary 201104).

«MO» MonetaryAmount professionalServiceFee professionalServiceFee

"Amount representing the contractually agreed upon fee for professional services rendered. This amount is included in the Total Amount Paid." - NCPDP Telecommunication (Field 562-J1, Data Dictionary 201104).

«MO» MonetaryAmount remainingBenefitAmount remainingBenefitAmount

"Amount remaining in a patient/family plan with a periodic maximum benefit." - NCPDP Telecommunication (Field 514-FE, Data Dictionary 201104).

«MO» MonetaryAmount remainingDeductibleAmount remainingDeductibleAmount

"Amount not met by the patient/family in the deductible plan." - NCPDP Telecommunication (Field 513-FD, Data Dictionary 201104).

«MO» MonetaryAmount spendingAccountAmountRemaining spendingAccountAmountRemaining

"The balance from the patient’s spending account after this transaction was applied." - NCPDP Telecommunication (Field 128-UC, Data Dictionary 201104).

«CS» Code taxExemptCategory taxExemptCategory

"Code indicating the payer and/or the patient is exempt from taxes." - NCPDP Telecommunication (Field 557-AV, Data Dictionary 201104). Possible values include: Payer/Plan is Tax Exempt; Patient is Tax Exempt; Payer/Plan and Patient are Tax Exempt.


Properties:

Alias
Classifier Behavior
Is Abstractfalse
Is Activefalse
Is Leaffalse
Keywords
NameBillingResponse
Name Expression
NamespaceEnrollEligCOB
Owned Template Signature
OwnerEnrollEligCOB
Owning Template Parameter
PackageEnrollEligCOB
Qualified NameFHIM::EnrollEligCOB::BillingResponse
Representation
Stereotype
Template Parameter
VisibilityPublic

Attribute Details

 accumulatedDeductibleAmount
Public «MO» MonetaryAmount accumulatedDeductibleAmount

"Amount in dollars met by the patient/family in a deductible plan." - NCPDP Telecommunication (Field 512-FC, Data Dictionary 201104).

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NameaccumulatedDeductibleAmount
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::accumulatedDeductibleAmount
Stereotype
Template Parameter
Type«MO» MonetaryAmount
Upper1
Upper Value(1)
VisibilityPublic


 amountAppliedToDeductible
Public «MO» MonetaryAmount amountAppliedToDeductible

"Amount to be collected from a patient that is included in Patient Pay Amount that is applied to a periodic deductible." - NCPDP Telecommunication (Field 517-FH, Data Dictionary 201104).

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NameamountAppliedToDeductible
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::amountAppliedToDeductible
Stereotype
Template Parameter
Type«MO» MonetaryAmount
Upper1
Upper Value(1)
VisibilityPublic


 amountAttributableToSalesTax
Public «MO» MonetaryAmount amountAttributableToSalesTax

"Amount to be collected from the patient that is included in Patient Pay Amount that is due to sales tax paid." - NCPDP Telecommunication (Field 523-FN, Data Dictionary 201104).

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NameamountAttributableToSalesTax
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::amountAttributableToSalesTax
Stereotype
Template Parameter
Type«MO» MonetaryAmount
Upper1
Upper Value(1)
VisibilityPublic


 amountAttributedToBrandNonFormularySelection
Public «MO» MonetaryAmount amountAttributedToBrandNonFormularySelection

"Amount to be collected from the patient that is included in Patient Pay Amount that is due to the patient’s selection of a Brand Non-Preferred Formulary product." - NCPDP Telecommunication (Field 136-UN, Data Dictionary 201104).

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NameamountAttributedToBrandNonFormularySelection
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::amountAttributedToBrandNonFormularySelection
Stereotype
Template Parameter
Type«MO» MonetaryAmount
Upper1
Upper Value(1)
VisibilityPublic


 amountAttributedToBrandSelection
Public «MO» MonetaryAmount amountAttributedToBrandSelection

"Amount to be collected from the patient that is included in Patient Pay Amount that is due to the patient’s selection of a Brand product." - NCPDP Telecommunication (Field 134-UK, Data Dictionary 201104).

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NameamountAttributedToBrandSelection
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::amountAttributedToBrandSelection
Stereotype
Template Parameter
Type«MO» MonetaryAmount
Upper1
Upper Value(1)
VisibilityPublic


 amountAttributedToCoverageGap
Public «MO» MonetaryAmount amountAttributedToCoverageGap

"Amount to be collected from the patient that is included in Patient Pay Amount that is due to the patient being in the coverage gap (for example Medicare Part D Coverage Gap (donut hole)). A coverage gap is defined as the period or amount during which the previous coverage ends and before an additional coverage begins." - NCPDP Telecommunication (Field 137-UP, Data Dictionary 201104).

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NameamountAttributedToCoverageGap
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::amountAttributedToCoverageGap
Stereotype
Template Parameter
Type«MO» MonetaryAmount
Upper1
Upper Value(1)
VisibilityPublic


 amountAttributedToNonFormularySelection
Public «MO» MonetaryAmount amountAttributedToNonFormularySelection

"Amount to be collected from the patient that is included in Patient Pay Amount that is due to the patient’s selection of a Non-Preferred Formulary product." - NCPDP Telecommunication (Field 135-UM, Data Dictionary 201104).

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NameamountAttributedToNonFormularySelection
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::amountAttributedToNonFormularySelection
Stereotype
Template Parameter
Type«MO» MonetaryAmount
Upper1
Upper Value(1)
VisibilityPublic


 amountAttributedToProviderNetworkSelection
Public «MO» MonetaryAmount amountAttributedToProviderNetworkSelection

"Amount to be collected from the patient that is included in Patient Pay Amount that is due to the patient’s provider network selection." - NCPDP Telecommunication (Field 133-UJ, Data Dictionary 201104).

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NameamountAttributedToProviderNetworkSelection
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::amountAttributedToProviderNetworkSelection
Stereotype
Template Parameter
Type«MO» MonetaryAmount
Upper1
Upper Value(1)
VisibilityPublic


 amountExceedingBenefitMaximum
Public «MO» MonetaryAmount amountExceedingBenefitMaximum

"Amount to be collected from the patient that is included in Patient Pay Amount that is due to the patient exceeding a periodic benefit maximum." - NCPDP Telecommunication (Field 520-FK, Data Dictionary 201104).

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NameamountExceedingBenefitMaximum
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::amountExceedingBenefitMaximum
Stereotype
Template Parameter
Type«MO» MonetaryAmount
Upper1
Upper Value(1)
VisibilityPublic


 amountOfCoinsurance
Public «MO» MonetaryAmount amountOfCoinsurance

"Amount to be collected from the patient that is included in Patient Pay Amount that is due to a per prescription coinsurance." - NCPDP Telecommunication (Field 572-4U, Data Dictionary 201104).

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NameamountOfCoinsurance
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::amountOfCoinsurance
Stereotype
Template Parameter
Type«MO» MonetaryAmount
Upper1
Upper Value(1)
VisibilityPublic


 amountOfCopay
Public «MO» MonetaryAmount amountOfCopay

"Amount to be collected from the patient that is included in Patient Pay Amount that is due to a per prescription copay." - NCPDP Telecommunication (Field 518-FI, Data Dictionary 201104).

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NameamountOfCopay
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::amountOfCopay
Stereotype
Template Parameter
Type«MO» MonetaryAmount
Upper1
Upper Value(1)
VisibilityPublic


 amountOfProcessingFee
Public «MO» MonetaryAmount amountOfProcessingFee

"Amount to be collected from the patient that is included in Patient Pay Amount that is due to the processing fee imposed by the processor." - NCPDP Telecommunication (Field 571-NZ, Data Dictionary 201104).

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NameamountOfProcessingFee
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::amountOfProcessingFee
Stereotype
Template Parameter
Type«MO» MonetaryAmount
Upper1
Upper Value(1)
VisibilityPublic


 basisOfCalculationCoInsurance
Public «CS» Code basisOfCalculationCoInsurance

"Code indicating how the Coinsurance reimbursement amount was calculated for Patient Pay Amount." - NCPDP Telecommunication (Field 573-4V, Data Dictionary 201104). Possible values include: Quantity Dispensed; Quantity Intended To Be Dispensed; Usual and Customary/Prorated; Waived Due To Partial Fill; Other.

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NamebasisOfCalculationCoInsurance
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::basisOfCalculationCoInsurance
Stereotype
Template Parameter
Type«CS» Code
Upper1
Upper Value(1)
VisibilityPublic


 basisOfCalculationCopay
Public «CS» Code basisOfCalculationCopay

"Code indicating how the Copay reimbursement amount was calculated for Patient Pay Amount." - NCPDP Telecommunication (Field 347-HJ, Data Dictionary 201104). Possible values include: Quantity Dispensed; Quantity Intended To Be Dispensed; Usual and Customary/Prorated; Waived Due To Partial Fill; Other.

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NamebasisOfCalculationCopay
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::basisOfCalculationCopay
Stereotype
Template Parameter
Type«CS» Code
Upper1
Upper Value(1)
VisibilityPublic


 basisOfCalculationDispensingFee
Public «CS» Code basisOfCalculationDispensingFee

"Code indicating how the reimbursement amount was calculated for Dispensing Fee Paid" - NCPDP Telecommunication (Field 346-HH, Data Dictionary 201104). Possible values include: Quantity Dispensed; Quantity Intended To Be Dispensed; Usual and Customary/Prorated; Waived Due To Partial Fill; Other.

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NamebasisOfCalculationDispensingFee
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::basisOfCalculationDispensingFee
Stereotype
Template Parameter
Type«CS» Code
Upper1
Upper Value(1)
VisibilityPublic


 basisOfCalculationFlatSalesTax
Public «CS» Code basisOfCalculationFlatSalesTax

"Code indicating how the reimbursement amount was calculated for Flat Sales Tax Amount Paid" - NCPDP Telecommunication (Field 348-HK, Data Dictionary 201104). Possible values include: Quantity Dispensed; Quantity Intended To Be Dispensed.

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NamebasisOfCalculationFlatSalesTax
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::basisOfCalculationFlatSalesTax
Stereotype
Template Parameter
Type«CS» Code
Upper1
Upper Value(1)
VisibilityPublic


 basisOfCalculationPercentageSalesTax
Public «CS» Code basisOfCalculationPercentageSalesTax

"Code indicating how the reimbursement amount was calculated for Percentage Sales Tax Amount Paid." - NCPDP Telecommunication (Field 349-HM, Data Dictionary 201104). Possible values include: Quantity Dispensed; Quantity Intended To Be Dispensed.

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NamebasisOfCalculationPercentageSalesTax
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::basisOfCalculationPercentageSalesTax
Stereotype
Template Parameter
Type«CS» Code
Upper1
Upper Value(1)
VisibilityPublic


 basisOfReimbursementDetermination
Public «CS» Code basisOfReimbursementDetermination

"Code identifying how the reimbursement amount was calculated for "Ingredient Cost Paid." - NCPDP Telecommunication (Field 522-FM, Data Dictionary 201104). Possible values include: Default; AWP (Average Wholesale Price); Local Wholesaler; Direct; EAC (Estimated Acquisition Cost); Acquisition; MAC (Maximum Allowable Cost); Usual & Customary; 340B /Disproportionate Share Pricing/Public Health Service; ASP (Average Sales Price); AMP (Average Manufacturer Price); WAC (Wholesale Acquisition Cost); Special Patient Pricing; Other.

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NamebasisOfReimbursementDetermination
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::basisOfReimbursementDetermination
Stereotype
Template Parameter
Type«CS» Code
Upper1
Upper Value(1)
VisibilityPublic


 benefitStage
Public BenefitStage benefitStage

Pointer to a record of the number and dollar amount of payments made in each Medicare Part D stage.

Constraints:
Properties:

AggregationNone
Alias
AssociationbillingResponse_benefitStage
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity*
NamebenefitStage
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::benefitStage
Stereotype
Template Parameter
TypeBenefitStage
Upper*
Upper Value(*)
VisibilityPublic


 benefitStageCount
Public Integer benefitStageCount

"Count of Benefit Stage Amount occurrences." - NCPDP Telecommunication (Field 392-MU, Data Dictionary 201104). Note that this property is marked as derived, since this number can be calculated from the number of Benefit Stage class instances.

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedtrue
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower1
Lower Value(1)
Multiplicity1
NamebenefitStageCount
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::benefitStageCount
Stereotype
Template Parameter
TypeInteger
Upper1
Upper Value(1)
VisibilityPublic


 dispensingFee
Public «MO» MonetaryAmount dispensingFee

"Dispensing fee paid included in the Total Amount Paid" - NCPDP Telecommunication (Field 507-F7, Data Dictionary 201104).

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NamedispensingFee
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::dispensingFee
Stereotype
Template Parameter
Type«MO» MonetaryAmount
Upper1
Upper Value(1)
VisibilityPublic


 dispensingFeeAmount
Public «MO» MonetaryAmount dispensingFeeAmount

"Informational field used when Other Payer-Patient Responsibility Amount or Patient Pay Amount is used for reimbursement. Amount is equal to contracted or reimbursable dispensing fee for product being dispensed." - NCPDP Telecommunication (Field 149-U9, Data Dictionary 201104).

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NamedispensingFeeAmount
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::dispensingFeeAmount
Stereotype
Template Parameter
Type«MO» MonetaryAmount
Upper1
Upper Value(1)
VisibilityPublic


 estimatedGenericSavings
Public «MO» MonetaryAmount estimatedGenericSavings

"The amount, not included in the Total Amount Paid, that the patient would have saved if they had chosen the generic drug instead of the brand drug." - NCPDP Telecommunication (Field 577-G3, Data Dictionary 201104).

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NameestimatedGenericSavings
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::estimatedGenericSavings
Stereotype
Template Parameter
Type«MO» MonetaryAmount
Upper1
Upper Value(1)
VisibilityPublic


 flatSalesTaxAmount
Public «MO» MonetaryAmount flatSalesTaxAmount

"Flat sales tax paid which is included in the Total Amount Paid" - NCPDP Telecommunication (Field 558-AW, Data Dictionary 201104).

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NameflatSalesTaxAmount
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::flatSalesTaxAmount
Stereotype
Template Parameter
Type«MO» MonetaryAmount
Upper1
Upper Value(1)
VisibilityPublic


 healthPlanFundedAssistanceAmount
Public «MO» MonetaryAmount healthPlanFundedAssistanceAmount

"The amount from the health plan-funded assistance account for the patient that was applied to reduce Patient Pay Amount. This amount is used in Healthcare Reimbursement Account (HRA) benefits only. This field is always a negative amount or zero. The Health Plan-funded Assistance Amount is part of the patient pay amount calculation and is used to report back to the provider and patient the portion of Patient Pay Amount that was reduced due to this plan-funded assistance. NOTE: There is no credit card transaction involved in this type of Patient Spending Assistance, as in a Flexible Spending Account (FSA)." - NCPDP Telecommunication (Field 129-UD, Data Dictionary 201104).

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NamehealthPlanFundedAssistanceAmount
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::healthPlanFundedAssistanceAmount
Stereotype
Template Parameter
Type«MO» MonetaryAmount
Upper1
Upper Value(1)
VisibilityPublic


 incentiveAmount
Public «MO» MonetaryAmount incentiveAmount

"Amount represents the contractually agreed upon incentive fee paid for specific services rendered. Amount is included in the Total Amount Paid." - NCPDP Telecommunication (Field 521-FL, Data Dictionary 201104).

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NameincentiveAmount
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::incentiveAmount
Stereotype
Template Parameter
Type«MO» MonetaryAmount
Upper1
Upper Value(1)
VisibilityPublic


 ingredientCost
Public «MO» MonetaryAmount ingredientCost

"Drug ingredient cost paid included in the Total Amount Paid." - NCPDP Telecommunication (Field 506-F6, Data Dictionary 201104).

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NameingredientCost
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::ingredientCost
Stereotype
Template Parameter
Type«MO» MonetaryAmount
Upper1
Upper Value(1)
VisibilityPublic


 ingredientCostAmount
Public «MO» MonetaryAmount ingredientCostAmount

"Informational field used when Other Payer-Patient Responsibility Amount or Patient Pay Amount is used for reimbursement. Amount is equal to contracted or reimbursable amount for product being dispensed." - NCPDP Telecommunication (Field 148-U8, Data Dictionary 201104).

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NameingredientCostAmount
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::ingredientCostAmount
Stereotype
Template Parameter
Type«MO» MonetaryAmount
Upper1
Upper Value(1)
VisibilityPublic


 otherAmount
Public OtherAmount otherAmount

Pointer to a set of additional costs associated with a dispensed prescription or service that were reimbursed. Examples of such costs include shipping, compound preparation, incentives, and taxes.

Constraints:
Properties:

AggregationNone
Alias
AssociationbillingResponse_otherAmount
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity*
NameotherAmount
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::otherAmount
Stereotype
Template Parameter
TypeOtherAmount
Upper*
Upper Value(*)
VisibilityPublic


 otherAmountPaidCount
Public Integer otherAmountPaidCount

"Count of the other amount paid occurrences." - NCPDP Telecommunication (Field 563-J2, Data Dictionary 201104). Note that this property could potentially be calculated based on the number of instances of the Other Amount class.

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedtrue
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower1
Lower Value(1)
Multiplicity1
NameotherAmountPaidCount
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::otherAmountPaidCount
Stereotype
Template Parameter
TypeInteger
Upper1
Upper Value(1)
VisibilityPublic


 otherPayerAmountRecognized
Public «MO» MonetaryAmount otherPayerAmountRecognized

"Total amount recognized by the processor of any payment from another source." - NCPDP Telecommunication (Field 566-J5, Data Dictionary 201104).

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NameotherPayerAmountRecognized
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::otherPayerAmountRecognized
Stereotype
Template Parameter
Type«MO» MonetaryAmount
Upper1
Upper Value(1)
VisibilityPublic


 patientPayAmount
Public «MO» MonetaryAmount patientPayAmount

"Amount that is calculated by the processor and returned to the pharmacy as the TOTAL amount to be paid by the patient to the pharmacy; the patient’s total cost share, including copayments, amounts applied to deductible, over maximum amounts, penalties, etc." - NCPDP Telecommunication (Field 505-F5, Data Dictionary 201104).

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NamepatientPayAmount
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::patientPayAmount
Stereotype
Template Parameter
Type«MO» MonetaryAmount
Upper1
Upper Value(1)
VisibilityPublic


 patientSalesTaxAmount
Public «MO» MonetaryAmount patientSalesTaxAmount

"Patient sales tax responsibility. This field is not a component of the Patient Pay Amount formula." - NCPDP Telecommunication (Field 575-EQ, Data Dictionary 201104).

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NamepatientSalesTaxAmount
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::patientSalesTaxAmount
Stereotype
Template Parameter
Type«MO» MonetaryAmount
Upper1
Upper Value(1)
VisibilityPublic


 percentageSalesTaxAmount
Public «MO» MonetaryAmount percentageSalesTaxAmount

"Amount of percentage sales tax paid which is included in the Total Amount Paid" - NCPDP Telecommunication (Field 559-AX, Data Dictionary 201104).

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NamepercentageSalesTaxAmount
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::percentageSalesTaxAmount
Stereotype
Template Parameter
Type«MO» MonetaryAmount
Upper1
Upper Value(1)
VisibilityPublic


 percentageSalesTaxBasis
Public «CS» Code percentageSalesTaxBasis

"Code indicating the percentage sales tax paid basis." - NCPDP Telecommunication (Field 561-AZ, Data Dictionary 201104). Possible values include: Ingredient Cost; Ingredient Cost plus Dispensing Fee; Not Specified.

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NamepercentageSalesTaxBasis
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::percentageSalesTaxBasis
Stereotype
Template Parameter
Type«CS» Code
Upper1
Upper Value(1)
VisibilityPublic


 percentageSalesTaxRate
Public «REAL» Decimal percentageSalesTaxRate

"Percentage sales tax rate used to calculate Percentage Sales Tax Amount Paid" - NCPDP Telecommunication (Field 560-AY, Data Dictionary 201104).

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NamepercentageSalesTaxRate
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::percentageSalesTaxRate
Stereotype
Template Parameter
Type«REAL» Decimal
Upper1
Upper Value(1)
VisibilityPublic


 planSalesTaxAmount
Public «MO» MonetaryAmount planSalesTaxAmount

"Plan sales tax responsibility. This field is not a component of the Patient Pay Amount formula." - NCPDP Telecommunication (Field 574-2Y, Data Dictionary 201104).

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NameplanSalesTaxAmount
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::planSalesTaxAmount
Stereotype
Template Parameter
Type«MO» MonetaryAmount
Upper1
Upper Value(1)
VisibilityPublic


 professionalServiceFee
Public «MO» MonetaryAmount professionalServiceFee

"Amount representing the contractually agreed upon fee for professional services rendered. This amount is included in the Total Amount Paid." - NCPDP Telecommunication (Field 562-J1, Data Dictionary 201104).

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NameprofessionalServiceFee
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::professionalServiceFee
Stereotype
Template Parameter
Type«MO» MonetaryAmount
Upper1
Upper Value(1)
VisibilityPublic


 remainingBenefitAmount
Public «MO» MonetaryAmount remainingBenefitAmount

"Amount remaining in a patient/family plan with a periodic maximum benefit." - NCPDP Telecommunication (Field 514-FE, Data Dictionary 201104).

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NameremainingBenefitAmount
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::remainingBenefitAmount
Stereotype
Template Parameter
Type«MO» MonetaryAmount
Upper1
Upper Value(1)
VisibilityPublic


 remainingDeductibleAmount
Public «MO» MonetaryAmount remainingDeductibleAmount

"Amount not met by the patient/family in the deductible plan." - NCPDP Telecommunication (Field 513-FD, Data Dictionary 201104).

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NameremainingDeductibleAmount
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::remainingDeductibleAmount
Stereotype
Template Parameter
Type«MO» MonetaryAmount
Upper1
Upper Value(1)
VisibilityPublic


 spendingAccountAmountRemaining
Public «MO» MonetaryAmount spendingAccountAmountRemaining

"The balance from the patient’s spending account after this transaction was applied." - NCPDP Telecommunication (Field 128-UC, Data Dictionary 201104).

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NamespendingAccountAmountRemaining
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::spendingAccountAmountRemaining
Stereotype
Template Parameter
Type«MO» MonetaryAmount
Upper1
Upper Value(1)
VisibilityPublic


 taxExemptCategory
Public «CS» Code taxExemptCategory

"Code indicating the payer and/or the patient is exempt from taxes." - NCPDP Telecommunication (Field 557-AV, Data Dictionary 201104). Possible values include: Payer/Plan is Tax Exempt; Patient is Tax Exempt; Payer/Plan and Patient are Tax Exempt.

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassBillingResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NametaxExemptCategory
Name Expression
NamespaceBillingResponse
Opposite
OwnerBillingResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::BillingResponse::taxExemptCategory
Stereotype
Template Parameter
Type«CS» Code
Upper1
Upper Value(1)
VisibilityPublic