Patient Cost Transparency Implementation Guide
2.0.1 - STU 2

Patient Cost Transparency Implementation Guide, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pct/ and changes regularly. See the Directory of published versions

## Downloads

Page standards status: Informative

### Downloads

- The full FHIR PCT Implementation Guide
- FHIR PCT Resource Definitions (JSON) (XML) (TTL)
- FHIR PCT IG Profile Examples (JSON) (XML) (TTL)
- FHIR PCT IG Validator Pack
- FHIR R4 Specification Downloads
- FHIR R4 Core Specification Text
- Instructions for the FHIR Validator
- Current version of the FHIR Validator

#### Package File

The following package file includes an NPM (Node Package Manager) package file used by many of the FHIR tools. It contains all the value sets, profiles, extensions, list of pages and URLs in the implementation guide (IG), etc. defined as part of this version of the IG. This file should be the first choice whenever generating any implementation artifacts since it contains all of the rules about what makes the profiles valid. Implementers will still need to be familiar with the content of the specification and profiles that apply to make a conformant implementation. See the overview on validating FHIR profiles and resources:

- Package

#### Cross Version Analysis

This is an R4 IG. None of the features it uses are changed in R4B, so it can be used as is with R4B systems. Packages for both R4 (hl7.fhir.us.davinci-pct.r4) and R4B (hl7.fhir.us.davinci-pct.r4b) are available.

#### Dependency Table

IG | Package | FHIR | Comment
--- | --- | --- | ---
Patient Cost Transparency Implementation Guide | hl7.fhir.us.davinci-pct#2.0.1 | R4 |
FHIR Extensions Pack | hl7.fhir.uv.extensions.r4#5.2.0 | R4 | Automatically added as a dependency - all IGs depend on the HL7 Extension Pack
US Core Implementation Guide | hl7.fhir.us.core#7.0.0 | R4 | Needed for systems supporting USCDI v4
HL7 Terminology (THO) | hl7.terminology.r4#5.5.0 | R4 |
SMART App Launch | hl7.fhir.uv.smart-app-launch#2.0.0 | R4 |
VSAC | us.nlm.vsac#0.18.0 | R4 |
Structured Data Capture | hl7.fhir.uv.sdc#3.0.0 | R4 |
PHINVads | us.cdc.phinvads#0.12.0 | R4 |
US Core (Reuse Wrapper) | hl7.fhir.us.core.v610#6.1.0 | R4 | Needed for systems supporting USCDI v3
US Core Implementation Guide | hl7.fhir.us.core#6.1.0 | R4 |
HL7 Terminology (THO) | hl7.terminology.r4#5.0.0 | R4 |
FHIR Extensions Pack | hl7.fhir.uv.extensions.r4#1.0.0 | R4 |
Bulk Data Access IG | hl7.fhir.uv.bulkdata#2.0.0 | R4 |
SMART App Launch | hl7.fhir.uv.smart-app-launch#2.1.0 | R4 |
VSAC | us.nlm.vsac#0.11.0 | R4 |
IHE FormatCode Vocabulary | ihe.formatcode.fhir#1.1.0 | R4 |
US Core (Reuse Wrapper) | hl7.fhir.us.core.v311#3.1.1 | R4 | Needed for systems supporting USCDI v1
US Core | hl7.fhir.us.core#3.1.1 | R4 |
Da Vinci Health Record Exchange (HRex) | hl7.fhir.us.davinci-hrex#1.1.0 | R4 |
HL7 Terminology (THO) | hl7.terminology.r4#6.1.0 | R4 |
FHIR Extensions Pack | hl7.fhir.uv.extensions.r4#5.1.0 | R4 |
VSAC | us.nlm.vsac#0.19.0 | R4 |
HL7 Terminology (THO) | hl7.terminology.r4#6.5.0 | R4 |
Subscriptions R5 Backport | hl7.fhir.uv.subscriptions-backport.r4#1.1.0 | R4 |
FHIR Tooling Extensions IG | hl7.fhir.uv.tools.r4#1.1.2 | R4 | for example references

Package hl7.fhir.uv.extensions.r4#5.2.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Mon, Feb 10, 2025 21:45+1100+11:00)

Package hl7.fhir.uv.sdc#3.0.0 The SDC specification provides an infrastructure to standardize the capture and expanded use of patient-level data collected within an EHR. This includes two components: * Support more sophisticated questionnaire/form use-cases such as those needed for research, oncology, pathology and other clinical domains. *Support pre-population and auto-population of EHR data into forms/questionnaires for uses outside direct clinical care (patient safety, adverse event reporting, public health reporting, etc.). (built Tue, Mar 8, 2022 18:32+0000+00:00)

Package hl7.fhir.us.core#7.0.0 The US Core Implementation Guide is based on FHIR Version R4 and defines the minimum conformance requirements for accessing patient data. The Argonaut pilot implementations, ONC 2015 Edition Common Clinical Data Set (CCDS), and ONC U.S. Core Data for Interoperability (USCDI) v1 provided the requirements for this guide. The prior Argonaut search and vocabulary requirements, based on FHIR DSTU2, are updated in this guide to support FHIR Version R4. This guide was used as the basis for further testing and guidance by the Argonaut Project Team to provide additional content and guidance specific to Data Query Access for purpose of ONC Certification testing. These profiles are the foundation for future US Realm FHIR implementation guides. In addition to Argonaut, they are used by DAF-Research, QI-Core, and CIMI. Under the guidance of HL7 and the HL7 US Realm Steering Committee, the content will expand in future versions to meet the needs specific to the US Realm. These requirements were originally developed, balloted, and published in FHIR DSTU2 as part of the Office of the National Coordinator for Health Information Technology (ONC) sponsored Data Access Framework (DAF) project. For more information on how DAF became US Core see the US Core change notes. (built Wed, May 8, 2024 15:33+0000+00:00)

Package hl7.fhir.uv.extensions.r4#1.0.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Sun, Mar 26, 2023 08:46+1100+11:00)

Package hl7.fhir.uv.bulkdata#2.0.0 FHIR based approach for exporting large data sets from a FHIR server to a client application (built Fri, Nov 26, 2021 05:56+1100+11:00)

Package ihe.formatcode.fhir#1.1.0 Implementation Guide for IHE defined FormatCode vocabulary. (built Thu, Feb 24, 2022 16:55-0600-06:00)

Package hl7.fhir.us.core#6.1.0 The US Core Implementation Guide is based on FHIR Version R4 and defines the minimum conformance requirements for accessing patient data. The Argonaut pilot implementations, ONC 2015 Edition Common Clinical Data Set (CCDS), and ONC U.S. Core Data for Interoperability (USCDI) v1 provided the requirements for this guide. The prior Argonaut search and vocabulary requirements, based on FHIR DSTU2, are updated in this guide to support FHIR Version R4. This guide was used as the basis for further testing and guidance by the Argonaut Project Team to provide additional content and guidance specific to Data Query Access for purpose of ONC Certification testing. These profiles are the foundation for future US Realm FHIR implementation guides. In addition to Argonaut, they are used by DAF-Research, QI-Core, and CIMI. Under the guidance of HL7 and the HL7 US Realm Steering Committee, the content will expand in future versions to meet the needs specific to the US Realm. These requirements were originally developed, balloted, and published in FHIR DSTU2 as part of the Office of the National Coordinator for Health Information Technology (ONC) sponsored Data Access Framework (DAF) project. For more information on how DAF became US Core see the US Core change notes. (built Fri, Jun 30, 2023 14:02+0000+00:00)

Package hl7.fhir.uv.extensions.r4#5.1.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Sat, Apr 27, 2024 18:39+1000+10:00)

Package hl7.fhir.us.davinci-hrex#1.1.0 The Da Vinci Payer Health Record exchange (HRex) Framework/library specifies the FHIR elements used in multiple Da Vinci implementation guides. This includes FHIR profiles, functions, operations, and constraints on other specifications such as CDS-Hooks and other aspects of Da Vinci Use Cases that are common across more than a single use case.\n\nDa Vinci HRex Implementation Guide (IG) will make use of US Core profiles that are based on the FHIR R4 specification wherever practical. The HRex IG will use the HL7 FHIR Release 4/US Core STU3 specification as its base but will provide additional guidance and documentation to support implementations that follow the HL7 FHIR STU3/US Core STU2 and HL7 FHIR DSTU2/Argonaut specifications.\n\nThe HRex profiles documented in this IG will be used to exchange data between providers systems (e.g. EHRs) and other providers, payers, and third-party applications where appropriate. In addition, exchanges from payer systems to providers, other payers, and third-party applications are supported by the HRex profiles and operations.\n\nHRex may define new extensions, profiles, value sets, constraints/extension to other specification (e.g. specific CDS-Hooks) that are specific Da Vinci requirements. Where appropriate these Da Vinci specific artifacts will be promoted for incorporation into the future versions of existing standards (e.g. R4 US Core profiles) and deprecated in this guide on publication in the updated standard. (built Tue, Dec 10, 2024 16:43+0000+00:00)

Package hl7.fhir.uv.subscriptions-backport.r4#1.1.0 The Subscription R5 Backport Implementation Guide enables servers running versions of FHIR earlier than R5 to implement a subset of R5 Subscriptions in a standardized way. (built Wed, Jan 11, 2023 15:34+1100+11:00)

Package hl7.fhir.uv.tools.r4#1.1.2 This IG defines the extensions that the tools use internally. Some of these extensions are content that are being evaluated for elevation into the main spec, and others are tooling concerns (built Tue, Mar 24, 2026 11:13+1100+11:00)

#### Globals Table

There are no Global profiles defined

#### IP Statements

This publication includes IP covered under the following statements.

- © Copyright 2022 American Medical Association
  Show Usage
  - NUCC Provider Taxonomy: Bundle/PCT-AEOB-Packet-1, Bundle/PCT-GFE-Bundle-Inst-1... Show 11 more, Bundle/PCT-GFE-Bundle-Prof-1, Bundle/PCT-GFE-Packet-Inst-1, Bundle/PCT-GFE-Packet-Prof-1, Claim/PCT-GFE-Institutional-1, Claim/PCT-GFE-Institutional-MRI, Claim/PCT-GFE-Professional-MRI, PCTGFEInstitutional, PCTGFEProfessional, PCTGFESummary, PCTPractitioner and ProviderTaxonomy
- All X12 products are subject to this IP policy, including published and draft works.X12 is the only organization authorized to grant permission for use of X12 products. Users of all X12 products should make sure that they understand the permissible uses, as well as the limitations on such usage, as outlined below.Additional IP information can be found here Send an email to ip@x12.org to request permission to reproduce X12 IP. Include your name, organization, title, address, city, state, zip, email, a detailed description of the Submitted Artifact, including the underlying or cited X12 Product, and a detailed description of the intended audience and planned distribution method for the Artifact.Additional information on X12 licensing program can be found here To purchase code list subscriptions call (425) 562-2245 or email admin@wpc-edi.com.
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  - X12 Claim Adjustment Reason Codes: PCTAdjustmentReasonVS and PCTAdvancedEOB
- All X12 work products are copyrighted. Any use of any X12 work product must be compliant with US Copyright laws and X12 Intellectual Property policies.Please see https://x12.org/products/licensing-program
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  - X12 Service Type Codes: Bundle/PCT-AEOB-Packet-1, ExplanationOfBenefit/PCT-AEOB-1... Show 4 more, ExplanationOfBenefit/PCT-AEOB-Summary-1, PCTAdvancedEOB, PCTAdvancedEOBSummary and PCTBenefitBalanceCategoryVS
- CMS maintains HIPPS. There are no known constraints on the use of HIPPS.
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  - Health Insurance Prospective Payment System (HIPPS): EstimateProcedureOrService, PCTAdvancedEOB... Show 4 more, PCTGFEInstitutional, PCTGFEProfessional, PCTServiceRequest and USClaimMedicalProductOrServiceCodes
- ISO maintains the copyright on the country codes, and controls its use carefully. For further details see the ISO 3166 web page: https://www.iso.org/iso-3166-country-codes.html
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  - ISO 3166-1 Codes for the representation of names of countries and their subdivisions — Part 1: Country code: AEOBAdjudicationError, AEOBComplete... Show 120 more, AEOBDateOfService, AHANUBCPointOfOriginVS, AHANUBCPriorityTypeOfAdmissionOrVisitVS, CoordinationPlatformPatientCostTransparencyCapabilityStatement, CoordinationRequesterPatientCostTransparencyCapabilityStatement, DocumentReferenceDocStatus, EstimateCondition, EstimateProcedureOrService, GFEBillingProviderLineItemCtrlNum, GFEConsentForBalanceBilling, GFEContributorPatientCostTransparencyCapabilityStatement, GFECoordinationRequest, GFEDisclaimer, GFEReference, GFERelatedTask, GFERetrieve, GFEServiceLinkingInfo, GFESubmit, GFEValidationError, ICD10ProcedureCodes, OutOfNetworkProviderInfo, PCTAEOBAvailableAuthorSubscription, PCTAEOBAvailableAuthorSubscriptionTopic, PCTAEOBAvailableSubjectSubscription, PCTAEOBAvailableSubjectSubscriptionTopic, PCTAEOBPacket, PCTAEOBProcessNoteCS, PCTAEOBProcessNoteVS, PCTAdjudication, PCTAdjudicationCategoryCS, PCTAdjudicationCategoryVS, PCTAdjudicationVS, PCTAdjustmentReasonVS, PCTAdvancedEOB, PCTAdvancedEOBComposition, PCTAdvancedEOBDocumentReference, PCTAdvancedEOBSummary, PCTBenefitBalanceCategoryVS, PCTCareTeamRoleVS, PCTContributorTaskStatusCodes, PCTContributorTaskStatusReasonCodes, PCTCoordinationTaskStatusCodes, PCTCoordinationTaskStatusReasonCodes, PCTCoverage, PCTDeviceRequest, PCTDiagnosticCodes, PCTDocumentSection, PCTDocumentTypeTemporaryTrialUse, PCTEstimateTypeSummaryCSTemporaryTrialUse, PCTFinancialType, PCTFinancialTypeVS, PCTGFEAvailableAuthorSubscription, PCTGFEAvailableAuthorSubscriptionTopic, PCTGFEAvailableSubjectSubscription, PCTGFEAvailableSubjectSubscriptionTopic, PCTGFEBundle, PCTGFECMSPOS, PCTGFEComposition, PCTGFEContributorTask, PCTGFECoordinationBundle, PCTGFECoordinationTask, PCTGFECoordinationTaskSubscriptionTopic, PCTGFEDocumentReference, PCTGFEInformationBundle, PCTGFEInstitutional, PCTGFEItemCptHcpcsVS, PCTGFEItemNDCVS, PCTGFEItemRevenueVS, PCTGFEMissingBundle, PCTGFEPacket, PCTGFEProfessional, PCTGFERequestTypeCSTemporaryTrialUse, PCTGFERequestTypeVS, PCTGFESummary, PCTGFETaskRelationship, PCTGFETaskUpdateSubscription, PCTGFETypeOfBillVS, PCTMedicationRequest, PCTNetworkStatusCS, PCTOrgContactPurposeType, PCTOrgContactPurposeTypeVS, PCTOrganization, PCTOrganizationTypeVS, PCTPayerBenefitPaymentStatusVS, PCTPayerProviderNetworkStatusVS, PCTPractitioner, PCTProcedureSurgicalCodes, PCTProcedureType, PCTProcedureTypeVS, PCTServiceLocation, PCTServiceRequest, PCTSupportingInfoType, PCTSupportingInfoTypeVS, PCTTaskAttachmentContentType, PCTTaskBusinessStatusCSTemporaryTrialUse, PCTTaskBusinessStatusCodes, PCTTaskStatusReasonCSTemporaryTrialUse, PCTTotal, PacketCondition, PacketLinkingIdentifier, PacketPlannedPeriodOfService, PacketProcedureOrService, PacketRequestInitiationTime, PatientCostTransparency, PatientCostTransparencyCapabilityStatement, PlannedServicePeriod, ProcessNoteClass, ProviderEventMethodology, ProviderTaxonomy, ReferralNumber, RelatedTask, RemainingBenefit, RequestInitiationTime, RequestOriginationType, SelfPayDeclared, ServiceDescription, SubjectToMedicalMgmt, TaskRequestedPeriod, USClaimDRGCodes and USClaimMedicalProductOrServiceCodes
- Licensing information can be found here These codes are listed within the UB-04 Data Specifications Manual. The Official UB-04 Data Specifications Manual, copyrighted by the American Hospital Association, is the only official source of UB-04 billing information adopted by the National Uniform Billing Committee. No other publication—governmental or private/commercial—can be considered authoritative. The AHA wants to make you aware that the use of codes, descriptions, or any other content contained in the manual to be used in a software application, publication, or any other derivative work must be properly licensed by the AHA. If your organization uses or intends to use any of the codes or other related content from the manual in this manner, please contact the AHA’s licensing manager, Tim Carlson, at 312.893.6816 or tcarlson@aha.org
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  - AHA NUBC Point of Origin for Non-newborn: AHANUBCPointOfOriginVS and PCTGFEInstitutional
  - AHA NUBC Point of Origin for Newborn: AHANUBCPointOfOriginVS and PCTGFEInstitutional
  - AHA NUBC Priority (Type) of Admission or Visit: AHANUBCPriorityTypeOfAdmissionOrVisitVS and PCTGFEInstitutional
  - AHA NUBC Revenue Codes: Bundle/PCT-AEOB-Packet-1, Bundle/PCT-GFE-Bundle-Inst-1... Show 7 more, Bundle/PCT-GFE-Packet-Inst-1, Claim/PCT-GFE-Institutional-1, Claim/PCT-GFE-Institutional-MRI, ExplanationOfBenefit/PCT-AEOB-1, PCTAdvancedEOB, PCTGFEInstitutional and PCTGFEItemRevenueVS
  - AHA NUBC Type Of Bill Codes: Bundle/PCT-AEOB-Packet-1, Bundle/PCT-GFE-Bundle-Inst-1... Show 6 more, Bundle/PCT-GFE-Packet-Inst-1, Claim/PCT-GFE-Institutional-1, Claim/PCT-GFE-Institutional-MRI, PCTGFEInstitutional, PCTGFEProfessional and PCTGFETypeOfBillVS
- The Centers for Medicare & Medicaid Services (CMS) maintain MS-DRGs used throughout the US health care industry. The CMS MS-DRGs are free to use without restriction.
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  - Medicare Severity Diagnosis Related Groups (MS-DRGs): PCTGFEInstitutional and USClaimDRGCodes
- This CodeSystem is not copyrighted.
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  - PCT AEOB Process Note Code System: Bundle/PCT-AEOB-Packet-1, ExplanationOfBenefit/PCT-AEOB-1, ExplanationOfBenefit/PCT-AEOB-Summary-1, PCTAEOBProcessNoteVS and ProcessNoteClass
  - PCT Adjudication Code System: PCTAdjudicationVS, PCTAdvancedEOB and PCTAdvancedEOBSummary
  - PCT Packet Section Codes: Bundle/PCT-AEOB-Packet-1, Bundle/PCT-GFE-Packet-Inst-1, Bundle/PCT-GFE-Packet-Prof-1, PCTAdvancedEOBComposition and PCTGFEComposition
  - PCT Document Types: Bundle/PCT-AEOB-Packet-1, Bundle/PCT-GFE-Coordination-Bundle-1... Show 13 more, Bundle/PCT-GFE-Packet-Inst-1, Bundle/PCT-GFE-Packet-Prof-1, DocumentReference/PCT-AEOB-DocumentReference-1, DocumentReference/PCT-GFE-DocumentReference-Inst-1, DocumentReference/PCT-GFE-DocumentReference-Prof-1, PCTAdvancedEOBComposition, PCTAdvancedEOBDocumentReference, PCTGFEComposition, PCTGFEContributorTask, PCTGFECoordinationTask, PCTGFEDocumentReference, Task/PCT-GFE-Coordination-Replacement-Task-1 and Task/PCT-GFE-Coordination-Task-1
  - PCT Estimate Type Code System: Bundle/PCT-AEOB-Packet-1, Bundle/PCT-GFE-Bundle-Inst-1... Show 8 more, Bundle/PCT-GFE-Bundle-Prof-1, Bundle/PCT-GFE-Packet-Inst-1, Bundle/PCT-GFE-Packet-Prof-1, Claim/PCT-GFE-Summary-1, Claim/PCT-GFE-Summary-MRI, ExplanationOfBenefit/PCT-AEOB-Summary-1, PCTAdvancedEOBSummary and PCTGFESummary
  - PCT Financial Type Code System: Bundle/PCT-AEOB-Packet-1, ExplanationOfBenefit/PCT-AEOB-1... Show 4 more, ExplanationOfBenefit/PCT-AEOB-Summary-1, PCTAdvancedEOB, PCTAdvancedEOBSummary and PCTFinancialTypeVS
  - PCT GFE Request Type Codes Code System: Bundle/PCT-GFE-Coordination-Bundle-1, Bundle/PCT-GFE-Packet-Inst-1... Show 11 more, Bundle/PCT-GFE-Packet-Prof-1, PCTGFEContributorTask, PCTGFECoordinationTask, PCTGFERequestTypeVS, RequestOriginationType, Task/PCT-GFE-Contributor-Replacement-Task-1, Task/PCT-GFE-Contributor-Replacement-Task-2, Task/PCT-GFE-Contributor-Task-1, Task/PCT-GFE-Contributor-Task-2, Task/PCT-GFE-Coordination-Replacement-Task-1 and Task/PCT-GFE-Coordination-Task-1
  - PCT Network Status: PCTAdvancedEOB, PCTAdvancedEOBSummary, PCTPayerBenefitPaymentStatusVS, PCTPayerProviderNetworkStatusVS and PCTTotal
  - PCT Organization Contact Purpose Type Code System: Bundle/PCT-AEOB-Packet-1, Bundle/PCT-GFE-Bundle-Inst-1... Show 4 more, Bundle/PCT-GFE-Packet-Inst-1, GFE Service Help INC., PCTOrgContactPurposeTypeVS and PCTOrganization
  - PCT Procedure Type: PCTGFEInstitutional, PCTGFEProfessional, PCTGFESummary and PCTProcedureTypeVS
  - PCT GFE Supporting Info Type Code System: Bundle/PCT-AEOB-Packet-1, Bundle/PCT-GFE-Bundle-Inst-1... Show 6 more, Bundle/PCT-GFE-Packet-Inst-1, Claim/PCT-GFE-Institutional-1, Claim/PCT-GFE-Institutional-MRI, PCTGFEInstitutional, PCTGFEProfessional and PCTSupportingInfoTypeVS
  - PCT GFE Request Task Business Status Code System: PCTGFEContributorTask, PCTGFECoordinationTask and PCTTaskBusinessStatusCodes
  - PCT GFE Request Task Status Reason Code Code System: PCTContributorTaskStatusReasonCodes, PCTCoordinationTaskStatusReasonCodes, PCTGFEContributorTask and PCTGFECoordinationTask
- This material contains content from LOINC. LOINC is copyright © 1995-2020, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the license. LOINC® is a registered United States trademark of Regenstrief Institute, Inc.
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  - LOINC: Bundle/PCT-AEOB-Packet-1, Bundle/PCT-GFE-Packet-Inst-1... Show 9 more, Bundle/PCT-GFE-Packet-Prof-1, DocumentReference/PCT-AEOB-DocumentReference-1, DocumentReference/PCT-GFE-DocumentReference-Inst-1, DocumentReference/PCT-GFE-DocumentReference-Prof-1, PCTAdvancedEOBComposition, PCTAdvancedEOBDocumentReference, PCTGFEComposition, PCTGFECoordinationTask and PCTGFEDocumentReference
- This material derives from the HL7 Terminology (THO). THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license.html
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  - Adjudication Value Codes: Bundle/PCT-AEOB-Packet-1, ExplanationOfBenefit/PCT-AEOB-1... Show 5 more, ExplanationOfBenefit/PCT-AEOB-Summary-1, PCTAdjudicationCategoryVS, PCTAdjudicationVS, PCTAdvancedEOB and PCTAdvancedEOBSummary
  - Benefit Term Codes: Bundle/PCT-AEOB-Packet-1, ExplanationOfBenefit/PCT-AEOB-1, ExplanationOfBenefit/PCT-AEOB-Summary-1, PCTAdvancedEOB and PCTAdvancedEOBSummary
  - Unit Type Codes: Bundle/PCT-AEOB-Packet-1, ExplanationOfBenefit/PCT-AEOB-1, ExplanationOfBenefit/PCT-AEOB-Summary-1, PCTAdvancedEOB and PCTAdvancedEOBSummary
  - Claim Type Codes: Bundle/PCT-AEOB-Packet-1, Bundle/PCT-GFE-Bundle-Inst-1... Show 10 more, Bundle/PCT-GFE-Bundle-Prof-1, Bundle/PCT-GFE-Packet-Inst-1, Bundle/PCT-GFE-Packet-Prof-1, Claim/PCT-GFE-Institutional-1, Claim/PCT-GFE-Institutional-MRI, Claim/PCT-GFE-Professional-MRI, ExplanationOfBenefit/PCT-AEOB-1, PCTAdvancedEOB, PCTGFEInstitutional and PCTGFEProfessional
  - Claim Care Team Role Codes: PCTCareTeamRoleVS, PCTGFEInstitutional, PCTGFEProfessional and PCTGFESummary
  - Contact entity type: PCTOrgContactPurposeTypeVS and PCTOrganization
  - Coverage Class Codes: Bundle/PCT-AEOB-Packet-1, Bundle/PCT-GFE-Bundle-Inst-1... Show 7 more, Bundle/PCT-GFE-Bundle-Prof-1, Bundle/PCT-GFE-Information-Bundle-1, Bundle/PCT-GFE-Missing-Bundle-1, Bundle/PCT-GFE-Packet-Inst-1, Bundle/PCT-GFE-Packet-Prof-1, Coverage/coverage1001 and PCTCoverage
  - Coverage Copay Type Codes: Bundle/PCT-AEOB-Packet-1, Bundle/PCT-GFE-Bundle-Inst-1... Show 7 more, Bundle/PCT-GFE-Bundle-Prof-1, Bundle/PCT-GFE-Information-Bundle-1, Bundle/PCT-GFE-Missing-Bundle-1, Bundle/PCT-GFE-Packet-Inst-1, Bundle/PCT-GFE-Packet-Prof-1, Coverage/coverage1001 and PCTCoverage
  - DataAbsentReason: EstimateProcedureOrService, PCTAdvancedEOB... Show 4 more, PCTGFEInstitutional, PCTGFEProfessional, PCTServiceRequest and USClaimMedicalProductOrServiceCodes
  - Diagnosis Type Codes: Bundle/PCT-AEOB-Packet-1, Bundle/PCT-GFE-Bundle-Inst-1... Show 11 more, Bundle/PCT-GFE-Bundle-Prof-1, Bundle/PCT-GFE-Packet-Inst-1, Bundle/PCT-GFE-Packet-Prof-1, Claim/PCT-GFE-Institutional-1, Claim/PCT-GFE-Institutional-MRI, Claim/PCT-GFE-Professional-MRI, Claim/PCT-GFE-Summary-1, Claim/PCT-GFE-Summary-MRI, PCTGFEInstitutional, PCTGFEProfessional and PCTGFESummary
  - Example Diagnosis Related Group Codes: Bundle/PCT-AEOB-Packet-1, Bundle/PCT-GFE-Bundle-Inst-1... Show 8 more, Bundle/PCT-GFE-Bundle-Prof-1, Bundle/PCT-GFE-Packet-Inst-1, Bundle/PCT-GFE-Packet-Prof-1, Claim/PCT-GFE-Institutional-1, Claim/PCT-GFE-Institutional-MRI, Claim/PCT-GFE-Professional-MRI, Claim/PCT-GFE-Summary-1 and Claim/PCT-GFE-Summary-MRI
  - Example Procedure Type Codes: PCTGFEInstitutional, PCTGFEProfessional, PCTGFESummary and PCTProcedureTypeVS
  - Medical Management Type: Bundle/PCT-AEOB-Packet-1, ExplanationOfBenefit/PCT-AEOB-1 and SubjectToMedicalMgmt
  - Organization type: Boston Radiology Center, Bundle/PCT-AEOB-Packet-1... Show 8 more, Bundle/PCT-GFE-Bundle-Inst-1, Bundle/PCT-GFE-Bundle-Prof-1, Bundle/PCT-GFE-Information-Bundle-1, Bundle/PCT-GFE-Missing-Bundle-1, Bundle/PCT-GFE-Packet-Inst-1, Bundle/PCT-GFE-Packet-Prof-1, GFE Service Help INC. and Umbrella Insurance Company
  - Payee Type Codes: Bundle/PCT-AEOB-Packet-1, Bundle/PCT-GFE-Bundle-Inst-1... Show 6 more, Bundle/PCT-GFE-Bundle-Prof-1, Bundle/PCT-GFE-Packet-Inst-1, Bundle/PCT-GFE-Packet-Prof-1, Claim/PCT-GFE-Institutional-1, Claim/PCT-GFE-Institutional-MRI and Claim/PCT-GFE-Professional-MRI
  - Process Priority Codes: Bundle/PCT-AEOB-Packet-1, Bundle/PCT-GFE-Bundle-Inst-1... Show 14 more, Bundle/PCT-GFE-Bundle-Prof-1, Bundle/PCT-GFE-Packet-Inst-1, Bundle/PCT-GFE-Packet-Prof-1, Claim/PCT-GFE-Institutional-1, Claim/PCT-GFE-Institutional-MRI, Claim/PCT-GFE-Professional-MRI, Claim/PCT-GFE-Summary-1, Claim/PCT-GFE-Summary-MRI, ExplanationOfBenefit/PCT-AEOB-1, PCTAdvancedEOB, PCTAdvancedEOBSummary, PCTGFEInstitutional, PCTGFEProfessional and PCTGFESummary
  - SubscriberPolicyholder Relationship Codes: Bundle/PCT-AEOB-Packet-1, Bundle/PCT-GFE-Bundle-Inst-1... Show 7 more, Bundle/PCT-GFE-Bundle-Prof-1, Bundle/PCT-GFE-Information-Bundle-1, Bundle/PCT-GFE-Missing-Bundle-1, Bundle/PCT-GFE-Packet-Inst-1, Bundle/PCT-GFE-Packet-Prof-1, Coverage/coverage1001 and Coverage/selfpaycoverage2001
  - identifierType: Boston Radiology Center, Bundle/PCT-AEOB-Packet-1... Show 21 more, Bundle/PCT-GFE-Bundle-Inst-1, Bundle/PCT-GFE-Bundle-Prof-1, Bundle/PCT-GFE-Information-Bundle-1, Bundle/PCT-GFE-Missing-Bundle-1, Bundle/PCT-GFE-Packet-Inst-1, Bundle/PCT-GFE-Packet-Prof-1, Claim/PCT-GFE-Institutional-1, Claim/PCT-GFE-Institutional-MRI, Claim/PCT-GFE-Professional-MRI, ExplanationOfBenefit/PCT-AEOB-1, GFE Service Help INC., PCTAdvancedEOB, PCTCoverage, PCTGFEContributorTask, PCTGFECoordinationTask, PCTGFEInstitutional, PCTGFEProfessional, PCTOrganization, PCTPractitioner, Practitioner/Submitter-Practitioner-1 and Umbrella Insurance Company
  - ActRelationshipType: GFERelatedTask, PCTGFETaskRelationship, Task/PCT-GFE-Contributor-Replacement-Task-1, Task/PCT-GFE-Contributor-Replacement-Task-2 and Task/PCT-GFE-Coordination-Replacement-Task-1
  - MaritalStatus: Bundle/PCT-AEOB-Packet-1, Bundle/PCT-GFE-Bundle-Inst-1... Show 6 more, Bundle/PCT-GFE-Bundle-Prof-1, Bundle/PCT-GFE-Information-Bundle-1, Bundle/PCT-GFE-Missing-Bundle-1, Bundle/PCT-GFE-Packet-Inst-1, Bundle/PCT-GFE-Packet-Prof-1 and Patient/patient1001
  - RoleCode: Bundle/PCT-GFE-Information-Bundle-1 and Hospital
- Using RxNorm codes of type SAB=RXNORM as this specification describes does not require a UMLS license. Access to the full set of RxNorm definitions, and/or additional use of other RxNorm structures and information requires a UMLS license. The use of RxNorm in this specification is pursuant to HL7's status as a licensee of the NLM UMLS. HL7's license does not convey the right to use RxNorm to any users of this specification; implementers must acquire a license to use RxNorm in their own right.
  Show Usage
  - RxNorm: MedicationRequest/PCT-MedicationRequest-1