Release 5 Ballot

This page is part of the FHIR Specification (v5.0.0-ballot: R5 Ballot - see ballot notes). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4

Financial Management icon Work GroupMaturity Level: 2 Trial Use Compartments: Patient, Practitioner

Dependency Graph for ClaimResponse FMM level 2

NameCard.TypeDependency Analysis
.. ClaimResponse DomainResource
... identifier 0..*Identifier
... status 1..1code
... type 1..1CodeableConcept
... subType 0..1CodeableConcept
... use 1..1code
... patient 1..1Reference(Patient)
... created 1..1dateTime
... insurer 0..1Reference(Organization)
... requestor 0..1Reference(Practitioner | PractitionerRole | Organization)
... request 0..1Reference(Claim)
... outcome 1..1code
... decision 0..1CodeableConcept
... disposition 0..1string
... preAuthRef 0..1string
... preAuthPeriod 0..1Period
... payeeType 0..1CodeableConcept
... encounter 0..*Reference(Encounter)
... diagnosisRelatedGroup 0..1CodeableConcept
... item 0..*BackboneElement
.... itemSequence 1..1positiveInt
.... noteNumber 0..*positiveInt
.... decision 0..1CodeableConcept
.... adjudication 0..*BackboneElement
..... category 1..1CodeableConcept
..... reason 0..1CodeableConcept
..... amount 0..1Money
..... value 0..1decimal
.... detail 0..*BackboneElement
..... detailSequence 1..1positiveInt
..... noteNumber 0..*positiveInt
..... decision 0..1CodeableConcept
..... adjudication 0..*see adjudication
..... subDetail 0..*BackboneElement
...... subDetailSequence 1..1positiveInt
...... noteNumber 0..*positiveInt
...... decision 0..1CodeableConcept
...... adjudication 0..*see adjudication
... addItem 0..*BackboneElement
.... itemSequence 0..*positiveInt
.... detailSequence 0..*positiveInt
.... subdetailSequence 0..*positiveInt
.... provider 0..*Reference(Practitioner | PractitionerRole | Organization)
.... revenue 0..1CodeableConcept
.... productOrService 0..1CodeableConcept
.... productOrServiceEnd 0..1CodeableConcept
.... modifier 0..*CodeableConcept
.... programCode 0..*CodeableConcept
.... serviced[x] 0..1
..... servicedDatedate
..... servicedPeriodPeriod
.... location[x] 0..1
..... locationCodeableConceptCodeableConcept
..... locationAddressAddress
..... locationReferenceReference(Location
.... quantity 0..1SimpleQuantity
.... unitPrice 0..1Money
.... factor 0..1decimal
.... tax 0..1Money
.... net 0..1Money
.... bodySite 0..*BackboneElement
..... site 1..*CodeableReferenceType Error: (CodeableReference = FMM5-Draft vs. Element = FMM2-Trial Use)
..... subSite 0..*CodeableConcept
.... noteNumber 0..*positiveInt
.... decision 0..1CodeableConcept
.... adjudication 0..*see adjudication
.... detail 0..*BackboneElement
..... revenue 0..1CodeableConcept
..... productOrService 0..1CodeableConcept
..... productOrServiceEnd 0..1CodeableConcept
..... modifier 0..*CodeableConcept
..... quantity 0..1SimpleQuantity
..... unitPrice 0..1Money
..... factor 0..1decimal
..... tax 0..1Money
..... net 0..1Money
..... noteNumber 0..*positiveInt
..... decision 0..1CodeableConcept
..... adjudication 0..*see adjudication
..... subDetail 0..*BackboneElement
...... revenue 0..1CodeableConcept
...... productOrService 0..1CodeableConcept
...... productOrServiceEnd 0..1CodeableConcept
...... modifier 0..*CodeableConcept
...... quantity 0..1SimpleQuantity
...... unitPrice 0..1Money
...... factor 0..1decimal
...... tax 0..1Money
...... net 0..1Money
...... noteNumber 0..*positiveInt
...... decision 0..1CodeableConcept
...... adjudication 0..*see adjudication
... adjudication 0..*see adjudication
... total 0..*BackboneElement
.... category 1..1CodeableConcept
.... amount 1..1Money
... payment 0..1BackboneElement
.... type 1..1CodeableConcept
.... adjustment 0..1Money
.... adjustmentReason 0..1CodeableConcept
.... date 0..1date
.... amount 1..1Money
.... identifier 0..1Identifier
... fundsReserve 0..1CodeableConcept
... formCode 0..1CodeableConcept
... form 0..1Attachment
... processNote 0..*BackboneElement
.... number 0..1positiveInt
.... type 0..1code
.... text 1..1string
.... language 0..1CodeableConcept
... communicationRequest 0..*Reference(CommunicationRequest)
... insurance 0..*BackboneElement
.... sequence 1..1positiveInt
.... focal 1..1boolean
.... coverage 1..1Reference(Coverage)
.... businessArrangement 0..1string
.... claimResponse 0..1Reference(ClaimResponse)
... error 0..*BackboneElement
.... itemSequence 0..1positiveInt
.... detailSequence 0..1positiveInt
.... subDetailSequence 0..1positiveInt
.... code 1..1CodeableConcept