HL7 Terminology
2.0.0 - Publication

This page is part of the HL7 Terminology (v2.0.0: Release) based on FHIR R4. The current version which supercedes this version is 5.2.0. For a full list of available versions, see the Directory of published versions

CodeSystem: Adjudication Value Codes


Defining URL:http://terminology.hl7.org/CodeSystem/adjudication
Title:Adjudication Value Codes
Status:Draft as of 2020-11-07T09:27:49+11:00 (Standards Status: Draft)

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.

Publisher:FHIR Project team
Committee:Financial Management

This is an example set.

Content:Complete: All the concepts defined by the code system are included in the code system resource
OID:2.16.840.1.113883.4.642.1.1171 (for OID based terminology systems)
Value Set:http://terminology.hl7.org/ValueSet/adjudication ( is the value set for all codes in this code system)
Source Resource:XML / JSON / Turtle

This Code system is referenced in the content logical definition of the following value sets:

This code system http://terminology.hl7.org/CodeSystem/adjudication defines the following codes:

submitted Submitted AmountThe total submitted amount for the claim or group or line item.
copay CoPayPatient Co-Payment
eligible Eligible AmountAmount of the change which is considered for adjudication.
deductible DeductibleAmount deducted from the eligible amount prior to adjudication.
unallocdeduct Unallocated DeductibleThe amount of deductible which could not allocated to other line items.
eligpercent Eligible %Eligible Percentage.
tax TaxThe amount of tax.
benefit Benefit AmountAmount payable under the coverage


2020-10-14reviseVocabulary WGGrahame GrieveReset Version after migration to UTG
2020-05-06reviseVocabulary WGTed KleinMigrated to the UTG maintenance environment and publishing tooling.