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: Adjudication Value Codes - XML Representation
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<CodeSystem xmlns="http://hl7.org/fhir">
<id value="adjudication"/>
<meta>
<lastUpdated value="2020-04-09T21:10:28.568+00:00"/>
<profile
value="http://hl7.org/fhir/StructureDefinition/shareablecodesystem"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
<valueCode value="fm"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
<valueInteger value="1"/>
</extension>
<url value="http://terminology.hl7.org/CodeSystem/adjudication"/>
<identifier>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:oid:2.16.840.1.113883.4.642.1.1171"/>
</identifier>
<version value="0.1.0"/>
<name value="AdjudicationValueCodes"/>
<title value="Adjudication Value Codes"/>
<status value="draft"/>
<experimental value="false"/>
<date value="2023-07-17T22:16:15-06:00"/>
<publisher value="FHIR Project team"/>
<contact>
<telecom>
<system value="url"/>
<value value="http://hl7.org/fhir"/>
</telecom>
</contact>
<description
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."/>
<copyright value="This is an example set."/>
<caseSensitive value="true"/>
<valueSet value="http://terminology.hl7.org/ValueSet/adjudication"/>
<content value="complete"/>
<concept>
<code value="submitted"/>
<display value="Submitted Amount"/>
<definition
value="The total submitted amount for the claim or group or line item."/>
</concept>
<concept>
<code value="copay"/>
<display value="CoPay"/>
<definition value="Patient Co-Payment"/>
</concept>
<concept>
<code value="eligible"/>
<display value="Eligible Amount"/>
<definition
value="Amount of the change which is considered for adjudication."/>
</concept>
<concept>
<code value="deductible"/>
<display value="Deductible"/>
<definition
value="Amount deducted from the eligible amount prior to adjudication."/>
</concept>
<concept>
<code value="unallocdeduct"/>
<display value="Unallocated Deductible"/>
<definition
value="The amount of deductible which could not allocated to other line items."/>
</concept>
<concept>
<code value="eligpercent"/>
<display value="Eligible %"/>
<definition value="Eligible Percentage."/>
</concept>
<concept>
<code value="tax"/>
<display value="Tax"/>
<definition value="The amount of tax."/>
</concept>
<concept>
<code value="benefit"/>
<display value="Benefit Amount"/>
<definition value="Amount payable under the coverage"/>
</concept>
</CodeSystem>