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4.4.1.693 ValueSet http://hl7.org/fhir/ValueSet/adjudication

Responsible Owner: Financial Management icon Work Group Normative Use Context: Country: World
Official URL: http://hl7.org/fhir/ValueSet/adjudication Version: 6.0.0-ballot3
active as of 2025-11-24 Computable Name: AdjudicationValueCodes
Flags: OID: 2.16.840.1.113883.4.642.3.596

This value set is used in the following places:

4.4.1.693.1 Definition

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.

4.4.1.693.2 Content Logical Definition

Generated Narrative: ValueSet adjudication

Last updated: 2025-11-24T20:46:00.1Z

 

4.4.1.693.3 Expansion

This expansion generated 24 Nov 2025

ValueSet

Expansion performed internally based on codesystem Adjudication Value Codes v1.0.1 (CodeSystem) icon

This value set contains 8 concepts

SystemCodeDisplayDefinition
http://terminology.hl7.org/CodeSystem/adjudication   submitted icon Submitted Amount The total submitted amount for the claim or group or line item.
http://terminology.hl7.org/CodeSystem/adjudication   copay icon CoPay Patient Co-Payment
http://terminology.hl7.org/CodeSystem/adjudication   eligible icon Eligible Amount Amount of the change which is considered for adjudication.
http://terminology.hl7.org/CodeSystem/adjudication   deductible icon Deductible Amount deducted from the eligible amount prior to adjudication.
http://terminology.hl7.org/CodeSystem/adjudication   unallocdeduct icon Unallocated Deductible The amount of deductible which could not allocated to other line items.
http://terminology.hl7.org/CodeSystem/adjudication   eligpercent icon Eligible % Eligible Percentage.
http://terminology.hl7.org/CodeSystem/adjudication   tax icon Tax The amount of tax.
http://terminology.hl7.org/CodeSystem/adjudication   benefit icon Benefit Amount Amount payable under the coverage

 

See the full registry of value sets defined as part of FHIR.

Explanation of the columns that may appear on this page:

Lvl A few code lists that FHIR defines are hierarchical - each code is assigned a level. For value sets, levels are mostly used to organize codes for user convenience, but may follow code system hierarchy - see Code System for further information
Source The source of the definition of the code (when the value set draws in codes defined elsewhere)
Code The code (used as the code in the resource instance). If the code is in italics, this indicates that the code is not selectable ('Abstract')
Display The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application
Definition An explanation of the meaning of the concept
Comments Additional notes about how to use the code