This page is part of the HL7 Terminology (v5.1.0: 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 
: Adjudication Value Codes - TTL Representation
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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .
# - resource -------------------------------------------------------------------
a fhir:CodeSystem;
fhir:nodeRole fhir:treeRoot;
fhir:Resource.id [ fhir:value "adjudication"]; #
fhir:Resource.meta [
fhir:Meta.lastUpdated [ fhir:value "2020-04-09T21:10:28.568+00:00"^^xsd:dateTime ];
fhir:Meta.profile [
fhir:value "http://hl7.org/fhir/StructureDefinition/shareablecodesystem";
fhir:index 0;
fhir:link <http://hl7.org/fhir/StructureDefinition/shareablecodesystem> ]
]; #
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "generated" ];
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>This code system <code>http://terminology.hl7.org/CodeSystem/adjudication</code> defines the following codes:</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style=\"white-space:nowrap\">submitted<a name=\"adjudication-submitted\"> </a></td><td>Submitted Amount</td><td>The total submitted amount for the claim or group or line item.</td></tr><tr><td style=\"white-space:nowrap\">copay<a name=\"adjudication-copay\"> </a></td><td>CoPay</td><td>Patient Co-Payment</td></tr><tr><td style=\"white-space:nowrap\">eligible<a name=\"adjudication-eligible\"> </a></td><td>Eligible Amount</td><td>Amount of the change which is considered for adjudication.</td></tr><tr><td style=\"white-space:nowrap\">deductible<a name=\"adjudication-deductible\"> </a></td><td>Deductible</td><td>Amount deducted from the eligible amount prior to adjudication.</td></tr><tr><td style=\"white-space:nowrap\">unallocdeduct<a name=\"adjudication-unallocdeduct\"> </a></td><td>Unallocated Deductible</td><td>The amount of deductible which could not allocated to other line items.</td></tr><tr><td style=\"white-space:nowrap\">eligpercent<a name=\"adjudication-eligpercent\"> </a></td><td>Eligible %</td><td>Eligible Percentage.</td></tr><tr><td style=\"white-space:nowrap\">tax<a name=\"adjudication-tax\"> </a></td><td>Tax</td><td>The amount of tax.</td></tr><tr><td style=\"white-space:nowrap\">benefit<a name=\"adjudication-benefit\"> </a></td><td>Benefit Amount</td><td>Amount payable under the coverage</td></tr></table></div>"
]; #
fhir:DomainResource.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg" ];
fhir:Extension.valueCode [ fhir:value "fm" ]
], [
fhir:index 1;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm" ];
fhir:Extension.valueInteger [ fhir:value "1"^^xsd:integer ]
]; #
fhir:CodeSystem.url [ fhir:value "http://terminology.hl7.org/CodeSystem/adjudication"]; #
fhir:CodeSystem.identifier [
fhir:index 0;
fhir:Identifier.system [ fhir:value "urn:ietf:rfc:3986" ];
fhir:Identifier.value [ fhir:value "urn:oid:2.16.840.1.113883.4.642.1.1171" ]
]; #
fhir:CodeSystem.version [ fhir:value "0.1.0"]; #
fhir:CodeSystem.name [ fhir:value "AdjudicationValueCodes"]; #
fhir:CodeSystem.title [ fhir:value "Adjudication Value Codes"]; #
fhir:CodeSystem.status [ fhir:value "draft"]; #
fhir:CodeSystem.experimental [ fhir:value "false"^^xsd:boolean]; #
fhir:CodeSystem.date [ fhir:value "2023-02-25T11:07:30-07:00"^^xsd:dateTime]; #
fhir:CodeSystem.publisher [ fhir:value "FHIR Project team"]; #
fhir:CodeSystem.contact [
fhir:index 0;
fhir:ContactDetail.telecom [
fhir:index 0;
fhir:ContactPoint.system [ fhir:value "url" ];
fhir:ContactPoint.value [ fhir:value "http://hl7.org/fhir" ] ]
]; #
fhir:CodeSystem.description [ fhir:value "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."]; #
fhir:CodeSystem.copyright [ fhir:value "This is an example set."]; #
fhir:CodeSystem.caseSensitive [ fhir:value "true"^^xsd:boolean]; #
fhir:CodeSystem.valueSet [
fhir:value "http://terminology.hl7.org/ValueSet/adjudication";
fhir:link <http://terminology.hl7.org/ValueSet/adjudication>
]; #
fhir:CodeSystem.content [ fhir:value "complete"]; #
fhir:CodeSystem.concept [
fhir:index 0;
fhir:CodeSystem.concept.code [ fhir:value "submitted" ];
fhir:CodeSystem.concept.display [ fhir:value "Submitted Amount" ];
fhir:CodeSystem.concept.definition [ fhir:value "The total submitted amount for the claim or group or line item." ]
], [
fhir:index 1;
fhir:CodeSystem.concept.code [ fhir:value "copay" ];
fhir:CodeSystem.concept.display [ fhir:value "CoPay" ];
fhir:CodeSystem.concept.definition [ fhir:value "Patient Co-Payment" ]
], [
fhir:index 2;
fhir:CodeSystem.concept.code [ fhir:value "eligible" ];
fhir:CodeSystem.concept.display [ fhir:value "Eligible Amount" ];
fhir:CodeSystem.concept.definition [ fhir:value "Amount of the change which is considered for adjudication." ]
], [
fhir:index 3;
fhir:CodeSystem.concept.code [ fhir:value "deductible" ];
fhir:CodeSystem.concept.display [ fhir:value "Deductible" ];
fhir:CodeSystem.concept.definition [ fhir:value "Amount deducted from the eligible amount prior to adjudication." ]
], [
fhir:index 4;
fhir:CodeSystem.concept.code [ fhir:value "unallocdeduct" ];
fhir:CodeSystem.concept.display [ fhir:value "Unallocated Deductible" ];
fhir:CodeSystem.concept.definition [ fhir:value "The amount of deductible which could not allocated to other line items." ]
], [
fhir:index 5;
fhir:CodeSystem.concept.code [ fhir:value "eligpercent" ];
fhir:CodeSystem.concept.display [ fhir:value "Eligible %" ];
fhir:CodeSystem.concept.definition [ fhir:value "Eligible Percentage." ]
], [
fhir:index 6;
fhir:CodeSystem.concept.code [ fhir:value "tax" ];
fhir:CodeSystem.concept.display [ fhir:value "Tax" ];
fhir:CodeSystem.concept.definition [ fhir:value "The amount of tax." ]
], [
fhir:index 7;
fhir:CodeSystem.concept.code [ fhir:value "benefit" ];
fhir:CodeSystem.concept.display [ fhir:value "Benefit Amount" ];
fhir:CodeSystem.concept.definition [ fhir:value "Amount payable under the coverage" ]
]. #
# - ontology header ------------------------------------------------------------
a owl:Ontology;
owl:imports fhir:fhir.ttl.
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