{
  "description": "Describes the various amount fields used when payers receive and adjudicate a claim.  It includes the values\\ndefined in http://terminology.hl7.org/CodeSystem/adjudication, as well as those defined in the C4BB Adjudication CodeSystem.",
  "compose": {
    "include": [ {
      "system": "http://terminology.hl7.org/CodeSystem/adjudication",
      "concept": [ {
        "code": "submitted"
      }, {
        "code": "copay"
      }, {
        "code": "eligible"
      }, {
        "code": "deductible"
      }, {
        "code": "benefit"
      } ]
    }, {
      "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication",
      "concept": [ {
        "code": "coinsurance",
        "display": "Coinsurance"
      }, {
        "code": "noncovered",
        "display": "Noncovered"
      }, {
        "code": "priorpayerpaid",
        "display": "Prior payer paid"
      }, {
        "code": "paidbypatient",
        "display": "Paid by patient"
      }, {
        "code": "paidtopatient",
        "display": "Paid to patient"
      }, {
        "code": "paidtoprovider",
        "display": "Paid to provider"
      }, {
        "code": "memberliability",
        "display": "Member liability"
      }, {
        "code": "discount",
        "display": "Discount"
      }, {
        "code": "drugcost",
        "display": "Drug cost"
      } ]
    } ]
  },
  "_filename": "ValueSet-PDexAdjudication.json",
  "package_name": "hl7.fhir.us.davinci-pdex.r4b",
  "date": "2025-06-18T03:12:04+00:00",
  "publisher": "HL7 International / Financial Management",
  "jurisdiction": [ {
    "coding": [ {
      "code": "US",
      "system": "urn:iso:std:iso:3166",
      "display": "United States of America"
    } ]
  } ],
  "name": "PDexAdjudication",
  "copyright": "This Valueset is not copyrighted.",
  "type": null,
  "experimental": "true",
  "resourceType": "ValueSet",
  "title": "PDex Adjudication",
  "package_version": "2.1.0",
  "extension": [ {
    "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
    "valueCode": "fm"
  }, {
    "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
    "valueCode": "informative",
    "_valueCode": {
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
        "valueCanonical": "http://hl7.org/fhir/us/davinci-pdex/ImplementationGuide/hl7.fhir.us.davinci-pdex"
      } ]
    }
  } ],
  "status": "active",
  "id": "716276db-b62f-4f30-a948-0cc510c494d6",
  "kind": null,
  "url": "http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexAdjudication",
  "version": "2.1.0",
  "contact": [ {
    "name": "HL7 International / Financial Management",
    "telecom": [ {
      "value": "http://www.hl7.org/Special/committees/fm",
      "system": "url"
    }, {
      "value": "fm@lists.HL7.org",
      "system": "email"
    } ]
  }, {
    "name": "Mark Scrimshire (mark.scrimshire@onyxhealth.io)",
    "telecom": [ {
      "value": "mailto:mark.scrimshire@onyxhealth.io",
      "system": "email"
    } ]
  }, {
    "name": "HL7 International - Financial Management",
    "telecom": [ {
      "value": "http://www.hl7.org/Special/committees/fm",
      "system": "url"
    } ]
  } ]
}