This page is part of the FHIR Specification (v4.3.0: R4B - STU). 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 Work Group | Maturity Level: N/A | Standards Status: Informative | Compartments: Device, Encounter, Patient, Practitioner, RelatedPerson |
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StructureDefinition for explanationofbenefit
@prefix fhir: <http://hl7.org/fhir/> . @prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> . # - resource ------------------------------------------------------------------- [] a fhir:StructureDefinition; fhir:Resource.id [ fhir:value "ExplanationOfBenefit"]; fhir:Resource.meta [ fhir:Meta.lastUpdated [ fhir:value "2022-05-28T12:47:40.239+10:00" ] ]; fhir:DomainResource.text [ fhir:Narrative.status [ fhir:value "generated" ] ]; fhir:DomainResource.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-category" ]; fhir:Extension.value [ fhir:value "Financial.General" ] ], [ fhir:index 1; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status" ]; fhir:Extension.value [ fhir:value "trial-use" ] ], [ fhir:index 2; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm" ]; fhir:Extension.value [ fhir:value "2" ] ], [ fhir:index 3; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-security-category" ]; fhir:Extension.value [ fhir:value "patient" ] ], [ fhir:index 4; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg" ]; fhir:Extension.value [ fhir:value "fm" ] ]; fhir:StructureDefinition.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit"]; fhir:StructureDefinition.version [ fhir:value "4.3.0"]; fhir:StructureDefinition.name [ fhir:value "ExplanationOfBenefit"]; fhir:StructureDefinition.status [ fhir:value "draft"]; fhir:StructureDefinition.experimental [ fhir:value "false"]; fhir:StructureDefinition.date [ fhir:value "2022-05-28T12:47:40+10:00"]; fhir:StructureDefinition.publisher [ fhir:value "Health Level Seven International (Financial Management)"]; fhir:StructureDefinition.contact [ fhir:index 0; fhir:ContactDetail.telecom [ fhir:index 0; fhir:ContactPoint.system [ fhir:value "url" ]; fhir:ContactPoint.value [ fhir:value "http://hl7.org/fhir" ] ] ], [ fhir:index 1; fhir:ContactDetail.telecom [ fhir:index 0; fhir:ContactPoint.system [ fhir:value "url" ]; fhir:ContactPoint.value [ fhir:value "http://www.hl7.org/Special/committees/fm/index.cfm" ] ] ]; fhir:StructureDefinition.description [ fhir: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."]; fhir:StructureDefinition.fhirVersion [ fhir:value "4.3.0"]; fhir:StructureDefinition.mapping [ fhir:index 0; fhir:StructureDefinition.identity [ fhir:value "workflow" ]; fhir:StructureDefinition.uri [ fhir:value "http://hl7.org/fhir/workflow" ]; fhir:StructureDefinition.name [ fhir:value "Workflow Pattern" ] ], [ fhir:index 1; fhir:StructureDefinition.identity [ fhir:value "w5" ]; fhir:StructureDefinition.uri [ fhir:value "http://hl7.org/fhir/fivews" ]; fhir:StructureDefinition.name [ fhir:value "FiveWs Pattern Mapping" ] ], [ fhir:index 2; fhir:StructureDefinition.identity [ fhir:value "v2" ]; fhir:StructureDefinition.uri [ fhir:value "http://hl7.org/v2" ]; fhir:StructureDefinition.name [ fhir:value "HL7 v2 Mapping" ] ], [ fhir:index 3; fhir:StructureDefinition.identity [ fhir:value "rim" ]; fhir:StructureDefinition.uri [ fhir:value "http://hl7.org/v3" ]; fhir:StructureDefinition.name [ fhir:value "RIM Mapping" ] ]; fhir:StructureDefinition.kind [ fhir:value "resource"]; fhir:StructureDefinition.abstract [ fhir:value "false"]; fhir:StructureDefinition.type [ fhir:value "ExplanationOfBenefit"]; fhir:StructureDefinition.baseDefinition [ fhir:value "http://hl7.org/fhir/StructureDefinition/DomainResource"]; fhir:StructureDefinition.derivation [ fhir:value "specialization"]; fhir:StructureDefinition.snapshot [ fhir:StructureDefinition.element [ fhir:index 0; fhir:Element.id [ fhir:value "ExplanationOfBenefit" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit" ]; fhir:ElementDefinition.short [ fhir:value "Explanation of Benefit resource" ]; fhir:ElementDefinition.definition [ fhir: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." ]; fhir:ElementDefinition.alias [ fhir:value "EOB"; fhir:index 0 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "dom-2" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "If the resource is contained in another resource, it SHALL NOT contain nested Resources" ]; fhir:ElementDefinition.expression [ fhir:value "contained.contained.empty()" ]; fhir:ElementDefinition.xpath [ fhir:value "not(parent::f:contained and f:contained)" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/DomainResource" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "dom-3" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource" ]; fhir:ElementDefinition.expression [ fhir:value "contained.where(((id.exists() and ('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url)))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(uri) = '#').exists()).not()).trace('unmatched', id).empty()" ]; fhir:ElementDefinition.xpath [ fhir:value "not(exists(for $contained in f:contained return $contained[not(exists(parent::*/descendant::f:reference/@value=concat('#', $contained/*/f:id/@value)) or exists(descendant::f:reference[@value='#']))]))" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/DomainResource" ] ], [ fhir:index 2; fhir:ElementDefinition.key [ fhir:value "dom-4" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" ]; fhir:ElementDefinition.expression [ fhir:value "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()" ]; fhir:ElementDefinition.xpath [ fhir:value "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/DomainResource" ] ], [ fhir:index 3; fhir:ElementDefinition.key [ fhir:value "dom-5" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "If a resource is contained in another resource, it SHALL NOT have a security label" ]; fhir:ElementDefinition.expression [ fhir:value "contained.meta.security.empty()" ]; fhir:ElementDefinition.xpath [ fhir:value "not(exists(f:contained/*/f:meta/f:security))" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/DomainResource" ] ], [ fhir:index 4; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice" ]; fhir:Extension.value [ fhir:value "true" ] ], [ fhir:index 1; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation" ]; fhir:Extension.value [ fhir:value "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time." ] ]; fhir:ElementDefinition.key [ fhir:value "dom-6" ]; fhir:ElementDefinition.severity [ fhir:value "warning" ]; fhir:ElementDefinition.human [ fhir:value "A resource should have narrative for robust management" ]; fhir:ElementDefinition.expression [ fhir:value "text.`div`.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:text/h:div)" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/DomainResource" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "Entity. Role, or Act" ] ], [ fhir:index 1; fhir:ElementDefinition.identity [ fhir:value "workflow" ]; fhir:ElementDefinition.map [ fhir:value "Event" ] ], [ fhir:index 2; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "financial.other" ] ] ], [ fhir:index 1; fhir:Element.id [ fhir:value "ExplanationOfBenefit.id" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.id" ]; fhir:ElementDefinition.short [ fhir:value "Logical id of this artifact" ]; fhir:ElementDefinition.definition [ fhir:value "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Resource.id" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type" ]; fhir:Extension.value [ fhir:value "id" ] ]; fhir:ElementDefinition.code [ fhir:value "http://hl7.org/fhirpath/System.String" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ] ], [ fhir:index 2; fhir:Element.id [ fhir:value "ExplanationOfBenefit.meta" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.meta" ]; fhir:ElementDefinition.short [ fhir:value "Metadata about the resource" ]; fhir:ElementDefinition.definition [ fhir:value "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Resource.meta" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Meta" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ] ], [ fhir:index 3; fhir:Element.id [ fhir:value "ExplanationOfBenefit.implicitRules" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.implicitRules" ]; fhir:ElementDefinition.short [ fhir:value "A set of rules under which this content was created" ]; fhir:ElementDefinition.definition [ fhir: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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc." ]; fhir:ElementDefinition.comment [ fhir: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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Resource.implicitRules" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "uri" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "true" ]; fhir:ElementDefinition.isModifierReason [ fhir:value "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ] ], [ fhir:index 4; fhir:Element.id [ fhir:value "ExplanationOfBenefit.language" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.language" ]; fhir:ElementDefinition.short [ fhir:value "Language of the resource content" ]; fhir:ElementDefinition.definition [ fhir:value "The base language in which the resource is written." ]; fhir:ElementDefinition.comment [ fhir: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)." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Resource.language" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "code" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet" ]; fhir:Extension.value [ fhir:value "http://hl7.org/fhir/ValueSet/all-languages" ] ], [ fhir:index 1; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "Language" ] ], [ fhir:index 2; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding" ]; fhir:Extension.value [ fhir:value "true" ] ]; fhir:ElementDefinition.strength [ fhir:value "preferred" ]; fhir:ElementDefinition.description [ fhir:value "IETF language tag" ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/languages" ] ] ], [ fhir:index 5; fhir:Element.id [ fhir:value "ExplanationOfBenefit.text" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.text" ]; fhir:ElementDefinition.short [ fhir:value "Text summary of the resource, for human interpretation" ]; fhir:ElementDefinition.definition [ fhir:value "A human-readable narrative that contains a summary of the resource and can 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." ]; fhir:ElementDefinition.comment [ fhir:value "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later." ]; fhir:ElementDefinition.alias [ fhir:value "narrative"; fhir:index 0 ], [ fhir:value "html"; fhir:index 1 ], [ fhir:value "xhtml"; fhir:index 2 ], [ fhir:value "display"; fhir:index 3 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "DomainResource.text" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Narrative" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "Act.text?" ] ] ], [ fhir:index 6; fhir:Element.id [ fhir:value "ExplanationOfBenefit.contained" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.contained" ]; fhir:ElementDefinition.short [ fhir:value "Contained, inline Resources" ]; fhir:ElementDefinition.definition [ fhir: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." ]; fhir:ElementDefinition.comment [ fhir: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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels." ]; fhir:ElementDefinition.alias [ fhir:value "inline resources"; fhir:index 0 ], [ fhir:value "anonymous resources"; fhir:index 1 ], [ fhir:value "contained resources"; fhir:index 2 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "DomainResource.contained" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Resource" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "dom-r4b" ]; fhir:ElementDefinition.severity [ fhir:value "warning" ]; fhir:ElementDefinition.human [ fhir:value "Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems" ]; fhir:ElementDefinition.expression [ fhir:value "($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic)" ]; fhir:ElementDefinition.xpath [ fhir:value "not(f:Citation|f:Evidence|f:EvidenceReport|f:EvidenceVariable|f:MedicinalProductDefinition|f:PackagedProductDefinition|f:AdministrableProductDefinition|f:Ingredient|f:ClinicalUseDefinition|f:RegulatedAuthorization|f:SubstanceDefinition|f:SubscriptionStatus|f:SubscriptionTopic) or not(parent::f:Citation|parent::f:Evidence|parent::f:EvidenceReport|parent::f:EvidenceVariable|parent::f:MedicinalProductDefinition|parent::f:PackagedProductDefinition|parent::f:AdministrableProductDefinition|parent::f:Ingredient|parent::f:ClinicalUseDefinition|parent::f:RegulatedAuthorization|parent::f:SubstanceDefinition|f:SubscriptionStatus|f:SubscriptionTopic)" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "N/A" ] ] ], [ fhir:index 7; fhir:Element.id [ fhir:value "ExplanationOfBenefit.extension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.extension" ]; fhir:ElementDefinition.short [ fhir:value "Additional content defined by implementations" ]; fhir:ElementDefinition.definition [ fhir:value "May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "DomainResource.extension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "N/A" ] ] ], [ fhir:index 8; fhir:Element.id [ fhir:value "ExplanationOfBenefit.modifierExtension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.modifierExtension" ]; fhir:ElementDefinition.short [ fhir:value "Extensions that cannot be ignored" ]; fhir:ElementDefinition.definition [ fhir: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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.requirements [ fhir:value "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "DomainResource.modifierExtension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "true" ]; fhir:ElementDefinition.isModifierReason [ fhir:value "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "N/A" ] ] ], [ fhir:index 9; fhir:Element.id [ fhir:value "ExplanationOfBenefit.identifier" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.identifier" ]; fhir:ElementDefinition.short [ fhir:value "Business Identifier for the resource" ]; fhir:ElementDefinition.definition [ fhir:value "A unique identifier assigned to this explanation of benefit." ]; fhir:ElementDefinition.requirements [ fhir:value "Allows EOBs to be distinguished and referenced." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.identifier" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Identifier" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "workflow" ]; fhir:ElementDefinition.map [ fhir:value "Event.identifier" ] ], [ fhir:index 1; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.identifier" ] ] ], [ fhir:index 10; fhir:Element.id [ fhir:value "ExplanationOfBenefit.status" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.status" ]; fhir:ElementDefinition.short [ fhir:value "active | cancelled | draft | entered-in-error" ]; fhir:ElementDefinition.definition [ fhir:value "The status of the resource instance." ]; fhir:ElementDefinition.comment [ fhir:value "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid." ]; fhir:ElementDefinition.requirements [ fhir:value "Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.status" ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "code" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "true" ]; fhir:ElementDefinition.isModifierReason [ fhir:value "This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ExplanationOfBenefitStatus" ] ]; fhir:ElementDefinition.strength [ fhir:value "required" ]; fhir:ElementDefinition.description [ fhir:value "A code specifying the state of the resource instance." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/explanationofbenefit-status|4.3.0" ] ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "workflow" ]; fhir:ElementDefinition.map [ fhir:value "Event.status" ] ], [ fhir:index 1; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.status" ] ] ], [ fhir:index 11; fhir:Element.id [ fhir:value "ExplanationOfBenefit.type" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.type" ]; fhir:ElementDefinition.short [ fhir:value "Category or discipline" ]; fhir:ElementDefinition.definition [ fhir:value "The category of claim, e.g. oral, pharmacy, vision, institutional, professional." ]; fhir:ElementDefinition.comment [ fhir:value "The majority of jurisdictions use: oral, pharmacy, vision, professional and institutional, or variants on those terms, as the general styles of claims. The valueset is extensible to accommodate other jurisdictional requirements." ]; fhir:ElementDefinition.requirements [ fhir:value "Claim type determine the general sets of business rules applied for information requirements and adjudication." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.type" ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ClaimType" ] ]; fhir:ElementDefinition.strength [ fhir:value "extensible" ]; fhir:ElementDefinition.description [ fhir:value "The type or discipline-style of the claim." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/claim-type" ] ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "workflow" ]; fhir:ElementDefinition.map [ fhir:value "Event.code" ] ], [ fhir:index 1; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.class" ] ] ], [ fhir:index 12; fhir:Element.id [ fhir:value "ExplanationOfBenefit.subType" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.subType" ]; fhir:ElementDefinition.short [ fhir:value "More granular claim type" ]; fhir:ElementDefinition.definition [ fhir:value "A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service." ]; fhir:ElementDefinition.comment [ fhir:value "This may contain the local bill type codes such as the US UB-04 bill type code." ]; fhir:ElementDefinition.requirements [ fhir:value "Some jurisdictions need a finer grained claim type for routing and adjudication." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.subType" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ClaimSubType" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "A more granular claim typecode." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/claim-subtype" ] ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.class" ] ] ], [ fhir:index 13; fhir:Element.id [ fhir:value "ExplanationOfBenefit.use" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.use" ]; fhir:ElementDefinition.short [ fhir:value "claim | preauthorization | predetermination" ]; fhir:ElementDefinition.definition [ fhir:value "A code to indicate whether the nature of the request is: to request adjudication of products and services previously rendered; or requesting authorization and adjudication for provision in the future; or requesting the non-binding adjudication of the listed products and services which could be provided in the future." ]; fhir:ElementDefinition.requirements [ fhir:value "This element is required to understand the nature of the request for adjudication." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.use" ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "code" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "Use" ] ]; fhir:ElementDefinition.strength [ fhir:value "required" ]; fhir:ElementDefinition.description [ fhir:value "Complete, proposed, exploratory, other." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/claim-use|4.3.0" ] ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.class" ] ] ], [ fhir:index 14; fhir:Element.id [ fhir:value "ExplanationOfBenefit.patient" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.patient" ]; fhir:ElementDefinition.short [ fhir:value "The recipient of the products and services" ]; fhir:ElementDefinition.definition [ fhir:value "The party to whom the professional services and/or products have been supplied or are being considered and for whom actual for forecast reimbursement is sought." ]; fhir:ElementDefinition.requirements [ fhir:value "The patient must be supplied to the insurer so that confirmation of coverage and service history may be considered as part of the authorization and/or adjudiction." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.patient" ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Patient"; fhir:index 0 ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "workflow" ]; fhir:ElementDefinition.map [ fhir:value "Event.subject" ] ], [ fhir:index 1; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.subject[x]" ] ], [ fhir:index 2; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.subject" ] ] ], [ fhir:index 15; fhir:Element.id [ fhir:value "ExplanationOfBenefit.billablePeriod" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.billablePeriod" ]; fhir:ElementDefinition.short [ fhir:value "Relevant time frame for the claim" ]; fhir:ElementDefinition.definition [ fhir:value "The period for which charges are being submitted." ]; fhir:ElementDefinition.comment [ fhir:value "Typically this would be today or in the past for a claim, and today or in the future for preauthorizations and prodeterminations. Typically line item dates of service should fall within the billing period if one is specified." ]; fhir:ElementDefinition.requirements [ fhir:value "A number jurisdictions required the submission of the billing period when submitting claims for example for hospital stays or long-term care." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.billablePeriod" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Period" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.done[x]" ] ] ], [ fhir:index 16; fhir:Element.id [ fhir:value "ExplanationOfBenefit.created" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.created" ]; fhir:ElementDefinition.short [ fhir:value "Response creation date" ]; fhir:ElementDefinition.definition [ fhir:value "The date this resource was created." ]; fhir:ElementDefinition.comment [ fhir:value "This field is independent of the date of creation of the resource as it may reflect the creation date of a source document prior to digitization. Typically for claims all services must be completed as of this date." ]; fhir:ElementDefinition.requirements [ fhir:value "Need to record a timestamp for use by both the recipient and the issuer." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.created" ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "dateTime" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "workflow" ]; fhir:ElementDefinition.map [ fhir:value "Event.occurrence[x]" ] ], [ fhir:index 1; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.recorded" ] ] ], [ fhir:index 17; fhir:Element.id [ fhir:value "ExplanationOfBenefit.enterer" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.enterer" ]; fhir:ElementDefinition.short [ fhir:value "Author of the claim" ]; fhir:ElementDefinition.definition [ fhir:value "Individual who created the claim, predetermination or preauthorization." ]; fhir:ElementDefinition.requirements [ fhir:value "Some jurisdictions require the contact information for personnel completing claims." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.enterer" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Practitioner"; fhir:index 0 ], [ fhir:value "http://hl7.org/fhir/StructureDefinition/PractitionerRole"; fhir:index 1 ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "workflow" ]; fhir:ElementDefinition.map [ fhir:value "Event.performer.agent" ] ], [ fhir:index 1; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.author" ] ] ], [ fhir:index 18; fhir:Element.id [ fhir:value "ExplanationOfBenefit.insurer" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.insurer" ]; fhir:ElementDefinition.short [ fhir:value "Party responsible for reimbursement" ]; fhir:ElementDefinition.definition [ fhir:value "The party responsible for authorization, adjudication and reimbursement." ]; fhir:ElementDefinition.requirements [ fhir:value "To be a valid claim, preauthorization or predetermination there must be a party who is responsible for adjudicating the contents against a policy which provides benefits for the patient." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.insurer" ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Organization"; fhir:index 0 ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "workflow" ]; fhir:ElementDefinition.map [ fhir:value "Event.performer.agent" ] ], [ fhir:index 1; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.author" ] ] ], [ fhir:index 19; fhir:Element.id [ fhir:value "ExplanationOfBenefit.provider" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.provider" ]; fhir:ElementDefinition.short [ fhir:value "Party responsible for the claim" ]; fhir:ElementDefinition.definition [ fhir:value "The provider which is responsible for the claim, predetermination or preauthorization." ]; fhir:ElementDefinition.comment [ fhir:value "Typically this field would be 1..1 where this party is responsible for the claim but not necessarily professionally responsible for the provision of the individual products and services listed below." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.provider" ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Practitioner"; fhir:index 0 ], [ fhir:value "http://hl7.org/fhir/StructureDefinition/PractitionerRole"; fhir:index 1 ], [ fhir:value "http://hl7.org/fhir/StructureDefinition/Organization"; fhir:index 2 ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.source" ] ] ], [ fhir:index 20; fhir:Element.id [ fhir:value "ExplanationOfBenefit.priority" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.priority" ]; fhir:ElementDefinition.short [ fhir:value "Desired processing urgency" ]; fhir:ElementDefinition.definition [ fhir:value "The provider-required urgency of processing the request. Typical values include: stat, routine deferred." ]; fhir:ElementDefinition.comment [ fhir:value "If a claim processor is unable to complete the processing as per the priority then they should generate and error and not process the request." ]; fhir:ElementDefinition.requirements [ fhir:value "The provider may need to indicate their processing requirements so that the processor can indicate if they are unable to comply." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.priority" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ProcessPriority" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "The timeliness with which processing is required: stat, normal, deferred." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/process-priority" ] ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "v2" ]; fhir:ElementDefinition.map [ fhir:value "Request.priority" ] ] ], [ fhir:index 21; fhir:Element.id [ fhir:value "ExplanationOfBenefit.fundsReserveRequested" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.fundsReserveRequested" ]; fhir:ElementDefinition.short [ fhir:value "For whom to reserve funds" ]; fhir:ElementDefinition.definition [ fhir:value "A code to indicate whether and for whom funds are to be reserved for future claims." ]; fhir:ElementDefinition.comment [ fhir:value "This field is only used for preauthorizations." ]; fhir:ElementDefinition.requirements [ fhir:value "In the case of a Pre-Determination/Pre-Authorization the provider may request that funds in the amount of the expected Benefit be reserved ('Patient' or 'Provider') to pay for the Benefits determined on the subsequent claim(s). 'None' explicitly indicates no funds reserving is requested." ]; fhir:ElementDefinition.alias [ fhir:value "Fund pre-allocation"; fhir:index 0 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.fundsReserveRequested" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "FundsReserve" ] ], [ fhir:index 1; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding" ]; fhir:Extension.value [ fhir:value "true" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "For whom funds are to be reserved: (Patient, Provider, None)." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/fundsreserve" ] ] ], [ fhir:index 22; fhir:Element.id [ fhir:value "ExplanationOfBenefit.fundsReserve" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.fundsReserve" ]; fhir:ElementDefinition.short [ fhir:value "Funds reserved status" ]; fhir:ElementDefinition.definition [ fhir:value "A code, used only on a response to a preauthorization, to indicate whether the benefits payable have been reserved and for whom." ]; fhir:ElementDefinition.comment [ fhir:value "Fund would be release by a future claim quoting the preAuthRef of this response. Examples of values include: provider, patient, none." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to advise the submitting provider on whether the rquest for reservation of funds has been honored." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.fundsReserve" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "FundsReserve" ] ], [ fhir:index 1; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding" ]; fhir:Extension.value [ fhir:value "true" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "For whom funds are to be reserved: (Patient, Provider, None)." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/fundsreserve" ] ] ], [ fhir:index 23; fhir:Element.id [ fhir:value "ExplanationOfBenefit.related" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "RelatedClaim" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.related" ]; fhir:ElementDefinition.short [ fhir:value "Prior or corollary claims" ]; fhir:ElementDefinition.definition [ fhir:value "Other claims which are related to this claim such as prior submissions or claims for related services or for the same event." ]; fhir:ElementDefinition.comment [ fhir:value "For example, for the original treatment and follow-up exams." ]; fhir:ElementDefinition.requirements [ fhir:value "For workplace or other accidents it is common to relate separate claims arising from the same event." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.related" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children unless an empty Parameters resource" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count()) or $this is Parameters" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div|self::f:Parameters" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 24; fhir:Element.id [ fhir:value "ExplanationOfBenefit.related.id" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.related.id" ]; fhir:ElementDefinition.representation [ fhir:value "xmlAttr"; fhir:index 0 ]; fhir:ElementDefinition.short [ fhir:value "Unique id for inter-element referencing" ]; fhir:ElementDefinition.definition [ fhir:value "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.id" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type" ]; fhir:Extension.value [ fhir:value "string" ] ]; fhir:ElementDefinition.code [ fhir:value "http://hl7.org/fhirpath/System.String" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 25; fhir:Element.id [ fhir:value "ExplanationOfBenefit.related.extension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.related.extension" ]; fhir:ElementDefinition.short [ fhir:value "Additional content defined by implementations" ]; fhir:ElementDefinition.definition [ fhir:value "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.extension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 26; fhir:Element.id [ fhir:value "ExplanationOfBenefit.related.modifierExtension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.related.modifierExtension" ]; fhir:ElementDefinition.short [ fhir:value "Extensions that cannot be ignored even if unrecognized" ]; fhir:ElementDefinition.definition [ fhir: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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.requirements [ fhir:value "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ], [ fhir:value "modifiers"; fhir:index 2 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "BackboneElement.modifierExtension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "true" ]; fhir:ElementDefinition.isModifierReason [ fhir:value "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "N/A" ] ] ], [ fhir:index 27; fhir:Element.id [ fhir:value "ExplanationOfBenefit.related.claim" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.related.claim" ]; fhir:ElementDefinition.short [ fhir:value "Reference to the related claim" ]; fhir:ElementDefinition.definition [ fhir:value "Reference to a related claim." ]; fhir:ElementDefinition.requirements [ fhir:value "For workplace or other accidents it is common to relate separate claims arising from the same event." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.related.claim" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Claim"; fhir:index 0 ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 28; fhir:Element.id [ fhir:value "ExplanationOfBenefit.related.relationship" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.related.relationship" ]; fhir:ElementDefinition.short [ fhir:value "How the reference claim is related" ]; fhir:ElementDefinition.definition [ fhir:value "A code to convey how the claims are related." ]; fhir:ElementDefinition.comment [ fhir:value "For example, prior claim or umbrella." ]; fhir:ElementDefinition.requirements [ fhir:value "Some insurers need a declaration of the type of relationship." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.related.relationship" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "RelatedClaimRelationship" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Relationship of this claim to a related Claim." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/related-claim-relationship" ] ] ], [ fhir:index 29; fhir:Element.id [ fhir:value "ExplanationOfBenefit.related.reference" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.related.reference" ]; fhir:ElementDefinition.short [ fhir:value "File or case reference" ]; fhir:ElementDefinition.definition [ fhir:value "An alternate organizational reference to the case or file to which this particular claim pertains." ]; fhir:ElementDefinition.comment [ fhir:value "For example, Property/Casualty insurer claim number or Workers Compensation case number." ]; fhir:ElementDefinition.requirements [ fhir:value "In cases where an event-triggered claim is being submitted to an insurer which requires a reference number to be specified on all exchanges." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.related.reference" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Identifier" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 30; fhir:Element.id [ fhir:value "ExplanationOfBenefit.prescription" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.prescription" ]; fhir:ElementDefinition.short [ fhir:value "Prescription authorizing services or products" ]; fhir:ElementDefinition.definition [ fhir:value "Prescription to support the dispensing of pharmacy, device or vision products." ]; fhir:ElementDefinition.requirements [ fhir:value "Required to authorize the dispensing of controlled substances and devices." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.prescription" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/MedicationRequest"; fhir:index 0 ], [ fhir:value "http://hl7.org/fhir/StructureDefinition/VisionPrescription"; fhir:index 1 ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 31; fhir:Element.id [ fhir:value "ExplanationOfBenefit.originalPrescription" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.originalPrescription" ]; fhir:ElementDefinition.short [ fhir:value "Original prescription if superceded by fulfiller" ]; fhir:ElementDefinition.definition [ fhir:value "Original prescription which has been superseded by this prescription to support the dispensing of pharmacy services, medications or products." ]; fhir:ElementDefinition.comment [ fhir:value "For example, a physician may prescribe a medication which the pharmacy determines is contraindicated, or for which the patient has an intolerance, and therefor issues a new prescription for an alternate medication which has the same therapeutic intent. The prescription from the pharmacy becomes the 'prescription' and that from the physician becomes the 'original prescription'." ]; fhir:ElementDefinition.requirements [ fhir:value "Often required when a fulfiller varies what is fulfilled from that authorized on the original prescription." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.originalPrescription" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/MedicationRequest"; fhir:index 0 ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 32; fhir:Element.id [ fhir:value "ExplanationOfBenefit.payee" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "Payee" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payee" ]; fhir:ElementDefinition.short [ fhir:value "Recipient of benefits payable" ]; fhir:ElementDefinition.definition [ fhir:value "The party to be reimbursed for cost of the products and services according to the terms of the policy." ]; fhir:ElementDefinition.comment [ fhir:value "Often providers agree to receive the benefits payable to reduce the near-term costs to the patient. The insurer may decline to pay the provider and may choose to pay the subscriber instead." ]; fhir:ElementDefinition.requirements [ fhir:value "The provider needs to specify who they wish to be reimbursed and the claims processor needs express who they will reimburse." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payee" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children unless an empty Parameters resource" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count()) or $this is Parameters" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div|self::f:Parameters" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 33; fhir:Element.id [ fhir:value "ExplanationOfBenefit.payee.id" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payee.id" ]; fhir:ElementDefinition.representation [ fhir:value "xmlAttr"; fhir:index 0 ]; fhir:ElementDefinition.short [ fhir:value "Unique id for inter-element referencing" ]; fhir:ElementDefinition.definition [ fhir:value "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.id" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type" ]; fhir:Extension.value [ fhir:value "string" ] ]; fhir:ElementDefinition.code [ fhir:value "http://hl7.org/fhirpath/System.String" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 34; fhir:Element.id [ fhir:value "ExplanationOfBenefit.payee.extension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payee.extension" ]; fhir:ElementDefinition.short [ fhir:value "Additional content defined by implementations" ]; fhir:ElementDefinition.definition [ fhir:value "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.extension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 35; fhir:Element.id [ fhir:value "ExplanationOfBenefit.payee.modifierExtension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payee.modifierExtension" ]; fhir:ElementDefinition.short [ fhir:value "Extensions that cannot be ignored even if unrecognized" ]; fhir:ElementDefinition.definition [ fhir: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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.requirements [ fhir:value "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ], [ fhir:value "modifiers"; fhir:index 2 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "BackboneElement.modifierExtension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "true" ]; fhir:ElementDefinition.isModifierReason [ fhir:value "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "N/A" ] ] ], [ fhir:index 36; fhir:Element.id [ fhir:value "ExplanationOfBenefit.payee.type" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payee.type" ]; fhir:ElementDefinition.short [ fhir:value "Category of recipient" ]; fhir:ElementDefinition.definition [ fhir:value "Type of Party to be reimbursed: Subscriber, provider, other." ]; fhir:ElementDefinition.requirements [ fhir:value "Need to know who should receive payment with the most common situations being the Provider (assignment of benefits) or the Subscriber." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payee.type" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "PayeeType" ] ], [ fhir:index 1; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding" ]; fhir:Extension.value [ fhir:value "true" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "A code for the party to be reimbursed." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/payeetype" ] ] ], [ fhir:index 37; fhir:Element.id [ fhir:value "ExplanationOfBenefit.payee.party" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payee.party" ]; fhir:ElementDefinition.short [ fhir:value "Recipient reference" ]; fhir:ElementDefinition.definition [ fhir:value "Reference to the individual or organization to whom any payment will be made." ]; fhir:ElementDefinition.comment [ fhir:value "Not required if the payee is 'subscriber' or 'provider'." ]; fhir:ElementDefinition.requirements [ fhir:value "Need to provide demographics if the payee is not 'subscriber' nor 'provider'." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payee.party" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Practitioner"; fhir:index 0 ], [ fhir:value "http://hl7.org/fhir/StructureDefinition/PractitionerRole"; fhir:index 1 ], [ fhir:value "http://hl7.org/fhir/StructureDefinition/Organization"; fhir:index 2 ], [ fhir:value "http://hl7.org/fhir/StructureDefinition/Patient"; fhir:index 3 ], [ fhir:value "http://hl7.org/fhir/StructureDefinition/RelatedPerson"; fhir:index 4 ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 38; fhir:Element.id [ fhir:value "ExplanationOfBenefit.referral" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.referral" ]; fhir:ElementDefinition.short [ fhir:value "Treatment Referral" ]; fhir:ElementDefinition.definition [ fhir:value "A reference to a referral resource." ]; fhir:ElementDefinition.comment [ fhir:value "The referral resource which lists the date, practitioner, reason and other supporting information." ]; fhir:ElementDefinition.requirements [ fhir:value "Some insurers require proof of referral to pay for services or to pay specialist rates for services." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.referral" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/ServiceRequest"; fhir:index 0 ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.cause" ] ] ], [ fhir:index 39; fhir:Element.id [ fhir:value "ExplanationOfBenefit.facility" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.facility" ]; fhir:ElementDefinition.short [ fhir:value "Servicing Facility" ]; fhir:ElementDefinition.definition [ fhir:value "Facility where the services were provided." ]; fhir:ElementDefinition.requirements [ fhir:value "Insurance adjudication can be dependant on where services were delivered." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.facility" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Location"; fhir:index 0 ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "workflow" ]; fhir:ElementDefinition.map [ fhir:value "Event.performer.location" ] ], [ fhir:index 1; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.where[x]" ] ] ], [ fhir:index 40; fhir:Element.id [ fhir:value "ExplanationOfBenefit.claim" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.claim" ]; fhir:ElementDefinition.short [ fhir:value "Claim reference" ]; fhir:ElementDefinition.definition [ fhir:value "The business identifier for the instance of the adjudication request: claim predetermination or preauthorization." ]; fhir:ElementDefinition.requirements [ fhir:value "To provide a link to the original adjudication request." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.claim" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Claim"; fhir:index 0 ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.why[x]" ] ] ], [ fhir:index 41; fhir:Element.id [ fhir:value "ExplanationOfBenefit.claimResponse" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.claimResponse" ]; fhir:ElementDefinition.short [ fhir:value "Claim response reference" ]; fhir:ElementDefinition.definition [ fhir:value "The business identifier for the instance of the adjudication response: claim, predetermination or preauthorization response." ]; fhir:ElementDefinition.requirements [ fhir:value "To provide a link to the original adjudication response." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.claimResponse" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/ClaimResponse"; fhir:index 0 ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 42; fhir:Element.id [ fhir:value "ExplanationOfBenefit.outcome" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.outcome" ]; fhir:ElementDefinition.short [ fhir:value "queued | complete | error | partial" ]; fhir:ElementDefinition.definition [ fhir:value "The outcome of the claim, predetermination, or preauthorization processing." ]; fhir:ElementDefinition.comment [ fhir:value "The resource may be used to indicate that: the request has been held (queued) for processing; that it has been processed and errors found (error); that no errors were found and that some of the adjudication has been undertaken (partial) or that all of the adjudication has been undertaken (complete)." ]; fhir:ElementDefinition.requirements [ fhir:value "To advise the requestor of an overall processing outcome." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.outcome" ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "code" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "RemittanceOutcome" ] ], [ fhir:index 1; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding" ]; fhir:Extension.value [ fhir:value "true" ] ]; fhir:ElementDefinition.strength [ fhir:value "required" ]; fhir:ElementDefinition.description [ fhir:value "The result of the claim processing." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/remittance-outcome|4.3.0" ] ] ], [ fhir:index 43; fhir:Element.id [ fhir:value "ExplanationOfBenefit.disposition" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.disposition" ]; fhir:ElementDefinition.short [ fhir:value "Disposition Message" ]; fhir:ElementDefinition.definition [ fhir:value "A human readable description of the status of the adjudication." ]; fhir:ElementDefinition.requirements [ fhir:value "Provided for user display." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.disposition" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "string" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 44; fhir:Element.id [ fhir:value "ExplanationOfBenefit.preAuthRef" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.preAuthRef" ]; fhir:ElementDefinition.short [ fhir:value "Preauthorization reference" ]; fhir:ElementDefinition.definition [ fhir:value "Reference from the Insurer which is used in later communications which refers to this adjudication." ]; fhir:ElementDefinition.comment [ fhir:value "This value is only present on preauthorization adjudications." ]; fhir:ElementDefinition.requirements [ fhir:value "On subsequent claims, the insurer may require the provider to quote this value." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.preAuthRef" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "string" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 45; fhir:Element.id [ fhir:value "ExplanationOfBenefit.preAuthRefPeriod" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.preAuthRefPeriod" ]; fhir:ElementDefinition.short [ fhir:value "Preauthorization in-effect period" ]; fhir:ElementDefinition.definition [ fhir:value "The timeframe during which the supplied preauthorization reference may be quoted on claims to obtain the adjudication as provided." ]; fhir:ElementDefinition.comment [ fhir:value "This value is only present on preauthorization adjudications." ]; fhir:ElementDefinition.requirements [ fhir:value "On subsequent claims, the insurer may require the provider to quote this value." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.preAuthRefPeriod" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Period" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 46; fhir:Element.id [ fhir:value "ExplanationOfBenefit.careTeam" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "CareTeam" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.careTeam" ]; fhir:ElementDefinition.short [ fhir:value "Care Team members" ]; fhir:ElementDefinition.definition [ fhir:value "The members of the team who provided the products and services." ]; fhir:ElementDefinition.requirements [ fhir:value "Common to identify the responsible and supporting practitioners." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.careTeam" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children unless an empty Parameters resource" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count()) or $this is Parameters" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div|self::f:Parameters" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 47; fhir:Element.id [ fhir:value "ExplanationOfBenefit.careTeam.id" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.careTeam.id" ]; fhir:ElementDefinition.representation [ fhir:value "xmlAttr"; fhir:index 0 ]; fhir:ElementDefinition.short [ fhir:value "Unique id for inter-element referencing" ]; fhir:ElementDefinition.definition [ fhir:value "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.id" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type" ]; fhir:Extension.value [ fhir:value "string" ] ]; fhir:ElementDefinition.code [ fhir:value "http://hl7.org/fhirpath/System.String" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 48; fhir:Element.id [ fhir:value "ExplanationOfBenefit.careTeam.extension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.careTeam.extension" ]; fhir:ElementDefinition.short [ fhir:value "Additional content defined by implementations" ]; fhir:ElementDefinition.definition [ fhir:value "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.extension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 49; fhir:Element.id [ fhir:value "ExplanationOfBenefit.careTeam.modifierExtension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.careTeam.modifierExtension" ]; fhir:ElementDefinition.short [ fhir:value "Extensions that cannot be ignored even if unrecognized" ]; fhir:ElementDefinition.definition [ fhir: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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.requirements [ fhir:value "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ], [ fhir:value "modifiers"; fhir:index 2 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "BackboneElement.modifierExtension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "true" ]; fhir:ElementDefinition.isModifierReason [ fhir:value "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "N/A" ] ] ], [ fhir:index 50; fhir:Element.id [ fhir:value "ExplanationOfBenefit.careTeam.sequence" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.careTeam.sequence" ]; fhir:ElementDefinition.short [ fhir:value "Order of care team" ]; fhir:ElementDefinition.definition [ fhir:value "A number to uniquely identify care team entries." ]; fhir:ElementDefinition.requirements [ fhir:value "Necessary to maintain the order of the care team and provide a mechanism to link individuals to claim details." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.careTeam.sequence" ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 51; fhir:Element.id [ fhir:value "ExplanationOfBenefit.careTeam.provider" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.careTeam.provider" ]; fhir:ElementDefinition.short [ fhir:value "Practitioner or organization" ]; fhir:ElementDefinition.definition [ fhir:value "Member of the team who provided the product or service." ]; fhir:ElementDefinition.requirements [ fhir:value "Often a regulatory requirement to specify the responsible provider." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.careTeam.provider" ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Practitioner"; fhir:index 0 ], [ fhir:value "http://hl7.org/fhir/StructureDefinition/PractitionerRole"; fhir:index 1 ], [ fhir:value "http://hl7.org/fhir/StructureDefinition/Organization"; fhir:index 2 ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.actor" ] ] ], [ fhir:index 52; fhir:Element.id [ fhir:value "ExplanationOfBenefit.careTeam.responsible" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.careTeam.responsible" ]; fhir:ElementDefinition.short [ fhir:value "Indicator of the lead practitioner" ]; fhir:ElementDefinition.definition [ fhir:value "The party who is billing and/or responsible for the claimed products or services." ]; fhir:ElementDefinition.comment [ fhir:value "Responsible might not be required when there is only a single provider listed." ]; fhir:ElementDefinition.requirements [ fhir:value "When multiple parties are present it is required to distinguish the lead or responsible individual." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.careTeam.responsible" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "boolean" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 53; fhir:Element.id [ fhir:value "ExplanationOfBenefit.careTeam.role" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.careTeam.role" ]; fhir:ElementDefinition.short [ fhir:value "Function within the team" ]; fhir:ElementDefinition.definition [ fhir:value "The lead, assisting or supervising practitioner and their discipline if a multidisciplinary team." ]; fhir:ElementDefinition.comment [ fhir:value "Role might not be required when there is only a single provider listed." ]; fhir:ElementDefinition.requirements [ fhir:value "When multiple parties are present it is required to distinguish the roles performed by each member." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.careTeam.role" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "CareTeamRole" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "The role codes for the care team members." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/claim-careteamrole" ] ] ], [ fhir:index 54; fhir:Element.id [ fhir:value "ExplanationOfBenefit.careTeam.qualification" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.careTeam.qualification" ]; fhir:ElementDefinition.short [ fhir:value "Practitioner credential or specialization" ]; fhir:ElementDefinition.definition [ fhir:value "The qualification of the practitioner which is applicable for this service." ]; fhir:ElementDefinition.requirements [ fhir:value "Need to specify which qualification a provider is delivering the product or service under." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.careTeam.qualification" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ProviderQualification" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Provider professional qualifications." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/provider-qualification" ] ] ], [ fhir:index 55; fhir:Element.id [ fhir:value "ExplanationOfBenefit.supportingInfo" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "SupportingInformation" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.supportingInfo" ]; fhir:ElementDefinition.short [ fhir:value "Supporting information" ]; fhir:ElementDefinition.definition [ fhir:value "Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues." ]; fhir:ElementDefinition.comment [ fhir:value "Often there are multiple jurisdiction specific valuesets which are required." ]; fhir:ElementDefinition.requirements [ fhir:value "Typically these information codes are required to support the services rendered or the adjudication of the services rendered." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.supportingInfo" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children unless an empty Parameters resource" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count()) or $this is Parameters" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div|self::f:Parameters" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 56; fhir:Element.id [ fhir:value "ExplanationOfBenefit.supportingInfo.id" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.supportingInfo.id" ]; fhir:ElementDefinition.representation [ fhir:value "xmlAttr"; fhir:index 0 ]; fhir:ElementDefinition.short [ fhir:value "Unique id for inter-element referencing" ]; fhir:ElementDefinition.definition [ fhir:value "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.id" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type" ]; fhir:Extension.value [ fhir:value "string" ] ]; fhir:ElementDefinition.code [ fhir:value "http://hl7.org/fhirpath/System.String" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 57; fhir:Element.id [ fhir:value "ExplanationOfBenefit.supportingInfo.extension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.supportingInfo.extension" ]; fhir:ElementDefinition.short [ fhir:value "Additional content defined by implementations" ]; fhir:ElementDefinition.definition [ fhir:value "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.extension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 58; fhir:Element.id [ fhir:value "ExplanationOfBenefit.supportingInfo.modifierExtension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.supportingInfo.modifierExtension" ]; fhir:ElementDefinition.short [ fhir:value "Extensions that cannot be ignored even if unrecognized" ]; fhir:ElementDefinition.definition [ fhir: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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.requirements [ fhir:value "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ], [ fhir:value "modifiers"; fhir:index 2 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "BackboneElement.modifierExtension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "true" ]; fhir:ElementDefinition.isModifierReason [ fhir:value "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "N/A" ] ] ], [ fhir:index 59; fhir:Element.id [ fhir:value "ExplanationOfBenefit.supportingInfo.sequence" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.supportingInfo.sequence" ]; fhir:ElementDefinition.short [ fhir:value "Information instance identifier" ]; fhir:ElementDefinition.definition [ fhir:value "A number to uniquely identify supporting information entries." ]; fhir:ElementDefinition.requirements [ fhir:value "Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.supportingInfo.sequence" ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 60; fhir:Element.id [ fhir:value "ExplanationOfBenefit.supportingInfo.category" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.supportingInfo.category" ]; fhir:ElementDefinition.short [ fhir:value "Classification of the supplied information" ]; fhir:ElementDefinition.definition [ fhir:value "The general class of the information supplied: information; exception; accident, employment; onset, etc." ]; fhir:ElementDefinition.comment [ fhir:value "This may contain a category for the local bill type codes." ]; fhir:ElementDefinition.requirements [ fhir:value "Required to group or associate information items with common characteristics. For example: admission information or prior treatments." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.supportingInfo.category" ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "InformationCategory" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "The valuset used for additional information category codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/claim-informationcategory" ] ] ], [ fhir:index 61; fhir:Element.id [ fhir:value "ExplanationOfBenefit.supportingInfo.code" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.supportingInfo.code" ]; fhir:ElementDefinition.short [ fhir:value "Type of information" ]; fhir:ElementDefinition.definition [ fhir:value "System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient for which care is sought." ]; fhir:ElementDefinition.comment [ fhir:value "This may contain the local bill type codes such as the US UB-04 bill type code." ]; fhir:ElementDefinition.requirements [ fhir:value "Required to identify the kind of additional information." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.supportingInfo.code" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "InformationCode" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "The valuset used for additional information codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/claim-exception" ] ] ], [ fhir:index 62; fhir:Element.id [ fhir:value "ExplanationOfBenefit.supportingInfo.timing[x]" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.supportingInfo.timing[x]" ]; fhir:ElementDefinition.short [ fhir:value "When it occurred" ]; fhir:ElementDefinition.definition [ fhir:value "The date when or period to which this information refers." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.supportingInfo.timing[x]" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "date" ] ], [ fhir:index 1; fhir:ElementDefinition.code [ fhir:value "Period" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 63; fhir:Element.id [ fhir:value "ExplanationOfBenefit.supportingInfo.value[x]" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.supportingInfo.value[x]" ]; fhir:ElementDefinition.short [ fhir:value "Data to be provided" ]; fhir:ElementDefinition.definition [ fhir:value "Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data." ]; fhir:ElementDefinition.comment [ fhir:value "Could be used to provide references to other resources, document. For example, could contain a PDF in an Attachment of the Police Report for an Accident." ]; fhir:ElementDefinition.requirements [ fhir:value "To convey the data content to be provided when the information is more than a simple code or period." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.supportingInfo.value[x]" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "boolean" ] ], [ fhir:index 1; fhir:ElementDefinition.code [ fhir:value "string" ] ], [ fhir:index 2; fhir:ElementDefinition.code [ fhir:value "Quantity" ] ], [ fhir:index 3; fhir:ElementDefinition.code [ fhir:value "Attachment" ] ], [ fhir:index 4; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Resource"; fhir:index 0 ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 64; fhir:Element.id [ fhir:value "ExplanationOfBenefit.supportingInfo.reason" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.supportingInfo.reason" ]; fhir:ElementDefinition.short [ fhir:value "Explanation for the information" ]; fhir:ElementDefinition.definition [ fhir:value "Provides the reason in the situation where a reason code is required in addition to the content." ]; fhir:ElementDefinition.comment [ fhir:value "For example: the reason for the additional stay, or why a tooth is missing." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed when the supporting information has both a date and amount/value and requires explanation." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.supportingInfo.reason" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Coding" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "MissingReason" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Reason codes for the missing teeth." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/missing-tooth-reason" ] ] ], [ fhir:index 65; fhir:Element.id [ fhir:value "ExplanationOfBenefit.diagnosis" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "Diagnosis" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.diagnosis" ]; fhir:ElementDefinition.short [ fhir:value "Pertinent diagnosis information" ]; fhir:ElementDefinition.definition [ fhir:value "Information about diagnoses relevant to the claim items." ]; fhir:ElementDefinition.requirements [ fhir:value "Required for the adjudication by provided context for the services and product listed." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.diagnosis" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children unless an empty Parameters resource" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count()) or $this is Parameters" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div|self::f:Parameters" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 66; fhir:Element.id [ fhir:value "ExplanationOfBenefit.diagnosis.id" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.diagnosis.id" ]; fhir:ElementDefinition.representation [ fhir:value "xmlAttr"; fhir:index 0 ]; fhir:ElementDefinition.short [ fhir:value "Unique id for inter-element referencing" ]; fhir:ElementDefinition.definition [ fhir:value "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.id" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type" ]; fhir:Extension.value [ fhir:value "string" ] ]; fhir:ElementDefinition.code [ fhir:value "http://hl7.org/fhirpath/System.String" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 67; fhir:Element.id [ fhir:value "ExplanationOfBenefit.diagnosis.extension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.diagnosis.extension" ]; fhir:ElementDefinition.short [ fhir:value "Additional content defined by implementations" ]; fhir:ElementDefinition.definition [ fhir:value "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.extension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 68; fhir:Element.id [ fhir:value "ExplanationOfBenefit.diagnosis.modifierExtension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.diagnosis.modifierExtension" ]; fhir:ElementDefinition.short [ fhir:value "Extensions that cannot be ignored even if unrecognized" ]; fhir:ElementDefinition.definition [ fhir: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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.requirements [ fhir:value "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ], [ fhir:value "modifiers"; fhir:index 2 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "BackboneElement.modifierExtension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "true" ]; fhir:ElementDefinition.isModifierReason [ fhir:value "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "N/A" ] ] ], [ fhir:index 69; fhir:Element.id [ fhir:value "ExplanationOfBenefit.diagnosis.sequence" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.diagnosis.sequence" ]; fhir:ElementDefinition.short [ fhir:value "Diagnosis instance identifier" ]; fhir:ElementDefinition.definition [ fhir:value "A number to uniquely identify diagnosis entries." ]; fhir:ElementDefinition.comment [ fhir:value "Diagnosis are presented in list order to their expected importance: primary, secondary, etc." ]; fhir:ElementDefinition.requirements [ fhir:value "Necessary to maintain the order of the diagnosis items and provide a mechanism to link to claim details." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.diagnosis.sequence" ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 70; fhir:Element.id [ fhir:value "ExplanationOfBenefit.diagnosis.diagnosis[x]" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.diagnosis.diagnosis[x]" ]; fhir:ElementDefinition.short [ fhir:value "Nature of illness or problem" ]; fhir:ElementDefinition.definition [ fhir:value "The nature of illness or problem in a coded form or as a reference to an external defined Condition." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides health context for the evaluation of the products and/or services." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.diagnosis.diagnosis[x]" ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ], [ fhir:index 1; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Condition"; fhir:index 0 ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ICD10" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "ICD10 Diagnostic codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/icd-10" ] ] ], [ fhir:index 71; fhir:Element.id [ fhir:value "ExplanationOfBenefit.diagnosis.type" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.diagnosis.type" ]; fhir:ElementDefinition.short [ fhir:value "Timing or nature of the diagnosis" ]; fhir:ElementDefinition.definition [ fhir:value "When the condition was observed or the relative ranking." ]; fhir:ElementDefinition.comment [ fhir:value "For example: admitting, primary, secondary, discharge." ]; fhir:ElementDefinition.requirements [ fhir:value "Often required to capture a particular diagnosis, for example: primary or discharge." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.diagnosis.type" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "DiagnosisType" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "The type of the diagnosis: admitting, principal, discharge." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/ex-diagnosistype" ] ] ], [ fhir:index 72; fhir:Element.id [ fhir:value "ExplanationOfBenefit.diagnosis.onAdmission" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.diagnosis.onAdmission" ]; fhir:ElementDefinition.short [ fhir:value "Present on admission" ]; fhir:ElementDefinition.definition [ fhir:value "Indication of whether the diagnosis was present on admission to a facility." ]; fhir:ElementDefinition.requirements [ fhir:value "Many systems need to understand for adjudication if the diagnosis was present a time of admission." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.diagnosis.onAdmission" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "DiagnosisOnAdmission" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Present on admission." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/ex-diagnosis-on-admission" ] ] ], [ fhir:index 73; fhir:Element.id [ fhir:value "ExplanationOfBenefit.diagnosis.packageCode" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.diagnosis.packageCode" ]; fhir:ElementDefinition.short [ fhir:value "Package billing code" ]; fhir:ElementDefinition.definition [ fhir:value "A package billing code or bundle code used to group products and services to a particular health condition (such as heart attack) which is based on a predetermined grouping code system." ]; fhir:ElementDefinition.comment [ fhir:value "For example, DRG (Diagnosis Related Group) or a bundled billing code. A patient may have a diagnosis of a Myocardio-infarction and a DRG for HeartAttack would assigned. The Claim item (and possible subsequent claims) would refer to the DRG for those line items that were for services related to the heart attack event." ]; fhir:ElementDefinition.requirements [ fhir:value "Required to relate the current diagnosis to a package billing code that is then referenced on the individual claim items which are specific to the health condition covered by the package code." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.diagnosis.packageCode" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "DiagnosisRelatedGroup" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "The DRG codes associated with the diagnosis." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/ex-diagnosisrelatedgroup" ] ] ], [ fhir:index 74; fhir:Element.id [ fhir:value "ExplanationOfBenefit.procedure" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "Procedure" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.procedure" ]; fhir:ElementDefinition.short [ fhir:value "Clinical procedures performed" ]; fhir:ElementDefinition.definition [ fhir:value "Procedures performed on the patient relevant to the billing items with the claim." ]; fhir:ElementDefinition.requirements [ fhir:value "The specific clinical invention are sometimes required to be provided to justify billing a greater than customary amount for a service." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.procedure" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children unless an empty Parameters resource" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count()) or $this is Parameters" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div|self::f:Parameters" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 75; fhir:Element.id [ fhir:value "ExplanationOfBenefit.procedure.id" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.procedure.id" ]; fhir:ElementDefinition.representation [ fhir:value "xmlAttr"; fhir:index 0 ]; fhir:ElementDefinition.short [ fhir:value "Unique id for inter-element referencing" ]; fhir:ElementDefinition.definition [ fhir:value "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.id" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type" ]; fhir:Extension.value [ fhir:value "string" ] ]; fhir:ElementDefinition.code [ fhir:value "http://hl7.org/fhirpath/System.String" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 76; fhir:Element.id [ fhir:value "ExplanationOfBenefit.procedure.extension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.procedure.extension" ]; fhir:ElementDefinition.short [ fhir:value "Additional content defined by implementations" ]; fhir:ElementDefinition.definition [ fhir:value "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.extension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 77; fhir:Element.id [ fhir:value "ExplanationOfBenefit.procedure.modifierExtension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.procedure.modifierExtension" ]; fhir:ElementDefinition.short [ fhir:value "Extensions that cannot be ignored even if unrecognized" ]; fhir:ElementDefinition.definition [ fhir: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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.requirements [ fhir:value "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ], [ fhir:value "modifiers"; fhir:index 2 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "BackboneElement.modifierExtension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "true" ]; fhir:ElementDefinition.isModifierReason [ fhir:value "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "N/A" ] ] ], [ fhir:index 78; fhir:Element.id [ fhir:value "ExplanationOfBenefit.procedure.sequence" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.procedure.sequence" ]; fhir:ElementDefinition.short [ fhir:value "Procedure instance identifier" ]; fhir:ElementDefinition.definition [ fhir:value "A number to uniquely identify procedure entries." ]; fhir:ElementDefinition.requirements [ fhir:value "Necessary to provide a mechanism to link to claim details." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.procedure.sequence" ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 79; fhir:Element.id [ fhir:value "ExplanationOfBenefit.procedure.type" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.procedure.type" ]; fhir:ElementDefinition.short [ fhir:value "Category of Procedure" ]; fhir:ElementDefinition.definition [ fhir:value "When the condition was observed or the relative ranking." ]; fhir:ElementDefinition.requirements [ fhir:value "Often required to capture a particular diagnosis, for example: primary or discharge." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.procedure.type" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ProcedureType" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Example procedure type codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/ex-procedure-type" ] ] ], [ fhir:index 80; fhir:Element.id [ fhir:value "ExplanationOfBenefit.procedure.date" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.procedure.date" ]; fhir:ElementDefinition.short [ fhir:value "When the procedure was performed" ]; fhir:ElementDefinition.definition [ fhir:value "Date and optionally time the procedure was performed." ]; fhir:ElementDefinition.requirements [ fhir:value "Required for auditing purposes." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.procedure.date" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "dateTime" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 81; fhir:Element.id [ fhir:value "ExplanationOfBenefit.procedure.procedure[x]" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.procedure.procedure[x]" ]; fhir:ElementDefinition.short [ fhir:value "Specific clinical procedure" ]; fhir:ElementDefinition.definition [ fhir:value "The code or reference to a Procedure resource which identifies the clinical intervention performed." ]; fhir:ElementDefinition.requirements [ fhir:value "This identifies the actual clinical procedure." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.procedure.procedure[x]" ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ], [ fhir:index 1; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Procedure"; fhir:index 0 ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ICD10_Procedures" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "ICD10 Procedure codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/icd-10-procedures" ] ] ], [ fhir:index 82; fhir:Element.id [ fhir:value "ExplanationOfBenefit.procedure.udi" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.procedure.udi" ]; fhir:ElementDefinition.short [ fhir:value "Unique device identifier" ]; fhir:ElementDefinition.definition [ fhir:value "Unique Device Identifiers associated with this line item." ]; fhir:ElementDefinition.requirements [ fhir:value "The UDI code allows the insurer to obtain device level information on the product supplied." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.procedure.udi" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Device"; fhir:index 0 ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 83; fhir:Element.id [ fhir:value "ExplanationOfBenefit.precedence" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.precedence" ]; fhir:ElementDefinition.short [ fhir:value "Precedence (primary, secondary, etc.)" ]; fhir:ElementDefinition.definition [ fhir:value "This indicates the relative order of a series of EOBs related to different coverages for the same suite of services." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to coordinate between multiple EOBs for the same suite of services." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.precedence" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 84; fhir:Element.id [ fhir:value "ExplanationOfBenefit.insurance" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "Insurance" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.insurance" ]; fhir:ElementDefinition.short [ fhir:value "Patient insurance information" ]; fhir:ElementDefinition.definition [ fhir:value "Financial instruments for reimbursement for the health care products and services specified on the claim." ]; fhir:ElementDefinition.comment [ fhir:value "All insurance coverages for the patient which may be applicable for reimbursement, of the products and services listed in the claim, are typically provided in the claim to allow insurers to confirm the ordering of the insurance coverages relative to local 'coordination of benefit' rules. One coverage (and only one) with 'focal=true' is to be used in the adjudication of this claim. Coverages appearing before the focal Coverage in the list, and where 'Coverage.subrogation=false', should provide a reference to the ClaimResponse containing the adjudication results of the prior claim." ]; fhir:ElementDefinition.requirements [ fhir:value "At least one insurer is required for a claim to be a claim." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.insurance" ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children unless an empty Parameters resource" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count()) or $this is Parameters" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div|self::f:Parameters" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "v2" ]; fhir:ElementDefinition.map [ fhir:value "Coverage" ] ] ], [ fhir:index 85; fhir:Element.id [ fhir:value "ExplanationOfBenefit.insurance.id" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.insurance.id" ]; fhir:ElementDefinition.representation [ fhir:value "xmlAttr"; fhir:index 0 ]; fhir:ElementDefinition.short [ fhir:value "Unique id for inter-element referencing" ]; fhir:ElementDefinition.definition [ fhir:value "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.id" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type" ]; fhir:Extension.value [ fhir:value "string" ] ]; fhir:ElementDefinition.code [ fhir:value "http://hl7.org/fhirpath/System.String" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 86; fhir:Element.id [ fhir:value "ExplanationOfBenefit.insurance.extension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.insurance.extension" ]; fhir:ElementDefinition.short [ fhir:value "Additional content defined by implementations" ]; fhir:ElementDefinition.definition [ fhir:value "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.extension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 87; fhir:Element.id [ fhir:value "ExplanationOfBenefit.insurance.modifierExtension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.insurance.modifierExtension" ]; fhir:ElementDefinition.short [ fhir:value "Extensions that cannot be ignored even if unrecognized" ]; fhir:ElementDefinition.definition [ fhir: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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.requirements [ fhir:value "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ], [ fhir:value "modifiers"; fhir:index 2 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "BackboneElement.modifierExtension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "true" ]; fhir:ElementDefinition.isModifierReason [ fhir:value "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "N/A" ] ] ], [ fhir:index 88; fhir:Element.id [ fhir:value "ExplanationOfBenefit.insurance.focal" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.insurance.focal" ]; fhir:ElementDefinition.short [ fhir:value "Coverage to be used for adjudication" ]; fhir:ElementDefinition.definition [ fhir:value "A flag to indicate that this Coverage is to be used for adjudication of this claim when set to true." ]; fhir:ElementDefinition.comment [ fhir:value "A patient may (will) have multiple insurance policies which provide reimbursement for healthcare services and products. For example, a person may also be covered by their spouse's policy and both appear in the list (and may be from the same insurer). This flag will be set to true for only one of the listed policies and that policy will be used for adjudicating this claim. Other claims would be created to request adjudication against the other listed policies." ]; fhir:ElementDefinition.requirements [ fhir:value "To identify which coverage in the list is being used to adjudicate this claim." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.insurance.focal" ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "boolean" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ] ], [ fhir:index 89; fhir:Element.id [ fhir:value "ExplanationOfBenefit.insurance.coverage" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.insurance.coverage" ]; fhir:ElementDefinition.short [ fhir:value "Insurance information" ]; fhir:ElementDefinition.definition [ fhir:value "Reference to the insurance card level information contained in the Coverage resource. The coverage issuing insurer will use these details to locate the patient's actual coverage within the insurer's information system." ]; fhir:ElementDefinition.requirements [ fhir:value "Required to allow the adjudicator to locate the correct policy and history within their information system." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.insurance.coverage" ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Coverage"; fhir:index 0 ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ] ], [ fhir:index 90; fhir:Element.id [ fhir:value "ExplanationOfBenefit.insurance.preAuthRef" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.insurance.preAuthRef" ]; fhir:ElementDefinition.short [ fhir:value "Prior authorization reference number" ]; fhir:ElementDefinition.definition [ fhir:value "Reference numbers previously provided by the insurer to the provider to be quoted on subsequent claims containing services or products related to the prior authorization." ]; fhir:ElementDefinition.comment [ fhir:value "This value is an alphanumeric string that may be provided over the phone, via text, via paper, or within a ClaimResponse resource and is not a FHIR Identifier." ]; fhir:ElementDefinition.requirements [ fhir:value "Providers must quote previously issued authorization reference numbers in order to obtain adjudication as previously advised on the Preauthorization." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.insurance.preAuthRef" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "string" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 91; fhir:Element.id [ fhir:value "ExplanationOfBenefit.accident" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "Accident" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.accident" ]; fhir:ElementDefinition.short [ fhir:value "Details of the event" ]; fhir:ElementDefinition.definition [ fhir:value "Details of a accident which resulted in injuries which required the products and services listed in the claim." ]; fhir:ElementDefinition.requirements [ fhir:value "When healthcare products and services are accident related, benefits may be payable under accident provisions of policies, such as automotive, etc before they are payable under normal health insurance." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.accident" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children unless an empty Parameters resource" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count()) or $this is Parameters" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div|self::f:Parameters" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 92; fhir:Element.id [ fhir:value "ExplanationOfBenefit.accident.id" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.accident.id" ]; fhir:ElementDefinition.representation [ fhir:value "xmlAttr"; fhir:index 0 ]; fhir:ElementDefinition.short [ fhir:value "Unique id for inter-element referencing" ]; fhir:ElementDefinition.definition [ fhir:value "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.id" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type" ]; fhir:Extension.value [ fhir:value "string" ] ]; fhir:ElementDefinition.code [ fhir:value "http://hl7.org/fhirpath/System.String" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 93; fhir:Element.id [ fhir:value "ExplanationOfBenefit.accident.extension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.accident.extension" ]; fhir:ElementDefinition.short [ fhir:value "Additional content defined by implementations" ]; fhir:ElementDefinition.definition [ fhir:value "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.extension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 94; fhir:Element.id [ fhir:value "ExplanationOfBenefit.accident.modifierExtension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.accident.modifierExtension" ]; fhir:ElementDefinition.short [ fhir:value "Extensions that cannot be ignored even if unrecognized" ]; fhir:ElementDefinition.definition [ fhir: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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.requirements [ fhir:value "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ], [ fhir:value "modifiers"; fhir:index 2 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "BackboneElement.modifierExtension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "true" ]; fhir:ElementDefinition.isModifierReason [ fhir:value "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "N/A" ] ] ], [ fhir:index 95; fhir:Element.id [ fhir:value "ExplanationOfBenefit.accident.date" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.accident.date" ]; fhir:ElementDefinition.short [ fhir:value "When the incident occurred" ]; fhir:ElementDefinition.definition [ fhir:value "Date of an accident event related to the products and services contained in the claim." ]; fhir:ElementDefinition.comment [ fhir:value "The date of the accident has to precede the dates of the products and services but within a reasonable timeframe." ]; fhir:ElementDefinition.requirements [ fhir:value "Required for audit purposes and adjudication." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.accident.date" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "date" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 96; fhir:Element.id [ fhir:value "ExplanationOfBenefit.accident.type" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.accident.type" ]; fhir:ElementDefinition.short [ fhir:value "The nature of the accident" ]; fhir:ElementDefinition.definition [ fhir:value "The type or context of the accident event for the purposes of selection of potential insurance coverages and determination of coordination between insurers." ]; fhir:ElementDefinition.requirements [ fhir:value "Coverage may be dependant on the type of accident." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.accident.type" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "AccidentType" ] ]; fhir:ElementDefinition.strength [ fhir:value "extensible" ]; fhir:ElementDefinition.description [ fhir:value "Type of accident: work place, auto, etc." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://terminology.hl7.org/ValueSet/v3-ActIncidentCode" ] ] ], [ fhir:index 97; fhir:Element.id [ fhir:value "ExplanationOfBenefit.accident.location[x]" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.accident.location[x]" ]; fhir:ElementDefinition.short [ fhir:value "Where the event occurred" ]; fhir:ElementDefinition.definition [ fhir:value "The physical location of the accident event." ]; fhir:ElementDefinition.requirements [ fhir:value "Required for audit purposes and determination of applicable insurance liability." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.accident.location[x]" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Address" ] ], [ fhir:index 1; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Location"; fhir:index 0 ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 98; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "Item" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item" ]; fhir:ElementDefinition.short [ fhir:value "Product or service provided" ]; fhir:ElementDefinition.definition [ fhir:value "A claim line. Either a simple (a product or service) or a 'group' of details which can also be a simple items or groups of sub-details." ]; fhir:ElementDefinition.requirements [ fhir:value "The items to be processed for adjudication." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children unless an empty Parameters resource" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count()) or $this is Parameters" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div|self::f:Parameters" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 99; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.id" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.id" ]; fhir:ElementDefinition.representation [ fhir:value "xmlAttr"; fhir:index 0 ]; fhir:ElementDefinition.short [ fhir:value "Unique id for inter-element referencing" ]; fhir:ElementDefinition.definition [ fhir:value "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.id" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type" ]; fhir:Extension.value [ fhir:value "string" ] ]; fhir:ElementDefinition.code [ fhir:value "http://hl7.org/fhirpath/System.String" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 100; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.extension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.extension" ]; fhir:ElementDefinition.short [ fhir:value "Additional content defined by implementations" ]; fhir:ElementDefinition.definition [ fhir:value "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.extension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 101; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.modifierExtension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.modifierExtension" ]; fhir:ElementDefinition.short [ fhir:value "Extensions that cannot be ignored even if unrecognized" ]; fhir:ElementDefinition.definition [ fhir: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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.requirements [ fhir:value "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ], [ fhir:value "modifiers"; fhir:index 2 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "BackboneElement.modifierExtension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "true" ]; fhir:ElementDefinition.isModifierReason [ fhir:value "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "N/A" ] ] ], [ fhir:index 102; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.sequence" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.sequence" ]; fhir:ElementDefinition.short [ fhir:value "Item instance identifier" ]; fhir:ElementDefinition.definition [ fhir:value "A number to uniquely identify item entries." ]; fhir:ElementDefinition.requirements [ fhir:value "Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.sequence" ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 103; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.careTeamSequence" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.careTeamSequence" ]; fhir:ElementDefinition.short [ fhir:value "Applicable care team members" ]; fhir:ElementDefinition.definition [ fhir:value "Care team members related to this service or product." ]; fhir:ElementDefinition.requirements [ fhir:value "Need to identify the individuals and their roles in the provision of the product or service." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.careTeamSequence" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 104; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.diagnosisSequence" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.diagnosisSequence" ]; fhir:ElementDefinition.short [ fhir:value "Applicable diagnoses" ]; fhir:ElementDefinition.definition [ fhir:value "Diagnoses applicable for this service or product." ]; fhir:ElementDefinition.requirements [ fhir:value "Need to related the product or service to the associated diagnoses." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.diagnosisSequence" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 105; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.procedureSequence" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.procedureSequence" ]; fhir:ElementDefinition.short [ fhir:value "Applicable procedures" ]; fhir:ElementDefinition.definition [ fhir:value "Procedures applicable for this service or product." ]; fhir:ElementDefinition.requirements [ fhir:value "Need to provide any listed specific procedures to support the product or service being claimed." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.procedureSequence" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 106; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.informationSequence" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.informationSequence" ]; fhir:ElementDefinition.short [ fhir:value "Applicable exception and supporting information" ]; fhir:ElementDefinition.definition [ fhir:value "Exceptions, special conditions and supporting information applicable for this service or product." ]; fhir:ElementDefinition.requirements [ fhir:value "Need to reference the supporting information items that relate directly to this product or service." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.informationSequence" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 107; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.revenue" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.revenue" ]; fhir:ElementDefinition.short [ fhir:value "Revenue or cost center code" ]; fhir:ElementDefinition.definition [ fhir:value "The type of revenue or cost center providing the product and/or service." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed in the processing of institutional claims." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.revenue" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "RevenueCenter" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Codes for the revenue or cost centers supplying the service and/or products." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/ex-revenue-center" ] ] ], [ fhir:index 108; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.category" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.category" ]; fhir:ElementDefinition.short [ fhir:value "Benefit classification" ]; fhir:ElementDefinition.definition [ fhir:value "Code to identify the general type of benefits under which products and services are provided." ]; fhir:ElementDefinition.comment [ fhir:value "Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.category" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "BenefitCategory" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Benefit categories such as: oral, medical, vision, oral-basic etc." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/ex-benefitcategory" ] ] ], [ fhir:index 109; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.productOrService" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.productOrService" ]; fhir:ElementDefinition.short [ fhir:value "Billing, service, product, or drug code" ]; fhir:ElementDefinition.definition [ fhir:value "When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item." ]; fhir:ElementDefinition.comment [ fhir:value "If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'." ]; fhir:ElementDefinition.requirements [ fhir:value "Necessary to state what was provided or done." ]; fhir:ElementDefinition.alias [ fhir:value "Drug Code"; fhir:index 0 ], [ fhir:value "Bill Code"; fhir:index 1 ], [ fhir:value "Service Code"; fhir:index 2 ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.productOrService" ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ServiceProduct" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Allowable service and product codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/service-uscls" ] ] ], [ fhir:index 110; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.modifier" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.modifier" ]; fhir:ElementDefinition.short [ fhir:value "Product or service billing modifiers" ]; fhir:ElementDefinition.definition [ fhir:value "Item typification or modifiers codes to convey additional context for the product or service." ]; fhir:ElementDefinition.comment [ fhir:value "For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours." ]; fhir:ElementDefinition.requirements [ fhir:value "To support inclusion of the item for adjudication or to charge an elevated fee." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.modifier" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "Modifiers" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir: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." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/claim-modifiers" ] ] ], [ fhir:index 111; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.programCode" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.programCode" ]; fhir:ElementDefinition.short [ fhir:value "Program the product or service is provided under" ]; fhir:ElementDefinition.definition [ fhir:value "Identifies the program under which this may be recovered." ]; fhir:ElementDefinition.comment [ fhir:value "For example: Neonatal program, child dental program or drug users recovery program." ]; fhir:ElementDefinition.requirements [ fhir:value "Commonly used in in the identification of publicly provided program focused on population segments or disease classifications." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.programCode" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ProgramCode" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Program specific reason codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/ex-program-code" ] ] ], [ fhir:index 112; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.serviced[x]" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.serviced[x]" ]; fhir:ElementDefinition.short [ fhir:value "Date or dates of service or product delivery" ]; fhir:ElementDefinition.definition [ fhir:value "The date or dates when the service or product was supplied, performed or completed." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to determine whether the service or product was provided during the term of the insurance coverage." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.serviced[x]" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "date" ] ], [ fhir:index 1; fhir:ElementDefinition.code [ fhir:value "Period" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.done[x]" ] ] ], [ fhir:index 113; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.location[x]" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.location[x]" ]; fhir:ElementDefinition.short [ fhir:value "Place of service or where product was supplied" ]; fhir:ElementDefinition.definition [ fhir:value "Where the product or service was provided." ]; fhir:ElementDefinition.requirements [ fhir:value "The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.location[x]" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ], [ fhir:index 1; fhir:ElementDefinition.code [ fhir:value "Address" ] ], [ fhir:index 2; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Location"; fhir:index 0 ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ServicePlace" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Place where the service is rendered." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/service-place" ] ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.where[x]" ] ] ], [ fhir:index 114; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.quantity" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.quantity" ]; fhir:ElementDefinition.short [ fhir:value "Count of products or services" ]; fhir:ElementDefinition.definition [ fhir:value "The number of repetitions of a service or product." ]; fhir:ElementDefinition.requirements [ fhir:value "Required when the product or service code does not convey the quantity provided." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.quantity" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Quantity" ]; fhir:ElementDefinition.profile [ fhir:value "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"; fhir:index 0 ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 115; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.unitPrice" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.unitPrice" ]; fhir:ElementDefinition.short [ fhir:value "Fee, charge or cost per item" ]; fhir:ElementDefinition.definition [ fhir:value "If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group." ]; fhir:ElementDefinition.requirements [ fhir:value "The amount charged to the patient by the provider for a single unit." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.unitPrice" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 116; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.factor" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.factor" ]; fhir:ElementDefinition.short [ fhir:value "Price scaling factor" ]; fhir:ElementDefinition.definition [ fhir: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." ]; fhir:ElementDefinition.comment [ fhir:value "To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10)." ]; fhir:ElementDefinition.requirements [ fhir:value "When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.factor" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "decimal" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 117; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.net" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.net" ]; fhir:ElementDefinition.short [ fhir:value "Total item cost" ]; fhir:ElementDefinition.definition [ fhir:value "The quantity times the unit price for an additional service or product or charge." ]; fhir:ElementDefinition.comment [ fhir:value "For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides the total amount claimed for the group (if a grouper) or the line item." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.net" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 118; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.udi" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.udi" ]; fhir:ElementDefinition.short [ fhir:value "Unique device identifier" ]; fhir:ElementDefinition.definition [ fhir:value "Unique Device Identifiers associated with this line item." ]; fhir:ElementDefinition.requirements [ fhir:value "The UDI code allows the insurer to obtain device level information on the product supplied." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.udi" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Device"; fhir:index 0 ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 119; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.bodySite" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.bodySite" ]; fhir:ElementDefinition.short [ fhir:value "Anatomical location" ]; fhir:ElementDefinition.definition [ fhir:value "Physical service site on the patient (limb, tooth, etc.)." ]; fhir:ElementDefinition.comment [ fhir:value "For example: Providing a tooth code, allows an insurer to identify a provider performing a filling on a tooth that was previously removed." ]; fhir:ElementDefinition.requirements [ fhir:value "Allows insurer to validate specific procedures." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.bodySite" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "OralSites" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "The code for the teeth, quadrant, sextant and arch." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/tooth" ] ] ], [ fhir:index 120; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.subSite" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.subSite" ]; fhir:ElementDefinition.short [ fhir:value "Anatomical sub-location" ]; fhir:ElementDefinition.definition [ fhir:value "A region or surface of the bodySite, e.g. limb region or tooth surface(s)." ]; fhir:ElementDefinition.requirements [ fhir:value "Allows insurer to validate specific procedures." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.subSite" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "Surface" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "The code for the tooth surface and surface combinations." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/surface" ] ] ], [ fhir:index 121; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.encounter" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.encounter" ]; fhir:ElementDefinition.short [ fhir:value "Encounters related to this billed item" ]; fhir:ElementDefinition.definition [ fhir:value "A billed item may include goods or services provided in multiple encounters." ]; fhir:ElementDefinition.requirements [ fhir:value "Used in some jurisdictions to link clinical events to claim items." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.encounter" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Encounter"; fhir:index 0 ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 122; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.noteNumber" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.noteNumber" ]; fhir:ElementDefinition.short [ fhir:value "Applicable note numbers" ]; fhir:ElementDefinition.definition [ fhir:value "The numbers associated with notes below which apply to the adjudication of this item." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.noteNumber" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 123; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.adjudication" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "Adjudication" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.adjudication" ]; fhir:ElementDefinition.short [ fhir:value "Adjudication details" ]; fhir:ElementDefinition.definition [ fhir:value "If this item is a group then the values here are a summary of the adjudication of the detail items. If this item is a simple product or service then this is the result of the adjudication of this item." ]; fhir:ElementDefinition.requirements [ fhir:value "The adjudication results conveys the insurer's assessment of the item provided in the claim under the terms of the patient's insurance coverage." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.adjudication" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children unless an empty Parameters resource" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count()) or $this is Parameters" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div|self::f:Parameters" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 124; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.adjudication.id" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.adjudication.id" ]; fhir:ElementDefinition.representation [ fhir:value "xmlAttr"; fhir:index 0 ]; fhir:ElementDefinition.short [ fhir:value "Unique id for inter-element referencing" ]; fhir:ElementDefinition.definition [ fhir:value "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.id" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type" ]; fhir:Extension.value [ fhir:value "string" ] ]; fhir:ElementDefinition.code [ fhir:value "http://hl7.org/fhirpath/System.String" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 125; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.adjudication.extension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.adjudication.extension" ]; fhir:ElementDefinition.short [ fhir:value "Additional content defined by implementations" ]; fhir:ElementDefinition.definition [ fhir:value "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.extension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 126; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.adjudication.modifierExtension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.adjudication.modifierExtension" ]; fhir:ElementDefinition.short [ fhir:value "Extensions that cannot be ignored even if unrecognized" ]; fhir:ElementDefinition.definition [ fhir: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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.requirements [ fhir:value "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ], [ fhir:value "modifiers"; fhir:index 2 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "BackboneElement.modifierExtension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "true" ]; fhir:ElementDefinition.isModifierReason [ fhir:value "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "N/A" ] ] ], [ fhir:index 127; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.adjudication.category" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.adjudication.category" ]; fhir:ElementDefinition.short [ fhir:value "Type of adjudication information" ]; fhir:ElementDefinition.definition [ fhir:value "A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in-aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item." ]; fhir:ElementDefinition.comment [ fhir:value "For example, codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to enable understanding of the context of the other information in the adjudication." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.adjudication.category" ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "Adjudication" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "The adjudication codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/adjudication" ] ] ], [ fhir:index 128; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.adjudication.reason" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.adjudication.reason" ]; fhir:ElementDefinition.short [ fhir:value "Explanation of adjudication outcome" ]; fhir:ElementDefinition.definition [ fhir:value "A code supporting the understanding of the adjudication result and explaining variance from expected amount." ]; fhir:ElementDefinition.comment [ fhir:value "For example, may indicate that the funds for this benefit type have been exhausted." ]; fhir:ElementDefinition.requirements [ fhir:value "To support understanding of variance from adjudication expectations." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.adjudication.reason" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "AdjudicationReason" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Adjudication reason codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/adjudication-reason" ] ] ], [ fhir:index 129; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.adjudication.amount" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.adjudication.amount" ]; fhir:ElementDefinition.short [ fhir:value "Monetary amount" ]; fhir:ElementDefinition.definition [ fhir:value "Monetary amount associated with the category." ]; fhir:ElementDefinition.comment [ fhir:value "For example, amount submitted, eligible amount, co-payment, and benefit payable." ]; fhir:ElementDefinition.requirements [ fhir:value "Most adjuciation categories convey a monetary amount." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.adjudication.amount" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 130; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.adjudication.value" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.adjudication.value" ]; fhir:ElementDefinition.short [ fhir:value "Non-monitary value" ]; fhir:ElementDefinition.definition [ fhir:value "A non-monetary value associated with the category. Mutually exclusive to the amount element above." ]; fhir:ElementDefinition.comment [ fhir:value "For example: eligible percentage or co-payment percentage." ]; fhir:ElementDefinition.requirements [ fhir:value "Some adjudication categories convey a percentage or a fixed value." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.adjudication.value" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "decimal" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 131; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "Detail" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail" ]; fhir:ElementDefinition.short [ fhir:value "Additional items" ]; fhir:ElementDefinition.definition [ fhir:value "Second-tier of goods and services." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children unless an empty Parameters resource" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count()) or $this is Parameters" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div|self::f:Parameters" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 132; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.id" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.id" ]; fhir:ElementDefinition.representation [ fhir:value "xmlAttr"; fhir:index 0 ]; fhir:ElementDefinition.short [ fhir:value "Unique id for inter-element referencing" ]; fhir:ElementDefinition.definition [ fhir:value "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.id" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type" ]; fhir:Extension.value [ fhir:value "string" ] ]; fhir:ElementDefinition.code [ fhir:value "http://hl7.org/fhirpath/System.String" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 133; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.extension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.extension" ]; fhir:ElementDefinition.short [ fhir:value "Additional content defined by implementations" ]; fhir:ElementDefinition.definition [ fhir:value "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.extension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 134; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.modifierExtension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.modifierExtension" ]; fhir:ElementDefinition.short [ fhir:value "Extensions that cannot be ignored even if unrecognized" ]; fhir:ElementDefinition.definition [ fhir: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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.requirements [ fhir:value "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ], [ fhir:value "modifiers"; fhir:index 2 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "BackboneElement.modifierExtension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "true" ]; fhir:ElementDefinition.isModifierReason [ fhir:value "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "N/A" ] ] ], [ fhir:index 135; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.sequence" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.sequence" ]; fhir:ElementDefinition.short [ fhir:value "Product or service provided" ]; fhir:ElementDefinition.definition [ fhir:value "A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items." ]; fhir:ElementDefinition.requirements [ fhir:value "The items to be processed for adjudication." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.sequence" ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 136; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.revenue" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.revenue" ]; fhir:ElementDefinition.short [ fhir:value "Revenue or cost center code" ]; fhir:ElementDefinition.definition [ fhir:value "The type of revenue or cost center providing the product and/or service." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed in the processing of institutional claims." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.revenue" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "RevenueCenter" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Codes for the revenue or cost centers supplying the service and/or products." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/ex-revenue-center" ] ] ], [ fhir:index 137; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.category" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.category" ]; fhir:ElementDefinition.short [ fhir:value "Benefit classification" ]; fhir:ElementDefinition.definition [ fhir:value "Code to identify the general type of benefits under which products and services are provided." ]; fhir:ElementDefinition.comment [ fhir:value "Examples include: Medical Care, Periodontics, Renal Dialysis, Vision Coverage." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.category" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "BenefitCategory" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Benefit categories such as: oral, medical, vision, oral-basic etc." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/ex-benefitcategory" ] ] ], [ fhir:index 138; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.productOrService" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.productOrService" ]; fhir:ElementDefinition.short [ fhir:value "Billing, service, product, or drug code" ]; fhir:ElementDefinition.definition [ fhir:value "When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item." ]; fhir:ElementDefinition.comment [ fhir:value "If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'." ]; fhir:ElementDefinition.requirements [ fhir:value "Necessary to state what was provided or done." ]; fhir:ElementDefinition.alias [ fhir:value "Drug Code"; fhir:index 0 ], [ fhir:value "Bill Code"; fhir:index 1 ], [ fhir:value "Service Code"; fhir:index 2 ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.productOrService" ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ServiceProduct" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Allowable service and product codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/service-uscls" ] ] ], [ fhir:index 139; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.modifier" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.modifier" ]; fhir:ElementDefinition.short [ fhir:value "Service/Product billing modifiers" ]; fhir:ElementDefinition.definition [ fhir:value "Item typification or modifiers codes to convey additional context for the product or service." ]; fhir:ElementDefinition.comment [ fhir:value "For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours." ]; fhir:ElementDefinition.requirements [ fhir:value "To support inclusion of the item for adjudication or to charge an elevated fee." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.modifier" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "Modifiers" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir: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." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/claim-modifiers" ] ] ], [ fhir:index 140; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.programCode" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.programCode" ]; fhir:ElementDefinition.short [ fhir:value "Program the product or service is provided under" ]; fhir:ElementDefinition.definition [ fhir:value "Identifies the program under which this may be recovered." ]; fhir:ElementDefinition.comment [ fhir:value "For example: Neonatal program, child dental program or drug users recovery program." ]; fhir:ElementDefinition.requirements [ fhir:value "Commonly used in in the identification of publicly provided program focused on population segments or disease classifications." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.programCode" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ProgramCode" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Program specific reason codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/ex-program-code" ] ] ], [ fhir:index 141; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.quantity" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.quantity" ]; fhir:ElementDefinition.short [ fhir:value "Count of products or services" ]; fhir:ElementDefinition.definition [ fhir:value "The number of repetitions of a service or product." ]; fhir:ElementDefinition.requirements [ fhir:value "Required when the product or service code does not convey the quantity provided." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.quantity" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Quantity" ]; fhir:ElementDefinition.profile [ fhir:value "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"; fhir:index 0 ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 142; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.unitPrice" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.unitPrice" ]; fhir:ElementDefinition.short [ fhir:value "Fee, charge or cost per item" ]; fhir:ElementDefinition.definition [ fhir:value "If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group." ]; fhir:ElementDefinition.requirements [ fhir:value "The amount charged to the patient by the provider for a single unit." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.unitPrice" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 143; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.factor" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.factor" ]; fhir:ElementDefinition.short [ fhir:value "Price scaling factor" ]; fhir:ElementDefinition.definition [ fhir: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." ]; fhir:ElementDefinition.comment [ fhir:value "To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10)." ]; fhir:ElementDefinition.requirements [ fhir:value "When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.factor" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "decimal" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 144; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.net" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.net" ]; fhir:ElementDefinition.short [ fhir:value "Total item cost" ]; fhir:ElementDefinition.definition [ fhir:value "The quantity times the unit price for an additional service or product or charge." ]; fhir:ElementDefinition.comment [ fhir:value "For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides the total amount claimed for the group (if a grouper) or the line item." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.net" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 145; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.udi" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.udi" ]; fhir:ElementDefinition.short [ fhir:value "Unique device identifier" ]; fhir:ElementDefinition.definition [ fhir:value "Unique Device Identifiers associated with this line item." ]; fhir:ElementDefinition.requirements [ fhir:value "The UDI code allows the insurer to obtain device level information on the product supplied." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.udi" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Device"; fhir:index 0 ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 146; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.noteNumber" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.noteNumber" ]; fhir:ElementDefinition.short [ fhir:value "Applicable note numbers" ]; fhir:ElementDefinition.definition [ fhir:value "The numbers associated with notes below which apply to the adjudication of this item." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.noteNumber" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 147; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.adjudication" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.adjudication" ]; fhir:ElementDefinition.short [ fhir:value "Detail level adjudication details" ]; fhir:ElementDefinition.definition [ fhir:value "The adjudication results." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.adjudication" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.contentReference [ fhir:value "#ExplanationOfBenefit.item.adjudication" ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 148; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.subDetail" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "SubDetail" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail" ]; fhir:ElementDefinition.short [ fhir:value "Additional items" ]; fhir:ElementDefinition.definition [ fhir:value "Third-tier of goods and services." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children unless an empty Parameters resource" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count()) or $this is Parameters" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div|self::f:Parameters" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 149; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.id" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.id" ]; fhir:ElementDefinition.representation [ fhir:value "xmlAttr"; fhir:index 0 ]; fhir:ElementDefinition.short [ fhir:value "Unique id for inter-element referencing" ]; fhir:ElementDefinition.definition [ fhir:value "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.id" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type" ]; fhir:Extension.value [ fhir:value "string" ] ]; fhir:ElementDefinition.code [ fhir:value "http://hl7.org/fhirpath/System.String" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 150; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.extension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.extension" ]; fhir:ElementDefinition.short [ fhir:value "Additional content defined by implementations" ]; fhir:ElementDefinition.definition [ fhir:value "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.extension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 151; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.modifierExtension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.modifierExtension" ]; fhir:ElementDefinition.short [ fhir:value "Extensions that cannot be ignored even if unrecognized" ]; fhir:ElementDefinition.definition [ fhir: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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.requirements [ fhir:value "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ], [ fhir:value "modifiers"; fhir:index 2 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "BackboneElement.modifierExtension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "true" ]; fhir:ElementDefinition.isModifierReason [ fhir:value "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "N/A" ] ] ], [ fhir:index 152; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.sequence" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.sequence" ]; fhir:ElementDefinition.short [ fhir:value "Product or service provided" ]; fhir:ElementDefinition.definition [ fhir:value "A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items." ]; fhir:ElementDefinition.requirements [ fhir:value "The items to be processed for adjudication." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.sequence" ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 153; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.revenue" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.revenue" ]; fhir:ElementDefinition.short [ fhir:value "Revenue or cost center code" ]; fhir:ElementDefinition.definition [ fhir:value "The type of revenue or cost center providing the product and/or service." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed in the processing of institutional claims." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.revenue" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "RevenueCenter" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Codes for the revenue or cost centers supplying the service and/or products." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/ex-revenue-center" ] ] ], [ fhir:index 154; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.category" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.category" ]; fhir:ElementDefinition.short [ fhir:value "Benefit classification" ]; fhir:ElementDefinition.definition [ fhir:value "Code to identify the general type of benefits under which products and services are provided." ]; fhir:ElementDefinition.comment [ fhir:value "Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.category" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "BenefitCategory" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Benefit categories such as: oral, medical, vision, oral-basic etc." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/ex-benefitcategory" ] ] ], [ fhir:index 155; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.productOrService" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.productOrService" ]; fhir:ElementDefinition.short [ fhir:value "Billing, service, product, or drug code" ]; fhir:ElementDefinition.definition [ fhir:value "When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item." ]; fhir:ElementDefinition.comment [ fhir:value "If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'." ]; fhir:ElementDefinition.requirements [ fhir:value "Necessary to state what was provided or done." ]; fhir:ElementDefinition.alias [ fhir:value "Drug Code"; fhir:index 0 ], [ fhir:value "Bill Code"; fhir:index 1 ], [ fhir:value "Service Code"; fhir:index 2 ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.productOrService" ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ServiceProduct" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Allowable service and product codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/service-uscls" ] ] ], [ fhir:index 156; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.modifier" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.modifier" ]; fhir:ElementDefinition.short [ fhir:value "Service/Product billing modifiers" ]; fhir:ElementDefinition.definition [ fhir:value "Item typification or modifiers codes to convey additional context for the product or service." ]; fhir:ElementDefinition.comment [ fhir:value "For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours." ]; fhir:ElementDefinition.requirements [ fhir:value "To support inclusion of the item for adjudication or to charge an elevated fee." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.modifier" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "Modifiers" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir: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." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/claim-modifiers" ] ] ], [ fhir:index 157; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.programCode" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.programCode" ]; fhir:ElementDefinition.short [ fhir:value "Program the product or service is provided under" ]; fhir:ElementDefinition.definition [ fhir:value "Identifies the program under which this may be recovered." ]; fhir:ElementDefinition.comment [ fhir:value "For example: Neonatal program, child dental program or drug users recovery program." ]; fhir:ElementDefinition.requirements [ fhir:value "Commonly used in in the identification of publicly provided program focused on population segments or disease classifications." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.programCode" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ProgramCode" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Program specific reason codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/ex-program-code" ] ] ], [ fhir:index 158; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.quantity" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.quantity" ]; fhir:ElementDefinition.short [ fhir:value "Count of products or services" ]; fhir:ElementDefinition.definition [ fhir:value "The number of repetitions of a service or product." ]; fhir:ElementDefinition.requirements [ fhir:value "Required when the product or service code does not convey the quantity provided." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.quantity" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Quantity" ]; fhir:ElementDefinition.profile [ fhir:value "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"; fhir:index 0 ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 159; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.unitPrice" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.unitPrice" ]; fhir:ElementDefinition.short [ fhir:value "Fee, charge or cost per item" ]; fhir:ElementDefinition.definition [ fhir:value "If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group." ]; fhir:ElementDefinition.requirements [ fhir:value "The amount charged to the patient by the provider for a single unit." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.unitPrice" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 160; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.factor" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.factor" ]; fhir:ElementDefinition.short [ fhir:value "Price scaling factor" ]; fhir:ElementDefinition.definition [ fhir: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." ]; fhir:ElementDefinition.comment [ fhir:value "To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10)." ]; fhir:ElementDefinition.requirements [ fhir:value "When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.factor" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "decimal" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 161; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.net" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.net" ]; fhir:ElementDefinition.short [ fhir:value "Total item cost" ]; fhir:ElementDefinition.definition [ fhir:value "The quantity times the unit price for an additional service or product or charge." ]; fhir:ElementDefinition.comment [ fhir:value "For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides the total amount claimed for the group (if a grouper) or the line item." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.net" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 162; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.udi" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.udi" ]; fhir:ElementDefinition.short [ fhir:value "Unique device identifier" ]; fhir:ElementDefinition.definition [ fhir:value "Unique Device Identifiers associated with this line item." ]; fhir:ElementDefinition.requirements [ fhir:value "The UDI code allows the insurer to obtain device level information on the product supplied." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.udi" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Device"; fhir:index 0 ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 163; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.noteNumber" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.noteNumber" ]; fhir:ElementDefinition.short [ fhir:value "Applicable note numbers" ]; fhir:ElementDefinition.definition [ fhir:value "The numbers associated with notes below which apply to the adjudication of this item." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.noteNumber" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 164; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.adjudication" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.adjudication" ]; fhir:ElementDefinition.short [ fhir:value "Subdetail level adjudication details" ]; fhir:ElementDefinition.definition [ fhir:value "The adjudication results." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.adjudication" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.contentReference [ fhir:value "#ExplanationOfBenefit.item.adjudication" ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 165; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint" ]; fhir:Extension.value [ fhir:value "740;600" ] ], [ fhir:index 1; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "AddedItem" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem" ]; fhir:ElementDefinition.short [ fhir:value "Insurer added line items" ]; fhir:ElementDefinition.definition [ fhir:value "The first-tier service adjudications for payor added product or service lines." ]; fhir:ElementDefinition.requirements [ fhir:value "Insurers may redefine the provided product or service or may package and/or decompose groups of products and services. The addItems allows the insurer to provide their line item list with linkage to the submitted items/details/sub-details. In a preauthorization the insurer may use the addItem structure to provide additional information on authorized products and services." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children unless an empty Parameters resource" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count()) or $this is Parameters" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div|self::f:Parameters" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 166; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.id" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.id" ]; fhir:ElementDefinition.representation [ fhir:value "xmlAttr"; fhir:index 0 ]; fhir:ElementDefinition.short [ fhir:value "Unique id for inter-element referencing" ]; fhir:ElementDefinition.definition [ fhir:value "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.id" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type" ]; fhir:Extension.value [ fhir:value "string" ] ]; fhir:ElementDefinition.code [ fhir:value "http://hl7.org/fhirpath/System.String" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 167; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.extension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.extension" ]; fhir:ElementDefinition.short [ fhir:value "Additional content defined by implementations" ]; fhir:ElementDefinition.definition [ fhir:value "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.extension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 168; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.modifierExtension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.modifierExtension" ]; fhir:ElementDefinition.short [ fhir:value "Extensions that cannot be ignored even if unrecognized" ]; fhir:ElementDefinition.definition [ fhir: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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.requirements [ fhir:value "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ], [ fhir:value "modifiers"; fhir:index 2 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "BackboneElement.modifierExtension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "true" ]; fhir:ElementDefinition.isModifierReason [ fhir:value "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "N/A" ] ] ], [ fhir:index 169; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.itemSequence" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.itemSequence" ]; fhir:ElementDefinition.short [ fhir:value "Item sequence number" ]; fhir:ElementDefinition.definition [ fhir:value "Claim items which this service line is intended to replace." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides references to the claim items." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.itemSequence" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 170; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detailSequence" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detailSequence" ]; fhir:ElementDefinition.short [ fhir:value "Detail sequence number" ]; fhir:ElementDefinition.definition [ fhir:value "The sequence number of the details within the claim item which this line is intended to replace." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides references to the claim details within the claim item." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detailSequence" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 171; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.subDetailSequence" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.subDetailSequence" ]; fhir:ElementDefinition.short [ fhir:value "Subdetail sequence number" ]; fhir:ElementDefinition.definition [ fhir:value "The sequence number of the sub-details woithin the details within the claim item which this line is intended to replace." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides references to the claim sub-details within the claim detail." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.subDetailSequence" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 172; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.provider" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.provider" ]; fhir:ElementDefinition.short [ fhir:value "Authorized providers" ]; fhir:ElementDefinition.definition [ fhir:value "The providers who are authorized for the services rendered to the patient." ]; fhir:ElementDefinition.requirements [ fhir:value "Insurer may provide authorization specifically to a restricted set of providers rather than an open authorization." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.provider" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Practitioner"; fhir:index 0 ], [ fhir:value "http://hl7.org/fhir/StructureDefinition/PractitionerRole"; fhir:index 1 ], [ fhir:value "http://hl7.org/fhir/StructureDefinition/Organization"; fhir:index 2 ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.source" ] ] ], [ fhir:index 173; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.productOrService" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.productOrService" ]; fhir:ElementDefinition.short [ fhir:value "Billing, service, product, or drug code" ]; fhir:ElementDefinition.definition [ fhir:value "When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item." ]; fhir:ElementDefinition.comment [ fhir:value "If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'." ]; fhir:ElementDefinition.requirements [ fhir:value "Necessary to state what was provided or done." ]; fhir:ElementDefinition.alias [ fhir:value "Drug Code"; fhir:index 0 ], [ fhir:value "Bill Code"; fhir:index 1 ], [ fhir:value "Service Code"; fhir:index 2 ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.productOrService" ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ServiceProduct" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Allowable service and product codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/service-uscls" ] ] ], [ fhir:index 174; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.modifier" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.modifier" ]; fhir:ElementDefinition.short [ fhir:value "Service/Product billing modifiers" ]; fhir:ElementDefinition.definition [ fhir:value "Item typification or modifiers codes to convey additional context for the product or service." ]; fhir:ElementDefinition.comment [ fhir:value "For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours." ]; fhir:ElementDefinition.requirements [ fhir:value "To support inclusion of the item for adjudication or to charge an elevated fee." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.modifier" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "Modifiers" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir: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." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/claim-modifiers" ] ] ], [ fhir:index 175; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.programCode" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.programCode" ]; fhir:ElementDefinition.short [ fhir:value "Program the product or service is provided under" ]; fhir:ElementDefinition.definition [ fhir:value "Identifies the program under which this may be recovered." ]; fhir:ElementDefinition.comment [ fhir:value "For example: Neonatal program, child dental program or drug users recovery program." ]; fhir:ElementDefinition.requirements [ fhir:value "Commonly used in in the identification of publicly provided program focused on population segments or disease classifications." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.programCode" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ProgramCode" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Program specific reason codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/ex-program-code" ] ] ], [ fhir:index 176; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.serviced[x]" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.serviced[x]" ]; fhir:ElementDefinition.short [ fhir:value "Date or dates of service or product delivery" ]; fhir:ElementDefinition.definition [ fhir:value "The date or dates when the service or product was supplied, performed or completed." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to determine whether the service or product was provided during the term of the insurance coverage." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.serviced[x]" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "date" ] ], [ fhir:index 1; fhir:ElementDefinition.code [ fhir:value "Period" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.done[x]" ] ] ], [ fhir:index 177; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.location[x]" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.location[x]" ]; fhir:ElementDefinition.short [ fhir:value "Place of service or where product was supplied" ]; fhir:ElementDefinition.definition [ fhir:value "Where the product or service was provided." ]; fhir:ElementDefinition.requirements [ fhir:value "The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.location[x]" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ], [ fhir:index 1; fhir:ElementDefinition.code [ fhir:value "Address" ] ], [ fhir:index 2; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Location"; fhir:index 0 ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ServicePlace" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Place where the service is rendered." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/service-place" ] ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.where[x]" ] ] ], [ fhir:index 178; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.quantity" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.quantity" ]; fhir:ElementDefinition.short [ fhir:value "Count of products or services" ]; fhir:ElementDefinition.definition [ fhir:value "The number of repetitions of a service or product." ]; fhir:ElementDefinition.requirements [ fhir:value "Required when the product or service code does not convey the quantity provided." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.quantity" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Quantity" ]; fhir:ElementDefinition.profile [ fhir:value "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"; fhir:index 0 ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 179; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.unitPrice" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.unitPrice" ]; fhir:ElementDefinition.short [ fhir:value "Fee, charge or cost per item" ]; fhir:ElementDefinition.definition [ fhir:value "If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group." ]; fhir:ElementDefinition.requirements [ fhir:value "The amount charged to the patient by the provider for a single unit." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.unitPrice" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 180; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.factor" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.factor" ]; fhir:ElementDefinition.short [ fhir:value "Price scaling factor" ]; fhir:ElementDefinition.definition [ fhir: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." ]; fhir:ElementDefinition.comment [ fhir:value "To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10)." ]; fhir:ElementDefinition.requirements [ fhir:value "When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.factor" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "decimal" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 181; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.net" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.net" ]; fhir:ElementDefinition.short [ fhir:value "Total item cost" ]; fhir:ElementDefinition.definition [ fhir:value "The quantity times the unit price for an additional service or product or charge." ]; fhir:ElementDefinition.comment [ fhir:value "For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides the total amount claimed for the group (if a grouper) or the line item." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.net" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 182; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.bodySite" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.bodySite" ]; fhir:ElementDefinition.short [ fhir:value "Anatomical location" ]; fhir:ElementDefinition.definition [ fhir:value "Physical service site on the patient (limb, tooth, etc.)." ]; fhir:ElementDefinition.comment [ fhir:value "For example, providing a tooth code allows an insurer to identify a provider performing a filling on a tooth that was previously removed." ]; fhir:ElementDefinition.requirements [ fhir:value "Allows insurer to validate specific procedures." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.bodySite" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "OralSites" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "The code for the teeth, quadrant, sextant and arch." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/tooth" ] ] ], [ fhir:index 183; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.subSite" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.subSite" ]; fhir:ElementDefinition.short [ fhir:value "Anatomical sub-location" ]; fhir:ElementDefinition.definition [ fhir:value "A region or surface of the bodySite, e.g. limb region or tooth surface(s)." ]; fhir:ElementDefinition.requirements [ fhir:value "Allows insurer to validate specific procedures." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.subSite" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "Surface" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "The code for the tooth surface and surface combinations." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/surface" ] ] ], [ fhir:index 184; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.noteNumber" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.noteNumber" ]; fhir:ElementDefinition.short [ fhir:value "Applicable note numbers" ]; fhir:ElementDefinition.definition [ fhir:value "The numbers associated with notes below which apply to the adjudication of this item." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.noteNumber" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 185; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.adjudication" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.adjudication" ]; fhir:ElementDefinition.short [ fhir:value "Added items adjudication" ]; fhir:ElementDefinition.definition [ fhir:value "The adjudication results." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.adjudication" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.contentReference [ fhir:value "#ExplanationOfBenefit.item.adjudication" ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 186; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint" ]; fhir:Extension.value [ fhir:value "740;600" ] ], [ fhir:index 1; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "AddedItemDetail" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail" ]; fhir:ElementDefinition.short [ fhir:value "Insurer added line items" ]; fhir:ElementDefinition.definition [ fhir:value "The second-tier service adjudications for payor added services." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children unless an empty Parameters resource" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count()) or $this is Parameters" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div|self::f:Parameters" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 187; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.id" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.id" ]; fhir:ElementDefinition.representation [ fhir:value "xmlAttr"; fhir:index 0 ]; fhir:ElementDefinition.short [ fhir:value "Unique id for inter-element referencing" ]; fhir:ElementDefinition.definition [ fhir:value "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.id" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type" ]; fhir:Extension.value [ fhir:value "string" ] ]; fhir:ElementDefinition.code [ fhir:value "http://hl7.org/fhirpath/System.String" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 188; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.extension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.extension" ]; fhir:ElementDefinition.short [ fhir:value "Additional content defined by implementations" ]; fhir:ElementDefinition.definition [ fhir:value "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.extension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 189; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.modifierExtension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.modifierExtension" ]; fhir:ElementDefinition.short [ fhir:value "Extensions that cannot be ignored even if unrecognized" ]; fhir:ElementDefinition.definition [ fhir: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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.requirements [ fhir:value "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ], [ fhir:value "modifiers"; fhir:index 2 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "BackboneElement.modifierExtension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "true" ]; fhir:ElementDefinition.isModifierReason [ fhir:value "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "N/A" ] ] ], [ fhir:index 190; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.productOrService" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.productOrService" ]; fhir:ElementDefinition.short [ fhir:value "Billing, service, product, or drug code" ]; fhir:ElementDefinition.definition [ fhir:value "When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item." ]; fhir:ElementDefinition.comment [ fhir:value "If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'." ]; fhir:ElementDefinition.requirements [ fhir:value "Necessary to state what was provided or done." ]; fhir:ElementDefinition.alias [ fhir:value "Drug Code"; fhir:index 0 ], [ fhir:value "Bill Code"; fhir:index 1 ], [ fhir:value "Service Code"; fhir:index 2 ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.productOrService" ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ServiceProduct" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Allowable service and product codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/service-uscls" ] ] ], [ fhir:index 191; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.modifier" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.modifier" ]; fhir:ElementDefinition.short [ fhir:value "Service/Product billing modifiers" ]; fhir:ElementDefinition.definition [ fhir:value "Item typification or modifiers codes to convey additional context for the product or service." ]; fhir:ElementDefinition.comment [ fhir:value "For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours." ]; fhir:ElementDefinition.requirements [ fhir:value "To support inclusion of the item for adjudication or to charge an elevated fee." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.modifier" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "Modifiers" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir: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." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/claim-modifiers" ] ] ], [ fhir:index 192; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.quantity" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.quantity" ]; fhir:ElementDefinition.short [ fhir:value "Count of products or services" ]; fhir:ElementDefinition.definition [ fhir:value "The number of repetitions of a service or product." ]; fhir:ElementDefinition.requirements [ fhir:value "Required when the product or service code does not convey the quantity provided." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.quantity" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Quantity" ]; fhir:ElementDefinition.profile [ fhir:value "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"; fhir:index 0 ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 193; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.unitPrice" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.unitPrice" ]; fhir:ElementDefinition.short [ fhir:value "Fee, charge or cost per item" ]; fhir:ElementDefinition.definition [ fhir:value "If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group." ]; fhir:ElementDefinition.requirements [ fhir:value "The amount charged to the patient by the provider for a single unit." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.unitPrice" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 194; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.factor" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.factor" ]; fhir:ElementDefinition.short [ fhir:value "Price scaling factor" ]; fhir:ElementDefinition.definition [ fhir: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." ]; fhir:ElementDefinition.comment [ fhir:value "To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10)." ]; fhir:ElementDefinition.requirements [ fhir:value "When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.factor" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "decimal" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 195; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.net" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.net" ]; fhir:ElementDefinition.short [ fhir:value "Total item cost" ]; fhir:ElementDefinition.definition [ fhir:value "The quantity times the unit price for an additional service or product or charge." ]; fhir:ElementDefinition.comment [ fhir:value "For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides the total amount claimed for the group (if a grouper) or the line item." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.net" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 196; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.noteNumber" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.noteNumber" ]; fhir:ElementDefinition.short [ fhir:value "Applicable note numbers" ]; fhir:ElementDefinition.definition [ fhir:value "The numbers associated with notes below which apply to the adjudication of this item." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.noteNumber" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 197; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.adjudication" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.adjudication" ]; fhir:ElementDefinition.short [ fhir:value "Added items adjudication" ]; fhir:ElementDefinition.definition [ fhir:value "The adjudication results." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.adjudication" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.contentReference [ fhir:value "#ExplanationOfBenefit.item.adjudication" ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 198; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint" ]; fhir:Extension.value [ fhir:value "740;600" ] ], [ fhir:index 1; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "AddedItemDetailSubDetail" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail" ]; fhir:ElementDefinition.short [ fhir:value "Insurer added line items" ]; fhir:ElementDefinition.definition [ fhir:value "The third-tier service adjudications for payor added services." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children unless an empty Parameters resource" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count()) or $this is Parameters" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div|self::f:Parameters" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 199; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.id" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.id" ]; fhir:ElementDefinition.representation [ fhir:value "xmlAttr"; fhir:index 0 ]; fhir:ElementDefinition.short [ fhir:value "Unique id for inter-element referencing" ]; fhir:ElementDefinition.definition [ fhir:value "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.id" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type" ]; fhir:Extension.value [ fhir:value "string" ] ]; fhir:ElementDefinition.code [ fhir:value "http://hl7.org/fhirpath/System.String" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 200; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.extension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.extension" ]; fhir:ElementDefinition.short [ fhir:value "Additional content defined by implementations" ]; fhir:ElementDefinition.definition [ fhir:value "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.extension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 201; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.modifierExtension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.modifierExtension" ]; fhir:ElementDefinition.short [ fhir:value "Extensions that cannot be ignored even if unrecognized" ]; fhir:ElementDefinition.definition [ fhir: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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.requirements [ fhir:value "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ], [ fhir:value "modifiers"; fhir:index 2 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "BackboneElement.modifierExtension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "true" ]; fhir:ElementDefinition.isModifierReason [ fhir:value "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "N/A" ] ] ], [ fhir:index 202; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.productOrService" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.productOrService" ]; fhir:ElementDefinition.short [ fhir:value "Billing, service, product, or drug code" ]; fhir:ElementDefinition.definition [ fhir:value "When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item." ]; fhir:ElementDefinition.comment [ fhir:value "If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'." ]; fhir:ElementDefinition.requirements [ fhir:value "Necessary to state what was provided or done." ]; fhir:ElementDefinition.alias [ fhir:value "Drug Code"; fhir:index 0 ], [ fhir:value "Bill Code"; fhir:index 1 ], [ fhir:value "Service Code"; fhir:index 2 ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.productOrService" ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ServiceProduct" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Allowable service and product codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/service-uscls" ] ] ], [ fhir:index 203; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.modifier" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.modifier" ]; fhir:ElementDefinition.short [ fhir:value "Service/Product billing modifiers" ]; fhir:ElementDefinition.definition [ fhir:value "Item typification or modifiers codes to convey additional context for the product or service." ]; fhir:ElementDefinition.comment [ fhir:value "For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours." ]; fhir:ElementDefinition.requirements [ fhir:value "To support inclusion of the item for adjudication or to charge an elevated fee." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.modifier" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "Modifiers" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir: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." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/claim-modifiers" ] ] ], [ fhir:index 204; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.quantity" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.quantity" ]; fhir:ElementDefinition.short [ fhir:value "Count of products or services" ]; fhir:ElementDefinition.definition [ fhir:value "The number of repetitions of a service or product." ]; fhir:ElementDefinition.requirements [ fhir:value "Required when the product or service code does not convey the quantity provided." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.quantity" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Quantity" ]; fhir:ElementDefinition.profile [ fhir:value "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"; fhir:index 0 ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 205; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.unitPrice" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.unitPrice" ]; fhir:ElementDefinition.short [ fhir:value "Fee, charge or cost per item" ]; fhir:ElementDefinition.definition [ fhir:value "If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group." ]; fhir:ElementDefinition.requirements [ fhir:value "The amount charged to the patient by the provider for a single unit." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.unitPrice" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 206; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.factor" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.factor" ]; fhir:ElementDefinition.short [ fhir:value "Price scaling factor" ]; fhir:ElementDefinition.definition [ fhir: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." ]; fhir:ElementDefinition.comment [ fhir:value "To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10)." ]; fhir:ElementDefinition.requirements [ fhir:value "When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.factor" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "decimal" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 207; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.net" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.net" ]; fhir:ElementDefinition.short [ fhir:value "Total item cost" ]; fhir:ElementDefinition.definition [ fhir:value "The quantity times the unit price for an additional service or product or charge." ]; fhir:ElementDefinition.comment [ fhir:value "For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides the total amount claimed for the group (if a grouper) or the line item." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.net" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 208; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.noteNumber" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.noteNumber" ]; fhir:ElementDefinition.short [ fhir:value "Applicable note numbers" ]; fhir:ElementDefinition.definition [ fhir:value "The numbers associated with notes below which apply to the adjudication of this item." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.noteNumber" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 209; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.adjudication" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.adjudication" ]; fhir:ElementDefinition.short [ fhir:value "Added items adjudication" ]; fhir:ElementDefinition.definition [ fhir:value "The adjudication results." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.adjudication" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.contentReference [ fhir:value "#ExplanationOfBenefit.item.adjudication" ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 210; fhir:Element.id [ fhir:value "ExplanationOfBenefit.adjudication" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.adjudication" ]; fhir:ElementDefinition.short [ fhir:value "Header-level adjudication" ]; fhir:ElementDefinition.definition [ fhir:value "The adjudication results which are presented at the header level rather than at the line-item or add-item levels." ]; fhir:ElementDefinition.requirements [ fhir:value "Some insurers will receive line-items but provide the adjudication only at a summary or header-level." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.adjudication" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.contentReference [ fhir:value "#ExplanationOfBenefit.item.adjudication" ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 211; fhir:Element.id [ fhir:value "ExplanationOfBenefit.total" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint" ]; fhir:Extension.value [ fhir:value "'360;620" ] ], [ fhir:index 1; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "Total" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.total" ]; fhir:ElementDefinition.short [ fhir:value "Adjudication totals" ]; fhir:ElementDefinition.definition [ fhir:value "Categorized monetary totals for the adjudication." ]; fhir:ElementDefinition.comment [ fhir:value "Totals for amounts submitted, co-pays, benefits payable etc." ]; fhir:ElementDefinition.requirements [ fhir:value "To provide the requestor with financial totals by category for the adjudication." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.total" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children unless an empty Parameters resource" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count()) or $this is Parameters" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div|self::f:Parameters" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ] ], [ fhir:index 212; fhir:Element.id [ fhir:value "ExplanationOfBenefit.total.id" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.total.id" ]; fhir:ElementDefinition.representation [ fhir:value "xmlAttr"; fhir:index 0 ]; fhir:ElementDefinition.short [ fhir:value "Unique id for inter-element referencing" ]; fhir:ElementDefinition.definition [ fhir:value "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.id" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type" ]; fhir:Extension.value [ fhir:value "string" ] ]; fhir:ElementDefinition.code [ fhir:value "http://hl7.org/fhirpath/System.String" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 213; fhir:Element.id [ fhir:value "ExplanationOfBenefit.total.extension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.total.extension" ]; fhir:ElementDefinition.short [ fhir:value "Additional content defined by implementations" ]; fhir:ElementDefinition.definition [ fhir:value "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.extension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 214; fhir:Element.id [ fhir:value "ExplanationOfBenefit.total.modifierExtension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.total.modifierExtension" ]; fhir:ElementDefinition.short [ fhir:value "Extensions that cannot be ignored even if unrecognized" ]; fhir:ElementDefinition.definition [ fhir: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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.requirements [ fhir:value "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ], [ fhir:value "modifiers"; fhir:index 2 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "BackboneElement.modifierExtension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "true" ]; fhir:ElementDefinition.isModifierReason [ fhir:value "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "N/A" ] ] ], [ fhir:index 215; fhir:Element.id [ fhir:value "ExplanationOfBenefit.total.category" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.total.category" ]; fhir:ElementDefinition.short [ fhir:value "Type of adjudication information" ]; fhir:ElementDefinition.definition [ fhir:value "A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item." ]; fhir:ElementDefinition.comment [ fhir:value "For example, codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to convey the type of total provided." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.total.category" ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "Adjudication" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "The adjudication codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/adjudication" ] ] ], [ fhir:index 216; fhir:Element.id [ fhir:value "ExplanationOfBenefit.total.amount" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.total.amount" ]; fhir:ElementDefinition.short [ fhir:value "Financial total for the category" ]; fhir:ElementDefinition.definition [ fhir:value "Monetary total amount associated with the category." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to convey the total monetary amount." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.total.amount" ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ] ], [ fhir:index 217; fhir:Element.id [ fhir:value "ExplanationOfBenefit.payment" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint" ]; fhir:Extension.value [ fhir:value "360;650" ] ], [ fhir:index 1; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "Payment" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payment" ]; fhir:ElementDefinition.short [ fhir:value "Payment Details" ]; fhir:ElementDefinition.definition [ fhir:value "Payment details for the adjudication of the claim." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to convey references to the financial instrument that has been used if payment has been made." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payment" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children unless an empty Parameters resource" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count()) or $this is Parameters" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div|self::f:Parameters" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 218; fhir:Element.id [ fhir:value "ExplanationOfBenefit.payment.id" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payment.id" ]; fhir:ElementDefinition.representation [ fhir:value "xmlAttr"; fhir:index 0 ]; fhir:ElementDefinition.short [ fhir:value "Unique id for inter-element referencing" ]; fhir:ElementDefinition.definition [ fhir:value "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.id" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type" ]; fhir:Extension.value [ fhir:value "string" ] ]; fhir:ElementDefinition.code [ fhir:value "http://hl7.org/fhirpath/System.String" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 219; fhir:Element.id [ fhir:value "ExplanationOfBenefit.payment.extension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payment.extension" ]; fhir:ElementDefinition.short [ fhir:value "Additional content defined by implementations" ]; fhir:ElementDefinition.definition [ fhir:value "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.extension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 220; fhir:Element.id [ fhir:value "ExplanationOfBenefit.payment.modifierExtension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payment.modifierExtension" ]; fhir:ElementDefinition.short [ fhir:value "Extensions that cannot be ignored even if unrecognized" ]; fhir:ElementDefinition.definition [ fhir: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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.requirements [ fhir:value "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ], [ fhir:value "modifiers"; fhir:index 2 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "BackboneElement.modifierExtension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "true" ]; fhir:ElementDefinition.isModifierReason [ fhir:value "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "N/A" ] ] ], [ fhir:index 221; fhir:Element.id [ fhir:value "ExplanationOfBenefit.payment.type" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payment.type" ]; fhir:ElementDefinition.short [ fhir:value "Partial or complete payment" ]; fhir:ElementDefinition.definition [ fhir:value "Whether this represents partial or complete payment of the benefits payable." ]; fhir:ElementDefinition.requirements [ fhir:value "To advise the requestor when the insurer believes all payments to have been completed." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payment.type" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "PaymentType" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "The type (partial, complete) of the payment." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/ex-paymenttype" ] ] ], [ fhir:index 222; fhir:Element.id [ fhir:value "ExplanationOfBenefit.payment.adjustment" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payment.adjustment" ]; fhir:ElementDefinition.short [ fhir:value "Payment adjustment for non-claim issues" ]; fhir:ElementDefinition.definition [ fhir:value "Total amount of all adjustments to this payment included in this transaction which are not related to this claim's adjudication." ]; fhir:ElementDefinition.comment [ fhir:value "Insurers will deduct amounts owing from the provider (adjustment), such as a prior overpayment, from the amount owing to the provider (benefits payable) when payment is made to the provider." ]; fhir:ElementDefinition.requirements [ fhir:value "To advise the requestor of adjustments applied to the payment." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payment.adjustment" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 223; fhir:Element.id [ fhir:value "ExplanationOfBenefit.payment.adjustmentReason" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payment.adjustmentReason" ]; fhir:ElementDefinition.short [ fhir:value "Explanation for the variance" ]; fhir:ElementDefinition.definition [ fhir:value "Reason for the payment adjustment." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to clarify the monetary adjustment." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payment.adjustmentReason" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "PaymentAdjustmentReason" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Payment Adjustment reason codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/payment-adjustment-reason" ] ] ], [ fhir:index 224; fhir:Element.id [ fhir:value "ExplanationOfBenefit.payment.date" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payment.date" ]; fhir:ElementDefinition.short [ fhir:value "Expected date of payment" ]; fhir:ElementDefinition.definition [ fhir:value "Estimated date the payment will be issued or the actual issue date of payment." ]; fhir:ElementDefinition.requirements [ fhir:value "To advise the payee when payment can be expected." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payment.date" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "date" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 225; fhir:Element.id [ fhir:value "ExplanationOfBenefit.payment.amount" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payment.amount" ]; fhir:ElementDefinition.short [ fhir:value "Payable amount after adjustment" ]; fhir:ElementDefinition.definition [ fhir:value "Benefits payable less any payment adjustment." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to provide the actual payment amount." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payment.amount" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 226; fhir:Element.id [ fhir:value "ExplanationOfBenefit.payment.identifier" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payment.identifier" ]; fhir:ElementDefinition.short [ fhir:value "Business identifier for the payment" ]; fhir:ElementDefinition.definition [ fhir:value "Issuer's unique identifier for the payment instrument." ]; fhir:ElementDefinition.comment [ fhir:value "For example: EFT number or check number." ]; fhir:ElementDefinition.requirements [ fhir:value "Enable the receiver to reconcile when payment received." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payment.identifier" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Identifier" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 227; fhir:Element.id [ fhir:value "ExplanationOfBenefit.formCode" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.formCode" ]; fhir:ElementDefinition.short [ fhir:value "Printed form identifier" ]; fhir:ElementDefinition.definition [ fhir:value "A code for the form to be used for printing the content." ]; fhir:ElementDefinition.comment [ fhir:value "May be needed to identify specific jurisdictional forms." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to specify the specific form used for producing output for this response." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.formCode" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "Forms" ] ], [ fhir:index 1; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding" ]; fhir:Extension.value [ fhir:value "true" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "The forms codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/forms" ] ] ], [ fhir:index 228; fhir:Element.id [ fhir:value "ExplanationOfBenefit.form" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.form" ]; fhir:ElementDefinition.short [ fhir:value "Printed reference or actual form" ]; fhir:ElementDefinition.definition [ fhir:value "The actual form, by reference or inclusion, for printing the content or an EOB." ]; fhir:ElementDefinition.comment [ fhir:value "Needed to permit insurers to include the actual form." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to include the specific form used for producing output for this response." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.form" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Attachment" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 229; fhir:Element.id [ fhir:value "ExplanationOfBenefit.processNote" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "Note" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.processNote" ]; fhir:ElementDefinition.short [ fhir:value "Note concerning adjudication" ]; fhir:ElementDefinition.definition [ fhir:value "A note that describes or explains adjudication results in a human readable form." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides the insurer specific textual explanations associated with the processing." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.processNote" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children unless an empty Parameters resource" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count()) or $this is Parameters" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div|self::f:Parameters" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 230; fhir:Element.id [ fhir:value "ExplanationOfBenefit.processNote.id" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.processNote.id" ]; fhir:ElementDefinition.representation [ fhir:value "xmlAttr"; fhir:index 0 ]; fhir:ElementDefinition.short [ fhir:value "Unique id for inter-element referencing" ]; fhir:ElementDefinition.definition [ fhir:value "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.id" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type" ]; fhir:Extension.value [ fhir:value "string" ] ]; fhir:ElementDefinition.code [ fhir:value "http://hl7.org/fhirpath/System.String" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 231; fhir:Element.id [ fhir:value "ExplanationOfBenefit.processNote.extension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.processNote.extension" ]; fhir:ElementDefinition.short [ fhir:value "Additional content defined by implementations" ]; fhir:ElementDefinition.definition [ fhir:value "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.extension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 232; fhir:Element.id [ fhir:value "ExplanationOfBenefit.processNote.modifierExtension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.processNote.modifierExtension" ]; fhir:ElementDefinition.short [ fhir:value "Extensions that cannot be ignored even if unrecognized" ]; fhir:ElementDefinition.definition [ fhir: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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.requirements [ fhir:value "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ], [ fhir:value "modifiers"; fhir:index 2 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "BackboneElement.modifierExtension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "true" ]; fhir:ElementDefinition.isModifierReason [ fhir:value "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "N/A" ] ] ], [ fhir:index 233; fhir:Element.id [ fhir:value "ExplanationOfBenefit.processNote.number" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.processNote.number" ]; fhir:ElementDefinition.short [ fhir:value "Note instance identifier" ]; fhir:ElementDefinition.definition [ fhir:value "A number to uniquely identify a note entry." ]; fhir:ElementDefinition.requirements [ fhir:value "Necessary to provide a mechanism to link from adjudications." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.processNote.number" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 234; fhir:Element.id [ fhir:value "ExplanationOfBenefit.processNote.type" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.processNote.type" ]; fhir:ElementDefinition.short [ fhir:value "display | print | printoper" ]; fhir:ElementDefinition.definition [ fhir:value "The business purpose of the note text." ]; fhir:ElementDefinition.requirements [ fhir:value "To convey the expectation for when the text is used." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.processNote.type" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "code" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "NoteType" ] ], [ fhir:index 1; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding" ]; fhir:Extension.value [ fhir:value "true" ] ]; fhir:ElementDefinition.strength [ fhir:value "required" ]; fhir:ElementDefinition.description [ fhir:value "The presentation types of notes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/note-type|4.3.0" ] ] ], [ fhir:index 235; fhir:Element.id [ fhir:value "ExplanationOfBenefit.processNote.text" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.processNote.text" ]; fhir:ElementDefinition.short [ fhir:value "Note explanatory text" ]; fhir:ElementDefinition.definition [ fhir:value "The explanation or description associated with the processing." ]; fhir:ElementDefinition.requirements [ fhir:value "Required to provide human readable explanation." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.processNote.text" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "string" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 236; fhir:Element.id [ fhir:value "ExplanationOfBenefit.processNote.language" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.processNote.language" ]; fhir:ElementDefinition.short [ fhir:value "Language of the text" ]; fhir:ElementDefinition.definition [ fhir:value "A code to define the language used in the text of the note." ]; fhir:ElementDefinition.comment [ fhir:value "Only required if the language is different from the resource language." ]; fhir:ElementDefinition.requirements [ fhir:value "Note text may vary from the resource defined language." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.processNote.language" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet" ]; fhir:Extension.value [ fhir:value "http://hl7.org/fhir/ValueSet/all-languages" ] ], [ fhir:index 1; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "Language" ] ], [ fhir:index 2; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding" ]; fhir:Extension.value [ fhir:value "true" ] ]; fhir:ElementDefinition.strength [ fhir:value "preferred" ]; fhir:ElementDefinition.description [ fhir:value "IETF language tag" ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/languages" ] ] ], [ fhir:index 237; fhir:Element.id [ fhir:value "ExplanationOfBenefit.benefitPeriod" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitPeriod" ]; fhir:ElementDefinition.short [ fhir:value "When the benefits are applicable" ]; fhir:ElementDefinition.definition [ fhir:value "The term of the benefits documented in this response." ]; fhir:ElementDefinition.comment [ fhir:value "Not applicable when use=claim." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed as coverages may be multi-year while benefits tend to be annual therefore a separate expression of the benefit period is needed." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitPeriod" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Period" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 238; fhir:Element.id [ fhir:value "ExplanationOfBenefit.benefitBalance" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "BenefitBalance" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance" ]; fhir:ElementDefinition.short [ fhir:value "Balance by Benefit Category" ]; fhir:ElementDefinition.definition [ fhir:value "Balance by Benefit Category." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children unless an empty Parameters resource" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count()) or $this is Parameters" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div|self::f:Parameters" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 239; fhir:Element.id [ fhir:value "ExplanationOfBenefit.benefitBalance.id" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.id" ]; fhir:ElementDefinition.representation [ fhir:value "xmlAttr"; fhir:index 0 ]; fhir:ElementDefinition.short [ fhir:value "Unique id for inter-element referencing" ]; fhir:ElementDefinition.definition [ fhir:value "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.id" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type" ]; fhir:Extension.value [ fhir:value "string" ] ]; fhir:ElementDefinition.code [ fhir:value "http://hl7.org/fhirpath/System.String" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 240; fhir:Element.id [ fhir:value "ExplanationOfBenefit.benefitBalance.extension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.extension" ]; fhir:ElementDefinition.short [ fhir:value "Additional content defined by implementations" ]; fhir:ElementDefinition.definition [ fhir:value "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.extension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 241; fhir:Element.id [ fhir:value "ExplanationOfBenefit.benefitBalance.modifierExtension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.modifierExtension" ]; fhir:ElementDefinition.short [ fhir:value "Extensions that cannot be ignored even if unrecognized" ]; fhir:ElementDefinition.definition [ fhir: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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.requirements [ fhir:value "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ], [ fhir:value "modifiers"; fhir:index 2 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "BackboneElement.modifierExtension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "true" ]; fhir:ElementDefinition.isModifierReason [ fhir:value "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "N/A" ] ] ], [ fhir:index 242; fhir:Element.id [ fhir:value "ExplanationOfBenefit.benefitBalance.category" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.category" ]; fhir:ElementDefinition.short [ fhir:value "Benefit classification" ]; fhir:ElementDefinition.definition [ fhir:value "Code to identify the general type of benefits under which products and services are provided." ]; fhir:ElementDefinition.comment [ fhir:value "Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to convey the category of service or product for which eligibility is sought." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.category" ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "BenefitCategory" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Benefit categories such as: oral, medical, vision, oral-basic etc." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/ex-benefitcategory" ] ] ], [ fhir:index 243; fhir:Element.id [ fhir:value "ExplanationOfBenefit.benefitBalance.excluded" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.excluded" ]; fhir:ElementDefinition.short [ fhir:value "Excluded from the plan" ]; fhir:ElementDefinition.definition [ fhir:value "True if the indicated class of service is excluded from the plan, missing or False indicates the product or service is included in the coverage." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to identify items that are specifically excluded from the coverage." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.excluded" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "boolean" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 244; fhir:Element.id [ fhir:value "ExplanationOfBenefit.benefitBalance.name" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.name" ]; fhir:ElementDefinition.short [ fhir:value "Short name for the benefit" ]; fhir:ElementDefinition.definition [ fhir:value "A short name or tag for the benefit." ]; fhir:ElementDefinition.comment [ fhir:value "For example: MED01, or DENT2." ]; fhir:ElementDefinition.requirements [ fhir:value "Required to align with other plan names." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.name" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "string" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 245; fhir:Element.id [ fhir:value "ExplanationOfBenefit.benefitBalance.description" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.description" ]; fhir:ElementDefinition.short [ fhir:value "Description of the benefit or services covered" ]; fhir:ElementDefinition.definition [ fhir:value "A richer description of the benefit or services covered." ]; fhir:ElementDefinition.comment [ fhir:value "For example, 'DENT2 covers 100% of basic, 50% of major but excludes Ortho, Implants and Cosmetic services'." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed for human readable reference." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.description" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "string" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 246; fhir:Element.id [ fhir:value "ExplanationOfBenefit.benefitBalance.network" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.network" ]; fhir:ElementDefinition.short [ fhir:value "In or out of network" ]; fhir:ElementDefinition.definition [ fhir:value "Is a flag to indicate whether the benefits refer to in-network providers or out-of-network providers." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed as in or out of network providers are treated differently under the coverage." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.network" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "BenefitNetwork" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Code to classify in or out of network services." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/benefit-network" ] ] ], [ fhir:index 247; fhir:Element.id [ fhir:value "ExplanationOfBenefit.benefitBalance.unit" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.unit" ]; fhir:ElementDefinition.short [ fhir:value "Individual or family" ]; fhir:ElementDefinition.definition [ fhir:value "Indicates if the benefits apply to an individual or to the family." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed for the understanding of the benefits." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.unit" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "BenefitUnit" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Unit covered/serviced - individual or family." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/benefit-unit" ] ] ], [ fhir:index 248; fhir:Element.id [ fhir:value "ExplanationOfBenefit.benefitBalance.term" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.term" ]; fhir:ElementDefinition.short [ fhir:value "Annual or lifetime" ]; fhir:ElementDefinition.definition [ fhir:value "The term or period of the values such as 'maximum lifetime benefit' or 'maximum annual visits'." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed for the understanding of the benefits." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.term" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "BenefitTerm" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Coverage unit - annual, lifetime." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/benefit-term" ] ] ], [ fhir:index 249; fhir:Element.id [ fhir:value "ExplanationOfBenefit.benefitBalance.financial" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "Benefit" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.financial" ]; fhir:ElementDefinition.short [ fhir:value "Benefit Summary" ]; fhir:ElementDefinition.definition [ fhir:value "Benefits Used to date." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.financial" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children unless an empty Parameters resource" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count()) or $this is Parameters" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div|self::f:Parameters" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 250; fhir:Element.id [ fhir:value "ExplanationOfBenefit.benefitBalance.financial.id" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.financial.id" ]; fhir:ElementDefinition.representation [ fhir:value "xmlAttr"; fhir:index 0 ]; fhir:ElementDefinition.short [ fhir:value "Unique id for inter-element referencing" ]; fhir:ElementDefinition.definition [ fhir:value "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.id" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type" ]; fhir:Extension.value [ fhir:value "string" ] ]; fhir:ElementDefinition.code [ fhir:value "http://hl7.org/fhirpath/System.String" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 251; fhir:Element.id [ fhir:value "ExplanationOfBenefit.benefitBalance.financial.extension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.financial.extension" ]; fhir:ElementDefinition.short [ fhir:value "Additional content defined by implementations" ]; fhir:ElementDefinition.definition [ fhir:value "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "Element.extension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "n/a" ] ] ], [ fhir:index 252; fhir:Element.id [ fhir:value "ExplanationOfBenefit.benefitBalance.financial.modifierExtension" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.financial.modifierExtension" ]; fhir:ElementDefinition.short [ fhir:value "Extensions that cannot be ignored even if unrecognized" ]; fhir:ElementDefinition.definition [ fhir: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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ]; fhir:ElementDefinition.comment [ fhir: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." ]; fhir:ElementDefinition.requirements [ fhir:value "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." ]; fhir:ElementDefinition.alias [ fhir:value "extensions"; fhir:index 0 ], [ fhir:value "user content"; fhir:index 1 ], [ fhir:value "modifiers"; fhir:index 2 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "BackboneElement.modifierExtension" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Extension" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ], [ fhir:index 1; fhir:ElementDefinition.key [ fhir:value "ext-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "Must have either extensions or value[x], not both" ]; fhir:ElementDefinition.expression [ fhir:value "extension.exists() != value.exists()" ]; fhir:ElementDefinition.xpath [ fhir:value "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Extension" ] ]; fhir:ElementDefinition.isModifier [ fhir:value "true" ]; fhir:ElementDefinition.isModifierReason [ fhir:value "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "rim" ]; fhir:ElementDefinition.map [ fhir:value "N/A" ] ] ], [ fhir:index 253; fhir:Element.id [ fhir:value "ExplanationOfBenefit.benefitBalance.financial.type" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.financial.type" ]; fhir:ElementDefinition.short [ fhir:value "Benefit classification" ]; fhir:ElementDefinition.definition [ fhir:value "Classification of benefit being provided." ]; fhir:ElementDefinition.comment [ fhir:value "For example: deductible, visits, benefit amount." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to convey the nature of the benefit." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.financial.type" ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "BenefitType" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Deductable, visits, co-pay, etc." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/benefit-type" ] ] ], [ fhir:index 254; fhir:Element.id [ fhir:value "ExplanationOfBenefit.benefitBalance.financial.allowed[x]" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.financial.allowed[x]" ]; fhir:ElementDefinition.short [ fhir:value "Benefits allowed" ]; fhir:ElementDefinition.definition [ fhir:value "The quantity of the benefit which is permitted under the coverage." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to convey the benefits offered under the coverage." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.financial.allowed[x]" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "unsignedInt" ] ], [ fhir:index 1; fhir:ElementDefinition.code [ fhir:value "string" ] ], [ fhir:index 2; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 255; fhir:Element.id [ fhir:value "ExplanationOfBenefit.benefitBalance.financial.used[x]" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.financial.used[x]" ]; fhir:ElementDefinition.short [ fhir:value "Benefits used" ]; fhir:ElementDefinition.definition [ fhir:value "The quantity of the benefit which have been consumed to date." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to convey the benefits consumed to date." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.base [ fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.financial.used[x]" ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ] ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "unsignedInt" ] ], [ fhir:index 1; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.constraint [ fhir:index 0; fhir:ElementDefinition.key [ fhir:value "ele-1" ]; fhir:ElementDefinition.severity [ fhir:value "error" ]; fhir:ElementDefinition.human [ fhir:value "All FHIR elements must have a @value or children" ]; fhir:ElementDefinition.expression [ fhir:value "hasValue() or (children().count() > id.count())" ]; fhir:ElementDefinition.xpath [ fhir:value "@value|f:*|h:div" ]; fhir:ElementDefinition.source [ fhir:value "http://hl7.org/fhir/StructureDefinition/Element" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ] ]; fhir:StructureDefinition.differential [ fhir:StructureDefinition.element [ fhir:index 0; fhir:Element.id [ fhir:value "ExplanationOfBenefit" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit" ]; fhir:ElementDefinition.short [ fhir:value "Explanation of Benefit resource" ]; fhir:ElementDefinition.definition [ fhir: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." ]; fhir:ElementDefinition.alias [ fhir:value "EOB"; fhir:index 0 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "workflow" ]; fhir:ElementDefinition.map [ fhir:value "Event" ] ], [ fhir:index 1; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "financial.other" ] ] ], [ fhir:index 1; fhir:Element.id [ fhir:value "ExplanationOfBenefit.identifier" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.identifier" ]; fhir:ElementDefinition.short [ fhir:value "Business Identifier for the resource" ]; fhir:ElementDefinition.definition [ fhir:value "A unique identifier assigned to this explanation of benefit." ]; fhir:ElementDefinition.requirements [ fhir:value "Allows EOBs to be distinguished and referenced." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Identifier" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "workflow" ]; fhir:ElementDefinition.map [ fhir:value "Event.identifier" ] ], [ fhir:index 1; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.identifier" ] ] ], [ fhir:index 2; fhir:Element.id [ fhir:value "ExplanationOfBenefit.status" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.status" ]; fhir:ElementDefinition.short [ fhir:value "active | cancelled | draft | entered-in-error" ]; fhir:ElementDefinition.definition [ fhir:value "The status of the resource instance." ]; fhir:ElementDefinition.comment [ fhir:value "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid." ]; fhir:ElementDefinition.requirements [ fhir:value "Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "code" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "true" ]; fhir:ElementDefinition.isModifierReason [ fhir:value "This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ExplanationOfBenefitStatus" ] ]; fhir:ElementDefinition.strength [ fhir:value "required" ]; fhir:ElementDefinition.description [ fhir:value "A code specifying the state of the resource instance." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/explanationofbenefit-status|4.3.0" ] ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "workflow" ]; fhir:ElementDefinition.map [ fhir:value "Event.status" ] ], [ fhir:index 1; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.status" ] ] ], [ fhir:index 3; fhir:Element.id [ fhir:value "ExplanationOfBenefit.type" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.type" ]; fhir:ElementDefinition.short [ fhir:value "Category or discipline" ]; fhir:ElementDefinition.definition [ fhir:value "The category of claim, e.g. oral, pharmacy, vision, institutional, professional." ]; fhir:ElementDefinition.comment [ fhir:value "The majority of jurisdictions use: oral, pharmacy, vision, professional and institutional, or variants on those terms, as the general styles of claims. The valueset is extensible to accommodate other jurisdictional requirements." ]; fhir:ElementDefinition.requirements [ fhir:value "Claim type determine the general sets of business rules applied for information requirements and adjudication." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ClaimType" ] ]; fhir:ElementDefinition.strength [ fhir:value "extensible" ]; fhir:ElementDefinition.description [ fhir:value "The type or discipline-style of the claim." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/claim-type" ] ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "workflow" ]; fhir:ElementDefinition.map [ fhir:value "Event.code" ] ], [ fhir:index 1; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.class" ] ] ], [ fhir:index 4; fhir:Element.id [ fhir:value "ExplanationOfBenefit.subType" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.subType" ]; fhir:ElementDefinition.short [ fhir:value "More granular claim type" ]; fhir:ElementDefinition.definition [ fhir:value "A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service." ]; fhir:ElementDefinition.comment [ fhir:value "This may contain the local bill type codes such as the US UB-04 bill type code." ]; fhir:ElementDefinition.requirements [ fhir:value "Some jurisdictions need a finer grained claim type for routing and adjudication." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ClaimSubType" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "A more granular claim typecode." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/claim-subtype" ] ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.class" ] ] ], [ fhir:index 5; fhir:Element.id [ fhir:value "ExplanationOfBenefit.use" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.use" ]; fhir:ElementDefinition.short [ fhir:value "claim | preauthorization | predetermination" ]; fhir:ElementDefinition.definition [ fhir:value "A code to indicate whether the nature of the request is: to request adjudication of products and services previously rendered; or requesting authorization and adjudication for provision in the future; or requesting the non-binding adjudication of the listed products and services which could be provided in the future." ]; fhir:ElementDefinition.requirements [ fhir:value "This element is required to understand the nature of the request for adjudication." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "code" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "Use" ] ]; fhir:ElementDefinition.strength [ fhir:value "required" ]; fhir:ElementDefinition.description [ fhir:value "Complete, proposed, exploratory, other." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/claim-use|4.3.0" ] ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.class" ] ] ], [ fhir:index 6; fhir:Element.id [ fhir:value "ExplanationOfBenefit.patient" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.patient" ]; fhir:ElementDefinition.short [ fhir:value "The recipient of the products and services" ]; fhir:ElementDefinition.definition [ fhir:value "The party to whom the professional services and/or products have been supplied or are being considered and for whom actual for forecast reimbursement is sought." ]; fhir:ElementDefinition.requirements [ fhir:value "The patient must be supplied to the insurer so that confirmation of coverage and service history may be considered as part of the authorization and/or adjudiction." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Patient"; fhir:index 0 ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "workflow" ]; fhir:ElementDefinition.map [ fhir:value "Event.subject" ] ], [ fhir:index 1; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.subject[x]" ] ], [ fhir:index 2; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.subject" ] ] ], [ fhir:index 7; fhir:Element.id [ fhir:value "ExplanationOfBenefit.billablePeriod" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.billablePeriod" ]; fhir:ElementDefinition.short [ fhir:value "Relevant time frame for the claim" ]; fhir:ElementDefinition.definition [ fhir:value "The period for which charges are being submitted." ]; fhir:ElementDefinition.comment [ fhir:value "Typically this would be today or in the past for a claim, and today or in the future for preauthorizations and prodeterminations. Typically line item dates of service should fall within the billing period if one is specified." ]; fhir:ElementDefinition.requirements [ fhir:value "A number jurisdictions required the submission of the billing period when submitting claims for example for hospital stays or long-term care." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Period" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.done[x]" ] ] ], [ fhir:index 8; fhir:Element.id [ fhir:value "ExplanationOfBenefit.created" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.created" ]; fhir:ElementDefinition.short [ fhir:value "Response creation date" ]; fhir:ElementDefinition.definition [ fhir:value "The date this resource was created." ]; fhir:ElementDefinition.comment [ fhir:value "This field is independent of the date of creation of the resource as it may reflect the creation date of a source document prior to digitization. Typically for claims all services must be completed as of this date." ]; fhir:ElementDefinition.requirements [ fhir:value "Need to record a timestamp for use by both the recipient and the issuer." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "dateTime" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "workflow" ]; fhir:ElementDefinition.map [ fhir:value "Event.occurrence[x]" ] ], [ fhir:index 1; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.recorded" ] ] ], [ fhir:index 9; fhir:Element.id [ fhir:value "ExplanationOfBenefit.enterer" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.enterer" ]; fhir:ElementDefinition.short [ fhir:value "Author of the claim" ]; fhir:ElementDefinition.definition [ fhir:value "Individual who created the claim, predetermination or preauthorization." ]; fhir:ElementDefinition.requirements [ fhir:value "Some jurisdictions require the contact information for personnel completing claims." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Practitioner"; fhir:index 0 ], [ fhir:value "http://hl7.org/fhir/StructureDefinition/PractitionerRole"; fhir:index 1 ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "workflow" ]; fhir:ElementDefinition.map [ fhir:value "Event.performer.agent" ] ], [ fhir:index 1; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.author" ] ] ], [ fhir:index 10; fhir:Element.id [ fhir:value "ExplanationOfBenefit.insurer" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.insurer" ]; fhir:ElementDefinition.short [ fhir:value "Party responsible for reimbursement" ]; fhir:ElementDefinition.definition [ fhir:value "The party responsible for authorization, adjudication and reimbursement." ]; fhir:ElementDefinition.requirements [ fhir:value "To be a valid claim, preauthorization or predetermination there must be a party who is responsible for adjudicating the contents against a policy which provides benefits for the patient." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Organization"; fhir:index 0 ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "workflow" ]; fhir:ElementDefinition.map [ fhir:value "Event.performer.agent" ] ], [ fhir:index 1; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.author" ] ] ], [ fhir:index 11; fhir:Element.id [ fhir:value "ExplanationOfBenefit.provider" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.provider" ]; fhir:ElementDefinition.short [ fhir:value "Party responsible for the claim" ]; fhir:ElementDefinition.definition [ fhir:value "The provider which is responsible for the claim, predetermination or preauthorization." ]; fhir:ElementDefinition.comment [ fhir:value "Typically this field would be 1..1 where this party is responsible for the claim but not necessarily professionally responsible for the provision of the individual products and services listed below." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Practitioner"; fhir:index 0 ], [ fhir:value "http://hl7.org/fhir/StructureDefinition/PractitionerRole"; fhir:index 1 ], [ fhir:value "http://hl7.org/fhir/StructureDefinition/Organization"; fhir:index 2 ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.source" ] ] ], [ fhir:index 12; fhir:Element.id [ fhir:value "ExplanationOfBenefit.priority" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.priority" ]; fhir:ElementDefinition.short [ fhir:value "Desired processing urgency" ]; fhir:ElementDefinition.definition [ fhir:value "The provider-required urgency of processing the request. Typical values include: stat, routine deferred." ]; fhir:ElementDefinition.comment [ fhir:value "If a claim processor is unable to complete the processing as per the priority then they should generate and error and not process the request." ]; fhir:ElementDefinition.requirements [ fhir:value "The provider may need to indicate their processing requirements so that the processor can indicate if they are unable to comply." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ProcessPriority" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "The timeliness with which processing is required: stat, normal, deferred." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/process-priority" ] ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "v2" ]; fhir:ElementDefinition.map [ fhir:value "Request.priority" ] ] ], [ fhir:index 13; fhir:Element.id [ fhir:value "ExplanationOfBenefit.fundsReserveRequested" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.fundsReserveRequested" ]; fhir:ElementDefinition.short [ fhir:value "For whom to reserve funds" ]; fhir:ElementDefinition.definition [ fhir:value "A code to indicate whether and for whom funds are to be reserved for future claims." ]; fhir:ElementDefinition.comment [ fhir:value "This field is only used for preauthorizations." ]; fhir:ElementDefinition.requirements [ fhir:value "In the case of a Pre-Determination/Pre-Authorization the provider may request that funds in the amount of the expected Benefit be reserved ('Patient' or 'Provider') to pay for the Benefits determined on the subsequent claim(s). 'None' explicitly indicates no funds reserving is requested." ]; fhir:ElementDefinition.alias [ fhir:value "Fund pre-allocation"; fhir:index 0 ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "FundsReserve" ] ], [ fhir:index 1; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding" ]; fhir:Extension.value [ fhir:value "true" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "For whom funds are to be reserved: (Patient, Provider, None)." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/fundsreserve" ] ] ], [ fhir:index 14; fhir:Element.id [ fhir:value "ExplanationOfBenefit.fundsReserve" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.fundsReserve" ]; fhir:ElementDefinition.short [ fhir:value "Funds reserved status" ]; fhir:ElementDefinition.definition [ fhir:value "A code, used only on a response to a preauthorization, to indicate whether the benefits payable have been reserved and for whom." ]; fhir:ElementDefinition.comment [ fhir:value "Fund would be release by a future claim quoting the preAuthRef of this response. Examples of values include: provider, patient, none." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to advise the submitting provider on whether the rquest for reservation of funds has been honored." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "FundsReserve" ] ], [ fhir:index 1; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding" ]; fhir:Extension.value [ fhir:value "true" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "For whom funds are to be reserved: (Patient, Provider, None)." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/fundsreserve" ] ] ], [ fhir:index 15; fhir:Element.id [ fhir:value "ExplanationOfBenefit.related" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "RelatedClaim" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.related" ]; fhir:ElementDefinition.short [ fhir:value "Prior or corollary claims" ]; fhir:ElementDefinition.definition [ fhir:value "Other claims which are related to this claim such as prior submissions or claims for related services or for the same event." ]; fhir:ElementDefinition.comment [ fhir:value "For example, for the original treatment and follow-up exams." ]; fhir:ElementDefinition.requirements [ fhir:value "For workplace or other accidents it is common to relate separate claims arising from the same event." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 16; fhir:Element.id [ fhir:value "ExplanationOfBenefit.related.claim" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.related.claim" ]; fhir:ElementDefinition.short [ fhir:value "Reference to the related claim" ]; fhir:ElementDefinition.definition [ fhir:value "Reference to a related claim." ]; fhir:ElementDefinition.requirements [ fhir:value "For workplace or other accidents it is common to relate separate claims arising from the same event." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Claim"; fhir:index 0 ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 17; fhir:Element.id [ fhir:value "ExplanationOfBenefit.related.relationship" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.related.relationship" ]; fhir:ElementDefinition.short [ fhir:value "How the reference claim is related" ]; fhir:ElementDefinition.definition [ fhir:value "A code to convey how the claims are related." ]; fhir:ElementDefinition.comment [ fhir:value "For example, prior claim or umbrella." ]; fhir:ElementDefinition.requirements [ fhir:value "Some insurers need a declaration of the type of relationship." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "RelatedClaimRelationship" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Relationship of this claim to a related Claim." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/related-claim-relationship" ] ] ], [ fhir:index 18; fhir:Element.id [ fhir:value "ExplanationOfBenefit.related.reference" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.related.reference" ]; fhir:ElementDefinition.short [ fhir:value "File or case reference" ]; fhir:ElementDefinition.definition [ fhir:value "An alternate organizational reference to the case or file to which this particular claim pertains." ]; fhir:ElementDefinition.comment [ fhir:value "For example, Property/Casualty insurer claim number or Workers Compensation case number." ]; fhir:ElementDefinition.requirements [ fhir:value "In cases where an event-triggered claim is being submitted to an insurer which requires a reference number to be specified on all exchanges." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Identifier" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 19; fhir:Element.id [ fhir:value "ExplanationOfBenefit.prescription" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.prescription" ]; fhir:ElementDefinition.short [ fhir:value "Prescription authorizing services or products" ]; fhir:ElementDefinition.definition [ fhir:value "Prescription to support the dispensing of pharmacy, device or vision products." ]; fhir:ElementDefinition.requirements [ fhir:value "Required to authorize the dispensing of controlled substances and devices." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/MedicationRequest"; fhir:index 0 ], [ fhir:value "http://hl7.org/fhir/StructureDefinition/VisionPrescription"; fhir:index 1 ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 20; fhir:Element.id [ fhir:value "ExplanationOfBenefit.originalPrescription" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.originalPrescription" ]; fhir:ElementDefinition.short [ fhir:value "Original prescription if superceded by fulfiller" ]; fhir:ElementDefinition.definition [ fhir:value "Original prescription which has been superseded by this prescription to support the dispensing of pharmacy services, medications or products." ]; fhir:ElementDefinition.comment [ fhir:value "For example, a physician may prescribe a medication which the pharmacy determines is contraindicated, or for which the patient has an intolerance, and therefor issues a new prescription for an alternate medication which has the same therapeutic intent. The prescription from the pharmacy becomes the 'prescription' and that from the physician becomes the 'original prescription'." ]; fhir:ElementDefinition.requirements [ fhir:value "Often required when a fulfiller varies what is fulfilled from that authorized on the original prescription." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/MedicationRequest"; fhir:index 0 ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 21; fhir:Element.id [ fhir:value "ExplanationOfBenefit.payee" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "Payee" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payee" ]; fhir:ElementDefinition.short [ fhir:value "Recipient of benefits payable" ]; fhir:ElementDefinition.definition [ fhir:value "The party to be reimbursed for cost of the products and services according to the terms of the policy." ]; fhir:ElementDefinition.comment [ fhir:value "Often providers agree to receive the benefits payable to reduce the near-term costs to the patient. The insurer may decline to pay the provider and may choose to pay the subscriber instead." ]; fhir:ElementDefinition.requirements [ fhir:value "The provider needs to specify who they wish to be reimbursed and the claims processor needs express who they will reimburse." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 22; fhir:Element.id [ fhir:value "ExplanationOfBenefit.payee.type" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payee.type" ]; fhir:ElementDefinition.short [ fhir:value "Category of recipient" ]; fhir:ElementDefinition.definition [ fhir:value "Type of Party to be reimbursed: Subscriber, provider, other." ]; fhir:ElementDefinition.requirements [ fhir:value "Need to know who should receive payment with the most common situations being the Provider (assignment of benefits) or the Subscriber." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "PayeeType" ] ], [ fhir:index 1; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding" ]; fhir:Extension.value [ fhir:value "true" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "A code for the party to be reimbursed." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/payeetype" ] ] ], [ fhir:index 23; fhir:Element.id [ fhir:value "ExplanationOfBenefit.payee.party" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payee.party" ]; fhir:ElementDefinition.short [ fhir:value "Recipient reference" ]; fhir:ElementDefinition.definition [ fhir:value "Reference to the individual or organization to whom any payment will be made." ]; fhir:ElementDefinition.comment [ fhir:value "Not required if the payee is 'subscriber' or 'provider'." ]; fhir:ElementDefinition.requirements [ fhir:value "Need to provide demographics if the payee is not 'subscriber' nor 'provider'." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Practitioner"; fhir:index 0 ], [ fhir:value "http://hl7.org/fhir/StructureDefinition/PractitionerRole"; fhir:index 1 ], [ fhir:value "http://hl7.org/fhir/StructureDefinition/Organization"; fhir:index 2 ], [ fhir:value "http://hl7.org/fhir/StructureDefinition/Patient"; fhir:index 3 ], [ fhir:value "http://hl7.org/fhir/StructureDefinition/RelatedPerson"; fhir:index 4 ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 24; fhir:Element.id [ fhir:value "ExplanationOfBenefit.referral" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.referral" ]; fhir:ElementDefinition.short [ fhir:value "Treatment Referral" ]; fhir:ElementDefinition.definition [ fhir:value "A reference to a referral resource." ]; fhir:ElementDefinition.comment [ fhir:value "The referral resource which lists the date, practitioner, reason and other supporting information." ]; fhir:ElementDefinition.requirements [ fhir:value "Some insurers require proof of referral to pay for services or to pay specialist rates for services." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/ServiceRequest"; fhir:index 0 ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.cause" ] ] ], [ fhir:index 25; fhir:Element.id [ fhir:value "ExplanationOfBenefit.facility" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.facility" ]; fhir:ElementDefinition.short [ fhir:value "Servicing Facility" ]; fhir:ElementDefinition.definition [ fhir:value "Facility where the services were provided." ]; fhir:ElementDefinition.requirements [ fhir:value "Insurance adjudication can be dependant on where services were delivered." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Location"; fhir:index 0 ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "workflow" ]; fhir:ElementDefinition.map [ fhir:value "Event.performer.location" ] ], [ fhir:index 1; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.where[x]" ] ] ], [ fhir:index 26; fhir:Element.id [ fhir:value "ExplanationOfBenefit.claim" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.claim" ]; fhir:ElementDefinition.short [ fhir:value "Claim reference" ]; fhir:ElementDefinition.definition [ fhir:value "The business identifier for the instance of the adjudication request: claim predetermination or preauthorization." ]; fhir:ElementDefinition.requirements [ fhir:value "To provide a link to the original adjudication request." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Claim"; fhir:index 0 ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.why[x]" ] ] ], [ fhir:index 27; fhir:Element.id [ fhir:value "ExplanationOfBenefit.claimResponse" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.claimResponse" ]; fhir:ElementDefinition.short [ fhir:value "Claim response reference" ]; fhir:ElementDefinition.definition [ fhir:value "The business identifier for the instance of the adjudication response: claim, predetermination or preauthorization response." ]; fhir:ElementDefinition.requirements [ fhir:value "To provide a link to the original adjudication response." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/ClaimResponse"; fhir:index 0 ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 28; fhir:Element.id [ fhir:value "ExplanationOfBenefit.outcome" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.outcome" ]; fhir:ElementDefinition.short [ fhir:value "queued | complete | error | partial" ]; fhir:ElementDefinition.definition [ fhir:value "The outcome of the claim, predetermination, or preauthorization processing." ]; fhir:ElementDefinition.comment [ fhir:value "The resource may be used to indicate that: the request has been held (queued) for processing; that it has been processed and errors found (error); that no errors were found and that some of the adjudication has been undertaken (partial) or that all of the adjudication has been undertaken (complete)." ]; fhir:ElementDefinition.requirements [ fhir:value "To advise the requestor of an overall processing outcome." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "code" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "RemittanceOutcome" ] ], [ fhir:index 1; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding" ]; fhir:Extension.value [ fhir:value "true" ] ]; fhir:ElementDefinition.strength [ fhir:value "required" ]; fhir:ElementDefinition.description [ fhir:value "The result of the claim processing." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/remittance-outcome|4.3.0" ] ] ], [ fhir:index 29; fhir:Element.id [ fhir:value "ExplanationOfBenefit.disposition" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.disposition" ]; fhir:ElementDefinition.short [ fhir:value "Disposition Message" ]; fhir:ElementDefinition.definition [ fhir:value "A human readable description of the status of the adjudication." ]; fhir:ElementDefinition.requirements [ fhir:value "Provided for user display." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "string" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 30; fhir:Element.id [ fhir:value "ExplanationOfBenefit.preAuthRef" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.preAuthRef" ]; fhir:ElementDefinition.short [ fhir:value "Preauthorization reference" ]; fhir:ElementDefinition.definition [ fhir:value "Reference from the Insurer which is used in later communications which refers to this adjudication." ]; fhir:ElementDefinition.comment [ fhir:value "This value is only present on preauthorization adjudications." ]; fhir:ElementDefinition.requirements [ fhir:value "On subsequent claims, the insurer may require the provider to quote this value." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "string" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 31; fhir:Element.id [ fhir:value "ExplanationOfBenefit.preAuthRefPeriod" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.preAuthRefPeriod" ]; fhir:ElementDefinition.short [ fhir:value "Preauthorization in-effect period" ]; fhir:ElementDefinition.definition [ fhir:value "The timeframe during which the supplied preauthorization reference may be quoted on claims to obtain the adjudication as provided." ]; fhir:ElementDefinition.comment [ fhir:value "This value is only present on preauthorization adjudications." ]; fhir:ElementDefinition.requirements [ fhir:value "On subsequent claims, the insurer may require the provider to quote this value." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Period" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 32; fhir:Element.id [ fhir:value "ExplanationOfBenefit.careTeam" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "CareTeam" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.careTeam" ]; fhir:ElementDefinition.short [ fhir:value "Care Team members" ]; fhir:ElementDefinition.definition [ fhir:value "The members of the team who provided the products and services." ]; fhir:ElementDefinition.requirements [ fhir:value "Common to identify the responsible and supporting practitioners." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 33; fhir:Element.id [ fhir:value "ExplanationOfBenefit.careTeam.sequence" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.careTeam.sequence" ]; fhir:ElementDefinition.short [ fhir:value "Order of care team" ]; fhir:ElementDefinition.definition [ fhir:value "A number to uniquely identify care team entries." ]; fhir:ElementDefinition.requirements [ fhir:value "Necessary to maintain the order of the care team and provide a mechanism to link individuals to claim details." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 34; fhir:Element.id [ fhir:value "ExplanationOfBenefit.careTeam.provider" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.careTeam.provider" ]; fhir:ElementDefinition.short [ fhir:value "Practitioner or organization" ]; fhir:ElementDefinition.definition [ fhir:value "Member of the team who provided the product or service." ]; fhir:ElementDefinition.requirements [ fhir:value "Often a regulatory requirement to specify the responsible provider." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Practitioner"; fhir:index 0 ], [ fhir:value "http://hl7.org/fhir/StructureDefinition/PractitionerRole"; fhir:index 1 ], [ fhir:value "http://hl7.org/fhir/StructureDefinition/Organization"; fhir:index 2 ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.actor" ] ] ], [ fhir:index 35; fhir:Element.id [ fhir:value "ExplanationOfBenefit.careTeam.responsible" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.careTeam.responsible" ]; fhir:ElementDefinition.short [ fhir:value "Indicator of the lead practitioner" ]; fhir:ElementDefinition.definition [ fhir:value "The party who is billing and/or responsible for the claimed products or services." ]; fhir:ElementDefinition.comment [ fhir:value "Responsible might not be required when there is only a single provider listed." ]; fhir:ElementDefinition.requirements [ fhir:value "When multiple parties are present it is required to distinguish the lead or responsible individual." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "boolean" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 36; fhir:Element.id [ fhir:value "ExplanationOfBenefit.careTeam.role" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.careTeam.role" ]; fhir:ElementDefinition.short [ fhir:value "Function within the team" ]; fhir:ElementDefinition.definition [ fhir:value "The lead, assisting or supervising practitioner and their discipline if a multidisciplinary team." ]; fhir:ElementDefinition.comment [ fhir:value "Role might not be required when there is only a single provider listed." ]; fhir:ElementDefinition.requirements [ fhir:value "When multiple parties are present it is required to distinguish the roles performed by each member." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "CareTeamRole" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "The role codes for the care team members." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/claim-careteamrole" ] ] ], [ fhir:index 37; fhir:Element.id [ fhir:value "ExplanationOfBenefit.careTeam.qualification" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.careTeam.qualification" ]; fhir:ElementDefinition.short [ fhir:value "Practitioner credential or specialization" ]; fhir:ElementDefinition.definition [ fhir:value "The qualification of the practitioner which is applicable for this service." ]; fhir:ElementDefinition.requirements [ fhir:value "Need to specify which qualification a provider is delivering the product or service under." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ProviderQualification" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Provider professional qualifications." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/provider-qualification" ] ] ], [ fhir:index 38; fhir:Element.id [ fhir:value "ExplanationOfBenefit.supportingInfo" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "SupportingInformation" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.supportingInfo" ]; fhir:ElementDefinition.short [ fhir:value "Supporting information" ]; fhir:ElementDefinition.definition [ fhir:value "Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues." ]; fhir:ElementDefinition.comment [ fhir:value "Often there are multiple jurisdiction specific valuesets which are required." ]; fhir:ElementDefinition.requirements [ fhir:value "Typically these information codes are required to support the services rendered or the adjudication of the services rendered." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 39; fhir:Element.id [ fhir:value "ExplanationOfBenefit.supportingInfo.sequence" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.supportingInfo.sequence" ]; fhir:ElementDefinition.short [ fhir:value "Information instance identifier" ]; fhir:ElementDefinition.definition [ fhir:value "A number to uniquely identify supporting information entries." ]; fhir:ElementDefinition.requirements [ fhir:value "Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 40; fhir:Element.id [ fhir:value "ExplanationOfBenefit.supportingInfo.category" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.supportingInfo.category" ]; fhir:ElementDefinition.short [ fhir:value "Classification of the supplied information" ]; fhir:ElementDefinition.definition [ fhir:value "The general class of the information supplied: information; exception; accident, employment; onset, etc." ]; fhir:ElementDefinition.comment [ fhir:value "This may contain a category for the local bill type codes." ]; fhir:ElementDefinition.requirements [ fhir:value "Required to group or associate information items with common characteristics. For example: admission information or prior treatments." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "InformationCategory" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "The valuset used for additional information category codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/claim-informationcategory" ] ] ], [ fhir:index 41; fhir:Element.id [ fhir:value "ExplanationOfBenefit.supportingInfo.code" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.supportingInfo.code" ]; fhir:ElementDefinition.short [ fhir:value "Type of information" ]; fhir:ElementDefinition.definition [ fhir:value "System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient for which care is sought." ]; fhir:ElementDefinition.comment [ fhir:value "This may contain the local bill type codes such as the US UB-04 bill type code." ]; fhir:ElementDefinition.requirements [ fhir:value "Required to identify the kind of additional information." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "InformationCode" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "The valuset used for additional information codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/claim-exception" ] ] ], [ fhir:index 42; fhir:Element.id [ fhir:value "ExplanationOfBenefit.supportingInfo.timing[x]" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.supportingInfo.timing[x]" ]; fhir:ElementDefinition.short [ fhir:value "When it occurred" ]; fhir:ElementDefinition.definition [ fhir:value "The date when or period to which this information refers." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "date" ] ], [ fhir:index 1; fhir:ElementDefinition.code [ fhir:value "Period" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 43; fhir:Element.id [ fhir:value "ExplanationOfBenefit.supportingInfo.value[x]" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.supportingInfo.value[x]" ]; fhir:ElementDefinition.short [ fhir:value "Data to be provided" ]; fhir:ElementDefinition.definition [ fhir:value "Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data." ]; fhir:ElementDefinition.comment [ fhir:value "Could be used to provide references to other resources, document. For example, could contain a PDF in an Attachment of the Police Report for an Accident." ]; fhir:ElementDefinition.requirements [ fhir:value "To convey the data content to be provided when the information is more than a simple code or period." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "boolean" ] ], [ fhir:index 1; fhir:ElementDefinition.code [ fhir:value "string" ] ], [ fhir:index 2; fhir:ElementDefinition.code [ fhir:value "Quantity" ] ], [ fhir:index 3; fhir:ElementDefinition.code [ fhir:value "Attachment" ] ], [ fhir:index 4; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Resource"; fhir:index 0 ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 44; fhir:Element.id [ fhir:value "ExplanationOfBenefit.supportingInfo.reason" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.supportingInfo.reason" ]; fhir:ElementDefinition.short [ fhir:value "Explanation for the information" ]; fhir:ElementDefinition.definition [ fhir:value "Provides the reason in the situation where a reason code is required in addition to the content." ]; fhir:ElementDefinition.comment [ fhir:value "For example: the reason for the additional stay, or why a tooth is missing." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed when the supporting information has both a date and amount/value and requires explanation." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Coding" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "MissingReason" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Reason codes for the missing teeth." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/missing-tooth-reason" ] ] ], [ fhir:index 45; fhir:Element.id [ fhir:value "ExplanationOfBenefit.diagnosis" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "Diagnosis" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.diagnosis" ]; fhir:ElementDefinition.short [ fhir:value "Pertinent diagnosis information" ]; fhir:ElementDefinition.definition [ fhir:value "Information about diagnoses relevant to the claim items." ]; fhir:ElementDefinition.requirements [ fhir:value "Required for the adjudication by provided context for the services and product listed." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 46; fhir:Element.id [ fhir:value "ExplanationOfBenefit.diagnosis.sequence" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.diagnosis.sequence" ]; fhir:ElementDefinition.short [ fhir:value "Diagnosis instance identifier" ]; fhir:ElementDefinition.definition [ fhir:value "A number to uniquely identify diagnosis entries." ]; fhir:ElementDefinition.comment [ fhir:value "Diagnosis are presented in list order to their expected importance: primary, secondary, etc." ]; fhir:ElementDefinition.requirements [ fhir:value "Necessary to maintain the order of the diagnosis items and provide a mechanism to link to claim details." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 47; fhir:Element.id [ fhir:value "ExplanationOfBenefit.diagnosis.diagnosis[x]" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.diagnosis.diagnosis[x]" ]; fhir:ElementDefinition.short [ fhir:value "Nature of illness or problem" ]; fhir:ElementDefinition.definition [ fhir:value "The nature of illness or problem in a coded form or as a reference to an external defined Condition." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides health context for the evaluation of the products and/or services." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ], [ fhir:index 1; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Condition"; fhir:index 0 ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ICD10" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "ICD10 Diagnostic codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/icd-10" ] ] ], [ fhir:index 48; fhir:Element.id [ fhir:value "ExplanationOfBenefit.diagnosis.type" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.diagnosis.type" ]; fhir:ElementDefinition.short [ fhir:value "Timing or nature of the diagnosis" ]; fhir:ElementDefinition.definition [ fhir:value "When the condition was observed or the relative ranking." ]; fhir:ElementDefinition.comment [ fhir:value "For example: admitting, primary, secondary, discharge." ]; fhir:ElementDefinition.requirements [ fhir:value "Often required to capture a particular diagnosis, for example: primary or discharge." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "DiagnosisType" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "The type of the diagnosis: admitting, principal, discharge." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/ex-diagnosistype" ] ] ], [ fhir:index 49; fhir:Element.id [ fhir:value "ExplanationOfBenefit.diagnosis.onAdmission" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.diagnosis.onAdmission" ]; fhir:ElementDefinition.short [ fhir:value "Present on admission" ]; fhir:ElementDefinition.definition [ fhir:value "Indication of whether the diagnosis was present on admission to a facility." ]; fhir:ElementDefinition.requirements [ fhir:value "Many systems need to understand for adjudication if the diagnosis was present a time of admission." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "DiagnosisOnAdmission" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Present on admission." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/ex-diagnosis-on-admission" ] ] ], [ fhir:index 50; fhir:Element.id [ fhir:value "ExplanationOfBenefit.diagnosis.packageCode" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.diagnosis.packageCode" ]; fhir:ElementDefinition.short [ fhir:value "Package billing code" ]; fhir:ElementDefinition.definition [ fhir:value "A package billing code or bundle code used to group products and services to a particular health condition (such as heart attack) which is based on a predetermined grouping code system." ]; fhir:ElementDefinition.comment [ fhir:value "For example, DRG (Diagnosis Related Group) or a bundled billing code. A patient may have a diagnosis of a Myocardio-infarction and a DRG for HeartAttack would assigned. The Claim item (and possible subsequent claims) would refer to the DRG for those line items that were for services related to the heart attack event." ]; fhir:ElementDefinition.requirements [ fhir:value "Required to relate the current diagnosis to a package billing code that is then referenced on the individual claim items which are specific to the health condition covered by the package code." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "DiagnosisRelatedGroup" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "The DRG codes associated with the diagnosis." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/ex-diagnosisrelatedgroup" ] ] ], [ fhir:index 51; fhir:Element.id [ fhir:value "ExplanationOfBenefit.procedure" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "Procedure" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.procedure" ]; fhir:ElementDefinition.short [ fhir:value "Clinical procedures performed" ]; fhir:ElementDefinition.definition [ fhir:value "Procedures performed on the patient relevant to the billing items with the claim." ]; fhir:ElementDefinition.requirements [ fhir:value "The specific clinical invention are sometimes required to be provided to justify billing a greater than customary amount for a service." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 52; fhir:Element.id [ fhir:value "ExplanationOfBenefit.procedure.sequence" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.procedure.sequence" ]; fhir:ElementDefinition.short [ fhir:value "Procedure instance identifier" ]; fhir:ElementDefinition.definition [ fhir:value "A number to uniquely identify procedure entries." ]; fhir:ElementDefinition.requirements [ fhir:value "Necessary to provide a mechanism to link to claim details." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 53; fhir:Element.id [ fhir:value "ExplanationOfBenefit.procedure.type" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.procedure.type" ]; fhir:ElementDefinition.short [ fhir:value "Category of Procedure" ]; fhir:ElementDefinition.definition [ fhir:value "When the condition was observed or the relative ranking." ]; fhir:ElementDefinition.requirements [ fhir:value "Often required to capture a particular diagnosis, for example: primary or discharge." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ProcedureType" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Example procedure type codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/ex-procedure-type" ] ] ], [ fhir:index 54; fhir:Element.id [ fhir:value "ExplanationOfBenefit.procedure.date" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.procedure.date" ]; fhir:ElementDefinition.short [ fhir:value "When the procedure was performed" ]; fhir:ElementDefinition.definition [ fhir:value "Date and optionally time the procedure was performed." ]; fhir:ElementDefinition.requirements [ fhir:value "Required for auditing purposes." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "dateTime" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 55; fhir:Element.id [ fhir:value "ExplanationOfBenefit.procedure.procedure[x]" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.procedure.procedure[x]" ]; fhir:ElementDefinition.short [ fhir:value "Specific clinical procedure" ]; fhir:ElementDefinition.definition [ fhir:value "The code or reference to a Procedure resource which identifies the clinical intervention performed." ]; fhir:ElementDefinition.requirements [ fhir:value "This identifies the actual clinical procedure." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ], [ fhir:index 1; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Procedure"; fhir:index 0 ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ICD10_Procedures" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "ICD10 Procedure codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/icd-10-procedures" ] ] ], [ fhir:index 56; fhir:Element.id [ fhir:value "ExplanationOfBenefit.procedure.udi" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.procedure.udi" ]; fhir:ElementDefinition.short [ fhir:value "Unique device identifier" ]; fhir:ElementDefinition.definition [ fhir:value "Unique Device Identifiers associated with this line item." ]; fhir:ElementDefinition.requirements [ fhir:value "The UDI code allows the insurer to obtain device level information on the product supplied." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Device"; fhir:index 0 ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 57; fhir:Element.id [ fhir:value "ExplanationOfBenefit.precedence" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.precedence" ]; fhir:ElementDefinition.short [ fhir:value "Precedence (primary, secondary, etc.)" ]; fhir:ElementDefinition.definition [ fhir:value "This indicates the relative order of a series of EOBs related to different coverages for the same suite of services." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to coordinate between multiple EOBs for the same suite of services." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 58; fhir:Element.id [ fhir:value "ExplanationOfBenefit.insurance" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "Insurance" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.insurance" ]; fhir:ElementDefinition.short [ fhir:value "Patient insurance information" ]; fhir:ElementDefinition.definition [ fhir:value "Financial instruments for reimbursement for the health care products and services specified on the claim." ]; fhir:ElementDefinition.comment [ fhir:value "All insurance coverages for the patient which may be applicable for reimbursement, of the products and services listed in the claim, are typically provided in the claim to allow insurers to confirm the ordering of the insurance coverages relative to local 'coordination of benefit' rules. One coverage (and only one) with 'focal=true' is to be used in the adjudication of this claim. Coverages appearing before the focal Coverage in the list, and where 'Coverage.subrogation=false', should provide a reference to the ClaimResponse containing the adjudication results of the prior claim." ]; fhir:ElementDefinition.requirements [ fhir:value "At least one insurer is required for a claim to be a claim." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "v2" ]; fhir:ElementDefinition.map [ fhir:value "Coverage" ] ] ], [ fhir:index 59; fhir:Element.id [ fhir:value "ExplanationOfBenefit.insurance.focal" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.insurance.focal" ]; fhir:ElementDefinition.short [ fhir:value "Coverage to be used for adjudication" ]; fhir:ElementDefinition.definition [ fhir:value "A flag to indicate that this Coverage is to be used for adjudication of this claim when set to true." ]; fhir:ElementDefinition.comment [ fhir:value "A patient may (will) have multiple insurance policies which provide reimbursement for healthcare services and products. For example, a person may also be covered by their spouse's policy and both appear in the list (and may be from the same insurer). This flag will be set to true for only one of the listed policies and that policy will be used for adjudicating this claim. Other claims would be created to request adjudication against the other listed policies." ]; fhir:ElementDefinition.requirements [ fhir:value "To identify which coverage in the list is being used to adjudicate this claim." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "boolean" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ] ], [ fhir:index 60; fhir:Element.id [ fhir:value "ExplanationOfBenefit.insurance.coverage" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.insurance.coverage" ]; fhir:ElementDefinition.short [ fhir:value "Insurance information" ]; fhir:ElementDefinition.definition [ fhir:value "Reference to the insurance card level information contained in the Coverage resource. The coverage issuing insurer will use these details to locate the patient's actual coverage within the insurer's information system." ]; fhir:ElementDefinition.requirements [ fhir:value "Required to allow the adjudicator to locate the correct policy and history within their information system." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Coverage"; fhir:index 0 ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ] ], [ fhir:index 61; fhir:Element.id [ fhir:value "ExplanationOfBenefit.insurance.preAuthRef" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.insurance.preAuthRef" ]; fhir:ElementDefinition.short [ fhir:value "Prior authorization reference number" ]; fhir:ElementDefinition.definition [ fhir:value "Reference numbers previously provided by the insurer to the provider to be quoted on subsequent claims containing services or products related to the prior authorization." ]; fhir:ElementDefinition.comment [ fhir:value "This value is an alphanumeric string that may be provided over the phone, via text, via paper, or within a ClaimResponse resource and is not a FHIR Identifier." ]; fhir:ElementDefinition.requirements [ fhir:value "Providers must quote previously issued authorization reference numbers in order to obtain adjudication as previously advised on the Preauthorization." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "string" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 62; fhir:Element.id [ fhir:value "ExplanationOfBenefit.accident" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "Accident" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.accident" ]; fhir:ElementDefinition.short [ fhir:value "Details of the event" ]; fhir:ElementDefinition.definition [ fhir:value "Details of a accident which resulted in injuries which required the products and services listed in the claim." ]; fhir:ElementDefinition.requirements [ fhir:value "When healthcare products and services are accident related, benefits may be payable under accident provisions of policies, such as automotive, etc before they are payable under normal health insurance." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 63; fhir:Element.id [ fhir:value "ExplanationOfBenefit.accident.date" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.accident.date" ]; fhir:ElementDefinition.short [ fhir:value "When the incident occurred" ]; fhir:ElementDefinition.definition [ fhir:value "Date of an accident event related to the products and services contained in the claim." ]; fhir:ElementDefinition.comment [ fhir:value "The date of the accident has to precede the dates of the products and services but within a reasonable timeframe." ]; fhir:ElementDefinition.requirements [ fhir:value "Required for audit purposes and adjudication." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "date" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 64; fhir:Element.id [ fhir:value "ExplanationOfBenefit.accident.type" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.accident.type" ]; fhir:ElementDefinition.short [ fhir:value "The nature of the accident" ]; fhir:ElementDefinition.definition [ fhir:value "The type or context of the accident event for the purposes of selection of potential insurance coverages and determination of coordination between insurers." ]; fhir:ElementDefinition.requirements [ fhir:value "Coverage may be dependant on the type of accident." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "AccidentType" ] ]; fhir:ElementDefinition.strength [ fhir:value "extensible" ]; fhir:ElementDefinition.description [ fhir:value "Type of accident: work place, auto, etc." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://terminology.hl7.org/ValueSet/v3-ActIncidentCode" ] ] ], [ fhir:index 65; fhir:Element.id [ fhir:value "ExplanationOfBenefit.accident.location[x]" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.accident.location[x]" ]; fhir:ElementDefinition.short [ fhir:value "Where the event occurred" ]; fhir:ElementDefinition.definition [ fhir:value "The physical location of the accident event." ]; fhir:ElementDefinition.requirements [ fhir:value "Required for audit purposes and determination of applicable insurance liability." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Address" ] ], [ fhir:index 1; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Location"; fhir:index 0 ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 66; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "Item" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item" ]; fhir:ElementDefinition.short [ fhir:value "Product or service provided" ]; fhir:ElementDefinition.definition [ fhir:value "A claim line. Either a simple (a product or service) or a 'group' of details which can also be a simple items or groups of sub-details." ]; fhir:ElementDefinition.requirements [ fhir:value "The items to be processed for adjudication." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 67; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.sequence" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.sequence" ]; fhir:ElementDefinition.short [ fhir:value "Item instance identifier" ]; fhir:ElementDefinition.definition [ fhir:value "A number to uniquely identify item entries." ]; fhir:ElementDefinition.requirements [ fhir:value "Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 68; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.careTeamSequence" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.careTeamSequence" ]; fhir:ElementDefinition.short [ fhir:value "Applicable care team members" ]; fhir:ElementDefinition.definition [ fhir:value "Care team members related to this service or product." ]; fhir:ElementDefinition.requirements [ fhir:value "Need to identify the individuals and their roles in the provision of the product or service." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 69; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.diagnosisSequence" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.diagnosisSequence" ]; fhir:ElementDefinition.short [ fhir:value "Applicable diagnoses" ]; fhir:ElementDefinition.definition [ fhir:value "Diagnoses applicable for this service or product." ]; fhir:ElementDefinition.requirements [ fhir:value "Need to related the product or service to the associated diagnoses." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 70; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.procedureSequence" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.procedureSequence" ]; fhir:ElementDefinition.short [ fhir:value "Applicable procedures" ]; fhir:ElementDefinition.definition [ fhir:value "Procedures applicable for this service or product." ]; fhir:ElementDefinition.requirements [ fhir:value "Need to provide any listed specific procedures to support the product or service being claimed." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 71; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.informationSequence" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.informationSequence" ]; fhir:ElementDefinition.short [ fhir:value "Applicable exception and supporting information" ]; fhir:ElementDefinition.definition [ fhir:value "Exceptions, special conditions and supporting information applicable for this service or product." ]; fhir:ElementDefinition.requirements [ fhir:value "Need to reference the supporting information items that relate directly to this product or service." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 72; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.revenue" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.revenue" ]; fhir:ElementDefinition.short [ fhir:value "Revenue or cost center code" ]; fhir:ElementDefinition.definition [ fhir:value "The type of revenue or cost center providing the product and/or service." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed in the processing of institutional claims." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "RevenueCenter" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Codes for the revenue or cost centers supplying the service and/or products." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/ex-revenue-center" ] ] ], [ fhir:index 73; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.category" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.category" ]; fhir:ElementDefinition.short [ fhir:value "Benefit classification" ]; fhir:ElementDefinition.definition [ fhir:value "Code to identify the general type of benefits under which products and services are provided." ]; fhir:ElementDefinition.comment [ fhir:value "Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "BenefitCategory" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Benefit categories such as: oral, medical, vision, oral-basic etc." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/ex-benefitcategory" ] ] ], [ fhir:index 74; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.productOrService" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.productOrService" ]; fhir:ElementDefinition.short [ fhir:value "Billing, service, product, or drug code" ]; fhir:ElementDefinition.definition [ fhir:value "When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item." ]; fhir:ElementDefinition.comment [ fhir:value "If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'." ]; fhir:ElementDefinition.requirements [ fhir:value "Necessary to state what was provided or done." ]; fhir:ElementDefinition.alias [ fhir:value "Drug Code"; fhir:index 0 ], [ fhir:value "Bill Code"; fhir:index 1 ], [ fhir:value "Service Code"; fhir:index 2 ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ServiceProduct" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Allowable service and product codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/service-uscls" ] ] ], [ fhir:index 75; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.modifier" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.modifier" ]; fhir:ElementDefinition.short [ fhir:value "Product or service billing modifiers" ]; fhir:ElementDefinition.definition [ fhir:value "Item typification or modifiers codes to convey additional context for the product or service." ]; fhir:ElementDefinition.comment [ fhir:value "For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours." ]; fhir:ElementDefinition.requirements [ fhir:value "To support inclusion of the item for adjudication or to charge an elevated fee." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "Modifiers" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir: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." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/claim-modifiers" ] ] ], [ fhir:index 76; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.programCode" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.programCode" ]; fhir:ElementDefinition.short [ fhir:value "Program the product or service is provided under" ]; fhir:ElementDefinition.definition [ fhir:value "Identifies the program under which this may be recovered." ]; fhir:ElementDefinition.comment [ fhir:value "For example: Neonatal program, child dental program or drug users recovery program." ]; fhir:ElementDefinition.requirements [ fhir:value "Commonly used in in the identification of publicly provided program focused on population segments or disease classifications." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ProgramCode" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Program specific reason codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/ex-program-code" ] ] ], [ fhir:index 77; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.serviced[x]" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.serviced[x]" ]; fhir:ElementDefinition.short [ fhir:value "Date or dates of service or product delivery" ]; fhir:ElementDefinition.definition [ fhir:value "The date or dates when the service or product was supplied, performed or completed." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to determine whether the service or product was provided during the term of the insurance coverage." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "date" ] ], [ fhir:index 1; fhir:ElementDefinition.code [ fhir:value "Period" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.done[x]" ] ] ], [ fhir:index 78; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.location[x]" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.location[x]" ]; fhir:ElementDefinition.short [ fhir:value "Place of service or where product was supplied" ]; fhir:ElementDefinition.definition [ fhir:value "Where the product or service was provided." ]; fhir:ElementDefinition.requirements [ fhir:value "The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ], [ fhir:index 1; fhir:ElementDefinition.code [ fhir:value "Address" ] ], [ fhir:index 2; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Location"; fhir:index 0 ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ServicePlace" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Place where the service is rendered." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/service-place" ] ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.where[x]" ] ] ], [ fhir:index 79; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.quantity" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.quantity" ]; fhir:ElementDefinition.short [ fhir:value "Count of products or services" ]; fhir:ElementDefinition.definition [ fhir:value "The number of repetitions of a service or product." ]; fhir:ElementDefinition.requirements [ fhir:value "Required when the product or service code does not convey the quantity provided." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Quantity" ]; fhir:ElementDefinition.profile [ fhir:value "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"; fhir:index 0 ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 80; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.unitPrice" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.unitPrice" ]; fhir:ElementDefinition.short [ fhir:value "Fee, charge or cost per item" ]; fhir:ElementDefinition.definition [ fhir:value "If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group." ]; fhir:ElementDefinition.requirements [ fhir:value "The amount charged to the patient by the provider for a single unit." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 81; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.factor" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.factor" ]; fhir:ElementDefinition.short [ fhir:value "Price scaling factor" ]; fhir:ElementDefinition.definition [ fhir: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." ]; fhir:ElementDefinition.comment [ fhir:value "To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10)." ]; fhir:ElementDefinition.requirements [ fhir:value "When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "decimal" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 82; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.net" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.net" ]; fhir:ElementDefinition.short [ fhir:value "Total item cost" ]; fhir:ElementDefinition.definition [ fhir:value "The quantity times the unit price for an additional service or product or charge." ]; fhir:ElementDefinition.comment [ fhir:value "For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides the total amount claimed for the group (if a grouper) or the line item." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 83; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.udi" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.udi" ]; fhir:ElementDefinition.short [ fhir:value "Unique device identifier" ]; fhir:ElementDefinition.definition [ fhir:value "Unique Device Identifiers associated with this line item." ]; fhir:ElementDefinition.requirements [ fhir:value "The UDI code allows the insurer to obtain device level information on the product supplied." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Device"; fhir:index 0 ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 84; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.bodySite" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.bodySite" ]; fhir:ElementDefinition.short [ fhir:value "Anatomical location" ]; fhir:ElementDefinition.definition [ fhir:value "Physical service site on the patient (limb, tooth, etc.)." ]; fhir:ElementDefinition.comment [ fhir:value "For example: Providing a tooth code, allows an insurer to identify a provider performing a filling on a tooth that was previously removed." ]; fhir:ElementDefinition.requirements [ fhir:value "Allows insurer to validate specific procedures." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "OralSites" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "The code for the teeth, quadrant, sextant and arch." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/tooth" ] ] ], [ fhir:index 85; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.subSite" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.subSite" ]; fhir:ElementDefinition.short [ fhir:value "Anatomical sub-location" ]; fhir:ElementDefinition.definition [ fhir:value "A region or surface of the bodySite, e.g. limb region or tooth surface(s)." ]; fhir:ElementDefinition.requirements [ fhir:value "Allows insurer to validate specific procedures." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "Surface" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "The code for the tooth surface and surface combinations." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/surface" ] ] ], [ fhir:index 86; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.encounter" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.encounter" ]; fhir:ElementDefinition.short [ fhir:value "Encounters related to this billed item" ]; fhir:ElementDefinition.definition [ fhir:value "A billed item may include goods or services provided in multiple encounters." ]; fhir:ElementDefinition.requirements [ fhir:value "Used in some jurisdictions to link clinical events to claim items." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Encounter"; fhir:index 0 ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 87; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.noteNumber" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.noteNumber" ]; fhir:ElementDefinition.short [ fhir:value "Applicable note numbers" ]; fhir:ElementDefinition.definition [ fhir:value "The numbers associated with notes below which apply to the adjudication of this item." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 88; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.adjudication" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "Adjudication" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.adjudication" ]; fhir:ElementDefinition.short [ fhir:value "Adjudication details" ]; fhir:ElementDefinition.definition [ fhir:value "If this item is a group then the values here are a summary of the adjudication of the detail items. If this item is a simple product or service then this is the result of the adjudication of this item." ]; fhir:ElementDefinition.requirements [ fhir:value "The adjudication results conveys the insurer's assessment of the item provided in the claim under the terms of the patient's insurance coverage." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 89; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.adjudication.category" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.adjudication.category" ]; fhir:ElementDefinition.short [ fhir:value "Type of adjudication information" ]; fhir:ElementDefinition.definition [ fhir:value "A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in-aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item." ]; fhir:ElementDefinition.comment [ fhir:value "For example, codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to enable understanding of the context of the other information in the adjudication." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "Adjudication" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "The adjudication codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/adjudication" ] ] ], [ fhir:index 90; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.adjudication.reason" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.adjudication.reason" ]; fhir:ElementDefinition.short [ fhir:value "Explanation of adjudication outcome" ]; fhir:ElementDefinition.definition [ fhir:value "A code supporting the understanding of the adjudication result and explaining variance from expected amount." ]; fhir:ElementDefinition.comment [ fhir:value "For example, may indicate that the funds for this benefit type have been exhausted." ]; fhir:ElementDefinition.requirements [ fhir:value "To support understanding of variance from adjudication expectations." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "AdjudicationReason" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Adjudication reason codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/adjudication-reason" ] ] ], [ fhir:index 91; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.adjudication.amount" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.adjudication.amount" ]; fhir:ElementDefinition.short [ fhir:value "Monetary amount" ]; fhir:ElementDefinition.definition [ fhir:value "Monetary amount associated with the category." ]; fhir:ElementDefinition.comment [ fhir:value "For example, amount submitted, eligible amount, co-payment, and benefit payable." ]; fhir:ElementDefinition.requirements [ fhir:value "Most adjuciation categories convey a monetary amount." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 92; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.adjudication.value" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.adjudication.value" ]; fhir:ElementDefinition.short [ fhir:value "Non-monitary value" ]; fhir:ElementDefinition.definition [ fhir:value "A non-monetary value associated with the category. Mutually exclusive to the amount element above." ]; fhir:ElementDefinition.comment [ fhir:value "For example: eligible percentage or co-payment percentage." ]; fhir:ElementDefinition.requirements [ fhir:value "Some adjudication categories convey a percentage or a fixed value." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "decimal" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 93; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "Detail" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail" ]; fhir:ElementDefinition.short [ fhir:value "Additional items" ]; fhir:ElementDefinition.definition [ fhir:value "Second-tier of goods and services." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 94; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.sequence" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.sequence" ]; fhir:ElementDefinition.short [ fhir:value "Product or service provided" ]; fhir:ElementDefinition.definition [ fhir:value "A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items." ]; fhir:ElementDefinition.requirements [ fhir:value "The items to be processed for adjudication." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 95; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.revenue" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.revenue" ]; fhir:ElementDefinition.short [ fhir:value "Revenue or cost center code" ]; fhir:ElementDefinition.definition [ fhir:value "The type of revenue or cost center providing the product and/or service." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed in the processing of institutional claims." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "RevenueCenter" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Codes for the revenue or cost centers supplying the service and/or products." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/ex-revenue-center" ] ] ], [ fhir:index 96; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.category" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.category" ]; fhir:ElementDefinition.short [ fhir:value "Benefit classification" ]; fhir:ElementDefinition.definition [ fhir:value "Code to identify the general type of benefits under which products and services are provided." ]; fhir:ElementDefinition.comment [ fhir:value "Examples include: Medical Care, Periodontics, Renal Dialysis, Vision Coverage." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "BenefitCategory" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Benefit categories such as: oral, medical, vision, oral-basic etc." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/ex-benefitcategory" ] ] ], [ fhir:index 97; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.productOrService" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.productOrService" ]; fhir:ElementDefinition.short [ fhir:value "Billing, service, product, or drug code" ]; fhir:ElementDefinition.definition [ fhir:value "When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item." ]; fhir:ElementDefinition.comment [ fhir:value "If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'." ]; fhir:ElementDefinition.requirements [ fhir:value "Necessary to state what was provided or done." ]; fhir:ElementDefinition.alias [ fhir:value "Drug Code"; fhir:index 0 ], [ fhir:value "Bill Code"; fhir:index 1 ], [ fhir:value "Service Code"; fhir:index 2 ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ServiceProduct" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Allowable service and product codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/service-uscls" ] ] ], [ fhir:index 98; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.modifier" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.modifier" ]; fhir:ElementDefinition.short [ fhir:value "Service/Product billing modifiers" ]; fhir:ElementDefinition.definition [ fhir:value "Item typification or modifiers codes to convey additional context for the product or service." ]; fhir:ElementDefinition.comment [ fhir:value "For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours." ]; fhir:ElementDefinition.requirements [ fhir:value "To support inclusion of the item for adjudication or to charge an elevated fee." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "Modifiers" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir: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." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/claim-modifiers" ] ] ], [ fhir:index 99; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.programCode" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.programCode" ]; fhir:ElementDefinition.short [ fhir:value "Program the product or service is provided under" ]; fhir:ElementDefinition.definition [ fhir:value "Identifies the program under which this may be recovered." ]; fhir:ElementDefinition.comment [ fhir:value "For example: Neonatal program, child dental program or drug users recovery program." ]; fhir:ElementDefinition.requirements [ fhir:value "Commonly used in in the identification of publicly provided program focused on population segments or disease classifications." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ProgramCode" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Program specific reason codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/ex-program-code" ] ] ], [ fhir:index 100; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.quantity" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.quantity" ]; fhir:ElementDefinition.short [ fhir:value "Count of products or services" ]; fhir:ElementDefinition.definition [ fhir:value "The number of repetitions of a service or product." ]; fhir:ElementDefinition.requirements [ fhir:value "Required when the product or service code does not convey the quantity provided." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Quantity" ]; fhir:ElementDefinition.profile [ fhir:value "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"; fhir:index 0 ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 101; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.unitPrice" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.unitPrice" ]; fhir:ElementDefinition.short [ fhir:value "Fee, charge or cost per item" ]; fhir:ElementDefinition.definition [ fhir:value "If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group." ]; fhir:ElementDefinition.requirements [ fhir:value "The amount charged to the patient by the provider for a single unit." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 102; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.factor" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.factor" ]; fhir:ElementDefinition.short [ fhir:value "Price scaling factor" ]; fhir:ElementDefinition.definition [ fhir: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." ]; fhir:ElementDefinition.comment [ fhir:value "To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10)." ]; fhir:ElementDefinition.requirements [ fhir:value "When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "decimal" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 103; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.net" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.net" ]; fhir:ElementDefinition.short [ fhir:value "Total item cost" ]; fhir:ElementDefinition.definition [ fhir:value "The quantity times the unit price for an additional service or product or charge." ]; fhir:ElementDefinition.comment [ fhir:value "For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides the total amount claimed for the group (if a grouper) or the line item." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 104; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.udi" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.udi" ]; fhir:ElementDefinition.short [ fhir:value "Unique device identifier" ]; fhir:ElementDefinition.definition [ fhir:value "Unique Device Identifiers associated with this line item." ]; fhir:ElementDefinition.requirements [ fhir:value "The UDI code allows the insurer to obtain device level information on the product supplied." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Device"; fhir:index 0 ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 105; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.noteNumber" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.noteNumber" ]; fhir:ElementDefinition.short [ fhir:value "Applicable note numbers" ]; fhir:ElementDefinition.definition [ fhir:value "The numbers associated with notes below which apply to the adjudication of this item." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 106; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.adjudication" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.adjudication" ]; fhir:ElementDefinition.short [ fhir:value "Detail level adjudication details" ]; fhir:ElementDefinition.definition [ fhir:value "The adjudication results." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.contentReference [ fhir:value "#ExplanationOfBenefit.item.adjudication" ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 107; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.subDetail" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "SubDetail" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail" ]; fhir:ElementDefinition.short [ fhir:value "Additional items" ]; fhir:ElementDefinition.definition [ fhir:value "Third-tier of goods and services." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 108; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.sequence" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.sequence" ]; fhir:ElementDefinition.short [ fhir:value "Product or service provided" ]; fhir:ElementDefinition.definition [ fhir:value "A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items." ]; fhir:ElementDefinition.requirements [ fhir:value "The items to be processed for adjudication." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 109; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.revenue" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.revenue" ]; fhir:ElementDefinition.short [ fhir:value "Revenue or cost center code" ]; fhir:ElementDefinition.definition [ fhir:value "The type of revenue or cost center providing the product and/or service." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed in the processing of institutional claims." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "RevenueCenter" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Codes for the revenue or cost centers supplying the service and/or products." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/ex-revenue-center" ] ] ], [ fhir:index 110; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.category" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.category" ]; fhir:ElementDefinition.short [ fhir:value "Benefit classification" ]; fhir:ElementDefinition.definition [ fhir:value "Code to identify the general type of benefits under which products and services are provided." ]; fhir:ElementDefinition.comment [ fhir:value "Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "BenefitCategory" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Benefit categories such as: oral, medical, vision, oral-basic etc." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/ex-benefitcategory" ] ] ], [ fhir:index 111; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.productOrService" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.productOrService" ]; fhir:ElementDefinition.short [ fhir:value "Billing, service, product, or drug code" ]; fhir:ElementDefinition.definition [ fhir:value "When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item." ]; fhir:ElementDefinition.comment [ fhir:value "If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'." ]; fhir:ElementDefinition.requirements [ fhir:value "Necessary to state what was provided or done." ]; fhir:ElementDefinition.alias [ fhir:value "Drug Code"; fhir:index 0 ], [ fhir:value "Bill Code"; fhir:index 1 ], [ fhir:value "Service Code"; fhir:index 2 ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ServiceProduct" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Allowable service and product codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/service-uscls" ] ] ], [ fhir:index 112; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.modifier" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.modifier" ]; fhir:ElementDefinition.short [ fhir:value "Service/Product billing modifiers" ]; fhir:ElementDefinition.definition [ fhir:value "Item typification or modifiers codes to convey additional context for the product or service." ]; fhir:ElementDefinition.comment [ fhir:value "For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours." ]; fhir:ElementDefinition.requirements [ fhir:value "To support inclusion of the item for adjudication or to charge an elevated fee." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "Modifiers" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir: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." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/claim-modifiers" ] ] ], [ fhir:index 113; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.programCode" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.programCode" ]; fhir:ElementDefinition.short [ fhir:value "Program the product or service is provided under" ]; fhir:ElementDefinition.definition [ fhir:value "Identifies the program under which this may be recovered." ]; fhir:ElementDefinition.comment [ fhir:value "For example: Neonatal program, child dental program or drug users recovery program." ]; fhir:ElementDefinition.requirements [ fhir:value "Commonly used in in the identification of publicly provided program focused on population segments or disease classifications." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ProgramCode" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Program specific reason codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/ex-program-code" ] ] ], [ fhir:index 114; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.quantity" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.quantity" ]; fhir:ElementDefinition.short [ fhir:value "Count of products or services" ]; fhir:ElementDefinition.definition [ fhir:value "The number of repetitions of a service or product." ]; fhir:ElementDefinition.requirements [ fhir:value "Required when the product or service code does not convey the quantity provided." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Quantity" ]; fhir:ElementDefinition.profile [ fhir:value "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"; fhir:index 0 ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 115; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.unitPrice" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.unitPrice" ]; fhir:ElementDefinition.short [ fhir:value "Fee, charge or cost per item" ]; fhir:ElementDefinition.definition [ fhir:value "If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group." ]; fhir:ElementDefinition.requirements [ fhir:value "The amount charged to the patient by the provider for a single unit." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 116; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.factor" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.factor" ]; fhir:ElementDefinition.short [ fhir:value "Price scaling factor" ]; fhir:ElementDefinition.definition [ fhir: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." ]; fhir:ElementDefinition.comment [ fhir:value "To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10)." ]; fhir:ElementDefinition.requirements [ fhir:value "When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "decimal" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 117; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.net" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.net" ]; fhir:ElementDefinition.short [ fhir:value "Total item cost" ]; fhir:ElementDefinition.definition [ fhir:value "The quantity times the unit price for an additional service or product or charge." ]; fhir:ElementDefinition.comment [ fhir:value "For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides the total amount claimed for the group (if a grouper) or the line item." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 118; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.udi" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.udi" ]; fhir:ElementDefinition.short [ fhir:value "Unique device identifier" ]; fhir:ElementDefinition.definition [ fhir:value "Unique Device Identifiers associated with this line item." ]; fhir:ElementDefinition.requirements [ fhir:value "The UDI code allows the insurer to obtain device level information on the product supplied." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Device"; fhir:index 0 ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 119; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.noteNumber" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.noteNumber" ]; fhir:ElementDefinition.short [ fhir:value "Applicable note numbers" ]; fhir:ElementDefinition.definition [ fhir:value "The numbers associated with notes below which apply to the adjudication of this item." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 120; fhir:Element.id [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.adjudication" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.item.detail.subDetail.adjudication" ]; fhir:ElementDefinition.short [ fhir:value "Subdetail level adjudication details" ]; fhir:ElementDefinition.definition [ fhir:value "The adjudication results." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.contentReference [ fhir:value "#ExplanationOfBenefit.item.adjudication" ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 121; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint" ]; fhir:Extension.value [ fhir:value "740;600" ] ], [ fhir:index 1; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "AddedItem" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem" ]; fhir:ElementDefinition.short [ fhir:value "Insurer added line items" ]; fhir:ElementDefinition.definition [ fhir:value "The first-tier service adjudications for payor added product or service lines." ]; fhir:ElementDefinition.requirements [ fhir:value "Insurers may redefine the provided product or service or may package and/or decompose groups of products and services. The addItems allows the insurer to provide their line item list with linkage to the submitted items/details/sub-details. In a preauthorization the insurer may use the addItem structure to provide additional information on authorized products and services." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 122; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.itemSequence" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.itemSequence" ]; fhir:ElementDefinition.short [ fhir:value "Item sequence number" ]; fhir:ElementDefinition.definition [ fhir:value "Claim items which this service line is intended to replace." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides references to the claim items." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 123; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detailSequence" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detailSequence" ]; fhir:ElementDefinition.short [ fhir:value "Detail sequence number" ]; fhir:ElementDefinition.definition [ fhir:value "The sequence number of the details within the claim item which this line is intended to replace." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides references to the claim details within the claim item." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 124; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.subDetailSequence" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.subDetailSequence" ]; fhir:ElementDefinition.short [ fhir:value "Subdetail sequence number" ]; fhir:ElementDefinition.definition [ fhir:value "The sequence number of the sub-details woithin the details within the claim item which this line is intended to replace." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides references to the claim sub-details within the claim detail." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 125; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.provider" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.provider" ]; fhir:ElementDefinition.short [ fhir:value "Authorized providers" ]; fhir:ElementDefinition.definition [ fhir:value "The providers who are authorized for the services rendered to the patient." ]; fhir:ElementDefinition.requirements [ fhir:value "Insurer may provide authorization specifically to a restricted set of providers rather than an open authorization." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Practitioner"; fhir:index 0 ], [ fhir:value "http://hl7.org/fhir/StructureDefinition/PractitionerRole"; fhir:index 1 ], [ fhir:value "http://hl7.org/fhir/StructureDefinition/Organization"; fhir:index 2 ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.source" ] ] ], [ fhir:index 126; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.productOrService" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.productOrService" ]; fhir:ElementDefinition.short [ fhir:value "Billing, service, product, or drug code" ]; fhir:ElementDefinition.definition [ fhir:value "When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item." ]; fhir:ElementDefinition.comment [ fhir:value "If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'." ]; fhir:ElementDefinition.requirements [ fhir:value "Necessary to state what was provided or done." ]; fhir:ElementDefinition.alias [ fhir:value "Drug Code"; fhir:index 0 ], [ fhir:value "Bill Code"; fhir:index 1 ], [ fhir:value "Service Code"; fhir:index 2 ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ServiceProduct" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Allowable service and product codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/service-uscls" ] ] ], [ fhir:index 127; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.modifier" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.modifier" ]; fhir:ElementDefinition.short [ fhir:value "Service/Product billing modifiers" ]; fhir:ElementDefinition.definition [ fhir:value "Item typification or modifiers codes to convey additional context for the product or service." ]; fhir:ElementDefinition.comment [ fhir:value "For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours." ]; fhir:ElementDefinition.requirements [ fhir:value "To support inclusion of the item for adjudication or to charge an elevated fee." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "Modifiers" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir: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." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/claim-modifiers" ] ] ], [ fhir:index 128; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.programCode" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.programCode" ]; fhir:ElementDefinition.short [ fhir:value "Program the product or service is provided under" ]; fhir:ElementDefinition.definition [ fhir:value "Identifies the program under which this may be recovered." ]; fhir:ElementDefinition.comment [ fhir:value "For example: Neonatal program, child dental program or drug users recovery program." ]; fhir:ElementDefinition.requirements [ fhir:value "Commonly used in in the identification of publicly provided program focused on population segments or disease classifications." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ProgramCode" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Program specific reason codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/ex-program-code" ] ] ], [ fhir:index 129; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.serviced[x]" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.serviced[x]" ]; fhir:ElementDefinition.short [ fhir:value "Date or dates of service or product delivery" ]; fhir:ElementDefinition.definition [ fhir:value "The date or dates when the service or product was supplied, performed or completed." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to determine whether the service or product was provided during the term of the insurance coverage." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "date" ] ], [ fhir:index 1; fhir:ElementDefinition.code [ fhir:value "Period" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.done[x]" ] ] ], [ fhir:index 130; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.location[x]" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.location[x]" ]; fhir:ElementDefinition.short [ fhir:value "Place of service or where product was supplied" ]; fhir:ElementDefinition.definition [ fhir:value "Where the product or service was provided." ]; fhir:ElementDefinition.requirements [ fhir:value "The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ], [ fhir:index 1; fhir:ElementDefinition.code [ fhir:value "Address" ] ], [ fhir:index 2; fhir:ElementDefinition.code [ fhir:value "Reference" ]; fhir:ElementDefinition.targetProfile [ fhir:value "http://hl7.org/fhir/StructureDefinition/Location"; fhir:index 0 ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ServicePlace" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Place where the service is rendered." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/service-place" ] ]; fhir:ElementDefinition.mapping [ fhir:index 0; fhir:ElementDefinition.identity [ fhir:value "w5" ]; fhir:ElementDefinition.map [ fhir:value "FiveWs.where[x]" ] ] ], [ fhir:index 131; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.quantity" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.quantity" ]; fhir:ElementDefinition.short [ fhir:value "Count of products or services" ]; fhir:ElementDefinition.definition [ fhir:value "The number of repetitions of a service or product." ]; fhir:ElementDefinition.requirements [ fhir:value "Required when the product or service code does not convey the quantity provided." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Quantity" ]; fhir:ElementDefinition.profile [ fhir:value "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"; fhir:index 0 ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 132; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.unitPrice" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.unitPrice" ]; fhir:ElementDefinition.short [ fhir:value "Fee, charge or cost per item" ]; fhir:ElementDefinition.definition [ fhir:value "If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group." ]; fhir:ElementDefinition.requirements [ fhir:value "The amount charged to the patient by the provider for a single unit." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 133; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.factor" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.factor" ]; fhir:ElementDefinition.short [ fhir:value "Price scaling factor" ]; fhir:ElementDefinition.definition [ fhir: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." ]; fhir:ElementDefinition.comment [ fhir:value "To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10)." ]; fhir:ElementDefinition.requirements [ fhir:value "When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "decimal" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 134; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.net" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.net" ]; fhir:ElementDefinition.short [ fhir:value "Total item cost" ]; fhir:ElementDefinition.definition [ fhir:value "The quantity times the unit price for an additional service or product or charge." ]; fhir:ElementDefinition.comment [ fhir:value "For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides the total amount claimed for the group (if a grouper) or the line item." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 135; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.bodySite" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.bodySite" ]; fhir:ElementDefinition.short [ fhir:value "Anatomical location" ]; fhir:ElementDefinition.definition [ fhir:value "Physical service site on the patient (limb, tooth, etc.)." ]; fhir:ElementDefinition.comment [ fhir:value "For example, providing a tooth code allows an insurer to identify a provider performing a filling on a tooth that was previously removed." ]; fhir:ElementDefinition.requirements [ fhir:value "Allows insurer to validate specific procedures." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "OralSites" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "The code for the teeth, quadrant, sextant and arch." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/tooth" ] ] ], [ fhir:index 136; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.subSite" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.subSite" ]; fhir:ElementDefinition.short [ fhir:value "Anatomical sub-location" ]; fhir:ElementDefinition.definition [ fhir:value "A region or surface of the bodySite, e.g. limb region or tooth surface(s)." ]; fhir:ElementDefinition.requirements [ fhir:value "Allows insurer to validate specific procedures." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "Surface" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "The code for the tooth surface and surface combinations." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/surface" ] ] ], [ fhir:index 137; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.noteNumber" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.noteNumber" ]; fhir:ElementDefinition.short [ fhir:value "Applicable note numbers" ]; fhir:ElementDefinition.definition [ fhir:value "The numbers associated with notes below which apply to the adjudication of this item." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 138; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.adjudication" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.adjudication" ]; fhir:ElementDefinition.short [ fhir:value "Added items adjudication" ]; fhir:ElementDefinition.definition [ fhir:value "The adjudication results." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.contentReference [ fhir:value "#ExplanationOfBenefit.item.adjudication" ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 139; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint" ]; fhir:Extension.value [ fhir:value "740;600" ] ], [ fhir:index 1; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "AddedItemDetail" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail" ]; fhir:ElementDefinition.short [ fhir:value "Insurer added line items" ]; fhir:ElementDefinition.definition [ fhir:value "The second-tier service adjudications for payor added services." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 140; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.productOrService" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.productOrService" ]; fhir:ElementDefinition.short [ fhir:value "Billing, service, product, or drug code" ]; fhir:ElementDefinition.definition [ fhir:value "When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item." ]; fhir:ElementDefinition.comment [ fhir:value "If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'." ]; fhir:ElementDefinition.requirements [ fhir:value "Necessary to state what was provided or done." ]; fhir:ElementDefinition.alias [ fhir:value "Drug Code"; fhir:index 0 ], [ fhir:value "Bill Code"; fhir:index 1 ], [ fhir:value "Service Code"; fhir:index 2 ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ServiceProduct" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Allowable service and product codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/service-uscls" ] ] ], [ fhir:index 141; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.modifier" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.modifier" ]; fhir:ElementDefinition.short [ fhir:value "Service/Product billing modifiers" ]; fhir:ElementDefinition.definition [ fhir:value "Item typification or modifiers codes to convey additional context for the product or service." ]; fhir:ElementDefinition.comment [ fhir:value "For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours." ]; fhir:ElementDefinition.requirements [ fhir:value "To support inclusion of the item for adjudication or to charge an elevated fee." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "Modifiers" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir: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." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/claim-modifiers" ] ] ], [ fhir:index 142; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.quantity" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.quantity" ]; fhir:ElementDefinition.short [ fhir:value "Count of products or services" ]; fhir:ElementDefinition.definition [ fhir:value "The number of repetitions of a service or product." ]; fhir:ElementDefinition.requirements [ fhir:value "Required when the product or service code does not convey the quantity provided." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Quantity" ]; fhir:ElementDefinition.profile [ fhir:value "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"; fhir:index 0 ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 143; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.unitPrice" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.unitPrice" ]; fhir:ElementDefinition.short [ fhir:value "Fee, charge or cost per item" ]; fhir:ElementDefinition.definition [ fhir:value "If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group." ]; fhir:ElementDefinition.requirements [ fhir:value "The amount charged to the patient by the provider for a single unit." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 144; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.factor" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.factor" ]; fhir:ElementDefinition.short [ fhir:value "Price scaling factor" ]; fhir:ElementDefinition.definition [ fhir: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." ]; fhir:ElementDefinition.comment [ fhir:value "To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10)." ]; fhir:ElementDefinition.requirements [ fhir:value "When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "decimal" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 145; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.net" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.net" ]; fhir:ElementDefinition.short [ fhir:value "Total item cost" ]; fhir:ElementDefinition.definition [ fhir:value "The quantity times the unit price for an additional service or product or charge." ]; fhir:ElementDefinition.comment [ fhir:value "For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides the total amount claimed for the group (if a grouper) or the line item." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 146; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.noteNumber" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.noteNumber" ]; fhir:ElementDefinition.short [ fhir:value "Applicable note numbers" ]; fhir:ElementDefinition.definition [ fhir:value "The numbers associated with notes below which apply to the adjudication of this item." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 147; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.adjudication" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.adjudication" ]; fhir:ElementDefinition.short [ fhir:value "Added items adjudication" ]; fhir:ElementDefinition.definition [ fhir:value "The adjudication results." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.contentReference [ fhir:value "#ExplanationOfBenefit.item.adjudication" ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 148; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint" ]; fhir:Extension.value [ fhir:value "740;600" ] ], [ fhir:index 1; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "AddedItemDetailSubDetail" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail" ]; fhir:ElementDefinition.short [ fhir:value "Insurer added line items" ]; fhir:ElementDefinition.definition [ fhir:value "The third-tier service adjudications for payor added services." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 149; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.productOrService" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.productOrService" ]; fhir:ElementDefinition.short [ fhir:value "Billing, service, product, or drug code" ]; fhir:ElementDefinition.definition [ fhir:value "When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item." ]; fhir:ElementDefinition.comment [ fhir:value "If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'." ]; fhir:ElementDefinition.requirements [ fhir:value "Necessary to state what was provided or done." ]; fhir:ElementDefinition.alias [ fhir:value "Drug Code"; fhir:index 0 ], [ fhir:value "Bill Code"; fhir:index 1 ], [ fhir:value "Service Code"; fhir:index 2 ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "ServiceProduct" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Allowable service and product codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/service-uscls" ] ] ], [ fhir:index 150; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.modifier" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.modifier" ]; fhir:ElementDefinition.short [ fhir:value "Service/Product billing modifiers" ]; fhir:ElementDefinition.definition [ fhir:value "Item typification or modifiers codes to convey additional context for the product or service." ]; fhir:ElementDefinition.comment [ fhir:value "For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours." ]; fhir:ElementDefinition.requirements [ fhir:value "To support inclusion of the item for adjudication or to charge an elevated fee." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "Modifiers" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir: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." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/claim-modifiers" ] ] ], [ fhir:index 151; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.quantity" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.quantity" ]; fhir:ElementDefinition.short [ fhir:value "Count of products or services" ]; fhir:ElementDefinition.definition [ fhir:value "The number of repetitions of a service or product." ]; fhir:ElementDefinition.requirements [ fhir:value "Required when the product or service code does not convey the quantity provided." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Quantity" ]; fhir:ElementDefinition.profile [ fhir:value "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"; fhir:index 0 ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 152; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.unitPrice" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.unitPrice" ]; fhir:ElementDefinition.short [ fhir:value "Fee, charge or cost per item" ]; fhir:ElementDefinition.definition [ fhir:value "If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group." ]; fhir:ElementDefinition.requirements [ fhir:value "The amount charged to the patient by the provider for a single unit." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 153; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.factor" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.factor" ]; fhir:ElementDefinition.short [ fhir:value "Price scaling factor" ]; fhir:ElementDefinition.definition [ fhir: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." ]; fhir:ElementDefinition.comment [ fhir:value "To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10)." ]; fhir:ElementDefinition.requirements [ fhir:value "When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "decimal" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 154; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.net" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.net" ]; fhir:ElementDefinition.short [ fhir:value "Total item cost" ]; fhir:ElementDefinition.definition [ fhir:value "The quantity times the unit price for an additional service or product or charge." ]; fhir:ElementDefinition.comment [ fhir:value "For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides the total amount claimed for the group (if a grouper) or the line item." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 155; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.noteNumber" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.noteNumber" ]; fhir:ElementDefinition.short [ fhir:value "Applicable note numbers" ]; fhir:ElementDefinition.definition [ fhir:value "The numbers associated with notes below which apply to the adjudication of this item." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 156; fhir:Element.id [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.adjudication" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.addItem.detail.subDetail.adjudication" ]; fhir:ElementDefinition.short [ fhir:value "Added items adjudication" ]; fhir:ElementDefinition.definition [ fhir:value "The adjudication results." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.contentReference [ fhir:value "#ExplanationOfBenefit.item.adjudication" ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 157; fhir:Element.id [ fhir:value "ExplanationOfBenefit.adjudication" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.adjudication" ]; fhir:ElementDefinition.short [ fhir:value "Header-level adjudication" ]; fhir:ElementDefinition.definition [ fhir:value "The adjudication results which are presented at the header level rather than at the line-item or add-item levels." ]; fhir:ElementDefinition.requirements [ fhir:value "Some insurers will receive line-items but provide the adjudication only at a summary or header-level." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.contentReference [ fhir:value "#ExplanationOfBenefit.item.adjudication" ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 158; fhir:Element.id [ fhir:value "ExplanationOfBenefit.total" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint" ]; fhir:Extension.value [ fhir:value "'360;620" ] ], [ fhir:index 1; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "Total" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.total" ]; fhir:ElementDefinition.short [ fhir:value "Adjudication totals" ]; fhir:ElementDefinition.definition [ fhir:value "Categorized monetary totals for the adjudication." ]; fhir:ElementDefinition.comment [ fhir:value "Totals for amounts submitted, co-pays, benefits payable etc." ]; fhir:ElementDefinition.requirements [ fhir:value "To provide the requestor with financial totals by category for the adjudication." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ] ], [ fhir:index 159; fhir:Element.id [ fhir:value "ExplanationOfBenefit.total.category" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.total.category" ]; fhir:ElementDefinition.short [ fhir:value "Type of adjudication information" ]; fhir:ElementDefinition.definition [ fhir:value "A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item." ]; fhir:ElementDefinition.comment [ fhir:value "For example, codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to convey the type of total provided." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "Adjudication" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "The adjudication codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/adjudication" ] ] ], [ fhir:index 160; fhir:Element.id [ fhir:value "ExplanationOfBenefit.total.amount" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.total.amount" ]; fhir:ElementDefinition.short [ fhir:value "Financial total for the category" ]; fhir:ElementDefinition.definition [ fhir:value "Monetary total amount associated with the category." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to convey the total monetary amount." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "true" ] ], [ fhir:index 161; fhir:Element.id [ fhir:value "ExplanationOfBenefit.payment" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint" ]; fhir:Extension.value [ fhir:value "360;650" ] ], [ fhir:index 1; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "Payment" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payment" ]; fhir:ElementDefinition.short [ fhir:value "Payment Details" ]; fhir:ElementDefinition.definition [ fhir:value "Payment details for the adjudication of the claim." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to convey references to the financial instrument that has been used if payment has been made." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 162; fhir:Element.id [ fhir:value "ExplanationOfBenefit.payment.type" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payment.type" ]; fhir:ElementDefinition.short [ fhir:value "Partial or complete payment" ]; fhir:ElementDefinition.definition [ fhir:value "Whether this represents partial or complete payment of the benefits payable." ]; fhir:ElementDefinition.requirements [ fhir:value "To advise the requestor when the insurer believes all payments to have been completed." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "PaymentType" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "The type (partial, complete) of the payment." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/ex-paymenttype" ] ] ], [ fhir:index 163; fhir:Element.id [ fhir:value "ExplanationOfBenefit.payment.adjustment" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payment.adjustment" ]; fhir:ElementDefinition.short [ fhir:value "Payment adjustment for non-claim issues" ]; fhir:ElementDefinition.definition [ fhir:value "Total amount of all adjustments to this payment included in this transaction which are not related to this claim's adjudication." ]; fhir:ElementDefinition.comment [ fhir:value "Insurers will deduct amounts owing from the provider (adjustment), such as a prior overpayment, from the amount owing to the provider (benefits payable) when payment is made to the provider." ]; fhir:ElementDefinition.requirements [ fhir:value "To advise the requestor of adjustments applied to the payment." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 164; fhir:Element.id [ fhir:value "ExplanationOfBenefit.payment.adjustmentReason" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payment.adjustmentReason" ]; fhir:ElementDefinition.short [ fhir:value "Explanation for the variance" ]; fhir:ElementDefinition.definition [ fhir:value "Reason for the payment adjustment." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to clarify the monetary adjustment." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "PaymentAdjustmentReason" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Payment Adjustment reason codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/payment-adjustment-reason" ] ] ], [ fhir:index 165; fhir:Element.id [ fhir:value "ExplanationOfBenefit.payment.date" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payment.date" ]; fhir:ElementDefinition.short [ fhir:value "Expected date of payment" ]; fhir:ElementDefinition.definition [ fhir:value "Estimated date the payment will be issued or the actual issue date of payment." ]; fhir:ElementDefinition.requirements [ fhir:value "To advise the payee when payment can be expected." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "date" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 166; fhir:Element.id [ fhir:value "ExplanationOfBenefit.payment.amount" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payment.amount" ]; fhir:ElementDefinition.short [ fhir:value "Payable amount after adjustment" ]; fhir:ElementDefinition.definition [ fhir:value "Benefits payable less any payment adjustment." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to provide the actual payment amount." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 167; fhir:Element.id [ fhir:value "ExplanationOfBenefit.payment.identifier" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.payment.identifier" ]; fhir:ElementDefinition.short [ fhir:value "Business identifier for the payment" ]; fhir:ElementDefinition.definition [ fhir:value "Issuer's unique identifier for the payment instrument." ]; fhir:ElementDefinition.comment [ fhir:value "For example: EFT number or check number." ]; fhir:ElementDefinition.requirements [ fhir:value "Enable the receiver to reconcile when payment received." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Identifier" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 168; fhir:Element.id [ fhir:value "ExplanationOfBenefit.formCode" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.formCode" ]; fhir:ElementDefinition.short [ fhir:value "Printed form identifier" ]; fhir:ElementDefinition.definition [ fhir:value "A code for the form to be used for printing the content." ]; fhir:ElementDefinition.comment [ fhir:value "May be needed to identify specific jurisdictional forms." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to specify the specific form used for producing output for this response." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "Forms" ] ], [ fhir:index 1; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding" ]; fhir:Extension.value [ fhir:value "true" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "The forms codes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/forms" ] ] ], [ fhir:index 169; fhir:Element.id [ fhir:value "ExplanationOfBenefit.form" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.form" ]; fhir:ElementDefinition.short [ fhir:value "Printed reference or actual form" ]; fhir:ElementDefinition.definition [ fhir:value "The actual form, by reference or inclusion, for printing the content or an EOB." ]; fhir:ElementDefinition.comment [ fhir:value "Needed to permit insurers to include the actual form." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to include the specific form used for producing output for this response." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Attachment" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 170; fhir:Element.id [ fhir:value "ExplanationOfBenefit.processNote" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "Note" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.processNote" ]; fhir:ElementDefinition.short [ fhir:value "Note concerning adjudication" ]; fhir:ElementDefinition.definition [ fhir:value "A note that describes or explains adjudication results in a human readable form." ]; fhir:ElementDefinition.requirements [ fhir:value "Provides the insurer specific textual explanations associated with the processing." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 171; fhir:Element.id [ fhir:value "ExplanationOfBenefit.processNote.number" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.processNote.number" ]; fhir:ElementDefinition.short [ fhir:value "Note instance identifier" ]; fhir:ElementDefinition.definition [ fhir:value "A number to uniquely identify a note entry." ]; fhir:ElementDefinition.requirements [ fhir:value "Necessary to provide a mechanism to link from adjudications." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "positiveInt" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 172; fhir:Element.id [ fhir:value "ExplanationOfBenefit.processNote.type" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.processNote.type" ]; fhir:ElementDefinition.short [ fhir:value "display | print | printoper" ]; fhir:ElementDefinition.definition [ fhir:value "The business purpose of the note text." ]; fhir:ElementDefinition.requirements [ fhir:value "To convey the expectation for when the text is used." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "code" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "NoteType" ] ], [ fhir:index 1; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding" ]; fhir:Extension.value [ fhir:value "true" ] ]; fhir:ElementDefinition.strength [ fhir:value "required" ]; fhir:ElementDefinition.description [ fhir:value "The presentation types of notes." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/note-type|4.3.0" ] ] ], [ fhir:index 173; fhir:Element.id [ fhir:value "ExplanationOfBenefit.processNote.text" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.processNote.text" ]; fhir:ElementDefinition.short [ fhir:value "Note explanatory text" ]; fhir:ElementDefinition.definition [ fhir:value "The explanation or description associated with the processing." ]; fhir:ElementDefinition.requirements [ fhir:value "Required to provide human readable explanation." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "string" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 174; fhir:Element.id [ fhir:value "ExplanationOfBenefit.processNote.language" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.processNote.language" ]; fhir:ElementDefinition.short [ fhir:value "Language of the text" ]; fhir:ElementDefinition.definition [ fhir:value "A code to define the language used in the text of the note." ]; fhir:ElementDefinition.comment [ fhir:value "Only required if the language is different from the resource language." ]; fhir:ElementDefinition.requirements [ fhir:value "Note text may vary from the resource defined language." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet" ]; fhir:Extension.value [ fhir:value "http://hl7.org/fhir/ValueSet/all-languages" ] ], [ fhir:index 1; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "Language" ] ], [ fhir:index 2; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding" ]; fhir:Extension.value [ fhir:value "true" ] ]; fhir:ElementDefinition.strength [ fhir:value "preferred" ]; fhir:ElementDefinition.description [ fhir:value "IETF language tag" ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/languages" ] ] ], [ fhir:index 175; fhir:Element.id [ fhir:value "ExplanationOfBenefit.benefitPeriod" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitPeriod" ]; fhir:ElementDefinition.short [ fhir:value "When the benefits are applicable" ]; fhir:ElementDefinition.definition [ fhir:value "The term of the benefits documented in this response." ]; fhir:ElementDefinition.comment [ fhir:value "Not applicable when use=claim." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed as coverages may be multi-year while benefits tend to be annual therefore a separate expression of the benefit period is needed." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "Period" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 176; fhir:Element.id [ fhir:value "ExplanationOfBenefit.benefitBalance" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "BenefitBalance" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance" ]; fhir:ElementDefinition.short [ fhir:value "Balance by Benefit Category" ]; fhir:ElementDefinition.definition [ fhir:value "Balance by Benefit Category." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 177; fhir:Element.id [ fhir:value "ExplanationOfBenefit.benefitBalance.category" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.category" ]; fhir:ElementDefinition.short [ fhir:value "Benefit classification" ]; fhir:ElementDefinition.definition [ fhir:value "Code to identify the general type of benefits under which products and services are provided." ]; fhir:ElementDefinition.comment [ fhir:value "Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to convey the category of service or product for which eligibility is sought." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "BenefitCategory" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Benefit categories such as: oral, medical, vision, oral-basic etc." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/ex-benefitcategory" ] ] ], [ fhir:index 178; fhir:Element.id [ fhir:value "ExplanationOfBenefit.benefitBalance.excluded" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.excluded" ]; fhir:ElementDefinition.short [ fhir:value "Excluded from the plan" ]; fhir:ElementDefinition.definition [ fhir:value "True if the indicated class of service is excluded from the plan, missing or False indicates the product or service is included in the coverage." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to identify items that are specifically excluded from the coverage." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "boolean" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 179; fhir:Element.id [ fhir:value "ExplanationOfBenefit.benefitBalance.name" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.name" ]; fhir:ElementDefinition.short [ fhir:value "Short name for the benefit" ]; fhir:ElementDefinition.definition [ fhir:value "A short name or tag for the benefit." ]; fhir:ElementDefinition.comment [ fhir:value "For example: MED01, or DENT2." ]; fhir:ElementDefinition.requirements [ fhir:value "Required to align with other plan names." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "string" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 180; fhir:Element.id [ fhir:value "ExplanationOfBenefit.benefitBalance.description" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.description" ]; fhir:ElementDefinition.short [ fhir:value "Description of the benefit or services covered" ]; fhir:ElementDefinition.definition [ fhir:value "A richer description of the benefit or services covered." ]; fhir:ElementDefinition.comment [ fhir:value "For example, 'DENT2 covers 100% of basic, 50% of major but excludes Ortho, Implants and Cosmetic services'." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed for human readable reference." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "string" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 181; fhir:Element.id [ fhir:value "ExplanationOfBenefit.benefitBalance.network" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.network" ]; fhir:ElementDefinition.short [ fhir:value "In or out of network" ]; fhir:ElementDefinition.definition [ fhir:value "Is a flag to indicate whether the benefits refer to in-network providers or out-of-network providers." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed as in or out of network providers are treated differently under the coverage." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "BenefitNetwork" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Code to classify in or out of network services." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/benefit-network" ] ] ], [ fhir:index 182; fhir:Element.id [ fhir:value "ExplanationOfBenefit.benefitBalance.unit" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.unit" ]; fhir:ElementDefinition.short [ fhir:value "Individual or family" ]; fhir:ElementDefinition.definition [ fhir:value "Indicates if the benefits apply to an individual or to the family." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed for the understanding of the benefits." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "BenefitUnit" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Unit covered/serviced - individual or family." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/benefit-unit" ] ] ], [ fhir:index 183; fhir:Element.id [ fhir:value "ExplanationOfBenefit.benefitBalance.term" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.term" ]; fhir:ElementDefinition.short [ fhir:value "Annual or lifetime" ]; fhir:ElementDefinition.definition [ fhir:value "The term or period of the values such as 'maximum lifetime benefit' or 'maximum annual visits'." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed for the understanding of the benefits." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "BenefitTerm" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Coverage unit - annual, lifetime." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/benefit-term" ] ] ], [ fhir:index 184; fhir:Element.id [ fhir:value "ExplanationOfBenefit.benefitBalance.financial" ]; fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ]; fhir:Extension.value [ fhir:value "Benefit" ] ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.financial" ]; fhir:ElementDefinition.short [ fhir:value "Benefit Summary" ]; fhir:ElementDefinition.definition [ fhir:value "Benefits Used to date." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "*" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "BackboneElement" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 185; fhir:Element.id [ fhir:value "ExplanationOfBenefit.benefitBalance.financial.type" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.financial.type" ]; fhir:ElementDefinition.short [ fhir:value "Benefit classification" ]; fhir:ElementDefinition.definition [ fhir:value "Classification of benefit being provided." ]; fhir:ElementDefinition.comment [ fhir:value "For example: deductible, visits, benefit amount." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to convey the nature of the benefit." ]; fhir:ElementDefinition.min [ fhir:value "1" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "CodeableConcept" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ]; fhir:ElementDefinition.binding [ fhir:Element.extension [ fhir:index 0; fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ]; fhir:Extension.value [ fhir:value "BenefitType" ] ]; fhir:ElementDefinition.strength [ fhir:value "example" ]; fhir:ElementDefinition.description [ fhir:value "Deductable, visits, co-pay, etc." ]; fhir:ElementDefinition.valueSet [ fhir:value "http://hl7.org/fhir/ValueSet/benefit-type" ] ] ], [ fhir:index 186; fhir:Element.id [ fhir:value "ExplanationOfBenefit.benefitBalance.financial.allowed[x]" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.financial.allowed[x]" ]; fhir:ElementDefinition.short [ fhir:value "Benefits allowed" ]; fhir:ElementDefinition.definition [ fhir:value "The quantity of the benefit which is permitted under the coverage." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to convey the benefits offered under the coverage." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "unsignedInt" ] ], [ fhir:index 1; fhir:ElementDefinition.code [ fhir:value "string" ] ], [ fhir:index 2; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ], [ fhir:index 187; fhir:Element.id [ fhir:value "ExplanationOfBenefit.benefitBalance.financial.used[x]" ]; fhir:ElementDefinition.path [ fhir:value "ExplanationOfBenefit.benefitBalance.financial.used[x]" ]; fhir:ElementDefinition.short [ fhir:value "Benefits used" ]; fhir:ElementDefinition.definition [ fhir:value "The quantity of the benefit which have been consumed to date." ]; fhir:ElementDefinition.requirements [ fhir:value "Needed to convey the benefits consumed to date." ]; fhir:ElementDefinition.min [ fhir:value "0" ]; fhir:ElementDefinition.max [ fhir:value "1" ]; fhir:ElementDefinition.type [ fhir:index 0; fhir:ElementDefinition.code [ fhir:value "unsignedInt" ] ], [ fhir:index 1; fhir:ElementDefinition.code [ fhir:value "Money" ] ]; fhir:ElementDefinition.mustSupport [ fhir:value "false" ]; fhir:ElementDefinition.isModifier [ fhir:value "false" ]; fhir:ElementDefinition.isSummary [ fhir:value "false" ] ] ] . # -------------------------------------------------------------------------------------
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.