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This video tutorial discusses medical claims data found in the all payer claims database. The data includes institutional and professional services claims such as hospital stays, outpatient visits, and doctor office visits. Dental and prescription drug claims are excluded, as well as fully denied claims. The data also includes fee-for-service and capitated payment claims recorded at the claim line level with detailed claim versioning. Claim re-adjudication occurs when insurance companies review and correct claim payments. The highest version indicator field helps identify the most recent version of a claim to prevent double counting.
