AMT

Coordination of Benefits (COB) Covered Amount

Pos: 300

Max: 1

Detail - Optional

Loop: 2320

Elements: 2

User Option (Usage): Situational

To indicate the total monetary amount

Element Summary:

	Ref	Id	Element Name	Req	Type	Min/Max	Usage
	AMT01	522	Amount Qualifier Code Description: Code to qualify amount	M	ID	1/3	Required

	Code	Name
	AU	Coverage Amount

AMT02

782

Monetary Amount
Description: Monetary amount
Industry: Covered Amount

1/18

Required

Notes:

1. Used only in payer-to-payer COB situations by the payer who is sending this claim to another payer. Providers do not complete this information.
2. The covered amount equals the amount for the total claim that was covered by the payer sending this 837 to another payer.

Example:

AMT*AU*203~

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