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4.4.1.664 Value Set http://hl7.org/fhir/ValueSet/adjudication

Financial Management Work Group Maturity Level: 1Draft Use Context: Any

This is a value set defined by the FHIR project.

Summary

Defining URL:http://hl7.org/fhir/ValueSet/adjudication
Version:4.1.0
Name:AdjudicationValueCodes
Title:Adjudication Value Codes
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.

Committee:Financial Management Work Group
OID:2.16.840.1.113883.4.642.3.596 (for OID based terminology systems)
Copyright:

This is an example set.

Source ResourceXML / JSON

This value set is used in the following places:


This value set includes codes from the following code systems:

 

This expansion generated 06 Dec 2019


This value set contains 8 concepts

Expansion based on http://terminology.hl7.org/CodeSystem/adjudication version 4.1.0

All codes from system http://terminology.hl7.org/CodeSystem/adjudication

CodeDisplayDefinition
submittedSubmitted AmountThe total submitted amount for the claim or group or line item.
copayCoPayPatient Co-Payment
eligibleEligible AmountAmount of the change which is considered for adjudication.
deductibleDeductibleAmount deducted from the eligible amount prior to adjudication.
unallocdeductUnallocated DeductibleThe amount of deductible which could not allocated to other line items.
eligpercentEligible %Eligible Percentage.
taxTaxThe amount of tax.
benefitBenefit AmountAmount 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:

LvlA 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
SourceThe source of the definition of the code (when the value set draws in codes defined elsewhere)
CodeThe code (used as the code in the resource instance). If the code is in italics, this indicates that the code is not selectable ('Abstract')
DisplayThe 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
DefinitionAn explanation of the meaning of the concept
CommentsAdditional notes about how to use the code