{
"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.terminology.r5",
"date": "2022-09-14T03:23:03-06:00",
"meta": {
"profile": [ "http://hl7.org/fhir/StructureDefinition/shareablecodesystem" ],
"lastUpdated": "2020-04-09T21:10:28.568+00:00"
},
"publisher": "FHIR Project team",
"content": "complete",
"name": "AdjudicationValueCodes",
"copyright": "This is an example set.",
"type": null,
"experimental": "false",
"resourceType": "CodeSystem",
"title": "Adjudication Value Codes",
"package_version": "4.0.0",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode": "fm"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "draft"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
"valueInteger": 1
} ],
"status": "draft",
"id": "2f153d5e-25ac-48af-bfda-58b838abf43d",
"valueSet": "http://terminology.hl7.org/ValueSet/adjudication",
"kind": null,
"url": "http://terminology.hl7.org/CodeSystem/adjudication",
"identifier": [ {
"value": "urn:oid:2.16.840.1.113883.4.642.1.1171",
"system": "urn:ietf:rfc:3986"
} ],
"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": "0.1.0",
"contact": [ {
"telecom": [ {
"value": "http://hl7.org/fhir",
"system": "url"
} ]
} ]
}