ServiceLines Array Record for a Dental Encounter
```json
"serviceLines": [
{
"serviceDate": "20190313",
"servicePaymentInformation": {
"productOrServiceIDQualifier": "AD",
"productOrServiceIDQualifierValue": "American Dental Association Codes",
"adjudicatedProcedureCode": "D4342",
"lineItemChargeAmount": "125",
"lineItemProviderPaymentAmount": "0"
},
"serviceAdjustments": [
{
"claimAdjustmentGroupCode": "CO",
"claimAdjustmentGroupCodeValue": "Contractual Obligations",
"adjustmentReasonCode1": "45",
"adjustmentAmount1": "125"
}
]
},
{
"serviceDate": "20190313",
"servicePaymentInformation": {
"productOrServiceIDQualifier": "AD",
"productOrServiceIDQualifierValue": "American Dental Association Codes",
"adjudicatedProcedureCode": "D4381",
"lineItemChargeAmount": "43",
"lineItemProviderPaymentAmount": "0"
},
"serviceAdjustments": [
{
"claimAdjustmentGroupCode": "PR",
"claimAdjustmentGroupCodeValue": "Patient Responsibility",
"adjustmentReasonCode1": "3",
"adjustmentAmount1": "33"
},
{
"claimAdjustmentGroupCode": "CO",
"claimAdjustmentGroupCodeValue": "Contractual Obligations",
"adjustmentReasonCode1": "45",
"adjustmentAmount1": "10"
}
]
},
...
```
Each line item specifies whether the payer agrees to pay any cash for each line item. In the preceding example, the lineItemProviderPaymentAmount
for each indicates that the provider did not apply any discounts or on-site payments towards the procedure. Each individual adjudicatedProcedureCode
denotes the procedure line item. The serviceAdjustments
object describes the payment that the payer agrees to pay for each individual line item.
Updated 7 months ago