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 2026-09-03

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:reviewResult
                .... 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:approvedAmount
                                                                                  ...... id
                                                                                    ...... extension
                                                                                      ...... modifierExtension
                                                                                        ...... category
                                                                                          ....... id
                                                                                            ....... extension
                                                                                              ....... coding
                                                                                                ........ id
                                                                                                  ........ extension
                                                                                                    ........ system
                                                                                                      ........ version
                                                                                                        ........ code
                                                                                                          ........ display
                                                                                                            ........ userSelected
                                                                                                              ....... text
                                                                                                                ...... reason
                                                                                                                  ...... amount
                                                                                                                  ...... value
                                                                                                                    ..... adjudication:eligibilityDenial
                                                                                                                      ...... id
                                                                                                                        ...... extension
                                                                                                                          ...... modifierExtension
                                                                                                                            ...... category
                                                                                                                              ....... id
                                                                                                                                ....... extension
                                                                                                                                  ....... coding
                                                                                                                                    ........ id
                                                                                                                                      ........ extension
                                                                                                                                        ........ system
                                                                                                                                          ........ version
                                                                                                                                            ........ code
                                                                                                                                              ........ display
                                                                                                                                                ........ userSelected
                                                                                                                                                  ....... text
                                                                                                                                                    ...... reason
                                                                                                                                                      ....... id
                                                                                                                                                        ....... extension
                                                                                                                                                          ....... coding
                                                                                                                                                            ....... text
                                                                                                                                                            ...... amount
                                                                                                                                                            ...... value
                                                                                                                                                              ..... adjudication:benefitTermination
                                                                                                                                                                ...... id
                                                                                                                                                                  ...... extension
                                                                                                                                                                    ...... modifierExtension
                                                                                                                                                                      ...... category
                                                                                                                                                                        ....... id
                                                                                                                                                                          ....... extension
                                                                                                                                                                            ....... coding
                                                                                                                                                                              ........ id
                                                                                                                                                                                ........ extension
                                                                                                                                                                                  ........ system
                                                                                                                                                                                    ........ version
                                                                                                                                                                                      ........ code
                                                                                                                                                                                        ........ display
                                                                                                                                                                                          ........ userSelected
                                                                                                                                                                                            ....... text
                                                                                                                                                                                              ...... reason
                                                                                                                                                                                                ....... id
                                                                                                                                                                                                  ....... extension
                                                                                                                                                                                                    ....... coding
                                                                                                                                                                                                      ....... text
                                                                                                                                                                                                      ...... amount
                                                                                                                                                                                                      ...... value
                                                                                                                                                                                                        ..... adjudication:benefitSuspension
                                                                                                                                                                                                          ...... id
                                                                                                                                                                                                            ...... extension
                                                                                                                                                                                                              ...... modifierExtension
                                                                                                                                                                                                                ...... category
                                                                                                                                                                                                                  ....... id
                                                                                                                                                                                                                    ....... extension
                                                                                                                                                                                                                      ....... coding
                                                                                                                                                                                                                        ........ id
                                                                                                                                                                                                                          ........ extension
                                                                                                                                                                                                                            ........ system
                                                                                                                                                                                                                              ........ version
                                                                                                                                                                                                                                ........ code
                                                                                                                                                                                                                                  ........ display
                                                                                                                                                                                                                                    ........ userSelected
                                                                                                                                                                                                                                      ....... text
                                                                                                                                                                                                                                        ...... reason
                                                                                                                                                                                                                                          ....... id
                                                                                                                                                                                                                                            ....... extension
                                                                                                                                                                                                                                              ....... coding
                                                                                                                                                                                                                                                ....... text
                                                                                                                                                                                                                                                ...... amount
                                                                                                                                                                                                                                                ...... value
                                                                                                                                                                                                                                                  .... detail
                                                                                                                                                                                                                                                    ..... id
                                                                                                                                                                                                                                                      ..... extension
                                                                                                                                                                                                                                                        ..... modifierExtension
                                                                                                                                                                                                                                                          ..... detailSequence
                                                                                                                                                                                                                                                            ..... noteNumber
                                                                                                                                                                                                                                                              ..... adjudication
                                                                                                                                                                                                                                                                ..... subDetail
                                                                                                                                                                                                                                                                  ...... id
                                                                                                                                                                                                                                                                    ...... extension
                                                                                                                                                                                                                                                                      ...... modifierExtension
                                                                                                                                                                                                                                                                        ...... subDetailSequence
                                                                                                                                                                                                                                                                          ...... noteNumber
                                                                                                                                                                                                                                                                            ...... adjudication
                                                                                                                                                                                                                                                                              ... addItem
                                                                                                                                                                                                                                                                                .... id
                                                                                                                                                                                                                                                                                  .... extension
                                                                                                                                                                                                                                                                                    .... modifierExtension
                                                                                                                                                                                                                                                                                      .... itemSequence
                                                                                                                                                                                                                                                                                        .... detailSequence
                                                                                                                                                                                                                                                                                          .... subdetailSequence
                                                                                                                                                                                                                                                                                            .... provider
                                                                                                                                                                                                                                                                                              .... productOrService
                                                                                                                                                                                                                                                                                                .... modifier
                                                                                                                                                                                                                                                                                                  .... programCode
                                                                                                                                                                                                                                                                                                    .... serviced[x]
                                                                                                                                                                                                                                                                                                      .... location[x]
                                                                                                                                                                                                                                                                                                        .... quantity
                                                                                                                                                                                                                                                                                                          .... unitPrice
                                                                                                                                                                                                                                                                                                            .... factor
                                                                                                                                                                                                                                                                                                              .... net
                                                                                                                                                                                                                                                                                                                .... bodySite
                                                                                                                                                                                                                                                                                                                  .... subSite
                                                                                                                                                                                                                                                                                                                    .... noteNumber
                                                                                                                                                                                                                                                                                                                      .... adjudication
                                                                                                                                                                                                                                                                                                                        .... detail
                                                                                                                                                                                                                                                                                                                          ..... id
                                                                                                                                                                                                                                                                                                                            ..... extension
                                                                                                                                                                                                                                                                                                                              ..... modifierExtension
                                                                                                                                                                                                                                                                                                                                ..... productOrService
                                                                                                                                                                                                                                                                                                                                  ..... modifier
                                                                                                                                                                                                                                                                                                                                    ..... quantity
                                                                                                                                                                                                                                                                                                                                      ..... unitPrice
                                                                                                                                                                                                                                                                                                                                        ..... factor
                                                                                                                                                                                                                                                                                                                                          ..... net
                                                                                                                                                                                                                                                                                                                                            ..... noteNumber
                                                                                                                                                                                                                                                                                                                                              ..... adjudication
                                                                                                                                                                                                                                                                                                                                                ..... subDetail
                                                                                                                                                                                                                                                                                                                                                  ...... id
                                                                                                                                                                                                                                                                                                                                                    ...... extension
                                                                                                                                                                                                                                                                                                                                                      ...... modifierExtension
                                                                                                                                                                                                                                                                                                                                                        ...... productOrService
                                                                                                                                                                                                                                                                                                                                                          ...... modifier
                                                                                                                                                                                                                                                                                                                                                            ...... quantity
                                                                                                                                                                                                                                                                                                                                                              ...... unitPrice
                                                                                                                                                                                                                                                                                                                                                                ...... factor
                                                                                                                                                                                                                                                                                                                                                                  ...... net
                                                                                                                                                                                                                                                                                                                                                                    ...... noteNumber
                                                                                                                                                                                                                                                                                                                                                                      ...... adjudication
                                                                                                                                                                                                                                                                                                                                                                        ... adjudication
                                                                                                                                                                                                                                                                                                                                                                          ... total
                                                                                                                                                                                                                                                                                                                                                                            .... id
                                                                                                                                                                                                                                                                                                                                                                              .... extension
                                                                                                                                                                                                                                                                                                                                                                                .... modifierExtension
                                                                                                                                                                                                                                                                                                                                                                                  .... category
                                                                                                                                                                                                                                                                                                                                                                                    .... amount
                                                                                                                                                                                                                                                                                                                                                                                      ... payment
                                                                                                                                                                                                                                                                                                                                                                                        .... id
                                                                                                                                                                                                                                                                                                                                                                                          .... extension
                                                                                                                                                                                                                                                                                                                                                                                            .... modifierExtension
                                                                                                                                                                                                                                                                                                                                                                                              .... type
                                                                                                                                                                                                                                                                                                                                                                                                .... adjustment
                                                                                                                                                                                                                                                                                                                                                                                                  .... adjustmentReason
                                                                                                                                                                                                                                                                                                                                                                                                    .... date
                                                                                                                                                                                                                                                                                                                                                                                                      .... amount
                                                                                                                                                                                                                                                                                                                                                                                                        .... identifier
                                                                                                                                                                                                                                                                                                                                                                                                          ... fundsReserve
                                                                                                                                                                                                                                                                                                                                                                                                            ... formCode
                                                                                                                                                                                                                                                                                                                                                                                                              ... form
                                                                                                                                                                                                                                                                                                                                                                                                                ... processNote
                                                                                                                                                                                                                                                                                                                                                                                                                  .... id
                                                                                                                                                                                                                                                                                                                                                                                                                    .... extension
                                                                                                                                                                                                                                                                                                                                                                                                                      .... modifierExtension
                                                                                                                                                                                                                                                                                                                                                                                                                        .... number
                                                                                                                                                                                                                                                                                                                                                                                                                          .... type
                                                                                                                                                                                                                                                                                                                                                                                                                            .... text
                                                                                                                                                                                                                                                                                                                                                                                                                            .... language
                                                                                                                                                                                                                                                                                                                                                                                                                              ... communicationRequest
                                                                                                                                                                                                                                                                                                                                                                                                                                ... insurance
                                                                                                                                                                                                                                                                                                                                                                                                                                  .... id
                                                                                                                                                                                                                                                                                                                                                                                                                                    .... extension
                                                                                                                                                                                                                                                                                                                                                                                                                                      .... modifierExtension
                                                                                                                                                                                                                                                                                                                                                                                                                                        .... sequence
                                                                                                                                                                                                                                                                                                                                                                                                                                          .... focal
                                                                                                                                                                                                                                                                                                                                                                                                                                            .... coverage
                                                                                                                                                                                                                                                                                                                                                                                                                                              .... businessArrangement
                                                                                                                                                                                                                                                                                                                                                                                                                                                .... claimResponse
                                                                                                                                                                                                                                                                                                                                                                                                                                                  ... error
                                                                                                                                                                                                                                                                                                                                                                                                                                                    .... id
                                                                                                                                                                                                                                                                                                                                                                                                                                                      .... extension
                                                                                                                                                                                                                                                                                                                                                                                                                                                        .... modifierExtension
                                                                                                                                                                                                                                                                                                                                                                                                                                                          .... itemSequence
                                                                                                                                                                                                                                                                                                                                                                                                                                                            .... detailSequence
                                                                                                                                                                                                                                                                                                                                                                                                                                                              .... subDetailSequence
                                                                                                                                                                                                                                                                                                                                                                                                                                                                .... code

                                                                                                                                                                                                                                                                                                                                                                                                                                                                  doco Documentation for this format

                                                                                                                                                                                                                                                                                                                                                                                                                                                                  Mappings to other Structures

                                                                                                                                                                                                                                                                                                                                                                                                                                                                  No Mappings Found

                                                                                                                                                                                                                                                                                                                                                                                                                                                                  Other Mappings

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

                                                                                                                                                                                                                                                                                                                                                                                                                                                                  doco Documentation for this format