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TX: CodeSystem adjudication

Properties

Profile http://hl7.org/fhir/StructureDefinition/shareablecodesystem
Defining URL http://terminology.hl7.org/CodeSystem/adjudication
Version 4.0.1
Name AdjudicationValueCodes
Title Adjudication Value Codes
Status draft
Definition

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.
Publisher FHIR Project team
Committee fm
Copyright This is an example set.
EXT_FMM_LEVEL 1
Value Set Adjudication Value Codes

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