This is the Continuous Integration Build of FHIR (will be incorrect/inconsistent at times).
See the Directory of published versions icon ValueSet http://hl7.org/fhir/ValueSet/adjudication

Financial Management icon Work Group Maturity Level: 0Informative Use Context: Country: World
Official URL: http://hl7.org/fhir/ValueSet/adjudication Version: 6.0.0-cibuild
draft as of 2024-06-17 Computable Name: AdjudicationValueCodes
Flags: OID: 2.16.840.1.113883.4.642.3.596

This value set is used in the following places:

This value set includes a smattering of Adjudication Value codes which includes codes to indicate the amounts eligible under the plan, the amount of benefit, copays etc.


This expansion generated 17 Jun 2024

Expansion based on codesystem Adjudication Value Codes v1.0.0 (CodeSystem) icon

This value set contains 8 concepts.

  submitted iconhttp://terminology.hl7.org/CodeSystem/adjudicationSubmitted Amount

The total submitted amount for the claim or group or line item.

  copay iconhttp://terminology.hl7.org/CodeSystem/adjudicationCoPay

Patient Co-Payment

  eligible iconhttp://terminology.hl7.org/CodeSystem/adjudicationEligible Amount

Amount of the change which is considered for adjudication.

  deductible iconhttp://terminology.hl7.org/CodeSystem/adjudicationDeductible

Amount deducted from the eligible amount prior to adjudication.

  unallocdeduct iconhttp://terminology.hl7.org/CodeSystem/adjudicationUnallocated Deductible

The amount of deductible which could not allocated to other line items.

  eligpercent iconhttp://terminology.hl7.org/CodeSystem/adjudicationEligible %

Eligible Percentage.

  tax iconhttp://terminology.hl7.org/CodeSystem/adjudicationTax

The amount of tax.

  benefit iconhttp://terminology.hl7.org/CodeSystem/adjudicationBenefit Amount

Amount payable under the coverage


See the full registry of value sets defined as part of FHIR.

Explanation of the columns that may appear on this page:

LvlA few code lists that FHIR defines are hierarchical - each code is assigned a level. For value sets, levels are mostly used to organize codes for user convenience, but may follow code system hierarchy - see Code System for further information
SourceThe source of the definition of the code (when the value set draws in codes defined elsewhere)
CodeThe code (used as the code in the resource instance). If the code is in italics, this indicates that the code is not selectable ('Abstract')
DisplayThe display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application
DefinitionAn explanation of the meaning of the concept
CommentsAdditional notes about how to use the code