{ "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": "paidbypatientcash", "display": "Paid by patient - cash" }, { "code": "paidbypatientother", "display": "Paid by patient - other" }, { "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-C4BBAdjudication.json", "package_name": "hl7.fhir.us.carin-bb", "date": "2025-02-18T17:31:24+00:00", "publisher": "HL7 International / Financial Management", "jurisdiction": [ { "coding": [ { "code": "US", "system": "urn:iso:std:iso:3166" } ] } ], "name": "C4BBAdjudication", "copyright": "This Valueset is not copyrighted.", "type": null, "experimental": "false", "resourceType": "ValueSet", "title": "C4BB Adjudication Value Set", "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": "trial-use", "_valueCode": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom", "valueCanonical": "http://hl7.org/fhir/us/carin-bb/ImplementationGuide/hl7.fhir.us.carin-bb" } ] } } ], "status": "active", "id": "cccfa46b-3684-4f1d-b8d8-2539c50a1bf2", "kind": null, "url": "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication", "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" } ] } ] }