description: PAS constraints on ClaimResponse resource that are common to both the request and the inquiry.
package_name: hl7.fhir.us.davinci-pas
derivation: constraint
name: PASClaimResponseBase
abstract: true
type: ClaimResponse
elements:
  patient:
    type: Reference
    mustSupport: true
    refers: ['http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-beneficiary|2.2.0']
    index: 8
  requestor:
    type: Reference
    mustSupport: true
    refers: ['http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitionerrole|2.2.0', 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-requestor|2.2.0']
    index: 11
  request:
    type: Reference
    mustSupport: true
    refers: ['http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim|2.2.0']
    index: 12
    extensions:
      DataAbsentReason: {url: 'http://hl7.org/fhir/StructureDefinition/data-absent-reason|5.3.0-ballot-tc1', min: 0, max: 1, type: Extension, mustSupport: true, index: 13}
    elements:
      extension:
        type: Extension
        mustSupport: true
        url: http://hl7.org/fhir/StructureDefinition/data-absent-reason|5.3.0-ballot-tc1
        index: 13
        slicing:
          slices:
            DataAbsentReason:
              match: {}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/StructureDefinition/data-absent-reason|5.3.0-ballot-tc1', index: 13}
              min: 0
              max: 1
  processNote:
    mustSupport: true
    index: 72
    elements:
      number: {mustSupport: true, index: 73}
      text: {mustSupport: true, index: 74}
    required: [number]
  adjudication:
    type: BackboneElement
    mustSupport: true
    index: 68
    extensions:
      reviewAction: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction|2.2.0', min: 0, max: 1, type: Extension, short: The details of the review action that is necessary for the authorization., mustSupport: true, index: 70}
    elements:
      extension:
        index: 69
        slicing:
          rules: open
          ordered: false
          discriminator:
          - {path: url, type: value}
          min: null
          slices:
            reviewAction:
              match: {url: null}
              schema: {type: Extension, short: The details of the review action that is necessary for the authorization., mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction|2.2.0', index: 70}
              min: 0
              max: 1
      category:
        short: This code is fixed to 'submitted' to indicate that the adjudication result is on what was submitted.
        pattern:
          type: CodeableConcept
          value:
            coding:
            - {code: submitted, system: 'http://terminology.hl7.org/CodeSystem/adjudication'}
        index: 71
  use:
    pattern: {type: Code, value: preauthorization}
    index: 7
  item:
    mustSupport: true
    index: 16
    extensions:
      previousAuthorizationNumber: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizationNumber|2.2.0', min: 0, max: 1, type: Extension, short: A string assigned by the UMO to an authorized review outcome associated with this service item., mustSupport: true, index: 21}
      authorizedItemDetail: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedDetail|2.2.0', min: 0, max: 1, type: Extension, short: The details of what has been authorized for this item., mustSupport: true, index: 25}
      requestedServiceDate: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemRequestedServiceDate|2.2.0', min: 0, max: 1, type: Extension, short: The original date/period that was requested by the submitter for this item., mustSupport: true, index: 23}
      preAuthPeriod: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthPeriod|2.2.0', min: 0, max: 1, type: Extension, short: The date/period when this item's preauthorization is valid., mustSupport: true, index: 20}
      dischargeDate: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-dischargeDate', min: 0, max: 1, type: Extension, short: The authorized discharge date for this item., mustSupport: true, index: 27}
      itemTraceNumber: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemTraceNumber|2.2.0', min: 0, type: Extension, short: Uniquely identifies this claim item. (2000F-TRN), mustSupport: true, index: 18}
      administrationReferenceNumber: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-administrationReferenceNumber|2.2.0', min: 0, max: 1, type: Extension, short: A string assigned by the UMO to the original disallowed review outcome associated with this service item., mustSupport: true, index: 22}
      preAuthIssueDate: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthIssueDate|2.2.0', min: 0, max: 1, type: Extension, short: The date when this item's preauthorization was issued., mustSupport: true, index: 19}
      admissionDates: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-admissionDates', min: 0, max: 1, type: Extension, short: The authorized admission dates for this item., mustSupport: true, index: 26}
      authorizedProvider: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedProvider|2.2.0', min: 0, type: Extension, short: The specific provider who has been authorized to provide this item., mustSupport: true, index: 24}
    elements:
      extension:
        index: 17
        slicing:
          rules: open
          ordered: false
          discriminator:
          - {path: url, type: value}
          min: null
          slices:
            previousAuthorizationNumber:
              match: {url: null}
              schema: {type: Extension, short: A string assigned by the UMO to an authorized review outcome associated with this service item., mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizationNumber|2.2.0', index: 21}
              min: 0
              max: 1
            authorizedItemDetail:
              match: {url: null}
              schema: {type: Extension, short: The details of what has been authorized for this item., mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedDetail|2.2.0', index: 25}
              min: 0
              max: 1
            requestedServiceDate:
              match: {url: null}
              schema: {type: Extension, short: The original date/period that was requested by the submitter for this item., mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemRequestedServiceDate|2.2.0', index: 23}
              min: 0
              max: 1
            preAuthPeriod:
              match: {url: null}
              schema: {type: Extension, short: The date/period when this item's preauthorization is valid., mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthPeriod|2.2.0', index: 20}
              min: 0
              max: 1
            dischargeDate:
              match: {url: null}
              schema: {type: Extension, short: The authorized discharge date for this item., mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-dischargeDate', index: 27}
              min: 0
              max: 1
            itemTraceNumber:
              match: {url: null}
              schema: {type: Extension, short: Uniquely identifies this claim item. (2000F-TRN), mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemTraceNumber|2.2.0', index: 18}
              min: 0
            administrationReferenceNumber:
              match: {url: null}
              schema: {type: Extension, short: A string assigned by the UMO to the original disallowed review outcome associated with this service item., mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-administrationReferenceNumber|2.2.0', index: 22}
              min: 0
              max: 1
            preAuthIssueDate:
              match: {url: null}
              schema: {type: Extension, short: The date when this item's preauthorization was issued., mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthIssueDate|2.2.0', index: 19}
              min: 0
              max: 1
            admissionDates:
              match: {url: null}
              schema: {type: Extension, short: The authorized admission dates for this item., mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-admissionDates', index: 26}
              min: 0
              max: 1
            authorizedProvider:
              match: {url: null}
              schema: {type: Extension, short: The specific provider who has been authorized to provide this item., mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedProvider|2.2.0', index: 24}
              min: 0
      itemSequence: {short: 'Sequence numbers SHALL stay the same across all instances of the Prior Authorization, eg the Claim, ClaimResponse, ClaimUpdate, ClaimUpdateResponse', mustSupport: true, index: 28}
      noteNumber: {mustSupport: true, index: 29}
      adjudication:
        mustSupport: true
        index: 30
        extensions:
          reviewAction: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction|2.2.0', min: 0, max: 1, type: Extension, short: The details of the review action that is necessary for the authorization., mustSupport: true, index: 32}
        elements:
          extension:
            index: 31
            slicing:
              rules: open
              ordered: false
              discriminator:
              - {path: url, type: value}
              min: null
              slices:
                reviewAction:
                  match: {url: null}
                  schema: {type: Extension, short: The details of the review action that is necessary for the authorization., mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction|2.2.0', index: 32}
                  min: 0
                  max: 1
          category:
            short: This code is fixed to 'submitted' to indicate that the adjudication result is on what was submitted.
            pattern:
              type: CodeableConcept
              value:
                coding:
                - {code: submitted, system: 'http://terminology.hl7.org/CodeSystem/adjudication'}
            index: 33
  created: {mustSupport: true, index: 9}
  preAuthPeriod: {mustSupport: true, index: 15}
  outcome:
    short: complete | error | partial
    binding: {strength: required, valueSet: 'http://hl7.org/fhir/us/davinci-pas/ValueSet/ClaimResponseOutcome'}
    mustSupport: true
    index: 14
  extension:
    index: 0
    slicing:
      rules: open
      ordered: false
      discriminator:
      - {path: url, type: value}
      min: null
      slices:
        transmissionIdentifiers:
          match: {url: null}
          schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-TransmissionIdentifiers', index: 1}
          min: 0
          max: 1
        claimResponseReviewer:
          match: {url: null}
          schema: {type: Extension, short: The responsible practitioner who reviewed to the request, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-claimResponseReviewer', index: 2}
          min: 0
          max: 1
        authorizedProvider:
          match: {url: null}
          schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedProvider|2.2.0', index: 3}
          min: 0
  insurer:
    type: Reference
    mustSupport: true
    refers: ['http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer|2.2.0']
    index: 10
  status:
    mustSupport: true
    pattern: {type: Code, value: active}
    index: 6
  identifier:
    type: Identifier
    mustSupport: true
    index: 4
    elements:
      system: {short: 'Should use a scheme of ''urn:trnorg:''', index: 5}
  error:
    mustSupport: true
    index: 75
    extensions:
      followupAction: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorFollowupAction|2.2.0', min: 0, max: 1, type: Extension, short: A code representing what action must occur to resolve this error., mustSupport: true, index: 77}
      errorElement: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorElement|2.2.0', min: 0, max: 1, type: Extension, short: 'The specific X12 loop, segment, or element that this error information is about.', mustSupport: true, index: 78}
      errorPath: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorPath|2.2.0', min: 0, max: 1, type: Extension, short: The FHIRPath expression that indicates which FHIR element that this error information is about., mustSupport: true, index: 79}
    elements:
      extension:
        index: 76
        slicing:
          rules: open
          ordered: false
          discriminator:
          - {path: url, type: value}
          min: null
          slices:
            followupAction:
              match: {url: null}
              schema: {type: Extension, short: A code representing what action must occur to resolve this error., mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorFollowupAction|2.2.0', index: 77}
              min: 0
              max: 1
            errorElement:
              match: {url: null}
              schema: {type: Extension, short: 'The specific X12 loop, segment, or element that this error information is about.', mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorElement|2.2.0', index: 78}
              min: 0
              max: 1
            errorPath:
              match: {url: null}
              schema: {type: Extension, short: The FHIRPath expression that indicates which FHIR element that this error information is about., mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorPath|2.2.0', index: 79}
              min: 0
              max: 1
      code:
        binding: {strength: required, valueSet: 'http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278RejectReasonCodes|2.2.0'}
        mustSupport: true
        index: 80
  addItem:
    mustSupport: true
    index: 34
    extensions:
      category: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemCategory', min: 0, max: 1, type: Extension, index: 50}
      previousAuthorizationNumber: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizationNumber|2.2.0', min: 0, max: 1, type: Extension, mustSupport: true, index: 39}
      certificationType: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-certificationType|2.2.0', min: 0, max: 1, type: Extension, mustSupport: true, index: 49}
      revenue: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-revenueCode|2.2.0', min: 0, max: 1, type: Extension, mustSupport: true, index: 45}
      nursingHomeLevelOfCare: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeLevelOfCare|2.2.0', min: 0, max: 1, type: Extension, mustSupport: true, index: 43}
      productOrServiceCodeEnd: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-productOrServiceCodeEnd|2.2.0', min: 0, max: 1, type: Extension, mustSupport: true, index: 44}
      preAuthPeriod: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthPeriod|2.2.0', min: 0, max: 1, type: Extension, mustSupport: true, index: 38}
      epsdtIndicator: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-epsdtIndicator|2.2.0', min: 0, max: 1, type: Extension, mustSupport: true, index: 41}
      requestedService: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-requestedService|2.2.0', min: 0, max: 1, type: Extension, mustSupport: true, index: 47}
      revenueUnitRateLimit: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-revenueUnitRateLimit|2.2.0', min: 0, max: 1, type: Extension, mustSupport: true, index: 46}
      dischargeDate: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-dischargeDate', min: 0, max: 1, type: Extension, mustSupport: true, index: 52}
      itemTraceNumber: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemTraceNumber|2.2.0', min: 0, type: Extension, mustSupport: true, index: 36}
      administrationReferenceNumber: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-administrationReferenceNumber|2.2.0', min: 0, max: 1, type: Extension, mustSupport: true, index: 40}
      requestType: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceItemRequestType|2.2.0', min: 0, max: 1, type: Extension, mustSupport: true, index: 48}
      nursingHomeResidentialStatus: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeResidentialStatus|2.2.0', min: 0, max: 1, type: Extension, mustSupport: true, index: 42}
      preAuthIssueDate: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthIssueDate|2.2.0', min: 0, max: 1, type: Extension, mustSupport: true, index: 37}
      admissionDates: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-admissionDates', min: 0, max: 1, type: Extension, mustSupport: true, index: 51}
    elements:
      modifier:
        binding: {strength: required, valueSet: 'http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278RequestedServiceModifierType|2.2.0'}
        mustSupport: true
        index: 57
      adjudication:
        type: BackboneElement
        mustSupport: true
        index: 64
        extensions:
          reviewAction: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction|2.2.0', min: 0, max: 1, type: Extension, short: The details of the review action that is necessary for the authorization., mustSupport: true, index: 66}
        elements:
          extension:
            index: 65
            slicing:
              rules: open
              ordered: false
              discriminator:
              - {path: url, type: value}
              min: null
              slices:
                reviewAction:
                  match: {url: null}
                  schema: {type: Extension, short: The details of the review action that is necessary for the authorization., mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction|2.2.0', index: 66}
                  min: 0
                  max: 1
          category:
            short: This code is fixed to 'submitted' to indicate that the adjudication result is on what was submitted.
            pattern:
              type: CodeableConcept
              value:
                coding:
                - {code: submitted, system: 'http://terminology.hl7.org/CodeSystem/adjudication'}
            index: 67
      itemSequence: {mustSupport: true, index: 53}
      serviced:
        mustSupport: true
        choices: []
        index: 59
      productOrService:
        binding: {strength: required, valueSet: 'http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278RequestedServiceType|2.2.0'}
        mustSupport: true
        index: 56
      extension:
        index: 35
        slicing:
          rules: open
          ordered: false
          discriminator:
          - {path: url, type: value}
          min: null
          slices:
            category:
              match: {url: null}
              schema: {type: Extension, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemCategory', index: 50}
              min: 0
              max: 1
            previousAuthorizationNumber:
              match: {url: null}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizationNumber|2.2.0', index: 39}
              min: 0
              max: 1
            certificationType:
              match: {url: null}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-certificationType|2.2.0', index: 49}
              min: 0
              max: 1
            revenue:
              match: {url: null}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-revenueCode|2.2.0', index: 45}
              min: 0
              max: 1
            nursingHomeLevelOfCare:
              match: {url: null}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeLevelOfCare|2.2.0', index: 43}
              min: 0
              max: 1
            productOrServiceCodeEnd:
              match: {url: null}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-productOrServiceCodeEnd|2.2.0', index: 44}
              min: 0
              max: 1
            preAuthPeriod:
              match: {url: null}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthPeriod|2.2.0', index: 38}
              min: 0
              max: 1
            epsdtIndicator:
              match: {url: null}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-epsdtIndicator|2.2.0', index: 41}
              min: 0
              max: 1
            requestedService:
              match: {url: null}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-requestedService|2.2.0', index: 47}
              min: 0
              max: 1
            revenueUnitRateLimit:
              match: {url: null}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-revenueUnitRateLimit|2.2.0', index: 46}
              min: 0
              max: 1
            dischargeDate:
              match: {url: null}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-dischargeDate', index: 52}
              min: 0
              max: 1
            itemTraceNumber:
              match: {url: null}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemTraceNumber|2.2.0', index: 36}
              min: 0
            administrationReferenceNumber:
              match: {url: null}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-administrationReferenceNumber|2.2.0', index: 40}
              min: 0
              max: 1
            requestType:
              match: {url: null}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceItemRequestType|2.2.0', index: 48}
              min: 0
              max: 1
            nursingHomeResidentialStatus:
              match: {url: null}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeResidentialStatus|2.2.0', index: 42}
              min: 0
              max: 1
            preAuthIssueDate:
              match: {url: null}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthIssueDate|2.2.0', index: 37}
              min: 0
              max: 1
            admissionDates:
              match: {url: null}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-admissionDates', index: 51}
              min: 0
              max: 1
      quantity: {type: Quantity, mustSupport: true, index: 62}
      location:
        mustSupport: true
        choices: []
        index: 61
      provider:
        type: Reference
        mustSupport: true
        refers: ['http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-organization|2.2.0', 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitioner|2.2.0']
        index: 54
        extensions:
          providerType: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizedProviderType|2.2.0', min: 0, max: 1, type: Extension, mustSupport: true, index: 55}
        elements:
          extension:
            type: Extension
            mustSupport: true
            url: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizedProviderType|2.2.0
            index: 55
            slicing:
              slices:
                providerType:
                  match: {}
                  schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizedProviderType|2.2.0', index: 55}
                  min: 0
                  max: 1
      unitPrice: {mustSupport: true, index: 63}
    required: [itemSequence]
package_version: 2.2.0
extensions:
  transmissionIdentifiers: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-TransmissionIdentifiers', min: 0, max: 1, type: Extension, mustSupport: true, index: 1}
  claimResponseReviewer: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-claimResponseReviewer', min: 0, max: 1, type: Extension, short: The responsible practitioner who reviewed to the request, mustSupport: true, index: 2}
  authorizedProvider: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedProvider|2.2.0', min: 0, type: Extension, mustSupport: true, index: 3}
class: profile
kind: resource
url: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claimresponse-base
base: http://hl7.org/fhir/StructureDefinition/ClaimResponse
version: 2.2.0
required: [request]