臺灣社政領域基礎實作指引
0.0.1 - ci-build

臺灣社政領域基礎實作指引, published by 衛生福利部社會及家庭署. This guide is not an authorized publication; it is the continuous build for version 0.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/sfaassn2025-source/base/ and changes regularly. See the Directory of published versions

Resource Profile: ClaimResponseTWSSBase - Mappings

Draft as of 2026-08-10

Mappings for the ClaimResponse-twss-base resource profile.

Mappings to Structures in this Implementation Guide

NameMapping to TWSSBase ClaimResponsedoco
.. ClaimResponse
    ... id
      ... meta
        ... implicitRules
          ... language
            ... text
              ... contained
                ... Slices for extension
                .... extension:reviewStatus
                .... extension:paymentStatus
                .... extension:subsidyMonth
                ... modifierExtension
                  ... identifier
                    ... status
                      ... type
                        ... subType
                          ... use
                            ... patient
                              ... created
                              ... insurer
                                ... requestor
                                  ... request
                                  ... outcome
                                    ... disposition
                                      ... preAuthRef
                                        ... preAuthPeriod
                                          ... payeeType
                                            ... item
                                              .... id
                                                .... extension
                                                  .... modifierExtension
                                                    .... itemSequence
                                                      .... noteNumber
                                                        .... Slices for adjudication
                                                          ..... adjudication:All Slices
                                                          ...... id
                                                            ...... extension
                                                              ...... modifierExtension
                                                                ...... category
                                                                  ...... reason
                                                                    ...... amount
                                                                    ...... value
                                                                      ..... adjudication:approvedAmount
                                                                        ...... id
                                                                          ...... extension
                                                                            ...... modifierExtension
                                                                              ...... category
                                                                                ....... id
                                                                                  ....... extension
                                                                                    ....... coding
                                                                                      ........ id
                                                                                        ........ extension
                                                                                          ........ system
                                                                                            ........ version
                                                                                              ........ code
                                                                                                ........ display
                                                                                                  ........ userSelected
                                                                                                    ....... text
                                                                                                      ...... reason
                                                                                                        ...... amount
                                                                                                        ...... value
                                                                                                          ..... adjudication:eligibilityDenial
                                                                                                            ...... id
                                                                                                              ...... extension
                                                                                                                ...... modifierExtension
                                                                                                                  ...... category
                                                                                                                    ....... id
                                                                                                                      ....... extension
                                                                                                                        ....... coding
                                                                                                                          ........ id
                                                                                                                            ........ extension
                                                                                                                              ........ system
                                                                                                                                ........ version
                                                                                                                                  ........ code
                                                                                                                                    ........ display
                                                                                                                                      ........ userSelected
                                                                                                                                        ....... text
                                                                                                                                          ...... reason
                                                                                                                                            ....... id
                                                                                                                                              ....... extension
                                                                                                                                                ....... coding
                                                                                                                                                  ....... text
                                                                                                                                                  ...... amount
                                                                                                                                                  ...... value
                                                                                                                                                    ..... adjudication:benefitTermination
                                                                                                                                                      ...... id
                                                                                                                                                        ...... extension
                                                                                                                                                          ...... modifierExtension
                                                                                                                                                            ...... category
                                                                                                                                                              ....... id
                                                                                                                                                                ....... extension
                                                                                                                                                                  ....... coding
                                                                                                                                                                    ........ id
                                                                                                                                                                      ........ extension
                                                                                                                                                                        ........ system
                                                                                                                                                                          ........ version
                                                                                                                                                                            ........ code
                                                                                                                                                                              ........ display
                                                                                                                                                                                ........ userSelected
                                                                                                                                                                                  ....... text
                                                                                                                                                                                    ...... reason
                                                                                                                                                                                      ....... id
                                                                                                                                                                                        ....... extension
                                                                                                                                                                                          ....... coding
                                                                                                                                                                                            ....... text
                                                                                                                                                                                            ...... amount
                                                                                                                                                                                            ...... value
                                                                                                                                                                                              ..... adjudication:benefitSuspension
                                                                                                                                                                                                ...... id
                                                                                                                                                                                                  ...... extension
                                                                                                                                                                                                    ...... modifierExtension
                                                                                                                                                                                                      ...... category
                                                                                                                                                                                                        ....... id
                                                                                                                                                                                                          ....... extension
                                                                                                                                                                                                            ....... coding
                                                                                                                                                                                                              ........ id
                                                                                                                                                                                                                ........ extension
                                                                                                                                                                                                                  ........ system
                                                                                                                                                                                                                    ........ version
                                                                                                                                                                                                                      ........ code
                                                                                                                                                                                                                        ........ display
                                                                                                                                                                                                                          ........ userSelected
                                                                                                                                                                                                                            ....... text
                                                                                                                                                                                                                              ...... reason
                                                                                                                                                                                                                                ....... id
                                                                                                                                                                                                                                  ....... extension
                                                                                                                                                                                                                                    ....... coding
                                                                                                                                                                                                                                      ....... text
                                                                                                                                                                                                                                      ...... amount
                                                                                                                                                                                                                                      ...... value
                                                                                                                                                                                                                                        .... detail
                                                                                                                                                                                                                                          ..... id
                                                                                                                                                                                                                                            ..... extension
                                                                                                                                                                                                                                              ..... modifierExtension
                                                                                                                                                                                                                                                ..... detailSequence
                                                                                                                                                                                                                                                  ..... noteNumber
                                                                                                                                                                                                                                                    ..... adjudication
                                                                                                                                                                                                                                                      ..... subDetail
                                                                                                                                                                                                                                                        ...... id
                                                                                                                                                                                                                                                          ...... extension
                                                                                                                                                                                                                                                            ...... modifierExtension
                                                                                                                                                                                                                                                              ...... subDetailSequence
                                                                                                                                                                                                                                                                ...... noteNumber
                                                                                                                                                                                                                                                                  ...... adjudication
                                                                                                                                                                                                                                                                    ... addItem
                                                                                                                                                                                                                                                                      .... id
                                                                                                                                                                                                                                                                        .... extension
                                                                                                                                                                                                                                                                          .... modifierExtension
                                                                                                                                                                                                                                                                            .... itemSequence
                                                                                                                                                                                                                                                                              .... detailSequence
                                                                                                                                                                                                                                                                                .... subdetailSequence
                                                                                                                                                                                                                                                                                  .... provider
                                                                                                                                                                                                                                                                                    .... productOrService
                                                                                                                                                                                                                                                                                      .... modifier
                                                                                                                                                                                                                                                                                        .... programCode
                                                                                                                                                                                                                                                                                          .... serviced[x]
                                                                                                                                                                                                                                                                                            .... location[x]
                                                                                                                                                                                                                                                                                              .... quantity
                                                                                                                                                                                                                                                                                                .... unitPrice
                                                                                                                                                                                                                                                                                                  .... factor
                                                                                                                                                                                                                                                                                                    .... net
                                                                                                                                                                                                                                                                                                      .... bodySite
                                                                                                                                                                                                                                                                                                        .... subSite
                                                                                                                                                                                                                                                                                                          .... noteNumber
                                                                                                                                                                                                                                                                                                            .... adjudication
                                                                                                                                                                                                                                                                                                              .... detail
                                                                                                                                                                                                                                                                                                                ..... id
                                                                                                                                                                                                                                                                                                                  ..... extension
                                                                                                                                                                                                                                                                                                                    ..... modifierExtension
                                                                                                                                                                                                                                                                                                                      ..... productOrService
                                                                                                                                                                                                                                                                                                                        ..... modifier
                                                                                                                                                                                                                                                                                                                          ..... quantity
                                                                                                                                                                                                                                                                                                                            ..... unitPrice
                                                                                                                                                                                                                                                                                                                              ..... factor
                                                                                                                                                                                                                                                                                                                                ..... net
                                                                                                                                                                                                                                                                                                                                  ..... noteNumber
                                                                                                                                                                                                                                                                                                                                    ..... adjudication
                                                                                                                                                                                                                                                                                                                                      ..... subDetail
                                                                                                                                                                                                                                                                                                                                        ...... id
                                                                                                                                                                                                                                                                                                                                          ...... extension
                                                                                                                                                                                                                                                                                                                                            ...... modifierExtension
                                                                                                                                                                                                                                                                                                                                              ...... productOrService
                                                                                                                                                                                                                                                                                                                                                ...... modifier
                                                                                                                                                                                                                                                                                                                                                  ...... quantity
                                                                                                                                                                                                                                                                                                                                                    ...... unitPrice
                                                                                                                                                                                                                                                                                                                                                      ...... factor
                                                                                                                                                                                                                                                                                                                                                        ...... net
                                                                                                                                                                                                                                                                                                                                                          ...... noteNumber
                                                                                                                                                                                                                                                                                                                                                            ...... adjudication
                                                                                                                                                                                                                                                                                                                                                              ... adjudication
                                                                                                                                                                                                                                                                                                                                                                ... total
                                                                                                                                                                                                                                                                                                                                                                  .... id
                                                                                                                                                                                                                                                                                                                                                                    .... extension
                                                                                                                                                                                                                                                                                                                                                                      .... modifierExtension
                                                                                                                                                                                                                                                                                                                                                                        .... category
                                                                                                                                                                                                                                                                                                                                                                          .... amount
                                                                                                                                                                                                                                                                                                                                                                            ... payment
                                                                                                                                                                                                                                                                                                                                                                              .... id
                                                                                                                                                                                                                                                                                                                                                                                .... extension
                                                                                                                                                                                                                                                                                                                                                                                  .... modifierExtension
                                                                                                                                                                                                                                                                                                                                                                                    .... type
                                                                                                                                                                                                                                                                                                                                                                                      .... adjustment
                                                                                                                                                                                                                                                                                                                                                                                        .... adjustmentReason
                                                                                                                                                                                                                                                                                                                                                                                          .... date
                                                                                                                                                                                                                                                                                                                                                                                            .... amount
                                                                                                                                                                                                                                                                                                                                                                                              .... identifier
                                                                                                                                                                                                                                                                                                                                                                                                ... fundsReserve
                                                                                                                                                                                                                                                                                                                                                                                                  ... formCode
                                                                                                                                                                                                                                                                                                                                                                                                    ... form
                                                                                                                                                                                                                                                                                                                                                                                                      ... processNote
                                                                                                                                                                                                                                                                                                                                                                                                        .... id
                                                                                                                                                                                                                                                                                                                                                                                                          .... extension
                                                                                                                                                                                                                                                                                                                                                                                                            .... modifierExtension
                                                                                                                                                                                                                                                                                                                                                                                                              .... number
                                                                                                                                                                                                                                                                                                                                                                                                                .... type
                                                                                                                                                                                                                                                                                                                                                                                                                  .... text
                                                                                                                                                                                                                                                                                                                                                                                                                  .... language
                                                                                                                                                                                                                                                                                                                                                                                                                    ... communicationRequest
                                                                                                                                                                                                                                                                                                                                                                                                                      ... insurance
                                                                                                                                                                                                                                                                                                                                                                                                                        .... id
                                                                                                                                                                                                                                                                                                                                                                                                                          .... extension
                                                                                                                                                                                                                                                                                                                                                                                                                            .... modifierExtension
                                                                                                                                                                                                                                                                                                                                                                                                                              .... sequence
                                                                                                                                                                                                                                                                                                                                                                                                                                .... focal
                                                                                                                                                                                                                                                                                                                                                                                                                                  .... coverage
                                                                                                                                                                                                                                                                                                                                                                                                                                    .... businessArrangement
                                                                                                                                                                                                                                                                                                                                                                                                                                      .... claimResponse
                                                                                                                                                                                                                                                                                                                                                                                                                                        ... error
                                                                                                                                                                                                                                                                                                                                                                                                                                          .... id
                                                                                                                                                                                                                                                                                                                                                                                                                                            .... extension
                                                                                                                                                                                                                                                                                                                                                                                                                                              .... modifierExtension
                                                                                                                                                                                                                                                                                                                                                                                                                                                .... itemSequence
                                                                                                                                                                                                                                                                                                                                                                                                                                                  .... detailSequence
                                                                                                                                                                                                                                                                                                                                                                                                                                                    .... subDetailSequence
                                                                                                                                                                                                                                                                                                                                                                                                                                                      .... code

                                                                                                                                                                                                                                                                                                                                                                                                                                                        doco Documentation for this format

                                                                                                                                                                                                                                                                                                                                                                                                                                                        Mappings to other Structures

                                                                                                                                                                                                                                                                                                                                                                                                                                                        No Mappings Found

                                                                                                                                                                                                                                                                                                                                                                                                                                                        Other Mappings

                                                                                                                                                                                                                                                                                                                                                                                                                                                        NameWorkflow PatternFiveWs Pattern MappingRIM Mappingdoco
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .. ClaimResponse
                                                                                                                                                                                                                                                                                                                                                                                                                                                        Event
                                                                                                                                                                                                                                                                                                                                                                                                                                                        • Entity. Role
                                                                                                                                                                                                                                                                                                                                                                                                                                                        • or Act
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... id
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... meta
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... implicitRules
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... language
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... text
                                                                                                                                                                                                                                                                                                                                                                                                                                                        Act.text?
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... contained
                                                                                                                                                                                                                                                                                                                                                                                                                                                        N/A
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... Slices for extension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... extension:reviewStatus
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... extension:paymentStatus
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... extension:subsidyMonth
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... modifierExtension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        N/A
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... identifier
                                                                                                                                                                                                                                                                                                                                                                                                                                                        Event.identifier
                                                                                                                                                                                                                                                                                                                                                                                                                                                        FiveWs.identifier
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... status
                                                                                                                                                                                                                                                                                                                                                                                                                                                        Event.status
                                                                                                                                                                                                                                                                                                                                                                                                                                                        FiveWs.status
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... type
                                                                                                                                                                                                                                                                                                                                                                                                                                                        FiveWs.class
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... subType
                                                                                                                                                                                                                                                                                                                                                                                                                                                        FiveWs.class
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... use
                                                                                                                                                                                                                                                                                                                                                                                                                                                        FiveWs.class
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... patient
                                                                                                                                                                                                                                                                                                                                                                                                                                                        FiveWs.subject
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... created
                                                                                                                                                                                                                                                                                                                                                                                                                                                        Event.occurrence[x]
                                                                                                                                                                                                                                                                                                                                                                                                                                                        FiveWs.recorded
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... insurer
                                                                                                                                                                                                                                                                                                                                                                                                                                                        Event.performer
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... requestor
                                                                                                                                                                                                                                                                                                                                                                                                                                                        FiveWs.source
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... request
                                                                                                                                                                                                                                                                                                                                                                                                                                                        Event.basedOn
                                                                                                                                                                                                                                                                                                                                                                                                                                                        FiveWs.why[x]
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... outcome
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... disposition
                                                                                                                                                                                                                                                                                                                                                                                                                                                        Event.note
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... preAuthRef
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... preAuthPeriod
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... payeeType
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... item
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... id
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... extension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... modifierExtension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        N/A
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... itemSequence
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... noteNumber
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... Slices for adjudication
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ..... adjudication:All Slices
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... id
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... extension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... modifierExtension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        N/A
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... category
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... reason
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... amount
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... value
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ..... adjudication:approvedAmount
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... id
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... extension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... modifierExtension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        N/A
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... category
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ....... id
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ....... extension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ....... coding
                                                                                                                                                                                                                                                                                                                                                                                                                                                        • union(.
                                                                                                                                                                                                                                                                                                                                                                                                                                                        • ./translation)
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ........ id
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ........ extension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ........ system
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ./codeSystem
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ........ version
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ./codeSystemVersion
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ........ code
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ./code
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ........ display
                                                                                                                                                                                                                                                                                                                                                                                                                                                        CV.displayName
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ........ userSelected
                                                                                                                                                                                                                                                                                                                                                                                                                                                        CD.codingRationale
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ....... text
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ./originalText[mediaType/code="text/plain"]/data
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... reason
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... amount
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... value
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ..... adjudication:eligibilityDenial
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... id
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... extension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... modifierExtension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        N/A
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... category
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ....... id
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ....... extension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ....... coding
                                                                                                                                                                                                                                                                                                                                                                                                                                                        • union(.
                                                                                                                                                                                                                                                                                                                                                                                                                                                        • ./translation)
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ........ id
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ........ extension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ........ system
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ./codeSystem
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ........ version
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ./codeSystemVersion
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ........ code
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ./code
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ........ display
                                                                                                                                                                                                                                                                                                                                                                                                                                                        CV.displayName
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ........ userSelected
                                                                                                                                                                                                                                                                                                                                                                                                                                                        CD.codingRationale
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ....... text
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ./originalText[mediaType/code="text/plain"]/data
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... reason
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ....... id
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ....... extension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ....... coding
                                                                                                                                                                                                                                                                                                                                                                                                                                                        • union(.
                                                                                                                                                                                                                                                                                                                                                                                                                                                        • ./translation)
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ....... text
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ./originalText[mediaType/code="text/plain"]/data
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... amount
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... value
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ..... adjudication:benefitTermination
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... id
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... extension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... modifierExtension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        N/A
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... category
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ....... id
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ....... extension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ....... coding
                                                                                                                                                                                                                                                                                                                                                                                                                                                        • union(.
                                                                                                                                                                                                                                                                                                                                                                                                                                                        • ./translation)
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ........ id
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ........ extension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ........ system
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ./codeSystem
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ........ version
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ./codeSystemVersion
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ........ code
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ./code
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ........ display
                                                                                                                                                                                                                                                                                                                                                                                                                                                        CV.displayName
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ........ userSelected
                                                                                                                                                                                                                                                                                                                                                                                                                                                        CD.codingRationale
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ....... text
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ./originalText[mediaType/code="text/plain"]/data
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... reason
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ....... id
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ....... extension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ....... coding
                                                                                                                                                                                                                                                                                                                                                                                                                                                        • union(.
                                                                                                                                                                                                                                                                                                                                                                                                                                                        • ./translation)
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ....... text
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ./originalText[mediaType/code="text/plain"]/data
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... amount
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... value
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ..... adjudication:benefitSuspension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... id
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... extension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... modifierExtension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        N/A
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... category
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ....... id
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ....... extension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ....... coding
                                                                                                                                                                                                                                                                                                                                                                                                                                                        • union(.
                                                                                                                                                                                                                                                                                                                                                                                                                                                        • ./translation)
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ........ id
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ........ extension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ........ system
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ./codeSystem
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ........ version
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ./codeSystemVersion
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ........ code
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ./code
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ........ display
                                                                                                                                                                                                                                                                                                                                                                                                                                                        CV.displayName
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ........ userSelected
                                                                                                                                                                                                                                                                                                                                                                                                                                                        CD.codingRationale
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ....... text
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ./originalText[mediaType/code="text/plain"]/data
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... reason
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ....... id
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ....... extension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ....... coding
                                                                                                                                                                                                                                                                                                                                                                                                                                                        • union(.
                                                                                                                                                                                                                                                                                                                                                                                                                                                        • ./translation)
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ....... text
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ./originalText[mediaType/code="text/plain"]/data
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... amount
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... value
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... detail
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ..... id
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ..... extension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ..... modifierExtension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        N/A
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ..... detailSequence
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ..... noteNumber
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ..... adjudication
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ..... subDetail
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... id
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... extension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... modifierExtension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        N/A
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... subDetailSequence
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... noteNumber
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... adjudication
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... addItem
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... id
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... extension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... modifierExtension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        N/A
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... itemSequence
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... detailSequence
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... subdetailSequence
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... provider
                                                                                                                                                                                                                                                                                                                                                                                                                                                        FiveWs.source
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... productOrService
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... modifier
                                                                                                                                                                                                                                                                                                                                                                                                                                                        • 24.C
                                                                                                                                                                                                                                                                                                                                                                                                                                                        • 24.D mods
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... programCode
                                                                                                                                                                                                                                                                                                                                                                                                                                                        24.H
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... serviced[x]
                                                                                                                                                                                                                                                                                                                                                                                                                                                        FiveWs.done[x]
                                                                                                                                                                                                                                                                                                                                                                                                                                                        24.A
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... location[x]
                                                                                                                                                                                                                                                                                                                                                                                                                                                        FiveWs.where[x]
                                                                                                                                                                                                                                                                                                                                                                                                                                                        24.B
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... quantity
                                                                                                                                                                                                                                                                                                                                                                                                                                                        24.G
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... unitPrice
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... factor
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... net
                                                                                                                                                                                                                                                                                                                                                                                                                                                        24.F
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... bodySite
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... subSite
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... noteNumber
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... adjudication
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... detail
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ..... id
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ..... extension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ..... modifierExtension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        N/A
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ..... productOrService
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ..... modifier
                                                                                                                                                                                                                                                                                                                                                                                                                                                        • 24.C
                                                                                                                                                                                                                                                                                                                                                                                                                                                        • 24.D mods
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ..... quantity
                                                                                                                                                                                                                                                                                                                                                                                                                                                        24.G
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ..... unitPrice
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ..... factor
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ..... net
                                                                                                                                                                                                                                                                                                                                                                                                                                                        24.F
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ..... noteNumber
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ..... adjudication
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ..... subDetail
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... id
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... extension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... modifierExtension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        N/A
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... productOrService
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... modifier
                                                                                                                                                                                                                                                                                                                                                                                                                                                        • 24.C
                                                                                                                                                                                                                                                                                                                                                                                                                                                        • 24.D mods
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... quantity
                                                                                                                                                                                                                                                                                                                                                                                                                                                        24.G
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... unitPrice
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... factor
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... net
                                                                                                                                                                                                                                                                                                                                                                                                                                                        24.F
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... noteNumber
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ...... adjudication
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... adjudication
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... total
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... id
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... extension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... modifierExtension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        N/A
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... category
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... amount
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... payment
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... id
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... extension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... modifierExtension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        N/A
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... type
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... adjustment
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... adjustmentReason
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... date
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... amount
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... identifier
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... fundsReserve
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... formCode
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... form
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... processNote
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... id
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... extension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... modifierExtension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        N/A
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... number
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... type
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... text
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... language
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... communicationRequest
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... insurance
                                                                                                                                                                                                                                                                                                                                                                                                                                                        Coverage
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... id
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... extension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... modifierExtension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        N/A
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... sequence
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... focal
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... coverage
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... businessArrangement
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... claimResponse
                                                                                                                                                                                                                                                                                                                                                                                                                                                        ... error
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... id
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... extension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... modifierExtension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        N/A
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... itemSequence
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... detailSequence
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... subDetailSequence
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... code

                                                                                                                                                                                                                                                                                                                                                                                                                                                        doco Documentation for this format