{
  "description": "This resource provides the adjudication details from the processing of a Claim resource.",
  "_filename": "StructureDefinition-ClaimResponse.json",
  "package_name": "hl7.fhir.core",
  "date": "2018-08-19T21:48:56+10:00",
  "derivation": "specialization",
  "meta": {
    "lastUpdated": "2018-08-19T21:48:56.559+10:00"
  },
  "publisher": "Health Level Seven International (Financial Management)",
  "fhirVersion": "3.5.0",
  "name": "ClaimResponse",
  "mapping": [ {
    "uri": "http://hl7.org/fhir/workflow",
    "name": "Workflow Pattern",
    "identity": "workflow"
  }, {
    "uri": "http://hl7.org/fhir/fivews",
    "name": "FiveWs Pattern",
    "identity": "w5"
  }, {
    "uri": "http://hl7.org/v3",
    "name": "RIM Mapping",
    "identity": "rim"
  } ],
  "abstract": false,
  "type": "ClaimResponse",
  "experimental": null,
  "resourceType": "StructureDefinition",
  "title": null,
  "package_version": "3.5.0",
  "extension": [ {
    "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-category",
    "valueString": "Financial.Billing"
  }, {
    "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
    "valueString": "Trial Use"
  }, {
    "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
    "valueInteger": 2
  }, {
    "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
    "valueCode": "fm"
  } ],
  "snapshot": {
    "element": [ {
      "constraint": [ {
        "key": "dom-2",
        "human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
        "xpath": "not(parent::f:contained and f:contained)",
        "source": "DomainResource",
        "severity": "error",
        "expression": "contained.contained.empty()"
      }, {
        "key": "dom-4",
        "human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
        "xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
        "source": "DomainResource",
        "severity": "error",
        "expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"
      }, {
        "key": "dom-3",
        "human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource",
        "xpath": "not(exists(for $contained in f:contained return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
        "source": "DomainResource",
        "severity": "error",
        "expression": "contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()"
      }, {
        "key": "dom-6",
        "human": "A resource should have narrative for robust management",
        "xpath": "exists(f:text/h:div)",
        "source": "DomainResource",
        "severity": "warning",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
          "valueBoolean": true
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
          "valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a guman readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
        } ],
        "expression": "text.div.exists()"
      }, {
        "key": "dom-5",
        "human": "If a resource is contained in another resource, it SHALL NOT have a security label",
        "xpath": "not(exists(f:contained/*/f:meta/f:security))",
        "source": "DomainResource",
        "severity": "error",
        "expression": "contained.meta.security.empty()"
      } ],
      "path": "ClaimResponse",
      "min": 0,
      "definition": "This resource provides the adjudication details from the processing of a Claim resource.",
      "isModifier": false,
      "short": "ClaimResponse resource",
      "mapping": [ {
        "map": "Entity. Role, or Act",
        "identity": "rim"
      }, {
        "map": "Event",
        "identity": "workflow"
      } ],
      "alias": [ "Remittance Advice" ],
      "max": "*",
      "id": "ClaimResponse",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.id",
      "min": 0,
      "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
      "isModifier": false,
      "short": "Logical id of this artifact",
      "type": [ {
        "code": "id"
      } ],
      "max": "1",
      "id": "ClaimResponse.id",
      "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.id"
      },
      "isSummary": true
    }, {
      "path": "ClaimResponse.meta",
      "min": 0,
      "definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.",
      "isModifier": false,
      "short": "Metadata about the resource",
      "type": [ {
        "code": "Meta"
      } ],
      "max": "1",
      "id": "ClaimResponse.meta",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.meta"
      },
      "isSummary": true
    }, {
      "path": "ClaimResponse.implicitRules",
      "min": 0,
      "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.",
      "isModifier": true,
      "short": "A set of rules under which this content was created",
      "type": [ {
        "code": "uri"
      } ],
      "max": "1",
      "id": "ClaimResponse.implicitRules",
      "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.implicitRules"
      },
      "isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
      "isSummary": true
    }, {
      "path": "ClaimResponse.language",
      "min": 0,
      "definition": "The base language in which the resource is written.",
      "isModifier": false,
      "short": "Language of the resource content",
      "type": [ {
        "code": "code"
      } ],
      "binding": {
        "strength": "preferred",
        "valueSet": "http://hl7.org/fhir/ValueSet/languages",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
          "valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Language"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean": true
        } ],
        "description": "A human language."
      },
      "max": "1",
      "id": "ClaimResponse.language",
      "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.language"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.text",
      "min": 0,
      "definition": "A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
      "isModifier": false,
      "short": "Text summary of the resource, for human interpretation",
      "mapping": [ {
        "map": "Act.text?",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Narrative"
      } ],
      "alias": [ "narrative", "html", "xhtml", "display" ],
      "max": "1",
      "id": "ClaimResponse.text",
      "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "DomainResource.text"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.contained",
      "min": 0,
      "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
      "isModifier": false,
      "short": "Contained, inline Resources",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Resource"
      } ],
      "alias": [ "inline resources", "anonymous resources", "contained resources" ],
      "max": "*",
      "id": "ClaimResponse.contained",
      "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.contained"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "isModifier": false,
      "short": "Additional Content defined by implementations",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "ClaimResponse.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.extension"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "ClaimResponse.modifierExtension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.modifierExtension"
      },
      "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
      "isSummary": false
    }, {
      "path": "ClaimResponse.identifier",
      "min": 0,
      "definition": "The response business identifier.",
      "isModifier": false,
      "short": "Response  number",
      "mapping": [ {
        "map": "Event.identifier",
        "identity": "workflow"
      }, {
        "map": "FiveWs.identifier",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "Identifier"
      } ],
      "max": "*",
      "id": "ClaimResponse.identifier",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse.identifier"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.status",
      "min": 0,
      "definition": "The status of the resource instance.",
      "isModifier": true,
      "short": "active | cancelled | draft | entered-in-error",
      "mapping": [ {
        "map": "Event.status",
        "identity": "workflow"
      }, {
        "map": "FiveWs.status",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/ValueSet/fm-status",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ClaimResponseStatus"
        } ],
        "description": "A code specifying the state of the resource instance."
      },
      "max": "1",
      "id": "ClaimResponse.status",
      "comment": "This element is labeled as a modifier because the status contains the code cancelled and entered-in-error that mark the response as not currently valid.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.status"
      },
      "isModifierReason": "This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid",
      "isSummary": true
    }, {
      "path": "ClaimResponse.type",
      "min": 0,
      "definition": "The category of claim, e.g, oral, pharmacy, vision, institutional, professional.",
      "isModifier": false,
      "short": "Type or discipline",
      "mapping": [ {
        "map": "FiveWs.class",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "extensible",
        "valueSet": "http://hl7.org/fhir/ValueSet/claim-type",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ClaimType"
        } ],
        "description": "The type or discipline-style of the claim."
      },
      "max": "1",
      "id": "ClaimResponse.type",
      "comment": "Affects which fields and value sets are used.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.type"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.subType",
      "min": 0,
      "definition": "A finer grained suite of claim subtype codes which may convey Inpatient vs Outpatient and/or a specialty service. In the US the CMS Bill Type.",
      "isModifier": false,
      "short": "Finer grained claim type information",
      "mapping": [ {
        "map": "FiveWs.class",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/claim-subtype",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ClaimSubType"
        } ],
        "description": "A more granulat claim typecode."
      },
      "max": "1",
      "id": "ClaimResponse.subType",
      "comment": "This may contain the local bill type codes such as the US UB-04 bill type code.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.subType"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.use",
      "min": 0,
      "definition": "A claim, a list of completed goods and services; a preauthorization, a list or proposed goods and services; or a predetermination, a set of goods and services being considered, for which insurer adjudication is sought.",
      "isModifier": false,
      "short": "claim | preauthorization | predetermination",
      "mapping": [ {
        "map": "FiveWs.class",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/ValueSet/claim-use",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Use"
        } ],
        "description": "Claim, preauthorization, predetermination."
      },
      "max": "1",
      "id": "ClaimResponse.use",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.use"
      },
      "isSummary": true
    }, {
      "path": "ClaimResponse.patient",
      "min": 0,
      "definition": "Patient Resource.",
      "isModifier": false,
      "short": "The subject of the Products and Services",
      "mapping": [ {
        "map": "FiveWs.subject[x]",
        "identity": "w5"
      }, {
        "map": "FiveWs.subject",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Patient" ]
      } ],
      "max": "1",
      "id": "ClaimResponse.patient",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.patient"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.created",
      "min": 0,
      "definition": "The date when this resource was created.",
      "isModifier": false,
      "short": "Creation date",
      "mapping": [ {
        "map": "Event.occurrence[x]",
        "identity": "workflow"
      }, {
        "map": "FiveWs.recorded",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "dateTime"
      } ],
      "max": "1",
      "id": "ClaimResponse.created",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.created"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.insurer",
      "min": 0,
      "definition": "The Insurer who produced this adjudicated response.",
      "isModifier": false,
      "short": "Insurance issuing organization",
      "mapping": [ {
        "map": "Event.performer",
        "identity": "workflow"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Organization" ]
      } ],
      "max": "1",
      "id": "ClaimResponse.insurer",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.insurer"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.requestProvider",
      "min": 0,
      "definition": "The practitioner who is responsible for the services rendered to the patient.",
      "isModifier": false,
      "short": "Responsible practitioner",
      "mapping": [ {
        "map": "FiveWs.source",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole", "http://hl7.org/fhir/StructureDefinition/Organization" ]
      } ],
      "max": "1",
      "id": "ClaimResponse.requestProvider",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.requestProvider"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.request",
      "min": 0,
      "definition": "Original request resource reference.",
      "isModifier": false,
      "short": "Id of resource triggering adjudication",
      "mapping": [ {
        "map": "Event.basedOn",
        "identity": "workflow"
      }, {
        "map": "FiveWs.why[x]",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Claim" ]
      } ],
      "max": "1",
      "id": "ClaimResponse.request",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.request"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.outcome",
      "min": 0,
      "definition": "Transaction: error, complete, partial processing.",
      "isModifier": false,
      "short": "queued | complete | error | partial",
      "type": [ {
        "code": "code"
      } ],
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/ValueSet/remittance-outcome",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "RemittanceOutcome"
        } ],
        "description": "The result of the claim processing."
      },
      "max": "1",
      "id": "ClaimResponse.outcome",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.outcome"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.disposition",
      "min": 0,
      "definition": "A description of the status of the adjudication.",
      "isModifier": false,
      "short": "Disposition Message",
      "mapping": [ {
        "map": "Event.note",
        "identity": "workflow"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "id": "ClaimResponse.disposition",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.disposition"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.preAuthRef",
      "requirements": "To provide any pre-determination or prior authorization reference.",
      "min": 0,
      "definition": "A list of references from the Insurer to which these services pertain.",
      "isModifier": false,
      "short": "Pre-Authorization/Determination Reference",
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "id": "ClaimResponse.preAuthRef",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.preAuthRef"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.payeeType",
      "min": 0,
      "definition": "Party to be reimbursed: Subscriber, provider, other.",
      "isModifier": false,
      "short": "Party to be paid any benefits payable",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/payeetype",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "PayeeType"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean": true
        } ],
        "description": "A code for the party to be reimbursed."
      },
      "max": "1",
      "id": "ClaimResponse.payeeType",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.payeeType"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "ClaimResponse.item",
      "min": 0,
      "definition": "The first-tier service adjudications for submitted services.",
      "isModifier": false,
      "short": "Line items",
      "type": [ {
        "code": "BackboneElement"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString": "Item"
      } ],
      "max": "*",
      "id": "ClaimResponse.item",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse.item"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.item.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "ClaimResponse.item.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.item.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "ClaimResponse.item.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.item.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
      "isModifier": true,
      "short": "Extensions that cannot be ignored if unrecognized",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "ClaimResponse.item.modifierExtension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
      "isSummary": true
    }, {
      "path": "ClaimResponse.item.itemSequence",
      "min": 1,
      "definition": "A service line number.",
      "isModifier": false,
      "short": "Service instance",
      "type": [ {
        "code": "positiveInt"
      } ],
      "max": "1",
      "id": "ClaimResponse.item.itemSequence",
      "base": {
        "max": "1",
        "min": 1,
        "path": "ClaimResponse.item.itemSequence"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.item.noteNumber",
      "min": 0,
      "definition": "A list of note references to the notes provided below.",
      "isModifier": false,
      "short": "List of note numbers which apply",
      "type": [ {
        "code": "positiveInt"
      } ],
      "max": "*",
      "id": "ClaimResponse.item.noteNumber",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse.item.noteNumber"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "ClaimResponse.item.adjudication",
      "min": 0,
      "definition": "The adjudication results.",
      "isModifier": false,
      "short": "Adjudication details",
      "type": [ {
        "code": "BackboneElement"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString": "Adjudication"
      } ],
      "max": "*",
      "id": "ClaimResponse.item.adjudication",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse.item.adjudication"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.item.adjudication.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "ClaimResponse.item.adjudication.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.item.adjudication.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "ClaimResponse.item.adjudication.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.item.adjudication.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
      "isModifier": true,
      "short": "Extensions that cannot be ignored if unrecognized",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "ClaimResponse.item.adjudication.modifierExtension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
      "isSummary": true
    }, {
      "path": "ClaimResponse.item.adjudication.category",
      "min": 1,
      "definition": "Code indicating: Co-Pay, deductible, eligible, benefit, tax, etc.",
      "isModifier": false,
      "short": "Adjudication category such as co-pay, eligible, benefit, etc.",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/adjudication",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Adjudication"
        } ],
        "description": "The adjudication codes."
      },
      "max": "1",
      "id": "ClaimResponse.item.adjudication.category",
      "base": {
        "max": "1",
        "min": 1,
        "path": "ClaimResponse.item.adjudication.category"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.item.adjudication.reason",
      "min": 0,
      "definition": "Adjudication reason such as limit reached.",
      "isModifier": false,
      "short": "Explanation of Adjudication outcome",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/adjudication-reason",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "AdjudicationReason"
        } ],
        "description": "The adjudication reason codes."
      },
      "max": "1",
      "id": "ClaimResponse.item.adjudication.reason",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.item.adjudication.reason"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.item.adjudication.amount",
      "min": 0,
      "definition": "Monetary amount associated with the code.",
      "isModifier": false,
      "short": "Monetary amount",
      "type": [ {
        "code": "Money"
      } ],
      "max": "1",
      "id": "ClaimResponse.item.adjudication.amount",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.item.adjudication.amount"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.item.adjudication.value",
      "min": 0,
      "definition": "A non-monetary value for example a percentage. Mutually exclusive to the amount element above.",
      "isModifier": false,
      "short": "Non-monetary value",
      "type": [ {
        "code": "decimal"
      } ],
      "max": "1",
      "id": "ClaimResponse.item.adjudication.value",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.item.adjudication.value"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "ClaimResponse.item.detail",
      "min": 0,
      "definition": "The second-tier service adjudications for submitted services.",
      "isModifier": false,
      "short": "Detail line items",
      "type": [ {
        "code": "BackboneElement"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString": "ItemDetail"
      } ],
      "max": "*",
      "id": "ClaimResponse.item.detail",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse.item.detail"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.item.detail.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "ClaimResponse.item.detail.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.item.detail.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "ClaimResponse.item.detail.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.item.detail.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
      "isModifier": true,
      "short": "Extensions that cannot be ignored if unrecognized",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "ClaimResponse.item.detail.modifierExtension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
      "isSummary": true
    }, {
      "path": "ClaimResponse.item.detail.detailSequence",
      "min": 1,
      "definition": "A service line number.",
      "isModifier": false,
      "short": "Service instance",
      "type": [ {
        "code": "positiveInt"
      } ],
      "max": "1",
      "id": "ClaimResponse.item.detail.detailSequence",
      "base": {
        "max": "1",
        "min": 1,
        "path": "ClaimResponse.item.detail.detailSequence"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.item.detail.noteNumber",
      "min": 0,
      "definition": "A list of note references to the notes provided below.",
      "isModifier": false,
      "short": "List of note numbers which apply",
      "type": [ {
        "code": "positiveInt"
      } ],
      "max": "*",
      "id": "ClaimResponse.item.detail.noteNumber",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse.item.detail.noteNumber"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.item.detail.adjudication",
      "min": 0,
      "definition": "The adjudication results.",
      "isModifier": false,
      "short": "Detail level adjudication details",
      "contentReference": "#ClaimResponse.item.adjudication",
      "max": "*",
      "id": "ClaimResponse.item.detail.adjudication",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse.item.detail.adjudication"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "ClaimResponse.item.detail.subDetail",
      "min": 0,
      "definition": "The third-tier service adjudications for submitted services.",
      "isModifier": false,
      "short": "Subdetail line items",
      "type": [ {
        "code": "BackboneElement"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString": "SubDetail"
      } ],
      "max": "*",
      "id": "ClaimResponse.item.detail.subDetail",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse.item.detail.subDetail"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.item.detail.subDetail.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "ClaimResponse.item.detail.subDetail.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.item.detail.subDetail.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "ClaimResponse.item.detail.subDetail.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.item.detail.subDetail.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
      "isModifier": true,
      "short": "Extensions that cannot be ignored if unrecognized",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "ClaimResponse.item.detail.subDetail.modifierExtension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
      "isSummary": true
    }, {
      "path": "ClaimResponse.item.detail.subDetail.subDetailSequence",
      "min": 1,
      "definition": "A service line number.",
      "isModifier": false,
      "short": "Service instance",
      "type": [ {
        "code": "positiveInt"
      } ],
      "max": "1",
      "id": "ClaimResponse.item.detail.subDetail.subDetailSequence",
      "base": {
        "max": "1",
        "min": 1,
        "path": "ClaimResponse.item.detail.subDetail.subDetailSequence"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.item.detail.subDetail.noteNumber",
      "min": 0,
      "definition": "A list of note references to the notes provided below.",
      "isModifier": false,
      "short": "List of note numbers which apply",
      "type": [ {
        "code": "positiveInt"
      } ],
      "max": "*",
      "id": "ClaimResponse.item.detail.subDetail.noteNumber",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse.item.detail.subDetail.noteNumber"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.item.detail.subDetail.adjudication",
      "min": 0,
      "definition": "The adjudication results.",
      "isModifier": false,
      "short": "Subdetail level adjudication details",
      "contentReference": "#ClaimResponse.item.adjudication",
      "max": "*",
      "id": "ClaimResponse.item.detail.subDetail.adjudication",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse.item.detail.subDetail.adjudication"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "ClaimResponse.addItem",
      "min": 0,
      "definition": "The first-tier service adjudications for payor added services.",
      "isModifier": false,
      "short": "Insurer added line items",
      "type": [ {
        "code": "BackboneElement"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString": "AddedItem"
      } ],
      "max": "*",
      "id": "ClaimResponse.addItem",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse.addItem"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "ClaimResponse.addItem.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "ClaimResponse.addItem.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
      "isModifier": true,
      "short": "Extensions that cannot be ignored if unrecognized",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "ClaimResponse.addItem.modifierExtension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
      "isSummary": true
    }, {
      "path": "ClaimResponse.addItem.itemSequence",
      "min": 0,
      "definition": "List of input service items which this service line is intended to replace.",
      "isModifier": false,
      "short": "Service instances",
      "type": [ {
        "code": "positiveInt"
      } ],
      "max": "*",
      "id": "ClaimResponse.addItem.itemSequence",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse.addItem.itemSequence"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.detailSequence",
      "min": 0,
      "definition": "The sequence number of the addition within the line item submitted which contains the error. This value is omitted when the error is not related to an Addition.",
      "isModifier": false,
      "short": "Detail sequence number",
      "type": [ {
        "code": "positiveInt"
      } ],
      "max": "*",
      "id": "ClaimResponse.addItem.detailSequence",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse.addItem.detailSequence"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.subdetailSequence",
      "min": 0,
      "definition": "The sequence number of the addition within the line item submitted which contains the error. This value is omitted when the error is not related to an Addition.",
      "isModifier": false,
      "short": "Subdetail sequence number",
      "type": [ {
        "code": "positiveInt"
      } ],
      "max": "*",
      "id": "ClaimResponse.addItem.subdetailSequence",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse.addItem.subdetailSequence"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.provider",
      "min": 0,
      "definition": "The providers who are authorized for the services rendered to the patient.",
      "isModifier": false,
      "short": "Authorized providers",
      "mapping": [ {
        "map": "FiveWs.source",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole", "http://hl7.org/fhir/StructureDefinition/Organization" ]
      } ],
      "max": "*",
      "id": "ClaimResponse.addItem.provider",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse.addItem.provider"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.billcode",
      "min": 0,
      "definition": "A code to indicate the Professional Service or Product supplied.",
      "isModifier": false,
      "short": "Group, Service or Product",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/service-uscls",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ServiceProduct"
        } ],
        "description": "Allowable service and product codes."
      },
      "max": "1",
      "id": "ClaimResponse.addItem.billcode",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.addItem.billcode"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.modifier",
      "requirements": "May impact on adjudication.",
      "min": 0,
      "definition": "Item typification or modifiers codes, e.g. for Oral whether the treatment is cosmetic or associated with TMJ, or for medical whether the treatment was outside the clinic or out of office hours.",
      "isModifier": false,
      "short": "Service/Product billing modifiers",
      "mapping": [ {
        "map": "24.C, 24.D mods",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/claim-modifiers",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Modifiers"
        } ],
        "description": "Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen."
      },
      "max": "*",
      "id": "ClaimResponse.addItem.modifier",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse.addItem.modifier"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.programCode",
      "min": 0,
      "definition": "For programs which require reason codes for the inclusion or covering of this billed item under the program or sub-program.",
      "isModifier": false,
      "short": "Program specific reason for item inclusion",
      "mapping": [ {
        "map": "24.H",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/ex-program-code",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ProgramCode"
        } ],
        "description": "Program specific reason codes."
      },
      "max": "*",
      "id": "ClaimResponse.addItem.programCode",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse.addItem.programCode"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.serviced[x]",
      "min": 0,
      "definition": "The date or dates when the service or product was supplied, performed or completed.",
      "isModifier": false,
      "short": "Date or dates of Service",
      "mapping": [ {
        "map": "FiveWs.done[x]",
        "identity": "w5"
      }, {
        "map": "24.A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "date"
      }, {
        "code": "Period"
      } ],
      "max": "1",
      "id": "ClaimResponse.addItem.serviced[x]",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.addItem.serviced[x]"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.location[x]",
      "min": 0,
      "definition": "Where the service was provided.",
      "isModifier": false,
      "short": "Place of service",
      "mapping": [ {
        "map": "FiveWs.where[x]",
        "identity": "w5"
      }, {
        "map": "24.B",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      }, {
        "code": "Address"
      }, {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Location" ]
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/service-place",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ServicePlace"
        } ],
        "description": "Place of service: pharmacy,school, prison, etc."
      },
      "max": "1",
      "id": "ClaimResponse.addItem.location[x]",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.addItem.location[x]"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.quantity",
      "min": 0,
      "definition": "The number of repetitions of a service or product.",
      "isModifier": false,
      "short": "Count of Products or Services",
      "mapping": [ {
        "map": "24.G",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Quantity",
        "profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" ]
      } ],
      "max": "1",
      "id": "ClaimResponse.addItem.quantity",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.addItem.quantity"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.unitPrice",
      "min": 0,
      "definition": "If the item is a node then this is the fee for the product or service, otherwise this is the total of the fees for the children of the group.",
      "isModifier": false,
      "short": "Fee, charge or cost per point",
      "type": [ {
        "code": "Money"
      } ],
      "max": "1",
      "id": "ClaimResponse.addItem.unitPrice",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.addItem.unitPrice"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.factor",
      "requirements": "If a fee is present the associated product/service code must be present.",
      "min": 0,
      "definition": "A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.",
      "isModifier": false,
      "short": "Price scaling factor",
      "type": [ {
        "code": "decimal"
      } ],
      "max": "1",
      "id": "ClaimResponse.addItem.factor",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.addItem.factor"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.net",
      "requirements": "If a fee is present the associated product/service code must be present.",
      "min": 0,
      "definition": "The quantity times the unit price for an additional service or product or charge. For example, the formula: unit Quantity * unit Price (Cost per Point) * factor Number  * points = net Amount. Quantity, factor and points are assumed to be 1 if not supplied.",
      "isModifier": false,
      "short": "Total item cost",
      "mapping": [ {
        "map": "24.F",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Money"
      } ],
      "max": "1",
      "id": "ClaimResponse.addItem.net",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.addItem.net"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.bodySite",
      "min": 0,
      "definition": "Physical service site on the patient (limb, tooth, etc.).",
      "isModifier": false,
      "short": "Service Location",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/tooth",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "OralSites"
        } ],
        "description": "The code for the teeth, quadrant, sextant and arch."
      },
      "max": "1",
      "id": "ClaimResponse.addItem.bodySite",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.addItem.bodySite"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.subSite",
      "min": 0,
      "definition": "A region or surface of the site, e.g. limb region or tooth surface(s).",
      "isModifier": false,
      "short": "Service Sub-location",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/surface",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Surface"
        } ],
        "description": "The code for the tooth surface and surface combinations."
      },
      "max": "*",
      "id": "ClaimResponse.addItem.subSite",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse.addItem.subSite"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.noteNumber",
      "min": 0,
      "definition": "A list of note references to the notes provided below.",
      "isModifier": false,
      "short": "List of note numbers which apply",
      "type": [ {
        "code": "positiveInt"
      } ],
      "max": "*",
      "id": "ClaimResponse.addItem.noteNumber",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse.addItem.noteNumber"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.adjudication",
      "min": 0,
      "definition": "The adjudication results.",
      "isModifier": false,
      "short": "Added items adjudication",
      "contentReference": "#ClaimResponse.item.adjudication",
      "max": "*",
      "id": "ClaimResponse.addItem.adjudication",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse.addItem.adjudication"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "ClaimResponse.addItem.detail",
      "min": 0,
      "definition": "The second-tier service adjudications for payor added services.",
      "isModifier": false,
      "short": "Insurer added line items",
      "type": [ {
        "code": "BackboneElement"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString": "AddedItemDetail"
      } ],
      "max": "*",
      "id": "ClaimResponse.addItem.detail",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse.addItem.detail"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.detail.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "ClaimResponse.addItem.detail.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.detail.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "ClaimResponse.addItem.detail.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.detail.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
      "isModifier": true,
      "short": "Extensions that cannot be ignored if unrecognized",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "ClaimResponse.addItem.detail.modifierExtension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
      "isSummary": true
    }, {
      "path": "ClaimResponse.addItem.detail.billcode",
      "min": 0,
      "definition": "A code to indicate the Professional Service or Product supplied.",
      "isModifier": false,
      "short": "Group, Service or Product",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/service-uscls",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ServiceProduct"
        } ],
        "description": "Allowable service and product codes."
      },
      "max": "1",
      "id": "ClaimResponse.addItem.detail.billcode",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.addItem.detail.billcode"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.detail.modifier",
      "requirements": "May impact on adjudication.",
      "min": 0,
      "definition": "Item typification or modifiers codes, e.g. for Oral whether the treatment is cosmetic or associated with TMJ, or for medical whether the treatment was outside the clinic or out of office hours.",
      "isModifier": false,
      "short": "Service/Product billing modifiers",
      "mapping": [ {
        "map": "24.C, 24.D mods",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/claim-modifiers",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Modifiers"
        } ],
        "description": "Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen."
      },
      "max": "*",
      "id": "ClaimResponse.addItem.detail.modifier",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse.addItem.detail.modifier"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.detail.quantity",
      "min": 0,
      "definition": "The number of repetitions of a service or product.",
      "isModifier": false,
      "short": "Count of Products or Services",
      "mapping": [ {
        "map": "24.G",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Quantity",
        "profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" ]
      } ],
      "max": "1",
      "id": "ClaimResponse.addItem.detail.quantity",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.addItem.detail.quantity"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.detail.unitPrice",
      "min": 0,
      "definition": "If the item is a node then this is the fee for the product or service, otherwise this is the total of the fees for the children of the group.",
      "isModifier": false,
      "short": "Fee, charge or cost per point",
      "type": [ {
        "code": "Money"
      } ],
      "max": "1",
      "id": "ClaimResponse.addItem.detail.unitPrice",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.addItem.detail.unitPrice"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.detail.factor",
      "requirements": "If a fee is present the associated product/service code must be present.",
      "min": 0,
      "definition": "A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.",
      "isModifier": false,
      "short": "Price scaling factor",
      "type": [ {
        "code": "decimal"
      } ],
      "max": "1",
      "id": "ClaimResponse.addItem.detail.factor",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.addItem.detail.factor"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.detail.net",
      "requirements": "If a fee is present the associated product/service code must be present.",
      "min": 0,
      "definition": "The quantity times the unit price for an additional service or product or charge. For example, the formula: unit Quantity * unit Price (Cost per Point) * factor Number  * points = net Amount. Quantity, factor and points are assumed to be 1 if not supplied.",
      "isModifier": false,
      "short": "Total item cost",
      "mapping": [ {
        "map": "24.F",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Money"
      } ],
      "max": "1",
      "id": "ClaimResponse.addItem.detail.net",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.addItem.detail.net"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.detail.noteNumber",
      "min": 0,
      "definition": "A list of note references to the notes provided below.",
      "isModifier": false,
      "short": "List of note numbers which apply",
      "type": [ {
        "code": "positiveInt"
      } ],
      "max": "*",
      "id": "ClaimResponse.addItem.detail.noteNumber",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse.addItem.detail.noteNumber"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.detail.adjudication",
      "min": 0,
      "definition": "The adjudication results.",
      "isModifier": false,
      "short": "Added items detail adjudication",
      "contentReference": "#ClaimResponse.item.adjudication",
      "max": "*",
      "id": "ClaimResponse.addItem.detail.adjudication",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse.addItem.detail.adjudication"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "ClaimResponse.addItem.detail.subDetail",
      "min": 0,
      "definition": "The third-tier service adjudications for payor added services.",
      "isModifier": false,
      "short": "Insurer added line items",
      "type": [ {
        "code": "BackboneElement"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString": "AddedItemSubDetail"
      } ],
      "max": "*",
      "id": "ClaimResponse.addItem.detail.subDetail",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse.addItem.detail.subDetail"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.detail.subDetail.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "ClaimResponse.addItem.detail.subDetail.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.detail.subDetail.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "ClaimResponse.addItem.detail.subDetail.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.detail.subDetail.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
      "isModifier": true,
      "short": "Extensions that cannot be ignored if unrecognized",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "ClaimResponse.addItem.detail.subDetail.modifierExtension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
      "isSummary": true
    }, {
      "path": "ClaimResponse.addItem.detail.subDetail.billcode",
      "min": 0,
      "definition": "A code to indicate the Professional Service or Product supplied.",
      "isModifier": false,
      "short": "Group, Service or Product",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/service-uscls",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ServiceProduct"
        } ],
        "description": "Allowable service and product codes."
      },
      "max": "1",
      "id": "ClaimResponse.addItem.detail.subDetail.billcode",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.addItem.detail.subDetail.billcode"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.detail.subDetail.modifier",
      "requirements": "May impact on adjudication.",
      "min": 0,
      "definition": "Item typification or modifiers codes, e.g. for Oral whether the treatment is cosmetic or associated with TMJ, or for medical whether the treatment was outside the clinic or out of office hours.",
      "isModifier": false,
      "short": "Service/Product billing modifiers",
      "mapping": [ {
        "map": "24.C, 24.D mods",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/claim-modifiers",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Modifiers"
        } ],
        "description": "Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen."
      },
      "max": "*",
      "id": "ClaimResponse.addItem.detail.subDetail.modifier",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse.addItem.detail.subDetail.modifier"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.detail.subDetail.quantity",
      "min": 0,
      "definition": "The number of repetitions of a service or product.",
      "isModifier": false,
      "short": "Count of Products or Services",
      "mapping": [ {
        "map": "24.G",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Quantity",
        "profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" ]
      } ],
      "max": "1",
      "id": "ClaimResponse.addItem.detail.subDetail.quantity",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.addItem.detail.subDetail.quantity"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.detail.subDetail.unitPrice",
      "min": 0,
      "definition": "If the item is a node then this is the fee for the product or service, otherwise this is the total of the fees for the children of the group.",
      "isModifier": false,
      "short": "Fee, charge or cost per point",
      "type": [ {
        "code": "Money"
      } ],
      "max": "1",
      "id": "ClaimResponse.addItem.detail.subDetail.unitPrice",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.addItem.detail.subDetail.unitPrice"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.detail.subDetail.factor",
      "requirements": "If a fee is present the associated product/service code must be present.",
      "min": 0,
      "definition": "A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.",
      "isModifier": false,
      "short": "Price scaling factor",
      "type": [ {
        "code": "decimal"
      } ],
      "max": "1",
      "id": "ClaimResponse.addItem.detail.subDetail.factor",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.addItem.detail.subDetail.factor"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.detail.subDetail.net",
      "requirements": "If a fee is present the associated product/service code must be present.",
      "min": 0,
      "definition": "The quantity times the unit price for an additional service or product or charge. For example, the formula: unit Quantity * unit Price (Cost per Point) * factor Number  * points = net Amount. Quantity, factor and points are assumed to be 1 if not supplied.",
      "isModifier": false,
      "short": "Total item cost",
      "mapping": [ {
        "map": "24.F",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Money"
      } ],
      "max": "1",
      "id": "ClaimResponse.addItem.detail.subDetail.net",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.addItem.detail.subDetail.net"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.detail.subDetail.noteNumber",
      "min": 0,
      "definition": "A list of note references to the notes provided below.",
      "isModifier": false,
      "short": "List of note numbers which apply",
      "type": [ {
        "code": "positiveInt"
      } ],
      "max": "*",
      "id": "ClaimResponse.addItem.detail.subDetail.noteNumber",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse.addItem.detail.subDetail.noteNumber"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.addItem.detail.subDetail.adjudication",
      "min": 0,
      "definition": "The adjudication results.",
      "isModifier": false,
      "short": "Added items detail adjudication",
      "contentReference": "#ClaimResponse.item.adjudication",
      "max": "*",
      "id": "ClaimResponse.addItem.detail.subDetail.adjudication",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse.addItem.detail.subDetail.adjudication"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "ClaimResponse.error",
      "min": 0,
      "definition": "Mutually exclusive with Services Provided (Item).",
      "isModifier": false,
      "short": "Processing errors",
      "type": [ {
        "code": "BackboneElement"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString": "Error"
      } ],
      "max": "*",
      "id": "ClaimResponse.error",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse.error"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.error.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "ClaimResponse.error.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.error.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "ClaimResponse.error.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.error.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
      "isModifier": true,
      "short": "Extensions that cannot be ignored if unrecognized",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "ClaimResponse.error.modifierExtension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
      "isSummary": true
    }, {
      "path": "ClaimResponse.error.itemSequence",
      "min": 0,
      "definition": "The sequence number of the line item submitted which contains the error. This value is omitted when the error is elsewhere.",
      "isModifier": false,
      "short": "Item sequence number",
      "type": [ {
        "code": "positiveInt"
      } ],
      "max": "1",
      "id": "ClaimResponse.error.itemSequence",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.error.itemSequence"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.error.detailSequence",
      "min": 0,
      "definition": "The sequence number of the addition within the line item submitted which contains the error. This value is omitted when the error is not related to an Addition.",
      "isModifier": false,
      "short": "Detail sequence number",
      "type": [ {
        "code": "positiveInt"
      } ],
      "max": "1",
      "id": "ClaimResponse.error.detailSequence",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.error.detailSequence"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.error.subDetailSequence",
      "min": 0,
      "definition": "The sequence number of the addition within the line item submitted which contains the error. This value is omitted when the error is not related to an Addition.",
      "isModifier": false,
      "short": "Subdetail sequence number",
      "type": [ {
        "code": "positiveInt"
      } ],
      "max": "1",
      "id": "ClaimResponse.error.subDetailSequence",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.error.subDetailSequence"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.error.code",
      "min": 1,
      "definition": "An error code, from a specified code system, which details why the claim could not be adjudicated.",
      "isModifier": false,
      "short": "Error code detailing processing issues",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/adjudication-error",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "AdjudicationError"
        } ],
        "description": "The adjudication error codes."
      },
      "max": "1",
      "id": "ClaimResponse.error.code",
      "base": {
        "max": "1",
        "min": 1,
        "path": "ClaimResponse.error.code"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "ClaimResponse.total",
      "min": 0,
      "definition": "Totals for amounts submitted, co-pays, benefits payable etc.",
      "isModifier": false,
      "short": "Adjudication totals",
      "type": [ {
        "code": "BackboneElement"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString": "Total"
      } ],
      "max": "*",
      "id": "ClaimResponse.total",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse.total"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.total.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "ClaimResponse.total.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.total.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "ClaimResponse.total.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.total.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
      "isModifier": true,
      "short": "Extensions that cannot be ignored if unrecognized",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "ClaimResponse.total.modifierExtension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
      "isSummary": true
    }, {
      "path": "ClaimResponse.total.category",
      "min": 1,
      "definition": "Code indicating: Submitted, Co-Pay, deductible, eligible, benefit, tax, etc.",
      "isModifier": false,
      "short": "Adjudication category such as submitted, co-pay, eligible, benefit, etc.",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/adjudication",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Adjudication"
        } ],
        "description": "The adjudication codes."
      },
      "max": "1",
      "id": "ClaimResponse.total.category",
      "base": {
        "max": "1",
        "min": 1,
        "path": "ClaimResponse.total.category"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.total.amount",
      "min": 1,
      "definition": "Monitory amount associated with the code.",
      "isModifier": false,
      "short": "Monetary amount",
      "type": [ {
        "code": "Money"
      } ],
      "max": "1",
      "id": "ClaimResponse.total.amount",
      "base": {
        "max": "1",
        "min": 1,
        "path": "ClaimResponse.total.amount"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "ClaimResponse.payment",
      "min": 0,
      "definition": "Payment details for the claim if the claim has been paid.",
      "isModifier": false,
      "short": "Payment Details",
      "type": [ {
        "code": "BackboneElement"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString": "Payment"
      } ],
      "max": "1",
      "id": "ClaimResponse.payment",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.payment"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.payment.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "ClaimResponse.payment.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.payment.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "ClaimResponse.payment.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.payment.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
      "isModifier": true,
      "short": "Extensions that cannot be ignored if unrecognized",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "ClaimResponse.payment.modifierExtension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
      "isSummary": true
    }, {
      "path": "ClaimResponse.payment.type",
      "min": 0,
      "definition": "Whether this represents partial or complete payment of the claim.",
      "isModifier": false,
      "short": "Partial or Complete",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/ex-paymenttype",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "PaymentType"
        } ],
        "description": "The type (partial, complete) of the payment."
      },
      "max": "1",
      "id": "ClaimResponse.payment.type",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.payment.type"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.payment.adjustment",
      "min": 0,
      "definition": "Adjustment to the payment of this transaction which is not related to adjudication of this transaction.",
      "isModifier": false,
      "short": "Payment adjustment for non-Claim issues",
      "type": [ {
        "code": "Money"
      } ],
      "max": "1",
      "id": "ClaimResponse.payment.adjustment",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.payment.adjustment"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.payment.adjustmentReason",
      "min": 0,
      "definition": "Reason for the payment adjustment.",
      "isModifier": false,
      "short": "Explanation for the non-claim adjustment",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/payment-adjustment-reason",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "PaymentAdjustmentReason"
        } ],
        "description": "Payment Adjustment reason codes."
      },
      "max": "1",
      "id": "ClaimResponse.payment.adjustmentReason",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.payment.adjustmentReason"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.payment.date",
      "min": 0,
      "definition": "Estimated payment data.",
      "isModifier": false,
      "short": "Expected data of Payment",
      "type": [ {
        "code": "date"
      } ],
      "max": "1",
      "id": "ClaimResponse.payment.date",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.payment.date"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.payment.amount",
      "min": 0,
      "definition": "Payable less any payment adjustment.",
      "isModifier": false,
      "short": "Payable amount after adjustment",
      "type": [ {
        "code": "Money"
      } ],
      "max": "1",
      "id": "ClaimResponse.payment.amount",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.payment.amount"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.payment.identifier",
      "min": 0,
      "definition": "Payment identifier.",
      "isModifier": false,
      "short": "Identifier of the payment instrument",
      "type": [ {
        "code": "Identifier"
      } ],
      "max": "1",
      "id": "ClaimResponse.payment.identifier",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.payment.identifier"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.reserved",
      "min": 0,
      "definition": "Status of funds reservation (For provider, for Patient, None).",
      "isModifier": false,
      "short": "Funds reserved status",
      "type": [ {
        "code": "Coding"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/fundsreserve",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "FundsReserve"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean": true
        } ],
        "description": "For whom funds are to be reserved: (Patient, Provider, None)."
      },
      "max": "1",
      "id": "ClaimResponse.reserved",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.reserved"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.form",
      "min": 0,
      "definition": "The form to be used for printing the content.",
      "isModifier": false,
      "short": "Printed Form Identifier",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/forms",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Forms"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean": true
        } ],
        "description": "The forms codes."
      },
      "max": "1",
      "id": "ClaimResponse.form",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.form"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "ClaimResponse.processNote",
      "min": 0,
      "definition": "Note text.",
      "isModifier": false,
      "short": "Processing notes",
      "type": [ {
        "code": "BackboneElement"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString": "Note"
      } ],
      "max": "*",
      "id": "ClaimResponse.processNote",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse.processNote"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.processNote.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "ClaimResponse.processNote.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.processNote.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "ClaimResponse.processNote.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.processNote.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
      "isModifier": true,
      "short": "Extensions that cannot be ignored if unrecognized",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "ClaimResponse.processNote.modifierExtension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
      "isSummary": true
    }, {
      "path": "ClaimResponse.processNote.number",
      "min": 0,
      "definition": "An integer associated with each note which may be referred to from each service line item.",
      "isModifier": false,
      "short": "Sequence Number for this note",
      "type": [ {
        "code": "positiveInt"
      } ],
      "max": "1",
      "id": "ClaimResponse.processNote.number",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.processNote.number"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.processNote.type",
      "min": 0,
      "definition": "The note purpose: Print/Display.",
      "isModifier": false,
      "short": "display | print | printoper",
      "type": [ {
        "code": "code"
      } ],
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/ValueSet/note-type",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "NoteType"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean": true
        } ],
        "description": "The presentation types of notes."
      },
      "max": "1",
      "id": "ClaimResponse.processNote.type",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.processNote.type"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.processNote.text",
      "min": 0,
      "definition": "The note text.",
      "isModifier": false,
      "short": "Note explanatory text",
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "id": "ClaimResponse.processNote.text",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.processNote.text"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.processNote.language",
      "min": 0,
      "definition": "The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. \"en\" for English, or \"en-US\" for American English versus \"en-EN\" for England English.",
      "isModifier": false,
      "short": "Language if different from the resource",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "preferred",
        "valueSet": "http://hl7.org/fhir/ValueSet/languages",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
          "valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Language"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean": true
        } ],
        "description": "A human language."
      },
      "max": "1",
      "id": "ClaimResponse.processNote.language",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.processNote.language"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.communicationRequest",
      "min": 0,
      "definition": "Request for additional supporting or authorizing information, such as: documents, images or resources.",
      "isModifier": false,
      "short": "Request for additional information",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/CommunicationRequest" ]
      } ],
      "max": "*",
      "id": "ClaimResponse.communicationRequest",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse.communicationRequest"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "ClaimResponse.insurance",
      "requirements": "Health care programs and insurers are significant payors of health service costs.",
      "min": 0,
      "definition": "Financial instrument by which payment information for health care.",
      "isModifier": false,
      "short": "Insurance or medical plan",
      "mapping": [ {
        "map": "Coverage",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString": "Insurance"
      } ],
      "max": "*",
      "id": "ClaimResponse.insurance",
      "base": {
        "max": "*",
        "min": 0,
        "path": "ClaimResponse.insurance"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.insurance.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "ClaimResponse.insurance.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.insurance.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "ClaimResponse.insurance.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.insurance.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
      "isModifier": true,
      "short": "Extensions that cannot be ignored if unrecognized",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "ClaimResponse.insurance.modifierExtension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
      "isSummary": true
    }, {
      "path": "ClaimResponse.insurance.sequence",
      "requirements": "To maintain order of the coverages.",
      "min": 1,
      "definition": "A service line item.",
      "isModifier": false,
      "short": "Service instance identifier",
      "type": [ {
        "code": "positiveInt"
      } ],
      "max": "1",
      "id": "ClaimResponse.insurance.sequence",
      "base": {
        "max": "1",
        "min": 1,
        "path": "ClaimResponse.insurance.sequence"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.insurance.focal",
      "requirements": "To identify which coverage is being adjudicated.",
      "min": 1,
      "definition": "The instance number of the Coverage which is the focus for adjudication. The Coverage against which the claim is to be adjudicated.",
      "isModifier": false,
      "short": "Is the focal Coverage",
      "type": [ {
        "code": "boolean"
      } ],
      "max": "1",
      "id": "ClaimResponse.insurance.focal",
      "base": {
        "max": "1",
        "min": 1,
        "path": "ClaimResponse.insurance.focal"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.insurance.coverage",
      "requirements": "Need to identify the issuer to target for processing and for coordination of benefit processing.",
      "min": 1,
      "definition": "Reference to the program or plan identification, underwriter or payor.",
      "isModifier": false,
      "short": "Insurance information",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Coverage" ]
      } ],
      "max": "1",
      "id": "ClaimResponse.insurance.coverage",
      "base": {
        "max": "1",
        "min": 1,
        "path": "ClaimResponse.insurance.coverage"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.insurance.businessArrangement",
      "min": 0,
      "definition": "The contract number of a business agreement which describes the terms and conditions.",
      "isModifier": false,
      "short": "Business agreement",
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "id": "ClaimResponse.insurance.businessArrangement",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.insurance.businessArrangement"
      },
      "isSummary": false
    }, {
      "path": "ClaimResponse.insurance.claimResponse",
      "requirements": "Used by downstream payers to determine what balance remains and the net payable.",
      "min": 0,
      "definition": "The Coverages adjudication details.",
      "isModifier": false,
      "short": "Adjudication results",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/ClaimResponse" ]
      } ],
      "max": "1",
      "id": "ClaimResponse.insurance.claimResponse",
      "base": {
        "max": "1",
        "min": 0,
        "path": "ClaimResponse.insurance.claimResponse"
      },
      "isSummary": false
    } ]
  },
  "status": "draft",
  "id": "35527f0e-59a6-40f4-829a-cb996b0ac111",
  "kind": "resource",
  "url": "http://hl7.org/fhir/StructureDefinition/ClaimResponse",
  "version": null,
  "differential": {
    "element": [ {
      "id": "ClaimResponse",
      "max": "*",
      "min": 0,
      "path": "ClaimResponse",
      "alias": [ "Remittance Advice" ],
      "short": "ClaimResponse resource",
      "mapping": [ {
        "map": "Event",
        "identity": "workflow"
      } ],
      "definition": "This resource provides the adjudication details from the processing of a Claim resource."
    }, {
      "id": "ClaimResponse.identifier",
      "max": "*",
      "min": 0,
      "path": "ClaimResponse.identifier",
      "type": [ {
        "code": "Identifier"
      } ],
      "short": "Response  number",
      "mapping": [ {
        "map": "Event.identifier",
        "identity": "workflow"
      }, {
        "map": "FiveWs.identifier",
        "identity": "w5"
      } ],
      "definition": "The response business identifier."
    }, {
      "path": "ClaimResponse.status",
      "min": 0,
      "definition": "The status of the resource instance.",
      "isModifier": true,
      "short": "active | cancelled | draft | entered-in-error",
      "mapping": [ {
        "map": "Event.status",
        "identity": "workflow"
      }, {
        "map": "FiveWs.status",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/ValueSet/fm-status",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ClaimResponseStatus"
        } ],
        "description": "A code specifying the state of the resource instance."
      },
      "max": "1",
      "id": "ClaimResponse.status",
      "comment": "This element is labeled as a modifier because the status contains the code cancelled and entered-in-error that mark the response as not currently valid.",
      "isModifierReason": "This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid",
      "isSummary": true
    }, {
      "path": "ClaimResponse.type",
      "min": 0,
      "definition": "The category of claim, e.g, oral, pharmacy, vision, institutional, professional.",
      "short": "Type or discipline",
      "mapping": [ {
        "map": "FiveWs.class",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "extensible",
        "valueSet": "http://hl7.org/fhir/ValueSet/claim-type",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ClaimType"
        } ],
        "description": "The type or discipline-style of the claim."
      },
      "max": "1",
      "id": "ClaimResponse.type",
      "comment": "Affects which fields and value sets are used."
    }, {
      "path": "ClaimResponse.subType",
      "min": 0,
      "definition": "A finer grained suite of claim subtype codes which may convey Inpatient vs Outpatient and/or a specialty service. In the US the CMS Bill Type.",
      "short": "Finer grained claim type information",
      "mapping": [ {
        "map": "FiveWs.class",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/claim-subtype",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ClaimSubType"
        } ],
        "description": "A more granulat claim typecode."
      },
      "max": "1",
      "id": "ClaimResponse.subType",
      "comment": "This may contain the local bill type codes such as the US UB-04 bill type code."
    }, {
      "path": "ClaimResponse.use",
      "min": 0,
      "definition": "A claim, a list of completed goods and services; a preauthorization, a list or proposed goods and services; or a predetermination, a set of goods and services being considered, for which insurer adjudication is sought.",
      "short": "claim | preauthorization | predetermination",
      "mapping": [ {
        "map": "FiveWs.class",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/ValueSet/claim-use",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Use"
        } ],
        "description": "Claim, preauthorization, predetermination."
      },
      "max": "1",
      "id": "ClaimResponse.use",
      "isSummary": true
    }, {
      "id": "ClaimResponse.patient",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.patient",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Patient" ]
      } ],
      "short": "The subject of the Products and Services",
      "mapping": [ {
        "map": "FiveWs.subject[x]",
        "identity": "w5"
      }, {
        "map": "FiveWs.subject",
        "identity": "w5"
      } ],
      "definition": "Patient Resource."
    }, {
      "id": "ClaimResponse.created",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.created",
      "type": [ {
        "code": "dateTime"
      } ],
      "short": "Creation date",
      "mapping": [ {
        "map": "Event.occurrence[x]",
        "identity": "workflow"
      }, {
        "map": "FiveWs.recorded",
        "identity": "w5"
      } ],
      "definition": "The date when this resource was created."
    }, {
      "id": "ClaimResponse.insurer",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.insurer",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Organization" ]
      } ],
      "short": "Insurance issuing organization",
      "mapping": [ {
        "map": "Event.performer",
        "identity": "workflow"
      } ],
      "definition": "The Insurer who produced this adjudicated response."
    }, {
      "id": "ClaimResponse.requestProvider",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.requestProvider",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole", "http://hl7.org/fhir/StructureDefinition/Organization" ]
      } ],
      "short": "Responsible practitioner",
      "mapping": [ {
        "map": "FiveWs.source",
        "identity": "w5"
      } ],
      "definition": "The practitioner who is responsible for the services rendered to the patient."
    }, {
      "id": "ClaimResponse.request",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.request",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Claim" ]
      } ],
      "short": "Id of resource triggering adjudication",
      "mapping": [ {
        "map": "Event.basedOn",
        "identity": "workflow"
      }, {
        "map": "FiveWs.why[x]",
        "identity": "w5"
      } ],
      "definition": "Original request resource reference."
    }, {
      "id": "ClaimResponse.outcome",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.outcome",
      "type": [ {
        "code": "code"
      } ],
      "short": "queued | complete | error | partial",
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/ValueSet/remittance-outcome",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "RemittanceOutcome"
        } ],
        "description": "The result of the claim processing."
      },
      "definition": "Transaction: error, complete, partial processing."
    }, {
      "id": "ClaimResponse.disposition",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.disposition",
      "type": [ {
        "code": "string"
      } ],
      "short": "Disposition Message",
      "mapping": [ {
        "map": "Event.note",
        "identity": "workflow"
      } ],
      "definition": "A description of the status of the adjudication."
    }, {
      "id": "ClaimResponse.preAuthRef",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.preAuthRef",
      "type": [ {
        "code": "string"
      } ],
      "short": "Pre-Authorization/Determination Reference",
      "definition": "A list of references from the Insurer to which these services pertain.",
      "requirements": "To provide any pre-determination or prior authorization reference."
    }, {
      "id": "ClaimResponse.payeeType",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.payeeType",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "short": "Party to be paid any benefits payable",
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/payeetype",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "PayeeType"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean": true
        } ],
        "description": "A code for the party to be reimbursed."
      },
      "definition": "Party to be reimbursed: Subscriber, provider, other."
    }, {
      "id": "ClaimResponse.item",
      "max": "*",
      "min": 0,
      "path": "ClaimResponse.item",
      "type": [ {
        "code": "BackboneElement"
      } ],
      "short": "Line items",
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString": "Item"
      } ],
      "definition": "The first-tier service adjudications for submitted services."
    }, {
      "id": "ClaimResponse.item.itemSequence",
      "max": "1",
      "min": 1,
      "path": "ClaimResponse.item.itemSequence",
      "type": [ {
        "code": "positiveInt"
      } ],
      "short": "Service instance",
      "definition": "A service line number."
    }, {
      "id": "ClaimResponse.item.noteNumber",
      "max": "*",
      "min": 0,
      "path": "ClaimResponse.item.noteNumber",
      "type": [ {
        "code": "positiveInt"
      } ],
      "short": "List of note numbers which apply",
      "definition": "A list of note references to the notes provided below."
    }, {
      "id": "ClaimResponse.item.adjudication",
      "max": "*",
      "min": 0,
      "path": "ClaimResponse.item.adjudication",
      "type": [ {
        "code": "BackboneElement"
      } ],
      "short": "Adjudication details",
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString": "Adjudication"
      } ],
      "definition": "The adjudication results."
    }, {
      "id": "ClaimResponse.item.adjudication.category",
      "max": "1",
      "min": 1,
      "path": "ClaimResponse.item.adjudication.category",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "short": "Adjudication category such as co-pay, eligible, benefit, etc.",
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/adjudication",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Adjudication"
        } ],
        "description": "The adjudication codes."
      },
      "definition": "Code indicating: Co-Pay, deductible, eligible, benefit, tax, etc."
    }, {
      "id": "ClaimResponse.item.adjudication.reason",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.item.adjudication.reason",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "short": "Explanation of Adjudication outcome",
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/adjudication-reason",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "AdjudicationReason"
        } ],
        "description": "The adjudication reason codes."
      },
      "definition": "Adjudication reason such as limit reached."
    }, {
      "id": "ClaimResponse.item.adjudication.amount",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.item.adjudication.amount",
      "type": [ {
        "code": "Money"
      } ],
      "short": "Monetary amount",
      "definition": "Monetary amount associated with the code."
    }, {
      "id": "ClaimResponse.item.adjudication.value",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.item.adjudication.value",
      "type": [ {
        "code": "decimal"
      } ],
      "short": "Non-monetary value",
      "definition": "A non-monetary value for example a percentage. Mutually exclusive to the amount element above."
    }, {
      "id": "ClaimResponse.item.detail",
      "max": "*",
      "min": 0,
      "path": "ClaimResponse.item.detail",
      "type": [ {
        "code": "BackboneElement"
      } ],
      "short": "Detail line items",
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString": "ItemDetail"
      } ],
      "definition": "The second-tier service adjudications for submitted services."
    }, {
      "id": "ClaimResponse.item.detail.detailSequence",
      "max": "1",
      "min": 1,
      "path": "ClaimResponse.item.detail.detailSequence",
      "type": [ {
        "code": "positiveInt"
      } ],
      "short": "Service instance",
      "definition": "A service line number."
    }, {
      "id": "ClaimResponse.item.detail.noteNumber",
      "max": "*",
      "min": 0,
      "path": "ClaimResponse.item.detail.noteNumber",
      "type": [ {
        "code": "positiveInt"
      } ],
      "short": "List of note numbers which apply",
      "definition": "A list of note references to the notes provided below."
    }, {
      "id": "ClaimResponse.item.detail.adjudication",
      "max": "*",
      "min": 0,
      "path": "ClaimResponse.item.detail.adjudication",
      "short": "Detail level adjudication details",
      "definition": "The adjudication results.",
      "contentReference": "#ClaimResponse.item.adjudication"
    }, {
      "id": "ClaimResponse.item.detail.subDetail",
      "max": "*",
      "min": 0,
      "path": "ClaimResponse.item.detail.subDetail",
      "type": [ {
        "code": "BackboneElement"
      } ],
      "short": "Subdetail line items",
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString": "SubDetail"
      } ],
      "definition": "The third-tier service adjudications for submitted services."
    }, {
      "id": "ClaimResponse.item.detail.subDetail.subDetailSequence",
      "max": "1",
      "min": 1,
      "path": "ClaimResponse.item.detail.subDetail.subDetailSequence",
      "type": [ {
        "code": "positiveInt"
      } ],
      "short": "Service instance",
      "definition": "A service line number."
    }, {
      "id": "ClaimResponse.item.detail.subDetail.noteNumber",
      "max": "*",
      "min": 0,
      "path": "ClaimResponse.item.detail.subDetail.noteNumber",
      "type": [ {
        "code": "positiveInt"
      } ],
      "short": "List of note numbers which apply",
      "definition": "A list of note references to the notes provided below."
    }, {
      "id": "ClaimResponse.item.detail.subDetail.adjudication",
      "max": "*",
      "min": 0,
      "path": "ClaimResponse.item.detail.subDetail.adjudication",
      "short": "Subdetail level adjudication details",
      "definition": "The adjudication results.",
      "contentReference": "#ClaimResponse.item.adjudication"
    }, {
      "id": "ClaimResponse.addItem",
      "max": "*",
      "min": 0,
      "path": "ClaimResponse.addItem",
      "type": [ {
        "code": "BackboneElement"
      } ],
      "short": "Insurer added line items",
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString": "AddedItem"
      } ],
      "definition": "The first-tier service adjudications for payor added services."
    }, {
      "id": "ClaimResponse.addItem.itemSequence",
      "max": "*",
      "min": 0,
      "path": "ClaimResponse.addItem.itemSequence",
      "type": [ {
        "code": "positiveInt"
      } ],
      "short": "Service instances",
      "definition": "List of input service items which this service line is intended to replace."
    }, {
      "id": "ClaimResponse.addItem.detailSequence",
      "max": "*",
      "min": 0,
      "path": "ClaimResponse.addItem.detailSequence",
      "type": [ {
        "code": "positiveInt"
      } ],
      "short": "Detail sequence number",
      "definition": "The sequence number of the addition within the line item submitted which contains the error. This value is omitted when the error is not related to an Addition."
    }, {
      "id": "ClaimResponse.addItem.subdetailSequence",
      "max": "*",
      "min": 0,
      "path": "ClaimResponse.addItem.subdetailSequence",
      "type": [ {
        "code": "positiveInt"
      } ],
      "short": "Subdetail sequence number",
      "definition": "The sequence number of the addition within the line item submitted which contains the error. This value is omitted when the error is not related to an Addition."
    }, {
      "id": "ClaimResponse.addItem.provider",
      "max": "*",
      "min": 0,
      "path": "ClaimResponse.addItem.provider",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole", "http://hl7.org/fhir/StructureDefinition/Organization" ]
      } ],
      "short": "Authorized providers",
      "mapping": [ {
        "map": "FiveWs.source",
        "identity": "w5"
      } ],
      "definition": "The providers who are authorized for the services rendered to the patient."
    }, {
      "id": "ClaimResponse.addItem.billcode",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.addItem.billcode",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "short": "Group, Service or Product",
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/service-uscls",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ServiceProduct"
        } ],
        "description": "Allowable service and product codes."
      },
      "definition": "A code to indicate the Professional Service or Product supplied."
    }, {
      "path": "ClaimResponse.addItem.modifier",
      "requirements": "May impact on adjudication.",
      "min": 0,
      "definition": "Item typification or modifiers codes, e.g. for Oral whether the treatment is cosmetic or associated with TMJ, or for medical whether the treatment was outside the clinic or out of office hours.",
      "short": "Service/Product billing modifiers",
      "mapping": [ {
        "map": "24.C, 24.D mods",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/claim-modifiers",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Modifiers"
        } ],
        "description": "Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen."
      },
      "max": "*",
      "id": "ClaimResponse.addItem.modifier"
    }, {
      "path": "ClaimResponse.addItem.programCode",
      "min": 0,
      "definition": "For programs which require reason codes for the inclusion or covering of this billed item under the program or sub-program.",
      "short": "Program specific reason for item inclusion",
      "mapping": [ {
        "map": "24.H",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/ex-program-code",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ProgramCode"
        } ],
        "description": "Program specific reason codes."
      },
      "max": "*",
      "id": "ClaimResponse.addItem.programCode"
    }, {
      "id": "ClaimResponse.addItem.serviced[x]",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.addItem.serviced[x]",
      "type": [ {
        "code": "date"
      }, {
        "code": "Period"
      } ],
      "short": "Date or dates of Service",
      "mapping": [ {
        "map": "FiveWs.done[x]",
        "identity": "w5"
      }, {
        "map": "24.A",
        "identity": "rim"
      } ],
      "definition": "The date or dates when the service or product was supplied, performed or completed."
    }, {
      "path": "ClaimResponse.addItem.location[x]",
      "min": 0,
      "definition": "Where the service was provided.",
      "short": "Place of service",
      "mapping": [ {
        "map": "FiveWs.where[x]",
        "identity": "w5"
      }, {
        "map": "24.B",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      }, {
        "code": "Address"
      }, {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Location" ]
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/service-place",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ServicePlace"
        } ],
        "description": "Place of service: pharmacy,school, prison, etc."
      },
      "max": "1",
      "id": "ClaimResponse.addItem.location[x]"
    }, {
      "id": "ClaimResponse.addItem.quantity",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.addItem.quantity",
      "type": [ {
        "code": "Quantity",
        "profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" ]
      } ],
      "short": "Count of Products or Services",
      "mapping": [ {
        "map": "24.G",
        "identity": "rim"
      } ],
      "definition": "The number of repetitions of a service or product."
    }, {
      "id": "ClaimResponse.addItem.unitPrice",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.addItem.unitPrice",
      "type": [ {
        "code": "Money"
      } ],
      "short": "Fee, charge or cost per point",
      "definition": "If the item is a node then this is the fee for the product or service, otherwise this is the total of the fees for the children of the group."
    }, {
      "id": "ClaimResponse.addItem.factor",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.addItem.factor",
      "type": [ {
        "code": "decimal"
      } ],
      "short": "Price scaling factor",
      "definition": "A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.",
      "requirements": "If a fee is present the associated product/service code must be present."
    }, {
      "path": "ClaimResponse.addItem.net",
      "requirements": "If a fee is present the associated product/service code must be present.",
      "min": 0,
      "definition": "The quantity times the unit price for an additional service or product or charge. For example, the formula: unit Quantity * unit Price (Cost per Point) * factor Number  * points = net Amount. Quantity, factor and points are assumed to be 1 if not supplied.",
      "short": "Total item cost",
      "mapping": [ {
        "map": "24.F",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Money"
      } ],
      "max": "1",
      "id": "ClaimResponse.addItem.net"
    }, {
      "id": "ClaimResponse.addItem.bodySite",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.addItem.bodySite",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "short": "Service Location",
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/tooth",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "OralSites"
        } ],
        "description": "The code for the teeth, quadrant, sextant and arch."
      },
      "definition": "Physical service site on the patient (limb, tooth, etc.)."
    }, {
      "id": "ClaimResponse.addItem.subSite",
      "max": "*",
      "min": 0,
      "path": "ClaimResponse.addItem.subSite",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "short": "Service Sub-location",
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/surface",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Surface"
        } ],
        "description": "The code for the tooth surface and surface combinations."
      },
      "definition": "A region or surface of the site, e.g. limb region or tooth surface(s)."
    }, {
      "id": "ClaimResponse.addItem.noteNumber",
      "max": "*",
      "min": 0,
      "path": "ClaimResponse.addItem.noteNumber",
      "type": [ {
        "code": "positiveInt"
      } ],
      "short": "List of note numbers which apply",
      "definition": "A list of note references to the notes provided below."
    }, {
      "id": "ClaimResponse.addItem.adjudication",
      "max": "*",
      "min": 0,
      "path": "ClaimResponse.addItem.adjudication",
      "short": "Added items adjudication",
      "definition": "The adjudication results.",
      "contentReference": "#ClaimResponse.item.adjudication"
    }, {
      "id": "ClaimResponse.addItem.detail",
      "max": "*",
      "min": 0,
      "path": "ClaimResponse.addItem.detail",
      "type": [ {
        "code": "BackboneElement"
      } ],
      "short": "Insurer added line items",
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString": "AddedItemDetail"
      } ],
      "definition": "The second-tier service adjudications for payor added services."
    }, {
      "id": "ClaimResponse.addItem.detail.billcode",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.addItem.detail.billcode",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "short": "Group, Service or Product",
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/service-uscls",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ServiceProduct"
        } ],
        "description": "Allowable service and product codes."
      },
      "definition": "A code to indicate the Professional Service or Product supplied."
    }, {
      "path": "ClaimResponse.addItem.detail.modifier",
      "requirements": "May impact on adjudication.",
      "min": 0,
      "definition": "Item typification or modifiers codes, e.g. for Oral whether the treatment is cosmetic or associated with TMJ, or for medical whether the treatment was outside the clinic or out of office hours.",
      "short": "Service/Product billing modifiers",
      "mapping": [ {
        "map": "24.C, 24.D mods",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/claim-modifiers",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Modifiers"
        } ],
        "description": "Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen."
      },
      "max": "*",
      "id": "ClaimResponse.addItem.detail.modifier"
    }, {
      "id": "ClaimResponse.addItem.detail.quantity",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.addItem.detail.quantity",
      "type": [ {
        "code": "Quantity",
        "profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" ]
      } ],
      "short": "Count of Products or Services",
      "mapping": [ {
        "map": "24.G",
        "identity": "rim"
      } ],
      "definition": "The number of repetitions of a service or product."
    }, {
      "id": "ClaimResponse.addItem.detail.unitPrice",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.addItem.detail.unitPrice",
      "type": [ {
        "code": "Money"
      } ],
      "short": "Fee, charge or cost per point",
      "definition": "If the item is a node then this is the fee for the product or service, otherwise this is the total of the fees for the children of the group."
    }, {
      "id": "ClaimResponse.addItem.detail.factor",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.addItem.detail.factor",
      "type": [ {
        "code": "decimal"
      } ],
      "short": "Price scaling factor",
      "definition": "A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.",
      "requirements": "If a fee is present the associated product/service code must be present."
    }, {
      "path": "ClaimResponse.addItem.detail.net",
      "requirements": "If a fee is present the associated product/service code must be present.",
      "min": 0,
      "definition": "The quantity times the unit price for an additional service or product or charge. For example, the formula: unit Quantity * unit Price (Cost per Point) * factor Number  * points = net Amount. Quantity, factor and points are assumed to be 1 if not supplied.",
      "short": "Total item cost",
      "mapping": [ {
        "map": "24.F",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Money"
      } ],
      "max": "1",
      "id": "ClaimResponse.addItem.detail.net"
    }, {
      "id": "ClaimResponse.addItem.detail.noteNumber",
      "max": "*",
      "min": 0,
      "path": "ClaimResponse.addItem.detail.noteNumber",
      "type": [ {
        "code": "positiveInt"
      } ],
      "short": "List of note numbers which apply",
      "definition": "A list of note references to the notes provided below."
    }, {
      "id": "ClaimResponse.addItem.detail.adjudication",
      "max": "*",
      "min": 0,
      "path": "ClaimResponse.addItem.detail.adjudication",
      "short": "Added items detail adjudication",
      "definition": "The adjudication results.",
      "contentReference": "#ClaimResponse.item.adjudication"
    }, {
      "id": "ClaimResponse.addItem.detail.subDetail",
      "max": "*",
      "min": 0,
      "path": "ClaimResponse.addItem.detail.subDetail",
      "type": [ {
        "code": "BackboneElement"
      } ],
      "short": "Insurer added line items",
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString": "AddedItemSubDetail"
      } ],
      "definition": "The third-tier service adjudications for payor added services."
    }, {
      "id": "ClaimResponse.addItem.detail.subDetail.billcode",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.addItem.detail.subDetail.billcode",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "short": "Group, Service or Product",
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/service-uscls",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ServiceProduct"
        } ],
        "description": "Allowable service and product codes."
      },
      "definition": "A code to indicate the Professional Service or Product supplied."
    }, {
      "path": "ClaimResponse.addItem.detail.subDetail.modifier",
      "requirements": "May impact on adjudication.",
      "min": 0,
      "definition": "Item typification or modifiers codes, e.g. for Oral whether the treatment is cosmetic or associated with TMJ, or for medical whether the treatment was outside the clinic or out of office hours.",
      "short": "Service/Product billing modifiers",
      "mapping": [ {
        "map": "24.C, 24.D mods",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/claim-modifiers",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Modifiers"
        } ],
        "description": "Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen."
      },
      "max": "*",
      "id": "ClaimResponse.addItem.detail.subDetail.modifier"
    }, {
      "id": "ClaimResponse.addItem.detail.subDetail.quantity",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.addItem.detail.subDetail.quantity",
      "type": [ {
        "code": "Quantity",
        "profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" ]
      } ],
      "short": "Count of Products or Services",
      "mapping": [ {
        "map": "24.G",
        "identity": "rim"
      } ],
      "definition": "The number of repetitions of a service or product."
    }, {
      "id": "ClaimResponse.addItem.detail.subDetail.unitPrice",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.addItem.detail.subDetail.unitPrice",
      "type": [ {
        "code": "Money"
      } ],
      "short": "Fee, charge or cost per point",
      "definition": "If the item is a node then this is the fee for the product or service, otherwise this is the total of the fees for the children of the group."
    }, {
      "id": "ClaimResponse.addItem.detail.subDetail.factor",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.addItem.detail.subDetail.factor",
      "type": [ {
        "code": "decimal"
      } ],
      "short": "Price scaling factor",
      "definition": "A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.",
      "requirements": "If a fee is present the associated product/service code must be present."
    }, {
      "path": "ClaimResponse.addItem.detail.subDetail.net",
      "requirements": "If a fee is present the associated product/service code must be present.",
      "min": 0,
      "definition": "The quantity times the unit price for an additional service or product or charge. For example, the formula: unit Quantity * unit Price (Cost per Point) * factor Number  * points = net Amount. Quantity, factor and points are assumed to be 1 if not supplied.",
      "short": "Total item cost",
      "mapping": [ {
        "map": "24.F",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Money"
      } ],
      "max": "1",
      "id": "ClaimResponse.addItem.detail.subDetail.net"
    }, {
      "id": "ClaimResponse.addItem.detail.subDetail.noteNumber",
      "max": "*",
      "min": 0,
      "path": "ClaimResponse.addItem.detail.subDetail.noteNumber",
      "type": [ {
        "code": "positiveInt"
      } ],
      "short": "List of note numbers which apply",
      "definition": "A list of note references to the notes provided below."
    }, {
      "id": "ClaimResponse.addItem.detail.subDetail.adjudication",
      "max": "*",
      "min": 0,
      "path": "ClaimResponse.addItem.detail.subDetail.adjudication",
      "short": "Added items detail adjudication",
      "definition": "The adjudication results.",
      "contentReference": "#ClaimResponse.item.adjudication"
    }, {
      "id": "ClaimResponse.error",
      "max": "*",
      "min": 0,
      "path": "ClaimResponse.error",
      "type": [ {
        "code": "BackboneElement"
      } ],
      "short": "Processing errors",
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString": "Error"
      } ],
      "definition": "Mutually exclusive with Services Provided (Item)."
    }, {
      "id": "ClaimResponse.error.itemSequence",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.error.itemSequence",
      "type": [ {
        "code": "positiveInt"
      } ],
      "short": "Item sequence number",
      "definition": "The sequence number of the line item submitted which contains the error. This value is omitted when the error is elsewhere."
    }, {
      "id": "ClaimResponse.error.detailSequence",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.error.detailSequence",
      "type": [ {
        "code": "positiveInt"
      } ],
      "short": "Detail sequence number",
      "definition": "The sequence number of the addition within the line item submitted which contains the error. This value is omitted when the error is not related to an Addition."
    }, {
      "id": "ClaimResponse.error.subDetailSequence",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.error.subDetailSequence",
      "type": [ {
        "code": "positiveInt"
      } ],
      "short": "Subdetail sequence number",
      "definition": "The sequence number of the addition within the line item submitted which contains the error. This value is omitted when the error is not related to an Addition."
    }, {
      "id": "ClaimResponse.error.code",
      "max": "1",
      "min": 1,
      "path": "ClaimResponse.error.code",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "short": "Error code detailing processing issues",
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/adjudication-error",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "AdjudicationError"
        } ],
        "description": "The adjudication error codes."
      },
      "definition": "An error code, from a specified code system, which details why the claim could not be adjudicated."
    }, {
      "id": "ClaimResponse.total",
      "max": "*",
      "min": 0,
      "path": "ClaimResponse.total",
      "type": [ {
        "code": "BackboneElement"
      } ],
      "short": "Adjudication totals",
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString": "Total"
      } ],
      "definition": "Totals for amounts submitted, co-pays, benefits payable etc."
    }, {
      "id": "ClaimResponse.total.category",
      "max": "1",
      "min": 1,
      "path": "ClaimResponse.total.category",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "short": "Adjudication category such as submitted, co-pay, eligible, benefit, etc.",
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/adjudication",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Adjudication"
        } ],
        "description": "The adjudication codes."
      },
      "definition": "Code indicating: Submitted, Co-Pay, deductible, eligible, benefit, tax, etc."
    }, {
      "id": "ClaimResponse.total.amount",
      "max": "1",
      "min": 1,
      "path": "ClaimResponse.total.amount",
      "type": [ {
        "code": "Money"
      } ],
      "short": "Monetary amount",
      "definition": "Monitory amount associated with the code."
    }, {
      "id": "ClaimResponse.payment",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.payment",
      "type": [ {
        "code": "BackboneElement"
      } ],
      "short": "Payment Details",
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString": "Payment"
      } ],
      "definition": "Payment details for the claim if the claim has been paid."
    }, {
      "id": "ClaimResponse.payment.type",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.payment.type",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "short": "Partial or Complete",
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/ex-paymenttype",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "PaymentType"
        } ],
        "description": "The type (partial, complete) of the payment."
      },
      "definition": "Whether this represents partial or complete payment of the claim."
    }, {
      "id": "ClaimResponse.payment.adjustment",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.payment.adjustment",
      "type": [ {
        "code": "Money"
      } ],
      "short": "Payment adjustment for non-Claim issues",
      "definition": "Adjustment to the payment of this transaction which is not related to adjudication of this transaction."
    }, {
      "id": "ClaimResponse.payment.adjustmentReason",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.payment.adjustmentReason",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "short": "Explanation for the non-claim adjustment",
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/payment-adjustment-reason",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "PaymentAdjustmentReason"
        } ],
        "description": "Payment Adjustment reason codes."
      },
      "definition": "Reason for the payment adjustment."
    }, {
      "id": "ClaimResponse.payment.date",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.payment.date",
      "type": [ {
        "code": "date"
      } ],
      "short": "Expected data of Payment",
      "definition": "Estimated payment data."
    }, {
      "id": "ClaimResponse.payment.amount",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.payment.amount",
      "type": [ {
        "code": "Money"
      } ],
      "short": "Payable amount after adjustment",
      "definition": "Payable less any payment adjustment."
    }, {
      "id": "ClaimResponse.payment.identifier",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.payment.identifier",
      "type": [ {
        "code": "Identifier"
      } ],
      "short": "Identifier of the payment instrument",
      "definition": "Payment identifier."
    }, {
      "id": "ClaimResponse.reserved",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.reserved",
      "type": [ {
        "code": "Coding"
      } ],
      "short": "Funds reserved status",
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/fundsreserve",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "FundsReserve"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean": true
        } ],
        "description": "For whom funds are to be reserved: (Patient, Provider, None)."
      },
      "definition": "Status of funds reservation (For provider, for Patient, None)."
    }, {
      "id": "ClaimResponse.form",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.form",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "short": "Printed Form Identifier",
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/forms",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Forms"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean": true
        } ],
        "description": "The forms codes."
      },
      "definition": "The form to be used for printing the content."
    }, {
      "id": "ClaimResponse.processNote",
      "max": "*",
      "min": 0,
      "path": "ClaimResponse.processNote",
      "type": [ {
        "code": "BackboneElement"
      } ],
      "short": "Processing notes",
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString": "Note"
      } ],
      "definition": "Note text."
    }, {
      "id": "ClaimResponse.processNote.number",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.processNote.number",
      "type": [ {
        "code": "positiveInt"
      } ],
      "short": "Sequence Number for this note",
      "definition": "An integer associated with each note which may be referred to from each service line item."
    }, {
      "id": "ClaimResponse.processNote.type",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.processNote.type",
      "type": [ {
        "code": "code"
      } ],
      "short": "display | print | printoper",
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/ValueSet/note-type",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "NoteType"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean": true
        } ],
        "description": "The presentation types of notes."
      },
      "definition": "The note purpose: Print/Display."
    }, {
      "id": "ClaimResponse.processNote.text",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.processNote.text",
      "type": [ {
        "code": "string"
      } ],
      "short": "Note explanatory text",
      "definition": "The note text."
    }, {
      "id": "ClaimResponse.processNote.language",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.processNote.language",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "short": "Language if different from the resource",
      "binding": {
        "strength": "preferred",
        "valueSet": "http://hl7.org/fhir/ValueSet/languages",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
          "valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Language"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean": true
        } ],
        "description": "A human language."
      },
      "definition": "The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. \"en\" for English, or \"en-US\" for American English versus \"en-EN\" for England English."
    }, {
      "id": "ClaimResponse.communicationRequest",
      "max": "*",
      "min": 0,
      "path": "ClaimResponse.communicationRequest",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/CommunicationRequest" ]
      } ],
      "short": "Request for additional information",
      "definition": "Request for additional supporting or authorizing information, such as: documents, images or resources."
    }, {
      "path": "ClaimResponse.insurance",
      "requirements": "Health care programs and insurers are significant payors of health service costs.",
      "min": 0,
      "definition": "Financial instrument by which payment information for health care.",
      "short": "Insurance or medical plan",
      "mapping": [ {
        "map": "Coverage",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString": "Insurance"
      } ],
      "max": "*",
      "id": "ClaimResponse.insurance"
    }, {
      "id": "ClaimResponse.insurance.sequence",
      "max": "1",
      "min": 1,
      "path": "ClaimResponse.insurance.sequence",
      "type": [ {
        "code": "positiveInt"
      } ],
      "short": "Service instance identifier",
      "definition": "A service line item.",
      "requirements": "To maintain order of the coverages."
    }, {
      "id": "ClaimResponse.insurance.focal",
      "max": "1",
      "min": 1,
      "path": "ClaimResponse.insurance.focal",
      "type": [ {
        "code": "boolean"
      } ],
      "short": "Is the focal Coverage",
      "definition": "The instance number of the Coverage which is the focus for adjudication. The Coverage against which the claim is to be adjudicated.",
      "requirements": "To identify which coverage is being adjudicated."
    }, {
      "id": "ClaimResponse.insurance.coverage",
      "max": "1",
      "min": 1,
      "path": "ClaimResponse.insurance.coverage",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Coverage" ]
      } ],
      "short": "Insurance information",
      "definition": "Reference to the program or plan identification, underwriter or payor.",
      "requirements": "Need to identify the issuer to target for processing and for coordination of benefit processing."
    }, {
      "id": "ClaimResponse.insurance.businessArrangement",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.insurance.businessArrangement",
      "type": [ {
        "code": "string"
      } ],
      "short": "Business agreement",
      "definition": "The contract number of a business agreement which describes the terms and conditions."
    }, {
      "id": "ClaimResponse.insurance.claimResponse",
      "max": "1",
      "min": 0,
      "path": "ClaimResponse.insurance.claimResponse",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/ClaimResponse" ]
      } ],
      "short": "Adjudication results",
      "definition": "The Coverages adjudication details.",
      "requirements": "Used by downstream payers to determine what balance remains and the net payable."
    } ]
  },
  "contact": [ {
    "telecom": [ {
      "value": "http://hl7.org/fhir",
      "system": "url"
    } ]
  }, {
    "telecom": [ {
      "value": "http://www.hl7.org/Special/committees/fm/index.cfm",
      "system": "url"
    } ]
  } ],
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/DomainResource"
}