{ "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 PDex 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/davinci-pdex/CodeSystem/PDexAdjudicationCS", "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", "date": "2022-02-18T14:02:32+00:00", "publisher": "HL7 Financial Management Working Group", "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": null, "resourceType": "ValueSet", "title": "PDex Adjudication", "package_version": "2.0.0-ballot", "status": "active", "id": "dc98ceb8-410c-4119-b4c6-a00f88b72b77", "kind": null, "url": "http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexAdjudication", "version": "2.0.0-ballot", "contact": [ { "name": "HL7 Financial Management Working Group", "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" } ] } ] }