{
  "description": "This value set includes a smattering of Adjudication Value codes which includes codes to indicate the amounts eligible under the plan, the amount of benefit, copays etc.",
  "_filename": "CodeSystem-adjudication.json",
  "package_name": "hl7.fhir.uv.xver",
  "date": "2025-09-13T16:22:57-04:00",
  "publisher": "Financial Management",
  "jurisdiction": [ {
    "coding": [ {
      "code": "001",
      "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
      "display": "World"
    } ]
  } ],
  "content": "complete",
  "name": "AdjudicationValueCodes",
  "copyright": "This is an example set.",
  "type": null,
  "experimental": "false",
  "resourceType": "CodeSystem",
  "title": "Adjudication Value Codes",
  "package_version": "r4.r5-0.0.1-snapshot-2",
  "extension": [ {
    "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
    "valueCode": "draft"
  }, {
    "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
    "valueInteger": 1
  }, {
    "url": "http://hl7.org/fhir/StructureDefinition/package-source",
    "extension": [ {
      "url": "packageId",
      "valueId": "hl7.fhir.uv.xver-r4.r5"
    }, {
      "url": "version",
      "valueString": "0.0.1-snapshot-2"
    } ]
  }, {
    "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
    "valueCode": "fm"
  } ],
  "status": "draft",
  "id": "261fd4c2-9dc3-435e-8225-0ed62bee015a",
  "valueSet": "http://hl7.org/fhir/ValueSet/adjudication|5.0.0",
  "kind": null,
  "url": "http://terminology.hl7.org/CodeSystem/adjudication",
  "concept": [ {
    "code": "submitted",
    "display": "Submitted Amount",
    "definition": "The total submitted amount for the claim or group or line item."
  }, {
    "code": "copay",
    "display": "CoPay",
    "definition": "Patient Co-Payment"
  }, {
    "code": "eligible",
    "display": "Eligible Amount",
    "definition": "Amount of the change which is considered for adjudication."
  }, {
    "code": "deductible",
    "display": "Deductible",
    "definition": "Amount deducted from the eligible amount prior to adjudication."
  }, {
    "code": "unallocdeduct",
    "display": "Unallocated Deductible",
    "definition": "The amount of deductible which could not allocated to other line items."
  }, {
    "code": "eligpercent",
    "display": "Eligible %",
    "definition": "Eligible Percentage."
  }, {
    "code": "tax",
    "display": "Tax",
    "definition": "The amount of tax."
  }, {
    "code": "benefit",
    "display": "Benefit Amount",
    "definition": "Amount payable under the coverage"
  } ],
  "caseSensitive": true,
  "version": "4.0.1",
  "contact": [ {
    "name": "Financial Management",
    "telecom": [ {
      "value": "http://www.hl7.org/Special/committees/fm",
      "system": "url"
    } ]
  } ]
}