# PAS Claim Response Base - Da Vinci Prior Authorization Support (PAS) FHIR IG v2.2.0-ballot

## Resource Profile: PAS Claim Response Base ( Abstract ) 

 
PAS constraints on ClaimResponse resource that are common to both the request and the inquiry. 

**Usages:**

* Derived from this Profile: [PAS Claim Inquiry Response](StructureDefinition-profile-claiminquiryresponse.md), [PAS Claim Response](StructureDefinition-profile-claimresponse.md), [PAS Claim Inquiry Response](http://hl7.org/fhir/us/davinci-pas/STU2.1/StructureDefinition-profile-claiminquiryresponse.html) and [PAS Claim Response](http://hl7.org/fhir/us/davinci-pas/STU2.1/StructureDefinition-profile-claimresponse.html)

You can also check for [usages in the FHIR IG Statistics](https://packages2.fhir.org/xig/hl7.fhir.us.davinci-pas|current/StructureDefinition/profile-claimresponse-base)

### Formal Views of Profile Content

 [Description Differentials, Snapshots, and other representations](http://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#structure-definitions). 

 

Other representations of profile: [CSV](../StructureDefinition-profile-claimresponse-base.csv), [Excel](../StructureDefinition-profile-claimresponse-base.xlsx), [Schematron](../StructureDefinition-profile-claimresponse-base.sch) 



## Resource Content

```json
{
  "resourceType" : "StructureDefinition",
  "id" : "profile-claimresponse-base",
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode" : "fm"
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger" : 3,
      "_valueInteger" : {
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical" : "http://hl7.org/fhir/us/davinci-pas/ImplementationGuide/hl7.fhir.us.davinci-pas"
          }
        ]
      }
    },
    {
      "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/davinci-pas/ImplementationGuide/hl7.fhir.us.davinci-pas"
          }
        ]
      }
    }
  ],
  "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claimresponse-base",
  "identifier" : [
    {
      "system" : "urn:ietf:rfc:3986",
      "value" : "urn:oid:2.16.840.1.113883.4.642.40.24.42.51"
    }
  ],
  "version" : "2.2.0-ballot",
  "name" : "PASClaimResponseBase",
  "title" : "PAS Claim Response Base",
  "status" : "active",
  "date" : "2026-01-30T16:26:59+00:00",
  "publisher" : "HL7 International / Financial Management",
  "contact" : [
    {
      "name" : "HL7 International / Financial Management",
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://hl7.org/Special/committees/fm"
        },
        {
          "system" : "email",
          "value" : "fmlists@lists.hl7.org"
        }
      ]
    },
    {
      "name" : "Jean Duteau",
      "telecom" : [
        {
          "system" : "email",
          "value" : "mailto:jean@duteaudesign.com"
        }
      ]
    },
    {
      "name" : "HL7 International / Financial Management",
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/fm"
        }
      ]
    }
  ],
  "description" : "PAS constraints on ClaimResponse resource that are common to both the request and the inquiry.",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US",
          "display" : "United States of America"
        }
      ]
    }
  ],
  "fhirVersion" : "4.0.1",
  "mapping" : [
    {
      "identity" : "workflow",
      "uri" : "http://hl7.org/fhir/workflow",
      "name" : "Workflow Pattern"
    },
    {
      "identity" : "w5",
      "uri" : "http://hl7.org/fhir/fivews",
      "name" : "FiveWs Pattern Mapping"
    },
    {
      "identity" : "rim",
      "uri" : "http://hl7.org/v3",
      "name" : "RIM Mapping"
    }
  ],
  "kind" : "resource",
  "abstract" : true,
  "type" : "ClaimResponse",
  "baseDefinition" : "http://hl7.org/fhir/StructureDefinition/ClaimResponse",
  "derivation" : "constraint",
  "differential" : {
    "element" : [
      {
        "id" : "ClaimResponse",
        "path" : "ClaimResponse",
        "short" : "Response to a preauthorization"
      },
      {
        "id" : "ClaimResponse.extension",
        "path" : "ClaimResponse.extension",
        "slicing" : {
          "discriminator" : [
            {
              "type" : "value",
              "path" : "url"
            }
          ],
          "ordered" : false,
          "rules" : "open"
        }
      },
      {
        "id" : "ClaimResponse.extension:claimResponseReviewer",
        "path" : "ClaimResponse.extension",
        "sliceName" : "claimResponseReviewer",
        "short" : "The responsible practitioner who reviewed to the request",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-claimResponseReviewer"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.extension:authorizedProvider",
        "path" : "ClaimResponse.extension",
        "sliceName" : "authorizedProvider",
        "min" : 0,
        "max" : "*",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedProvider|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.identifier",
        "path" : "ClaimResponse.identifier",
        "type" : [
          {
            "code" : "Identifier",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-identifier|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.identifier.system",
        "path" : "ClaimResponse.identifier.system",
        "short" : "Should use a scheme of 'urn:trnorg:<TRN03>'"
      },
      {
        "id" : "ClaimResponse.status",
        "path" : "ClaimResponse.status",
        "patternCode" : "active",
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.use",
        "path" : "ClaimResponse.use",
        "patternCode" : "preauthorization"
      },
      {
        "id" : "ClaimResponse.patient",
        "path" : "ClaimResponse.patient",
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-beneficiary|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.created",
        "path" : "ClaimResponse.created",
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.insurer",
        "path" : "ClaimResponse.insurer",
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.requestor",
        "path" : "ClaimResponse.requestor",
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-requestor|2.2.0-ballot",
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitionerrole|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.request",
        "path" : "ClaimResponse.request",
        "min" : 1,
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.request.extension:DataAbsentReason",
        "path" : "ClaimResponse.request.extension",
        "sliceName" : "DataAbsentReason",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/StructureDefinition/data-absent-reason|5.2.0"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.outcome",
        "path" : "ClaimResponse.outcome",
        "short" : "complete | error | partial",
        "mustSupport" : true,
        "binding" : {
          "strength" : "required",
          "valueSet" : "http://hl7.org/fhir/us/davinci-pas/ValueSet/ClaimResponseOutcome"
        }
      },
      {
        "id" : "ClaimResponse.preAuthPeriod",
        "path" : "ClaimResponse.preAuthPeriod",
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.item",
        "path" : "ClaimResponse.item",
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.item.extension",
        "path" : "ClaimResponse.item.extension",
        "slicing" : {
          "discriminator" : [
            {
              "type" : "value",
              "path" : "url"
            }
          ],
          "ordered" : false,
          "rules" : "open"
        }
      },
      {
        "id" : "ClaimResponse.item.extension:itemTraceNumber",
        "path" : "ClaimResponse.item.extension",
        "sliceName" : "itemTraceNumber",
        "short" : "Uniquely identifies this claim item. (2000F-TRN)",
        "min" : 0,
        "max" : "*",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemTraceNumber|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.item.extension:preAuthIssueDate",
        "path" : "ClaimResponse.item.extension",
        "sliceName" : "preAuthIssueDate",
        "short" : "The date when this item's preauthorization was issued.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthIssueDate|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.item.extension:preAuthPeriod",
        "path" : "ClaimResponse.item.extension",
        "sliceName" : "preAuthPeriod",
        "short" : "The date/period when this item's preauthorization is valid.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthPeriod|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.item.extension:previousAuthorizationNumber",
        "path" : "ClaimResponse.item.extension",
        "sliceName" : "previousAuthorizationNumber",
        "short" : "A string assigned by the UMO to an authorized review outcome associated with this service item.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizationNumber|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.item.extension:administrationReferenceNumber",
        "path" : "ClaimResponse.item.extension",
        "sliceName" : "administrationReferenceNumber",
        "short" : "A string assigned by the UMO to the original disallowed review outcome associated with this service item.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-administrationReferenceNumber|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.item.extension:requestedServiceDate",
        "path" : "ClaimResponse.item.extension",
        "sliceName" : "requestedServiceDate",
        "short" : "The original date/period that was requested by the submitter for this item.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemRequestedServiceDate|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.item.extension:authorizedProvider",
        "path" : "ClaimResponse.item.extension",
        "sliceName" : "authorizedProvider",
        "short" : "The specific provider who has been authorized to provide this item.",
        "min" : 0,
        "max" : "*",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedProvider|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.item.extension:authorizedItemDetail",
        "path" : "ClaimResponse.item.extension",
        "sliceName" : "authorizedItemDetail",
        "short" : "The details of what has been authorized for this item.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedDetail|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.item.itemSequence",
        "path" : "ClaimResponse.item.itemSequence",
        "short" : "Sequence numbers SHALL stay the same across all instances of the Prior Authorization, eg the Claim, ClaimResponse, ClaimUpdate, ClaimUpdateResponse",
        "comment" : "Each item returned on the PAS ClaimResponse SHALL echo the same item sequence number as that same item had on the Claim. The item.sequence element SHALL serve as the main tracing identifier of items throughout requests and responses.",
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.item.noteNumber",
        "path" : "ClaimResponse.item.noteNumber",
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.item.adjudication",
        "path" : "ClaimResponse.item.adjudication",
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.item.adjudication.extension",
        "path" : "ClaimResponse.item.adjudication.extension",
        "slicing" : {
          "discriminator" : [
            {
              "type" : "value",
              "path" : "url"
            }
          ],
          "ordered" : false,
          "rules" : "open"
        }
      },
      {
        "id" : "ClaimResponse.item.adjudication.extension:reviewAction",
        "path" : "ClaimResponse.item.adjudication.extension",
        "sliceName" : "reviewAction",
        "short" : "The details of the review action that is necessary for the authorization.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.item.adjudication.category",
        "path" : "ClaimResponse.item.adjudication.category",
        "short" : "This code is fixed to 'submitted' to indicate that the adjudication result is on what was submitted.",
        "patternCodeableConcept" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
              "code" : "submitted"
            }
          ]
        }
      },
      {
        "id" : "ClaimResponse.addItem",
        "path" : "ClaimResponse.addItem",
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.addItem.extension",
        "path" : "ClaimResponse.addItem.extension",
        "slicing" : {
          "discriminator" : [
            {
              "type" : "value",
              "path" : "url"
            }
          ],
          "ordered" : false,
          "rules" : "open"
        }
      },
      {
        "id" : "ClaimResponse.addItem.extension:itemTraceNumber",
        "path" : "ClaimResponse.addItem.extension",
        "sliceName" : "itemTraceNumber",
        "min" : 0,
        "max" : "*",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemTraceNumber|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.addItem.extension:preAuthIssueDate",
        "path" : "ClaimResponse.addItem.extension",
        "sliceName" : "preAuthIssueDate",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthIssueDate|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.addItem.extension:preAuthPeriod",
        "path" : "ClaimResponse.addItem.extension",
        "sliceName" : "preAuthPeriod",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthPeriod|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.addItem.extension:previousAuthorizationNumber",
        "path" : "ClaimResponse.addItem.extension",
        "sliceName" : "previousAuthorizationNumber",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizationNumber|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.addItem.extension:administrationReferenceNumber",
        "path" : "ClaimResponse.addItem.extension",
        "sliceName" : "administrationReferenceNumber",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-administrationReferenceNumber|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.addItem.extension:epsdtIndicator",
        "path" : "ClaimResponse.addItem.extension",
        "sliceName" : "epsdtIndicator",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-epsdtIndicator|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.addItem.extension:nursingHomeResidentialStatus",
        "path" : "ClaimResponse.addItem.extension",
        "sliceName" : "nursingHomeResidentialStatus",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeResidentialStatus|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.addItem.extension:nursingHomeLevelOfCare",
        "path" : "ClaimResponse.addItem.extension",
        "sliceName" : "nursingHomeLevelOfCare",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeLevelOfCare|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.addItem.extension:productOrServiceCodeEnd",
        "path" : "ClaimResponse.addItem.extension",
        "sliceName" : "productOrServiceCodeEnd",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-productOrServiceCodeEnd|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.addItem.extension:revenue",
        "path" : "ClaimResponse.addItem.extension",
        "sliceName" : "revenue",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-revenueCode|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.addItem.extension:revenueUnitRateLimit",
        "path" : "ClaimResponse.addItem.extension",
        "sliceName" : "revenueUnitRateLimit",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-revenueUnitRateLimit|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.addItem.extension:requestedService",
        "path" : "ClaimResponse.addItem.extension",
        "sliceName" : "requestedService",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-requestedService|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.addItem.extension:requestType",
        "path" : "ClaimResponse.addItem.extension",
        "sliceName" : "requestType",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceItemRequestType|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.addItem.extension:certificationType",
        "path" : "ClaimResponse.addItem.extension",
        "sliceName" : "certificationType",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-certificationType|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.addItem.extension:category",
        "path" : "ClaimResponse.addItem.extension",
        "sliceName" : "category",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemCategory"
            ]
          }
        ]
      },
      {
        "id" : "ClaimResponse.addItem.itemSequence",
        "path" : "ClaimResponse.addItem.itemSequence",
        "min" : 1,
        "max" : "1",
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.addItem.provider",
        "path" : "ClaimResponse.addItem.provider",
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitioner|2.2.0-ballot",
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-organization|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.addItem.provider.extension:providerType",
        "path" : "ClaimResponse.addItem.provider.extension",
        "sliceName" : "providerType",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizedProviderType|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.addItem.productOrService",
        "path" : "ClaimResponse.addItem.productOrService",
        "mustSupport" : true,
        "binding" : {
          "strength" : "required",
          "valueSet" : "http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278RequestedServiceType|2.2.0-ballot"
        }
      },
      {
        "id" : "ClaimResponse.addItem.modifier",
        "path" : "ClaimResponse.addItem.modifier",
        "mustSupport" : true,
        "binding" : {
          "strength" : "required",
          "valueSet" : "http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278RequestedServiceModifierType|2.2.0-ballot"
        }
      },
      {
        "id" : "ClaimResponse.addItem.serviced[x]",
        "path" : "ClaimResponse.addItem.serviced[x]",
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.addItem.location[x]",
        "path" : "ClaimResponse.addItem.location[x]",
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.addItem.quantity",
        "path" : "ClaimResponse.addItem.quantity",
        "type" : [
          {
            "code" : "Quantity",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-quantity|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.addItem.unitPrice",
        "path" : "ClaimResponse.addItem.unitPrice",
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.addItem.adjudication",
        "path" : "ClaimResponse.addItem.adjudication",
        "type" : [
          {
            "code" : "BackboneElement"
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.addItem.adjudication.extension",
        "path" : "ClaimResponse.addItem.adjudication.extension",
        "slicing" : {
          "discriminator" : [
            {
              "type" : "value",
              "path" : "url"
            }
          ],
          "ordered" : false,
          "rules" : "open"
        }
      },
      {
        "id" : "ClaimResponse.addItem.adjudication.extension:reviewAction",
        "path" : "ClaimResponse.addItem.adjudication.extension",
        "sliceName" : "reviewAction",
        "short" : "The details of the review action that is necessary for the authorization.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.addItem.adjudication.category",
        "path" : "ClaimResponse.addItem.adjudication.category",
        "short" : "This code is fixed to 'submitted' to indicate that the adjudication result is on what was submitted.",
        "patternCodeableConcept" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
              "code" : "submitted"
            }
          ]
        }
      },
      {
        "id" : "ClaimResponse.adjudication",
        "path" : "ClaimResponse.adjudication",
        "type" : [
          {
            "code" : "BackboneElement"
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.adjudication.extension",
        "path" : "ClaimResponse.adjudication.extension",
        "slicing" : {
          "discriminator" : [
            {
              "type" : "value",
              "path" : "url"
            }
          ],
          "ordered" : false,
          "rules" : "open"
        }
      },
      {
        "id" : "ClaimResponse.adjudication.extension:reviewAction",
        "path" : "ClaimResponse.adjudication.extension",
        "sliceName" : "reviewAction",
        "short" : "The details of the review action that is necessary for the authorization.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.adjudication.category",
        "path" : "ClaimResponse.adjudication.category",
        "short" : "This code is fixed to 'submitted' to indicate that the adjudication result is on what was submitted.",
        "patternCodeableConcept" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
              "code" : "submitted"
            }
          ]
        }
      },
      {
        "id" : "ClaimResponse.processNote",
        "path" : "ClaimResponse.processNote",
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.processNote.number",
        "path" : "ClaimResponse.processNote.number",
        "min" : 1,
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.processNote.text",
        "path" : "ClaimResponse.processNote.text",
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.error",
        "path" : "ClaimResponse.error",
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.error.extension",
        "path" : "ClaimResponse.error.extension",
        "slicing" : {
          "discriminator" : [
            {
              "type" : "value",
              "path" : "url"
            }
          ],
          "ordered" : false,
          "rules" : "open"
        }
      },
      {
        "id" : "ClaimResponse.error.extension:followupAction",
        "path" : "ClaimResponse.error.extension",
        "sliceName" : "followupAction",
        "short" : "A code representing what action must occur to resolve this error.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorFollowupAction|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.error.extension:errorElement",
        "path" : "ClaimResponse.error.extension",
        "sliceName" : "errorElement",
        "short" : "The specific X12 loop, segment, or element that this error information is about.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorElement|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.error.extension:errorPath",
        "path" : "ClaimResponse.error.extension",
        "sliceName" : "errorPath",
        "short" : "The FHIRPath expression that indicates which FHIR element that this error information is about.",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : [
              "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorPath|2.2.0-ballot"
            ]
          }
        ],
        "mustSupport" : true
      },
      {
        "id" : "ClaimResponse.error.code",
        "path" : "ClaimResponse.error.code",
        "mustSupport" : true,
        "binding" : {
          "strength" : "required",
          "valueSet" : "http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278RejectReasonCodes|2.2.0-ballot"
        }
      }
    ]
  }
}

```
