Connectathon 11 Snapshot
This page is part of the FHIR Specification (v1.2.0: STU 3 Draft). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions 
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StructureDefinition for explanationofbenefit
<StructureDefinition xmlns="http://hl7.org/fhir"> <id value="ExplanationOfBenefit"/> <meta> <lastUpdated value="2015-12-11T17:38:40.294+11:00"/> </meta> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"> <table border="0" cellpadding="0" cellspacing="0" style="border: 0px; font-size: 11px; font-family: verdana; vertical-align: top;"> <tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"> <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="formats.html#table" title="The logical name of the element">Name</a> </th> <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="formats.html#table" title="Information about the use of the element">Flags</a> </th> <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="formats.html#table" title="Minimum and Maximum # of times the the element can appear in the instance">Card.</a> </th> <th class="hierarchy" style="width: 100px"> <a href="formats.html#table" title="Reference to the type of the element">Type</a> </th> <th class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="formats.html#table" title="Additional information about the element">Description & Constraints</a> <span style="float: right"> <a href="formats.html#table" title="Legend for this format"> <img alt="doco" src="help16.png" style="background-color: inherit"/> </a> </span> </th> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABGdBTUEAAK/INwWK6QAAABl0RVh0U 29mdHdhcmUAQWRvYmUgSW1hZ2VSZWFkeXHJZTwAAAJBSURBVDjLhdKxa5NBGMfx713yvkmbJnaoFiSF4mJTh06Kg4OgiyCCRXCof4 YIdXdxFhQVHPo3OFSoUx0FySQttaVKYq2NbdO8ed/L3fM4JG3tYPvAcfBw9+HHPWdUlf/V0tLSqKo+EpEHInJFRIohhDUR+RBCeDM 7O7ua55QSkRfVanVufHyckZERrLV0Op2Zra2tmXq9fg+YsmcAdyYnJykUCke9OI6ZmJgghHAZ4KwE3ntPs9mkVCohIjQaDWq1GiEE AM5KoHEcY62lVCrRarUoFotUKpUjIL/y/uqXYmV62ph/LSVrr30P4bEFcM4B0Ov1jk547/uAUTs1ceNdZIwB7V/GGHz6+9LXxY96e DiEgHMOY8xJAK8p4grZz5cElwNbwZgyxYu3EFM01lriOCZJEqIoIooiALIsGwA9Y1UcwcWoKNLdpLu9zvbnBWqNBhuvn5EDUmB0EH /1E2TZw5U+YLQovkun+Ytsaw1xCbnCOap334LC7s4Oe/ttvA+ICLmhMXRxDufczUECS37oAuevPwUEVFFp4/eXkXSdYc2IopSepnj tUh5/wg9gfn6+OQBUNaRIUkfDHhraSLoBKqikIF3yHJDLHaAkFOLciVHnyVAVj/S2Ub/XRyQD9aAZKgkaOohvo6ENgykcA07VEFDf Qv1uf4W9Y8y30bCPhg4qKZJtMnjTPqBO/vhkZ7h3EJeRslWNQMqgY2jIAIfa/m5sIKSpqpPsGEiz599e3b+GchtD+bSvjQJm2SG6c Nj6C+QmaxAek5tyAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Resource"/> <span title="ExplanationOfBenefit : This resource provides: the claim details; adjudication details from the processing of a Claim; and optionally account balance information, for informing the subscriber of the benefits provided.">ExplanationOfBenefit</span> <a name="ExplanationOfBenefit"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="domainresource.html">DomainResource</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Explanation of Benefit resource</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.identifier : The Response Business Identifier.">identifier</span> <a name="ExplanationOfBenefit.identifier"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..*</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Identifier">Identifier</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Business Identifier</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxj wv8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAAAadEVYdFNvZnR3YXJlAFBhaW50Lk5FVCB2My41LjEwMPRyoQAAAFxJREFUOE/NjE EOACEIA/0o/38GGw+agoXYeNnDJDCUDnd/gkoFKhWozJiZI3gLwY6rAgxhsPKTPUzycTl8lAryMyMsVQG6TFi6cHULyz8KOjC7OIQ KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/> <span title="ExplanationOfBenefit.claim : The business identifier for the instance: invoice number, claim number, pre-determination or pre-authorization number.">claim</span> <a name="ExplanationOfBenefit.claim"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="references.html">Reference</a>( <a href="claim.html">Claim</a>) </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Claim reference</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxj wv8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAAAadEVYdFNvZnR3YXJlAFBhaW50Lk5FVCB2My41LjEwMPRyoQAAAFxJREFUOE/NjE EOACEIA/0o/38GGw+agoXYeNnDJDCUDnd/gkoFKhWozJiZI3gLwY6rAgxhsPKTPUzycTl8lAryMyMsVQG6TFi6cHULyz8KOjC7OIQ KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/> <span title="ExplanationOfBenefit.claimResponse : The business identifier for the instance: invoice number, claim number, pre-determination or pre-authorization number.">claimResponse</span> <a name="ExplanationOfBenefit.claimResponse"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="references.html">Reference</a>( <a href="claimresponse.html">ClaimResponse</a>) </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Claim response reference</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.ruleset : The version of the specification on which this instance relies.">ruleset</span> <a name="ExplanationOfBenefit.ruleset"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Current specification followed <br/> <a href="valueset-ruleset.html" title="The static and dynamic model to which contents conform, which may be business version or standard/version.">Ruleset Codes</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set. The value set merely provides examples of the types of concepts intended to be included.">Example</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.originalRuleset : The version of the specification from which the original instance was created.">originalRuleset</span> <a name="ExplanationOfBenefit.originalRuleset"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Original specification followed <br/> <a href="valueset-ruleset.html" title="The static and dynamic model to which contents conform, which may be business version or standard/version.">Ruleset Codes</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set. 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background-color: inherit" title="Primitive Data Type"/> <span title="ExplanationOfBenefit.created : The date when the EOB was created.">created</span> <a name="ExplanationOfBenefit.created"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#dateTime">dateTime</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Creation date</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.billablePeriod : The billable period for which charges are being submitted.">billablePeriod</span> <a name="ExplanationOfBenefit.billablePeriod"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Period">Period</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Period for charge submission</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i 8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="ExplanationOfBenefit.disposition : A description of the status of the adjudication.">disposition</span> <a name="ExplanationOfBenefit.disposition"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#string">string</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Disposition Message</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxj wv8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAAAadEVYdFNvZnR3YXJlAFBhaW50Lk5FVCB2My41LjEwMPRyoQAAAFxJREFUOE/NjE EOACEIA/0o/38GGw+agoXYeNnDJDCUDnd/gkoFKhWozJiZI3gLwY6rAgxhsPKTPUzycTl8lAryMyMsVQG6TFi6cHULyz8KOjC7OIQ KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/> <span title="ExplanationOfBenefit.provider : The provider which is responsible for the claim.">provider</span> <a name="ExplanationOfBenefit.provider"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="references.html">Reference</a>( <a href="practitioner.html">Practitioner</a>) </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Responsible provider for the claim</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxj wv8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAAAadEVYdFNvZnR3YXJlAFBhaW50Lk5FVCB2My41LjEwMPRyoQAAAFxJREFUOE/NjE EOACEIA/0o/38GGw+agoXYeNnDJDCUDnd/gkoFKhWozJiZI3gLwY6rAgxhsPKTPUzycTl8lAryMyMsVQG6TFi6cHULyz8KOjC7OIQ KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/> <span title="ExplanationOfBenefit.organization : The provider which is responsible for the claim.">organization</span> <a name="ExplanationOfBenefit.organization"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="references.html">Reference</a>( <a href="organization.html">Organization</a>) </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Responsible organization for the claim</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxj wv8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAAAadEVYdFNvZnR3YXJlAFBhaW50Lk5FVCB2My41LjEwMPRyoQAAAFxJREFUOE/NjE EOACEIA/0o/38GGw+agoXYeNnDJDCUDnd/gkoFKhWozJiZI3gLwY6rAgxhsPKTPUzycTl8lAryMyMsVQG6TFi6cHULyz8KOjC7OIQ KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/> <span title="ExplanationOfBenefit.facility : Facility where the services were provided.">facility</span> <a name="ExplanationOfBenefit.facility"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="references.html">Reference</a>( <a href="location.html">Location</a>) </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Servicing Facility</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxj wv8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAAAadEVYdFNvZnR3YXJlAFBhaW50Lk5FVCB2My41LjEwMPRyoQAAAFxJREFUOE/NjE EOACEIA/0o/38GGw+agoXYeNnDJDCUDnd/gkoFKhWozJiZI3gLwY6rAgxhsPKTPUzycTl8lAryMyMsVQG6TFi6cHULyz8KOjC7OIQ KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/> <span title="ExplanationOfBenefit.relatedClaim : Other claims which are related to this claim such as prior claim versions or for related services.">relatedClaim</span> <a name="ExplanationOfBenefit.relatedClaim"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..*</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="references.html">Reference</a>( <a href="claim.html">Claim</a>) </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Related Claims</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxj wv8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAAAadEVYdFNvZnR3YXJlAFBhaW50Lk5FVCB2My41LjEwMPRyoQAAAFxJREFUOE/NjE EOACEIA/0o/38GGw+agoXYeNnDJDCUDnd/gkoFKhWozJiZI3gLwY6rAgxhsPKTPUzycTl8lAryMyMsVQG6TFi6cHULyz8KOjC7OIQ KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/> <span title="ExplanationOfBenefit.prescription : Prescription to support the dispensing of Pharmacy or Vision products.">prescription</span> <a name="ExplanationOfBenefit.prescription"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="references.html">Reference</a>( <a href="medicationorder.html">MedicationOrder</a> | <a href="visionprescription.html">VisionPrescription</a>) </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Prescription</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxj wv8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAAAadEVYdFNvZnR3YXJlAFBhaW50Lk5FVCB2My41LjEwMPRyoQAAAFxJREFUOE/NjE EOACEIA/0o/38GGw+agoXYeNnDJDCUDnd/gkoFKhWozJiZI3gLwY6rAgxhsPKTPUzycTl8lAryMyMsVQG6TFi6cHULyz8KOjC7OIQ KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/> <span title="ExplanationOfBenefit.originalPrescription : Original prescription which has been superceded by this prescription to support the dispensing of pharmacy services, medications or products.">originalPrescription</span> <a name="ExplanationOfBenefit.originalPrescription"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="references.html">Reference</a>( <a href="medicationorder.html">MedicationOrder</a>) </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Original Prescription</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAMQfAOvGUf7ztuvPMf/78/fkl/Pbg+u8Rvjqteu2Pf3zxPz36Pz0z+vTmPzurPvuw /npofbjquvNefHVduuyN+uuMu3Oafbgjfnqvf/3zv/3xevPi+vRjP/20/bmsP///////yH5BAEAAB8ALAAAAAAQABAAAAV24CeOZG mepqeqqOgxjBZFa+19r4ftWQUAgqDgltthMshMIJAZ4jYDHsBARSAmFOJvq+g6HIdEFgcYmBWNxoNAsDjGHgBnmV5bCoUDHLBIq9s FEhIdcAYJdYASFRUQhQkLCwkOFwcdEBAXhVabE52ecDahKy0oIQA7" style="background-color: white; background-color: inherit" title="Element"/> <span title="ExplanationOfBenefit.payee : The party to be reimbursed for the services.">payee</span> <a name="ExplanationOfBenefit.payee"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="backboneelement.html">BackboneElement</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Payee</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.payee.type : Party to be reimbursed: Subscriber, provider, other.">type</span> <a name="ExplanationOfBenefit.payee.type"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Party to be paid any benefits payable <br/> <a href="valueset-payeetype.html" title="A code for the party to be reimbursed.">Payee Type Codes</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set. The value set merely provides examples of the types of concepts intended to be included.">Example</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxj wv8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAAAadEVYdFNvZnR3YXJlAFBhaW50Lk5FVCB2My41LjEwMPRyoQAAAFxJREFUOE/NjE EOACEIA/0o/38GGw+agoXYeNnDJDCUDnd/gkoFKhWozJiZI3gLwY6rAgxhsPKTPUzycTl8lAryMyMsVQG6TFi6cHULyz8KOjC7OIQ KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/> <span title="ExplanationOfBenefit.payee.provider : The provider who is to be reimbursed for the claim (the party to whom any benefit is assigned).">provider</span> <a name="ExplanationOfBenefit.payee.provider"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="references.html">Reference</a>( <a href="practitioner.html">Practitioner</a>) </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Provider who is the payee</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxj wv8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAAAadEVYdFNvZnR3YXJlAFBhaW50Lk5FVCB2My41LjEwMPRyoQAAAFxJREFUOE/NjE EOACEIA/0o/38GGw+agoXYeNnDJDCUDnd/gkoFKhWozJiZI3gLwY6rAgxhsPKTPUzycTl8lAryMyMsVQG6TFi6cHULyz8KOjC7OIQ KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/> <span title="ExplanationOfBenefit.payee.organization : The organization who is to be reimbursed for the claim (the party to whom any benefit is assigned).">organization</span> <a name="ExplanationOfBenefit.payee.organization"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="references.html">Reference</a>( <a href="organization.html">Organization</a>) </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Organization who is the payee</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzME+lXFigAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+3OsRUAIAjEUO L+O8cJABttJM11/x1qZAGqRBEVcNIqdWj1efDqQbb3HwwwwEfABmQUHSPM9dtDAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxj wv8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAAAadEVYdFNvZnR3YXJlAFBhaW50Lk5FVCB2My41LjEwMPRyoQAAAFxJREFUOE/NjE EOACEIA/0o/38GGw+agoXYeNnDJDCUDnd/gkoFKhWozJiZI3gLwY6rAgxhsPKTPUzycTl8lAryMyMsVQG6TFi6cHULyz8KOjC7OIQ KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/> <span title="ExplanationOfBenefit.payee.person : The person other than the subscriber who is to be reimbursed for the claim (the party to whom any benefit is assigned).">person</span> <a name="ExplanationOfBenefit.payee.person"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="references.html">Reference</a>( <a href="patient.html">Patient</a>) </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Other person who is the payee</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxj wv8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAAAadEVYdFNvZnR3YXJlAFBhaW50Lk5FVCB2My41LjEwMPRyoQAAAFxJREFUOE/NjE EOACEIA/0o/38GGw+agoXYeNnDJDCUDnd/gkoFKhWozJiZI3gLwY6rAgxhsPKTPUzycTl8lAryMyMsVQG6TFi6cHULyz8KOjC7OIQ KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/> <span title="ExplanationOfBenefit.referral : The referral resource which lists the date, practitioner, reason and other supporting information.">referral</span> <a name="ExplanationOfBenefit.referral"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="references.html">Reference</a>( <a href="referralrequest.html">ReferralRequest</a>) </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Treatment Referral</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAMQfAOvGUf7ztuvPMf/78/fkl/Pbg+u8Rvjqteu2Pf3zxPz36Pz0z+vTmPzurPvuw /npofbjquvNefHVduuyN+uuMu3Oafbgjfnqvf/3zv/3xevPi+vRjP/20/bmsP///////yH5BAEAAB8ALAAAAAAQABAAAAV24CeOZG mepqeqqOgxjBZFa+19r4ftWQUAgqDgltthMshMIJAZ4jYDHsBARSAmFOJvq+g6HIdEFgcYmBWNxoNAsDjGHgBnmV5bCoUDHLBIq9s FEhIdcAYJdYASFRUQhQkLCwkOFwcdEBAXhVabE52ecDahKy0oIQA7" style="background-color: white; background-color: inherit" title="Element"/> <span title="ExplanationOfBenefit.diagnosis : Ordered list of patient diagnosis for which care is sought.">diagnosis</span> <a name="ExplanationOfBenefit.diagnosis"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..*</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="backboneelement.html">BackboneElement</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Diagnosis</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i 8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="ExplanationOfBenefit.diagnosis.sequence : Sequence of diagnosis which serves to order and provide a link.">sequence</span> <a name="ExplanationOfBenefit.diagnosis.sequence"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">1..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#positiveInt">positiveInt</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Sequence of diagnosis</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzME+lXFigAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+3OsRUAIAjEUO L+O8cJABttJM11/x1qZAGqRBEVcNIqdWj1efDqQbb3HwwwwEfABmQUHSPM9dtDAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.diagnosis.diagnosis : The diagnosis.">diagnosis</span> <a name="ExplanationOfBenefit.diagnosis.diagnosis"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">1..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Patient's list of diagnosis <br/> <a href="valueset-icd-10.html" title="ICD10 Diagnostic codes">ICD-10 Codes</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set. The value set merely provides examples of the types of concepts intended to be included.">Example</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.specialCondition : List of special conditions relating to the setting, treatment or patient for which care is sought which may influence the adjudication.">specialCondition</span> <a name="ExplanationOfBenefit.specialCondition"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..*</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">List of special Conditions <br/> <a href="valueset-fm-conditions.html" title="List of special conditions relating to the setting, treatment or patient for which care is sought which may influence the adjudication.">Conditions Codes</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set. The value set merely provides examples of the types of concepts intended to be included.">Example</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxj wv8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAAAadEVYdFNvZnR3YXJlAFBhaW50Lk5FVCB2My41LjEwMPRyoQAAAFxJREFUOE/NjE EOACEIA/0o/38GGw+agoXYeNnDJDCUDnd/gkoFKhWozJiZI3gLwY6rAgxhsPKTPUzycTl8lAryMyMsVQG6TFi6cHULyz8KOjC7OIQ KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/> <span title="ExplanationOfBenefit.patient : Patient Resource.">patient</span> <a name="ExplanationOfBenefit.patient"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">1..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="references.html">Reference</a>( <a href="patient.html">Patient</a>) </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">The subject of the Products and Services</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i 8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="ExplanationOfBenefit.precedence : Precedence (primary, secondary, etc.).">precedence</span> <a name="ExplanationOfBenefit.precedence"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#positiveInt">positiveInt</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Precedence (primary, secondary, etc.)</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAMQfAOvGUf7ztuvPMf/78/fkl/Pbg+u8Rvjqteu2Pf3zxPz36Pz0z+vTmPzurPvuw /npofbjquvNefHVduuyN+uuMu3Oafbgjfnqvf/3zv/3xevPi+vRjP/20/bmsP///////yH5BAEAAB8ALAAAAAAQABAAAAV24CeOZG mepqeqqOgxjBZFa+19r4ftWQUAgqDgltthMshMIJAZ4jYDHsBARSAmFOJvq+g6HIdEFgcYmBWNxoNAsDjGHgBnmV5bCoUDHLBIq9s FEhIdcAYJdYASFRUQhQkLCwkOFwcdEBAXhVabE52ecDahKy0oIQA7" style="background-color: white; background-color: inherit" title="Element"/> <span title="ExplanationOfBenefit.coverage : Financial instrument by which payment information for health care.">coverage</span> <a name="ExplanationOfBenefit.coverage"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">1..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="backboneelement.html">BackboneElement</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Insurance or medical plan</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxj wv8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAAAadEVYdFNvZnR3YXJlAFBhaW50Lk5FVCB2My41LjEwMPRyoQAAAFxJREFUOE/NjE EOACEIA/0o/38GGw+agoXYeNnDJDCUDnd/gkoFKhWozJiZI3gLwY6rAgxhsPKTPUzycTl8lAryMyMsVQG6TFi6cHULyz8KOjC7OIQ KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/> <span title="ExplanationOfBenefit.coverage.coverage : Reference to the program or plan identification, underwriter or payor.">coverage</span> <a name="ExplanationOfBenefit.coverage.coverage"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">1..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="references.html">Reference</a>( <a href="coverage.html">Coverage</a>) </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Insurance information</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.coverage.relationship : The relationship of the patient to the subscriber.">relationship</span> <a name="ExplanationOfBenefit.coverage.relationship"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">1..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Patient relationship to subscriber <br/> <a href="valueset-relationship.html" title="The code for the relationship of the patient to the subscriber.">Surface Codes</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set. The value set merely provides examples of the types of concepts intended to be included.">Example</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzME+lXFigAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+3OsRUAIAjEUO L+O8cJABttJM11/x1qZAGqRBEVcNIqdWj1efDqQbb3HwwwwEfABmQUHSPM9dtDAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i 8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="ExplanationOfBenefit.coverage.preAuthRef : A list of references from the Insurer to which these services pertain.">preAuthRef</span> <a name="ExplanationOfBenefit.coverage.preAuthRef"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..*</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#string">string</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Pre-Authorization/Determination Reference</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.exception : Factors which may influence the applicability of coverage.">exception</span> <a name="ExplanationOfBenefit.exception"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..*</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Eligibility exceptions <br/> <a href="valueset-claim-exception.html" title="Factors which may influence the applicability of coverage.">Exception Codes</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set. The value set merely provides examples of the types of concepts intended to be included.">Example</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i 8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="ExplanationOfBenefit.school : Name of school for over-aged dependants.">school</span> <a name="ExplanationOfBenefit.school"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#string">string</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Name of School</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i 8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="ExplanationOfBenefit.accidentDate : Date of an accident which these services are addressing.">accidentDate</span> <a name="ExplanationOfBenefit.accidentDate"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#date">date</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Accident Date</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.accidentType : Type of accident: work, auto, etc.">accidentType</span> <a name="ExplanationOfBenefit.accidentType"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Accident Type <br/> <a href="v3/ActIncidentCode/index.html" title="Type of accident: work place, auto, etc.">ActIncidentCode</a> ( <a href="terminologies.html#required" title="To be conformant, instances of this element SHALL include a code from the specified value set.">Required</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAMQfAGm6/idTd4yTmF+v8Xa37KvW+lyh3KHJ62aq41ee2bXZ98nm/2mt5W2Ck5XN/ C1chEZieho8WXXA/2Gn4P39/W+y6V+l3qjP8Njt/lx2izxPYGyv51Oa1EJWZ////////yH5BAEAAB8ALAAAAAAQABAAAAWH4Cd+Xm l6Y0pCQts0EKp6GbYshaM/skhjhCChUmFIeL4OsHIxXRAISQTl6SgIG8+FgfBMoh2qtbLZQr0TQJhk3TC4pYPBApiyFVDEwSOf18U FXxMWBoUJBn9sDgmDewcJCRyJJBoEkRyYmAABPZQEAAOhA5seFDMaDw8BAQ9TpiokJyWwtLUhADs=" style="background-color: white; background-color: inherit" title="Choice of Types"/> <span title="ExplanationOfBenefit.accidentLocation[x] : Accident Place.">accidentLocation[x]</span> <a name="ExplanationOfBenefit.accidentLocation_x_"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Accident Place</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; 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background-color: inherit" title="Primitive Data Type"/> <span title="A sequence of Unicode characters">accidentLocationString</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#string">string</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> accidentLocationAddress </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Address">Address</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzME+lXFigAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+3OsRUAIAjEUO L+O8cJABttJM11/x1qZAGqRBEVcNIqdWj1efDqQbb3HwwwwEfABmQUHSPM9dtDAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxj wv8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAAAadEVYdFNvZnR3YXJlAFBhaW50Lk5FVCB2My41LjEwMPRyoQAAAFxJREFUOE/NjE EOACEIA/0o/38GGw+agoXYeNnDJDCUDnd/gkoFKhWozJiZI3gLwY6rAgxhsPKTPUzycTl8lAryMyMsVQG6TFi6cHULyz8KOjC7OIQ KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/> accidentLocationReference </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="references.html">Reference</a>( <a href="location.html">Location</a>) </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.interventionException : A list of intervention and exception codes which may influence the adjudication of the claim.">interventionException</span> <a name="ExplanationOfBenefit.interventionException"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..*</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Intervention and exception code (Pharma) <br/> <a href="valueset-intervention.html" title="Intervention and exception codes (Pharm)">Intervention Codes</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set. The value set merely provides examples of the types of concepts intended to be included.">Example</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAMQfAGm6/idTd4yTmF+v8Xa37KvW+lyh3KHJ62aq41ee2bXZ98nm/2mt5W2Ck5XN/ C1chEZieho8WXXA/2Gn4P39/W+y6V+l3qjP8Njt/lx2izxPYGyv51Oa1EJWZ////////yH5BAEAAB8ALAAAAAAQABAAAAWH4Cd+Xm l6Y0pCQts0EKp6GbYshaM/skhjhCChUmFIeL4OsHIxXRAISQTl6SgIG8+FgfBMoh2qtbLZQr0TQJhk3TC4pYPBApiyFVDEwSOf18U FXxMWBoUJBn9sDgmDewcJCRyJJBoEkRyYmAABPZQEAAOhA5seFDMaDw8BAQ9TpiokJyWwtLUhADs=" style="background-color: white; background-color: inherit" title="Choice of Types"/> <span title="ExplanationOfBenefit.onset[x] : The start or start and end dates for the treatable condition.">onset[x]</span> <a name="ExplanationOfBenefit.onset_x_"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Illness, injury or treatable condition date</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i 8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="A date or partial date (e.g. just year or year + month). There is no time zone. The format is a union of the schema types gYear, gYearMonth and date. Dates SHALL be valid dates.">onsetDate</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#date">date</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzME+lXFigAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+3OsRUAIAjEUO L+O8cJABttJM11/x1qZAGqRBEVcNIqdWj1efDqQbb3HwwwwEfABmQUHSPM9dtDAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="A time period defined by a start and end date and optionally time.">onsetPeriod</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Period">Period</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.employmentImpacted : The start and optional end dates of when the patient was precluded from working due to the treatable condition(s).">employmentImpacted</span> <a name="ExplanationOfBenefit.employmentImpacted"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Period">Period</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Period unable to work</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.hospitalization : The start and optional end dates of when the patient was confined to a treatment center.">hospitalization</span> <a name="ExplanationOfBenefit.hospitalization"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Period">Period</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Period in hospital</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAMQfAOvGUf7ztuvPMf/78/fkl/Pbg+u8Rvjqteu2Pf3zxPz36Pz0z+vTmPzurPvuw /npofbjquvNefHVduuyN+uuMu3Oafbgjfnqvf/3zv/3xevPi+vRjP/20/bmsP///////yH5BAEAAB8ALAAAAAAQABAAAAV24CeOZG mepqeqqOgxjBZFa+19r4ftWQUAgqDgltthMshMIJAZ4jYDHsBARSAmFOJvq+g6HIdEFgcYmBWNxoNAsDjGHgBnmV5bCoUDHLBIq9s FEhIdcAYJdYASFRUQhQkLCwkOFwcdEBAXhVabE52ecDahKy0oIQA7" style="background-color: white; background-color: inherit" title="Element"/> <span title="ExplanationOfBenefit.item : First tier of goods and services.">item</span> <a name="ExplanationOfBenefit.item"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..*</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="backboneelement.html">BackboneElement</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Goods and Services</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i 8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="ExplanationOfBenefit.item.sequence : A service line number.">sequence</span> <a name="ExplanationOfBenefit.item.sequence"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">1..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#positiveInt">positiveInt</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Service instance</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.item.type : The type of product or service.">type</span> <a name="ExplanationOfBenefit.item.type"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">1..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Group or type of product or service <br/> <a href="v3/ActInvoiceGroupCode/index.html" title="Service, Product, Rx Dispense, Rx Compound etc.">ActInvoiceGroupCode</a> ( <a href="terminologies.html#required" title="To be conformant, instances of this element SHALL include a code from the specified value set.">Required</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAAAXNSR0IArs4c6QAAAARnQU1BAACxj wv8YQUAAAAJcEhZcwAADsMAAA7DAcdvqGQAAAAadEVYdFNvZnR3YXJlAFBhaW50Lk5FVCB2My41LjEwMPRyoQAAAFxJREFUOE/NjE EOACEIA/0o/38GGw+agoXYeNnDJDCUDnd/gkoFKhWozJiZI3gLwY6rAgxhsPKTPUzycTl8lAryMyMsVQG6TFi6cHULyz8KOjC7OIQ KlQpU3uPjAwhX2CCcGsgOAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Reference to another Resource"/> <span title="ExplanationOfBenefit.item.provider : The practitioner who is responsible for the services rendered to the patient.">provider</span> <a name="ExplanationOfBenefit.item.provider"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="references.html">Reference</a>( <a href="practitioner.html">Practitioner</a>) </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Responsible practitioner</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i 8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="ExplanationOfBenefit.item.diagnosisLinkId : Diagnosis applicable for this service or product line.">diagnosisLinkId</span> <a name="ExplanationOfBenefit.item.diagnosisLinkId"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..*</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#positiveInt">positiveInt</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Diagnosis Link</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.item.service : If a grouping item then 'GROUP' otherwise it is a node therefore a code to indicate the Professional Service or Product supplied.">service</span> <a name="ExplanationOfBenefit.item.service"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">1..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Item Code <br/> <a href="valueset-service-uscls.html" title="Allowable service and product codes">USCLS Codes</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set. The value set merely provides examples of the types of concepts intended to be included.">Example</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAMQfAGm6/idTd4yTmF+v8Xa37KvW+lyh3KHJ62aq41ee2bXZ98nm/2mt5W2Ck5XN/ C1chEZieho8WXXA/2Gn4P39/W+y6V+l3qjP8Njt/lx2izxPYGyv51Oa1EJWZ////////yH5BAEAAB8ALAAAAAAQABAAAAWH4Cd+Xm l6Y0pCQts0EKp6GbYshaM/skhjhCChUmFIeL4OsHIxXRAISQTl6SgIG8+FgfBMoh2qtbLZQr0TQJhk3TC4pYPBApiyFVDEwSOf18U FXxMWBoUJBn9sDgmDewcJCRyJJBoEkRyYmAABPZQEAAOhA5seFDMaDw8BAQ9TpiokJyWwtLUhADs=" style="background-color: white; background-color: inherit" title="Choice of Types"/> <span title="ExplanationOfBenefit.item.serviced[x] : The date or dates when the enclosed suite of services were performed or completed.">serviced[x]</span> <a name="ExplanationOfBenefit.item.serviced_x_"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Date or dates of Service</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3QoREAMAwDsezq/WdoskJIWyDfCT5xJamN2dk2P/UAAMA7TgAAAK5pTFFALJuuCkgAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i 8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="A date or partial date (e.g. just year or year + month). There is no time zone. The format is a union of the schema types gYear, gYearMonth and date. 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background-color: inherit" title="Data Type"/> <span title="A time period defined by a start and end date and optionally time.">servicedPeriod</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Period">Period</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.item.place : Where the service was provided.">place</span> <a name="ExplanationOfBenefit.item.place"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Place of service <br/> <a href="valueset-service-place.html" title="Place where the service is rendered">Example Service Place Codes</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set. The value set merely provides examples of the types of concepts intended to be included.">Example</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.item.quantity : The number of repetitions of a service or product.">quantity</span> <a name="ExplanationOfBenefit.item.quantity"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#SimpleQuantity">SimpleQuantity</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Count of Products or Services</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.item.unitPrice : If the item is a node then this is the fee for the product or service, otherwise this is the total of the fees for the children of the group.">unitPrice</span> <a name="ExplanationOfBenefit.item.unitPrice"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Money">Money</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Fee, charge or cost per point</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i 8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="ExplanationOfBenefit.item.factor : A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.">factor</span> <a name="ExplanationOfBenefit.item.factor"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#decimal">decimal</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Price scaling factor</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i 8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="ExplanationOfBenefit.item.points : An amount that expresses the weighting (based on difficulty, cost and/or resource intensiveness) associated with the good or service delivered. The concept of Points allows for assignment of point values for services and/or goods, such that a monetary amount can be assigned to each point.">points</span> <a name="ExplanationOfBenefit.item.points"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#decimal">decimal</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Difficulty scaling factor</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.item.net : The quantity times the unit price for an addittional service or product or charge. For example, the formula: unit Quantity * unit Price (Cost per Point) * factor Number * points = net Amount. Quantity, factor and points are assumed to be 1 if not supplied.">net</span> <a name="ExplanationOfBenefit.item.net"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Money">Money</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Total item cost</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.item.udi : List of Unique Device Identifiers associated with this line item.">udi</span> <a name="ExplanationOfBenefit.item.udi"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Unique Device Identifier <br/> <a href="valueset-udi.html" title="The GUDID (FDA), or other, UDI repository.">UDI Codes</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set. The value set merely provides examples of the types of concepts intended to be included.">Example</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.item.bodySite : Physical service site on the patient (limb, tooth, etc).">bodySite</span> <a name="ExplanationOfBenefit.item.bodySite"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Service Location <br/> <a href="valueset-tooth.html" title="The code for the teeth, quadrant, sextant and arch">Surface Codes</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set. The value set merely provides examples of the types of concepts intended to be included.">Example</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.item.subSite : A region or surface of the site, eg. limb region or tooth surface(s).">subSite</span> <a name="ExplanationOfBenefit.item.subSite"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..*</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Service Sub-location <br/> <a href="valueset-surface.html" title="The code for the tooth surface and surface combinations">Surface Codes</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set. The value set merely provides examples of the types of concepts intended to be included.">Example</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.item.modifier : Item typification or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.">modifier</span> <a name="ExplanationOfBenefit.item.modifier"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..*</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Service/Product billing modifiers <br/> <a href="valueset-claim-modifiers.html" title="Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.">Modifier type Codes</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set. The value set merely provides examples of the types of concepts intended to be included.">Example</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i 8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="ExplanationOfBenefit.item.noteNumber : A list of note references to the notes provided below.">noteNumber</span> <a name="ExplanationOfBenefit.item.noteNumber"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..*</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#positiveInt">positiveInt</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">List of note numbers which apply</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAMQfAOvGUf7ztuvPMf/78/fkl/Pbg+u8Rvjqteu2Pf3zxPz36Pz0z+vTmPzurPvuw /npofbjquvNefHVduuyN+uuMu3Oafbgjfnqvf/3zv/3xevPi+vRjP/20/bmsP///////yH5BAEAAB8ALAAAAAAQABAAAAV24CeOZG mepqeqqOgxjBZFa+19r4ftWQUAgqDgltthMshMIJAZ4jYDHsBARSAmFOJvq+g6HIdEFgcYmBWNxoNAsDjGHgBnmV5bCoUDHLBIq9s FEhIdcAYJdYASFRUQhQkLCwkOFwcdEBAXhVabE52ecDahKy0oIQA7" style="background-color: white; background-color: inherit" title="Element"/> <span title="ExplanationOfBenefit.item.adjudication : The adjudications results.">adjudication</span> <a name="ExplanationOfBenefit.item.adjudication"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..*</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="backboneelement.html">BackboneElement</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Adjudication details</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3QoREAMAwDsezq/WdoskJIWyDfCT5xJamN2dk2P/UAAMA7TgAAAK5pTFFALJuuCkgAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.item.adjudication.category : Code indicating: Co-Pay, deductable, elegible, benefit, tax, etc.">category</span> <a name="ExplanationOfBenefit.item.adjudication.category"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">1..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Adjudication category such as co-pay, eligible, benefit, etc. <br/> <a href="valueset-adjudication.html" title="The adjudication codes.">Adjudication Codes</a> ( <a href="terminologies.html#extensible" title="To be conformant, instances of this element SHALL include a code from the specified value set if any of the codes within the value set can apply to the concept being communicated. If the valueset does not cover the concept (based on human review), alternate codings (or, data type allowing, text) may be included instead.">Extensible</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3QoREAMAwDsezq/WdoskJIWyDfCT5xJamN2dk2P/UAAMA7TgAAAK5pTFFALJuuCkgAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.item.adjudication.reason : Adjudication reason such as limit reached.">reason</span> <a name="ExplanationOfBenefit.item.adjudication.reason"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Adjudication reason <br/> <a href="valueset-adjudication-reason.html" title="Adjudication reason codes.">Adjudication Reason Codes</a> ( <a href="terminologies.html#extensible" title="To be conformant, instances of this element SHALL include a code from the specified value set if any of the codes within the value set can apply to the concept being communicated. If the valueset does not cover the concept (based on human review), alternate codings (or, data type allowing, text) may be included instead.">Extensible</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3QoREAMAwDsezq/WdoskJIWyDfCT5xJamN2dk2P/UAAMA7TgAAAK5pTFFALJuuCkgAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.item.adjudication.amount : Monitory amount associated with the code.">amount</span> <a name="ExplanationOfBenefit.item.adjudication.amount"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Money">Money</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Monetary amount</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzME+lXFigAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+3OsRUAIAjEUO L+O8cJABttJM11/x1qZAGqRBEVcNIqdWj1efDqQbb3HwwwwEfABmQUHSPM9dtDAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i 8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="ExplanationOfBenefit.item.adjudication.value : A non-monetary value for example a percentage. Mutually exclusive to the amount element above.">value</span> <a name="ExplanationOfBenefit.item.adjudication.value"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#decimal">decimal</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Non-monitory value</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAMQfAOvGUf7ztuvPMf/78/fkl/Pbg+u8Rvjqteu2Pf3zxPz36Pz0z+vTmPzurPvuw /npofbjquvNefHVduuyN+uuMu3Oafbgjfnqvf/3zv/3xevPi+vRjP/20/bmsP///////yH5BAEAAB8ALAAAAAAQABAAAAV24CeOZG mepqeqqOgxjBZFa+19r4ftWQUAgqDgltthMshMIJAZ4jYDHsBARSAmFOJvq+g6HIdEFgcYmBWNxoNAsDjGHgBnmV5bCoUDHLBIq9s FEhIdcAYJdYASFRUQhQkLCwkOFwcdEBAXhVabE52ecDahKy0oIQA7" style="background-color: white; background-color: inherit" title="Element"/> <span title="ExplanationOfBenefit.item.detail : Second tier of goods and services.">detail</span> <a name="ExplanationOfBenefit.item.detail"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..*</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="backboneelement.html">BackboneElement</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Additional items</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3QoREAMAwDsezq/WdoskJIWyDfCT5xJamN2dk2P/UAAMA7TgAAAK5pTFFALJuuCkgAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i 8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="ExplanationOfBenefit.item.detail.sequence : A service line number.">sequence</span> <a name="ExplanationOfBenefit.item.detail.sequence"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">1..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#positiveInt">positiveInt</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Service instance</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3QoREAMAwDsezq/WdoskJIWyDfCT5xJamN2dk2P/UAAMA7TgAAAK5pTFFALJuuCkgAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.item.detail.type : The type of product or service.">type</span> <a name="ExplanationOfBenefit.item.detail.type"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">1..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Group or type of product or service <br/> <a href="v3/ActInvoiceGroupCode/index.html" title="Service, Product, Rx Dispense, Rx Compound etc.">ActInvoiceGroupCode</a> ( <a href="terminologies.html#required" title="To be conformant, instances of this element SHALL include a code from the specified value set.">Required</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3QoREAMAwDsezq/WdoskJIWyDfCT5xJamN2dk2P/UAAMA7TgAAAK5pTFFALJuuCkgAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.item.detail.service : If a grouping item then 'GROUP' otherwise it is a node therefore a code to indicate the Professional Service or Product supplied.">service</span> <a name="ExplanationOfBenefit.item.detail.service"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">1..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Additional item codes <br/> <a href="valueset-service-uscls.html" title="Allowable service and product codes">USCLS Codes</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set. The value set merely provides examples of the types of concepts intended to be included.">Example</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3QoREAMAwDsezq/WdoskJIWyDfCT5xJamN2dk2P/UAAMA7TgAAAK5pTFFALJuuCkgAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.item.detail.quantity : The number of repetitions of a service or product.">quantity</span> <a name="ExplanationOfBenefit.item.detail.quantity"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#SimpleQuantity">SimpleQuantity</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Count of Products or Services</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3QoREAMAwDsezq/WdoskJIWyDfCT5xJamN2dk2P/UAAMA7TgAAAK5pTFFALJuuCkgAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.item.detail.unitPrice : If the item is a node then this is the fee for the product or service, otherwise this is the total of the fees for the children of the group.">unitPrice</span> <a name="ExplanationOfBenefit.item.detail.unitPrice"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Money">Money</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Fee, charge or cost per point</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3QoREAMAwDsezq/WdoskJIWyDfCT5xJamN2dk2P/UAAMA7TgAAAK5pTFFALJuuCkgAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i 8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="ExplanationOfBenefit.item.detail.factor : A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.">factor</span> <a name="ExplanationOfBenefit.item.detail.factor"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#decimal">decimal</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Price scaling factor</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3QoREAMAwDsezq/WdoskJIWyDfCT5xJamN2dk2P/UAAMA7TgAAAK5pTFFALJuuCkgAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i 8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="ExplanationOfBenefit.item.detail.points : An amount that expresses the weighting (based on difficulty, cost and/or resource intensiveness) associated with the good or service delivered. The concept of Points allows for assignment of point values for services and/or goods, such that a monetary amount can be assigned to each point.">points</span> <a name="ExplanationOfBenefit.item.detail.points"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#decimal">decimal</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Difficulty scaling factor</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3QoREAMAwDsezq/WdoskJIWyDfCT5xJamN2dk2P/UAAMA7TgAAAK5pTFFALJuuCkgAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.item.detail.net : The quantity times the unit price for an addittional service or product or charge. For example, the formula: unit Quantity * unit Price (Cost per Point) * factor Number * points = net Amount. Quantity, factor and points are assumed to be 1 if not supplied.">net</span> <a name="ExplanationOfBenefit.item.detail.net"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Money">Money</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Total additional item cost</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3QoREAMAwDsezq/WdoskJIWyDfCT5xJamN2dk2P/UAAMA7TgAAAK5pTFFALJuuCkgAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.item.detail.udi : List of Unique Device Identifiers associated with this line item.">udi</span> <a name="ExplanationOfBenefit.item.detail.udi"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Unique Device Identifier <br/> <a href="valueset-udi.html" title="The GUDID (FDA), or other, UDI repository.">UDI Codes</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set. The value set merely provides examples of the types of concepts intended to be included.">Example</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3QoREAMAwDsezq/WdoskJIWyDfCT5xJamN2dk2P/UAAMA7TgAAAK5pTFFALJuuCkgAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAMQfAOvGUf7ztuvPMf/78/fkl/Pbg+u8Rvjqteu2Pf3zxPz36Pz0z+vTmPzurPvuw /npofbjquvNefHVduuyN+uuMu3Oafbgjfnqvf/3zv/3xevPi+vRjP/20/bmsP///////yH5BAEAAB8ALAAAAAAQABAAAAV24CeOZG mepqeqqOgxjBZFa+19r4ftWQUAgqDgltthMshMIJAZ4jYDHsBARSAmFOJvq+g6HIdEFgcYmBWNxoNAsDjGHgBnmV5bCoUDHLBIq9s FEhIdcAYJdYASFRUQhQkLCwkOFwcdEBAXhVabE52ecDahKy0oIQA7" style="background-color: white; background-color: inherit" title="Element"/> <span title="ExplanationOfBenefit.item.detail.adjudication : The adjudications results.">adjudication</span> <a name="ExplanationOfBenefit.item.detail.adjudication"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..*</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="backboneelement.html">BackboneElement</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Detail adjudication</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMklEQVR42u3WsQkAMAwDsPzq/29o8kIodCgyaPTiyZWkNiZn2/mpDwAAXPxxIwAAAK80V3dAAj3qyVQAAAAASUV ORK5CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.item.detail.adjudication.code : Code indicating: Co-Pay, deductable, elegible, benefit, tax, etc.">code</span> <a name="ExplanationOfBenefit.item.detail.adjudication.code"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">1..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Adjudication category such as co-pay, eligible, benefit, etc. <br/> <a href="valueset-adjudication.html" title="The adjudication codes.">Adjudication Codes</a> ( <a href="terminologies.html#extensible" title="To be conformant, instances of this element SHALL include a code from the specified value set if any of the codes within the value set can apply to the concept being communicated. If the valueset does not cover the concept (based on human review), alternate codings (or, data type allowing, text) may be included instead.">Extensible</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMklEQVR42u3WsQkAMAwDsPzq/29o8kIodCgyaPTiyZWkNiZn2/mpDwAAXPxxIwAAAK80V3dAAj3qyVQAAAAASUV ORK5CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.item.detail.adjudication.reason : Adjudication reason such as limit reached.">reason</span> <a name="ExplanationOfBenefit.item.detail.adjudication.reason"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Adjudication reason <br/> <a href="valueset-adjudication-reason.html" title="Adjudication reason codes.">Adjudication Reason Codes</a> ( <a href="terminologies.html#extensible" title="To be conformant, instances of this element SHALL include a code from the specified value set if any of the codes within the value set can apply to the concept being communicated. If the valueset does not cover the concept (based on human review), alternate codings (or, data type allowing, text) may be included instead.">Extensible</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMklEQVR42u3WsQkAMAwDsPzq/29o8kIodCgyaPTiyZWkNiZn2/mpDwAAXPxxIwAAAK80V3dAAj3qyVQAAAAASUV ORK5CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.item.detail.adjudication.amount : Monitory amount associated with the code.">amount</span> <a name="ExplanationOfBenefit.item.detail.adjudication.amount"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Money">Money</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Monetary amount</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3QoREAMAwDsezq/WdoskJIWyDfCT5xJamN2dk2P/UAAMA7TgAAAK5pTFFALJuuCkgAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzME+lXFigAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+3OsRUAIAjEUO L+O8cJABttJM11/x1qZAGqRBEVcNIqdWj1efDqQbb3HwwwwEfABmQUHSPM9dtDAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i 8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="ExplanationOfBenefit.item.detail.adjudication.value : A non-monetary value for example a percentage. Mutually exclusive to the amount element above.">value</span> <a name="ExplanationOfBenefit.item.detail.adjudication.value"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#decimal">decimal</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Non-monitory value</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzME+lXFigAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+3OsRUAIAjEUO L+O8cJABttJM11/x1qZAGqRBEVcNIqdWj1efDqQbb3HwwwwEfABmQUHSPM9dtDAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAMQfAOvGUf7ztuvPMf/78/fkl/Pbg+u8Rvjqteu2Pf3zxPz36Pz0z+vTmPzurPvuw /npofbjquvNefHVduuyN+uuMu3Oafbgjfnqvf/3zv/3xevPi+vRjP/20/bmsP///////yH5BAEAAB8ALAAAAAAQABAAAAV24CeOZG mepqeqqOgxjBZFa+19r4ftWQUAgqDgltthMshMIJAZ4jYDHsBARSAmFOJvq+g6HIdEFgcYmBWNxoNAsDjGHgBnmV5bCoUDHLBIq9s FEhIdcAYJdYASFRUQhQkLCwkOFwcdEBAXhVabE52ecDahKy0oIQA7" style="background-color: white; background-color: inherit" title="Element"/> <span title="ExplanationOfBenefit.item.detail.subDetail : Third tier of goods and services.">subDetail</span> <a name="ExplanationOfBenefit.item.detail.subDetail"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..*</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="backboneelement.html">BackboneElement</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Additional items</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAM0lEQVR42u3QwQkAIAwDwO6a/WdQVyiKPrzAPUMglaQ6Vka3c7K/6/U+AAD8zAkAAMA1E1bRQCwtE1WUAAAAAEl FTkSuQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i 8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="ExplanationOfBenefit.item.detail.subDetail.sequence : A service line number.">sequence</span> <a name="ExplanationOfBenefit.item.detail.subDetail.sequence"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">1..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#positiveInt">positiveInt</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Service instance</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; 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background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.item.detail.subDetail.type : The type of product or service.">type</span> <a name="ExplanationOfBenefit.item.detail.subDetail.type"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">1..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Type of product or service <br/> <a href="v3/ActInvoiceGroupCode/index.html" title="Service, Product, Rx Dispense, Rx Compound etc.">ActInvoiceGroupCode</a> ( <a href="terminologies.html#required" title="To be conformant, instances of this element SHALL include a code from the specified value set.">Required</a>) </td> </tr> <tr style="border: 0px; 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background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.item.detail.subDetail.service : The fee for an addittional service or product or charge.">service</span> <a name="ExplanationOfBenefit.item.detail.subDetail.service"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">1..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Additional item codes <br/> <a href="valueset-service-uscls.html" title="Allowable service and product codes">USCLS Codes</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set. The value set merely provides examples of the types of concepts intended to be included.">Example</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAM0lEQVR42u3QwQkAIAwDwO6a/WdQVyiKPrzAPUMglaQ6Vka3c7K/6/U+AAD8zAkAAMA1E1bRQCwtE1WUAAAAAEl FTkSuQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.item.detail.subDetail.quantity : The number of repetitions of a service or product.">quantity</span> <a name="ExplanationOfBenefit.item.detail.subDetail.quantity"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#SimpleQuantity">SimpleQuantity</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Count of Products or Services</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; 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text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAM0lEQVR42u3QwQkAIAwDwO6a/WdQVyiKPrzAPUMglaQ6Vka3c7K/6/U+AAD8zAkAAMA1E1bRQCwtE1WUAAAAAEl FTkSuQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i 8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="ExplanationOfBenefit.item.detail.subDetail.factor : A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.">factor</span> <a name="ExplanationOfBenefit.item.detail.subDetail.factor"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#decimal">decimal</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Price scaling factor</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAM0lEQVR42u3QwQkAIAwDwO6a/WdQVyiKPrzAPUMglaQ6Vka3c7K/6/U+AAD8zAkAAMA1E1bRQCwtE1WUAAAAAEl FTkSuQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i 8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="ExplanationOfBenefit.item.detail.subDetail.points : An amount that expresses the weighting (based on difficulty, cost and/or resource intensiveness) associated with the good or service delivered. The concept of Points allows for assignment of point values for services and/or goods, such that a monetary amount can be assigned to each point.">points</span> <a name="ExplanationOfBenefit.item.detail.subDetail.points"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#decimal">decimal</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Difficulty scaling factor</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAM0lEQVR42u3QwQkAIAwDwO6a/WdQVyiKPrzAPUMglaQ6Vka3c7K/6/U+AAD8zAkAAMA1E1bRQCwtE1WUAAAAAEl FTkSuQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.item.detail.subDetail.net : The quantity times the unit price for an addittional service or product or charge. For example, the formula: unit Quantity * unit Price (Cost per Point) * factor Number * points = net Amount. Quantity, factor and points are assumed to be 1 if not supplied.">net</span> <a name="ExplanationOfBenefit.item.detail.subDetail.net"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Money">Money</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Net additional item cost</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAM0lEQVR42u3QwQkAIAwDwO6a/WdQVyiKPrzAPUMglaQ6Vka3c7K/6/U+AAD8zAkAAMA1E1bRQCwtE1WUAAAAAEl FTkSuQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.item.detail.subDetail.udi : List of Unique Device Identifiers associated with this line item.">udi</span> <a name="ExplanationOfBenefit.item.detail.subDetail.udi"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Unique Device Identifier <br/> <a href="valueset-udi.html" title="The GUDID (FDA), or other, UDI repository.">UDI Codes</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set. The value set merely provides examples of the types of concepts intended to be included.">Example</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzME+lXFigAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+3OsRUAIAjEUO L+O8cJABttJM11/x1qZAGqRBEVcNIqdWj1efDqQbb3HwwwwEfABmQUHSPM9dtDAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAMQfAOvGUf7ztuvPMf/78/fkl/Pbg+u8Rvjqteu2Pf3zxPz36Pz0z+vTmPzurPvuw /npofbjquvNefHVduuyN+uuMu3Oafbgjfnqvf/3zv/3xevPi+vRjP/20/bmsP///////yH5BAEAAB8ALAAAAAAQABAAAAV24CeOZG mepqeqqOgxjBZFa+19r4ftWQUAgqDgltthMshMIJAZ4jYDHsBARSAmFOJvq+g6HIdEFgcYmBWNxoNAsDjGHgBnmV5bCoUDHLBIq9s FEhIdcAYJdYASFRUQhQkLCwkOFwcdEBAXhVabE52ecDahKy0oIQA7" style="background-color: white; background-color: inherit" title="Element"/> <span title="ExplanationOfBenefit.item.detail.subDetail.adjudication : The adjudications results.">adjudication</span> <a name="ExplanationOfBenefit.item.detail.subDetail.adjudication"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..*</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="backboneelement.html">BackboneElement</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">SubDetail adjudication</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAANklEQVR42u3WwQkAIAwDwO6a/WdQVyiIRbjAPQOlr1SS6jhZ3c7N/rTf7wcAgNE97QkAAMArG2FRQCyoxnjnAAA AAElFTkSuQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.item.detail.subDetail.adjudication.code : Code indicating: Co-Pay, deductable, elegible, benefit, tax, etc.">code</span> <a name="ExplanationOfBenefit.item.detail.subDetail.adjudication.code"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">1..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Adjudication category such as co-pay, eligible, benefit, etc. <br/> <a href="valueset-adjudication.html" title="The adjudication codes.">Adjudication Codes</a> ( <a href="terminologies.html#extensible" title="To be conformant, instances of this element SHALL include a code from the specified value set if any of the codes within the value set can apply to the concept being communicated. If the valueset does not cover the concept (based on human review), alternate codings (or, data type allowing, text) may be included instead.">Extensible</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAANklEQVR42u3WwQkAIAwDwO6a/WdQVyiIRbjAPQOlr1SS6jhZ3c7N/rTf7wcAgNE97QkAAMArG2FRQCyoxnjnAAA AAElFTkSuQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.item.detail.subDetail.adjudication.reason : Adjudication reason such as limit reached.">reason</span> <a name="ExplanationOfBenefit.item.detail.subDetail.adjudication.reason"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Adjudication reason <br/> <a href="valueset-adjudication-reason.html" title="Adjudication reason codes.">Adjudication Reason Codes</a> ( <a href="terminologies.html#extensible" title="To be conformant, instances of this element SHALL include a code from the specified value set if any of the codes within the value set can apply to the concept being communicated. If the valueset does not cover the concept (based on human review), alternate codings (or, data type allowing, text) may be included instead.">Extensible</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAANklEQVR42u3WwQkAIAwDwO6a/WdQVyiIRbjAPQOlr1SS6jhZ3c7N/rTf7wcAgNE97QkAAMArG2FRQCyoxnjnAAA AAElFTkSuQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.item.detail.subDetail.adjudication.amount : Monitory amount associated with the code.">amount</span> <a name="ExplanationOfBenefit.item.detail.subDetail.adjudication.amount"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Money">Money</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Monetary amount</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzME+lXFigAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+3OsRUAIAjEUO L+O8cJABttJM11/x1qZAGqRBEVcNIqdWj1efDqQbb3HwwwwEfABmQUHSPM9dtDAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i 8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="ExplanationOfBenefit.item.detail.subDetail.adjudication.value : A non-monetary value for example a percentage. Mutually exclusive to the amount element above.">value</span> <a name="ExplanationOfBenefit.item.detail.subDetail.adjudication.value"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#decimal">decimal</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Non-monitory value</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzME+lXFigAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+3OsRUAIAjEUO L+O8cJABttJM11/x1qZAGqRBEVcNIqdWj1efDqQbb3HwwwwEfABmQUHSPM9dtDAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAMQfAOvGUf7ztuvPMf/78/fkl/Pbg+u8Rvjqteu2Pf3zxPz36Pz0z+vTmPzurPvuw /npofbjquvNefHVduuyN+uuMu3Oafbgjfnqvf/3zv/3xevPi+vRjP/20/bmsP///////yH5BAEAAB8ALAAAAAAQABAAAAV24CeOZG mepqeqqOgxjBZFa+19r4ftWQUAgqDgltthMshMIJAZ4jYDHsBARSAmFOJvq+g6HIdEFgcYmBWNxoNAsDjGHgBnmV5bCoUDHLBIq9s FEhIdcAYJdYASFRUQhQkLCwkOFwcdEBAXhVabE52ecDahKy0oIQA7" style="background-color: white; background-color: inherit" title="Element"/> <span title="ExplanationOfBenefit.item.prosthesis : The materials and placement date of prior fixed prosthesis.">prosthesis</span> <a name="ExplanationOfBenefit.item.prosthesis"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="backboneelement.html">BackboneElement</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Prosthetic details</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAANElEQVR42u3WwQkAIAwDwO6a/WdQVygW/VzhniGQVytJdZxb3cyk3/0AAMDFP28EAADglQ1WK0BWTK0BuwAAAAB JRU5ErkJggg==)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i 8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="ExplanationOfBenefit.item.prosthesis.initial : Indicates whether this is the initial placement of a fixed prosthesis.">initial</span> <a name="ExplanationOfBenefit.item.prosthesis.initial"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#boolean">boolean</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Is this the initial service</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAANElEQVR42u3WwQkAIAwDwO6a/WdQVygW/VzhniGQVytJdZxb3cyk3/0AAMDFP28EAADglQ1WK0BWTK0BuwAAAAB JRU5ErkJggg==)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i 8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="ExplanationOfBenefit.item.prosthesis.priorDate : Date of the initial placement.">priorDate</span> <a name="ExplanationOfBenefit.item.prosthesis.priorDate"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#date">date</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Initial service Date</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzME+lXFigAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+3OsRUAIAjEUO L+O8cJABttJM11/x1qZAGqRBEVcNIqdWj1efDqQbb3HwwwwEfABmQUHSPM9dtDAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.item.prosthesis.priorMaterial : Material of the prior denture or bridge prosthesis. (Oral).">priorMaterial</span> <a name="ExplanationOfBenefit.item.prosthesis.priorMaterial"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Prosthetic Material <br/> <a href="valueset-oral-prosthodontic-material.html" title="Material of the prior denture or bridge prosthesis. (Oral)">Oral Prostho Material type Codes</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set. The value set merely provides examples of the types of concepts intended to be included.">Example</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAMQfAOvGUf7ztuvPMf/78/fkl/Pbg+u8Rvjqteu2Pf3zxPz36Pz0z+vTmPzurPvuw /npofbjquvNefHVduuyN+uuMu3Oafbgjfnqvf/3zv/3xevPi+vRjP/20/bmsP///////yH5BAEAAB8ALAAAAAAQABAAAAV24CeOZG mepqeqqOgxjBZFa+19r4ftWQUAgqDgltthMshMIJAZ4jYDHsBARSAmFOJvq+g6HIdEFgcYmBWNxoNAsDjGHgBnmV5bCoUDHLBIq9s FEhIdcAYJdYASFRUQhQkLCwkOFwcdEBAXhVabE52ecDahKy0oIQA7" style="background-color: white; background-color: inherit" title="Element"/> <span title="ExplanationOfBenefit.addItem : The first tier service adjudications for payor added services.">addItem</span> <a name="ExplanationOfBenefit.addItem"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..*</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="backboneelement.html">BackboneElement</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Insurer added line items</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i 8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="ExplanationOfBenefit.addItem.sequenceLinkId : List of input service items which this service line is intended to replace.">sequenceLinkId</span> <a name="ExplanationOfBenefit.addItem.sequenceLinkId"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..*</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#positiveInt">positiveInt</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Service instances</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.addItem.service : A code to indicate the Professional Service or Product supplied.">service</span> <a name="ExplanationOfBenefit.addItem.service"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">1..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Group, Service or Product <br/> <a href="valueset-service-uscls.html" title="Allowable service and product codes">USCLS Codes</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set. The value set merely provides examples of the types of concepts intended to be included.">Example</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.addItem.fee : The fee charged for the professional service or product..">fee</span> <a name="ExplanationOfBenefit.addItem.fee"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Money">Money</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Professional fee or Product charge</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i 8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="ExplanationOfBenefit.addItem.noteNumberLinkId : A list of note references to the notes provided below.">noteNumberLinkId</span> <a name="ExplanationOfBenefit.addItem.noteNumberLinkId"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..*</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#positiveInt">positiveInt</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">List of note numbers which apply</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAMQfAOvGUf7ztuvPMf/78/fkl/Pbg+u8Rvjqteu2Pf3zxPz36Pz0z+vTmPzurPvuw /npofbjquvNefHVduuyN+uuMu3Oafbgjfnqvf/3zv/3xevPi+vRjP/20/bmsP///////yH5BAEAAB8ALAAAAAAQABAAAAV24CeOZG mepqeqqOgxjBZFa+19r4ftWQUAgqDgltthMshMIJAZ4jYDHsBARSAmFOJvq+g6HIdEFgcYmBWNxoNAsDjGHgBnmV5bCoUDHLBIq9s FEhIdcAYJdYASFRUQhQkLCwkOFwcdEBAXhVabE52ecDahKy0oIQA7" style="background-color: white; background-color: inherit" title="Element"/> <span title="ExplanationOfBenefit.addItem.adjudication : The adjudications results.">adjudication</span> <a name="ExplanationOfBenefit.addItem.adjudication"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..*</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="backboneelement.html">BackboneElement</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Added items adjudication</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3QoREAMAwDsezq/WdoskJIWyDfCT5xJamN2dk2P/UAAMA7TgAAAK5pTFFALJuuCkgAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.addItem.adjudication.code : Code indicating: Co-Pay, deductable, elegible, benefit, tax, etc.">code</span> <a name="ExplanationOfBenefit.addItem.adjudication.code"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">1..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Adjudication category such as co-pay, eligible, benefit, etc. <br/> <a href="valueset-adjudication.html" title="The adjudication codes.">Adjudication Codes</a> ( <a href="terminologies.html#extensible" title="To be conformant, instances of this element SHALL include a code from the specified value set if any of the codes within the value set can apply to the concept being communicated. If the valueset does not cover the concept (based on human review), alternate codings (or, data type allowing, text) may be included instead.">Extensible</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3QoREAMAwDsezq/WdoskJIWyDfCT5xJamN2dk2P/UAAMA7TgAAAK5pTFFALJuuCkgAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.addItem.adjudication.amount : Monitory amount associated with the code.">amount</span> <a name="ExplanationOfBenefit.addItem.adjudication.amount"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Money">Money</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Monetary amount</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzME+lXFigAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+3OsRUAIAjEUO L+O8cJABttJM11/x1qZAGqRBEVcNIqdWj1efDqQbb3HwwwwEfABmQUHSPM9dtDAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i 8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="ExplanationOfBenefit.addItem.adjudication.value : A non-monetary value for example a percentage. Mutually exclusive to the amount element above.">value</span> <a name="ExplanationOfBenefit.addItem.adjudication.value"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#decimal">decimal</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Non-monitory value</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzME+lXFigAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+3OsRUAIAjEUO L+O8cJABttJM11/x1qZAGqRBEVcNIqdWj1efDqQbb3HwwwwEfABmQUHSPM9dtDAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAMQfAOvGUf7ztuvPMf/78/fkl/Pbg+u8Rvjqteu2Pf3zxPz36Pz0z+vTmPzurPvuw /npofbjquvNefHVduuyN+uuMu3Oafbgjfnqvf/3zv/3xevPi+vRjP/20/bmsP///////yH5BAEAAB8ALAAAAAAQABAAAAV24CeOZG mepqeqqOgxjBZFa+19r4ftWQUAgqDgltthMshMIJAZ4jYDHsBARSAmFOJvq+g6HIdEFgcYmBWNxoNAsDjGHgBnmV5bCoUDHLBIq9s FEhIdcAYJdYASFRUQhQkLCwkOFwcdEBAXhVabE52ecDahKy0oIQA7" style="background-color: white; background-color: inherit" title="Element"/> <span title="ExplanationOfBenefit.addItem.detail : The second tier service adjudications for payor added services.">detail</span> <a name="ExplanationOfBenefit.addItem.detail"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..*</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="backboneelement.html">BackboneElement</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Added items details</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; 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background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.addItem.detail.service : A code to indicate the Professional Service or Product supplied.">service</span> <a name="ExplanationOfBenefit.addItem.detail.service"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">1..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Service or Product <br/> <a href="valueset-service-uscls.html" title="Allowable service and product codes">USCLS Codes</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set. The value set merely provides examples of the types of concepts intended to be included.">Example</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAANElEQVR42u3WwQkAIAwDwO6a/WdQVygW/VzhniGQVytJdZxb3cyk3/0AAMDFP28EAADglQ1WK0BWTK0BuwAAAAB JRU5ErkJggg==)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.addItem.detail.fee : The fee charged for the professional service or product..">fee</span> <a name="ExplanationOfBenefit.addItem.detail.fee"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Money">Money</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Professional fee or Product charge</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzME+lXFigAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+3OsRUAIAjEUO L+O8cJABttJM11/x1qZAGqRBEVcNIqdWj1efDqQbb3HwwwwEfABmQUHSPM9dtDAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAMQfAOvGUf7ztuvPMf/78/fkl/Pbg+u8Rvjqteu2Pf3zxPz36Pz0z+vTmPzurPvuw /npofbjquvNefHVduuyN+uuMu3Oafbgjfnqvf/3zv/3xevPi+vRjP/20/bmsP///////yH5BAEAAB8ALAAAAAAQABAAAAV24CeOZG mepqeqqOgxjBZFa+19r4ftWQUAgqDgltthMshMIJAZ4jYDHsBARSAmFOJvq+g6HIdEFgcYmBWNxoNAsDjGHgBnmV5bCoUDHLBIq9s FEhIdcAYJdYASFRUQhQkLCwkOFwcdEBAXhVabE52ecDahKy0oIQA7" style="background-color: white; background-color: inherit" title="Element"/> <span title="ExplanationOfBenefit.addItem.detail.adjudication : The adjudications results.">adjudication</span> <a name="ExplanationOfBenefit.addItem.detail.adjudication"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..*</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="backboneelement.html">BackboneElement</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Added items detail adjudication</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAANElEQVR42u3WwQkAMAgDQHfN/jO0XcFPUTjhnoGQl5WkOt6dbmaS7f0BAGD1P24EAADglwtgq0BWZ7/LGQAAAAB JRU5ErkJggg==)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.addItem.detail.adjudication.code : Code indicating: Co-Pay, deductable, elegible, benefit, tax, etc.">code</span> <a name="ExplanationOfBenefit.addItem.detail.adjudication.code"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">1..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Adjudication category such as co-pay, eligible, benefit, etc. <br/> <a href="valueset-adjudication.html" title="The adjudication codes.">Adjudication Codes</a> ( <a href="terminologies.html#extensible" title="To be conformant, instances of this element SHALL include a code from the specified value set if any of the codes within the value set can apply to the concept being communicated. If the valueset does not cover the concept (based on human review), alternate codings (or, data type allowing, text) may be included instead.">Extensible</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAANElEQVR42u3WwQkAMAgDQHfN/jO0XcFPUTjhnoGQl5WkOt6dbmaS7f0BAGD1P24EAADglwtgq0BWZ7/LGQAAAAB JRU5ErkJggg==)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.addItem.detail.adjudication.amount : Monitory amount associated with the code.">amount</span> <a name="ExplanationOfBenefit.addItem.detail.adjudication.amount"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Money">Money</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Monetary amount</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzME+lXFigAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+3OsRUAIAjEUO L+O8cJABttJM11/x1qZAGqRBEVcNIqdWj1efDqQbb3HwwwwEfABmQUHSPM9dtDAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i 8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="ExplanationOfBenefit.addItem.detail.adjudication.value : A non-monetary value for example a percentage. Mutually exclusive to the amount element above.">value</span> <a name="ExplanationOfBenefit.addItem.detail.adjudication.value"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#decimal">decimal</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Non-monitory value</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.claimTotal : The total value of the claim.">claimTotal</span> <a name="ExplanationOfBenefit.claimTotal"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Money">Money</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Total claim cost</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAMQfAOvGUf7ztuvPMf/78/fkl/Pbg+u8Rvjqteu2Pf3zxPz36Pz0z+vTmPzurPvuw /npofbjquvNefHVduuyN+uuMu3Oafbgjfnqvf/3zv/3xevPi+vRjP/20/bmsP///////yH5BAEAAB8ALAAAAAAQABAAAAV24CeOZG mepqeqqOgxjBZFa+19r4ftWQUAgqDgltthMshMIJAZ4jYDHsBARSAmFOJvq+g6HIdEFgcYmBWNxoNAsDjGHgBnmV5bCoUDHLBIq9s FEhIdcAYJdYASFRUQhQkLCwkOFwcdEBAXhVabE52ecDahKy0oIQA7" style="background-color: white; background-color: inherit" title="Element"/> <span title="ExplanationOfBenefit.missingTeeth : A list of teeth which would be expected but are not found due to having been previously extracted or for other reasons.">missingTeeth</span> <a name="ExplanationOfBenefit.missingTeeth"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..*</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="backboneelement.html">BackboneElement</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Only if type = oral</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.missingTeeth.tooth : The code identifying which tooth is missing.">tooth</span> <a name="ExplanationOfBenefit.missingTeeth.tooth"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">1..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Tooth Code <br/> <a href="valueset-teeth.html" title="The codes for the teeth, subset of OralSites">Teeth Codes</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set. The value set merely provides examples of the types of concepts intended to be included.">Example</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAMElEQVR42u3QwQkAMAwDsezq/WdoskKgFAoy6HkfV5LamJ1tc7MHAAD+5QQAAOCZBkurQFbnaRSlAAAAAElFTkS uQmCC)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.missingTeeth.reason : Missing reason may be: E-extraction, O-other.">reason</span> <a name="ExplanationOfBenefit.missingTeeth.reason"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Reason for missing <br/> <a href="valueset-missing-tooth-reason.html" title="Reason codes for the missing teeth">Missing Tooth Reason Codes</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set. The value set merely provides examples of the types of concepts intended to be included.">Example</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzME+lXFigAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+3OsRUAIAjEUO L+O8cJABttJM11/x1qZAGqRBEVcNIqdWj1efDqQbb3HwwwwEfABmQUHSPM9dtDAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i 8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="ExplanationOfBenefit.missingTeeth.extractionDate : The date of the extraction either known from records or patient reported estimate.">extractionDate</span> <a name="ExplanationOfBenefit.missingTeeth.extractionDate"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#date">date</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Date of Extraction</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.unallocDeductable : The amount of deductable applied which was not allocated to any particular service line.">unallocDeductable</span> <a name="ExplanationOfBenefit.unallocDeductable"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Money">Money</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Unallocated deductable</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.totalBenefit : Total amount of benefit payable (Equal to sum of the Benefit amounts from all detail lines and additions less the Unallocated Deductable).">totalBenefit</span> <a name="ExplanationOfBenefit.totalBenefit"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Money">Money</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Total benefit payable for the Claim</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.paymentAdjustment : Adjustment to the payment of this transaction which is not related to adjudication of this transaction.">paymentAdjustment</span> <a name="ExplanationOfBenefit.paymentAdjustment"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Money">Money</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Payment adjustment for non-Claim issues</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.paymentAdjustmentReason : Reason for the payment adjustment.">paymentAdjustmentReason</span> <a name="ExplanationOfBenefit.paymentAdjustmentReason"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Reason for Payment adjustment <br/> <a href="valueset-payment-adjustment-reason.html" title="Payment Adjustment reason codes.">Payment Adjustment Reason Codes</a> ( <a href="terminologies.html#extensible" title="To be conformant, instances of this element SHALL include a code from the specified value set if any of the codes within the value set can apply to the concept being communicated. If the valueset does not cover the concept (based on human review), alternate codings (or, data type allowing, text) may be included instead.">Extensible</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i 8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="ExplanationOfBenefit.paymentDate : Estimated payment data.">paymentDate</span> <a name="ExplanationOfBenefit.paymentDate"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#date">date</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Expected data of Payment</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.paymentAmount : Payable less any payment adjustment.">paymentAmount</span> <a name="ExplanationOfBenefit.paymentAmount"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Money">Money</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Payment amount</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.paymentRef : Payment identifer.">paymentRef</span> <a name="ExplanationOfBenefit.paymentRef"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Identifier">Identifier</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Payment identifier</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.reserved : Status of funds reservation (For provider, for Patient, None).">reserved</span> <a name="ExplanationOfBenefit.reserved"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Funds reserved status <br/> <a href="valueset-fundsreserve.html" title="For whom funds are to be reserved: (Patient, Provider, None).">Funds Reservation Codes</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set. The value set merely provides examples of the types of concepts intended to be included.">Example</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3XsQ0AQAgCQHdl/xn8jxvYWB3JlTR0VJLa+OltBwAAYP6EEQAAgCsPVYVAgIJrA/sAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.form : The form to be used for printing the content.">form</span> <a name="ExplanationOfBenefit.form"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Printed Form Identifier <br/> <a href="valueset-forms.html" title="The forms codes.">Form Codes</a> ( <a href="terminologies.html#required" title="To be conformant, instances of this element SHALL include a code from the specified value set.">Required</a>) </td> </tr> <tr style="border: 0px; 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background-color: inherit" title="Primitive Data Type"/> <span title="ExplanationOfBenefit.note.text : The note text.">text</span> <a name="ExplanationOfBenefit.note.text"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#string">string</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Note explanitory text</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; 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background-color: inherit" title="Element"/> <span title="ExplanationOfBenefit.benefitBalance : Balance by Benefit Category.">benefitBalance</span> <a name="ExplanationOfBenefit.benefitBalance"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..*</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="backboneelement.html">BackboneElement</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Balance by Benefit Category</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAALElEQVR42u3QwQkAMAwDsezq/WdIO4XJQwa9DTdJpulv258AAMANIgAAADUPYAVAgAJ//usAAAAASUVORK5CYII =)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.benefitBalance.category : Dental, Vision, Medical, Pharmacy, Rehab etc.">category</span> <a name="ExplanationOfBenefit.benefitBalance.category"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">1..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Benefit Category <br/> <a href="valueset-benefit-category.html" title="Benefit categories such as: oral, medical, vision etc.">Benefit Category Codes</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set. The value set merely provides examples of the types of concepts intended to be included.">Example</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAALElEQVR42u3QwQkAMAwDsezq/WdIO4XJQwa9DTdJpulv258AAMANIgAAADUPYAVAgAJ//usAAAAASUVORK5CYII =)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.benefitBalance.subCategory : Dental: basic, major, ortho; Vision exam, glasses, contacts; etc.">subCategory</span> <a name="ExplanationOfBenefit.benefitBalance.subCategory"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Benefit SubCategory <br/> <a href="valueset-benefit-subcategory.html" title="Benefit subcategories such as: oral-basic, major, glasses">Benefit SubCategory Codes</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set. The value set merely provides examples of the types of concepts intended to be included.">Example</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAALElEQVR42u3QwQkAMAwDsezq/WdIO4XJQwa9DTdJpulv258AAMANIgAAADUPYAVAgAJ//usAAAAASUVORK5CYII =)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.benefitBalance.network : Network designation.">network</span> <a name="ExplanationOfBenefit.benefitBalance.network"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">In or out of network <br/> <a href="valueset-benefit-network.html" title="Code to classify in or out of network services">Network Type Codes</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set. The value set merely provides examples of the types of concepts intended to be included.">Example</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAALElEQVR42u3QwQkAMAwDsezq/WdIO4XJQwa9DTdJpulv258AAMANIgAAADUPYAVAgAJ//usAAAAASUVORK5CYII =)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.benefitBalance.unit : Unit designation: individual or family.">unit</span> <a name="ExplanationOfBenefit.benefitBalance.unit"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Individual or family <br/> <a href="valueset-benefit-unit.html" title="Unit covered/serviced - individual or family">Unit Type Codes</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set. The value set merely provides examples of the types of concepts intended to be included.">Example</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAALElEQVR42u3QwQkAMAwDsezq/WdIO4XJQwa9DTdJpulv258AAMANIgAAADUPYAVAgAJ//usAAAAASUVORK5CYII =)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.benefitBalance.term : The term or period of the values such as 'maximum lifetime benefit' or 'maximum annual vistis'.">term</span> <a name="ExplanationOfBenefit.benefitBalance.term"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Annual or lifetime <br/> <a href="valueset-benefit-term.html" title="Coverage unit - annual, lifetime">Benefit Term Codes</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set. The value set merely provides examples of the types of concepts intended to be included.">Example</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAI0lEQVR42u3QIQEAAAACIL/6/4MvTAQOkLYBAAB4kAAAANwMad9AqkRjgNAAAAAASUVORK5CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzME+lXFigAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+3OsRUAIAjEUO L+O8cJABttJM11/x1qZAGqRBEVcNIqdWj1efDqQbb3HwwwwEfABmQUHSPM9dtDAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAMQfAOvGUf7ztuvPMf/78/fkl/Pbg+u8Rvjqteu2Pf3zxPz36Pz0z+vTmPzurPvuw /npofbjquvNefHVduuyN+uuMu3Oafbgjfnqvf/3zv/3xevPi+vRjP/20/bmsP///////yH5BAEAAB8ALAAAAAAQABAAAAV24CeOZG mepqeqqOgxjBZFa+19r4ftWQUAgqDgltthMshMIJAZ4jYDHsBARSAmFOJvq+g6HIdEFgcYmBWNxoNAsDjGHgBnmV5bCoUDHLBIq9s FEhIdcAYJdYASFRUQhQkLCwkOFwcdEBAXhVabE52ecDahKy0oIQA7" style="background-color: white; background-color: inherit" title="Element"/> <span title="ExplanationOfBenefit.benefitBalance.financial : Benefits Used to date.">financial</span> <a name="ExplanationOfBenefit.benefitBalance.financial"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..*</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="backboneelement.html">BackboneElement</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Benefit Summary</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3WsQkAQAgDQHfN/jO8Fs7wIFzg+pAqlaQumbxrnQEAgP3zRgAAAH5paoVAgEFM+GgAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> <span title="ExplanationOfBenefit.benefitBalance.financial.type : Deductable, visits, benefit amount.">type</span> <a name="ExplanationOfBenefit.benefitBalance.financial.type"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">1..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Coding">Coding</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Deductable, visits, benefit amount <br/> <a href="valueset-benefit-type.html" title="Deductable, visits, co-pay, etc.">Benefit Type Codes</a> ( <a href="terminologies.html#example" title="Instances are not expected or even encouraged to draw from the specified value set. The value set merely provides examples of the types of concepts intended to be included.">Example</a>) </td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3WsQkAQAgDQHfN/jO8Fs7wIFzg+pAqlaQumbxrnQEAgP3zRgAAAH5paoVAgEFM+GgAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAMQfAGm6/idTd4yTmF+v8Xa37KvW+lyh3KHJ62aq41ee2bXZ98nm/2mt5W2Ck5XN/ C1chEZieho8WXXA/2Gn4P39/W+y6V+l3qjP8Njt/lx2izxPYGyv51Oa1EJWZ////////yH5BAEAAB8ALAAAAAAQABAAAAWH4Cd+Xm l6Y0pCQts0EKp6GbYshaM/skhjhCChUmFIeL4OsHIxXRAISQTl6SgIG8+FgfBMoh2qtbLZQr0TQJhk3TC4pYPBApiyFVDEwSOf18U FXxMWBoUJBn9sDgmDewcJCRyJJBoEkRyYmAABPZQEAAOhA5seFDMaDw8BAQ9TpiokJyWwtLUhADs=" style="background-color: white; background-color: inherit" title="Choice of Types"/> <span title="ExplanationOfBenefit.benefitBalance.financial.benefit[x] : Benefits allowed.">benefit[x]</span> <a name="ExplanationOfBenefit.benefitBalance.financial.benefit_x_"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Benefits allowed</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; 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background-color: inherit" title="Primitive Data Type"/> <span title="An integer with a value that is not negative (e.g. >= 0)">benefitUnsignedInt</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#unsignedInt">unsignedInt</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3WsQkAQAgDQHfN/jO8Fs7wIFzg+pAqlaQumbxrnQEAgP3zRgAAAH5paoVAgEFM+GgAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzMPbYccAgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAMElEQVQ4y+3OQREAIBDDwA v+PQcFFN5MIyCzqHMKUGVCpMFLK97heq+gggoq+EiwAVjvMhFGmlEUAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzME+lXFigAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+3OsRUAIAjEUO L+O8cJABttJM11/x1qZAGqRBEVcNIqdWj1efDqQbb3HwwwwEfABmQUHSPM9dtDAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> benefitQuantity </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Money">Money</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAI0lEQVR42u3QIQEAAAACIL/6/4MvTAQOkLYBAAB4kAAAANwMad9AqkRjgNAAAAAASUVORK5CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzME+lXFigAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+3OsRUAIAjEUO L+O8cJABttJM11/x1qZAGqRBEVcNIqdWj1efDqQbb3HwwwwEfABmQUHSPM9dtDAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAMQfAGm6/idTd4yTmF+v8Xa37KvW+lyh3KHJ62aq41ee2bXZ98nm/2mt5W2Ck5XN/ C1chEZieho8WXXA/2Gn4P39/W+y6V+l3qjP8Njt/lx2izxPYGyv51Oa1EJWZ////////yH5BAEAAB8ALAAAAAAQABAAAAWH4Cd+Xm l6Y0pCQts0EKp6GbYshaM/skhjhCChUmFIeL4OsHIxXRAISQTl6SgIG8+FgfBMoh2qtbLZQr0TQJhk3TC4pYPBApiyFVDEwSOf18U FXxMWBoUJBn9sDgmDewcJCRyJJBoEkRyYmAABPZQEAAOhA5seFDMaDw8BAQ9TpiokJyWwtLUhADs=" style="background-color: white; background-color: inherit" title="Choice of Types"/> <span title="ExplanationOfBenefit.benefitBalance.financial.benefitUsed[x] : Benefits used.">benefitUsed[x]</span> <a name="ExplanationOfBenefit.benefitBalance.financial.benefitUsed_x_"> </a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <span title="This element is included in summaries">Σ</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">0..1</td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px">Benefits used</td> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAAL0lEQVR42u3WQQkAMAwDwHqNfw1rVZRBL3ACklcqSV0yedc6AwDAN3/cCAAAwJYGdQVAgLmrCkUAAAAASUVORK5 CYII=)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzI3XJ6V3QAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+2RsQ0AIAzDav 7/2VzQwoCY4iWbZSmo1QGoUgNMghvWaIejPQW/CrrNCylIwcOCDYfLNRcNer4SAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIW XMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3gYBFzI0BrFQCwAAAERJREFUOMtj/P//PwMlgImBQjDwBrCcOnWKokBgYWBgYDCU+06W5i 8MUggvnH/EOVJjAW4AuQHJ+O75LYqikXE0LzAAALePEntTkEoSAAAAAElFTkSuQmCC" style="background-color: white; background-color: inherit" title="Primitive Data Type"/> <span title="An integer with a value that is not negative (e.g. >= 0)">benefitUsedUnsignedInt</span> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#unsignedInt">unsignedInt</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> </tr> <tr style="border: 0px; padding:0px; vertical-align: top; background-color: white;"> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAyAAAAACCA YAAACg/LjIAAAALklEQVR42u3WsQ0AQAgDMXbN/jPwPwKioHIkL3BVKkkx99c6AADA8k+LAAAAXHl/hUCAvLYESQAAAABJRU5ErkJ ggg==)"> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAAWCAYAAAABxvaqAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIs1vtcMQAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAE0lEQVQI12P4//8/AxMDAw NdCABMPwMo2ctnoQAAAABJRU5ErkJggg==" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzIZgEiYEgAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAAIElEQVQ4y2P8//8/AyWAiY FCMGrAqAGjBowaMGoAAgAALL0DKYQ0DPIAAAAASUVORK5CYII=" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAWCAYAAADJqhx8AAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB 3RJTUUH3wYeFzME+lXFigAAAB1pVFh0Q29tbWVudAAAAAAAQ3JlYXRlZCB3aXRoIEdJTVBkLmUHAAAANklEQVQ4y+3OsRUAIAjEUO L+O8cJABttJM11/x1qZAGqRBEVcNIqdWj1efDqQbb3HwwwwEfABmQUHSPM9dtDAAAAAElFTkSuQmCC" style="background-color: inherit"/> <img alt="." class="hierarchy" src="data: image/png;base64,R0lGODlhEAAQAOZ/APrkusOiYvvfqbiXWaV2G+jGhdq1b8GgYf3v1frw3vTUlsWkZNewbcSjY/DQk ad4Hb6dXv3u0f3v1ObEgfPTlerJiP3w1v79+e7OkPrfrfnjuNOtZPrpydaxa+/YrvvdpP779ZxvFPvnwKKBQaFyF/369M2vdaqHRP z58/HNh/vowufFhfroxO3OkPrluv779tK0e6JzGProwvrow9m4eOnIifPTlPDPkP78+Naxaf3v0/zowfXRi+bFhLWUVv379/rnwPv szv3rye3LiPvnv+3MjPDasKiIS/789/3x2f747eXDg+7Mifvu0tu7f+/QkfDTnPXWmPrjsvrjtPbPgrqZW+/QlPz48K2EMv36866O UPvowat8Ivvgq/Pbrvzgq/PguvrgrqN0Gda2evfYm9+7d/rpw9q6e/LSku/Rl/XVl/LSlfrkt+zVqe7Wqv3x1/bNffbOf59wFdS6i f3u0vrqyP3owPvepfXQivDQkO/PkKh9K7STVf779P///////yH5BAEAAH8ALAAAAAAQABAAAAfNgH+Cg36FfoOIhH4JBxBghYl/hQ kNAV0IVT5GkJKLCwtQaSsSdx9aR26Gcwt2IkQaNRI6dBERIzCFDSgWSW8WCDkbBnoOQ3uFARc/JQJfCAZlT0x4ZFyFBxdNQT9ZCBN WKQoKUQ+FEDgcdTIAV14YDmg2CgSFA0hmQC5TLE4VRTdrKJAoxOeFCzZSwsw4U6BCizwUQhQyEaAPiAwCVNCY0FCNnA6GPAwYoETI FgY9loiRA4dToTYnsOxg8CBGHE6ICvEYQ4AKzkidfgoKBAA7" style="background-color: white; background-color: inherit" title="Data Type"/> benefitUsedQuantity </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"> <a href="datatypes.html#Money">Money</a> </td> <td class="hierarchy" style="vertical-align: top; text-align : left; background-color: white; padding:0px 4px 0px 4px"/> </tr> <tr> <td class="hierarchy" colspan="5"> <br/> <a href="formats.html#table" title="Legend for this format"> <img alt="doco" src="help16.png" style="background-color: inherit"/> Documentation for this format </a> </td> </tr> </table> </div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm"> <valueInteger value="0"/> </extension> <url value="http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit"/> <name value="ExplanationOfBenefit"/> <status value="draft"/> <publisher value="Health Level Seven International (Financial Management)"/> <contact> <telecom> <system value="other"/> <value value="http://hl7.org/fhir"/> </telecom> </contact> <contact> <telecom> <system value="other"/> <value value="http://www.hl7.org/Special/committees/fm/index.cfm"/> </telecom> </contact> <date value="2015-12-11T17:38:40+11:00"/> <description value="Base StructureDefinition for ExplanationOfBenefit Resource"/> <fhirVersion value="1.2.0"/> <mapping> <identity value="w5"/> <uri value="http://hl7.org/fhir/w5"/> <name value="W5 Mapping"/> </mapping> <mapping> <identity value="cdanetv4"/> <uri value="http://www.cda-adc.ca/en/services/cdanet/"/> <name value="Canadian Dental Association eclaims standard"/> </mapping> <mapping> <identity value="v2"/> <uri value="http://hl7.org/v2"/> <name value="HL7 v2"/> </mapping> <mapping> <identity value="rim"/> <uri value="http://hl7.org/v3"/> <name value="RIM"/> </mapping> <kind value="resource"/> <abstract value="false"/> <base value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> <snapshot> <element> <path value="ExplanationOfBenefit"/> <short value="Explanation of Benefit resource"/> <definition value="This resource provides: the claim details; adjudication details from the processing of a Claim; and optionally account balance information, for informing the subscriber of the benefits provided."/> <alias value="EOB"/> <min value="0"/> <max value="*"/> <type> <code value="DomainResource"/> </type> <isSummary value="true"/> <mapping> <identity value="w5"/> <map value="financial.other"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.id"/> <short value="Logical id of this artifact"/> <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/> <comments value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Bundles always have an id, though it is usually a generated UUID."/> <min value="0"/> <max value="1"/> <type> <code value="id"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.meta"/> <short value="Metadata about the resource"/> <definition value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource."/> <min value="0"/> <max value="1"/> <type> <code value="Meta"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.implicitRules"/> <short value="A set of rules under which this content was created"/> <definition value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content."/> <comments value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible."/> <min value="0"/> <max value="1"/> <type> <code value="uri"/> </type> <isModifier value="true"/> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.language"/> <short value="Language of the resource content"/> <definition value="The base language in which the resource is written."/> <comments value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)."/> <min value="0"/> <max value="1"/> <type> <code value="code"/> </type> <binding> <strength value="required"/> <description value="A human language."/> <valueSetUri value="http://tools.ietf.org/html/bcp47"/> </binding> </element> <element> <path value="ExplanationOfBenefit.text"/> <short value="Text summary of the resource, for human interpretation"/> <definition value="A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety."/> <comments value="Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative."/> <alias value="narrative"/> <alias value="html"/> <alias value="xhtml"/> <alias value="display"/> <min value="0"/> <max value="1"/> <type> <code value="Narrative"/> </type> <condition value="dom-1"/> <mapping> <identity value="rim"/> <map value="Act.text?"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.contained"/> <short value="Contained, inline Resources"/> <definition value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope."/> <comments value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again."/> <alias value="inline resources"/> <alias value="anonymous resources"/> <alias value="contained resources"/> <min value="0"/> <max value="*"/> <type> <code value="Resource"/> </type> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.extension"/> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.modifierExtension"/> <short value="Extensions that cannot be ignored"/> <definition value="May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <isModifier value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.identifier"/> <short value="Business Identifier"/> <definition value="The Response Business Identifier."/> <min value="0"/> <max value="*"/> <type> <code value="Identifier"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.claim"/> <short value="Claim reference"/> <definition value="The business identifier for the instance: invoice number, claim number, pre-determination or pre-authorization number."/> <min value="0"/> <max value="1"/> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/Claim"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="A02|G01"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.claimResponse"/> <short value="Claim response reference"/> <definition value="The business identifier for the instance: invoice number, claim number, pre-determination or pre-authorization number."/> <min value="0"/> <max value="1"/> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/ClaimResponse"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="A02|G01"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.ruleset"/> <short value="Current specification followed"/> <definition value="The version of the specification on which this instance relies."/> <alias value="BusinessVersion"/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="The static and dynamic model to which contents conform, which may be business version or standard/version."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ruleset"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.originalRuleset"/> <short value="Original specification followed"/> <definition value="The version of the specification from which the original instance was created."/> <alias value="OriginalBusinessVersion"/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="The static and dynamic model to which contents conform, which may be business version or standard/version."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ruleset"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.created"/> <short value="Creation date"/> <definition value="The date when the EOB was created."/> <min value="0"/> <max value="1"/> <type> <code value="dateTime"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.billablePeriod"/> <short value="Period for charge submission"/> <definition value="The billable period for which charges are being submitted."/> <min value="0"/> <max value="1"/> <type> <code value="Period"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.disposition"/> <short value="Disposition Message"/> <definition value="A description of the status of the adjudication."/> <comments value="Do we need a disposition code?"/> <min value="0"/> <max value="1"/> <type> <code value="string"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.provider"/> <short value="Responsible provider for the claim"/> <definition value="The provider which is responsible for the claim."/> <min value="0"/> <max value="1"/> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="B02"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.organization"/> <short value="Responsible organization for the claim"/> <definition value="The provider which is responsible for the claim."/> <min value="0"/> <max value="1"/> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/Organization"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="B02"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.facility"/> <short value="Servicing Facility"/> <definition value="Facility where the services were provided."/> <min value="0"/> <max value="1"/> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/Location"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.relatedClaim"/> <short value="Related Claims"/> <definition value="Other claims which are related to this claim such as prior claim versions or for related services."/> <min value="0"/> <max value="*"/> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/Claim"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.prescription"/> <short value="Prescription"/> <definition value="Prescription to support the dispensing of Pharmacy or Vision products."/> <requirements value="For type=Pharmacy and Vision only."/> <min value="0"/> <max value="1"/> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/MedicationOrder"/> </type> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/VisionPrescription"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.originalPrescription"/> <short value="Original Prescription"/> <definition value="Original prescription which has been superceded by this prescription to support the dispensing of pharmacy services, medications or products."/> <min value="0"/> <max value="1"/> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/MedicationOrder"/> </type> <isSummary value="true"/> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="Payee"/> </extension> <path value="ExplanationOfBenefit.payee"/> <short value="Payee"/> <definition value="The party to be reimbursed for the services."/> <min value="0"/> <max value="1"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F02"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.payee.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references)."/> <min value="0"/> <max value="1"/> <type> <code value="id"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.payee.extension"/> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.payee.modifierExtension"/> <short value="Extensions that cannot be ignored"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <isModifier value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.payee.type"/> <short value="Party to be paid any benefits payable"/> <definition value="Party to be reimbursed: Subscriber, provider, other."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="A code for the party to be reimbursed."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/payeetype"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.payee.provider"/> <short value="Provider who is the payee"/> <definition value="The provider who is to be reimbursed for the claim (the party to whom any benefit is assigned)."/> <min value="0"/> <max value="1"/> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="B03"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.payee.organization"/> <short value="Organization who is the payee"/> <definition value="The organization who is to be reimbursed for the claim (the party to whom any benefit is assigned)."/> <min value="0"/> <max value="1"/> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/Organization"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="B04"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.payee.person"/> <short value="Other person who is the payee"/> <definition value="The person other than the subscriber who is to be reimbursed for the claim (the party to whom any benefit is assigned)."/> <min value="0"/> <max value="1"/> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/Patient"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.referral"/> <short value="Treatment Referral"/> <definition value="The referral resource which lists the date, practitioner, reason and other supporting information."/> <min value="0"/> <max value="1"/> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/ReferralRequest"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="B05"/> </mapping> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="Diagnosis"/> </extension> <path value="ExplanationOfBenefit.diagnosis"/> <short value="Diagnosis"/> <definition value="Ordered list of patient diagnosis for which care is sought."/> <min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.diagnosis.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references)."/> <min value="0"/> <max value="1"/> <type> <code value="id"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.diagnosis.extension"/> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.diagnosis.modifierExtension"/> <short value="Extensions that cannot be ignored"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <isModifier value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.diagnosis.sequence"/> <short value="Sequence of diagnosis"/> <definition value="Sequence of diagnosis which serves to order and provide a link."/> <requirements value="Required to maintain order of the diagnoses."/> <min value="1"/> <max value="1"/> <type> <code value="positiveInt"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.diagnosis.diagnosis"/> <short value="Patient's list of diagnosis"/> <definition value="The diagnosis."/> <requirements value="Required to adjudicate services rendered to condition presented."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="ICD10 Diagnostic codes"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/icd-10"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.specialCondition"/> <short value="List of special Conditions"/> <definition value="List of special conditions relating to the setting, treatment or patient for which care is sought which may influence the adjudication."/> <min value="0"/> <max value="*"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="List of special conditions relating to the setting, treatment or patient for which care is sought which may influence the adjudication."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/fm-conditions"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.patient"/> <short value="The subject of the Products and Services"/> <definition value="Patient Resource."/> <min value="1"/> <max value="1"/> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/Patient"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="C06,C07,C08, C05, C04"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.precedence"/> <short value="Precedence (primary, secondary, etc.)"/> <definition value="Precedence (primary, secondary, etc.)."/> <requirements value="Health care programs and insurers are significant payors of health service costs."/> <min value="0"/> <max value="1"/> <type> <code value="positiveInt"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="Coverage"/> </mapping> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="Coverage"/> </extension> <path value="ExplanationOfBenefit.coverage"/> <short value="Insurance or medical plan"/> <definition value="Financial instrument by which payment information for health care."/> <requirements value="Health care programs and insurers are significant payors of health service costs."/> <min value="1"/> <max value="1"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="Coverage"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.coverage.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references)."/> <min value="0"/> <max value="1"/> <type> <code value="id"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.coverage.extension"/> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.coverage.modifierExtension"/> <short value="Extensions that cannot be ignored"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <isModifier value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.coverage.coverage"/> <short value="Insurance information"/> <definition value="Reference to the program or plan identification, underwriter or payor."/> <requirements value="Need to identify the issuer to target for processing and for coordination of benefit processing."/> <min value="1"/> <max value="1"/> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/Coverage"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.coverage.relationship"/> <short value="Patient relationship to subscriber"/> <definition value="The relationship of the patient to the subscriber."/> <requirements value="To determine relationship between the patient and the subscriber."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="The code for the relationship of the patient to the subscriber."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/relationship"/> </valueSetReference> </binding> <mapping> <identity value="cdanetv4"/> <map value="C03"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.coverage.preAuthRef"/> <short value="Pre-Authorization/Determination Reference"/> <definition value="A list of references from the Insurer to which these services pertain."/> <requirements value="To provide any pre=determination or prior authorization reference."/> <min value="0"/> <max value="*"/> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F03"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.exception"/> <short value="Eligibility exceptions"/> <definition value="Factors which may influence the applicability of coverage."/> <requirements value="To determine extenuating circumstances for coverage."/> <min value="0"/> <max value="*"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Factors which may influence the applicability of coverage."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/claim-exception"/> </valueSetReference> </binding> <mapping> <identity value="cdanetv4"/> <map value="C09"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.school"/> <short value="Name of School"/> <definition value="Name of school for over-aged dependants."/> <requirements value="Often required for over-age dependents."/> <min value="0"/> <max value="1"/> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="C10"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.accidentDate"/> <short value="Accident Date"/> <definition value="Date of an accident which these services are addressing."/> <requirements value="Coverage may be dependant on accidents."/> <min value="0"/> <max value="1"/> <type> <code value="date"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F02"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.accidentType"/> <short value="Accident Type"/> <definition value="Type of accident: work, auto, etc."/> <requirements value="Coverage may be dependant on the type of accident."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="required"/> <description value="Type of accident: work place, auto, etc."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/v3-ActIncidentCode"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.accidentLocation[x]"/> <short value="Accident Place"/> <definition value="Accident Place."/> <min value="0"/> <max value="1"/> <type> <code value="string"/> </type> <type> <code value="Address"/> </type> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/Location"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.interventionException"/> <short value="Intervention and exception code (Pharma)"/> <definition value="A list of intervention and exception codes which may influence the adjudication of the claim."/> <requirements value="Coverage may be modified based on exception information provided."/> <min value="0"/> <max value="*"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Intervention and exception codes (Pharm)"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/intervention"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.onset[x]"/> <short value="Illness, injury or treatable condition date"/> <definition value="The start or start and end dates for the treatable condition."/> <min value="0"/> <max value="1"/> <type> <code value="date"/> </type> <type> <code value="Period"/> </type> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="CMS15 has some additional qualifiers"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.employmentImpacted"/> <short value="Period unable to work"/> <definition value="The start and optional end dates of when the patient was precluded from working due to the treatable condition(s)."/> <min value="0"/> <max value="1"/> <type> <code value="Period"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.hospitalization"/> <short value="Period in hospital"/> <definition value="The start and optional end dates of when the patient was confined to a treatment center."/> <min value="0"/> <max value="1"/> <type> <code value="Period"/> </type> <isSummary value="true"/> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="Items"/> </extension> <path value="ExplanationOfBenefit.item"/> <short value="Goods and Services"/> <definition value="First tier of goods and services."/> <min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.item.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references)."/> <min value="0"/> <max value="1"/> <type> <code value="id"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.extension"/> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.modifierExtension"/> <short value="Extensions that cannot be ignored"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <isModifier value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.sequence"/> <short value="Service instance"/> <definition value="A service line number."/> <min value="1"/> <max value="1"/> <type> <code value="positiveInt"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F07"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.type"/> <short value="Group or type of product or service"/> <definition value="The type of product or service."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="required"/> <description value="Service, Product, Rx Dispense, Rx Compound etc."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/v3-ActInvoiceGroupCode"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.item.provider"/> <short value="Responsible practitioner"/> <definition value="The practitioner who is responsible for the services rendered to the patient."/> <min value="0"/> <max value="1"/> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> </type> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="24G&H not sure"/> </mapping> <mapping> <identity value="cdanetv4"/> <map value="not used"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.diagnosisLinkId"/> <short value="Diagnosis Link"/> <definition value="Diagnosis applicable for this service or product line."/> <min value="0"/> <max value="*"/> <type> <code value="positiveInt"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.item.service"/> <short value="Item Code"/> <definition value="If a grouping item then 'GROUP' otherwise it is a node therefore a code to indicate the Professional Service or Product supplied."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Allowable service and product codes"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/service-uscls"/> </valueSetReference> </binding> <mapping> <identity value="cdanetv4"/> <map value="F06"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.serviced[x]"/> <short value="Date or dates of Service"/> <definition value="The date or dates when the enclosed suite of services were performed or completed."/> <min value="0"/> <max value="1"/> <type> <code value="date"/> </type> <type> <code value="Period"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F09"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.place"/> <short value="Place of service"/> <definition value="Where the service was provided."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Place where the service is rendered"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/service-place"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.item.quantity"/> <short value="Count of Products or Services"/> <definition value="The number of repetitions of a service or product."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.item.unitPrice"/> <short value="Fee, charge or cost per point"/> <definition value="If the item is a node then this is the fee for the product or service, otherwise this is the total of the fees for the children of the group."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F12"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.factor"/> <short value="Price scaling factor"/> <definition value="A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount."/> <requirements value="If a fee is present the associated product/service code must be present."/> <min value="0"/> <max value="1"/> <type> <code value="decimal"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F13/F14"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.points"/> <short value="Difficulty scaling factor"/> <definition value="An amount that expresses the weighting (based on difficulty, cost and/or resource intensiveness) associated with the good or service delivered. The concept of Points allows for assignment of point values for services and/or goods, such that a monetary amount can be assigned to each point."/> <requirements value="If a fee is present the associated product/service code must be present."/> <min value="0"/> <max value="1"/> <type> <code value="decimal"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F13/F14"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.net"/> <short value="Total item cost"/> <definition value="The quantity times the unit price for an addittional service or product or charge. For example, the formula: unit Quantity * unit Price (Cost per Point) * factor Number * points = net Amount. Quantity, factor and points are assumed to be 1 if not supplied."/> <requirements value="If a fee is present the associated product/service code must be present."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F13/F14"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.udi"/> <short value="Unique Device Identifier"/> <definition value="List of Unique Device Identifiers associated with this line item."/> <requirements value="The UDI code and issuer if applicable for the supplied product."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="The GUDID (FDA), or other, UDI repository."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/udi"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.item.bodySite"/> <short value="Service Location"/> <definition value="Physical service site on the patient (limb, tooth, etc)."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="The code for the teeth, quadrant, sextant and arch"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/tooth"/> </valueSetReference> </binding> <mapping> <identity value="cdanetv4"/> <map value="F10"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.subSite"/> <short value="Service Sub-location"/> <definition value="A region or surface of the site, eg. limb region or tooth surface(s)."/> <min value="0"/> <max value="*"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="The code for the tooth surface and surface combinations"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/surface"/> </valueSetReference> </binding> <mapping> <identity value="cdanetv4"/> <map value="F11"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.modifier"/> <short value="Service/Product billing modifiers"/> <definition value="Item typification or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen."/> <requirements value="May impact on adjudication."/> <min value="0"/> <max value="*"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/claim-modifiers"/> </valueSetReference> </binding> <mapping> <identity value="cdanetv4"/> <map value="F16 (required field for Oral) and F05"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.noteNumber"/> <short value="List of note numbers which apply"/> <definition value="A list of note references to the notes provided below."/> <min value="0"/> <max value="*"/> <type> <code value="positiveInt"/> </type> <isSummary value="true"/> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="ItemAdjudication"/> </extension> <path value="ExplanationOfBenefit.item.adjudication"/> <short value="Adjudication details"/> <definition value="The adjudications results."/> <min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.item.adjudication.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references)."/> <min value="0"/> <max value="1"/> <type> <code value="id"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.adjudication.extension"/> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.adjudication.modifierExtension"/> <short value="Extensions that cannot be ignored"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <isModifier value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.adjudication.category"/> <short value="Adjudication category such as co-pay, eligible, benefit, etc."/> <definition value="Code indicating: Co-Pay, deductable, elegible, benefit, tax, etc."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="extensible"/> <description value="The adjudication codes."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/adjudication"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.item.adjudication.reason"/> <short value="Adjudication reason"/> <definition value="Adjudication reason such as limit reached."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="extensible"/> <description value="Adjudication reason codes."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/adjudication-reason"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.item.adjudication.amount"/> <short value="Monetary amount"/> <definition value="Monitory amount associated with the code."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.item.adjudication.value"/> <short value="Non-monitory value"/> <definition value="A non-monetary value for example a percentage. Mutually exclusive to the amount element above."/> <min value="0"/> <max value="1"/> <type> <code value="decimal"/> </type> <isSummary value="true"/> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="Detail"/> </extension> <path value="ExplanationOfBenefit.item.detail"/> <short value="Additional items"/> <definition value="Second tier of goods and services."/> <min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.item.detail.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references)."/> <min value="0"/> <max value="1"/> <type> <code value="id"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.extension"/> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.modifierExtension"/> <short value="Extensions that cannot be ignored"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <isModifier value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.sequence"/> <short value="Service instance"/> <definition value="A service line number."/> <min value="1"/> <max value="1"/> <type> <code value="positiveInt"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F07"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.type"/> <short value="Group or type of product or service"/> <definition value="The type of product or service."/> <comments value="ItemType."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="required"/> <description value="Service, Product, Rx Dispense, Rx Compound etc."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/v3-ActInvoiceGroupCode"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.item.detail.service"/> <short value="Additional item codes"/> <definition value="If a grouping item then 'GROUP' otherwise it is a node therefore a code to indicate the Professional Service or Product supplied."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Allowable service and product codes"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/service-uscls"/> </valueSetReference> </binding> <mapping> <identity value="cdanetv4"/> <map value="F34/F35"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.quantity"/> <short value="Count of Products or Services"/> <definition value="The number of repetitions of a service or product."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.item.detail.unitPrice"/> <short value="Fee, charge or cost per point"/> <definition value="If the item is a node then this is the fee for the product or service, otherwise this is the total of the fees for the children of the group."/> <requirements value="If a fee is present the associated product/service code must be present."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F13/F14"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.factor"/> <short value="Price scaling factor"/> <definition value="A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount."/> <requirements value="If a fee is present the associated product/service code must be present."/> <min value="0"/> <max value="1"/> <type> <code value="decimal"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F13/F14"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.points"/> <short value="Difficulty scaling factor"/> <definition value="An amount that expresses the weighting (based on difficulty, cost and/or resource intensiveness) associated with the good or service delivered. The concept of Points allows for assignment of point values for services and/or goods, such that a monetary amount can be assigned to each point."/> <requirements value="If a fee is present the associated product/service code must be present."/> <min value="0"/> <max value="1"/> <type> <code value="decimal"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F13/F14"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.net"/> <short value="Total additional item cost"/> <definition value="The quantity times the unit price for an addittional service or product or charge. For example, the formula: unit Quantity * unit Price (Cost per Point) * factor Number * points = net Amount. Quantity, factor and points are assumed to be 1 if not supplied."/> <requirements value="If a fee is present the associated product/service code must be present."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F13/F14"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.udi"/> <short value="Unique Device Identifier"/> <definition value="List of Unique Device Identifiers associated with this line item."/> <requirements value="The UDI code and issuer if applicable for the supplied product."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="The GUDID (FDA), or other, UDI repository."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/udi"/> </valueSetReference> </binding> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="DetailAdjudication"/> </extension> <path value="ExplanationOfBenefit.item.detail.adjudication"/> <short value="Detail adjudication"/> <definition value="The adjudications results."/> <min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.item.detail.adjudication.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references)."/> <min value="0"/> <max value="1"/> <type> <code value="id"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.adjudication.extension"/> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.adjudication.modifierExtension"/> <short value="Extensions that cannot be ignored"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <isModifier value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.adjudication.code"/> <short value="Adjudication category such as co-pay, eligible, benefit, etc."/> <definition value="Code indicating: Co-Pay, deductable, elegible, benefit, tax, etc."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="extensible"/> <description value="The adjudication codes."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/adjudication"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.item.detail.adjudication.reason"/> <short value="Adjudication reason"/> <definition value="Adjudication reason such as limit reached."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="extensible"/> <description value="Adjudication reason codes."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/adjudication-reason"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.item.detail.adjudication.amount"/> <short value="Monetary amount"/> <definition value="Monitory amount associated with the code."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.item.detail.adjudication.value"/> <short value="Non-monitory value"/> <definition value="A non-monetary value for example a percentage. Mutually exclusive to the amount element above."/> <min value="0"/> <max value="1"/> <type> <code value="decimal"/> </type> <isSummary value="true"/> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="SubDetail"/> </extension> <path value="ExplanationOfBenefit.item.detail.subDetail"/> <short value="Additional items"/> <definition value="Third tier of goods and services."/> <min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.item.detail.subDetail.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references)."/> <min value="0"/> <max value="1"/> <type> <code value="id"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.subDetail.extension"/> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.subDetail.modifierExtension"/> <short value="Extensions that cannot be ignored"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <isModifier value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.subDetail.sequence"/> <short value="Service instance"/> <definition value="A service line number."/> <min value="1"/> <max value="1"/> <type> <code value="positiveInt"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F07"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.subDetail.type"/> <short value="Type of product or service"/> <definition value="The type of product or service."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="required"/> <description value="Service, Product, Rx Dispense, Rx Compound etc."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/v3-ActInvoiceGroupCode"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.item.detail.subDetail.service"/> <short value="Additional item codes"/> <definition value="The fee for an addittional service or product or charge."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Allowable service and product codes"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/service-uscls"/> </valueSetReference> </binding> <mapping> <identity value="cdanetv4"/> <map value="F34/F35"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.subDetail.quantity"/> <short value="Count of Products or Services"/> <definition value="The number of repetitions of a service or product."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.item.detail.subDetail.unitPrice"/> <short value="Fee, charge or cost per point"/> <definition value="The fee for an addittional service or product or charge."/> <requirements value="If a fee is present the associated product/service code must be present."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F13/F14"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.subDetail.factor"/> <short value="Price scaling factor"/> <definition value="A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount."/> <requirements value="If a fee is present the associated product/service code must be present."/> <min value="0"/> <max value="1"/> <type> <code value="decimal"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F13/F14"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.subDetail.points"/> <short value="Difficulty scaling factor"/> <definition value="An amount that expresses the weighting (based on difficulty, cost and/or resource intensiveness) associated with the good or service delivered. The concept of Points allows for assignment of point values for services and/or goods, such that a monetary amount can be assigned to each point."/> <requirements value="If a fee is present the associated product/service code must be present."/> <min value="0"/> <max value="1"/> <type> <code value="decimal"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F13/F14"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.subDetail.net"/> <short value="Net additional item cost"/> <definition value="The quantity times the unit price for an addittional service or product or charge. For example, the formula: unit Quantity * unit Price (Cost per Point) * factor Number * points = net Amount. Quantity, factor and points are assumed to be 1 if not supplied."/> <requirements value="If a fee is present the associated product/service code must be present."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F13/F14"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.subDetail.udi"/> <short value="Unique Device Identifier"/> <definition value="List of Unique Device Identifiers associated with this line item."/> <requirements value="The UDI code and issuer if applicable for the supplied product."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="The GUDID (FDA), or other, UDI repository."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/udi"/> </valueSetReference> </binding> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="SubDetailAdjudication"/> </extension> <path value="ExplanationOfBenefit.item.detail.subDetail.adjudication"/> <short value="SubDetail adjudication"/> <definition value="The adjudications results."/> <min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.item.detail.subDetail.adjudication.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references)."/> <min value="0"/> <max value="1"/> <type> <code value="id"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.subDetail.adjudication.extension"/> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.subDetail.adjudication.modifierExtension"/> <short value="Extensions that cannot be ignored"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <isModifier value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.subDetail.adjudication.code"/> <short value="Adjudication category such as co-pay, eligible, benefit, etc."/> <definition value="Code indicating: Co-Pay, deductable, elegible, benefit, tax, etc."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="extensible"/> <description value="The adjudication codes."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/adjudication"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.item.detail.subDetail.adjudication.reason"/> <short value="Adjudication reason"/> <definition value="Adjudication reason such as limit reached."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="extensible"/> <description value="Adjudication reason codes."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/adjudication-reason"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.item.detail.subDetail.adjudication.amount"/> <short value="Monetary amount"/> <definition value="Monitory amount associated with the code."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.item.detail.subDetail.adjudication.value"/> <short value="Non-monitory value"/> <definition value="A non-monetary value for example a percentage. Mutually exclusive to the amount element above."/> <min value="0"/> <max value="1"/> <type> <code value="decimal"/> </type> <isSummary value="true"/> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="Prosthesis"/> </extension> <path value="ExplanationOfBenefit.item.prosthesis"/> <short value="Prosthetic details"/> <definition value="The materials and placement date of prior fixed prosthesis."/> <min value="0"/> <max value="1"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.item.prosthesis.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references)."/> <min value="0"/> <max value="1"/> <type> <code value="id"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.prosthesis.extension"/> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.prosthesis.modifierExtension"/> <short value="Extensions that cannot be ignored"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <isModifier value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.prosthesis.initial"/> <short value="Is this the initial service"/> <definition value="Indicates whether this is the initial placement of a fixed prosthesis."/> <requirements value="May impact on adjudication."/> <min value="0"/> <max value="1"/> <type> <code value="boolean"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F15/F18 Only for Denture, Crown, Bridge"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.prosthesis.priorDate"/> <short value="Initial service Date"/> <definition value="Date of the initial placement."/> <requirements value="May impact on adjudication."/> <min value="0"/> <max value="1"/> <type> <code value="date"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F04/F19"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.prosthesis.priorMaterial"/> <short value="Prosthetic Material"/> <definition value="Material of the prior denture or bridge prosthesis. (Oral)."/> <requirements value="May impact on adjudication."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Material of the prior denture or bridge prosthesis. (Oral)"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/oral-prosthodontic-material"/> </valueSetReference> </binding> <mapping> <identity value="cdanetv4"/> <map value="F20/F21"/> </mapping> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="AddedItem"/> </extension> <path value="ExplanationOfBenefit.addItem"/> <short value="Insurer added line items"/> <definition value="The first tier service adjudications for payor added services."/> <min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.addItem.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references)."/> <min value="0"/> <max value="1"/> <type> <code value="id"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.addItem.extension"/> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.addItem.modifierExtension"/> <short value="Extensions that cannot be ignored"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <isModifier value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.addItem.sequenceLinkId"/> <short value="Service instances"/> <definition value="List of input service items which this service line is intended to replace."/> <min value="0"/> <max value="*"/> <type> <code value="positiveInt"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.addItem.service"/> <short value="Group, Service or Product"/> <definition value="A code to indicate the Professional Service or Product supplied."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Allowable service and product codes"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/service-uscls"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.addItem.fee"/> <short value="Professional fee or Product charge"/> <definition value="The fee charged for the professional service or product.."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.addItem.noteNumberLinkId"/> <short value="List of note numbers which apply"/> <definition value="A list of note references to the notes provided below."/> <min value="0"/> <max value="*"/> <type> <code value="positiveInt"/> </type> <isSummary value="true"/> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="AddedItemAdjudication"/> </extension> <path value="ExplanationOfBenefit.addItem.adjudication"/> <short value="Added items adjudication"/> <definition value="The adjudications results."/> <min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.addItem.adjudication.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references)."/> <min value="0"/> <max value="1"/> <type> <code value="id"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.addItem.adjudication.extension"/> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.addItem.adjudication.modifierExtension"/> <short value="Extensions that cannot be ignored"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <isModifier value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.addItem.adjudication.code"/> <short value="Adjudication category such as co-pay, eligible, benefit, etc."/> <definition value="Code indicating: Co-Pay, deductable, elegible, benefit, tax, etc."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="extensible"/> <description value="The adjudication codes."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/adjudication"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.addItem.adjudication.amount"/> <short value="Monetary amount"/> <definition value="Monitory amount associated with the code."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.addItem.adjudication.value"/> <short value="Non-monitory value"/> <definition value="A non-monetary value for example a percentage. Mutually exclusive to the amount element above."/> <min value="0"/> <max value="1"/> <type> <code value="decimal"/> </type> <isSummary value="true"/> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="AddedItemsDetail"/> </extension> <path value="ExplanationOfBenefit.addItem.detail"/> <short value="Added items details"/> <definition value="The second tier service adjudications for payor added services."/> <min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.addItem.detail.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references)."/> <min value="0"/> <max value="1"/> <type> <code value="id"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.addItem.detail.extension"/> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.addItem.detail.modifierExtension"/> <short value="Extensions that cannot be ignored"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <isModifier value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.addItem.detail.service"/> <short value="Service or Product"/> <definition value="A code to indicate the Professional Service or Product supplied."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Allowable service and product codes"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/service-uscls"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.addItem.detail.fee"/> <short value="Professional fee or Product charge"/> <definition value="The fee charged for the professional service or product.."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="AddedItemDetailAdjudication"/> </extension> <path value="ExplanationOfBenefit.addItem.detail.adjudication"/> <short value="Added items detail adjudication"/> <definition value="The adjudications results."/> <min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.addItem.detail.adjudication.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references)."/> <min value="0"/> <max value="1"/> <type> <code value="id"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.addItem.detail.adjudication.extension"/> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.addItem.detail.adjudication.modifierExtension"/> <short value="Extensions that cannot be ignored"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <isModifier value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.addItem.detail.adjudication.code"/> <short value="Adjudication category such as co-pay, eligible, benefit, etc."/> <definition value="Code indicating: Co-Pay, deductable, elegible, benefit, tax, etc."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="extensible"/> <description value="The adjudication codes."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/adjudication"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.addItem.detail.adjudication.amount"/> <short value="Monetary amount"/> <definition value="Monitory amount associated with the code."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.addItem.detail.adjudication.value"/> <short value="Non-monitory value"/> <definition value="A non-monetary value for example a percentage. Mutually exclusive to the amount element above."/> <min value="0"/> <max value="1"/> <type> <code value="decimal"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.claimTotal"/> <short value="Total claim cost"/> <definition value="The total value of the claim."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="MissingTeeth"/> </extension> <path value="ExplanationOfBenefit.missingTeeth"/> <short value="Only if type = oral"/> <definition value="A list of teeth which would be expected but are not found due to having been previously extracted or for other reasons."/> <requirements value="The list of missing teeth may influence the adjudication of services for example with Bridges."/> <min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.missingTeeth.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references)."/> <min value="0"/> <max value="1"/> <type> <code value="id"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.missingTeeth.extension"/> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.missingTeeth.modifierExtension"/> <short value="Extensions that cannot be ignored"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <isModifier value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.missingTeeth.tooth"/> <short value="Tooth Code"/> <definition value="The code identifying which tooth is missing."/> <requirements value="Provides the tooth number of the missing tooth."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="The codes for the teeth, subset of OralSites"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/teeth"/> </valueSetReference> </binding> <mapping> <identity value="cdanetv4"/> <map value="F23"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.missingTeeth.reason"/> <short value="Reason for missing"/> <definition value="Missing reason may be: E-extraction, O-other."/> <requirements value="Provides the reason for the missing tooth."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Reason codes for the missing teeth"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/missing-tooth-reason"/> </valueSetReference> </binding> <mapping> <identity value="cdanetv4"/> <map value="not used"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.missingTeeth.extractionDate"/> <short value="Date of Extraction"/> <definition value="The date of the extraction either known from records or patient reported estimate."/> <requirements value="Some services and adjudications require this information."/> <min value="0"/> <max value="1"/> <type> <code value="date"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F24"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.unallocDeductable"/> <short value="Unallocated deductable"/> <definition value="The amount of deductable applied which was not allocated to any particular service line."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.totalBenefit"/> <short value="Total benefit payable for the Claim"/> <definition value="Total amount of benefit payable (Equal to sum of the Benefit amounts from all detail lines and additions less the Unallocated Deductable)."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.paymentAdjustment"/> <short value="Payment adjustment for non-Claim issues"/> <definition value="Adjustment to the payment of this transaction which is not related to adjudication of this transaction."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.paymentAdjustmentReason"/> <short value="Reason for Payment adjustment"/> <definition value="Reason for the payment adjustment."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="extensible"/> <description value="Payment Adjustment reason codes."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/payment-adjustment-reason"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.paymentDate"/> <short value="Expected data of Payment"/> <definition value="Estimated payment data."/> <min value="0"/> <max value="1"/> <type> <code value="date"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.paymentAmount"/> <short value="Payment amount"/> <definition value="Payable less any payment adjustment."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.paymentRef"/> <short value="Payment identifier"/> <definition value="Payment identifer."/> <min value="0"/> <max value="1"/> <type> <code value="Identifier"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="G01, B.23"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.reserved"/> <short value="Funds reserved status"/> <definition value="Status of funds reservation (For provider, for Patient, None)."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="For whom funds are to be reserved: (Patient, Provider, None)."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/fundsreserve"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.form"/> <short value="Printed Form Identifier"/> <definition value="The form to be used for printing the content."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="required"/> <description value="The forms codes."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/forms"/> </valueSetReference> </binding> <mapping> <identity value="cdanetv4"/> <map value="G42"/> </mapping> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="Notes"/> </extension> <path value="ExplanationOfBenefit.note"/> <short value="Processing notes"/> <definition value="Note text."/> <min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.note.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references)."/> <min value="0"/> <max value="1"/> <type> <code value="id"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.note.extension"/> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.note.modifierExtension"/> <short value="Extensions that cannot be ignored"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <isModifier value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.note.number"/> <short value="Note Number for this note"/> <definition value="An integer associated with each note which may be referred to from each service line item."/> <min value="0"/> <max value="1"/> <type> <code value="positiveInt"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.note.type"/> <short value="display | print | printoper"/> <definition value="The note purpose: Print/Display."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="required"/> <description value="The presentation types of notes."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/note-type"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.note.text"/> <short value="Note explanitory text"/> <definition value="The note text."/> <min value="0"/> <max value="1"/> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="G32"/> </mapping> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="BenefitBalance"/> </extension> <path value="ExplanationOfBenefit.benefitBalance"/> <short value="Balance by Benefit Category"/> <definition value="Balance by Benefit Category."/> <min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.benefitBalance.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references)."/> <min value="0"/> <max value="1"/> <type> <code value="id"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.benefitBalance.extension"/> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.benefitBalance.modifierExtension"/> <short value="Extensions that cannot be ignored"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <isModifier value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.benefitBalance.category"/> <short value="Benefit Category"/> <definition value="Dental, Vision, Medical, Pharmacy, Rehab etc."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Benefit categories such as: oral, medical, vision etc."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/benefit-category"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.benefitBalance.subCategory"/> <short value="Benefit SubCategory"/> <definition value="Dental: basic, major, ortho; Vision exam, glasses, contacts; etc."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Benefit subcategories such as: oral-basic, major, glasses"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/benefit-subcategory"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.benefitBalance.network"/> <short value="In or out of network"/> <definition value="Network designation."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Code to classify in or out of network services"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/benefit-network"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.benefitBalance.unit"/> <short value="Individual or family"/> <definition value="Unit designation: individual or family."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Unit covered/serviced - individual or family"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/benefit-unit"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.benefitBalance.term"/> <short value="Annual or lifetime"/> <definition value="The term or period of the values such as 'maximum lifetime benefit' or 'maximum annual vistis'."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Coverage unit - annual, lifetime"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/benefit-term"/> </valueSetReference> </binding> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="Benefit"/> </extension> <path value="ExplanationOfBenefit.benefitBalance.financial"/> <short value="Benefit Summary"/> <definition value="Benefits Used to date."/> <min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.benefitBalance.financial.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references)."/> <min value="0"/> <max value="1"/> <type> <code value="id"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.benefitBalance.financial.extension"/> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.benefitBalance.financial.modifierExtension"/> <short value="Extensions that cannot be ignored"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/> <comments value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <type> <code value="Extension"/> </type> <isModifier value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.benefitBalance.financial.type"/> <short value="Deductable, visits, benefit amount"/> <definition value="Deductable, visits, benefit amount."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Deductable, visits, co-pay, etc."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/benefit-type"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.benefitBalance.financial.benefit[x]"/> <short value="Benefits allowed"/> <definition value="Benefits allowed."/> <min value="0"/> <max value="1"/> <type> <code value="unsignedInt"/> </type> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.benefitBalance.financial.benefitUsed[x]"/> <short value="Benefits used"/> <definition value="Benefits used."/> <min value="0"/> <max value="1"/> <type> <code value="unsignedInt"/> </type> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> </element> </snapshot> <differential> <element> <path value="ExplanationOfBenefit"/> <short value="Explanation of Benefit resource"/> <definition value="This resource provides: the claim details; adjudication details from the processing of a Claim; and optionally account balance information, for informing the subscriber of the benefits provided."/> <alias value="EOB"/> <min value="0"/> <max value="*"/> <type> <code value="DomainResource"/> </type> <isSummary value="true"/> <mapping> <identity value="w5"/> <map value="financial.other"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.identifier"/> <short value="Business Identifier"/> <definition value="The Response Business Identifier."/> <min value="0"/> <max value="*"/> <type> <code value="Identifier"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.claim"/> <short value="Claim reference"/> <definition value="The business identifier for the instance: invoice number, claim number, pre-determination or pre-authorization number."/> <min value="0"/> <max value="1"/> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/Claim"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="A02|G01"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.claimResponse"/> <short value="Claim response reference"/> <definition value="The business identifier for the instance: invoice number, claim number, pre-determination or pre-authorization number."/> <min value="0"/> <max value="1"/> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/ClaimResponse"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="A02|G01"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.ruleset"/> <short value="Current specification followed"/> <definition value="The version of the specification on which this instance relies."/> <alias value="BusinessVersion"/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="The static and dynamic model to which contents conform, which may be business version or standard/version."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ruleset"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.originalRuleset"/> <short value="Original specification followed"/> <definition value="The version of the specification from which the original instance was created."/> <alias value="OriginalBusinessVersion"/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="The static and dynamic model to which contents conform, which may be business version or standard/version."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/ruleset"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.created"/> <short value="Creation date"/> <definition value="The date when the EOB was created."/> <min value="0"/> <max value="1"/> <type> <code value="dateTime"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.billablePeriod"/> <short value="Period for charge submission"/> <definition value="The billable period for which charges are being submitted."/> <min value="0"/> <max value="1"/> <type> <code value="Period"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.disposition"/> <short value="Disposition Message"/> <definition value="A description of the status of the adjudication."/> <comments value="Do we need a disposition code?"/> <min value="0"/> <max value="1"/> <type> <code value="string"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.provider"/> <short value="Responsible provider for the claim"/> <definition value="The provider which is responsible for the claim."/> <min value="0"/> <max value="1"/> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="B02"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.organization"/> <short value="Responsible organization for the claim"/> <definition value="The provider which is responsible for the claim."/> <min value="0"/> <max value="1"/> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/Organization"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="B02"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.facility"/> <short value="Servicing Facility"/> <definition value="Facility where the services were provided."/> <min value="0"/> <max value="1"/> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/Location"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.relatedClaim"/> <short value="Related Claims"/> <definition value="Other claims which are related to this claim such as prior claim versions or for related services."/> <min value="0"/> <max value="*"/> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/Claim"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.prescription"/> <short value="Prescription"/> <definition value="Prescription to support the dispensing of Pharmacy or Vision products."/> <requirements value="For type=Pharmacy and Vision only."/> <min value="0"/> <max value="1"/> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/MedicationOrder"/> </type> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/VisionPrescription"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.originalPrescription"/> <short value="Original Prescription"/> <definition value="Original prescription which has been superceded by this prescription to support the dispensing of pharmacy services, medications or products."/> <min value="0"/> <max value="1"/> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/MedicationOrder"/> </type> <isSummary value="true"/> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="Payee"/> </extension> <path value="ExplanationOfBenefit.payee"/> <short value="Payee"/> <definition value="The party to be reimbursed for the services."/> <min value="0"/> <max value="1"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F02"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.payee.type"/> <short value="Party to be paid any benefits payable"/> <definition value="Party to be reimbursed: Subscriber, provider, other."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="A code for the party to be reimbursed."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/payeetype"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.payee.provider"/> <short value="Provider who is the payee"/> <definition value="The provider who is to be reimbursed for the claim (the party to whom any benefit is assigned)."/> <min value="0"/> <max value="1"/> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="B03"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.payee.organization"/> <short value="Organization who is the payee"/> <definition value="The organization who is to be reimbursed for the claim (the party to whom any benefit is assigned)."/> <min value="0"/> <max value="1"/> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/Organization"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="B04"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.payee.person"/> <short value="Other person who is the payee"/> <definition value="The person other than the subscriber who is to be reimbursed for the claim (the party to whom any benefit is assigned)."/> <min value="0"/> <max value="1"/> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/Patient"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.referral"/> <short value="Treatment Referral"/> <definition value="The referral resource which lists the date, practitioner, reason and other supporting information."/> <min value="0"/> <max value="1"/> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/ReferralRequest"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="B05"/> </mapping> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="Diagnosis"/> </extension> <path value="ExplanationOfBenefit.diagnosis"/> <short value="Diagnosis"/> <definition value="Ordered list of patient diagnosis for which care is sought."/> <min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.diagnosis.sequence"/> <short value="Sequence of diagnosis"/> <definition value="Sequence of diagnosis which serves to order and provide a link."/> <requirements value="Required to maintain order of the diagnoses."/> <min value="1"/> <max value="1"/> <type> <code value="positiveInt"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.diagnosis.diagnosis"/> <short value="Patient's list of diagnosis"/> <definition value="The diagnosis."/> <requirements value="Required to adjudicate services rendered to condition presented."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="ICD10 Diagnostic codes"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/icd-10"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.specialCondition"/> <short value="List of special Conditions"/> <definition value="List of special conditions relating to the setting, treatment or patient for which care is sought which may influence the adjudication."/> <min value="0"/> <max value="*"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="List of special conditions relating to the setting, treatment or patient for which care is sought which may influence the adjudication."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/fm-conditions"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.patient"/> <short value="The subject of the Products and Services"/> <definition value="Patient Resource."/> <min value="1"/> <max value="1"/> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/Patient"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="C06,C07,C08, C05, C04"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.precedence"/> <short value="Precedence (primary, secondary, etc.)"/> <definition value="Precedence (primary, secondary, etc.)."/> <requirements value="Health care programs and insurers are significant payors of health service costs."/> <min value="0"/> <max value="1"/> <type> <code value="positiveInt"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="Coverage"/> </mapping> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="Coverage"/> </extension> <path value="ExplanationOfBenefit.coverage"/> <short value="Insurance or medical plan"/> <definition value="Financial instrument by which payment information for health care."/> <requirements value="Health care programs and insurers are significant payors of health service costs."/> <min value="1"/> <max value="1"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="Coverage"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.coverage.coverage"/> <short value="Insurance information"/> <definition value="Reference to the program or plan identification, underwriter or payor."/> <requirements value="Need to identify the issuer to target for processing and for coordination of benefit processing."/> <min value="1"/> <max value="1"/> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/Coverage"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.coverage.relationship"/> <short value="Patient relationship to subscriber"/> <definition value="The relationship of the patient to the subscriber."/> <requirements value="To determine relationship between the patient and the subscriber."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="The code for the relationship of the patient to the subscriber."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/relationship"/> </valueSetReference> </binding> <mapping> <identity value="cdanetv4"/> <map value="C03"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.coverage.preAuthRef"/> <short value="Pre-Authorization/Determination Reference"/> <definition value="A list of references from the Insurer to which these services pertain."/> <requirements value="To provide any pre=determination or prior authorization reference."/> <min value="0"/> <max value="*"/> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F03"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.exception"/> <short value="Eligibility exceptions"/> <definition value="Factors which may influence the applicability of coverage."/> <requirements value="To determine extenuating circumstances for coverage."/> <min value="0"/> <max value="*"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Factors which may influence the applicability of coverage."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/claim-exception"/> </valueSetReference> </binding> <mapping> <identity value="cdanetv4"/> <map value="C09"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.school"/> <short value="Name of School"/> <definition value="Name of school for over-aged dependants."/> <requirements value="Often required for over-age dependents."/> <min value="0"/> <max value="1"/> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="C10"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.accidentDate"/> <short value="Accident Date"/> <definition value="Date of an accident which these services are addressing."/> <requirements value="Coverage may be dependant on accidents."/> <min value="0"/> <max value="1"/> <type> <code value="date"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F02"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.accidentType"/> <short value="Accident Type"/> <definition value="Type of accident: work, auto, etc."/> <requirements value="Coverage may be dependant on the type of accident."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="required"/> <description value="Type of accident: work place, auto, etc."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/v3-ActIncidentCode"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.accidentLocation[x]"/> <short value="Accident Place"/> <definition value="Accident Place."/> <min value="0"/> <max value="1"/> <type> <code value="string"/> </type> <type> <code value="Address"/> </type> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/Location"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.interventionException"/> <short value="Intervention and exception code (Pharma)"/> <definition value="A list of intervention and exception codes which may influence the adjudication of the claim."/> <requirements value="Coverage may be modified based on exception information provided."/> <min value="0"/> <max value="*"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Intervention and exception codes (Pharm)"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/intervention"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.onset[x]"/> <short value="Illness, injury or treatable condition date"/> <definition value="The start or start and end dates for the treatable condition."/> <min value="0"/> <max value="1"/> <type> <code value="date"/> </type> <type> <code value="Period"/> </type> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="CMS15 has some additional qualifiers"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.employmentImpacted"/> <short value="Period unable to work"/> <definition value="The start and optional end dates of when the patient was precluded from working due to the treatable condition(s)."/> <min value="0"/> <max value="1"/> <type> <code value="Period"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.hospitalization"/> <short value="Period in hospital"/> <definition value="The start and optional end dates of when the patient was confined to a treatment center."/> <min value="0"/> <max value="1"/> <type> <code value="Period"/> </type> <isSummary value="true"/> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="Items"/> </extension> <path value="ExplanationOfBenefit.item"/> <short value="Goods and Services"/> <definition value="First tier of goods and services."/> <min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.item.sequence"/> <short value="Service instance"/> <definition value="A service line number."/> <min value="1"/> <max value="1"/> <type> <code value="positiveInt"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F07"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.type"/> <short value="Group or type of product or service"/> <definition value="The type of product or service."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="required"/> <description value="Service, Product, Rx Dispense, Rx Compound etc."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/v3-ActInvoiceGroupCode"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.item.provider"/> <short value="Responsible practitioner"/> <definition value="The practitioner who is responsible for the services rendered to the patient."/> <min value="0"/> <max value="1"/> <type> <code value="Reference"/> <profile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> </type> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="24G&H not sure"/> </mapping> <mapping> <identity value="cdanetv4"/> <map value="not used"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.diagnosisLinkId"/> <short value="Diagnosis Link"/> <definition value="Diagnosis applicable for this service or product line."/> <min value="0"/> <max value="*"/> <type> <code value="positiveInt"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.item.service"/> <short value="Item Code"/> <definition value="If a grouping item then 'GROUP' otherwise it is a node therefore a code to indicate the Professional Service or Product supplied."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Allowable service and product codes"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/service-uscls"/> </valueSetReference> </binding> <mapping> <identity value="cdanetv4"/> <map value="F06"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.serviced[x]"/> <short value="Date or dates of Service"/> <definition value="The date or dates when the enclosed suite of services were performed or completed."/> <min value="0"/> <max value="1"/> <type> <code value="date"/> </type> <type> <code value="Period"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F09"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.place"/> <short value="Place of service"/> <definition value="Where the service was provided."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Place where the service is rendered"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/service-place"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.item.quantity"/> <short value="Count of Products or Services"/> <definition value="The number of repetitions of a service or product."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.item.unitPrice"/> <short value="Fee, charge or cost per point"/> <definition value="If the item is a node then this is the fee for the product or service, otherwise this is the total of the fees for the children of the group."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F12"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.factor"/> <short value="Price scaling factor"/> <definition value="A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount."/> <requirements value="If a fee is present the associated product/service code must be present."/> <min value="0"/> <max value="1"/> <type> <code value="decimal"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F13/F14"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.points"/> <short value="Difficulty scaling factor"/> <definition value="An amount that expresses the weighting (based on difficulty, cost and/or resource intensiveness) associated with the good or service delivered. The concept of Points allows for assignment of point values for services and/or goods, such that a monetary amount can be assigned to each point."/> <requirements value="If a fee is present the associated product/service code must be present."/> <min value="0"/> <max value="1"/> <type> <code value="decimal"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F13/F14"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.net"/> <short value="Total item cost"/> <definition value="The quantity times the unit price for an addittional service or product or charge. For example, the formula: unit Quantity * unit Price (Cost per Point) * factor Number * points = net Amount. Quantity, factor and points are assumed to be 1 if not supplied."/> <requirements value="If a fee is present the associated product/service code must be present."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F13/F14"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.udi"/> <short value="Unique Device Identifier"/> <definition value="List of Unique Device Identifiers associated with this line item."/> <requirements value="The UDI code and issuer if applicable for the supplied product."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="The GUDID (FDA), or other, UDI repository."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/udi"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.item.bodySite"/> <short value="Service Location"/> <definition value="Physical service site on the patient (limb, tooth, etc)."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="The code for the teeth, quadrant, sextant and arch"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/tooth"/> </valueSetReference> </binding> <mapping> <identity value="cdanetv4"/> <map value="F10"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.subSite"/> <short value="Service Sub-location"/> <definition value="A region or surface of the site, eg. limb region or tooth surface(s)."/> <min value="0"/> <max value="*"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="The code for the tooth surface and surface combinations"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/surface"/> </valueSetReference> </binding> <mapping> <identity value="cdanetv4"/> <map value="F11"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.modifier"/> <short value="Service/Product billing modifiers"/> <definition value="Item typification or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen."/> <requirements value="May impact on adjudication."/> <min value="0"/> <max value="*"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/claim-modifiers"/> </valueSetReference> </binding> <mapping> <identity value="cdanetv4"/> <map value="F16 (required field for Oral) and F05"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.noteNumber"/> <short value="List of note numbers which apply"/> <definition value="A list of note references to the notes provided below."/> <min value="0"/> <max value="*"/> <type> <code value="positiveInt"/> </type> <isSummary value="true"/> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="ItemAdjudication"/> </extension> <path value="ExplanationOfBenefit.item.adjudication"/> <short value="Adjudication details"/> <definition value="The adjudications results."/> <min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.item.adjudication.category"/> <short value="Adjudication category such as co-pay, eligible, benefit, etc."/> <definition value="Code indicating: Co-Pay, deductable, elegible, benefit, tax, etc."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="extensible"/> <description value="The adjudication codes."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/adjudication"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.item.adjudication.reason"/> <short value="Adjudication reason"/> <definition value="Adjudication reason such as limit reached."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="extensible"/> <description value="Adjudication reason codes."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/adjudication-reason"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.item.adjudication.amount"/> <short value="Monetary amount"/> <definition value="Monitory amount associated with the code."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.item.adjudication.value"/> <short value="Non-monitory value"/> <definition value="A non-monetary value for example a percentage. Mutually exclusive to the amount element above."/> <min value="0"/> <max value="1"/> <type> <code value="decimal"/> </type> <isSummary value="true"/> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="Detail"/> </extension> <path value="ExplanationOfBenefit.item.detail"/> <short value="Additional items"/> <definition value="Second tier of goods and services."/> <min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.item.detail.sequence"/> <short value="Service instance"/> <definition value="A service line number."/> <min value="1"/> <max value="1"/> <type> <code value="positiveInt"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F07"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.type"/> <short value="Group or type of product or service"/> <definition value="The type of product or service."/> <comments value="ItemType."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="required"/> <description value="Service, Product, Rx Dispense, Rx Compound etc."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/v3-ActInvoiceGroupCode"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.item.detail.service"/> <short value="Additional item codes"/> <definition value="If a grouping item then 'GROUP' otherwise it is a node therefore a code to indicate the Professional Service or Product supplied."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Allowable service and product codes"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/service-uscls"/> </valueSetReference> </binding> <mapping> <identity value="cdanetv4"/> <map value="F34/F35"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.quantity"/> <short value="Count of Products or Services"/> <definition value="The number of repetitions of a service or product."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.item.detail.unitPrice"/> <short value="Fee, charge or cost per point"/> <definition value="If the item is a node then this is the fee for the product or service, otherwise this is the total of the fees for the children of the group."/> <requirements value="If a fee is present the associated product/service code must be present."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F13/F14"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.factor"/> <short value="Price scaling factor"/> <definition value="A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount."/> <requirements value="If a fee is present the associated product/service code must be present."/> <min value="0"/> <max value="1"/> <type> <code value="decimal"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F13/F14"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.points"/> <short value="Difficulty scaling factor"/> <definition value="An amount that expresses the weighting (based on difficulty, cost and/or resource intensiveness) associated with the good or service delivered. The concept of Points allows for assignment of point values for services and/or goods, such that a monetary amount can be assigned to each point."/> <requirements value="If a fee is present the associated product/service code must be present."/> <min value="0"/> <max value="1"/> <type> <code value="decimal"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F13/F14"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.net"/> <short value="Total additional item cost"/> <definition value="The quantity times the unit price for an addittional service or product or charge. For example, the formula: unit Quantity * unit Price (Cost per Point) * factor Number * points = net Amount. Quantity, factor and points are assumed to be 1 if not supplied."/> <requirements value="If a fee is present the associated product/service code must be present."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F13/F14"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.udi"/> <short value="Unique Device Identifier"/> <definition value="List of Unique Device Identifiers associated with this line item."/> <requirements value="The UDI code and issuer if applicable for the supplied product."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="The GUDID (FDA), or other, UDI repository."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/udi"/> </valueSetReference> </binding> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="DetailAdjudication"/> </extension> <path value="ExplanationOfBenefit.item.detail.adjudication"/> <short value="Detail adjudication"/> <definition value="The adjudications results."/> <min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.item.detail.adjudication.code"/> <short value="Adjudication category such as co-pay, eligible, benefit, etc."/> <definition value="Code indicating: Co-Pay, deductable, elegible, benefit, tax, etc."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="extensible"/> <description value="The adjudication codes."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/adjudication"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.item.detail.adjudication.reason"/> <short value="Adjudication reason"/> <definition value="Adjudication reason such as limit reached."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="extensible"/> <description value="Adjudication reason codes."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/adjudication-reason"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.item.detail.adjudication.amount"/> <short value="Monetary amount"/> <definition value="Monitory amount associated with the code."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.item.detail.adjudication.value"/> <short value="Non-monitory value"/> <definition value="A non-monetary value for example a percentage. Mutually exclusive to the amount element above."/> <min value="0"/> <max value="1"/> <type> <code value="decimal"/> </type> <isSummary value="true"/> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="SubDetail"/> </extension> <path value="ExplanationOfBenefit.item.detail.subDetail"/> <short value="Additional items"/> <definition value="Third tier of goods and services."/> <min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.item.detail.subDetail.sequence"/> <short value="Service instance"/> <definition value="A service line number."/> <min value="1"/> <max value="1"/> <type> <code value="positiveInt"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F07"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.subDetail.type"/> <short value="Type of product or service"/> <definition value="The type of product or service."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="required"/> <description value="Service, Product, Rx Dispense, Rx Compound etc."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/v3-ActInvoiceGroupCode"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.item.detail.subDetail.service"/> <short value="Additional item codes"/> <definition value="The fee for an addittional service or product or charge."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Allowable service and product codes"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/service-uscls"/> </valueSetReference> </binding> <mapping> <identity value="cdanetv4"/> <map value="F34/F35"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.subDetail.quantity"/> <short value="Count of Products or Services"/> <definition value="The number of repetitions of a service or product."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.item.detail.subDetail.unitPrice"/> <short value="Fee, charge or cost per point"/> <definition value="The fee for an addittional service or product or charge."/> <requirements value="If a fee is present the associated product/service code must be present."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F13/F14"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.subDetail.factor"/> <short value="Price scaling factor"/> <definition value="A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount."/> <requirements value="If a fee is present the associated product/service code must be present."/> <min value="0"/> <max value="1"/> <type> <code value="decimal"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F13/F14"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.subDetail.points"/> <short value="Difficulty scaling factor"/> <definition value="An amount that expresses the weighting (based on difficulty, cost and/or resource intensiveness) associated with the good or service delivered. The concept of Points allows for assignment of point values for services and/or goods, such that a monetary amount can be assigned to each point."/> <requirements value="If a fee is present the associated product/service code must be present."/> <min value="0"/> <max value="1"/> <type> <code value="decimal"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F13/F14"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.subDetail.net"/> <short value="Net additional item cost"/> <definition value="The quantity times the unit price for an addittional service or product or charge. For example, the formula: unit Quantity * unit Price (Cost per Point) * factor Number * points = net Amount. Quantity, factor and points are assumed to be 1 if not supplied."/> <requirements value="If a fee is present the associated product/service code must be present."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F13/F14"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.detail.subDetail.udi"/> <short value="Unique Device Identifier"/> <definition value="List of Unique Device Identifiers associated with this line item."/> <requirements value="The UDI code and issuer if applicable for the supplied product."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="The GUDID (FDA), or other, UDI repository."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/udi"/> </valueSetReference> </binding> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="SubDetailAdjudication"/> </extension> <path value="ExplanationOfBenefit.item.detail.subDetail.adjudication"/> <short value="SubDetail adjudication"/> <definition value="The adjudications results."/> <min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.item.detail.subDetail.adjudication.code"/> <short value="Adjudication category such as co-pay, eligible, benefit, etc."/> <definition value="Code indicating: Co-Pay, deductable, elegible, benefit, tax, etc."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="extensible"/> <description value="The adjudication codes."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/adjudication"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.item.detail.subDetail.adjudication.reason"/> <short value="Adjudication reason"/> <definition value="Adjudication reason such as limit reached."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="extensible"/> <description value="Adjudication reason codes."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/adjudication-reason"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.item.detail.subDetail.adjudication.amount"/> <short value="Monetary amount"/> <definition value="Monitory amount associated with the code."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.item.detail.subDetail.adjudication.value"/> <short value="Non-monitory value"/> <definition value="A non-monetary value for example a percentage. Mutually exclusive to the amount element above."/> <min value="0"/> <max value="1"/> <type> <code value="decimal"/> </type> <isSummary value="true"/> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="Prosthesis"/> </extension> <path value="ExplanationOfBenefit.item.prosthesis"/> <short value="Prosthetic details"/> <definition value="The materials and placement date of prior fixed prosthesis."/> <min value="0"/> <max value="1"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.item.prosthesis.initial"/> <short value="Is this the initial service"/> <definition value="Indicates whether this is the initial placement of a fixed prosthesis."/> <requirements value="May impact on adjudication."/> <min value="0"/> <max value="1"/> <type> <code value="boolean"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F15/F18 Only for Denture, Crown, Bridge"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.prosthesis.priorDate"/> <short value="Initial service Date"/> <definition value="Date of the initial placement."/> <requirements value="May impact on adjudication."/> <min value="0"/> <max value="1"/> <type> <code value="date"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F04/F19"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.item.prosthesis.priorMaterial"/> <short value="Prosthetic Material"/> <definition value="Material of the prior denture or bridge prosthesis. (Oral)."/> <requirements value="May impact on adjudication."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Material of the prior denture or bridge prosthesis. (Oral)"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/oral-prosthodontic-material"/> </valueSetReference> </binding> <mapping> <identity value="cdanetv4"/> <map value="F20/F21"/> </mapping> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="AddedItem"/> </extension> <path value="ExplanationOfBenefit.addItem"/> <short value="Insurer added line items"/> <definition value="The first tier service adjudications for payor added services."/> <min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.addItem.sequenceLinkId"/> <short value="Service instances"/> <definition value="List of input service items which this service line is intended to replace."/> <min value="0"/> <max value="*"/> <type> <code value="positiveInt"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.addItem.service"/> <short value="Group, Service or Product"/> <definition value="A code to indicate the Professional Service or Product supplied."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Allowable service and product codes"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/service-uscls"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.addItem.fee"/> <short value="Professional fee or Product charge"/> <definition value="The fee charged for the professional service or product.."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.addItem.noteNumberLinkId"/> <short value="List of note numbers which apply"/> <definition value="A list of note references to the notes provided below."/> <min value="0"/> <max value="*"/> <type> <code value="positiveInt"/> </type> <isSummary value="true"/> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="AddedItemAdjudication"/> </extension> <path value="ExplanationOfBenefit.addItem.adjudication"/> <short value="Added items adjudication"/> <definition value="The adjudications results."/> <min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.addItem.adjudication.code"/> <short value="Adjudication category such as co-pay, eligible, benefit, etc."/> <definition value="Code indicating: Co-Pay, deductable, elegible, benefit, tax, etc."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="extensible"/> <description value="The adjudication codes."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/adjudication"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.addItem.adjudication.amount"/> <short value="Monetary amount"/> <definition value="Monitory amount associated with the code."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.addItem.adjudication.value"/> <short value="Non-monitory value"/> <definition value="A non-monetary value for example a percentage. Mutually exclusive to the amount element above."/> <min value="0"/> <max value="1"/> <type> <code value="decimal"/> </type> <isSummary value="true"/> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="AddedItemsDetail"/> </extension> <path value="ExplanationOfBenefit.addItem.detail"/> <short value="Added items details"/> <definition value="The second tier service adjudications for payor added services."/> <min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.addItem.detail.service"/> <short value="Service or Product"/> <definition value="A code to indicate the Professional Service or Product supplied."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Allowable service and product codes"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/service-uscls"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.addItem.detail.fee"/> <short value="Professional fee or Product charge"/> <definition value="The fee charged for the professional service or product.."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="AddedItemDetailAdjudication"/> </extension> <path value="ExplanationOfBenefit.addItem.detail.adjudication"/> <short value="Added items detail adjudication"/> <definition value="The adjudications results."/> <min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.addItem.detail.adjudication.code"/> <short value="Adjudication category such as co-pay, eligible, benefit, etc."/> <definition value="Code indicating: Co-Pay, deductable, elegible, benefit, tax, etc."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="extensible"/> <description value="The adjudication codes."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/adjudication"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.addItem.detail.adjudication.amount"/> <short value="Monetary amount"/> <definition value="Monitory amount associated with the code."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.addItem.detail.adjudication.value"/> <short value="Non-monitory value"/> <definition value="A non-monetary value for example a percentage. Mutually exclusive to the amount element above."/> <min value="0"/> <max value="1"/> <type> <code value="decimal"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.claimTotal"/> <short value="Total claim cost"/> <definition value="The total value of the claim."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="MissingTeeth"/> </extension> <path value="ExplanationOfBenefit.missingTeeth"/> <short value="Only if type = oral"/> <definition value="A list of teeth which would be expected but are not found due to having been previously extracted or for other reasons."/> <requirements value="The list of missing teeth may influence the adjudication of services for example with Bridges."/> <min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.missingTeeth.tooth"/> <short value="Tooth Code"/> <definition value="The code identifying which tooth is missing."/> <requirements value="Provides the tooth number of the missing tooth."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="The codes for the teeth, subset of OralSites"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/teeth"/> </valueSetReference> </binding> <mapping> <identity value="cdanetv4"/> <map value="F23"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.missingTeeth.reason"/> <short value="Reason for missing"/> <definition value="Missing reason may be: E-extraction, O-other."/> <requirements value="Provides the reason for the missing tooth."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Reason codes for the missing teeth"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/missing-tooth-reason"/> </valueSetReference> </binding> <mapping> <identity value="cdanetv4"/> <map value="not used"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.missingTeeth.extractionDate"/> <short value="Date of Extraction"/> <definition value="The date of the extraction either known from records or patient reported estimate."/> <requirements value="Some services and adjudications require this information."/> <min value="0"/> <max value="1"/> <type> <code value="date"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="F24"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.unallocDeductable"/> <short value="Unallocated deductable"/> <definition value="The amount of deductable applied which was not allocated to any particular service line."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.totalBenefit"/> <short value="Total benefit payable for the Claim"/> <definition value="Total amount of benefit payable (Equal to sum of the Benefit amounts from all detail lines and additions less the Unallocated Deductable)."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.paymentAdjustment"/> <short value="Payment adjustment for non-Claim issues"/> <definition value="Adjustment to the payment of this transaction which is not related to adjudication of this transaction."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.paymentAdjustmentReason"/> <short value="Reason for Payment adjustment"/> <definition value="Reason for the payment adjustment."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="extensible"/> <description value="Payment Adjustment reason codes."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/payment-adjustment-reason"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.paymentDate"/> <short value="Expected data of Payment"/> <definition value="Estimated payment data."/> <min value="0"/> <max value="1"/> <type> <code value="date"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.paymentAmount"/> <short value="Payment amount"/> <definition value="Payable less any payment adjustment."/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.paymentRef"/> <short value="Payment identifier"/> <definition value="Payment identifer."/> <min value="0"/> <max value="1"/> <type> <code value="Identifier"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="G01, B.23"/> </mapping> </element> <element> <path value="ExplanationOfBenefit.reserved"/> <short value="Funds reserved status"/> <definition value="Status of funds reservation (For provider, for Patient, None)."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="For whom funds are to be reserved: (Patient, Provider, None)."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/fundsreserve"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.form"/> <short value="Printed Form Identifier"/> <definition value="The form to be used for printing the content."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="required"/> <description value="The forms codes."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/forms"/> </valueSetReference> </binding> <mapping> <identity value="cdanetv4"/> <map value="G42"/> </mapping> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="Notes"/> </extension> <path value="ExplanationOfBenefit.note"/> <short value="Processing notes"/> <definition value="Note text."/> <min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.note.number"/> <short value="Note Number for this note"/> <definition value="An integer associated with each note which may be referred to from each service line item."/> <min value="0"/> <max value="1"/> <type> <code value="positiveInt"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.note.type"/> <short value="display | print | printoper"/> <definition value="The note purpose: Print/Display."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="required"/> <description value="The presentation types of notes."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/note-type"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.note.text"/> <short value="Note explanitory text"/> <definition value="The note text."/> <min value="0"/> <max value="1"/> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="cdanetv4"/> <map value="G32"/> </mapping> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="BenefitBalance"/> </extension> <path value="ExplanationOfBenefit.benefitBalance"/> <short value="Balance by Benefit Category"/> <definition value="Balance by Benefit Category."/> <min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.benefitBalance.category"/> <short value="Benefit Category"/> <definition value="Dental, Vision, Medical, Pharmacy, Rehab etc."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Benefit categories such as: oral, medical, vision etc."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/benefit-category"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.benefitBalance.subCategory"/> <short value="Benefit SubCategory"/> <definition value="Dental: basic, major, ortho; Vision exam, glasses, contacts; etc."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Benefit subcategories such as: oral-basic, major, glasses"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/benefit-subcategory"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.benefitBalance.network"/> <short value="In or out of network"/> <definition value="Network designation."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Code to classify in or out of network services"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/benefit-network"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.benefitBalance.unit"/> <short value="Individual or family"/> <definition value="Unit designation: individual or family."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Unit covered/serviced - individual or family"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/benefit-unit"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.benefitBalance.term"/> <short value="Annual or lifetime"/> <definition value="The term or period of the values such as 'maximum lifetime benefit' or 'maximum annual vistis'."/> <min value="0"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Coverage unit - annual, lifetime"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/benefit-term"/> </valueSetReference> </binding> </element> <element> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name"> <valueString value="Benefit"/> </extension> <path value="ExplanationOfBenefit.benefitBalance.financial"/> <short value="Benefit Summary"/> <definition value="Benefits Used to date."/> <min value="0"/> <max value="*"/> <type> <code value="BackboneElement"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.benefitBalance.financial.type"/> <short value="Deductable, visits, benefit amount"/> <definition value="Deductable, visits, benefit amount."/> <min value="1"/> <max value="1"/> <type> <code value="Coding"/> </type> <isSummary value="true"/> <binding> <strength value="example"/> <description value="Deductable, visits, co-pay, etc."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/benefit-type"/> </valueSetReference> </binding> </element> <element> <path value="ExplanationOfBenefit.benefitBalance.financial.benefit[x]"/> <short value="Benefits allowed"/> <definition value="Benefits allowed."/> <min value="0"/> <max value="1"/> <type> <code value="unsignedInt"/> </type> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> </element> <element> <path value="ExplanationOfBenefit.benefitBalance.financial.benefitUsed[x]"/> <short value="Benefits used"/> <definition value="Benefits used."/> <min value="0"/> <max value="1"/> <type> <code value="unsignedInt"/> </type> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/Money"/> </type> <isSummary value="true"/> </element> </differential> </StructureDefinition>
Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.
© HL7.org 2011+. FHIR DSTU2 (v1.2.0-7447) generated on Fri, Dec 11, 2015 17:42+1100.
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