abstractbaseDefinitioncopyrightdate- Values Differ
description- Values Differ
experimentalfhirVersionjurisdiction
jurisdiction[0]kindnamepublisher- Values Differ
purposestatustitletypeurlversion- Values Differ
| Left: | PCT Good Faith Estimate Professional (http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-professional) |
| Right: | PCT Good Faith Estimate Professional (http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-professional) |
| Error | StructureDefinition.version | Values for version differ: '1.0.0' vs '2.0.2' |
| Information | StructureDefinition.date | Values for date differ: '2023-03-30T13:34:22+00:00' vs '2026-11-12T03:43:07+00:00' |
| Information | StructureDefinition.publisher | Values for publisher differ: 'HL7 International - Financial Management Work Group' vs 'HL7 International / Financial Management' |
| Information | Claim.language | Example/preferred bindings differ at Claim.language using binding from PCTGFEProfessional |
| Information | Claim.extension | Element minimum cardinalities differ: '1' vs '0' |
| Information | Claim.insurer | Element minimum cardinalities differ: '1' vs '0' |
| Error | Claim.insurer | Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-organization]]) vs Reference([CanonicalType[http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-organization]]) |
| Error | Claim.provider | Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-organization], CanonicalType[http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-practitioner]]) vs Reference([CanonicalType[http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-organization], CanonicalType[http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-practitioner]]) |
| Error | Claim.payee.party | Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-practitioner], CanonicalType[http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-organization]]) vs Reference([CanonicalType[http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-practitioner], CanonicalType[http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-organization]]) |
| Error | Claim.careTeam.provider | Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-practitioner], CanonicalType[http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-organization]]) vs Reference([CanonicalType[http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-practitioner], CanonicalType[http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-organization]]) |
| Information | Claim.diagnosis | Element minimum cardinalities differ: '1' vs '0' |
| Name | Value | Comments | |
|---|---|---|---|
| abstract | false | ||
| baseDefinition | http://hl7.org/fhir/StructureDefinition/Claim | ||
| copyright | |||
| date | 2023-03-30T13:34:22+00:00 | 2026-11-12T03:43:07+00:00 |
|
| description | PCT Good Faith Estimate Professional is a profile for capturing submission data needed to be processed by a payer for the creation of an Advanced EOB. This profile is used for a professional GFE submission. | PCT Good Faith Estimate Professional is a profile for an professional provider to capture estimation for items and services for the patient or, optionally, to submit to a payer (for patients using insurance). If submitting to a payer, this includes the data needed to be processed by a payer for the creation of an Advanced EOB. This profile is used for a professional GFE submission. |
|
| experimental | |||
| fhirVersion | 4.0.1 | ||
| jurisdiction | |||
| jurisdiction[0] | urn:iso:std:iso:3166#US | ||
| kind | resource | ||
| name | PCTGFEProfessional | ||
| publisher | HL7 International - Financial Management Work Group | HL7 International / Financial Management |
|
| purpose | |||
| status | active | ||
| title | PCT Good Faith Estimate Professional | ||
| type | Claim | ||
| url | http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-professional | ||
| version | 1.0.0 | 2.0.2 |
|
| Name | L Flags | L Card. | L Type | L Description & Constraints | R Flags | R Card. | R Type | R Description & Constraints | Comments | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
 Claim | 0..* | Claim | Claim, Pre-determination or Pre-authorization | 0..* | Claim | Claim, Pre-determination or Pre-authorization | |||||||||||
 id | 0..1 | id | Logical id of this artifact | 0..1 | id | Logical id of this artifact | |||||||||||
| meta | 0..1 | Meta | Metadata about the resource | 0..1 | Meta | Metadata about the resource | |||||||||||
| implicitRules | 0..1 | uri | A set of rules under which this content was created | 0..1 | uri | A set of rules under which this content was created | |||||||||||
| language | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
| 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
|
| ||||||||||
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |||||||||||
| contained | 0..* | Resource | Contained, inline Resources | 0..* | Resource | Contained, inline Resources | |||||||||||
 Slices for extension | 1..* | Extension | Extension Slice: Unordered, Open by value:url | 0..* | Extension | Extension Slice: Unordered, Open by value:url |
| ||||||||||
 modifierExtension | 0..* | Extension | Extensions that cannot be ignored | 0..* | Extension | Extensions that cannot be ignored | |||||||||||
| Slices for identifier | 1..* | Identifier | Business Identifier for claim Slice: Unordered, Open by pattern:type | 1..* | Identifier | Business Identifier for claim Slice: Unordered, Open by value:type | |||||||||||
| status | 1..1 | code | active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance. | 1..1 | code | active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance. | |||||||||||
| type | 1..1 | CodeableConcept | Category or discipline Binding: ?? (extensible): The type or discipline-style of the claim. Required Pattern: | 1..1 | CodeableConcept | Category or discipline Binding: ?? (extensible): The type or discipline-style of the claim. Required Pattern: | |||||||||||
| subType | 0..1 | CodeableConcept | More granular claim type Binding: ?? (example): A more granular claim typecode. | 0..1 | CodeableConcept | More granular claim type Binding: ?? (example): A more granular claim typecode. | |||||||||||
| use | 1..1 | code | claim | preauthorization | predetermination Binding: ?? (required): The purpose of the Claim: predetermination, preauthorization, claim. Required Pattern: predetermination (extensions allowed) | 1..1 | code | claim | preauthorization | predetermination Binding: ?? (required): The purpose of the Claim: predetermination, preauthorization, claim. Required Pattern: predetermination (extensions allowed) | |||||||||||
| patient | 1..1 | Reference(HRex Patient Demographics) | The recipient of the products and services | 1..1 | Reference(US Core Patient Profile(7.0.0)) | The recipient of the products and services | |||||||||||
| billablePeriod | 0..1 | Period | Relevant time frame for the claim | 0..1 | Period | Relevant time frame for the claim | |||||||||||
| created | 1..1 | dateTime | Resource creation date | 1..1 | dateTime | Resource creation date | |||||||||||
| enterer | 0..1 | Reference(Practitioner | PractitionerRole) | Author of the claim | 0..1 | Reference(Practitioner | PractitionerRole) | Author of the claim | |||||||||||
| insurer | 1..1 | Reference(PCT Organization) | Target | 0..1 | Reference(PCT Organization) | Target |
| ||||||||||
| provider | 1..1 | Reference(PCT Organization | PCT Practitioner) | Billing provider - party responsible for the GFE | 1..1 | Reference(PCT Organization | PCT Practitioner) | Billing provider - party responsible for the GFE |
| ||||||||||
 id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| Slices for extension | 1..* | Extension | Extension Slice: Unordered, Open by value:url | 1..* | Extension | Extension Slice: Unordered, Open by value:url | |||||||||||
| reference | C | 0..1 | string | Literal reference, Relative, internal or absolute URL | C | 0..1 | string | Literal reference, Relative, internal or absolute URL | |||||||||
| type | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ?? (extensible): Aa resource (or, for logical models, the URI of the logical model). | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ?? (extensible): Aa resource (or, for logical models, the URI of the logical model). | |||||||||||
| identifier | 0..1 | Identifier | Logical reference, when literal reference is not known | 0..1 | Identifier | Logical reference, when literal reference is not known | |||||||||||
| display | 0..1 | string | Text alternative for the resource | 0..1 | string | Text alternative for the resource | |||||||||||
| priority | 1..1 | CodeableConcept | Desired processing ugency Binding: ?? (required) | 1..1 | CodeableConcept | Desired processing ugency Binding: ?? (required) | |||||||||||
| fundsReserve | 0..1 | CodeableConcept | For whom to reserve funds Binding: ?? (example): For whom funds are to be reserved: (Patient, Provider, None). | 0..1 | CodeableConcept | For whom to reserve funds Binding: ?? (example): For whom funds are to be reserved: (Patient, Provider, None). | |||||||||||
| related | 0..* | BackboneElement | Prior or corollary claims | 0..* | BackboneElement | Prior or corollary claims | |||||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||||
| claim | 0..1 | Reference(Claim) | Reference to the related claim | 0..1 | Reference(Claim) | Reference to the related claim | |||||||||||
| relationship | 0..1 | CodeableConcept | How the reference claim is related Binding: ?? (example): Relationship of this claim to a related Claim. | 0..1 | CodeableConcept | How the reference claim is related Binding: ?? (example): Relationship of this claim to a related Claim. | |||||||||||
| reference | 0..1 | Identifier | File or case reference | 0..1 | Identifier | File or case reference | |||||||||||
| prescription | 0..1 | Reference(DeviceRequest | MedicationRequest | VisionPrescription) | Prescription authorizing services and products | 0..1 | Reference(DeviceRequest | MedicationRequest | VisionPrescription) | Prescription authorizing services and products | |||||||||||
| originalPrescription | 0..1 | Reference(DeviceRequest | MedicationRequest | VisionPrescription) | Original prescription if superseded by fulfiller | 0..1 | Reference(DeviceRequest | MedicationRequest | VisionPrescription) | Original prescription if superseded by fulfiller | |||||||||||
| payee | 0..1 | BackboneElement | Recipient of benefits payable | 0..1 | BackboneElement | Recipient of benefits payable | |||||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||||
| type | 1..1 | CodeableConcept | Category of recipient Binding: ?? (example): A code for the party to be reimbursed. | 1..1 | CodeableConcept | Category of recipient Binding: ?? (example): A code for the party to be reimbursed. | |||||||||||
| party | 0..1 | Reference(PCT Practitioner | PCT Organization) | Recipient reference | 0..1 | Reference(PCT Practitioner | PCT Organization) | Recipient reference |
| ||||||||||
| referral | 0..1 | Reference(ServiceRequest) | Treatment referral | 0..1 | Reference(ServiceRequest) | Treatment referral | |||||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| Slices for extension | 1..* | Extension | Extension Slice: Unordered, Open by value:url | 1..* | Extension | Extension Slice: Unordered, Open by value:url | |||||||||||
| reference | C | 0..1 | string | Literal reference, Relative, internal or absolute URL | C | 0..1 | string | Literal reference, Relative, internal or absolute URL | |||||||||
| type | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ?? (extensible): Aa resource (or, for logical models, the URI of the logical model). | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ?? (extensible): Aa resource (or, for logical models, the URI of the logical model). | |||||||||||
| identifier | 0..1 | Identifier | Logical reference, when literal reference is not known | 0..1 | Identifier | Logical reference, when literal reference is not known | |||||||||||
| display | 0..1 | string | Text alternative for the resource | 0..1 | string | Text alternative for the resource | |||||||||||
| facility | 0..1 | Reference(Location) | Servicing facility | 0..1 | Reference(Location) | Servicing facility | |||||||||||
| Slices for careTeam | 0..* | BackboneElement | Members of the care team Slice: Unordered, Open by pattern:role Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | 0..* | BackboneElement | Members of the care team Slice: Unordered, Open by value:role Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||||
| sequence | 1..1 | positiveInt | Order of care team | 1..1 | positiveInt | Order of care team | |||||||||||
| provider | 1..1 | Reference(PCT Practitioner | PCT Organization) | Practitioner or organization | 1..1 | Reference(PCT Practitioner | PCT Organization) | Practitioner or organization |
| ||||||||||
| responsible | 0..1 | boolean | Indicator of the lead practitioner | 0..1 | boolean | Indicator of the lead practitioner | |||||||||||
| role | 1..1 | CodeableConcept | Function within the team Binding: ?? (required) | 1..1 | CodeableConcept | Function within the team Binding: ?? (required) | |||||||||||
| qualification | 0..1 | CodeableConcept | Practitioner credential or specialization Binding: ?? (required) | 0..1 | CodeableConcept | Practitioner credential or specialization Binding: ?? (required) | |||||||||||
| Slices for supportingInfo | 0..* | BackboneElement | Supporting information Slice: Unordered, Open by pattern:category Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | 0..* | BackboneElement | Supporting information Slice: Unordered, Open by value:category Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||||
| sequence | 1..1 | positiveInt | Information instance identifier | 1..1 | positiveInt | Information instance identifier | |||||||||||
| category | 1..1 | CodeableConcept | Classification of the supplied information Binding: ?? (extensible) | 1..1 | CodeableConcept | Classification of the supplied information Binding: ?? (extensible) | |||||||||||
| code | 0..1 | CodeableConcept | Type of information Binding: ?? (example): The valuset used for additional information codes. | 0..1 | CodeableConcept | Type of information Binding: ?? (example): The valuset used for additional information codes. | |||||||||||
| timing[x] | 0..1 | date, Period | When it occurred | 0..1 | date, Period | When it occurred | |||||||||||
| value[x] | 0..1 | boolean, string, Quantity, Attachment, Reference(Resource) | Data to be provided | 0..1 | boolean, string, Quantity, Attachment, Reference(Resource) | Data to be provided | |||||||||||
| reason | 0..1 | CodeableConcept | Explanation for the information Binding: ?? (example): Reason codes for the missing teeth. | 0..1 | CodeableConcept | Explanation for the information Binding: ?? (example): Reason codes for the missing teeth. | |||||||||||
| Slices for diagnosis | 1..* | BackboneElement | Pertinent diagnosis information Slice: Unordered, Open by pattern:type Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | 0..* | BackboneElement | Pertinent diagnosis information Slice: Unordered, Open by value:type Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them |
| ||||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||||
| sequence | 1..1 | positiveInt | Diagnosis instance identifier | 1..1 | positiveInt | Diagnosis instance identifier | |||||||||||
| diagnosis[x] | 1..1 | CodeableConcept, Reference(Condition) | Nature of illness or problem Binding: ?? (example): Example ICD10 Diagnostic codes. | 1..1 | CodeableConcept, Reference(Condition) | Nature of illness or problem Binding: ?? (example): Example ICD10 Diagnostic codes. | |||||||||||
| type | 0..* | CodeableConcept | Timing or nature of the diagnosis Binding: ?? (required) | 0..* | CodeableConcept | Timing or nature of the diagnosis Binding: ?? (required) | |||||||||||
| onAdmission | 0..1 | CodeableConcept | Present on admission Binding: ?? (example): Present on admission. | 0..1 | CodeableConcept | Present on admission Binding: ?? (example): Present on admission. | |||||||||||
| packageCode | 0..1 | CodeableConcept | Package billing code Binding: ?? (example): The DRG codes associated with the diagnosis. | 0..1 | CodeableConcept | Package billing code Binding: ?? (example): The DRG codes associated with the diagnosis. | |||||||||||
| Slices for procedure | 0..* | BackboneElement | Clinical procedures performed Slice: Unordered, Open by pattern:type Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | 0..* | BackboneElement | Clinical procedures performed Slice: Unordered, Open by value:type Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| Slices for extension | 1..* | Extension | Extension Slice: Unordered, Open by value:url | 1..* | Extension | Extension Slice: Unordered, Open by value:url | |||||||||||
| modifierExtension | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||||
| sequence | 1..1 | positiveInt | Procedure instance identifier | 1..1 | positiveInt | Procedure instance identifier | |||||||||||
| type | 0..* | CodeableConcept | Category of Procedure Binding: ?? (required) | 0..* | CodeableConcept | Category of Procedure Binding: ?? (required) | |||||||||||
| date | 0..1 | dateTime | When the procedure was performed | 0..1 | dateTime | When the procedure was performed | |||||||||||
| procedure[x] | 1..1 | CodeableConcept, Reference(Procedure) | Specific clinical procedure Binding: ?? (example): Example ICD10 Procedure codes. | 1..1 | CodeableConcept, Reference(Procedure) | Specific clinical procedure Binding: ?? (example): Example ICD10 Procedure codes. | |||||||||||
| udi | 0..* | Reference(Device) | Unique device identifier | 0..* | Reference(Device) | Unique device identifier | |||||||||||
| insurance | 1..* | BackboneElement | Patient insurance information | 1..* | BackboneElement | Patient insurance information | |||||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||||
| sequence | 1..1 | positiveInt | Insurance instance identifier | 1..1 | positiveInt | Insurance instance identifier | |||||||||||
| focal | 1..1 | boolean | Coverage to be used for adjudication | 1..1 | boolean | Coverage to be used for adjudication | |||||||||||
| identifier | 0..1 | Identifier | Pre-assigned Claim number | 0..1 | Identifier | Pre-assigned Claim number | |||||||||||
| coverage | 1..1 | Reference(PCT Coverage) | Insurance information | 1..1 | Reference(PCT Coverage) | Insurance information | |||||||||||
| id | 0..1 | string | Unique id for inter-element referencing |
| |||||||||||||
| Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |
| |||||||||||||
| reference | C | 0..1 | string | Literal reference, Relative, internal or absolute URL |
| ||||||||||||
| type | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ?? (extensible): Aa resource (or, for logical models, the URI of the logical model). |
| |||||||||||||
| identifier | 0..1 | Identifier | Logical reference, when literal reference is not known |
| |||||||||||||
| display | 0..1 | string | Text alternative for the resource |
| |||||||||||||
| businessArrangement | 0..1 | string | Additional provider contract number | 0..1 | string | Additional provider contract number | |||||||||||
| preAuthRef | 0..2 | string | Prior authorization reference number | 0..2 | string | Prior authorization reference number | |||||||||||
| claimResponse | 0..1 | Reference(ClaimResponse) | Adjudication results | 0..1 | Reference(ClaimResponse) | Adjudication results | |||||||||||
| accident | 0..1 | BackboneElement | Details of the event | 0..1 | BackboneElement | Details of the event | |||||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||||
| date | 1..1 | date | When the incident occurred | 1..1 | date | When the incident occurred | |||||||||||
| type | 0..1 | CodeableConcept | The nature of the accident Binding: ?? (extensible): Type of accident: work place, auto, etc. | 0..1 | CodeableConcept | The nature of the accident Binding: ?? (extensible): Type of accident: work place, auto, etc. | |||||||||||
| location[x] | 0..1 | Address | Where the event occurred | 0..1 | Address | Where the event occurred | |||||||||||
 id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||||||
| use | 0..1 | code | home | work | temp | old | billing - purpose of this address Binding: ?? (required): The use of an address. Example General: home | 0..1 | code | home | work | temp | old | billing - purpose of this address Binding: ?? (required): The use of an address. Example General: home | |||||||||||
| type | 0..1 | code | postal | physical | both Binding: ?? (required): The type of an address (physical / postal). Example General: both | 0..1 | code | postal | physical | both Binding: ?? (required): The type of an address (physical / postal). Example General: both | |||||||||||
| text | 0..1 | string | Text representation of the address Example General: 137 Nowhere Street, Erewhon 9132 | 0..1 | string | Text representation of the address Example General: 137 Nowhere Street, Erewhon 9132 | |||||||||||
| line | 0..* | string | Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street | 0..* | string | Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street | |||||||||||
| city | 0..1 | string | Name of city, town etc. Example General: Erewhon | 0..1 | string | Name of city, town etc. Example General: Erewhon | |||||||||||
| district | 0..1 | string | District name (aka county) Example General: Madison | 0..1 | string | District name (aka county) Example General: Madison | |||||||||||
| state | 0..1 | string | Sub-unit of country (abbreviations ok) | 0..1 | string | Sub-unit of country (abbreviations ok) | |||||||||||
| postalCode | 0..1 | string | Postal code for area Example General: 9132 | 0..1 | string | Postal code for area Example General: 9132 | |||||||||||
| country | 0..1 | string | Country (e.g. can be ISO 3166 2 or 3 letter code) Binding: ?? (required) | 0..1 | string | Country (e.g. can be ISO 3166 2 or 3 letter code) Binding: ?? (required) | |||||||||||
| period | 0..1 | Period | Time period when address was/is in use Example General: {"start":"2010-03-23","end":"2010-07-01"} | 0..1 | Period | Time period when address was/is in use Example General: {"start":"2010-03-23","end":"2010-07-01"} | |||||||||||
| item | 1..50 | BackboneElement | Product or service provided | 1..50 | BackboneElement | Product or service provided | |||||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| Slices for extension | 1..* | Extension | Extension Slice: Unordered, Open by value:url | 1..* | Extension | Extension Slice: Unordered, Open by value:url | |||||||||||
| modifierExtension | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||||
| sequence | 1..1 | positiveInt | Item instance identifier | 1..1 | positiveInt | Item instance identifier | |||||||||||
| careTeamSequence | 0..* | positiveInt | Applicable careTeam members | 0..* | positiveInt | Applicable careTeam members | |||||||||||
| diagnosisSequence | 0..* | positiveInt | Applicable diagnoses | 0..* | positiveInt | Applicable diagnoses | |||||||||||
| procedureSequence | 0..* | positiveInt | Applicable procedures | 0..* | positiveInt | Applicable procedures | |||||||||||
| informationSequence | 0..* | positiveInt | Applicable exception and supporting information | 0..* | positiveInt | Applicable exception and supporting information | |||||||||||
| revenue | 0..1 | CodeableConcept | Revenue or cost center code Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products. | 0..1 | CodeableConcept | Revenue or cost center code Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products. | |||||||||||
| category | 0..1 | CodeableConcept | Benefit classification Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses. | 0..1 | CodeableConcept | Benefit classification Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses. | |||||||||||
| productOrService | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: ?? (required) | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: ?? (required) | |||||||||||
| id | 0..1 | string | Unique id for inter-element referencing |
| |||||||||||||
| Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |
| |||||||||||||
| coding | C | 0..* | Coding | Code defined by a terminology system Constraints: pct-cpt-display |
| ||||||||||||
| text | 0..1 | string | Plain text representation of the concept |
| |||||||||||||
| modifier | 0..4 | CodeableConcept | Product or service billing modifiers Binding: ?? (required) | 0..4 | CodeableConcept | Product or service billing modifiers Binding: ?? (required) | |||||||||||
| id | 0..1 | string | Unique id for inter-element referencing |
| |||||||||||||
| Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |
| |||||||||||||
| coding | C | 0..* | Coding | Code defined by a terminology system Constraints: pct-cpt-display |
| ||||||||||||
| text | 0..1 | string | Plain text representation of the concept |
| |||||||||||||
| programCode | 0..* | CodeableConcept | Program the product or service is provided under Binding: ?? (example): Program specific reason codes. | 0..* | CodeableConcept | Program the product or service is provided under Binding: ?? (example): Program specific reason codes. | |||||||||||
| serviced[x] | 1..1 | date, Period | This is the planned or estimated date(s)s of service | 1..1 | date, Period | This is the planned or estimated date(s)s of service | |||||||||||
| Slices for location[x] | 1..1 | CodeableConcept | Place of service or where product was supplied Slice: Unordered, Closed by type:$this Binding: ?? (example): Place of service: pharmacy, school, prison, etc. | 1..1 | CodeableConcept | Place of service or where product was supplied Binding: ?? (required) | |||||||||||
| quantity | 1..1 | ??  | Count of products or services | C | 1..1 | ?? | Count of products or services | ||||||||||
| unitPrice | 1..1 | Money | Fee, charge or cost per item | 1..1 | Money | Fee, charge or cost per item | |||||||||||
| factor | 0..1 | decimal | Price scaling factor | 0..1 | decimal | Price scaling factor | |||||||||||
| net | 1..1 | Money | Total charge amount for the service line | 1..1 | Money | Total charge amount for the service line | |||||||||||
| udi | 0..* | Reference(Device) | Unique device identifier | 0..* | Reference(Device) | Unique device identifier | |||||||||||
| bodySite | 0..1 | CodeableConcept | Anatomical location Binding: ?? (example): The code for the teeth, quadrant, sextant and arch. | 0..1 | CodeableConcept | Anatomical location Binding: ?? (example): The code for the teeth, quadrant, sextant and arch. | |||||||||||
| subSite | 0..* | CodeableConcept | Anatomical sub-location Binding: ?? (example): The code for the tooth surface and surface combinations. | 0..* | CodeableConcept | Anatomical sub-location Binding: ?? (example): The code for the tooth surface and surface combinations. | |||||||||||
| encounter | 0..* | Reference(Encounter) | Encounters related to this billed item | 0..* | Reference(Encounter) | Encounters related to this billed item | |||||||||||
| detail | 0..* | BackboneElement | Drug Identification Information | 0..* | BackboneElement | Drug Identification Information | |||||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||||
| sequence | 1..1 | positiveInt | Item instance identifier | 1..1 | positiveInt | Item instance identifier | |||||||||||
| revenue | 0..1 | CodeableConcept | Revenue or cost center code Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products. | 0..1 | CodeableConcept | Revenue or cost center code Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products. | |||||||||||
| category | 0..1 | CodeableConcept | Benefit classification Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses. | 0..1 | CodeableConcept | Benefit classification Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses. | |||||||||||
| productOrService | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: ?? (required) | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: ?? (required) | |||||||||||
| modifier | 0..* | CodeableConcept | Service/Product billing modifiers Binding: ?? (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | 0..* | CodeableConcept | Service/Product billing modifiers Binding: ?? (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | |||||||||||
| programCode | 0..* | CodeableConcept | Program the product or service is provided under Binding: ?? (example): Program specific reason codes. | 0..* | CodeableConcept | Program the product or service is provided under Binding: ?? (example): Program specific reason codes. | |||||||||||
| quantity | 0..1 | ?? | Count of products or services | C | 0..1 | ?? | Count of products or services | ||||||||||
| unitPrice | 0..1 | Money | Fee, charge or cost per item | 0..1 | Money | Fee, charge or cost per item | |||||||||||
| factor | 0..1 | decimal | Price scaling factor | 0..1 | decimal | Price scaling factor | |||||||||||
| net | 0..1 | Money | Total item cost | 0..1 | Money | Total item cost | |||||||||||
| udi | 0..* | Reference(Device) | Unique device identifier | 0..* | Reference(Device) | Unique device identifier | |||||||||||
| subDetail | 0..* | BackboneElement | Product or service provided | 0..* | BackboneElement | Product or service provided | |||||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||||
| sequence | 1..1 | positiveInt | Item instance identifier | 1..1 | positiveInt | Item instance identifier | |||||||||||
| revenue | 0..1 | CodeableConcept | Revenue or cost center code Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products. | 0..1 | CodeableConcept | Revenue or cost center code Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products. | |||||||||||
| category | 0..1 | CodeableConcept | Benefit classification Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses. | 0..1 | CodeableConcept | Benefit classification Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses. | |||||||||||
| productOrService | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: ?? (example): Allowable service and product codes. | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: ?? (example): Allowable service and product codes. | |||||||||||
| modifier | 0..* | CodeableConcept | Service/Product billing modifiers Binding: ?? (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | 0..* | CodeableConcept | Service/Product billing modifiers Binding: ?? (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | |||||||||||
| programCode | 0..* | CodeableConcept | Program the product or service is provided under Binding: ?? (example): Program specific reason codes. | 0..* | CodeableConcept | Program the product or service is provided under Binding: ?? (example): Program specific reason codes. | |||||||||||
| quantity | 0..1 | ?? | Count of products or services | C | 0..1 | ?? | Count of products or services | ||||||||||
| unitPrice | 0..1 | Money | Fee, charge or cost per item | 0..1 | Money | Fee, charge or cost per item | |||||||||||
| factor | 0..1 | decimal | Price scaling factor | 0..1 | decimal | Price scaling factor | |||||||||||
| net | 0..1 | Money | Total item cost | 0..1 | Money | Total item cost | |||||||||||
| udi | 0..* | Reference(Device) | Unique device identifier | 0..* | Reference(Device) | Unique device identifier | |||||||||||
| total | 1..1 | Money | Total GFE Charges Submitted | 1..1 | Money | Total GFE Charges Submitted | |||||||||||
| Documentation for this format | |||||||||||||||||