<status value="active"/> <experimental value="false"/> <date value="2025-04-30T21:25:30-06:00"/> <publisher value="Health Level Seven International"/> <contact> <telecom> <system value="url"/> <value value="http://hl7.org"/> </telecom> <telecom> <system value="email"/> <value value="hq@HL7.org"/> </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 material derives from the HL7 Terminology (THO). THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license"/> <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>

Generated Narrative: CodeSystem adjudication

Last updated: 2024-04-24 00:00:00+0000

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

Code	Display	Definition
submitted	Submitted Amount	The total submitted amount for the claim or group or line item.
copay	CoPay	Patient Co-Payment
eligible	Eligible Amount	Amount of the change which is considered for adjudication.
deductible	Deductible	Amount deducted from the eligible amount prior to adjudication.
unallocdeduct	Unallocated Deductible	The amount of deductible which could not allocated to other line items.
eligpercent	Eligible %	Eligible Percentage.
tax	Tax	The amount of tax.
benefit	Benefit Amount	Amount payable under the coverage