## Profile Comparison between http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-claim vs http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-claim

Left: | QICore Claim (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-claim)
Right: | QICore Claim (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-claim)

### Messages

Error | StructureDefinition.version | Values for version differ: '8.0.0-ballot' vs '7.0.2'
Information | Claim.language | Example/preferred bindings differ at Claim.language using binding from QICoreClaim
Error | Claim.prescription | Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-devicerequest], CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest], CanonicalType[http://hl7.org/fhir/StructureDefinition/VisionPrescription]]) vs Reference([CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-devicerequest], CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest], CanonicalType[http://hl7.org/fhir/StructureDefinition/VisionPrescription]])

### Metadata

Name | Value | Comments
--- | --- | ---
abstract | false |
baseDefinition | http://hl7.org/fhir/StructureDefinition/Claim |
copyright |  |
date | 2018-08-22 |
description | Profile of Claim for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors. |
experimental | false |
fhirVersion | 4.0.1 |
jurisdiction |  |
jurisdiction[0] | urn:iso:std:iso:3166#US |
kind | resource |
name | QICoreClaim |
publisher | HL7 International / Clinical Quality Information |
purpose |  |
status | active |
title | QICore Claim |
type | Claim |
url | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-claim |
version | 8.0.0-ballot | 7.0.2 | Values Differ

### Structure

Name | L Flags | L Card. | L Type | L Description & Constraints | R Flags | R Card. | R Type | R Description & Constraints | Comments
--- | --- | --- | --- | --- | --- | --- | --- | --- | ---
Claim |  | 0..* | Claim | Claim, Pre-determination or Pre-authorization |  | 0..* | Claim | Claim, Pre-determination or Pre-authorization |
id | Σ | 0..1 | id | Logical id of this artifact | Σ | 0..1 | id | Logical id of this artifact |
meta | Σ | 0..1 | Meta | Metadata about the resource | Σ | 0..1 | Meta | Metadata about the resource |
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
language |  | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
Additional Bindings | Purpose
?? | Max Binding
|  | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
Additional Bindings | Purpose
?? | Max Binding
| Example/preferred bindings differ at Claim.language using binding from QICoreClaim
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements |
contained |  | 0..* | Resource | Contained, inline Resources |  | 0..* | Resource | Contained, inline Resources |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ?! | 0..* | Extension | Extensions that cannot be ignored |
identifier |  | 0..* | Identifier | Business Identifier for claim |  | 0..* | Identifier | Business Identifier for claim |
status | ?!Σ | 1..1 | code | (QI) active Binding: ?? (required): A code specifying the state of the resource instance. Fixed Value: active | ?!Σ | 1..1 | code | (QI) active Binding: ?? (required): A code specifying the state of the resource instance. Fixed Value: active |
type | Σ | 1..1 | CodeableConcept | (QI) category | discipline Binding: ?? (extensible): The type or discipline-style of the claim. | Σ | 1..1 | CodeableConcept | (QI) category | discipline Binding: ?? (extensible): The type or discipline-style of the claim. |
subType |  | 0..1 | CodeableConcept | More granular claim type Binding: ?? (example): A more granular claim typecode. |  | 0..1 | CodeableConcept | More granular claim type Binding: ?? (example): A more granular claim typecode. |
use | Σ | 1..1 | code | (QI) claim | preauthorization | predetermination Binding: ?? (required): The purpose of the Claim: predetermination, preauthorization, claim. | Σ | 1..1 | code | (QI) claim | preauthorization | predetermination Binding: ?? (required): The purpose of the Claim: predetermination, preauthorization, claim. |
patient | Σ | 1..1 | Reference(QICore Patient) | (QI) The recipient of the products and services | Σ | 1..1 | Reference(QICore Patient) | (QI) The recipient of the products and services |
billablePeriod | Σ | 0..1 | Period | (QI) Relevant time frame for the claim | Σ | 0..1 | Period | (QI) Relevant time frame for the claim |
created | Σ | 1..1 | dateTime | (QI) Resource creation date | Σ | 1..1 | dateTime | (QI) Resource creation date |
enterer |  | 0..1 | Reference(Practitioner | PractitionerRole) | Author of the claim |  | 0..1 | Reference(Practitioner | PractitionerRole) | Author of the claim |
insurer | Σ | 0..1 | Reference(Organization) | Target | Σ | 0..1 | Reference(Organization) | Target |
provider | Σ | 1..1 | Reference(QICore Practitioner | QICore PractitionerRole | QICore Organization) | (QI) Party responsible for the claim | Σ | 1..1 | Reference(QICore Practitioner | QICore PractitionerRole | QICore Organization) | (QI) Party responsible for the claim |
priority | Σ | 1..1 | CodeableConcept | Desired processing ugency Binding: ?? (example): The timeliness with which processing is required: stat, normal, deferred. | Σ | 1..1 | CodeableConcept | Desired processing ugency Binding: ?? (example): The timeliness with which processing is required: stat, normal, deferred. |
fundsReserve |  | 0..1 | CodeableConcept | For whom to reserve funds Binding: ?? (example): For whom funds are to be reserved: (Patient, Provider, None). |  | 0..1 | CodeableConcept | For whom to reserve funds Binding: ?? (example): For whom funds are to be reserved: (Patient, Provider, None). |
related |  | 0..* | BackboneElement | Prior or corollary claims |  | 0..* | BackboneElement | Prior or corollary claims |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
claim |  | 0..1 | Reference(Claim) | Reference to the related claim |  | 0..1 | Reference(Claim) | Reference to the related claim |
relationship |  | 0..1 | CodeableConcept | How the reference claim is related Binding: ?? (example): Relationship of this claim to a related Claim. |  | 0..1 | CodeableConcept | How the reference claim is related Binding: ?? (example): Relationship of this claim to a related Claim. |
reference |  | 0..1 | Identifier | File or case reference |  | 0..1 | Identifier | File or case reference |
prescription |  | 0..1 | Reference(QICore DeviceRequest | QICore MedicationRequest | VisionPrescription) | (QI) Prescription authorizing services and products |  | 0..1 | Reference(QICore DeviceRequest | QICore MedicationRequest | VisionPrescription) | (QI) Prescription authorizing services and products | Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-devicerequest], CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest], CanonicalType[http://hl7.org/fhir/StructureDefinition/VisionPrescription]]) vs Reference([CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-devicerequest], CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest], CanonicalType[http://hl7.org/fhir/StructureDefinition/VisionPrescription]])
originalPrescription |  | 0..1 | Reference(DeviceRequest | MedicationRequest | VisionPrescription) | Original prescription if superseded by fulfiller |  | 0..1 | Reference(DeviceRequest | MedicationRequest | VisionPrescription) | Original prescription if superseded by fulfiller |
payee |  | 0..1 | BackboneElement | Recipient of benefits payable |  | 0..1 | BackboneElement | Recipient of benefits payable |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type |  | 1..1 | CodeableConcept | Category of recipient Binding: ?? (example): A code for the party to be reimbursed. |  | 1..1 | CodeableConcept | Category of recipient Binding: ?? (example): A code for the party to be reimbursed. |
party |  | 0..1 | Reference(QICore Practitioner | QICore PractitionerRole | QICore Organization | QICore Patient | QICore RelatedPerson) | Recipient reference |  | 0..1 | Reference(QICore Practitioner | QICore PractitionerRole | QICore Organization | QICore Patient | QICore RelatedPerson) | Recipient reference |
referral |  | 0..1 | Reference(QICore ServiceRequest) | Treatment referral |  | 0..1 | Reference(QICore ServiceRequest) | Treatment referral |
facility |  | 0..1 | Reference(QICore Location) | Servicing facility |  | 0..1 | Reference(QICore Location) | Servicing facility |
careTeam |  | 0..* | BackboneElement | Members of the care team |  | 0..* | BackboneElement | Members of the care team |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
sequence |  | 1..1 | positiveInt | Order of care team |  | 1..1 | positiveInt | Order of care team |
provider |  | 1..1 | Reference(QICore Practitioner | QICore PractitionerRole | QICore Organization) | Practitioner or organization |  | 1..1 | Reference(QICore Practitioner | QICore PractitionerRole | QICore Organization) | Practitioner or organization |
responsible |  | 0..1 | boolean | Indicator of the lead practitioner |  | 0..1 | boolean | Indicator of the lead practitioner |
role |  | 0..1 | CodeableConcept | Function within the team Binding: ?? (example): The role codes for the care team members. |  | 0..1 | CodeableConcept | Function within the team Binding: ?? (example): The role codes for the care team members. |
qualification |  | 0..1 | CodeableConcept | Practitioner credential or specialization Binding: ?? (example): Provider professional qualifications. |  | 0..1 | CodeableConcept | Practitioner credential or specialization Binding: ?? (example): Provider professional qualifications. |
supportingInfo |  | 0..* | BackboneElement | Supporting information |  | 0..* | BackboneElement | Supporting information |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
sequence |  | 1..1 | positiveInt | Information instance identifier |  | 1..1 | positiveInt | Information instance identifier |
category |  | 1..1 | CodeableConcept | Classification of the supplied information Binding: ?? (example): The valuset used for additional information category codes. |  | 1..1 | CodeableConcept | Classification of the supplied information Binding: ?? (example): The valuset used for additional information category codes. |
code |  | 0..1 | CodeableConcept | Type of information Binding: ?? (example): The valuset used for additional information codes. |  | 0..1 | CodeableConcept | Type of information Binding: ?? (example): The valuset used for additional information codes. |
timing[x] |  | 0..1 | date, Period | When it occurred |  | 0..1 | date, Period | When it occurred |
value[x] |  | 0..1 | boolean, string, Quantity, Attachment, Reference(Resource) | Data to be provided |  | 0..1 | boolean, string, Quantity, Attachment, Reference(Resource) | Data to be provided |
reason |  | 0..1 | CodeableConcept | Explanation for the information Binding: ?? (example): Reason codes for the missing teeth. |  | 0..1 | CodeableConcept | Explanation for the information Binding: ?? (example): Reason codes for the missing teeth. |
diagnosis |  | 0..* | BackboneElement | (QI) Pertinent diagnosis information |  | 0..* | BackboneElement | (QI) Pertinent diagnosis information |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
sequence |  | 1..1 | positiveInt | (QI) Diagnosis instance identifier |  | 1..1 | positiveInt | (QI) Diagnosis instance identifier |
diagnosis[x] |  | 1..1 | CodeableConcept, Reference(QICore Condition Encounter Diagnosis) | (QI) Nature of illness or problem Binding: ?? (example): Example ICD10 Diagnostic codes. |  | 1..1 | CodeableConcept, Reference(QICore Condition Encounter Diagnosis) | (QI) Nature of illness or problem Binding: ?? (example): Example ICD10 Diagnostic codes. |
type |  | 0..* | CodeableConcept | (QI) Timing or nature of the diagnosis Binding: ?? (preferred): The type of the diagnosis: admitting, principal, discharge. |  | 0..* | CodeableConcept | (QI) Timing or nature of the diagnosis Binding: ?? (preferred): The type of the diagnosis: admitting, principal, discharge. |
onAdmission |  | 0..1 | CodeableConcept | (QI) Present on admission Binding: ?? (required): Present on admission. |  | 0..1 | CodeableConcept | (QI) Present on admission Binding: ?? (required): Present on admission. |
packageCode |  | 0..1 | CodeableConcept | Package billing code Binding: ?? (example): The DRG codes associated with the diagnosis. |  | 0..1 | CodeableConcept | Package billing code Binding: ?? (example): The DRG codes associated with the diagnosis. |
procedure |  | 0..* | BackboneElement | (QI) Clinical procedures performed |  | 0..* | BackboneElement | (QI) Clinical procedures performed |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
sequence |  | 1..1 | positiveInt | (QI) Procedure instance identifier |  | 1..1 | positiveInt | (QI) Procedure instance identifier |
type |  | 0..* | CodeableConcept | (QI) Category of Procedure Binding: ?? (example): Example procedure type codes. |  | 0..* | CodeableConcept | (QI) Category of Procedure Binding: ?? (example): Example procedure type codes. |
date |  | 0..1 | dateTime | When the procedure was performed |  | 0..1 | dateTime | When the procedure was performed |
procedure[x] |  | 1..1 | CodeableConcept, Reference(QICore Procedure) | (QI) Specific clinical procedure Binding: ?? (example): Example ICD10 Procedure codes. |  | 1..1 | CodeableConcept, Reference(QICore Procedure) | (QI) Specific clinical procedure Binding: ?? (example): Example ICD10 Procedure codes. |
udi |  | 0..* | Reference(Device) | Unique device identifier |  | 0..* | Reference(Device) | Unique device identifier |
insurance | Σ | 1..* | BackboneElement | Patient insurance information | Σ | 1..* | BackboneElement | Patient insurance information |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
sequence | Σ | 1..1 | positiveInt | Insurance instance identifier | Σ | 1..1 | positiveInt | Insurance instance identifier |
focal | Σ | 1..1 | boolean | Coverage to be used for adjudication | Σ | 1..1 | boolean | Coverage to be used for adjudication |
identifier |  | 0..1 | Identifier | Pre-assigned Claim number |  | 0..1 | Identifier | Pre-assigned Claim number |
coverage | Σ | 1..1 | Reference(QICore Coverage) | Insurance information | Σ | 1..1 | Reference(QICore Coverage) | Insurance information |
businessArrangement |  | 0..1 | string | Additional provider contract number |  | 0..1 | string | Additional provider contract number |
preAuthRef |  | 0..* | string | Prior authorization reference number |  | 0..* | string | Prior authorization reference number |
claimResponse |  | 0..1 | Reference(ClaimResponse) | Adjudication results |  | 0..1 | Reference(ClaimResponse) | Adjudication results |
accident |  | 0..1 | BackboneElement | Details of the event |  | 0..1 | BackboneElement | Details of the event |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
date |  | 1..1 | date | When the incident occurred |  | 1..1 | date | When the incident occurred |
type |  | 0..1 | CodeableConcept | The nature of the accident Binding: ?? (extensible): Type of accident: work place, auto, etc. |  | 0..1 | CodeableConcept | The nature of the accident Binding: ?? (extensible): Type of accident: work place, auto, etc. |
location[x] |  | 0..1 | Address, Reference(Location) | Where the event occurred |  | 0..1 | Address, Reference(Location) | Where the event occurred |
item |  | 0..* | BackboneElement | Product or service provided |  | 0..* | BackboneElement | Product or service provided |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
sequence |  | 1..1 | positiveInt | Item instance identifier |  | 1..1 | positiveInt | Item instance identifier |
careTeamSequence |  | 0..* | positiveInt | Applicable careTeam members |  | 0..* | positiveInt | Applicable careTeam members |
diagnosisSequence |  | 0..* | positiveInt | Applicable diagnoses |  | 0..* | positiveInt | Applicable diagnoses |
procedureSequence |  | 0..* | positiveInt | Applicable procedures |  | 0..* | positiveInt | Applicable procedures |
informationSequence |  | 0..* | positiveInt | Applicable exception and supporting information |  | 0..* | positiveInt | Applicable exception and supporting information |
revenue |  | 0..1 | CodeableConcept | Revenue or cost center code Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products. |  | 0..1 | CodeableConcept | Revenue or cost center code Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products. |
category |  | 0..1 | CodeableConcept | Benefit classification Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses. |  | 0..1 | CodeableConcept | Benefit classification Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses. |
productOrService |  | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: ?? (example): Allowable service and product codes. |  | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: ?? (example): Allowable service and product codes. |
modifier |  | 0..* | CodeableConcept | Product or service billing modifiers Binding: ?? (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. |  | 0..* | CodeableConcept | Product or service billing modifiers Binding: ?? (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. |
programCode |  | 0..* | CodeableConcept | Program the product or service is provided under Binding: ?? (example): Program specific reason codes. |  | 0..* | CodeableConcept | Program the product or service is provided under Binding: ?? (example): Program specific reason codes. |
serviced[x] |  | 0..1 | date, Period | Date or dates of service or product delivery |  | 0..1 | date, Period | Date or dates of service or product delivery |
location[x] |  | 0..1 | CodeableConcept, Address, Reference(Location) | Place of service or where product was supplied Binding: ?? (example): Place of service: pharmacy, school, prison, etc. |  | 0..1 | CodeableConcept, Address, Reference(Location) | Place of service or where product was supplied Binding: ?? (example): Place of service: pharmacy, school, prison, etc. |
quantity |  | 0..1 | ?? | Count of products or services |  | 0..1 | ?? | Count of products or services |
unitPrice |  | 0..1 | Money | Fee, charge or cost per item |  | 0..1 | Money | Fee, charge or cost per item |
factor |  | 0..1 | decimal | Price scaling factor |  | 0..1 | decimal | Price scaling factor |
net |  | 0..1 | Money | Total item cost |  | 0..1 | Money | Total item cost |
udi |  | 0..* | Reference(Device) | Unique device identifier |  | 0..* | Reference(Device) | Unique device identifier |
bodySite |  | 0..1 | CodeableConcept | Anatomical location Binding: ?? (example): The code for the teeth, quadrant, sextant and arch. |  | 0..1 | CodeableConcept | Anatomical location Binding: ?? (example): The code for the teeth, quadrant, sextant and arch. |
subSite |  | 0..* | CodeableConcept | Anatomical sub-location Binding: ?? (example): The code for the tooth surface and surface combinations. |  | 0..* | CodeableConcept | Anatomical sub-location Binding: ?? (example): The code for the tooth surface and surface combinations. |
encounter |  | 0..* | Reference(QICore Encounter) | (QI) Encounters related to this billed item |  | 0..* | Reference(QICore Encounter) | (QI) Encounters related to this billed item |
detail |  | 0..* | BackboneElement | Product or service provided |  | 0..* | BackboneElement | Product or service provided |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
sequence |  | 1..1 | positiveInt | Item instance identifier |  | 1..1 | positiveInt | Item instance identifier |
revenue |  | 0..1 | CodeableConcept | Revenue or cost center code Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products. |  | 0..1 | CodeableConcept | Revenue or cost center code Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products. |
category |  | 0..1 | CodeableConcept | Benefit classification Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses. |  | 0..1 | CodeableConcept | Benefit classification Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses. |
productOrService |  | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: ?? (example): Allowable service and product codes. |  | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: ?? (example): Allowable service and product codes. |
modifier |  | 0..* | CodeableConcept | Service/Product billing modifiers Binding: ?? (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. |  | 0..* | CodeableConcept | Service/Product billing modifiers Binding: ?? (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. |
programCode |  | 0..* | CodeableConcept | Program the product or service is provided under Binding: ?? (example): Program specific reason codes. |  | 0..* | CodeableConcept | Program the product or service is provided under Binding: ?? (example): Program specific reason codes. |
quantity |  | 0..1 | ?? | Count of products or services |  | 0..1 | ?? | Count of products or services |
unitPrice |  | 0..1 | Money | Fee, charge or cost per item |  | 0..1 | Money | Fee, charge or cost per item |
factor |  | 0..1 | decimal | Price scaling factor |  | 0..1 | decimal | Price scaling factor |
net |  | 0..1 | Money | Total item cost |  | 0..1 | Money | Total item cost |
udi |  | 0..* | Reference(Device) | Unique device identifier |  | 0..* | Reference(Device) | Unique device identifier |
subDetail |  | 0..* | BackboneElement | Product or service provided |  | 0..* | BackboneElement | Product or service provided |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
sequence |  | 1..1 | positiveInt | Item instance identifier |  | 1..1 | positiveInt | Item instance identifier |
revenue |  | 0..1 | CodeableConcept | Revenue or cost center code Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products. |  | 0..1 | CodeableConcept | Revenue or cost center code Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products. |
category |  | 0..1 | CodeableConcept | Benefit classification Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses. |  | 0..1 | CodeableConcept | Benefit classification Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses. |
productOrService |  | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: ?? (example): Allowable service and product codes. |  | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: ?? (example): Allowable service and product codes. |
modifier |  | 0..* | CodeableConcept | Service/Product billing modifiers Binding: ?? (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. |  | 0..* | CodeableConcept | Service/Product billing modifiers Binding: ?? (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. |
programCode |  | 0..* | CodeableConcept | Program the product or service is provided under Binding: ?? (example): Program specific reason codes. |  | 0..* | CodeableConcept | Program the product or service is provided under Binding: ?? (example): Program specific reason codes. |
quantity |  | 0..1 | ?? | Count of products or services |  | 0..1 | ?? | Count of products or services |
unitPrice |  | 0..1 | Money | Fee, charge or cost per item |  | 0..1 | Money | Fee, charge or cost per item |
factor |  | 0..1 | decimal | Price scaling factor |  | 0..1 | decimal | Price scaling factor |
net |  | 0..1 | Money | Total item cost |  | 0..1 | Money | Total item cost |
udi |  | 0..* | Reference(Device) | Unique device identifier |  | 0..* | Reference(Device) | Unique device identifier |
total |  | 0..1 | Money | Total claim cost |  | 0..1 | Money | Total claim cost |
Documentation for this format