Profile Comparison between http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim-update vs http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim-update

Messages

Metadata

Name	Value		Comments
abstract	false
baseDefinition	http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim	http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim-base	Values Differ
copyright
date	2023-12-01T20:58:53+00:00	2024-12-20T19:33:39+00:00	Values Differ
description	PAS constraints on Claim resource when submitting an update to a previous PAS prior authorization request	This profile defines constraints and extensions used when update a previously submitted Claim instance. * The Claim instance of the update Bundle SHALL reference the updated Claim instance within the `Claim.related.claim` element. Note that the presence of this reference and the requirement that referenced instances be included in the submitted Bundle implies that the instance representing the prior version of the Claim SHALL be included in the update Bundle. * The Claim instance of the update Bundle SHALL contain within the `Claim.item` element each item requested in the updated claim and any prior versions of the claim, including requested items that have been added, modified, deleted, or left unchanged during this or previous updates. * The Claim instance of the update Bundle SHALL contain within the `Claim.supportingInfo` element each piece of supporting documentation submitted with the updated claim and any prior versions of claim, including supporting documentation that has been added, modified, deleted, or left unchanged during this or previous updates. * Each `Claim.item` entry that represents an item no longer being requested, whether removed in this update or a previous one, SHALL be flagged using the infoCancelledFlag modifierExtension and SHALL have the code `3` (Cancel) in the Certification Type extension. * Each `Claim.supportingInfo` entry that is no longer to be used when evaluating the request, whether removed in this update or a previous one, SHALL be flagged using the infoCancelledFlag modifierExtension. * Each `Claim.item` and `Claim.supportingInfo` entry that has been changed as a part of this most recent update, including removal, SHALL be flagged using the changed extension with a value of `changed`. * Each `Claim.item` and `Claim.supportingInfo` entry that has been added as a part of this most recent update, SHALL be flagged using the changed extension with a value of `added`.	Values Differ
experimental
fhirVersion	4.0.1
jurisdiction
jurisdiction[0]	urn:iso:std:iso:3166#US
kind	resource
name	PASClaimUpdate
publisher	HL7 International / Financial Management
purpose
status	active
title	PAS Claim Update
type	Claim
url	http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim-update
version	2.0.1	2.1.0	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..*	PASClaim	Claim, Pre-determination or Pre-authorization		0..*	PASClaimBase	Preauthorization
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
text		0..1	Narrative	Text summary of the resource, for human interpretation		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url		0..*	Extension	Extension Slice: Unordered, Open by value:url
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored	?!	0..*	Extension	Extensions that cannot be ignored
identifier	S	1..1	??	Business identifier for claim	S	1..2	??	Business identifier for claim	Element maximum cardinalities differ: '1' vs '2'
id						0..1	string	Unique id for inter-element referencing	Added this element
Slices for extension						0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url	Added this element
use					?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: ?? (required): Identifies the purpose for this identifier, if known .	Added this element
type					Σ	0..1	CodeableConcept	Description of identifier Binding: ?? (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.	Added this element
system					SΣ	1..1	uri	SHOULD use a scheme of 'urn:trnorg:<TRN03>' Example General: http://www.acme.com/identifiers/patient	Added this element
value					SΣ	1..1	string	The value that is unique Example General: 123456	Added this element
period					Σ	0..1	Period	Time period when id is/was valid for use	Added this element
assigner					Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)	Added this element
status	?!Σ	1..1	code	active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance. Required Pattern: active	?!SΣ	1..1	code	active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance. Required Pattern: active	Elements differ in definition for mustSupport: 'false' vs 'true'
type	Σ	1..1	CodeableConcept	Category or discipline Binding: ?? (extensible): The type or discipline-style of the claim.	Σ	1..1	CodeableConcept	Category or 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	claim | preauthorization | predetermination Binding: ?? (required): The purpose of the Claim: predetermination, preauthorization, claim. Required Pattern: preauthorization	SΣ	1..1	code	claim | preauthorization | predetermination Binding: ?? (required): The purpose of the Claim: predetermination, preauthorization, claim. Required Pattern: preauthorization	Elements differ in definition for mustSupport: 'false' vs 'true'
patient	Σ	1..1	Reference(PAS Beneficiary Patient)	The recipient of the products and services	SΣ	1..1	Reference(PAS Beneficiary Patient)	The recipient of the products and services	Elements differ in definition for mustSupport: 'false' vs 'true'
billablePeriod	Σ	0..1	Period	Relevant time frame for the claim	Σ	0..1	Period	Relevant time frame for the claim
created	Σ	1..1	dateTime	Resource creation date	Σ	1..1	dateTime	Resource creation date
enterer		0..1	Reference(Practitioner | PractitionerRole)	Author of the claim		0..1	Reference(Practitioner | PractitionerRole)	Author of the claim
insurer	SΣ	1..1	Reference(PAS Insurer Organization)	Target	SΣ	1..1	Reference(PAS Insurer Organization)	Target
provider	SΣ	1..1	Reference(PAS Requestor Organization | PAS PractitionerRole)	Party responsible for the claim	SΣ	1..1	Reference(PAS Requestor Organization | PAS PractitionerRole)	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	S	1..1	BackboneElement	Prior or corollary claims	Elements differ in definition for mustSupport: 'false' vs 'true' Element minimum cardinalities differ: '0' vs '1' Element maximum cardinalities differ: '2147483647' vs '1'
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	S	1..1	Reference(Claim)	Reference to the related claim	Elements differ in definition for mustSupport: 'false' vs 'true' Element minimum cardinalities differ: '0' vs '1'
relationship		0..1	CodeableConcept	How the reference claim is related Binding: ?? (example): Relationship of this claim to a related Claim.	S	1..1	CodeableConcept	How the reference claim is related Binding: ?? (example): Relationship of this claim to a related Claim. Required Pattern: {"coding":[{"system":"http://terminology.hl7.org/CodeSystem/ex-relatedclaimrelationship","code":"prior"}]}	Elements differ in definition for mustSupport: 'false' vs 'true' Element minimum cardinalities differ: '0' vs '1'
reference		0..1	Identifier	File or case reference		0..1	Identifier	File or case reference
prescription		0..1	Reference(DeviceRequest | MedicationRequest | VisionPrescription)	Prescription authorizing services and products		0..1	Reference(DeviceRequest | MedicationRequest | VisionPrescription)	Prescription authorizing services and products
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(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson)	Recipient reference		0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson)	Recipient reference
referral		0..1	Reference(ServiceRequest)	Treatment referral		0..1	Reference(ServiceRequest)	Treatment referral
facility		0..1	Reference(Location)	Servicing facility		0..1	Reference(Location)	Servicing facility
Slices for careTeam	S	0..*	BackboneElement	Members of the care team Slice: Unordered, Open by value:extension('http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-careTeamClaimScope').value as boolean	S	0..*	BackboneElement	Members of the care team Slice: Unordered, Open by value:extension('http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-careTeamClaimScope').value.ofType(boolean)
id		0..1	string	Unique id for inter-element referencing		0..1	string	Unique id for inter-element referencing
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url		1..*	Extension	Extension Slice: Unordered, Open by value:url
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	S	1..1	positiveInt	Order of care team	S	1..1	positiveInt	Order of care team
provider	S	1..1	Reference(PAS Organization Base Profile | PAS PractitionerRole)	Practitioner or organization	S	1..1	Reference(PAS Organization Base Profile | PAS PractitionerRole)	Practitioner or organization
responsible		0..1	boolean	Indicator of the lead practitioner		0..1	boolean	Indicator of the lead practitioner
role	S	0..1	CodeableConcept	Function within the team Binding: ?? (example): The role codes for the care team members.	S	0..1	CodeableConcept	Function within the team Binding: ?? (example): The role codes for the care team members.
qualification	S	0..1	CodeableConcept	Practitioner credential or specialization Binding: ?? (example): Provider professional qualifications.	S	0..1	CodeableConcept	Practitioner credential or specialization Binding: ?? (example): Provider professional qualifications.
Slices for supportingInfo	S	0..*	BackboneElement	Supporting information Slice: Unordered, Open by value:category	S	0..*	BackboneElement	Supporting information Slice: Unordered, Open by value:category
id		0..1	string	Unique id for inter-element referencing		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url		0..*	Extension	Extension Slice: Unordered, Open by value:url
Slices for modifierExtension	?!Σ	0..*	Extension	Extension Slice: Unordered, Open by value:url	?!Σ	0..*	Extension	Extension Slice: Unordered, Open by value:url
sequence	S	1..1	positiveInt	Information instance identifier	S	1..1	positiveInt	Information instance identifier
category	S	1..1	CodeableConcept	Classification of the supplied information Binding: ?? (extensible)	S	1..1	CodeableConcept	Classification of the supplied information Binding: ?? (extensible)
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	S	0..*	BackboneElement	Pertinent diagnosis information. NOTE: Only the first 12 diagnoses can be sent in the X12 request.	S	0..*	BackboneElement	Pertinent diagnosis information. NOTE: Only the first 12 diagnoses can be sent in the X12 request.
id		0..1	string	Unique id for inter-element referencing		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url		0..*	Extension	Extension Slice: Unordered, Open by value:url
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	S	1..1	positiveInt	Diagnosis instance identifier	S	1..1	positiveInt	Diagnosis instance identifier
diagnosis[x]	S	1..1	CodeableConcept	Nature of illness or problem Binding: ?? (required)	S	1..1	CodeableConcept	Nature of illness or problem Binding: ?? (required)
type	S	0..1	CodeableConcept	Timing or nature of the diagnosis Binding: ?? (required)	S	0..1	CodeableConcept	Timing or nature of the diagnosis Binding: ?? (required)
onAdmission		0..1	CodeableConcept	Present on admission Binding: ?? (example): Present on admission.		0..1	CodeableConcept	Present on admission Binding: ?? (example): 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	Clinical procedures performed		0..*	BackboneElement	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	Procedure instance identifier		1..1	positiveInt	Procedure instance identifier
type		0..*	CodeableConcept	Category of Procedure Binding: ?? (example): Example procedure type codes.		0..*	CodeableConcept	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(Procedure)	Specific clinical procedure Binding: ?? (example): Example ICD10 Procedure codes.		1..1	CodeableConcept, Reference(Procedure)	Specific clinical procedure Binding: ?? (example): Example ICD10 Procedure codes.
udi		0..*	Reference(Device)	Unique device identifier		0..*	Reference(Device)	Unique device identifier
insurance	SΣ	1..*	BackboneElement	Patient insurance information	SΣ	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	SΣ	1..1	positiveInt	Insurance instance identifier	SΣ	1..1	positiveInt	Insurance instance identifier
focal	Σ	1..1	boolean	Coverage to be used for adjudication Required Pattern: true	Σ	1..1	boolean	Coverage to be used for adjudication Required Pattern: true
identifier		0..1	Identifier	Pre-assigned Claim number		0..1	Identifier	Pre-assigned Claim number
coverage	SΣ	1..1	Reference(PAS Coverage)	Insurance information	SΣ	1..1	Reference(PAS 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	S	0..1	BackboneElement	Details of the event	S	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	S	1..1	date	When the incident occurred	SC	1..1	date	When the incident occurred FullDateRule: Dates need to be a full date - YYYY-MM-DD
type	S	0..1	CodeableConcept	The nature of the accident Binding: ?? (required): Codes identifying an accompanying cause of an illness, injury or an accident. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.	S	0..1	CodeableConcept	The nature of the accident Binding: ?? (required): Codes identifying an accompanying cause of an illness, injury or an accident. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.
location[x]		0..1	Address	Where the event occurred	S	0..1	Address	Where the event occurred	Elements differ in definition for mustSupport: 'false' vs 'true'
item	S	1..*	BackboneElement	Product or service provided	SC	1..*	BackboneElement	Product or service provided ImmediateLevelOfCare: If Certification Type is an immediate appeal, then Level of Service Code must be present
id		0..1	string	Unique id for inter-element referencing		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url		2..*	Extension	Extension Slice: Unordered, Open by value:url	Element minimum cardinalities differ: '0' vs '2'
Slices for modifierExtension	?!Σ	0..*	Extension	Extension Slice: Unordered, Open by value:url	?!Σ	0..*	Extension	Extension Slice: Unordered, Open by value:url
sequence	S	1..1	positiveInt	Item instance identifier	S	1..1	positiveInt	Item instance identifier
careTeamSequence	S	0..*	positiveInt	Applicable careTeam members	S	0..*	positiveInt	Applicable careTeam members
diagnosisSequence	S	0..*	positiveInt	Applicable diagnoses	S	0..*	positiveInt	Applicable diagnoses
procedureSequence		0..*	positiveInt	Applicable procedures		0..*	positiveInt	Applicable procedures
informationSequence	S	0..*	positiveInt	Applicable exception and supporting information	S	0..*	positiveInt	Applicable exception and supporting information
revenue	S	0..1	CodeableConcept	Revenue or cost center code Binding: ?? (required)	S	0..1	CodeableConcept	Revenue or cost center code Binding: ?? (required)
category	S	1..1	CodeableConcept	Since PAS requests only have item-level information, a category is required for conformance with the X12 278 request. Binding: ?? (required): Codes identifying the classification of service. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.	S	1..1	CodeableConcept	Since PAS requests only have item-level information, a category is required for conformance with the X12 278 request. Binding: ?? (required): Codes identifying the classification of service. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.
productOrService	S	1..1	CodeableConcept	Billing, service, product, or drug code Binding: ?? (required)	S	1..1	CodeableConcept	Billing, service, product, or drug code Binding: ?? (required)
modifier	S	0..*	CodeableConcept	Product or service billing modifiers Binding: ?? (required)	S	0..*	CodeableConcept	Product or service billing modifiers Binding: ?? (required)
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]	S	0..1	date, Period	Date or dates of service or product delivery	S	0..1	date, Period	Date or dates of service or product delivery Slice: Unordered, Closed by type:$this
location[x]	S	0..1	CodeableConcept	Place of service or where product was supplied Binding: ?? (required)	S	1..1	CodeableConcept	Place of service or where product was supplied Binding: ?? (required)	Element minimum cardinalities differ: '0' vs '1'
quantity	S	0..1	??	Count of products or services	SC	0..1	??	A fixed quantity (no comparator) qty-3: If a code for the unit is present, the system SHALL also be present sqty-1: The comparator is not used on a SimpleQuantity
unitPrice	S	0..1	Money	Fee, charge or cost per item	S	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(Encounter)	Encounters related to this billed item		0..*	Reference(Encounter)	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