Medicare Claims Processing Manual (Pub. 100-04), Ch. 17 § 70.1.2
Coordination of Benefits (COB)
70.1.2 - Coordination of Benefits (COB)
(Rev. 1, 10-01-03)
The NCPDP has approved the following use of qualifiers for reporting Medicare COB amounts:
Qualifier Description
07
Medicare Allowed Amount
08
Medicare Paid Amount
99
1st Occurrence - Deductible Amount
99
2nd Occurrence - Coinsurance Amount
99
3rd Occurrence - Co-Payment Amount