AMT

Patient Amount Paid

Pos: 175

Max: 1

Detail - Optional

Loop: 2300

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
	F5	Patient Amount Paid

AMT02

782

Monetary Amount
Description: Monetary amount
Industry: Patient Amount Paid
NSF Reference: XA0-19.0

1/18

Required

Notes:

1. Required when patient has made payment specifically toward this claim.
2. Patient Amount Paid refers to the sum of all amounts paid on the claim by the patient or his/her representative(s).

Example:

AMT*F5*152.45~

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