{
  "description": "This value set includes a smattering of Adjudication Value codes which includes codes to indicate the amounts eligible under the plan, the amount of benefit, copays etc.",
  "_filename": "CodeSystem-adjudication.json",
  "package_name": "hl7.terminology.r3",
  "date": "2025-01-22T18:33:38-07:00",
  "meta": {
    "profile": [ "http://hl7.org/fhir/StructureDefinition/shareablecodesystem" ],
    "lastUpdated": "2024-04-24T00:00:00+00:00"
  },
  "publisher": "Health Level Seven International",
  "content": "complete",
  "name": "AdjudicationValueCodes",
  "copyright": "This material derives from the HL7 Terminology (THO). THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license",
  "type": null,
  "experimental": "false",
  "resourceType": "CodeSystem",
  "title": "Adjudication Value Codes",
  "package_version": "6.2.0",
  "extension": [ {
    "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
    "valueCode": "fm"
  }, {
    "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
    "valueInteger": 1
  } ],
  "status": "active",
  "id": "a45d625c-827d-48c8-96f2-a821e1e4ee51",
  "valueSet": "http://terminology.hl7.org/ValueSet/adjudication",
  "kind": null,
  "url": "http://terminology.hl7.org/CodeSystem/adjudication",
  "identifier": {
    "value": "urn:oid:2.16.840.1.113883.4.642.1.1171",
    "system": "urn:ietf:rfc:3986"
  },
  "concept": [ {
    "code": "submitted",
    "display": "Submitted Amount",
    "definition": "The total submitted amount for the claim or group or line item."
  }, {
    "code": "copay",
    "display": "CoPay",
    "definition": "Patient Co-Payment"
  }, {
    "code": "eligible",
    "display": "Eligible Amount",
    "definition": "Amount of the change which is considered for adjudication."
  }, {
    "code": "deductible",
    "display": "Deductible",
    "definition": "Amount deducted from the eligible amount prior to adjudication."
  }, {
    "code": "unallocdeduct",
    "display": "Unallocated Deductible",
    "definition": "The amount of deductible which could not allocated to other line items."
  }, {
    "code": "eligpercent",
    "display": "Eligible %",
    "definition": "Eligible Percentage."
  }, {
    "code": "tax",
    "display": "Tax",
    "definition": "The amount of tax."
  }, {
    "code": "benefit",
    "display": "Benefit Amount",
    "definition": "Amount payable under the coverage"
  } ],
  "caseSensitive": true,
  "version": "1.0.1",
  "contact": [ {
    "telecom": [ {
      "value": "http://hl7.org",
      "system": "url"
    }, {
      "value": "hq@HL7.org",
      "system": "email"
    } ]
  } ]
}