Superbill Variables

Field Description	Field ID
Appointment Alert on the Patient	@APPTALERT
Appointment Chief Complaint	@APPTCC
Appointment Comments	@APPTCOM
Appointment Date	@APPTDATE
Appointment Facility	@APPTFAC
Appointment Notes - Last Note Added to Appointment	@APPTNOTE
Appointment Provider	@APPTPRV
Appointment Resource	@APPTRES
Appointment Time	@APPTTIME
Appointment Type	@APPTTYPE
Next Appointment Date	@NEXTAPPTDT
Next Appointment time	@NEXTAPPT-TIME
Patient Last Seen	@PSEEN

Facility Information

Field Description	Field ID
Secondary Payer Name	@INS2
Secondary Policy Group #	@INS2GRP
Secondary Policy Member ID	@INS2MEM
Secondary Payer Address 1	@INS2ADDR
Secondary Payer Address 2	@INS2ADDR2
Secondary Payer City	@INS2CITY
Secondary Payer State	@INS2STATE
Secondary Payer Zip	@INS2ZIP
Secondary Payer Phone	@INS2PH
Secondary Payer Copay	@SCOP
Secondary Policy Co-Insurance	@SCOINS
Secondary Patient Deductible	@SDEDUCT

Field Description	Field ID
Tertiary Payer Name	@INS3
Tertiary Policy Group #	@INS3GRP
Tertiary Policy Member ID	@INS3MEM
Tertiary Payer Address 1	@INS3ADDR
Tertiary Payer Address 2	@INS3ADDR2
Tertiary Payer City	@INS3CITY
Tertiary Payer State	@INS3STATE
Tertiary Payer Zip	@INS3ZIP
Tertiary Payer Phone	@INS3PH
Tertiary Payer Copay	@TCOP
Tertiary Policy Co-Insurance	@TCOINS
Tertiary Patient Deductible	@TDEDUCT

Field Description	Field ID
Primary Insured Last Name	@PILAST
Primary Insured First Name	@PIFIRST
Primary Insured Middle Name	@PIMI
Primary Insured Name (Last, First Middle)	@PINAME1
Primary Insured Name (First Middle Last)	@PINAME2
Primary Insured Address 1	@PIADDR1
Primary Insured Address 2	@PIADDR2
Primary Insured City	@PICITY
Primary Insured State	@PISTATE
Primary Insured Zip	@PIZIP
Primary Insured Home Phone	@PIHOME
Primary Insured Work Phone	@PIWORK
Primary Insured Cell Phone	@PICELL

Field Description	Field ID
Secondary Last Name	@SILAST
Secondary Insured First Name	@SIFIRST
Secondary Insured Middle Name	@SIMI
Secondary Insured Name (Last, First Middle)	@SINAME1
Secondary Insured Name (First Middle Last)	@SINAME2
Secondary Insured Address 1	@SIADDR1
Secondary Insured Address 2	@SIADDR2
Secondary Insured City	@SICITY
Secondary Insured State	@SISTATE
Secondary Insured Zip	@SIZIP
Secondary Insured Home Phone	@SIHOME
Secondary Insured Work Phone	@SIWORK
Secondary Insured Cell Phone	@SICELL

Field Description	Field ID
Tertiary Last Name	@TILAST
Tertiary Insured First Name	@TIFIRST
Tertiary Insured Middle Name	@TIMI
Tertiary Insured Name (Last, First Middle)	@TINAME1
Tertiary Insured Name (First Middle Last)	@TINAME2
Tertiary Insured Address 1	@TIADDR1
Tertiary Insured Address 2	@TIADDR2
Tertiary Insured City	@TICITY
Tertiary Insured State	@TISTATE
Tertiary Insured Zip	@TIZIP
Tertiary Insured Home Phone	@TIHOME
Tertiary Insured Work Phone	@TIWORK
Tertiary Insured Cell Phone	@TICELL

Field Description	Field ID
Account#	@PACCT
Address Line 1	@PADDR1
Address Line 2	@PADDR2
Age	@PAGE
Balance Due Insurance	@IBAL
Balance Due Patient	@PBAL
Balance Due Collection	@CBAL
Cell Phone	@PCELL
City	@PCITY
Co-Insurance	@PCOINS
Co-pay	@PCOP
Credits Due Insurance	@PCRI
Credits Due Patient	@PCRP
Patient's Unapplied Copay Credit amount	@PCRCOPAY
Date of Birth	@PDOB
Default ICD Codes	%DEFAULTICD
Deducitlbe	@PDEDUCT
Email	@PEMAIL
First Name	@PFIRST
Full Address (Address City State Zip)	@PADDRFULL
Full Name (First MI Last)	@PNAME2
Full Name (Last, First MI)	@PNAME1
Home Phone	@PHOME
Last Name	@PLAST
Last Seen Date	@PLASTSEEN
Middle Initial	@PMI
Patient Reference	@PREF
Sex	@PSEX
State	@PSTATE
Work Phone	@PWORK
Zip Code	@PZIP

Field Description	Field ID
Primary Payer Group Number	@IN1GRP
Primary Payer Member Number	@IN1MEM
Primary Payer Name	@TIN1
Secondary Payer Group Number	@IN2GRP
Secondary Payer Member Number	@IN2MEM
Secondary Payer Name	@TIN2
Primary Payer Address 1	@AINADDR1
Primary Payer Address 2	@AINADDR2
Primary Payer City	@AIN1CITY
Primary Payer Phone	@AIN1PH
Primary Payer State	@AIN1STATE
Primary Payer Zip Code	@AIN1ZIP
Secondary Payer Address 1	@AIN2ADDR1
Secondary Payer Address 2	@AIN2ADDR2
Secondary Payer City	@AIN2CITY
Secondary Payer Phone	@AIN2PH
Secondary Payer State	@AIN2STATE
Secondary Payer Zip Code	@AUB2ZIP

Field Description	Field ID
Address Line 1	@PRADDR1
Address Line 2	@PRADDR2
City	@PRCITY
Full Address (Address City State Zip)	@PRADDFULL
Name	@PRNAME
Phone	@PRPH
State	@PRST
Zip Code	@PRZIP