Line # | Adj. Date | OHI ID | PST | From | B/U | Rev. | Proc. | Modifiers | Line Charge | OHI Paid | Qty. | Adj. | Total Non-Covered Amount |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
{{ getDisplayString(ohiSrvcLineAdjInfo[i]?.lineNumber) }} | {{ getDisplayString(ohiSrvcLineAdjInfo[i]?.adjudicationDate) }} | {{ getDisplayString(ohiSrvcLineAdjInfo[i]?.payerId) }} | {{ getDisplayString(ohiSrvcLineAdjInfo[i]?.paymentSequenceIndicator) }} | {{ getDisplayString(ohiSrvcLineAdjInfo[i]?.beginDateOfService) }} | {{ getDisplayString(ohiSrvcLineAdjInfo[i]?.bundledUnbundledLineNumber) }} | {{ getDisplayString(ohiSrvcLineAdjInfo[i]?.revenueCode) }} | {{ getDisplayString(ohiSrvcLineAdjInfo[i]?.procedureCode) }} | {{ getDisplayString(ohiSrvcLineAdjInfo[i]?.modifiers) }} | {{ getDisplayString(ohiSrvcLineAdjInfo[i]?.lineCharge) }} | {{ getDisplayString(ohiSrvcLineAdjInfo[i]?.payerPaidAmount) }} | {{ getDisplayString(ohiSrvcLineAdjInfo[i]?.quantity) }} |
{{ ohiSrvcLineAdjInfo[i]?.adjustment?.adjustmentCode }}
{{ ohiSrvcLineAdjInfo[i]?.adjustment?.adjustmentCode }}: {{ ohiSrvcLineAdjInfo[i]?.adjustment?.descriptionLong
}}
|
{{ getDollarSignString(ohiSrvcLineAdjInfo[i]?.adjustment?.adjustmentAmount) }} |
{{ getDisplayString(row?.lineNumber) }} | {{ getDisplayString(row?.adjudicationDate) }} | {{ getDisplayString(row?.payerId) }} | {{ getDisplayString(row?.paymentSequenceIndicator) }} | {{ getDisplayString(row?.beginDateOfService) }} | {{ getDisplayString(row?.bundledUnbundledLineNumber) }} | {{ getDisplayString(row?.revenueCode) }} | {{ getDisplayString(row?.procedureCode) }} | {{ getDisplayString(row?.modifiers) }} | {{ getDollarSignString(row?.lineCharge) }} | {{ getDollarSignString(row?.payerPaidAmount) }} | {{ getDisplayString(row?.quantity) }} |
{{ row?.adjustment?.adjustmentCode }}
{{ row?.adjustment?.adjustmentCode }}: {{ row?.adjustment?.descriptionLong }}
|
{{ getDollarSignString(row.adjustment?.adjustmentAmount) }} |