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Patient Superbills

patient-superbills.tsv

Super bill header data of a patient

Field Name Data type Field Description
PatientPracticeGuid Guid Unique identifier representing a patient
BillingHeaderGuid Guid Unique identifier for the billing header
BillingStatus String Indicates the current billing status of a patient’s account
PerformingProviderProfileGuid Guid Unique identifier representing the profile of a provider who performed medical services to a patient
PerformingFacilityGuid Guid Unique identifier for the facility where medical services performed on a patient
EncounterGuid Guid? Unique identifier of the encounter associated to a patient
PatientContactCode String Code assigned to a patient’s medical record
PatientFirstName String First name of the patient
PatientMiddleName String Middle name of the patient
PatientLastName String Last name of the patient
PatientBirthDate DateField Date of birth of the patient
PatientDeathDate DateField Date of death of the patient
PatientGender String Gender of the patient
PatientAddressStreet1 String Street Address 1 for the address of the patient
PatientAddressStreet2 String Street Address 2 for the address of the patient
PatientAddressCity String City of residence for the address of the patient
PatientAddressState String State of residence for the address of the patient
PatientAddressPostalCode String Postal code of residence for the address of the patient
PatientAddressCountry String Country of residence for the address of the patient
PatientPrimaryPhone String Primary phone number of the patient
PatientPrimaryPhoneExtension String Primary phone extension of the patient
PatientSecondaryPhone String Secondary phone number of the patient
PatientSecondaryPhoneExtension String Secondary phone extension of the patient
PatientSSN String Social security number of the patient
PatientEmail String Email address of the patient
PerformingProviderNpi String National provider identifier of the provider who performed medical services to a patient
PerformingProviderFirstName String First name of the provider who performed medical services to a patient
PerformingProviderMiddleName String Middle name of the provider who performed medical services to a patient
PerformingProviderLastName String Last name of the provider who performed medical services to a patient
PerformingProviderBirthDate DateField Birth date of the provider who performed medical services to a patient
PerformingProviderGender String Gender of the provider who performed medical services to a patient
PerformingProviderPrimaryPhone String Primary phone number of the provider who performed medical services to a patient
PerformingProviderSecondaryPhone String Secondary phone number of the provider who performed medical services to a patient
OrderingProviderNpi String National provider identifier of the provider who ordered medical services for a patient
OrderingProviderFirstName String First name of the provider who ordered medical services for a patient
OrderingProviderMiddleName String Middle name of the provider who ordered medical services for a patient
OrderingProviderLastName String Last name of the provider who ordered medical services for a patient
OrderingProviderBirthDate DateField Birth date of the provider who ordered medical services for a patient
OrderingProviderGender String Gender of the provider who ordered medical services for a patient
OrderingProviderPrimaryPhone String Primary phone number of the provider who ordered medical services for a patient
OrderingProviderSecondaryPhone String Secondary phone number of the provider who ordered medical services for a patient
OtherProviderNpi String National provider identifier of the provider who involved in providing medical services to a patient
OtherProviderFirstName String First name of the other provider who involved in providing medical services to a patient
OtherProviderMiddleName String Middle name of the other provider who involved in providing medical services to a patient
OtherProviderLastName String Last name of the other provider who involved in providing medical services to a patient
OtherProviderGender String Gender of the other provider who involved in providing medical services to a patient
OtherProviderPrimaryPhone String Primary phone number of the other provider who involved in providing medical services to a patient
OtherProviderSecondaryPhone String Secondary phone number of the other provider who involved in providing medical services to a patient
BillingGuarantorFirstName String First name of the billing guarantor
BillingGuarantorMiddleName String Middle name of the billing guarantor
BillingGuarantorLastName String Last name of the billing guarantor
BillingGuarantorPrimaryPhone String Primary phone number of the billing guarantor
BillingGuarantorSecondaryPhone String Secondary phone number of the billing guarantor
BillingGuarantorBirthDate DateField Birth date of the billing guarantor
BillingGuarantorGender String Gender of the billing guarantor
BillingGuarantorAddressStreet1 String Street Address 1 for the address of the billing guarantor
BillingGuarantorAddressStreet2 String Street Address 2 for the address of the billing guarantor
BillingGuarantorAddressCity String City of residence for the address of the billing guarantor
BillingGuarantorAddressState String State of residence for the address of the billing guarantor
BillingGuarantorAddressPostalCode String Postal code of residence for the address of the billing guarantor
BillingGuarantorAddressCountry String Country of residence for the address of the billing guarantor
BillingGuarantorSSN String Social security number of the billing guarantor
BillingGuarantorRelationship String Relationship of the billing guarantor with a patient
BillingGuarantorOrganizationName String Organization name of the billing guarantor
PriorAuthorizationNumber String Unique identification code or reference number issued by a healthcare insurance company or payer
HospitalAdmitDateTimeUtc DateTime? UTC date and time when the patient was admitted to the hospital
InjuryDateTimeUtc DateTime? UTC date and time when an injury occurred to the patient
LastModifiedByProfileGuid Guid Unique identifier representing the user’s profile that last updated this record
LastModifiedDateTimeUtc DateTime UTC date and time when the last update was performed
InsuranceCoverageType String The insurance coverage type associated with the superbill