out of pocket coinsurance amount

oop_coins_amt

claims

Updated 5/16/2026

Definition

The shared cost value for a patient paid amount. Used to capture financial data associated with out of pocket transactions. This field is commonly used in electronic health records (EHR), healthcare information systems (HIS), and clinical data warehouses for out of pocket management and reporting.

Standard Abbreviation

oop_coins_amt

Database Usage

-- Example column naming
CREATE TABLE claims (
  clm_id VARCHAR(50),
  oop_coins_amt NUMBER(12,2),  -- out of pocket coinsurance amount (precision 12, scale 2)
  ...
);

-- Example in SELECT
SELECT
  clm_id,
  oop_coins_amt as out_of_pocket_coinsurance_amount
FROM claims;

Common uses in healthcare data

Claims adjudication and remittance processing
837P/837I/837D claim file parsing and validation
Revenue cycle management and denial analytics
CMS cost report and Medicare cost reporting
Payer contract performance and underpayment analysis

Example database column name

ISO-11179 snake_case standard

-- Recommended column name
out_of_pocket_coinsurance_amount

-- Example DDL
CREATE TABLE healthcare_data (
  record_id   VARCHAR(50)   NOT NULL,
  out_of_pocket_coinsurance_amount NUMBER(12,2),  -- out of pocket coinsurance amount (precision 12, scale 2)
  created_dt  TIMESTAMP     NOT NULL DEFAULT NOW()
);

Column names follow the ISO-11179 naming convention: lowercase, underscore-separated, using the standard abbreviation as a prefix where applicable.

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