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

Left:PAS Claim Inquiry Response (http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claiminquiryresponse)
Right:PAS Claim Inquiry Response (http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claiminquiryresponse)

Messages

ErrorStructureDefinition.versionValues for version differ: '2.1.0-preview' vs '2.1.0'
InformationStructureDefinition.dateValues for date differ: '2024-09-26T18:54:51-04:00' vs '2024-12-20T19:33:39+00:00'
InformationStructureDefinition.shortValues for short differ: 'Count of products or services' vs 'A fixed quantity (no comparator)'
InformationStructureDefinition.definitionValues for definition differ: 'The number of repetitions of a service or product.' vs 'The comparator is not used on a SimpleQuantity'
WarningClaimResponse.adjudicationElements differ in definition for mustSupport: 'false' vs 'true'
ErrorClaimResponse.adjudicationType Mismatch: vs BackboneElement

Metadata

NameValueComments
.abstractfalse
    .baseDefinitionhttp://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claimresponse-base
      .copyright
        .date2024-09-26T18:54:51-04:002024-12-20T19:33:39+00:00
        • Values Differ
        .descriptionPAS constraints on Claim resource mandating support for elements relevant to the response of an inquiry for details of previous authorizations.
          .experimental
            .fhirVersion4.0.1
              .jurisdiction
                ..jurisdiction[0]urn:iso:std:iso:3166#US
                  .kindresource
                    .namePASClaimInquiryResponse
                      .publisherHL7 International / Financial Management
                        .purpose
                          .statusactive
                            .titlePAS Claim Inquiry Response
                              .typeClaimResponse
                                .urlhttp://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claiminquiryresponse
                                  .version2.1.0-preview2.1.0
                                  • Values Differ

                                  Structure

                                  NameL FlagsL Card.L TypeL Description & ConstraintsR FlagsR Card.R TypeR Description & ConstraintsCommentsdoco
                                  .. ClaimResponse 0..*PASClaimResponseBaseResponse to a preauthorization query
                                  0..*PASClaimResponseBaseResponse to a preauthorization query
                                    ... id Σ0..1idLogical id of this artifactΣ0..1idLogical id of this artifact
                                      ... meta Σ0..1MetaMetadata about the resourceΣ0..1MetaMetadata about the resource
                                        ... implicitRules ?!Σ0..1uriA set of rules under which this content was created?!Σ0..1uriA set of rules under which this content was created
                                          ... language 0..1codeLanguage of the resource content
                                          Binding: ?? (preferred): A human language.

                                          Additional BindingsPurpose
                                          ??Max Binding
                                          0..1codeLanguage of the resource content
                                          Binding: ?? (preferred): A human language.

                                          Additional BindingsPurpose
                                          ??Max Binding
                                            ... text 0..1NarrativeText summary of the resource, for human interpretation0..1NarrativeText summary of the resource, for human interpretation
                                              ... contained 0..*ResourceContained, inline Resources
                                              0..*ResourceContained, inline Resources
                                                ... extension 0..*ExtensionAdditional content defined by implementations
                                                0..*ExtensionAdditional content defined by implementations
                                                  ... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
                                                  ?!0..*ExtensionExtensions that cannot be ignored
                                                    ... identifier S0..*??An identifier intended for computation
                                                    S0..*??An identifier intended for computation
                                                      .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                        .... Slices for extension 0..*ExtensionAdditional content defined by implementations
                                                        Slice: Unordered, Open by value:url
                                                        0..*ExtensionAdditional content defined by implementations
                                                        Slice: Unordered, Open by value:url
                                                          .... use ?!Σ0..1codeusual | official | temp | secondary | old (If known)
                                                          Binding: ?? (required): Identifies the purpose for this identifier, if known .

                                                          ?!Σ0..1codeusual | official | temp | secondary | old (If known)
                                                          Binding: ?? (required): Identifies the purpose for this identifier, if known .

                                                            .... type Σ0..1CodeableConceptDescription of identifier
                                                            Binding: ?? (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                                                            Σ0..1CodeableConceptDescription of identifier
                                                            Binding: ?? (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                                                              .... system SΣ1..1uriShould use a scheme of 'urn:trnorg:<TRN03>'
                                                              Example General: http://www.acme.com/identifiers/patient
                                                              SΣ1..1uriShould use a scheme of 'urn:trnorg:<TRN03>'
                                                              Example General: http://www.acme.com/identifiers/patient
                                                                .... value SΣ1..1stringThe value that is unique
                                                                Example General: 123456
                                                                SΣ1..1stringThe value that is unique
                                                                Example General: 123456
                                                                  .... period Σ0..1PeriodTime period when id is/was valid for useΣ0..1PeriodTime period when id is/was valid for use
                                                                    .... assigner Σ0..1Reference(Organization)Organization that issued id (may be just text)Σ0..1Reference(Organization)Organization that issued id (may be just text)
                                                                      ... status ?!SΣ1..1codeactive | cancelled | draft | entered-in-error
                                                                      Binding: ?? (required): A code specifying the state of the resource instance.


                                                                      Required Pattern: active
                                                                      ?!SΣ1..1codeactive | cancelled | draft | entered-in-error
                                                                      Binding: ?? (required): A code specifying the state of the resource instance.


                                                                      Required Pattern: active
                                                                        ... type Σ1..1CodeableConceptMore granular claim type
                                                                        Binding: ?? (extensible): The type or discipline-style of the claim.

                                                                        Σ1..1CodeableConceptMore granular claim type
                                                                        Binding: ?? (extensible): The type or discipline-style of the claim.

                                                                          ... subType 0..1CodeableConceptMore granular claim type
                                                                          Binding: ?? (example): A more granular claim typecode.

                                                                          0..1CodeableConceptMore granular claim type
                                                                          Binding: ?? (example): A more granular claim typecode.

                                                                            ... use Σ1..1codeclaim | preauthorization | predetermination
                                                                            Binding: ?? (required): Claim, preauthorization, predetermination.


                                                                            Required Pattern: preauthorization
                                                                            Σ1..1codeclaim | preauthorization | predetermination
                                                                            Binding: ?? (required): Claim, preauthorization, predetermination.


                                                                            Required Pattern: preauthorization
                                                                              ... patient SΣ1..1Reference(PAS Beneficiary Patient)The recipient of the products and servicesSΣ1..1Reference(PAS Beneficiary Patient)The recipient of the products and services
                                                                                ... created SΣ1..1dateTimeResponse creation dateSΣ1..1dateTimeResponse creation date
                                                                                  ... insurer SΣ1..1Reference(PAS Insurer Organization)Party responsible for reimbursementSΣ1..1Reference(PAS Insurer Organization)Party responsible for reimbursement
                                                                                    ... requestor S0..1Reference(PAS Requestor Organization | PAS PractitionerRole)Party responsible for the claimS0..1Reference(PAS Requestor Organization | PAS PractitionerRole)Party responsible for the claim
                                                                                      ... request SΣ1..1Reference(PAS Claim)Id of resource triggering adjudicationSΣ1..1Reference(PAS Claim)Id of resource triggering adjudication
                                                                                        ... outcome SΣ1..1codequeued | complete | error | partial
                                                                                        Binding: ?? (required): The result of the claim processing.

                                                                                        SΣ1..1codequeued | complete | error | partial
                                                                                        Binding: ?? (required): The result of the claim processing.

                                                                                          ... disposition 0..1stringDisposition Message0..1stringDisposition Message
                                                                                            ... preAuthRef 0..1stringPreauthorization reference0..1stringPreauthorization reference
                                                                                              ... preAuthPeriod S0..1PeriodPreauthorization reference effective periodS0..1PeriodPreauthorization reference effective period
                                                                                                ... payeeType 0..1CodeableConceptParty to be paid any benefits payable
                                                                                                Binding: ?? (example): A code for the party to be reimbursed.

                                                                                                0..1CodeableConceptParty to be paid any benefits payable
                                                                                                Binding: ?? (example): A code for the party to be reimbursed.

                                                                                                  ... item S0..*BackboneElementAdjudication for claim line items
                                                                                                  S0..*BackboneElementAdjudication for claim line items
                                                                                                    .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                      .... Slices for extension 0..*ExtensionExtension
                                                                                                      Slice: Unordered, Open by value:url
                                                                                                      0..*ExtensionExtension
                                                                                                      Slice: Unordered, Open by value:url
                                                                                                        .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                        ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                          .... itemSequence S1..1positiveIntClaim item instance identifierS1..1positiveIntClaim item instance identifier
                                                                                                            .... noteNumber 0..*positiveIntApplicable note numbers
                                                                                                            0..*positiveIntApplicable note numbers
                                                                                                              .... adjudication S1..*BackboneElementAdjudication details
                                                                                                              S1..*BackboneElementAdjudication details
                                                                                                                ..... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                  ..... Slices for extension 0..*ExtensionExtension
                                                                                                                  Slice: Unordered, Open by value:url
                                                                                                                  0..*ExtensionExtension
                                                                                                                  Slice: Unordered, Open by value:url
                                                                                                                    ..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                    ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                      ..... category 1..1CodeableConceptThis code is fixed to 'submitted' to indicate that the adjudication result is on what was submitted.
                                                                                                                      Binding: ?? (example): The adjudication codes.


                                                                                                                      Required Pattern: {"coding":[{"system":"http://terminology.hl7.org/CodeSystem/adjudication","code":"submitted"}]}
                                                                                                                      1..1CodeableConceptThis code is fixed to 'submitted' to indicate that the adjudication result is on what was submitted.
                                                                                                                      Binding: ?? (example): The adjudication codes.


                                                                                                                      Required Pattern: {"coding":[{"system":"http://terminology.hl7.org/CodeSystem/adjudication","code":"submitted"}]}
                                                                                                                        ..... reason 0..1CodeableConceptExplanation of adjudication outcome
                                                                                                                        Binding: ?? (example): The adjudication reason codes.

                                                                                                                        0..1CodeableConceptExplanation of adjudication outcome
                                                                                                                        Binding: ?? (example): The adjudication reason codes.

                                                                                                                          ..... amount 0..1MoneyMonetary amount0..1MoneyMonetary amount
                                                                                                                            ..... value 0..1decimalNon-monetary value0..1decimalNon-monetary value
                                                                                                                              .... detail 0..*BackboneElementAdjudication for claim details
                                                                                                                              0..*BackboneElementAdjudication for claim details
                                                                                                                                ..... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                  ..... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                  0..*ExtensionAdditional content defined by implementations
                                                                                                                                    ..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                    ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                      ..... detailSequence 1..1positiveIntClaim detail instance identifier1..1positiveIntClaim detail instance identifier
                                                                                                                                        ..... noteNumber 0..*positiveIntApplicable note numbers
                                                                                                                                        0..*positiveIntApplicable note numbers
                                                                                                                                          ..... adjudication 1..*See adjudication (ClaimResponse)Detail level adjudication details
                                                                                                                                          1..*See adjudication (ClaimResponse)Detail level adjudication details
                                                                                                                                            ..... subDetail 0..*BackboneElementAdjudication for claim sub-details
                                                                                                                                            0..*BackboneElementAdjudication for claim sub-details
                                                                                                                                              ...... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                ...... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                0..*ExtensionAdditional content defined by implementations
                                                                                                                                                  ...... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                  ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                    ...... subDetailSequence 1..1positiveIntClaim sub-detail instance identifier1..1positiveIntClaim sub-detail instance identifier
                                                                                                                                                      ...... noteNumber 0..*positiveIntApplicable note numbers
                                                                                                                                                      0..*positiveIntApplicable note numbers
                                                                                                                                                        ...... adjudication 0..*See adjudication (ClaimResponse)Subdetail level adjudication details
                                                                                                                                                        0..*See adjudication (ClaimResponse)Subdetail level adjudication details
                                                                                                                                                          ... addItem S0..*BackboneElementInsurer added line items
                                                                                                                                                          S0..*BackboneElementInsurer added line items
                                                                                                                                                            .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                              .... Slices for extension 0..*ExtensionExtension
                                                                                                                                                              Slice: Unordered, Open by value:url
                                                                                                                                                              0..*ExtensionExtension
                                                                                                                                                              Slice: Unordered, Open by value:url
                                                                                                                                                                .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                  .... itemSequence S1..1positiveIntItem sequence number
                                                                                                                                                                  S1..1positiveIntItem sequence number
                                                                                                                                                                    .... detailSequence 0..*positiveIntDetail sequence number
                                                                                                                                                                    0..*positiveIntDetail sequence number
                                                                                                                                                                      .... subdetailSequence 0..*positiveIntSubdetail sequence number
                                                                                                                                                                      0..*positiveIntSubdetail sequence number
                                                                                                                                                                        .... provider S0..*Reference(PAS Practitioner | PAS Organization Base Profile)Authorized providers
                                                                                                                                                                        S0..*Reference(PAS Practitioner | PAS Organization Base Profile)Authorized providers
                                                                                                                                                                          ..... id 0..1stringUnique id for inter-element referencing
                                                                                                                                                                          • Added this element
                                                                                                                                                                          ..... Slices for extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                          Slice: Unordered, Open by value:url
                                                                                                                                                                          • Added this element
                                                                                                                                                                          ..... reference ΣC0..1stringLiteral reference, Relative, internal or absolute URL
                                                                                                                                                                          • Added this element
                                                                                                                                                                          ..... type Σ0..1uriType the reference refers to (e.g. "Patient")
                                                                                                                                                                          Binding: ?? (extensible): Aa resource (or, for logical models, the URI of the logical model).

                                                                                                                                                                          • Added this element
                                                                                                                                                                          ..... identifier Σ0..1IdentifierLogical reference, when literal reference is not known
                                                                                                                                                                          • Added this element
                                                                                                                                                                          ..... display Σ0..1stringText alternative for the resource
                                                                                                                                                                          • Added this element
                                                                                                                                                                          .... productOrService S1..1CodeableConceptBilling, service, product, or drug code
                                                                                                                                                                          Binding: ?? (required)
                                                                                                                                                                          S1..1CodeableConceptBilling, service, product, or drug code
                                                                                                                                                                          Binding: ?? (required)
                                                                                                                                                                            .... modifier S0..*CodeableConceptService/Product billing modifiers
                                                                                                                                                                            Binding: ?? (required)
                                                                                                                                                                            S0..*CodeableConceptService/Product billing modifiers
                                                                                                                                                                            Binding: ?? (required)
                                                                                                                                                                              .... programCode 0..*CodeableConceptProgram the product or service is provided under
                                                                                                                                                                              Binding: ?? (example): Program specific reason codes.


                                                                                                                                                                              0..*CodeableConceptProgram the product or service is provided under
                                                                                                                                                                              Binding: ?? (example): Program specific reason codes.


                                                                                                                                                                                .... serviced[x] S0..1date, PeriodDate or dates of service or product deliveryS0..1date, PeriodDate or dates of service or product delivery
                                                                                                                                                                                  .... location[x] S0..1CodeableConcept, Address, Reference(Location)Place of service or where product was supplied
                                                                                                                                                                                  Binding: ?? (example): Place of service: pharmacy, school, prison, etc.

                                                                                                                                                                                  S0..1CodeableConcept, Address, Reference(Location)Place of service or where product was supplied
                                                                                                                                                                                  Binding: ?? (example): Place of service: pharmacy, school, prison, etc.

                                                                                                                                                                                    .... quantity S0..1??Count of products or servicesSC0..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 S0..1MoneyFee, charge or cost per itemS0..1MoneyFee, charge or cost per item
                                                                                                                                                                                        .... factor 0..1decimalPrice scaling factor0..1decimalPrice scaling factor
                                                                                                                                                                                          .... net 0..1MoneyTotal item cost0..1MoneyTotal item cost
                                                                                                                                                                                            .... bodySite 0..1CodeableConceptAnatomical location
                                                                                                                                                                                            Binding: ?? (example): The code for the teeth, quadrant, sextant and arch.

                                                                                                                                                                                            0..1CodeableConceptAnatomical location
                                                                                                                                                                                            Binding: ?? (example): The code for the teeth, quadrant, sextant and arch.

                                                                                                                                                                                              .... subSite 0..*CodeableConceptAnatomical sub-location
                                                                                                                                                                                              Binding: ?? (example): The code for the tooth surface and surface combinations.


                                                                                                                                                                                              0..*CodeableConceptAnatomical sub-location
                                                                                                                                                                                              Binding: ?? (example): The code for the tooth surface and surface combinations.


                                                                                                                                                                                                .... noteNumber 0..*positiveIntApplicable note numbers
                                                                                                                                                                                                0..*positiveIntApplicable note numbers
                                                                                                                                                                                                  .... adjudication S1..*BackboneElementAdded items adjudication
                                                                                                                                                                                                  S1..*BackboneElementAdded items adjudication
                                                                                                                                                                                                    ..... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                      ..... Slices for extension 0..*ExtensionExtension
                                                                                                                                                                                                      Slice: Unordered, Open by value:url
                                                                                                                                                                                                      0..*ExtensionExtension
                                                                                                                                                                                                      Slice: Unordered, Open by value:url
                                                                                                                                                                                                        ..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                        ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                          ..... category 1..1CodeableConceptThis code is fixed to 'submitted' to indicate that the adjudication result is on what was submitted.
                                                                                                                                                                                                          Binding: ?? (example): The adjudication codes.


                                                                                                                                                                                                          Required Pattern: {"coding":[{"system":"http://terminology.hl7.org/CodeSystem/adjudication","code":"submitted"}]}
                                                                                                                                                                                                          1..1CodeableConceptThis code is fixed to 'submitted' to indicate that the adjudication result is on what was submitted.
                                                                                                                                                                                                          Binding: ?? (example): The adjudication codes.


                                                                                                                                                                                                          Required Pattern: {"coding":[{"system":"http://terminology.hl7.org/CodeSystem/adjudication","code":"submitted"}]}
                                                                                                                                                                                                            ..... reason 0..1CodeableConceptExplanation of adjudication outcome
                                                                                                                                                                                                            Binding: ?? (example): The adjudication reason codes.

                                                                                                                                                                                                            0..1CodeableConceptExplanation of adjudication outcome
                                                                                                                                                                                                            Binding: ?? (example): The adjudication reason codes.

                                                                                                                                                                                                              ..... amount 0..1MoneyMonetary amount0..1MoneyMonetary amount
                                                                                                                                                                                                                ..... value 0..1decimalNon-monetary value0..1decimalNon-monetary value
                                                                                                                                                                                                                  .... detail 0..*BackboneElementInsurer added line details
                                                                                                                                                                                                                  0..*BackboneElementInsurer added line details
                                                                                                                                                                                                                    ..... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                                      ..... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                      0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                        ..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                        ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                          ..... productOrService 1..1CodeableConceptBilling, service, product, or drug code
                                                                                                                                                                                                                          Binding: ?? (example): Allowable service and product codes.

                                                                                                                                                                                                                          1..1CodeableConceptBilling, service, product, or drug code
                                                                                                                                                                                                                          Binding: ?? (example): Allowable service and product codes.

                                                                                                                                                                                                                            ..... modifier 0..*CodeableConceptService/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..*CodeableConceptService/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.


                                                                                                                                                                                                                              ..... quantity 0..1??Count of products or services0..1??Count of products or services
                                                                                                                                                                                                                                ..... unitPrice 0..1MoneyFee, charge or cost per item0..1MoneyFee, charge or cost per item
                                                                                                                                                                                                                                  ..... factor 0..1decimalPrice scaling factor0..1decimalPrice scaling factor
                                                                                                                                                                                                                                    ..... net 0..1MoneyTotal item cost0..1MoneyTotal item cost
                                                                                                                                                                                                                                      ..... noteNumber 0..*positiveIntApplicable note numbers
                                                                                                                                                                                                                                      0..*positiveIntApplicable note numbers
                                                                                                                                                                                                                                        ..... adjudication 1..*See adjudication (ClaimResponse)Added items detail adjudication
                                                                                                                                                                                                                                        1..*See adjudication (ClaimResponse)Added items detail adjudication
                                                                                                                                                                                                                                          ..... subDetail 0..*BackboneElementInsurer added line items
                                                                                                                                                                                                                                          0..*BackboneElementInsurer added line items
                                                                                                                                                                                                                                            ...... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                                                              ...... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                              0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                ...... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                  ...... productOrService 1..1CodeableConceptBilling, service, product, or drug code
                                                                                                                                                                                                                                                  Binding: ?? (example): Allowable service and product codes.

                                                                                                                                                                                                                                                  1..1CodeableConceptBilling, service, product, or drug code
                                                                                                                                                                                                                                                  Binding: ?? (example): Allowable service and product codes.

                                                                                                                                                                                                                                                    ...... modifier 0..*CodeableConceptService/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..*CodeableConceptService/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.


                                                                                                                                                                                                                                                      ...... quantity 0..1??Count of products or services0..1??Count of products or services
                                                                                                                                                                                                                                                        ...... unitPrice 0..1MoneyFee, charge or cost per item0..1MoneyFee, charge or cost per item
                                                                                                                                                                                                                                                          ...... factor 0..1decimalPrice scaling factor0..1decimalPrice scaling factor
                                                                                                                                                                                                                                                            ...... net 0..1MoneyTotal item cost0..1MoneyTotal item cost
                                                                                                                                                                                                                                                              ...... noteNumber 0..*positiveIntApplicable note numbers
                                                                                                                                                                                                                                                              0..*positiveIntApplicable note numbers
                                                                                                                                                                                                                                                                ...... adjudication 1..*See adjudication (ClaimResponse)Added items detail adjudication
                                                                                                                                                                                                                                                                1..*See adjudication (ClaimResponse)Added items detail adjudication
                                                                                                                                                                                                                                                                  ... adjudication 0..*See adjudication (ClaimResponse)Header-level adjudication
                                                                                                                                                                                                                                                                  S0..*BackboneElementHeader-level adjudication
                                                                                                                                                                                                                                                                  • Elements differ in definition for mustSupport: 'false' vs 'true'
                                                                                                                                                                                                                                                                  • Type Mismatch: vs BackboneElement
                                                                                                                                                                                                                                                                  .... id 0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                                                                                  • Added this element
                                                                                                                                                                                                                                                                  .... Slices for extension 0..*ExtensionExtension
                                                                                                                                                                                                                                                                  Slice: Unordered, Open by value:url
                                                                                                                                                                                                                                                                  • Added this element
                                                                                                                                                                                                                                                                  .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                  • Added this element
                                                                                                                                                                                                                                                                  .... category 1..1CodeableConceptThis code is fixed to 'submitted' to indicate that the adjudication result is on what was submitted.
                                                                                                                                                                                                                                                                  Binding: ?? (example): The adjudication codes.


                                                                                                                                                                                                                                                                  Required Pattern: {"coding":[{"system":"http://terminology.hl7.org/CodeSystem/adjudication","code":"submitted"}]}
                                                                                                                                                                                                                                                                  • Added this element
                                                                                                                                                                                                                                                                  .... reason 0..1CodeableConceptExplanation of adjudication outcome
                                                                                                                                                                                                                                                                  Binding: ?? (example): The adjudication reason codes.

                                                                                                                                                                                                                                                                  • Added this element
                                                                                                                                                                                                                                                                  .... amount 0..1MoneyMonetary amount
                                                                                                                                                                                                                                                                  • Added this element
                                                                                                                                                                                                                                                                  .... value 0..1decimalNon-monetary value
                                                                                                                                                                                                                                                                  • Added this element
                                                                                                                                                                                                                                                                  ... total Σ0..*BackboneElementAdjudication totals
                                                                                                                                                                                                                                                                  Σ0..*BackboneElementAdjudication totals
                                                                                                                                                                                                                                                                    .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                                                                                      .... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                      0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                        .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                        ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                          .... category Σ1..1CodeableConceptType of adjudication information
                                                                                                                                                                                                                                                                          Binding: ?? (example): The adjudication codes.

                                                                                                                                                                                                                                                                          Σ1..1CodeableConceptType of adjudication information
                                                                                                                                                                                                                                                                          Binding: ?? (example): The adjudication codes.

                                                                                                                                                                                                                                                                            .... amount Σ1..1MoneyFinancial total for the categoryΣ1..1MoneyFinancial total for the category
                                                                                                                                                                                                                                                                              ... payment 0..1BackboneElementPayment Details0..1BackboneElementPayment Details
                                                                                                                                                                                                                                                                                .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                                                                                                  .... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                  0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                    .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                    ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                      .... type 1..1CodeableConceptPartial or complete payment
                                                                                                                                                                                                                                                                                      Binding: ?? (example): The type (partial, complete) of the payment.

                                                                                                                                                                                                                                                                                      1..1CodeableConceptPartial or complete payment
                                                                                                                                                                                                                                                                                      Binding: ?? (example): The type (partial, complete) of the payment.

                                                                                                                                                                                                                                                                                        .... adjustment 0..1MoneyPayment adjustment for non-claim issues0..1MoneyPayment adjustment for non-claim issues
                                                                                                                                                                                                                                                                                          .... adjustmentReason 0..1CodeableConceptExplanation for the adjustment
                                                                                                                                                                                                                                                                                          Binding: ?? (example): Payment Adjustment reason codes.

                                                                                                                                                                                                                                                                                          0..1CodeableConceptExplanation for the adjustment
                                                                                                                                                                                                                                                                                          Binding: ?? (example): Payment Adjustment reason codes.

                                                                                                                                                                                                                                                                                            .... date 0..1dateExpected date of payment0..1dateExpected date of payment
                                                                                                                                                                                                                                                                                              .... amount 1..1MoneyPayable amount after adjustment1..1MoneyPayable amount after adjustment
                                                                                                                                                                                                                                                                                                .... identifier 0..1IdentifierBusiness identifier for the payment0..1IdentifierBusiness identifier for the payment
                                                                                                                                                                                                                                                                                                  ... fundsReserve 0..1CodeableConceptFunds reserved status
                                                                                                                                                                                                                                                                                                  Binding: ?? (example): For whom funds are to be reserved: (Patient, Provider, None).

                                                                                                                                                                                                                                                                                                  0..1CodeableConceptFunds reserved status
                                                                                                                                                                                                                                                                                                  Binding: ?? (example): For whom funds are to be reserved: (Patient, Provider, None).

                                                                                                                                                                                                                                                                                                    ... formCode 0..1CodeableConceptPrinted form identifier
                                                                                                                                                                                                                                                                                                    Binding: ?? (example): The forms codes.

                                                                                                                                                                                                                                                                                                    0..1CodeableConceptPrinted form identifier
                                                                                                                                                                                                                                                                                                    Binding: ?? (example): The forms codes.

                                                                                                                                                                                                                                                                                                      ... form 0..1AttachmentPrinted reference or actual form0..1AttachmentPrinted reference or actual form
                                                                                                                                                                                                                                                                                                        ... processNote 0..*BackboneElementNote concerning adjudication
                                                                                                                                                                                                                                                                                                        0..*BackboneElementNote concerning adjudication
                                                                                                                                                                                                                                                                                                          .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                                                                                                                            .... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                                            0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                                              .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                              ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                                .... number 0..1positiveIntNote instance identifier0..1positiveIntNote instance identifier
                                                                                                                                                                                                                                                                                                                  .... type 0..1codedisplay | print | printoper
                                                                                                                                                                                                                                                                                                                  Binding: ?? (required): The presentation types of notes.

                                                                                                                                                                                                                                                                                                                  0..1codedisplay | print | printoper
                                                                                                                                                                                                                                                                                                                  Binding: ?? (required): The presentation types of notes.

                                                                                                                                                                                                                                                                                                                    .... text 1..1stringNote explanatory text1..1stringNote explanatory text
                                                                                                                                                                                                                                                                                                                      .... language 0..1CodeableConceptLanguage of the text
                                                                                                                                                                                                                                                                                                                      Binding: ?? (preferred): A human language.

                                                                                                                                                                                                                                                                                                                      Additional BindingsPurpose
                                                                                                                                                                                                                                                                                                                      ??Max Binding
                                                                                                                                                                                                                                                                                                                      0..1CodeableConceptLanguage of the text
                                                                                                                                                                                                                                                                                                                      Binding: ?? (preferred): A human language.

                                                                                                                                                                                                                                                                                                                      Additional BindingsPurpose
                                                                                                                                                                                                                                                                                                                      ??Max Binding
                                                                                                                                                                                                                                                                                                                        ... communicationRequest 0..*Reference(CommunicationRequest)Request for additional information
                                                                                                                                                                                                                                                                                                                        0..*Reference(CommunicationRequest)Request for additional information
                                                                                                                                                                                                                                                                                                                          ... insurance 0..*BackboneElementPatient insurance information
                                                                                                                                                                                                                                                                                                                          0..*BackboneElementPatient insurance information
                                                                                                                                                                                                                                                                                                                            .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                                                                                                                                              .... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                                                              0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                                                                .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                                                ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                                                  .... sequence 1..1positiveIntInsurance instance identifier1..1positiveIntInsurance instance identifier
                                                                                                                                                                                                                                                                                                                                    .... focal 1..1booleanCoverage to be used for adjudication1..1booleanCoverage to be used for adjudication
                                                                                                                                                                                                                                                                                                                                      .... coverage 1..1Reference(Coverage)Insurance information1..1Reference(Coverage)Insurance information
                                                                                                                                                                                                                                                                                                                                        .... businessArrangement 0..1stringAdditional provider contract number0..1stringAdditional provider contract number
                                                                                                                                                                                                                                                                                                                                          .... claimResponse 0..1Reference(ClaimResponse)Adjudication results0..1Reference(ClaimResponse)Adjudication results
                                                                                                                                                                                                                                                                                                                                            ... error S0..*BackboneElementProcessing errors
                                                                                                                                                                                                                                                                                                                                            S0..*BackboneElementProcessing errors
                                                                                                                                                                                                                                                                                                                                              .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                                                                                                                                                                .... Slices for extension 0..*ExtensionExtension
                                                                                                                                                                                                                                                                                                                                                Slice: Unordered, Open by value:url
                                                                                                                                                                                                                                                                                                                                                0..*ExtensionExtension
                                                                                                                                                                                                                                                                                                                                                Slice: Unordered, Open by value:url
                                                                                                                                                                                                                                                                                                                                                  .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                                                                  ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                                                                    .... itemSequence 0..1positiveIntItem sequence number0..1positiveIntItem sequence number
                                                                                                                                                                                                                                                                                                                                                      .... detailSequence 0..1positiveIntDetail sequence number0..1positiveIntDetail sequence number
                                                                                                                                                                                                                                                                                                                                                        .... subDetailSequence 0..1positiveIntSubdetail sequence number0..1positiveIntSubdetail sequence number
                                                                                                                                                                                                                                                                                                                                                          .... code S1..1CodeableConceptError code detailing processing issues
                                                                                                                                                                                                                                                                                                                                                          Binding: ?? (required)
                                                                                                                                                                                                                                                                                                                                                          S1..1CodeableConceptError code detailing processing issues
                                                                                                                                                                                                                                                                                                                                                          Binding: ?? (required)

                                                                                                                                                                                                                                                                                                                                                            doco Documentation for this format