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 2026-09-23

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:paymentStatus
                .... extension:subsidyMonth
                .... extension:subsidyPeriod
                ... modifierExtension
                  ... identifier
                    ... status
                      ... type
                        ... subType
                          ... use
                            ... patient
                              ... created
                              ... insurer
                                ... requestor
                                  ... request
                                    ... outcome
                                      ... disposition
                                        ... preAuthRef
                                          ... preAuthPeriod
                                            .... id
                                              .... extension
                                                .... start
                                                  .... end
                                                    ... payeeType
                                                      ... item
                                                        .... id
                                                          .... extension
                                                            .... modifierExtension
                                                              .... itemSequence
                                                                .... noteNumber
                                                                  .... Slices for adjudication
                                                                    ..... adjudication:All Slices
                                                                    ...... id
                                                                      ...... extension
                                                                        ...... modifierExtension
                                                                          ...... category
                                                                          ...... reason
                                                                          ...... amount
                                                                          ...... value
                                                                            ..... adjudication:approvedBenefit
                                                                              ...... id
                                                                                ...... extension
                                                                                  ...... modifierExtension
                                                                                    ...... category
                                                                                    ....... id
                                                                                      ....... extension
                                                                                        ....... coding
                                                                                          ........ id
                                                                                            ........ extension
                                                                                              ........ system
                                                                                                ........ version
                                                                                                  ........ code
                                                                                                    ........ display
                                                                                                      ........ userSelected
                                                                                                        ....... text
                                                                                                          ...... reason
                                                                                                          ....... id
                                                                                                            ....... extension
                                                                                                              ....... coding
                                                                                                                ....... text
                                                                                                                ...... 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:paymentStatus
                                                                                                                                                                                                                                                                                                                                                                                                                                                    .... extension:subsidyMonth
                                                                                                                                                                                                                                                                                                                                                                                                                                                    .... extension:subsidyPeriod
                                                                                                                                                                                                                                                                                                                                                                                                                                                    ... 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
                                                                                                                                                                                                                                                                                                                                                                                                                                                    .... id
                                                                                                                                                                                                                                                                                                                                                                                                                                                    n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                    .... extension
                                                                                                                                                                                                                                                                                                                                                                                                                                                    n/a
                                                                                                                                                                                                                                                                                                                                                                                                                                                    .... start
                                                                                                                                                                                                                                                                                                                                                                                                                                                    ./low
                                                                                                                                                                                                                                                                                                                                                                                                                                                    .... end
                                                                                                                                                                                                                                                                                                                                                                                                                                                    ./high
                                                                                                                                                                                                                                                                                                                                                                                                                                                    ... 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:approvedBenefit
                                                                                                                                                                                                                                                                                                                                                                                                                                                    ...... 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: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