{ "description": "This value set includes a smattering of Adjudication Value codes which includes codes to indicate the amounts eligible under the plan, the amount of benefit, copays etc.", "_filename": "CodeSystem-adjudication.json", "package_name": "hl7.fhir.r4.core", "date": null, "meta": { "profile": [ "http://hl7.org/fhir/StructureDefinition/shareablecodesystem" ], "lastUpdated": "2019-11-01T09:29:23.356+11:00" }, "publisher": "FHIR Project team", "content": "complete", "name": "AdjudicationValueCodes", "copyright": "This is an example set.", "type": null, "experimental": "false", "resourceType": "CodeSystem", "title": "Adjudication Value Codes", "package_version": "4.0.1", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg", "valueCode": "fm" }, { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status", "valueCode": "draft" }, { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm", "valueInteger": 1 } ], "status": "draft", "id": "3bee3c7b-19c1-4097-a1c6-2f1d26ecc555", "valueSet": "http://hl7.org/fhir/ValueSet/adjudication", "kind": null, "url": "http://terminology.hl7.org/CodeSystem/adjudication", "identifier": [ { "value": "urn:oid:2.16.840.1.113883.4.642.4.1171", "system": "urn:ietf:rfc:3986" } ], "concept": [ { "code": "submitted", "display": "Submitted Amount", "definition": "The total submitted amount for the claim or group or line item." }, { "code": "copay", "display": "CoPay", "definition": "Patient Co-Payment" }, { "code": "eligible", "display": "Eligible Amount", "definition": "Amount of the change which is considered for adjudication." }, { "code": "deductible", "display": "Deductible", "definition": "Amount deducted from the eligible amount prior to adjudication." }, { "code": "unallocdeduct", "display": "Unallocated Deductible", "definition": "The amount of deductible which could not allocated to other line items." }, { "code": "eligpercent", "display": "Eligible %", "definition": "Eligible Percentage." }, { "code": "tax", "display": "Tax", "definition": "The amount of tax." }, { "code": "benefit", "display": "Benefit Amount", "definition": "Amount payable under the coverage" } ], "caseSensitive": true, "version": "4.0.1", "contact": [ { "telecom": [ { "value": "http://hl7.org/fhir", "system": "url" } ] } ] }