HL7 Terminology
1.0.0 - Publication

This page is part of the HL7 Terminology (v1.0.0: Release) based on FHIR R4. This is the current published version. 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 "2020-04-09T17:10:28.568-04:00"^^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\">\n            \n      <h2>Adjudication Value Codes</h2>\n            \n      <div>\n              \n        <p>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.</p>\n\n            \n      </div>\n            \n      <p>\n              \n        <b>Copyright Statement:</b> This is an example set.\n            \n      </p>\n            \n      <p>This code system http://terminology.hl7.org/CodeSystem/adjudication defines the following codes:</p>\n            \n      <table class=\"codes\">\n              \n        <tr>\n                \n          <td style=\"white-space:nowrap\">\n                  \n            <b>Code</b>\n                \n          </td>\n                \n          <td>\n                  \n            <b>Display</b>\n                \n          </td>\n                \n          <td>\n                  \n            <b>Definition</b>\n                \n          </td>\n              \n        </tr>\n              \n        <tr>\n                \n          <td style=\"white-space:nowrap\">submitted\n                  \n            <a name=\"adjudication-submitted\"> </a>\n                \n          </td>\n                \n          <td>Submitted Amount</td>\n                \n          <td>The total submitted amount for the claim or group or line item.</td>\n              \n        </tr>\n              \n        <tr>\n                \n          <td style=\"white-space:nowrap\">copay\n                  \n            <a name=\"adjudication-copay\"> </a>\n                \n          </td>\n                \n          <td>CoPay</td>\n                \n          <td>Patient Co-Payment</td>\n              \n        </tr>\n              \n        <tr>\n                \n          <td style=\"white-space:nowrap\">eligible\n                  \n            <a name=\"adjudication-eligible\"> </a>\n                \n          </td>\n                \n          <td>Eligible Amount</td>\n                \n          <td>Amount of the change which is considered for adjudication.</td>\n              \n        </tr>\n              \n        <tr>\n                \n          <td style=\"white-space:nowrap\">deductible\n                  \n            <a name=\"adjudication-deductible\"> </a>\n                \n          </td>\n                \n          <td>Deductible</td>\n                \n          <td>Amount deducted from the eligible amount prior to adjudication.</td>\n              \n        </tr>\n              \n        <tr>\n                \n          <td style=\"white-space:nowrap\">unallocdeduct\n                  \n            <a name=\"adjudication-unallocdeduct\"> </a>\n                \n          </td>\n                \n          <td>Unallocated Deductible</td>\n                \n          <td>The amount of deductible which could not allocated to other line items.</td>\n              \n        </tr>\n              \n        <tr>\n                \n          <td style=\"white-space:nowrap\">eligpercent\n                  \n            <a name=\"adjudication-eligpercent\"> </a>\n                \n          </td>\n                \n          <td>Eligible %</td>\n                \n          <td>Eligible Percentage.</td>\n              \n        </tr>\n              \n        <tr>\n                \n          <td style=\"white-space:nowrap\">tax\n                  \n            <a name=\"adjudication-tax\"> </a>\n                \n          </td>\n                \n          <td>Tax</td>\n                \n          <td>The amount of tax.</td>\n              \n        </tr>\n              \n        <tr>\n                \n          <td style=\"white-space:nowrap\">benefit\n                  \n            <a name=\"adjudication-benefit\"> </a>\n                \n          </td>\n                \n          <td>Benefit Amount</td>\n                \n          <td>Amount payable under the coverage</td>\n              \n        </tr>\n            \n      </table>\n          \n    </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-standards-status" ];
     fhir:Extension.valueCode [ fhir:value "draft" ]
  ], [
     fhir:index 2;
     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 "4.2.0"];
  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 "2020-05-09T12:49:00-04:00"^^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.