HL7 Terminology (THO)
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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

: Benefit Type Codes - JSON Representation

Draft as of 2023-02-25 Maturity Level: 1

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{
  "resourceType" : "CodeSystem",
  "id" : "benefit-type",
  "meta" : {
    "lastUpdated" : "2020-04-09T21:10:28.568+00:00",
    "profile" : [
      "http://hl7.org/fhir/StructureDefinition/shareablecodesystem"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>This code system <code>http://terminology.hl7.org/CodeSystem/benefit-type</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\">benefit<a name=\"benefit-type-benefit\"> </a></td><td>Benefit</td><td>Maximum benefit allowable.</td></tr><tr><td style=\"white-space:nowrap\">deductible<a name=\"benefit-type-deductible\"> </a></td><td>Deductible</td><td>Cost to be incurred before benefits are applied</td></tr><tr><td style=\"white-space:nowrap\">visit<a name=\"benefit-type-visit\"> </a></td><td>Visit</td><td>Service visit</td></tr><tr><td style=\"white-space:nowrap\">room<a name=\"benefit-type-room\"> </a></td><td>Room</td><td>Type of room</td></tr><tr><td style=\"white-space:nowrap\">copay<a name=\"benefit-type-copay\"> </a></td><td>Copayment per service</td><td>Copayment per service</td></tr><tr><td style=\"white-space:nowrap\">copay-percent<a name=\"benefit-type-copay-percent\"> </a></td><td>Copayment Percent per service</td><td>Copayment percentage per service</td></tr><tr><td style=\"white-space:nowrap\">copay-maximum<a name=\"benefit-type-copay-maximum\"> </a></td><td>Copayment maximum per service</td><td>Copayment maximum per service</td></tr><tr><td style=\"white-space:nowrap\">vision-exam<a name=\"benefit-type-vision-exam\"> </a></td><td>Vision Exam</td><td>Vision Exam</td></tr><tr><td style=\"white-space:nowrap\">vision-glasses<a name=\"benefit-type-vision-glasses\"> </a></td><td>Vision Glasses</td><td>Frames and lenses</td></tr><tr><td style=\"white-space:nowrap\">vision-contacts<a name=\"benefit-type-vision-contacts\"> </a></td><td>Vision Contacts Coverage</td><td>Contact Lenses</td></tr><tr><td style=\"white-space:nowrap\">medical-primarycare<a name=\"benefit-type-medical-primarycare\"> </a></td><td>Medical Primary Health Coverage</td><td>Medical Primary Health Coverage</td></tr><tr><td style=\"white-space:nowrap\">pharmacy-dispense<a name=\"benefit-type-pharmacy-dispense\"> </a></td><td>Pharmacy Dispense Coverage</td><td>Pharmacy Dispense Coverage</td></tr></table></div>"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode" : "fm"
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger" : 1
    }
  ],
  "url" : "http://terminology.hl7.org/CodeSystem/benefit-type",
  "identifier" : [
    {
      "system" : "urn:ietf:rfc:3986",
      "value" : "urn:oid:2.16.840.1.113883.4.642.1.1176"
    }
  ],
  "version" : "0.1.0",
  "name" : "BenefitTypeCodes",
  "title" : "Benefit Type Codes",
  "status" : "draft",
  "experimental" : false,
  "date" : "2023-02-25T11:07:30-07:00",
  "publisher" : "Financial Management",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://hl7.org/fhir"
        }
      ]
    }
  ],
  "description" : "This value set includes a smattering of Benefit type codes.",
  "copyright" : "This is an example set.",
  "caseSensitive" : true,
  "valueSet" : "http://terminology.hl7.org/ValueSet/benefit-type",
  "content" : "complete",
  "concept" : [
    {
      "code" : "benefit",
      "display" : "Benefit",
      "definition" : "Maximum benefit allowable."
    },
    {
      "code" : "deductible",
      "display" : "Deductible",
      "definition" : "Cost to be incurred before benefits are applied"
    },
    {
      "code" : "visit",
      "display" : "Visit",
      "definition" : "Service visit"
    },
    {
      "code" : "room",
      "display" : "Room",
      "definition" : "Type of room"
    },
    {
      "code" : "copay",
      "display" : "Copayment per service",
      "definition" : "Copayment per service"
    },
    {
      "code" : "copay-percent",
      "display" : "Copayment Percent per service",
      "definition" : "Copayment percentage per service"
    },
    {
      "code" : "copay-maximum",
      "display" : "Copayment maximum per service",
      "definition" : "Copayment maximum per service"
    },
    {
      "code" : "vision-exam",
      "display" : "Vision Exam",
      "definition" : "Vision Exam"
    },
    {
      "code" : "vision-glasses",
      "display" : "Vision Glasses",
      "definition" : "Frames and lenses"
    },
    {
      "code" : "vision-contacts",
      "display" : "Vision Contacts Coverage",
      "definition" : "Contact Lenses"
    },
    {
      "code" : "medical-primarycare",
      "display" : "Medical Primary Health Coverage",
      "definition" : "Medical Primary Health Coverage"
    },
    {
      "code" : "pharmacy-dispense",
      "display" : "Pharmacy Dispense Coverage",
      "definition" : "Pharmacy Dispense Coverage"
    }
  ]
}