NextGen Knowledge Center

Charges Data Field Descriptions for Form and Label Templates

Data Repository lists data fields for Charges and data fields for sub category, Diagnosis.
  • Chrg 1 Deductible
  • Chrg 2 Deductible
  • Chrg 3 Deductible
  • Chrg 4 Deductible
  • Chrg 5 Deductible
  • Chrg 6 Deductible
  • Chrg1 Additional Provider
  • Chrg1 Additional Provider Address 1
  • Chrg1 Additional Provider Address 2
  • Chrg1 Additional Provider City
  • Chrg1 Additional Provider City, State Zip
  • Chrg1 Additional Provider State
  • Chrg1 Additional Provider Zip
  • Chrg1 Adjustments
  • Chrg1 Allowed Amounts
  • *Chrg1 Amount
  • *Chrg1 Amount ($$$$ cc)
  • Chrg1 Cpt4 Code
  • Chrg1 Cpt4 Description
  • *Chrg1 Date of Service
  • *Chrg1 Date of Service(mmddyy)
  • Chrg1 Diagnosis Code
  • Chrg1 Diagnosis Desc
  • Chrg1 End Date of Service
  • Chrg1 Line Notes
  • Chrg1 Location Zip
  • Chrg1 Modifier 1
  • Chrg1 Modifier 2
  • Chrg1 Modifier 3
  • Chrg2 Narrative
  • Chrg1 Occurrence Code
  • Chrg1 Payments
  • Chrg1 Place of Service
  • Chrg1 Quantity
  • Chrg1 Revenue Description
  • Chrg1 Service Item
  • Chrg1 Service Item Description
  • Chrg1 Total Tax Amount
  • Chrg1 UD1 Amount
  • Chrg1 UD2 Amount
  • Chrg1 Value Code
  • Chrg2 Additional Provider
  • Chrg2 Additional Provider Address1
  • Chrg2 Additional Provider Address2
  • Chrg2 Additional Provider City
  • Chrg2 Additional Provider City, State Zip
  • Chrg2 Additional Provider State
  • Chrg2 Additional Provider Zip
  • Chrg2 Adjustments
  • Chrg2 Allowed Amounts
  • *Chrg2 Amount
  • *Chrg2 Amount ($$$$ cc)
  • Chrg2 Cpt4 Code
  • Chrg2 Cpt4 Description
  • *Chrg2 Date of Service
  • *Chrg2 Date of Service(mmddyy)
  • Chrg2 Diagnosis Code
  • Chrg2 Diagnosis Desc
  • Chrg2 End Date of Service
  • Chrg2 Line Notes
  • Chrg2 Location Zip
  • Chrg2 Modifier 1
  • Chrg2 Modifier 2
  • Chrg2 Modifier 3
  • Chrg2 Narrative
  • Chrg2 Occurrence Code
  • Chrg2 Payments
  • Chrg2 Place of Service
  • Chrg2 Quantity
  • Chrg2 Revenue Description
  • Chrg2 Service Item
  • Chrg2 Service Item Description
  • Chrg2 Total Tax Amount
  • Chrg2 UD1 Amount
  • Chrg2 UD2 Amount
  • Chrg2 Value Code
  • Chrg3 Additional Provider
  • Chrg3 Additional Provider Address1
  • Chrg3 Additional Provider Address2
  • Chrg3 Additional Provider City
  • Chrg3 Additional Provider City, State Zip
  • Chrg3 Additional Provider State
  • Chrg3 Additional Provider Zip
  • Chrg3 Adjustments
  • Chrg3 Allowed Amounts
  • *Chrg3 Amount
  • *Chrg3 Amount ($$$$ cc)
  • Chrg3 Cpt4 Code
  • Chrg3 Cpt4 Description
  • *Chrg3 Date of Service
  • *Chrg3 Date of Service(mmddyy)
  • Chrg3 Diagnosis Code
  • Chrg3 Diagnosis Desc
  • Chrg3 End Date of Service
  • Chrg3 Line Notes
  • Chrg3 Location Zip
  • Chrg3 Modifier 1
  • Chrg3 Modifier 2
  • Chrg3 Modifier 3
  • Chrg3 Narrative
  • Chrg3 Occurrence Code
  • Chrg3 Payments
  • Chrg3 Place of Service
  • Chrg3 Quantity
  • Chrg3 Revenue Description
  • Chrg3 Service Item
  • Chrg3 Service Item Description
  • Chrg3 Total Tax Amount
  • Chrg3 UD1 Amount
  • Chrg3 UD2 Amount
  • Chrg3 Value Code
  • Chrg4 Additional Provider
  • Chrg4 Additional Provider Address1
  • Chrg4 Additional Provider Address2
  • Chrg4 Additional Provider City
  • Chrg4 Additional Provider City, State Zip
  • Chrg4 Additional Provider State
  • Chrg4 Additional Provider Zip
  • Chrg4 Adjustments
  • Chrg4 Allowed Amounts
  • *Chrg4 Amount
  • *Chrg4 Amount ($$$$ cc)
  • Chrg4 Cpt4 Code
  • Chrg4 Cpt4 Description
  • *Chrg4 Date of Service
  • *Chrg4 Date of Service(mmddyy)
  • Chrg4 Diagnosis Code
  • Chrg4 Diagnosis Desc
  • Chrg4 End Date of Service
  • Chrg4 Line Notes
  • Chrg4 Location Zip
  • Chrg4 Modifier 1
  • Chrg4 Modifier 2
  • Chrg4 Modifier 3
  • Chrg4 Narrative
  • Chrg4 Occurrence Code
  • Chrg4 Payments
  • Chrg4 Place of Service
  • Chrg4 Quantity
  • Chrg4 Revenue Description
  • Chrg4 Service Item
  • Chrg4 Service Item Description
  • Chrg4 Total Tax Amount
  • Chrg4 UD1 Amount
  • Chrg4 UD2 Amount
  • Chrg4 Value Code
  • Chrg5 Additional Provider
  • Chrg5 Additional Provider Address1
  • Chrg5 Additional Provider Address2
  • Chrg5 Additional Provider City
  • Chrg5 Additional Provider City, State Zip
  • Chrg5 Additional Provider State
  • Chrg5 Additional Provider Zip
  • Chrg5 Adjustments
  • Chrg5 Allowed Amounts
  • *Chrg5 Amount
  • *Chrg5 Amount ($$$$ cc)
  • Chrg5 Cpt4 Code
  • Chrg5 Cpt4 Description
  • *Chrg5 Date of Service
  • *Chrg5 Date of Service(mmddyy)
  • Chrg5 Diagnosis Code
  • Chrg5 Diagnosis Desc
  • Chrg5 End Date of Service
  • Chrg5 Line Notes
  • Chrg5 Location Zip
  • Chrg5 Modifier 1
  • Chrg5 Modifier 2
  • Chrg5 Modifier 3
  • Chrg5 Narrative
  • Chrg5 Occurrence Code
  • Chrg5 Payments
  • Chrg5 Place of Service
  • Chrg5 Quantity
  • Chrg5 Revenue Description
  • Chrg5 Service Item
  • Chrg5 Service Item Description
  • Chrg5 Total Tax Amount
  • Chrg5 UD1 Amount
  • Chrg5 UD2 Amount
  • Chrg5 Value Code
  • Chrg6 Additional Provider
  • Chrg6 Additional Provider Address1
  • Chrg6 Additional Provider Address2
  • Chrg6 Additional Provider City
  • Chrg6 Additional Provider City, State Zip
  • Chrg6 Additional Provider State
  • Chrg6 Additional Provider Zip
  • Chrg6 Adjustments
  • Chrg6 Allowed Amounts
  • *Chrg6 Amount
  • *Chrg6 Amount ($$$$ cc)
  • Chrg6 Cpt4 Code
  • Chrg6 Cpt4 Description
  • *Chrg6 Date of Service
  • *Chrg6 Date of Service(mmddyy)
  • Chrg6 Diagnosis Code
  • Chrg6 Diagnosis Desc
  • Chrg6 End Date of Service
  • Chrg6 Line Notes
  • Chrg6 Location Zip
  • Chrg6 Modifier 1
  • Chrg6 Modifier 2
  • Chrg6 Modifier 3
  • Chrg6 Narrative
  • Chrg6 Occurrence Code
  • Chrg6 Payments
  • Chrg6 Place of Service
  • Chrg6 Quantity
  • Chrg6 Revenue Description
  • Chrg6 Service Item
  • Chrg6 Service Item Description
  • Chrg6 Total Tax Amount
  • Chrg6 UD1 Amount
  • Chrg6 UD2 Amount
  • Chrg6 Value Code
  • Diag1 Code
  • Diag1 Description
  • Diag2 Code
  • Diag2 Description
  • Diag3 Code
  • Diag3 Description
  • Diag4 Code
  • Diag4 Description