Health data as reflected in a patient's Explanation of Benefits (EOB) statements, typically derived from claims and other administrative data.

Data Element

Information from the submission form

Line Noncovered Amount
Description

Medical: The portion of the cost of this service that was deemed not eligible by the insurer because the service or member was not covered by the subscriber contract.
Pharmacy: Non-Covered Amount represents the NCPDP financial response field Amount Exceeding Periodic Benefit Maximum.

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