at-moped-claimresponse-lkfresponse-generisch
type: StructureDefinition
node role: treeRoot
id:
  v: at-moped-claimresponse-lkfresponse-generisch
text:
  status:
    v: extensions
  div:
    v: Generated Narrative: StructureDefinition at-moped-claimresponse-lkfresponse-generisch Name Flags Card. Type Description & Constraints<img src="[binary]" alt="doco" style="background-color: inherit"/> ClaimResponse ClaimResponse #xD; status O 1..1 code active | cancelled | draft | entered-in-error Required Pattern: active Obligations Actor SHALL:populate Moped LGF Actor SHALL:handle Moped Device Actor #xD; type O 1..1 CodeableConcept More granular claim type Binding: Claim Type ValueSet (required) Obligations Actor SHALL:populate Moped LGF Actor #xD; coding 0..* Coding Code defined by a terminology system Fixed Value: As shown (LKF Response) #xD; system 1..1 uri Identity of the terminology system Fixed Value: https://elga.moped.at/CodeSystem/MopedClaimTypeCS #xD; code 1..1 code Symbol in syntax defined by the system Fixed Value: LKFRESP #xD; subType O 0..1 CodeableConcept More granular claim type Binding: Kostenmeldung für (A/R/K) (required) Obligations Actor SHALL:populate Moped LGF Actor #xD; use O 1..1 code claim | preauthorization | predetermination Required Pattern: claim Obligations Actor SHALL:populate Moped LGF Actor #xD; patient O 1..1 Reference(AT MOPED Patient vbPK Basis Profil | AT MOPED Patient Klarname Basis Profil) The recipient of the products and services Obligations Actor SHALL:handle Moped Device Actor #xD; created O 1..1 dateTime Response creation date Obligations Actor SHALL:populate Moped LGF Actor #xD; requestor O 1..1 Reference(AT MOPED Organization KA Profil) Party responsible for the claim Obligations Actor SHALL:handle Moped Device Actor #xD; request O 1..1 Reference(AT MOPED Claim LKFRequest Basis Profil) Id of resource triggering adjudication Obligations Actor SHALL:populate Moped LGF Actor #xD; outcome O 1..1 code LKF Bewilligung/Ablehnung Obligations Actor SHALL:populate Moped LGF Actor #xD; decision O 1..1 CodeableConcept Result of the adjudication Obligations Actor SHALL:populate Moped LGF Actor #xD; addItem #xD; Slices for extension …
url:
  v: https://elga.moped.at/StructureDefinition/at-moped-claimresponse-lkfresponse-generisch
  l: at-moped-claimresponse-lkfresponse-generisch
version:
  v: 0.1.0
name:
  v: AtMopedClaimResponseLKFResponseGenerisch
title:
  v: AT MOPED ClaimResponse LKFResponse generisches Profil
status:
  v: draft
date:
  v: 2026-05-22T14:50:58+00:00
publisher:
  v: ELGA GmbH
contact:
  name:
    v: ELGA GmbH
  telecom:
    system:
      v: url
    value:
      v: https://elga.gv.at
description:
  v: MOPED generisches Profil der ClaimResponse Ressource für die Leistungsabrechnungsantwort.
fhir version:
  v: 5.0.0
kind:
  v: resource
abstract:
  v: false
type:
  v: ClaimResponse
  l: ClaimResponse
base definition:
  v: http://hl7.org/fhir/StructureDefinition/ClaimResponse
  l: ClaimResponse
derivation:
  v: constraint
snapshot:
  extension:
    url:
      v: http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version
      l: snapshot-base-version
    value: String
      v: 5.0.0
  element:
    id:
      v: ClaimResponse
    path:
      v: ClaimResponse
    short:
      v: Response to a claim predetermination or preauthorization
    definition:
      v: This resource provides the adjudication details from the processing of a Claim resource.
    alias:
      v: Remittance Advice
    min:
      v: 0
    max:
      v: *
    base:
      path:
        v: ClaimResponse
      min:
        v: 0
      max:
        v: *
    constraint:
      key:
        v: dom-2
      severity:
        v: error
      human:
        v: If the resource is contained in another resource, it SHALL NOT contain nested Resources
      expression:
        v: contained.contained.empty()
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        l: DomainResource
    constraint:
      key:
        v: dom-3
      severity:
        v: error
      human:
        v: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
      expression:
        v: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        l: DomainResource
    constraint:
      key:
        v: dom-4
      severity:
        v: error
      human:
        v: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
      expression:
        v: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        l: DomainResource
    constraint:
      key:
        v: dom-5
      severity:
        v: error
      human:
        v: If a resource is contained in another resource, it SHALL NOT have a security label
      expression:
        v: contained.meta.security.empty()
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        l: DomainResource
    constraint:
      extension:
        value: Boolean
      extension:
        value: Markdown
      key:
        v: dom-6
      severity:
        v: warning
      human:
        v: A resource should have narrative for robust management
      expression:
        v: text.`div`.exists()
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        l: DomainResource
    must support:
      v: false
    is modifier:
      v: false
    is summary:
      v: false
    mapping:
      identity:
        v: rim
      map:
        v: Entity, Role, or Act
    mapping:
      identity:
        v: workflow
      map:
        v: Event
    mapping:
      identity:
        v: w5
      map:
        v: financial.billing
  element:
    id:
      v: ClaimResponse.id
    path:
      v: ClaimResponse.id
    short:
      v: Logical id of this artifact
    definition:
      v: The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
    comment:
      v: Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.
    min:
      v: 0
    max:
      v: 1
    base:
      path:
        v: Resource.id
      min:
        v: 0
      max:
        v: 1
    type:
      extension:
        value: Url
      code:
        v: http://hl7.org/fhirpath/System.String
        l: System.String
    must support:
      v: false
    is modifier:
      v: false
    is summary:
      v: true
  element:
    id:
      v: ClaimResponse.meta
    path:
      v: ClaimResponse.meta
    short:
      v: Metadata about the resource

Boolean
v: true

Markdown
v: When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.

Url
v: id
l: id

v: The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

v: 0

v: 1

path:
  v: Resource.meta
min:
  v: 0
max:
  v: 1

code:
  v: Meta
  l: Meta

key:
  v: ele-1
severity:
  v: error
human:
  v: All FHIR elements must have a @value or children
expression:
  v: hasValue() or (children().count() > id.count())
source:
  v: http://hl7.org/fhir/StructureDefinition/Element
  l: Element

v: false

v: false

v: true

id:
  v: ClaimResponse.implicitRules
path:
  v: ClaimResponse.implicitRules
short:
  v: A set of rules under which this content was created
definition:
  v: A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
comment:
  v: Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Resource.implicitRules
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: uri
    l: uri
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: true
is modifier reason:
  v: This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
is summary:
  v: true

id:
  v: ClaimResponse.language
path:
  v: ClaimResponse.language
short:
  v: Language of the resource content
definition:
  v: The base language in which the resource is written.
comment:
  v: Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Resource.language
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
    l: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: Language
  strength:
    v: required
  description:
    v: IETF language tag for a human language
  value set:
    v: http://hl7.org/fhir/ValueSet/all-languages|5.0.0
    l: http://hl7.org/fhir/ValueSet/all-languages
  additional:
    purpose:
      v: starter
    value set:
      v: http://hl7.org/fhir/ValueSet/languages|5.0.0
      l: http://hl7.org/fhir/ValueSet/languages

id:
  v: ClaimResponse.text
path:
  v: ClaimResponse.text
short:
  v: Text summary of the resource, for human interpretation
definition:
  v: A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
comment:
  v: Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
alias:
  v: narrative
alias:
  v: html
alias:
  v: xhtml
alias:
  v: display
min:
  v: 0
max:
  v: 1
base:
  path:
    v: DomainResource.text
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Narrative
    l: Narrative
condition:
  v: dom-6
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: Act.text?

id:
  v: ClaimResponse.contained
path:
  v: ClaimResponse.contained
short:
  v: Contained, inline Resources
definition:
  v: These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.
comment:
  v: This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.
alias:
  v: inline resources
alias:
  v: anonymous resources
alias:
  v: contained resources
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.contained
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Resource
    l: Resource
condition:
  v: dom-2
condition:
  v: dom-4
condition:
  v: dom-3
condition:
  v: dom-5
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: ClaimResponse.extension
path:
  v: ClaimResponse.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: ClaimResponse.modifierExtension
path:
  v: ClaimResponse.modifierExtension
short:
  v: Extensions that cannot be ignored
definition:
  v: May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R5/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
must support:
  v: false
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: ClaimResponse.identifier
path:
  v: ClaimResponse.identifier
short:
  v: Business Identifier for a claim response
definition:
  v: A unique identifier assigned to this claim response.
requirements:
  v: Allows claim responses to be distinguished and referenced.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.identifier
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Identifier
    l: Identifier
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: workflow
  map:
    v: Event.identifier
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.identifier

id:
  v: ClaimResponse.traceNumber
path:
  v: ClaimResponse.traceNumber
short:
  v: Number for tracking
definition:
  v: Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.
requirements:
  v: Allows partners to uniquely identify components for tracking.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.traceNumber
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Identifier
    l: Identifier
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.status
extension:
  extension:
    url:
      v: code
      l: code
    value: Code
      v: SHALL:populate
  extension:
    url:
      v: actor
      l: actor
    value: Canonical
      v: https://elga.moped.at/ActorDefinition/MopedLGFActor
      l: MopedLGFActor
  extension:
    url:
      v: http://hl7.org/fhir/tools/StructureDefinition/snapshot-source
      l: snapshot-source
    value: Canonical
      v: https://elga.moped.at/StructureDefinition/at-moped-claimresponse-lkfresponse-generisch|0.1.0
      l: https://elga.moped.at/StructureDefinition/at-moped-claimresponse-lkfresponse-generisch
  url:
    v: http://hl7.org/fhir/StructureDefinition/obligation
    l: obligation
extension:
  extension:
    url:
      v: code
      l: code
    value: Code
      v: SHALL:handle
  extension:
    url:
      v: actor
      l: actor
    value: Canonical
      v: https://elga.moped.at/ActorDefinition/MopedDeviceActor
      l: MopedDeviceActor
  extension:
    url:
      v: http://hl7.org/fhir/tools/StructureDefinition/snapshot-source
      l: snapshot-source
    value: Canonical
      v: https://elga.moped.at/StructureDefinition/at-moped-claimresponse-lkfresponse-generisch|0.1.0
      l: https://elga.moped.at/StructureDefinition/at-moped-claimresponse-lkfresponse-generisch
  url:
    v: http://hl7.org/fhir/StructureDefinition/obligation
    l: obligation
path:
  v: ClaimResponse.status
short:
  v: active | cancelled | draft | entered-in-error
definition:
  v: The status of the resource instance.
comment:
  v: This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
requirements:
  v: Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.status
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: code
    l: code
pattern: Code
  v: active
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: true
is modifier reason:
  v: This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: ClaimResponseStatus
  strength:
    v: required
  description:
    v: A code specifying the state of the resource instance.
  value set:
    v: http://hl7.org/fhir/ValueSet/fm-status|5.0.0
    l: http://hl7.org/fhir/ValueSet/fm-status
mapping:
  identity:
    v: workflow
  map:
    v: Event.status
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.status

id:
  v: ClaimResponse.type
extension:
  extension:
    url:
      v: code
      l: code
    value: Code
      v: SHALL:populate
  extension:
    url:
      v: actor
      l: actor
    value: Canonical
      v: https://elga.moped.at/ActorDefinition/MopedLGFActor
      l: MopedLGFActor
  extension:
    url:
      v: http://hl7.org/fhir/tools/StructureDefinition/snapshot-source
      l: snapshot-source
    value: Canonical
      v: https://elga.moped.at/StructureDefinition/at-moped-claimresponse-lkfresponse-generisch|0.1.0
      l: https://elga.moped.at/StructureDefinition/at-moped-claimresponse-lkfresponse-generisch
  url:
    v: http://hl7.org/fhir/StructureDefinition/obligation
    l: obligation
path:
  v: ClaimResponse.type
short:
  v: More granular claim type
definition:
  v: A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service.
comment:
  v: This may contain the local bill type codes, for example the US UB-04 bill type code or the CMS bill type.
requirements:
  v: Some jurisdictions need a finer grained claim type for routing and adjudication.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.type
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: true
binding:
  strength:
    v: required
  value set:
    v: https://elga.moped.at/ValueSet/MopedClaimTypeVS
    l: MopedClaimTypeVS
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.class

id:
  v: ClaimResponse.type.id
path:
  v: ClaimResponse.type.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: id
      l: id
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
condition:
  v: ele-1
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.type.extension
path:
  v: ClaimResponse.type.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.type.coding
path:
  v: ClaimResponse.type.coding
short:
  v: Code defined by a terminology system
definition:
  v: A reference to a code defined by a terminology system.
comment:
  v: Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
requirements:
  v: Allows for alternative encodings within a code system, and translations to other code systems.
min:
  v: 0
max:
  v: *
base:
  path:
    v: CodeableConcept.coding
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Coding
    l: Coding
fixed: Coding
  system:
    v: https://elga.moped.at/CodeSystem/MopedClaimTypeCS
    l: MopedClaimTypeCS
  code:
    v: LKFRESP
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: C*E.1-8, C*E.10-22
mapping:
  identity:
    v: rim
  map:
    v: union(., ./translation)
mapping:
  identity:
    v: orim
  map:
    v: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

id:
  v: ClaimResponse.type.text
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable
    l: elementdefinition-translatable
  value: Boolean
    v: true
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable
    l: elementdefinition-translatable
  value: Boolean
    v: true
path:
  v: ClaimResponse.type.text
short:
  v: Plain text representation of the concept
definition:
  v: A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
comment:
  v: Very often the text is the same as a displayName of one of the codings.
requirements:
  v: The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CodeableConcept.text
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: C*E.9. But note many systems use C*E.2 for this
mapping:
  identity:
    v: rim
  map:
    v: ./originalText[mediaType/code="text/plain"]/data
mapping:
  identity:
    v: orim
  map:
    v: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

id:
  v: ClaimResponse.subType
extension:
  extension:
    url:
      v: code
      l: code
    value: Code
      v: SHALL:populate
  extension:
    url:
      v: actor
      l: actor
    value: Canonical
      v: https://elga.moped.at/ActorDefinition/MopedLGFActor
      l: MopedLGFActor
  extension:
    url:
      v: http://hl7.org/fhir/tools/StructureDefinition/snapshot-source
      l: snapshot-source
    value: Canonical
      v: https://elga.moped.at/StructureDefinition/at-moped-claimresponse-lkfresponse-generisch|0.1.0
      l: https://elga.moped.at/StructureDefinition/at-moped-claimresponse-lkfresponse-generisch
  url:
    v: http://hl7.org/fhir/StructureDefinition/obligation
    l: obligation
path:
  v: ClaimResponse.subType
short:
  v: More granular claim type
definition:
  v: A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service.
comment:
  v: This may contain the local bill type codes, for example the US UB-04 bill type code or the CMS bill type.
requirements:
  v: Some jurisdictions need a finer grained claim type for routing and adjudication.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.subType
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
binding:
  strength:
    v: required
  value set:
    v: https://elga.moped.at/ValueSet/KostenmeldungARKVS
    l: KostenmeldungARKVS
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.class

id:
  v: ClaimResponse.use
extension:
  extension:
    url:
      v: code
      l: code
    value: Code
      v: SHALL:populate
  extension:
    url:
      v: actor
      l: actor
    value: Canonical
      v: https://elga.moped.at/ActorDefinition/MopedLGFActor
      l: MopedLGFActor
  extension:
    url:
      v: http://hl7.org/fhir/tools/StructureDefinition/snapshot-source
      l: snapshot-source
    value: Canonical
      v: https://elga.moped.at/StructureDefinition/at-moped-claimresponse-lkfresponse-generisch|0.1.0
      l: https://elga.moped.at/StructureDefinition/at-moped-claimresponse-lkfresponse-generisch
  url:
    v: http://hl7.org/fhir/StructureDefinition/obligation
    l: obligation
path:
  v: ClaimResponse.use
short:
  v: claim | preauthorization | predetermination
definition:
  v: A code to indicate whether the nature of the request is: Claim - A request to an Insurer to adjudicate the supplied charges for health care goods and services under the identified policy and to pay the determined Benefit amount, if any; Preauthorization - A request to an Insurer to adjudicate the supplied proposed future charges for health care goods and services under the identified policy and to approve the services and provide the expected benefit amounts and potentially to reserve funds to pay the benefits when Claims for the indicated services are later submitted; or, Pre-determination - A request to an Insurer to adjudicate the supplied 'what if' charges for health care goods and services under the identified policy and report back what the Benefit payable would be had the services actually been provided.
requirements:
  v: This element is required to understand the nature of the request for adjudication.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.use
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: code
    l: code
pattern: Code
  v: claim
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: Use
  strength:
    v: required
  description:
    v: Claim, preauthorization, predetermination.
  value set:
    v: http://hl7.org/fhir/ValueSet/claim-use|5.0.0
    l: http://hl7.org/fhir/ValueSet/claim-use
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.class

id:
  v: ClaimResponse.patient
extension:
  extension:
    url:
      v: code
      l: code
    value: Code
      v: SHALL:handle
  extension:
    url:
      v: actor
      l: actor
    value: Canonical
      v: https://elga.moped.at/ActorDefinition/MopedDeviceActor
      l: MopedDeviceActor
  extension:
    url:
      v: http://hl7.org/fhir/tools/StructureDefinition/snapshot-source
      l: snapshot-source
    value: Canonical
      v: https://elga.moped.at/StructureDefinition/at-moped-claimresponse-lkfresponse-generisch|0.1.0
      l: https://elga.moped.at/StructureDefinition/at-moped-claimresponse-lkfresponse-generisch
  url:
    v: http://hl7.org/fhir/StructureDefinition/obligation
    l: obligation
path:
  v: ClaimResponse.patient
short:
  v: The recipient of the products and services
definition:
  v: The party to whom the professional services and/or products have been supplied or are being considered and for whom actual for facast reimbursement is sought.
requirements:
  v: The patient must be supplied to the insurer so that confirmation of coverage and service hstory may be considered as part of the authorization and/or adjudiction.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.patient
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: https://elga.moped.at/StructureDefinition/at-moped-patient-vbPK-basis
    l: at-moped-patient-vbPK-basis
  target profile:
    v: https://elga.moped.at/StructureDefinition/at-moped-patient-klarname-basis
    l: at-moped-patient-klarname-basis
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.subject[x]

id:
  v: ClaimResponse.created
extension:
  extension:
    url:
      v: code
      l: code
    value: Code
      v: SHALL:populate
  extension:
    url:
      v: actor
      l: actor
    value: Canonical
      v: https://elga.moped.at/ActorDefinition/MopedLGFActor
      l: MopedLGFActor
  extension:
    url:
      v: http://hl7.org/fhir/tools/StructureDefinition/snapshot-source
      l: snapshot-source
    value: Canonical
      v: https://elga.moped.at/StructureDefinition/at-moped-claimresponse-lkfresponse-generisch|0.1.0
      l: https://elga.moped.at/StructureDefinition/at-moped-claimresponse-lkfresponse-generisch
  url:
    v: http://hl7.org/fhir/StructureDefinition/obligation
    l: obligation
path:
  v: ClaimResponse.created
short:
  v: Response creation date
definition:
  v: The date this resource was created.
requirements:
  v: Need to record a timestamp for use by both the recipient and the issuer.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.created
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: dateTime
    l: dateTime
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: workflow
  map:
    v: Event.occurrence[x]
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.recorded

id:
  v: ClaimResponse.insurer
path:
  v: ClaimResponse.insurer
short:
  v: Party responsible for reimbursement
definition:
  v: The party responsible for authorization, adjudication and reimbursement.
requirements:
  v: To be a valid claim, preauthorization or predetermination there must be a party who is responsible for adjudicating the contents against a policy which provides benefits for the patient.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.insurer
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Organization|5.0.0
    l: http://hl7.org/fhir/StructureDefinition/Organization
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: workflow
  map:
    v: Event.performer

id:
  v: ClaimResponse.requestor
extension:
  extension:
    url:
      v: code
      l: code
    value: Code
      v: SHALL:handle
  extension:
    url:
      v: actor
      l: actor
    value: Canonical
      v: https://elga.moped.at/ActorDefinition/MopedDeviceActor
      l: MopedDeviceActor
  extension:
    url:
      v: http://hl7.org/fhir/tools/StructureDefinition/snapshot-source
      l: snapshot-source
    value: Canonical
      v: https://elga.moped.at/StructureDefinition/at-moped-claimresponse-lkfresponse-generisch|0.1.0
      l: https://elga.moped.at/StructureDefinition/at-moped-claimresponse-lkfresponse-generisch
  url:
    v: http://hl7.org/fhir/StructureDefinition/obligation
    l: obligation
path:
  v: ClaimResponse.requestor
short:
  v: Party responsible for the claim
definition:
  v: The provider which is responsible for the claim, predetermination or preauthorization.
comment:
  v: Typically this field would be 1..1 where this party is accountable for the data content within the claim but is not necessarily the facility, provider group or practitioner who provided the products and services listed within this claim resource. This field is the Billing Provider, for example, a facility, provider group, lab or practitioner..
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.requestor
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: https://elga.moped.at/StructureDefinition/at-moped-organization-KA
    l: at-moped-organization-KA
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.source

id:
  v: ClaimResponse.request
extension:
  extension:
    url:
      v: code
      l: code
    value: Code
      v: SHALL:populate
  extension:
    url:
      v: actor
      l: actor
    value: Canonical
      v: https://elga.moped.at/ActorDefinition/MopedLGFActor
      l: MopedLGFActor
  extension:
    url:
      v: http://hl7.org/fhir/tools/StructureDefinition/snapshot-source
      l: snapshot-source
    value: Canonical
      v: https://elga.moped.at/StructureDefinition/at-moped-claimresponse-lkfresponse-generisch|0.1.0
      l: https://elga.moped.at/StructureDefinition/at-moped-claimresponse-lkfresponse-generisch
  url:
    v: http://hl7.org/fhir/StructureDefinition/obligation
    l: obligation
path:
  v: ClaimResponse.request
short:
  v: Id of resource triggering adjudication
definition:
  v: Original request resource reference.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.request
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: https://elga.moped.at/StructureDefinition/at-moped-claim-lkfrequest-basis
    l: at-moped-claim-lkfrequest-basis
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: workflow
  map:
    v: Event.basedOn
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.why[x]

id:
  v: ClaimResponse.outcome
extension:
  extension:
    url:
      v: code
      l: code
    value: Code
      v: SHALL:populate
  extension:
    url:
      v: actor
      l: actor
    value: Canonical
      v: https://elga.moped.at/ActorDefinition/MopedLGFActor
      l: MopedLGFActor
  extension:
    url:
      v: http://hl7.org/fhir/tools/StructureDefinition/snapshot-source
      l: snapshot-source
    value: Canonical
      v: https://elga.moped.at/StructureDefinition/at-moped-claimresponse-lkfresponse-generisch|0.1.0
      l: https://elga.moped.at/StructureDefinition/at-moped-claimresponse-lkfresponse-generisch
  url:
    v: http://hl7.org/fhir/StructureDefinition/obligation
    l: obligation
path:
  v: ClaimResponse.outcome
short:
  v: LKF Bewilligung/Ablehnung
definition:
  v: The outcome of the claim, predetermination, or preauthorization processing.
comment:
  v: The resource may be used to indicate that the Claim/Preauthorization/Pre-determination has been received but processing has not begun (queued); that it has been processed and one or more errors have been detected (error); no errors were detected and some of the adjudication processing has been performed (partial); or all of the adjudication processing has completed without errors (complete).
requirements:
  v: To advise the requestor of an overall processing outcome.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.outcome
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: code
    l: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: RemittanceOutcome
  strength:
    v: required
  description:
    v: The result of the claim processing.
  value set:
    v: http://hl7.org/fhir/ValueSet/claim-outcome|5.0.0
    l: http://hl7.org/fhir/ValueSet/claim-outcome

id:
  v: ClaimResponse.decision
extension:
  extension:
    url:
      v: code
      l: code
    value: Code
      v: SHALL:populate
  extension:
    url:
      v: actor
      l: actor
    value: Canonical
      v: https://elga.moped.at/ActorDefinition/MopedLGFActor
      l: MopedLGFActor
  extension:
    url:
      v: http://hl7.org/fhir/tools/StructureDefinition/snapshot-source
      l: snapshot-source
    value: Canonical
      v: https://elga.moped.at/StructureDefinition/at-moped-claimresponse-lkfresponse-generisch|0.1.0
      l: https://elga.moped.at/StructureDefinition/at-moped-claimresponse-lkfresponse-generisch
  url:
    v: http://hl7.org/fhir/StructureDefinition/obligation
    l: obligation
path:
  v: ClaimResponse.decision
short:
  v: Result of the adjudication
definition:
  v: The result of the claim, predetermination, or preauthorization adjudication.
comment:
  v: The element is used to indicate the current state of the adjudication overall for the claim resource, for example: the request has been held (pended) for adjudication processing, for manual review or other reasons; that it has been processed and will be paid, or the outstanding paid, as submitted (approved); that no amount will be paid (denied); or that some amount between zero and the submitted amount will be paid (partial).
requirements:
  v: To advise the requestor of the result of the adjudication process.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.decision
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: AdjudicationDecision
  strength:
    v: example
  description:
    v: The overall result of the claim adjudication.
  value set:
    v: http://hl7.org/fhir/ValueSet/claim-decision|5.0.0
    l: http://hl7.org/fhir/ValueSet/claim-decision

id:
  v: ClaimResponse.disposition
path:
  v: ClaimResponse.disposition
short:
  v: Disposition Message
definition:
  v: A human readable description of the status of the adjudication.
requirements:
  v: Provided for user display.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.disposition
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: workflow
  map:
    v: Event.note

id:
  v: ClaimResponse.preAuthRef
path:
  v: ClaimResponse.preAuthRef
short:
  v: Preauthorization reference
definition:
  v: Reference from the Insurer which is used in later communications which refers to this adjudication.
comment:
  v: This value is only present on preauthorization adjudications.
requirements:
  v: On subsequent claims, the insurer may require the provider to quote this value.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.preAuthRef
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.preAuthPeriod
path:
  v: ClaimResponse.preAuthPeriod
short:
  v: Preauthorization reference effective period
definition:
  v: The time frame during which this authorization is effective.
requirements:
  v: To convey to the provider when the authorized products and services must be supplied for the authorized adjudication to apply.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.preAuthPeriod
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Period
    l: Period
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.event
path:
  v: ClaimResponse.event
short:
  v: Event information
definition:
  v: Information code for an event with a corresponding date or period.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.event
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
    l: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.event.id
path:
  v: ClaimResponse.event.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
condition:
  v: ele-1
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.event.extension
path:
  v: ClaimResponse.event.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.event.modifierExtension
path:
  v: ClaimResponse.event.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R5/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: ClaimResponse.event.type
path:
  v: ClaimResponse.event.type
short:
  v: Specific event
definition:
  v: A coded event such as when a service is expected or a card printed.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.event.type
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: DatesType
  strength:
    v: example
  value set:
    v: http://hl7.org/fhir/ValueSet/datestype|5.0.0
    l: http://hl7.org/fhir/ValueSet/datestype

id:
  v: ClaimResponse.event.when[x]
path:
  v: ClaimResponse.event.when[x]
short:
  v: Occurance date or period
definition:
  v: A date or period in the past or future indicating when the event occurred or is expectd to occur.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.event.when[x]
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: dateTime
    l: dateTime
type:
  code:
    v: Period
    l: Period
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.payeeType
path:
  v: ClaimResponse.payeeType
short:
  v: Party to be paid any benefits payable
definition:
  v: Type of Party to be reimbursed: subscriber, provider, other.
requirements:
  v: Need to know who should receive payment with the most common situations being the Provider (assignment of benefits) or the Subscriber.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.payeeType
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: PayeeType
  strength:
    v: example
  description:
    v: A code for the party to be reimbursed.
  value set:
    v: http://hl7.org/fhir/ValueSet/payeetype|5.0.0
    l: http://hl7.org/fhir/ValueSet/payeetype

id:
  v: ClaimResponse.encounter
path:
  v: ClaimResponse.encounter
short:
  v: Encounters associated with the listed treatments
definition:
  v: Healthcare encounters related to this claim.
comment:
  v: This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.
requirements:
  v: Used in some jurisdictions to link clinical events to claim items.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.encounter
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Encounter|5.0.0
    l: http://hl7.org/fhir/StructureDefinition/Encounter
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.diagnosisRelatedGroup
path:
  v: ClaimResponse.diagnosisRelatedGroup
short:
  v: Package billing code
definition:
  v: A package billing code or bundle code used to group products and services to a particular health condition (such as heart attack) which is based on a predetermined grouping code system.
comment:
  v: For example DRG (Diagnosis Related Group) or a bundled billing code. A patient may have a diagnosis of a Myocardial Infarction and a DRG for HeartAttack would be assigned. The Claim item (and possible subsequent claims) would refer to the DRG for those line items that were for services related to the heart attack event.
requirements:
  v: Required to relate the current diagnosis to a package billing code that is then referenced on the individual claim items which are specific to the health condition covered by the package code.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.diagnosisRelatedGroup
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: DiagnosisRelatedGroup
  strength:
    v: example
  value set:
    v: http://hl7.org/fhir/ValueSet/ex-diagnosisrelatedgroup|5.0.0
    l: http://hl7.org/fhir/ValueSet/ex-diagnosisrelatedgroup

id:
  v: ClaimResponse.item
path:
  v: ClaimResponse.item
short:
  v: Adjudication for claim line items
definition:
  v: A claim line. Either a simple (a product or service) or a 'group' of details which can also be a simple items or groups of sub-details.
requirements:
  v: The adjudication for items provided on the claim.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.item
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
    l: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.id
path:
  v: ClaimResponse.item.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
condition:
  v: ele-1
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.item.extension
path:
  v: ClaimResponse.item.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.item.modifierExtension
path:
  v: ClaimResponse.item.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R5/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: ClaimResponse.item.itemSequence
path:
  v: ClaimResponse.item.itemSequence
short:
  v: Claim item instance identifier
definition:
  v: A number to uniquely reference the claim item entries.
requirements:
  v: Necessary to provide a mechanism to link the adjudication result to the submitted claim item.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.item.itemSequence
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: positiveInt
    l: positiveInt
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.traceNumber
path:
  v: ClaimResponse.item.traceNumber
short:
  v: Number for tracking
definition:
  v: Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.
requirements:
  v: Allows partners to uniquely identify components for tracking.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.item.traceNumber
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Identifier
    l: Identifier
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.noteNumber
path:
  v: ClaimResponse.item.noteNumber
short:
  v: Applicable note numbers
definition:
  v: The numbers associated with notes below which apply to the adjudication of this item.
requirements:
  v: Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.item.noteNumber
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: positiveInt
    l: positiveInt
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.reviewOutcome
path:
  v: ClaimResponse.item.reviewOutcome
short:
  v: Adjudication results
definition:
  v: The high-level results of the adjudication if adjudication has been performed.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.item.reviewOutcome
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: BackboneElement
    l: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.reviewOutcome.id
path:
  v: ClaimResponse.item.reviewOutcome.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
condition:
  v: ele-1
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.item.reviewOutcome.extension
path:
  v: ClaimResponse.item.reviewOutcome.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.item.reviewOutcome.modifierExtension
path:
  v: ClaimResponse.item.reviewOutcome.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R5/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: ClaimResponse.item.reviewOutcome.decision
path:
  v: ClaimResponse.item.reviewOutcome.decision
short:
  v: Result of the adjudication
definition:
  v: The result of the claim, predetermination, or preauthorization adjudication.
comment:
  v: The element is used to indicate the current state of the adjudication overall for the claim resource, for example: the request has been held (pended) for adjudication processing, for manual review or other reasons; that it has been processed and will be paid, or the outstanding paid, as submitted (approved); that no amount will be paid (denied); or that some amount between zero and the submitted amount will be paid (partial).
requirements:
  v: To advise the requestor of the result of the adjudication process.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.item.reviewOutcome.decision
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: AdjudicationDecision
  strength:
    v: example
  value set:
    v: http://hl7.org/fhir/ValueSet/claim-decision|5.0.0
    l: http://hl7.org/fhir/ValueSet/claim-decision

id:
  v: ClaimResponse.item.reviewOutcome.reason
path:
  v: ClaimResponse.item.reviewOutcome.reason
short:
  v: Reason for result of the adjudication
definition:
  v: The reasons for the result of the claim, predetermination, or preauthorization adjudication.
requirements:
  v: To advise the requestor of the contributors to the result of the adjudication process.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.item.reviewOutcome.reason
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: AdjudicationDecisionReason
  strength:
    v: example
  value set:
    v: http://hl7.org/fhir/ValueSet/claim-decision-reason|5.0.0
    l: http://hl7.org/fhir/ValueSet/claim-decision-reason

id:
  v: ClaimResponse.item.reviewOutcome.preAuthRef
path:
  v: ClaimResponse.item.reviewOutcome.preAuthRef
short:
  v: Preauthorization reference
definition:
  v: Reference from the Insurer which is used in later communications which refers to this adjudication.
comment:
  v: This value is only present on preauthorization adjudications.
requirements:
  v: On subsequent claims, the insurer may require the provider to quote this value.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.item.reviewOutcome.preAuthRef
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.reviewOutcome.preAuthPeriod
path:
  v: ClaimResponse.item.reviewOutcome.preAuthPeriod
short:
  v: Preauthorization reference effective period
definition:
  v: The time frame during which this authorization is effective.
requirements:
  v: To convey to the provider when the authorized products and services must be supplied for the authorized adjudication to apply.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.item.reviewOutcome.preAuthPeriod
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Period
    l: Period
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.adjudication
path:
  v: ClaimResponse.item.adjudication
short:
  v: Adjudication details
definition:
  v: If this item is a group then the values here are a summary of the adjudication of the detail items. If this item is a simple product or service then this is the result of the adjudication of this item.
requirements:
  v: The adjudication results conveys the insurer's assessment of the item provided in the claim under the terms of the patient's insurance coverage.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.item.adjudication
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
    l: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.adjudication.id
path:
  v: ClaimResponse.item.adjudication.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
condition:
  v: ele-1
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.item.adjudication.extension
path:
  v: ClaimResponse.item.adjudication.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.item.adjudication.modifierExtension
path:
  v: ClaimResponse.item.adjudication.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R5/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: ClaimResponse.item.adjudication.category
path:
  v: ClaimResponse.item.adjudication.category
short:
  v: Type of adjudication information
definition:
  v: A code to indicate the information type of this adjudication record. Information types may include the value submitted, maximum values or percentages allowed or payable under the plan, amounts that: the patient is responsible for in aggregate or pertaining to this item; amounts paid by other coverages; and, the benefit payable for this item.
comment:
  v: For example codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.
requirements:
  v: Needed to enable understanding of the context of the other information in the adjudication.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.item.adjudication.category
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: Adjudication
  strength:
    v: example
  description:
    v: The adjudication codes.
  value set:
    v: http://hl7.org/fhir/ValueSet/adjudication|5.0.0
    l: http://hl7.org/fhir/ValueSet/adjudication

id:
  v: ClaimResponse.item.adjudication.reason
path:
  v: ClaimResponse.item.adjudication.reason
short:
  v: Explanation of adjudication outcome
definition:
  v: A code supporting the understanding of the adjudication result and explaining variance from expected amount.
comment:
  v: For example may indicate that the funds for this benefit type have been exhausted.
requirements:
  v: To support understanding of variance from adjudication expectations.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.item.adjudication.reason
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: AdjudicationReason
  strength:
    v: example
  description:
    v: The adjudication reason codes.
  value set:
    v: http://hl7.org/fhir/ValueSet/adjudication-reason|5.0.0
    l: http://hl7.org/fhir/ValueSet/adjudication-reason

id:
  v: ClaimResponse.item.adjudication.amount
path:
  v: ClaimResponse.item.adjudication.amount
short:
  v: Monetary amount
definition:
  v: Monetary amount associated with the category.
comment:
  v: For example: amount submitted, eligible amount, co-payment, and benefit payable.
requirements:
  v: Most adjudication categories convey a monetary amount.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.item.adjudication.amount
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Money
    l: Money
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.adjudication.quantity
path:
  v: ClaimResponse.item.adjudication.quantity
short:
  v: Non-monetary value
definition:
  v: A non-monetary value associated with the category. Mutually exclusive to the amount element above.
comment:
  v: For example: eligible percentage or co-payment percentage.
requirements:
  v: Some adjudication categories convey a percentage or a fixed value.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.item.adjudication.quantity
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Quantity
    l: Quantity
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.detail
path:
  v: ClaimResponse.item.detail
short:
  v: Adjudication for claim details
definition:
  v: A claim detail. Either a simple (a product or service) or a 'group' of sub-details which are simple items.
requirements:
  v: The adjudication for details provided on the claim.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.item.detail
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
    l: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.detail.id
path:
  v: ClaimResponse.item.detail.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
condition:
  v: ele-1
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.item.detail.extension
path:
  v: ClaimResponse.item.detail.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
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    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.item.detail.modifierExtension
path:
  v: ClaimResponse.item.detail.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R5/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: ClaimResponse.item.detail.detailSequence
path:
  v: ClaimResponse.item.detail.detailSequence
short:
  v: Claim detail instance identifier
definition:
  v: A number to uniquely reference the claim detail entry.
requirements:
  v: Necessary to provide a mechanism to link the adjudication result to the submitted claim detail.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.item.detail.detailSequence
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    v: 1
  max:
    v: 1
type:
  code:
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    l: positiveInt
constraint:
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    v: ele-1
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  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.detail.traceNumber
path:
  v: ClaimResponse.item.detail.traceNumber
short:
  v: Number for tracking
definition:
  v: Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.
requirements:
  v: Allows partners to uniquely identify components for tracking.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.item.detail.traceNumber
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Identifier
    l: Identifier
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.detail.noteNumber
path:
  v: ClaimResponse.item.detail.noteNumber
short:
  v: Applicable note numbers
definition:
  v: The numbers associated with notes below which apply to the adjudication of this item.
requirements:
  v: Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.item.detail.noteNumber
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: positiveInt
    l: positiveInt
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.detail.reviewOutcome
path:
  v: ClaimResponse.item.detail.reviewOutcome
short:
  v: Detail level adjudication results
definition:
  v: The high-level results of the adjudication if adjudication has been performed.
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  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.item.detail.reviewOutcome
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    v: 0
  max:
    v: 1
content reference:
  v: http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.reviewOutcome
  l: ClaimResponse.item.reviewOutcome
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.detail.adjudication
path:
  v: ClaimResponse.item.detail.adjudication
short:
  v: Detail level adjudication details
definition:
  v: The adjudication results.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.item.detail.adjudication
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    v: 0
  max:
    v: *
content reference:
  v: http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.adjudication
  l: ClaimResponse.item.adjudication
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.detail.subDetail
path:
  v: ClaimResponse.item.detail.subDetail
short:
  v: Adjudication for claim sub-details
definition:
  v: A sub-detail adjudication of a simple product or service.
requirements:
  v: The adjudication for sub-details provided on the claim.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.item.detail.subDetail
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
    l: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.detail.subDetail.id
path:
  v: ClaimResponse.item.detail.subDetail.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
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      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
condition:
  v: ele-1
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.item.detail.subDetail.extension
path:
  v: ClaimResponse.item.detail.subDetail.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.item.detail.subDetail.modifierExtension
path:
  v: ClaimResponse.item.detail.subDetail.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R5/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: ClaimResponse.item.detail.subDetail.subDetailSequence
path:
  v: ClaimResponse.item.detail.subDetail.subDetailSequence
short:
  v: Claim sub-detail instance identifier
definition:
  v: A number to uniquely reference the claim sub-detail entry.
requirements:
  v: Necessary to provide a mechanism to link the adjudication result to the submitted claim sub-detail.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.item.detail.subDetail.subDetailSequence
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    v: 1
  max:
    v: 1
type:
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    v: positiveInt
    l: positiveInt
constraint:
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    v: ele-1
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    v: error
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    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.detail.subDetail.traceNumber
path:
  v: ClaimResponse.item.detail.subDetail.traceNumber
short:
  v: Number for tracking
definition:
  v: Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.
requirements:
  v: Allows partners to uniquely identify components for tracking.
min:
  v: 0
max:
  v: *
base:
  path:
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  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Identifier
    l: Identifier
constraint:
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    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.detail.subDetail.noteNumber
path:
  v: ClaimResponse.item.detail.subDetail.noteNumber
short:
  v: Applicable note numbers
definition:
  v: The numbers associated with notes below which apply to the adjudication of this item.
requirements:
  v: Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.item.detail.subDetail.noteNumber
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: positiveInt
    l: positiveInt
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.detail.subDetail.reviewOutcome
path:
  v: ClaimResponse.item.detail.subDetail.reviewOutcome
short:
  v: Subdetail level adjudication results
definition:
  v: The high-level results of the adjudication if adjudication has been performed.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.item.detail.subDetail.reviewOutcome
  min:
    v: 0
  max:
    v: 1
content reference:
  v: http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.reviewOutcome
  l: ClaimResponse.item.reviewOutcome
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.item.detail.subDetail.adjudication
path:
  v: ClaimResponse.item.detail.subDetail.adjudication
short:
  v: Subdetail level adjudication details
definition:
  v: The adjudication results.
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  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.item.detail.subDetail.adjudication
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    v: 0
  max:
    v: *
content reference:
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constraint:
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    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem
path:
  v: ClaimResponse.addItem
short:
  v: Insurer added line items
definition:
  v: The first-tier service adjudications for payor added product or service lines.
requirements:
  v: Insurers may redefine the provided product or service or may package and/or decompose groups of products and services. The addItems allows the insurer to provide their line item list with linkage to the submitted items/details/sub-details. In a preauthorization the insurer may use the addItem structure to provide additional information on authorized products and services.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem
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    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
    l: BackboneElement
constraint:
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    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
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  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.id
path:
  v: ClaimResponse.addItem.id
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  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
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    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
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      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
condition:
  v: ele-1
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
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path:
  v: ClaimResponse.addItem.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  ordered:
    v: false
  rules:
    v: open
short:
  v: Extension
definition:
  v: An Extension
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  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
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    v: 0
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    v: *
type:
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    l: Extension
constraint:
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    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
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  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
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    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.extension:AddItemCategory
path:
  v: ClaimResponse.addItem.extension
slice name:
  v: AddItemCategory
short:
  v: AddItemCategory
definition:
  v: Benefit classification
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  v: 0
max:
  v: 1
base:
  path:
    v: Element.extension
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    v: 0
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    v: *
type:
  code:
    v: Extension
    l: Extension
  profile:
    v: https://elga.moped.at/StructureDefinition/moped-ext-AddItemCategory
    l: moped-ext-AddItemCategory
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.modifierExtension
path:
  v: ClaimResponse.addItem.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R5/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: ClaimResponse.addItem.itemSequence
path:
  v: ClaimResponse.addItem.itemSequence
short:
  v: Item sequence number
definition:
  v: Claim items which this service line is intended to replace.
requirements:
  v: Provides references to the claim items.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.itemSequence
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: positiveInt
    l: positiveInt
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.detailSequence
path:
  v: ClaimResponse.addItem.detailSequence
short:
  v: Detail sequence number
definition:
  v: The sequence number of the details within the claim item which this line is intended to replace.
requirements:
  v: Provides references to the claim details within the claim item.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.detailSequence
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: positiveInt
    l: positiveInt
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.subdetailSequence
path:
  v: ClaimResponse.addItem.subdetailSequence
short:
  v: Subdetail sequence number
definition:
  v: The sequence number of the sub-details within the details within the claim item which this line is intended to replace.
requirements:
  v: Provides references to the claim sub-details within the claim detail.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.subdetailSequence
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: positiveInt
    l: positiveInt
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.traceNumber
path:
  v: ClaimResponse.addItem.traceNumber
short:
  v: Number for tracking
definition:
  v: Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.
requirements:
  v: Allows partners to uniquely identify components for tracking.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.traceNumber
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Identifier
    l: Identifier
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.provider
path:
  v: ClaimResponse.addItem.provider
short:
  v: Authorized providers
definition:
  v: The providers who are authorized for the services rendered to the patient.
requirements:
  v: Insurer may provide authorization specifically to a restricted set of providers rather than an open authorization.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.provider
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Practitioner|5.0.0
    l: http://hl7.org/fhir/StructureDefinition/Practitioner
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/PractitionerRole|5.0.0
    l: http://hl7.org/fhir/StructureDefinition/PractitionerRole
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Organization|5.0.0
    l: http://hl7.org/fhir/StructureDefinition/Organization
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.source

id:
  v: ClaimResponse.addItem.revenue
path:
  v: ClaimResponse.addItem.revenue
short:
  v: Revenue or cost center code
definition:
  v: The type of revenue or cost center providing the product and/or service.
requirements:
  v: Needed in the processing of institutional claims.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.revenue
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: RevenueCenter
  strength:
    v: example
  description:
    v: Codes for the revenue or cost centers supplying the service and/or products.
  value set:
    v: http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0
    l: http://hl7.org/fhir/ValueSet/ex-revenue-center

id:
  v: ClaimResponse.addItem.productOrService
path:
  v: ClaimResponse.addItem.productOrService
short:
  v: Billing, service, product, or drug code
definition:
  v: When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.
comment:
  v: If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.
requirements:
  v: Necessary to state what was provided or done.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.productOrService
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: ServiceProduct
  strength:
    v: example
  description:
    v: Allowable service and product codes.
  value set:
    v: http://hl7.org/fhir/ValueSet/service-uscls|5.0.0
    l: http://hl7.org/fhir/ValueSet/service-uscls

id:
  v: ClaimResponse.addItem.productOrServiceEnd
path:
  v: ClaimResponse.addItem.productOrServiceEnd
short:
  v: End of a range of codes
definition:
  v: This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.
alias:
  v: End of a range of Drug Code; Bill Code; Service Cod
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.productOrServiceEnd
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: ServiceProduct
  strength:
    v: example
  value set:
    v: http://hl7.org/fhir/ValueSet/service-uscls|5.0.0
    l: http://hl7.org/fhir/ValueSet/service-uscls

id:
  v: ClaimResponse.addItem.request
path:
  v: ClaimResponse.addItem.request
short:
  v: Request or Referral for Service
definition:
  v: Request or Referral for Goods or Service to be rendered.
requirements:
  v: May identify the service to be provided or provider authorization for the service.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.request
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/DeviceRequest|5.0.0
    l: http://hl7.org/fhir/StructureDefinition/DeviceRequest
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/MedicationRequest|5.0.0
    l: http://hl7.org/fhir/StructureDefinition/MedicationRequest
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/NutritionOrder|5.0.0
    l: http://hl7.org/fhir/StructureDefinition/NutritionOrder
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/ServiceRequest|5.0.0
    l: http://hl7.org/fhir/StructureDefinition/ServiceRequest
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/SupplyRequest|5.0.0
    l: http://hl7.org/fhir/StructureDefinition/SupplyRequest
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/VisionPrescription|5.0.0
    l: http://hl7.org/fhir/StructureDefinition/VisionPrescription
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.modifier
path:
  v: ClaimResponse.addItem.modifier
short:
  v: Service/Product billing modifiers
definition:
  v: Item typification or modifiers codes to convey additional context for the product or service.
comment:
  v: For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours.
requirements:
  v: To support inclusion of the item for adjudication or to charge an elevated fee.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.modifier
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: Modifiers
  strength:
    v: example
  description:
    v: Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
  value set:
    v: http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0
    l: http://hl7.org/fhir/ValueSet/claim-modifiers
mapping:
  identity:
    v: rim
  map:
    v: 24.C, 24.D mods

id:
  v: ClaimResponse.addItem.programCode
path:
  v: ClaimResponse.addItem.programCode
short:
  v: Program the product or service is provided under
definition:
  v: Identifies the program under which this may be recovered.
comment:
  v: For example: Neonatal program, child dental program or drug users recovery program.
requirements:
  v: Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.programCode
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: ProgramCode
  strength:
    v: example
  description:
    v: Program specific reason codes.
  value set:
    v: http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0
    l: http://hl7.org/fhir/ValueSet/ex-program-code
mapping:
  identity:
    v: rim
  map:
    v: 24.H

id:
  v: ClaimResponse.addItem.serviced[x]
path:
  v: ClaimResponse.addItem.serviced[x]
short:
  v: Date or dates of service or product delivery
definition:
  v: The date or dates when the service or product was supplied, performed or completed.
requirements:
  v: Needed to determine whether the service or product was provided during the term of the insurance coverage.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.serviced[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: date
    l: date
type:
  code:
    v: Period
    l: Period
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.done[x]
mapping:
  identity:
    v: rim
  map:
    v: 24.A

id:
  v: ClaimResponse.addItem.location[x]
path:
  v: ClaimResponse.addItem.location[x]
short:
  v: Place of service or where product was supplied
definition:
  v: Where the product or service was provided.
requirements:
  v: The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.location[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
type:
  code:
    v: Address
    l: Address
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Location|5.0.0
    l: http://hl7.org/fhir/StructureDefinition/Location
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: ServicePlace
  strength:
    v: example
  description:
    v: Place of service: pharmacy, school, prison, etc.
  value set:
    v: http://hl7.org/fhir/ValueSet/service-place|5.0.0
    l: http://hl7.org/fhir/ValueSet/service-place
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.where[x]
mapping:
  identity:
    v: rim
  map:
    v: 24.B

id:
  v: ClaimResponse.addItem.quantity
path:
  v: ClaimResponse.addItem.quantity
short:
  v: Count of products or services
definition:
  v: The number of repetitions of a service or product.
requirements:
  v: Required when the product or service code does not convey the quantity provided.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.quantity
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Quantity
    l: Quantity
  profile:
    v: http://hl7.org/fhir/StructureDefinition/SimpleQuantity|5.0.0
    l: http://hl7.org/fhir/StructureDefinition/SimpleQuantity
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: 24.G

id:
  v: ClaimResponse.addItem.unitPrice
path:
  v: ClaimResponse.addItem.unitPrice
short:
  v: Fee, charge or cost per item
definition:
  v: If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.
requirements:
  v: The amount charged to the patient by the provider for a single unit.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.unitPrice
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Money
    l: Money
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.factor
path:
  v: ClaimResponse.addItem.factor
short:
  v: Price scaling factor
definition:
  v: A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.
comment:
  v: To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).
requirements:
  v: When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.factor
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: decimal
    l: decimal
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.tax
path:
  v: ClaimResponse.addItem.tax
short:
  v: Total tax
definition:
  v: The total of taxes applicable for this product or service.
requirements:
  v: Required when taxes are not embedded in the unit price or provided as a separate service.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.tax
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Money
    l: Money
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.net
path:
  v: ClaimResponse.addItem.net
short:
  v: Total item cost
definition:
  v: The total amount claimed for the group (if a grouper) or the addItem. Net = unit price * quantity * factor.
comment:
  v: For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.
requirements:
  v: Provides the total amount claimed for the group (if a grouper) or the line item.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.net
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Money
    l: Money
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: 24.F

id:
  v: ClaimResponse.addItem.bodySite
path:
  v: ClaimResponse.addItem.bodySite
short:
  v: Anatomical location
definition:
  v: Physical location where the service is performed or applies.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.bodySite
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
    l: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.bodySite.id
path:
  v: ClaimResponse.addItem.bodySite.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
condition:
  v: ele-1
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.addItem.bodySite.extension
path:
  v: ClaimResponse.addItem.bodySite.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.addItem.bodySite.modifierExtension
path:
  v: ClaimResponse.addItem.bodySite.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R5/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: ClaimResponse.addItem.bodySite.site
path:
  v: ClaimResponse.addItem.bodySite.site
short:
  v: Location
definition:
  v: Physical service site on the patient (limb, tooth, etc.).
comment:
  v: For example: Providing a tooth code allows an insurer to identify a provider performing a filling on a tooth that was previously removed.
requirements:
  v: Allows insurer to validate specific procedures.
min:
  v: 1
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.bodySite.site
  min:
    v: 1
  max:
    v: *
type:
  code:
    v: CodeableReference
    l: CodeableReference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/BodyStructure|5.0.0
    l: http://hl7.org/fhir/StructureDefinition/BodyStructure
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: OralSites
  strength:
    v: example
  value set:
    v: http://hl7.org/fhir/ValueSet/tooth|5.0.0
    l: http://hl7.org/fhir/ValueSet/tooth

id:
  v: ClaimResponse.addItem.bodySite.subSite
path:
  v: ClaimResponse.addItem.bodySite.subSite
short:
  v: Sub-location
definition:
  v: A region or surface of the bodySite, e.g. limb region or tooth surface(s).
requirements:
  v: Allows insurer to validate specific procedures.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.bodySite.subSite
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: Surface
  strength:
    v: example
  value set:
    v: http://hl7.org/fhir/ValueSet/surface|5.0.0
    l: http://hl7.org/fhir/ValueSet/surface

id:
  v: ClaimResponse.addItem.noteNumber
path:
  v: ClaimResponse.addItem.noteNumber
short:
  v: Applicable note numbers
definition:
  v: The numbers associated with notes below which apply to the adjudication of this item.
requirements:
  v: Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.noteNumber
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: positiveInt
    l: positiveInt
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.reviewOutcome
path:
  v: ClaimResponse.addItem.reviewOutcome
short:
  v: Added items adjudication results
definition:
  v: The high-level results of the adjudication if adjudication has been performed.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.reviewOutcome
  min:
    v: 0
  max:
    v: 1
content reference:
  v: http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.reviewOutcome
  l: ClaimResponse.item.reviewOutcome
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.adjudication
path:
  v: ClaimResponse.addItem.adjudication
short:
  v: Added items adjudication
definition:
  v: The adjudication results.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.adjudication
  min:
    v: 0
  max:
    v: *
content reference:
  v: http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.adjudication
  l: ClaimResponse.item.adjudication
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.detail
path:
  v: ClaimResponse.addItem.detail
short:
  v: Insurer added line details
definition:
  v: The second-tier service adjudications for payor added services.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.detail
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
    l: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.detail.id
path:
  v: ClaimResponse.addItem.detail.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
condition:
  v: ele-1
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.addItem.detail.extension
path:
  v: ClaimResponse.addItem.detail.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.addItem.detail.modifierExtension
path:
  v: ClaimResponse.addItem.detail.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R5/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: ClaimResponse.addItem.detail.traceNumber
path:
  v: ClaimResponse.addItem.detail.traceNumber
short:
  v: Number for tracking
definition:
  v: Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.
requirements:
  v: Allows partners to uniquely identify components for tracking.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.detail.traceNumber
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Identifier
    l: Identifier
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.detail.revenue
path:
  v: ClaimResponse.addItem.detail.revenue
short:
  v: Revenue or cost center code
definition:
  v: The type of revenue or cost center providing the product and/or service.
requirements:
  v: Needed in the processing of institutional claims.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.detail.revenue
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: RevenueCenter
  strength:
    v: example
  description:
    v: Codes for the revenue or cost centers supplying the service and/or products.
  value set:
    v: http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0
    l: http://hl7.org/fhir/ValueSet/ex-revenue-center

id:
  v: ClaimResponse.addItem.detail.productOrService
path:
  v: ClaimResponse.addItem.detail.productOrService
short:
  v: Billing, service, product, or drug code
definition:
  v: When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.
comment:
  v: If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.
requirements:
  v: Necessary to state what was provided or done.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.detail.productOrService
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: ServiceProduct
  strength:
    v: example
  description:
    v: Allowable service and product codes.
  value set:
    v: http://hl7.org/fhir/ValueSet/service-uscls|5.0.0
    l: http://hl7.org/fhir/ValueSet/service-uscls

id:
  v: ClaimResponse.addItem.detail.productOrServiceEnd
path:
  v: ClaimResponse.addItem.detail.productOrServiceEnd
short:
  v: End of a range of codes
definition:
  v: This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.
alias:
  v: End of a range of Drug Code; Bill Code; Service Cod
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.detail.productOrServiceEnd
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: ServiceProduct
  strength:
    v: example
  value set:
    v: http://hl7.org/fhir/ValueSet/service-uscls|5.0.0
    l: http://hl7.org/fhir/ValueSet/service-uscls

id:
  v: ClaimResponse.addItem.detail.modifier
path:
  v: ClaimResponse.addItem.detail.modifier
short:
  v: Service/Product billing modifiers
definition:
  v: Item typification or modifiers codes to convey additional context for the product or service.
comment:
  v: For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours.
requirements:
  v: To support inclusion of the item for adjudication or to charge an elevated fee.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.detail.modifier
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: Modifiers
  strength:
    v: example
  description:
    v: Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
  value set:
    v: http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0
    l: http://hl7.org/fhir/ValueSet/claim-modifiers
mapping:
  identity:
    v: rim
  map:
    v: 24.C, 24.D mods

id:
  v: ClaimResponse.addItem.detail.quantity
path:
  v: ClaimResponse.addItem.detail.quantity
short:
  v: Count of products or services
definition:
  v: The number of repetitions of a service or product.
requirements:
  v: Required when the product or service code does not convey the quantity provided.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.detail.quantity
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Quantity
    l: Quantity
  profile:
    v: http://hl7.org/fhir/StructureDefinition/SimpleQuantity|5.0.0
    l: http://hl7.org/fhir/StructureDefinition/SimpleQuantity
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: 24.G

id:
  v: ClaimResponse.addItem.detail.unitPrice
path:
  v: ClaimResponse.addItem.detail.unitPrice
short:
  v: Fee, charge or cost per item
definition:
  v: If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.
requirements:
  v: The amount charged to the patient by the provider for a single unit.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.detail.unitPrice
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Money
    l: Money
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.detail.factor
path:
  v: ClaimResponse.addItem.detail.factor
short:
  v: Price scaling factor
definition:
  v: A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.
comment:
  v: To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).
requirements:
  v: When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.detail.factor
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: decimal
    l: decimal
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.detail.tax
path:
  v: ClaimResponse.addItem.detail.tax
short:
  v: Total tax
definition:
  v: The total of taxes applicable for this product or service.
requirements:
  v: Required when taxes are not embedded in the unit price or provided as a separate service.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.detail.tax
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Money
    l: Money
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.detail.net
path:
  v: ClaimResponse.addItem.detail.net
short:
  v: Total item cost
definition:
  v: The total amount claimed for the group (if a grouper) or the addItem.detail. Net = unit price * quantity * factor.
comment:
  v: For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.
requirements:
  v: Provides the total amount claimed for the group (if a grouper) or the line item.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.detail.net
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Money
    l: Money
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: 24.F

id:
  v: ClaimResponse.addItem.detail.noteNumber
path:
  v: ClaimResponse.addItem.detail.noteNumber
short:
  v: Applicable note numbers
definition:
  v: The numbers associated with notes below which apply to the adjudication of this item.
requirements:
  v: Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.detail.noteNumber
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: positiveInt
    l: positiveInt
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.detail.reviewOutcome
path:
  v: ClaimResponse.addItem.detail.reviewOutcome
short:
  v: Added items detail level adjudication results
definition:
  v: The high-level results of the adjudication if adjudication has been performed.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.detail.reviewOutcome
  min:
    v: 0
  max:
    v: 1
content reference:
  v: http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.reviewOutcome
  l: ClaimResponse.item.reviewOutcome
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.detail.adjudication
path:
  v: ClaimResponse.addItem.detail.adjudication
short:
  v: Added items detail adjudication
definition:
  v: The adjudication results.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.detail.adjudication
  min:
    v: 0
  max:
    v: *
content reference:
  v: http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.adjudication
  l: ClaimResponse.item.adjudication
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.detail.subDetail
path:
  v: ClaimResponse.addItem.detail.subDetail
short:
  v: Insurer added line items
definition:
  v: The third-tier service adjudications for payor added services.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.detail.subDetail
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
    l: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.detail.subDetail.id
path:
  v: ClaimResponse.addItem.detail.subDetail.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
condition:
  v: ele-1
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.addItem.detail.subDetail.extension
path:
  v: ClaimResponse.addItem.detail.subDetail.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.addItem.detail.subDetail.modifierExtension
path:
  v: ClaimResponse.addItem.detail.subDetail.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R5/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: ClaimResponse.addItem.detail.subDetail.traceNumber
path:
  v: ClaimResponse.addItem.detail.subDetail.traceNumber
short:
  v: Number for tracking
definition:
  v: Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.
requirements:
  v: Allows partners to uniquely identify components for tracking.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.detail.subDetail.traceNumber
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Identifier
    l: Identifier
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.detail.subDetail.revenue
path:
  v: ClaimResponse.addItem.detail.subDetail.revenue
short:
  v: Revenue or cost center code
definition:
  v: The type of revenue or cost center providing the product and/or service.
requirements:
  v: Needed in the processing of institutional claims.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.detail.subDetail.revenue
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: RevenueCenter
  strength:
    v: example
  description:
    v: Codes for the revenue or cost centers supplying the service and/or products.
  value set:
    v: http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0
    l: http://hl7.org/fhir/ValueSet/ex-revenue-center

id:
  v: ClaimResponse.addItem.detail.subDetail.productOrService
path:
  v: ClaimResponse.addItem.detail.subDetail.productOrService
short:
  v: Billing, service, product, or drug code
definition:
  v: When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.
comment:
  v: If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.
requirements:
  v: Necessary to state what was provided or done.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.detail.subDetail.productOrService
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: ServiceProduct
  strength:
    v: example
  description:
    v: Allowable service and product codes.
  value set:
    v: http://hl7.org/fhir/ValueSet/service-uscls|5.0.0
    l: http://hl7.org/fhir/ValueSet/service-uscls

id:
  v: ClaimResponse.addItem.detail.subDetail.productOrServiceEnd
path:
  v: ClaimResponse.addItem.detail.subDetail.productOrServiceEnd
short:
  v: End of a range of codes
definition:
  v: This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.
alias:
  v: End of a range of Drug Code; Bill Code; Service Cod
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.detail.subDetail.productOrServiceEnd
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: ServiceProduct
  strength:
    v: example
  value set:
    v: http://hl7.org/fhir/ValueSet/service-uscls|5.0.0
    l: http://hl7.org/fhir/ValueSet/service-uscls

id:
  v: ClaimResponse.addItem.detail.subDetail.modifier
path:
  v: ClaimResponse.addItem.detail.subDetail.modifier
short:
  v: Service/Product billing modifiers
definition:
  v: Item typification or modifiers codes to convey additional context for the product or service.
comment:
  v: For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours.
requirements:
  v: To support inclusion of the item for adjudication or to charge an elevated fee.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.detail.subDetail.modifier
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: Modifiers
  strength:
    v: example
  description:
    v: Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
  value set:
    v: http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0
    l: http://hl7.org/fhir/ValueSet/claim-modifiers
mapping:
  identity:
    v: rim
  map:
    v: 24.C, 24.D mods

id:
  v: ClaimResponse.addItem.detail.subDetail.quantity
path:
  v: ClaimResponse.addItem.detail.subDetail.quantity
short:
  v: Count of products or services
definition:
  v: The number of repetitions of a service or product.
requirements:
  v: Required when the product or service code does not convey the quantity provided.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.detail.subDetail.quantity
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Quantity
    l: Quantity
  profile:
    v: http://hl7.org/fhir/StructureDefinition/SimpleQuantity|5.0.0
    l: http://hl7.org/fhir/StructureDefinition/SimpleQuantity
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: 24.G

id:
  v: ClaimResponse.addItem.detail.subDetail.unitPrice
path:
  v: ClaimResponse.addItem.detail.subDetail.unitPrice
short:
  v: Fee, charge or cost per item
definition:
  v: If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.
requirements:
  v: The amount charged to the patient by the provider for a single unit.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.detail.subDetail.unitPrice
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Money
    l: Money
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.detail.subDetail.factor
path:
  v: ClaimResponse.addItem.detail.subDetail.factor
short:
  v: Price scaling factor
definition:
  v: A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.
comment:
  v: To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).
requirements:
  v: When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.detail.subDetail.factor
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: decimal
    l: decimal
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.detail.subDetail.tax
path:
  v: ClaimResponse.addItem.detail.subDetail.tax
short:
  v: Total tax
definition:
  v: The total of taxes applicable for this product or service.
requirements:
  v: Required when taxes are not embedded in the unit price or provided as a separate service.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.detail.subDetail.tax
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Money
    l: Money
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.detail.subDetail.net
path:
  v: ClaimResponse.addItem.detail.subDetail.net
short:
  v: Total item cost
definition:
  v: The total amount claimed for the addItem.detail.subDetail. Net = unit price * quantity * factor.
comment:
  v: For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.
requirements:
  v: Provides the total amount claimed for the group (if a grouper) or the line item.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.detail.subDetail.net
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Money
    l: Money
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: 24.F

id:
  v: ClaimResponse.addItem.detail.subDetail.noteNumber
path:
  v: ClaimResponse.addItem.detail.subDetail.noteNumber
short:
  v: Applicable note numbers
definition:
  v: The numbers associated with notes below which apply to the adjudication of this item.
requirements:
  v: Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.detail.subDetail.noteNumber
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: positiveInt
    l: positiveInt
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.detail.subDetail.reviewOutcome
path:
  v: ClaimResponse.addItem.detail.subDetail.reviewOutcome
short:
  v: Added items subdetail level adjudication results
definition:
  v: The high-level results of the adjudication if adjudication has been performed.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.addItem.detail.subDetail.reviewOutcome
  min:
    v: 0
  max:
    v: 1
content reference:
  v: http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.reviewOutcome
  l: ClaimResponse.item.reviewOutcome
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.addItem.detail.subDetail.adjudication
path:
  v: ClaimResponse.addItem.detail.subDetail.adjudication
short:
  v: Added items subdetail adjudication
definition:
  v: The adjudication results.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.addItem.detail.subDetail.adjudication
  min:
    v: 0
  max:
    v: *
content reference:
  v: http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.adjudication
  l: ClaimResponse.item.adjudication
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.adjudication
path:
  v: ClaimResponse.adjudication
short:
  v: Header-level adjudication
definition:
  v: The adjudication results which are presented at the header level rather than at the line-item or add-item levels.
requirements:
  v: Some insurers will receive line-items but provide the adjudication only at a summary or header-level.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.adjudication
  min:
    v: 0
  max:
    v: *
content reference:
  v: http://hl7.org/fhir/StructureDefinition/ClaimResponse#ClaimResponse.item.adjudication
  l: ClaimResponse.item.adjudication
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.total
path:
  v: ClaimResponse.total
short:
  v: Adjudication totals
definition:
  v: Categorized monetary totals for the adjudication.
comment:
  v: Totals for amounts submitted, co-pays, benefits payable etc.
requirements:
  v: To provide the requestor with financial totals by category for the adjudication.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.total
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
    l: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: true

id:
  v: ClaimResponse.total.id
path:
  v: ClaimResponse.total.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
condition:
  v: ele-1
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.total.extension
path:
  v: ClaimResponse.total.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.total.modifierExtension
path:
  v: ClaimResponse.total.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R5/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: ClaimResponse.total.category
path:
  v: ClaimResponse.total.category
short:
  v: Type of adjudication information
definition:
  v: A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item.
comment:
  v: For example codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.
requirements:
  v: Needed to convey the type of total provided.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.total.category
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: Adjudication
  strength:
    v: example
  description:
    v: The adjudication codes.
  value set:
    v: http://hl7.org/fhir/ValueSet/adjudication|5.0.0
    l: http://hl7.org/fhir/ValueSet/adjudication

id:
  v: ClaimResponse.total.amount
path:
  v: ClaimResponse.total.amount
short:
  v: Financial total for the category
definition:
  v: Monetary total amount associated with the category.
requirements:
  v: Needed to convey the total monetary amount.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.total.amount
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: Money
    l: Money
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: true

id:
  v: ClaimResponse.payment
path:
  v: ClaimResponse.payment
short:
  v: Payment Details
definition:
  v: Payment details for the adjudication of the claim.
requirements:
  v: Needed to convey references to the financial instrument that has been used if payment has been made.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.payment
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: BackboneElement
    l: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.payment.id
path:
  v: ClaimResponse.payment.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
condition:
  v: ele-1
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.payment.extension
path:
  v: ClaimResponse.payment.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.payment.modifierExtension
path:
  v: ClaimResponse.payment.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R5/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: ClaimResponse.payment.type
path:
  v: ClaimResponse.payment.type
short:
  v: Partial or complete payment
definition:
  v: Whether this represents partial or complete payment of the benefits payable.
requirements:
  v: To advise the requestor when the insurer believes all payments to have been completed.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.payment.type
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: PaymentType
  strength:
    v: example
  description:
    v: The type (partial, complete) of the payment.
  value set:
    v: http://hl7.org/fhir/ValueSet/ex-paymenttype|5.0.0
    l: http://hl7.org/fhir/ValueSet/ex-paymenttype

id:
  v: ClaimResponse.payment.adjustment
path:
  v: ClaimResponse.payment.adjustment
short:
  v: Payment adjustment for non-claim issues
definition:
  v: Total amount of all adjustments to this payment included in this transaction which are not related to this claim's adjudication.
comment:
  v: Insurers will deduct amounts owing from the provider (adjustment), such as a prior overpayment, from the amount owing to the provider (benefits payable) when payment is made to the provider.
requirements:
  v: To advise the requestor of adjustments applied to the payment.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.payment.adjustment
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Money
    l: Money
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.payment.adjustmentReason
path:
  v: ClaimResponse.payment.adjustmentReason
short:
  v: Explanation for the adjustment
definition:
  v: Reason for the payment adjustment.
requirements:
  v: Needed to clarify the monetary adjustment.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.payment.adjustmentReason
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: PaymentAdjustmentReason
  strength:
    v: example
  description:
    v: Payment Adjustment reason codes.
  value set:
    v: http://hl7.org/fhir/ValueSet/payment-adjustment-reason|5.0.0
    l: http://hl7.org/fhir/ValueSet/payment-adjustment-reason

id:
  v: ClaimResponse.payment.date
path:
  v: ClaimResponse.payment.date
short:
  v: Expected date of payment
definition:
  v: Estimated date the payment will be issued or the actual issue date of payment.
requirements:
  v: To advise the payee when payment can be expected.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.payment.date
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: date
    l: date
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.payment.amount
path:
  v: ClaimResponse.payment.amount
short:
  v: Payable amount after adjustment
definition:
  v: Benefits payable less any payment adjustment.
requirements:
  v: Needed to provide the actual payment amount.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.payment.amount
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: Money
    l: Money
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.payment.identifier
path:
  v: ClaimResponse.payment.identifier
short:
  v: Business identifier for the payment
definition:
  v: Issuer's unique identifier for the payment instrument.
comment:
  v: For example: EFT number or check number.
requirements:
  v: Enable the receiver to reconcile when payment received.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.payment.identifier
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Identifier
    l: Identifier
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.fundsReserve
path:
  v: ClaimResponse.fundsReserve
short:
  v: Funds reserved status
definition:
  v: A code, used only on a response to a preauthorization, to indicate whether the benefits payable have been reserved and for whom.
comment:
  v: Fund would be release by a future claim quoting the preAuthRef of this response. Examples of values include: provider, patient, none.
requirements:
  v: Needed to advise the submitting provider on whether the rquest for reservation of funds has been honored.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.fundsReserve
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: FundsReserve
  strength:
    v: example
  description:
    v: For whom funds are to be reserved: (Patient, Provider, None).
  value set:
    v: http://hl7.org/fhir/ValueSet/fundsreserve|5.0.0
    l: http://hl7.org/fhir/ValueSet/fundsreserve

id:
  v: ClaimResponse.formCode
path:
  v: ClaimResponse.formCode
short:
  v: Printed form identifier
definition:
  v: A code for the form to be used for printing the content.
comment:
  v: May be needed to identify specific jurisdictional forms.
requirements:
  v: Needed to specify the specific form used for producing output for this response.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.formCode
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: Forms
  strength:
    v: example
  description:
    v: The forms codes.
  value set:
    v: http://hl7.org/fhir/ValueSet/forms|5.0.0
    l: http://hl7.org/fhir/ValueSet/forms

id:
  v: ClaimResponse.form
path:
  v: ClaimResponse.form
short:
  v: Printed reference or actual form
definition:
  v: The actual form, by reference or inclusion, for printing the content or an EOB.
comment:
  v: Needed to permit insurers to include the actual form.
requirements:
  v: Needed to include the specific form used for producing output for this response.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.form
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Attachment
    l: Attachment
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.processNote
path:
  v: ClaimResponse.processNote
short:
  v: Note concerning adjudication
definition:
  v: A note that describes or explains adjudication results in a human readable form.
requirements:
  v: Provides the insurer specific textual explanations associated with the processing.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.processNote
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
    l: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.processNote.id
path:
  v: ClaimResponse.processNote.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
condition:
  v: ele-1
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.processNote.extension
path:
  v: ClaimResponse.processNote.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.processNote.modifierExtension
path:
  v: ClaimResponse.processNote.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R5/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: ClaimResponse.processNote.number
path:
  v: ClaimResponse.processNote.number
short:
  v: Note instance identifier
definition:
  v: A number to uniquely identify a note entry.
requirements:
  v: Necessary to provide a mechanism to link from adjudications.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.processNote.number
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: positiveInt
    l: positiveInt
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.processNote.type
path:
  v: ClaimResponse.processNote.type
short:
  v: Note purpose
definition:
  v: The business purpose of the note text.
requirements:
  v: To convey the expectation for when the text is used.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.processNote.type
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: NoteType
  strength:
    v: extensible
  description:
    v: The presentation types of notes.
  value set:
    v: http://hl7.org/fhir/ValueSet/note-type|5.0.0
    l: http://hl7.org/fhir/ValueSet/note-type

id:
  v: ClaimResponse.processNote.text
path:
  v: ClaimResponse.processNote.text
short:
  v: Note explanatory text
definition:
  v: The explanation or description associated with the processing.
requirements:
  v: Required to provide human readable explanation.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: ClaimResponse.processNote.text
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: string
    l: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.processNote.language
path:
  v: ClaimResponse.processNote.language
short:
  v: Language of the text
definition:
  v: A code to define the language used in the text of the note.
comment:
  v: Only required if the language is different from the resource language.
requirements:
  v: Note text may vary from the resource defined language.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: ClaimResponse.processNote.language
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: Language
  strength:
    v: required
  description:
    v: IETF language tag for a human language
  value set:
    v: http://hl7.org/fhir/ValueSet/all-languages|5.0.0
    l: http://hl7.org/fhir/ValueSet/all-languages
  additional:
    purpose:
      v: starter
    value set:
      v: http://hl7.org/fhir/ValueSet/languages|5.0.0
      l: http://hl7.org/fhir/ValueSet/languages

id:
  v: ClaimResponse.communicationRequest
path:
  v: ClaimResponse.communicationRequest
short:
  v: Request for additional information
definition:
  v: Request for additional supporting or authorizing information.
comment:
  v: For example: professional reports, documents, images, clinical resources, or accident reports.
requirements:
  v: Need to communicate insurer request for additional information required to support the adjudication.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.communicationRequest
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/CommunicationRequest|5.0.0
    l: http://hl7.org/fhir/StructureDefinition/CommunicationRequest
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false

id:
  v: ClaimResponse.insurance
path:
  v: ClaimResponse.insurance
short:
  v: Patient insurance information
definition:
  v: Financial instruments for reimbursement for the health care products and services specified on the claim.
comment:
  v: All insurance coverages for the patient which may be applicable for reimbursement, of the products and services listed in the claim, are typically provided in the claim to allow insurers to confirm the ordering of the insurance coverages relative to local 'coordination of benefit' rules. One coverage (and only one) with 'focal=true' is to be used in the adjudication of this claim. Coverages appearing before the focal Coverage in the list, and where 'subrogation=false', should provide a reference to the ClaimResponse containing the adjudication results of the prior claim.
requirements:
  v: At least one insurer is required for a claim to be a claim.
min:
  v: 0
max:
  v: *
base:
  path:
    v: ClaimResponse.insurance
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
    l: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: false
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: Coverage

id:
  v: ClaimResponse.insurance.id
path:
  v: ClaimResponse.insurance.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
condition:
  v: ele-1
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: ClaimResponse.insurance.extension
path:
  v: ClaimResponse.insurance.extension