| Name | Description | Type | Additional information |
|---|---|---|---|
| TPAName | string |
None. |
|
| TPAClaimNumber | string |
None. |
|
| AuthorizationType | string |
None. |
|
| InitialAuthorizationClaimNumber | string |
None. |
|
| DateandTimeofintimation | string |
None. |
|
| DateandTimeofAdmission | string |
None. |
|
| ModifiedDateandTimeofAdmission | string |
None. |
|
| DateandTimeofDischarge | string |
None. |
|
| DateofLastdocumentreceived | string |
None. |
|
| PolicyNumber | string |
None. |
|
| TPAMemberID | string |
None. |
|
| MemberID | string |
None. |
|
| ExpectedAmount | string |
None. |
|
| ApprovedAmount | string |
None. |
|
| ApprovedfromsumInsured | string |
None. |
|
| ApprovedfromCorporateBuffer | string |
None. |
|
| ApprovedfromCriticalIllness | string |
None. |
|
| ICDCodeDescriptionlevelIII | string |
None. |
|
| ICDPCSCodeDescription | string |
None. |
|
| ProviderName | string |
None. |
|
| ROHINICode | string |
None. |
|
| ProviderPincode | string |
None. |
|
| ProviderState | string |
None. |
|
| ProviderCity | string |
None. |
|
| ProviderAddress | string |
None. |
|
| PastClaimpresent | string |
None. |
|
| AilmentCappingasperpolicy | string |
None. |
|
| AgreedPackagewithHospital | string |
None. |
|
| CaseSummary | string |
None. |
|
| TPARecommendation | string |
None. |
|
| Specialremarkverificationinvestigation | string |
None. |
|
| GroupName | string |
None. |
|
| Reasonforrepudiationofclaim | string |
None. |
|
| RepudiationDescription | string |
None. |
|
| SurgicalorNonSurgical | string |
None. |
|
| RoomType | string |
None. |
|
| NIDB | string |
None. |