FHIR Extensions Pack
5.1.0-ballot1 - Ballot for Release 5.1.0
FHIR Extensions Pack
5.1.0-ballot1 - Ballot for Release 5.1.0
This page is part of the FHIR Core Extensions Registry (v5.1.0-ballot: Releases Ballot 4) based on FHIR (HL7® FHIR® Standard) v5.0.0. The current version which supersedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions
| Page standards status: Trial-use | Maturity Level: 1 |
<StructureMap xmlns="http://hl7.org/fhir">
<id value="ClaimResponse4Bto5"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><pre class="fml">
<span style="color: #cc00cc">/// <b>url</b> = </span><span style="color: blue">'http://hl7.org/fhir/StructureMap/ClaimResponse4Bto5'</span>
<span style="color: #cc00cc">/// <b>name</b> = </span><span style="color: blue">'ClaimResponse4Bto5'</span>
<span style="color: #cc00cc">/// <b>title</b> = </span><span style="color: blue">'FML Conversion for ClaimResponse: R4B to R5'</span>
<span style="color: #cc00cc">/// <b>status</b> = </span><span style="color: blue">'active'</span>
<b>conceptmap</b><span style="color: navy"> "</span>ClaimResponseStatus<span style="color: navy">" {
</span><b> prefix </b>s<span style="color: navy"> = "</span><a href="http://hl7.org/fhir/R4B/codesystem-fm-status.html" title="Financial Resource Status Codes">http://hl7.org/fhir/4.3/fm-status</a><span style="color: navy">"
</span><b> prefix </b>t<span style="color: navy"> = "</span><a href="http://hl7.org/fhir/R5/codesystem-fm-status.html" title="Financial Resource Status Codes">http://hl7.org/fhir/fm-status</a><span style="color: navy">"
</span>
s<span style="color: navy">:</span>active <b>-</b> t<span style="color: navy">:</span>active
s<span style="color: navy">:</span>cancelled <b>-</b> t<span style="color: navy">:</span>cancelled
s<span style="color: navy">:</span>draft <b>-</b> t<span style="color: navy">:</span>draft
s<span style="color: navy">:</span>"entered-in-error" <b>-</b> t<span style="color: navy">:</span><span style="color: navy">"</span>entered-in-error<span style="color: navy">"</span>
<span style="color: navy">}
</span><b>conceptmap</b><span style="color: navy"> "</span>RemittanceOutcome<span style="color: navy">" {
</span><b> prefix </b>s<span style="color: navy"> = "</span><a href="http://hl7.org/fhir/R4B/codesystem-remittance-outcome.html" title="RemittanceOutcome">http://hl7.org/fhir/4.3/remittance-outcome</a><span style="color: navy">"
</span><b> prefix </b>t<span style="color: navy"> = "</span><a href="http://hl7.org/fhir/R5/codesystem-claim-outcome.html" title="Claim Processing Outcome Codes">http://hl7.org/fhir/claim-outcome</a><span style="color: navy">"
</span>
s<span style="color: navy">:</span>queued <b>-</b> t<span style="color: navy">:</span>queued
s<span style="color: navy">:</span>complete <b>-</b> t<span style="color: navy">:</span>complete
s<span style="color: navy">:</span>error <b>-</b> t<span style="color: navy">:</span>error
s<span style="color: navy">:</span>partial <b>-</b> t<span style="color: navy">:</span>partial
<span style="color: navy">}
</span><b>conceptmap</b><span style="color: navy"> "</span>Use<span style="color: navy">" {
</span><b> prefix </b>s<span style="color: navy"> = "</span><a href="http://hl7.org/fhir/R4B/codesystem-claim-use.html" title="Use">http://hl7.org/fhir/4.3/claim-use</a><span style="color: navy">"
</span><b> prefix </b>t<span style="color: navy"> = "</span><a href="http://hl7.org/fhir/R5/codesystem-claim-use.html" title="Use">http://hl7.org/fhir/claim-use</a><span style="color: navy">"
</span>
s<span style="color: navy">:</span>claim <b>-</b> t<span style="color: navy">:</span>claim
s<span style="color: navy">:</span>preauthorization <b>-</b> t<span style="color: navy">:</span>preauthorization
s<span style="color: navy">:</span>predetermination <b>-</b> t<span style="color: navy">:</span>predetermination
<span style="color: navy">}
</span><b>uses</b><span style="color: navy"> "</span><a href="http://hl7.org/fhir/R4B/claimresponse.html" title="ClaimResponse">http://hl7.org/fhir/4.3/StructureDefinition/ClaimResponse</a><span style="color: navy">" </span><b>alias </b>ClaimResponseR4B <b>as </b><b>source</b>
<b>uses</b><span style="color: navy"> "</span><a href="http://hl7.org/fhir/R5/claimresponse.html" title="ClaimResponse">http://hl7.org/fhir/StructureDefinition/ClaimResponse</a><span style="color: navy">" </span><b>alias </b>ClaimResponseR5 <b>as </b><b>target</b>
<b>imports</b><span style="color: navy"> "</span>http://hl7.org/fhir/StructureMap/*4Bto5<span style="color: navy">"
</span>
<b>group </b>ClaimResponse<span style="color: navy">(</span><b>source</b> <span style="color: maroon">src</span><span style="color: navy"> : </span>ClaimResponseR4B, <b>target</b> <span style="color: maroon">tgt</span><span style="color: navy"> : </span>ClaimResponseR5<span style="color: navy">)</span><b> extends </b>DomainResource<b> <<type+>></b><span style="color: navy"> {
</span> src.identifier<span style="color: navy"><b> -> </b></span>tgt.identifier<span style="color: navy">;</span>
src.status<b> as </b><span style="color: maroon">v</span><span style="color: navy"><b> -> </b></span>tgt.status = <b>translate</b><span style="color: navy">(</span><span style="color: maroon">v</span><span style="color: navy">, </span><span style="color: blue">'#ClaimResponseStatus'</span><span style="color: navy">, </span><span style="color: blue">'code'</span><span style="color: navy">)</span><span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.traceNumber -> tgt.traceNumber;</span>
src.type<span style="color: navy"><b> -> </b></span>tgt.type<span style="color: navy">;</span>
src.subType<span style="color: navy"><b> -> </b></span>tgt.subType<span style="color: navy">;</span>
src.use<b> as </b><span style="color: maroon">v</span><span style="color: navy"><b> -> </b></span>tgt.use = <b>translate</b><span style="color: navy">(</span><span style="color: maroon">v</span><span style="color: navy">, </span><span style="color: blue">'#Use'</span><span style="color: navy">, </span><span style="color: blue">'code'</span><span style="color: navy">)</span><span style="color: navy">;</span>
src.patient<span style="color: navy"><b> -> </b></span>tgt.patient<span style="color: navy">;</span>
src.created<span style="color: navy"><b> -> </b></span>tgt.created<span style="color: navy">;</span>
src.insurer<span style="color: navy"><b> -> </b></span>tgt.insurer<span style="color: navy">;</span>
src.requestor<span style="color: navy"><b> -> </b></span>tgt.requestor<span style="color: navy">;</span>
src.request<span style="color: navy"><b> -> </b></span>tgt.request<span style="color: navy">;</span>
src.outcome<b> as </b><span style="color: maroon">v</span><span style="color: navy"><b> -> </b></span>tgt.outcome = <b>translate</b><span style="color: navy">(</span><span style="color: maroon">v</span><span style="color: navy">, </span><span style="color: blue">'#RemittanceOutcome'</span><span style="color: navy">, </span><span style="color: blue">'code'</span><span style="color: navy">)</span><span style="color: navy">;</span>
src.disposition<span style="color: navy"><b> -> </b></span>tgt.disposition<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.decision -> tgt.decision;</span>
src.preAuthRef<span style="color: navy"><b> -> </b></span>tgt.preAuthRef<span style="color: navy">;</span>
src.preAuthPeriod<span style="color: navy"><b> -> </b></span>tgt.preAuthPeriod<span style="color: navy">;</span>
src.payeeType<span style="color: navy"><b> -> </b></span>tgt.payeeType<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.event as s -> tgt.event as t then ClaimResponseEvent(s,t);</span>
src.item<b> as </b><span style="color: maroon">s</span><span style="color: navy"><b> -> </b></span>tgt.item<b> as </b><span style="color: maroon">t</span><b> then </b>ClaimResponseItem<span style="color: navy">(</span><span style="color: maroon">s</span><span style="color: navy">, </span><span style="color: maroon">t</span><span style="color: navy">)</span><span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.encounter -> tgt.encounter;</span>
src.addItem<b> as </b><span style="color: maroon">s</span><span style="color: navy"><b> -> </b></span>tgt.addItem<b> as </b><span style="color: maroon">t</span><b> then </b>ClaimResponseAddItem<span style="color: navy">(</span><span style="color: maroon">s</span><span style="color: navy">, </span><span style="color: maroon">t</span><span style="color: navy">)</span><span style="color: navy">;</span>
src.total<b> as </b><span style="color: maroon">s</span><span style="color: navy"><b> -> </b></span>tgt.total<b> as </b><span style="color: maroon">t</span><b> then </b>ClaimResponseTotal<span style="color: navy">(</span><span style="color: maroon">s</span><span style="color: navy">, </span><span style="color: maroon">t</span><span style="color: navy">)</span><span style="color: navy">;</span>
src.payment<b> as </b><span style="color: maroon">s</span><span style="color: navy"><b> -> </b></span>tgt.payment<b> as </b><span style="color: maroon">t</span><b> then </b>ClaimResponsePayment<span style="color: navy">(</span><span style="color: maroon">s</span><span style="color: navy">, </span><span style="color: maroon">t</span><span style="color: navy">)</span><span style="color: navy">;</span>
src.fundsReserve<span style="color: navy"><b> -> </b></span>tgt.fundsReserve<span style="color: navy">;</span>
src.formCode<span style="color: navy"><b> -> </b></span>tgt.formCode<span style="color: navy">;</span>
src.form<span style="color: navy"><b> -> </b></span>tgt.form<span style="color: navy">;</span>
src.processNote<b> as </b><span style="color: maroon">s</span><span style="color: navy"><b> -> </b></span>tgt.processNote<b> as </b><span style="color: maroon">t</span><b> then </b>ClaimResponseProcessNote<span style="color: navy">(</span><span style="color: maroon">s</span><span style="color: navy">, </span><span style="color: maroon">t</span><span style="color: navy">)</span><span style="color: navy">;</span>
src.communicationRequest<span style="color: navy"><b> -> </b></span>tgt.communicationRequest<span style="color: navy">;</span>
src.insurance<b> as </b><span style="color: maroon">s</span><span style="color: navy"><b> -> </b></span>tgt.insurance<b> as </b><span style="color: maroon">t</span><b> then </b>ClaimResponseInsurance<span style="color: navy">(</span><span style="color: maroon">s</span><span style="color: navy">, </span><span style="color: maroon">t</span><span style="color: navy">)</span><span style="color: navy">;</span>
src.error<b> as </b><span style="color: maroon">s</span><span style="color: navy"><b> -> </b></span>tgt.error<b> as </b><span style="color: maroon">t</span><b> then </b>ClaimResponseError<span style="color: navy">(</span><span style="color: maroon">s</span><span style="color: navy">, </span><span style="color: maroon">t</span><span style="color: navy">)</span><span style="color: navy">;</span>
<span style="color: navy">}
</span><span style="color: navy">// </span><span style="color: green">group ClaimResponseEvent(source src, target tgt) extends BackboneElement {</span>
<span style="color: #b36b00" title="This element was not defined prior to R5">// src.type -> tgt.type;</span>
<span style="color: #b36b00" title="This element was not defined prior to R5">// src.when : dateTime -> tgt.when;</span>
<span style="color: #b36b00" title="This element was not defined prior to R5">// src.when : Period -> tgt.when;</span>
<span style="color: navy">// </span><span style="color: green">}</span>
<b>group </b>ClaimResponseItem<span style="color: navy">(</span><b>source</b> <span style="color: maroon">src</span>, <b>target</b> <span style="color: maroon">tgt</span><span style="color: navy">)</span><b> extends </b>BackboneElement<span style="color: navy"> {
</span> src.itemSequence<span style="color: navy"><b> -> </b></span>tgt.itemSequence<span style="color: navy">;</span>
src.noteNumber<span style="color: navy"><b> -> </b></span>tgt.noteNumber<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.traceNumber -> tgt.traceNumber;</span>
src.adjudication<b> as </b><span style="color: maroon">s</span><span style="color: navy"><b> -> </b></span>tgt.adjudication<b> as </b><span style="color: maroon">t</span><b> then </b>ClaimResponseItemAdjudication<span style="color: navy">(</span><span style="color: maroon">s</span><span style="color: navy">, </span><span style="color: maroon">t</span><span style="color: navy">)</span><span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.reviewOutcome as s -> tgt.reviewOutcome as t then ClaimResponseItemReviewOutcome(s,t);</span>
src.detail<b> as </b><span style="color: maroon">s</span><span style="color: navy"><b> -> </b></span>tgt.detail<b> as </b><span style="color: maroon">t</span><b> then </b>ClaimResponseItemDetail<span style="color: navy">(</span><span style="color: maroon">s</span><span style="color: navy">, </span><span style="color: maroon">t</span><span style="color: navy">)</span><span style="color: navy">;</span>
<span style="color: navy">}
</span><span style="color: navy">// </span><span style="color: green">group ClaimResponseItemReviewOutcome(source src, target tgt) extends BackboneElement {</span>
<span style="color: #b36b00" title="This element was not defined prior to R5">// src.decision -> tgt.decision;</span>
<span style="color: #b36b00" title="This element was not defined prior to R5">// src.reason -> tgt.reason;</span>
<span style="color: #b36b00" title="This element was not defined prior to R5">// src.preAuthRef -> tgt.preAuthRef;</span>
<span style="color: #b36b00" title="This element was not defined prior to R5">// src.preAuthPeriod -> tgt.preAuthPeriod;</span>
<span style="color: navy">// </span><span style="color: green">}</span>
<b>group </b>ClaimResponseItemAdjudication<span style="color: navy">(</span><b>source</b> <span style="color: maroon">src</span>, <b>target</b> <span style="color: maroon">tgt</span><span style="color: navy">)</span><b> extends </b>BackboneElement<span style="color: navy"> {
</span> src.category<span style="color: navy"><b> -> </b></span>tgt.category<span style="color: navy">;</span>
src.reason<span style="color: navy"><b> -> </b></span>tgt.reason<span style="color: navy">;</span>
src.amount<span style="color: navy"><b> -> </b></span>tgt.amount<span style="color: navy">;</span>
src.value<b> as </b><span style="color: maroon">s</span><span style="color: navy"><b> -> </b></span> tgt.quantity<b> as </b><span style="color: maroon">t</span><span style="color: navy">, </span> t.value = <span style="color: maroon">s</span><span style="color: navy">;</span>
<span style="color: navy">}
</span><b>group </b>ClaimResponseItemDetail<span style="color: navy">(</span><b>source</b> <span style="color: maroon">src</span>, <b>target</b> <span style="color: maroon">tgt</span><span style="color: navy">)</span><b> extends </b>BackboneElement<span style="color: navy"> {
</span> src.detailSequence<span style="color: navy"><b> -> </b></span>tgt.detailSequence<span style="color: navy">;</span>
src.noteNumber<span style="color: navy"><b> -> </b></span>tgt.noteNumber<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.traceNumber -> tgt.traceNumber;</span>
src.subDetail<b> as </b><span style="color: maroon">s</span><span style="color: navy"><b> -> </b></span>tgt.subDetail<b> as </b><span style="color: maroon">t</span><b> then </b>ClaimResponseItemDetailSubDetail<span style="color: navy">(</span><span style="color: maroon">s</span><span style="color: navy">, </span><span style="color: maroon">t</span><span style="color: navy">)</span><span style="color: navy">;</span>
<span style="color: navy">}
</span><b>group </b>ClaimResponseItemDetailSubDetail<span style="color: navy">(</span><b>source</b> <span style="color: maroon">src</span>, <b>target</b> <span style="color: maroon">tgt</span><span style="color: navy">)</span><b> extends </b>BackboneElement<span style="color: navy"> {
</span> src.subDetailSequence<span style="color: navy"><b> -> </b></span>tgt.subDetailSequence<span style="color: navy">;</span>
src.noteNumber<span style="color: navy"><b> -> </b></span>tgt.noteNumber<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.traceNumber -> tgt.traceNumber;</span>
<span style="color: navy">}
</span><b>group </b>ClaimResponseAddItem<span style="color: navy">(</span><b>source</b> <span style="color: maroon">src</span>, <b>target</b> <span style="color: maroon">tgt</span><span style="color: navy">)</span><b> extends </b>BackboneElement<span style="color: navy"> {
</span> src.itemSequence<span style="color: navy"><b> -> </b></span>tgt.itemSequence<span style="color: navy">;</span>
src.detailSequence<span style="color: navy"><b> -> </b></span>tgt.detailSequence<span style="color: navy">;</span>
src.subdetailSequence<span style="color: navy"><b> -> </b></span>tgt.subdetailSequence<span style="color: navy">;</span>
src.provider<span style="color: navy"><b> -> </b></span>tgt.provider<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.traceNumber -> tgt.traceNumber;</span>
src.productOrService<span style="color: navy"><b> -> </b></span>tgt.productOrService<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.revenue -> tgt.revenue;</span>
src.modifier<span style="color: navy"><b> -> </b></span>tgt.modifier<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.productOrServiceEnd -> tgt.productOrServiceEnd;</span>
src.programCode<span style="color: navy"><b> -> </b></span>tgt.programCode<span style="color: navy">;</span>
src.serviced<span style="color: navy"> : </span>date<span style="color: navy"><b> -> </b></span>tgt.serviced<span style="color: navy">;</span>
src.serviced<span style="color: navy"> : </span>Period<span style="color: navy"><b> -> </b></span>tgt.serviced<span style="color: navy">;</span>
src.location<span style="color: navy"> : </span>CodeableConcept<span style="color: navy"><b> -> </b></span>tgt.location<span style="color: navy">;</span>
src.location<span style="color: navy"> : </span>Address<span style="color: navy"><b> -> </b></span>tgt.location<span style="color: navy">;</span>
src.location<span style="color: navy"> : </span>Reference<span style="color: navy"><b> -> </b></span>tgt.location<span style="color: navy">;</span>
src.quantity<span style="color: navy"><b> -> </b></span>tgt.quantity<span style="color: navy">;</span>
src.unitPrice<span style="color: navy"><b> -> </b></span>tgt.unitPrice<span style="color: navy">;</span>
src.factor<span style="color: navy"><b> -> </b></span>tgt.factor<span style="color: navy">;</span>
src.net<span style="color: navy"><b> -> </b></span>tgt.net<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.tax -> tgt.tax;</span>
src.bodySite<b> as </b><span style="color: maroon">s</span><span style="color: navy"><b> -> </b></span> tgt.bodySite<b> as </b><span style="color: maroon">t</span><span style="color: navy">, </span> t.site = <span style="color: maroon">s</span><span style="color: navy">;</span>
src.noteNumber<span style="color: navy"><b> -> </b></span>tgt.noteNumber<span style="color: navy">;</span>
src.detail<b> as </b><span style="color: maroon">s</span><span style="color: navy"><b> -> </b></span>tgt.detail<b> as </b><span style="color: maroon">t</span><b> then </b>ClaimResponseAddItemDetail<span style="color: navy">(</span><span style="color: maroon">s</span><span style="color: navy">, </span><span style="color: maroon">t</span><span style="color: navy">)</span><span style="color: navy">;</span>
<span style="color: navy">}
</span><span style="color: navy">// </span><span style="color: green">group ClaimResponseAddItemBodySite(source src, target tgt) extends BackboneElement {</span>
<span style="color: #b36b00" title="This element was not defined prior to R5">// src.site -> tgt.site;</span>
<span style="color: #b36b00" title="This element was not defined prior to R5">// src.subSite -> tgt.subSite;</span>
<span style="color: navy">// </span><span style="color: green">}</span>
<b>group </b>ClaimResponseAddItemDetail<span style="color: navy">(</span><b>source</b> <span style="color: maroon">src</span>, <b>target</b> <span style="color: maroon">tgt</span><span style="color: navy">)</span><b> extends </b>BackboneElement<span style="color: navy"> {
</span> src.productOrService<span style="color: navy"><b> -> </b></span>tgt.productOrService<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.traceNumber -> tgt.traceNumber;</span>
src.modifier<span style="color: navy"><b> -> </b></span>tgt.modifier<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.productOrServiceEnd -> tgt.productOrServiceEnd;</span>
src.quantity<span style="color: navy"><b> -> </b></span>tgt.quantity<span style="color: navy">;</span>
src.unitPrice<span style="color: navy"><b> -> </b></span>tgt.unitPrice<span style="color: navy">;</span>
src.factor<span style="color: navy"><b> -> </b></span>tgt.factor<span style="color: navy">;</span>
src.net<span style="color: navy"><b> -> </b></span>tgt.net<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.tax -> tgt.tax;</span>
src.noteNumber<span style="color: navy"><b> -> </b></span>tgt.noteNumber<span style="color: navy">;</span>
src.subDetail<b> as </b><span style="color: maroon">s</span><span style="color: navy"><b> -> </b></span>tgt.subDetail<b> as </b><span style="color: maroon">t</span><b> then </b>ClaimResponseAddItemDetailSubDetail<span style="color: navy">(</span><span style="color: maroon">s</span><span style="color: navy">, </span><span style="color: maroon">t</span><span style="color: navy">)</span><span style="color: navy">;</span>
<span style="color: navy">}
</span><b>group </b>ClaimResponseAddItemDetailSubDetail<span style="color: navy">(</span><b>source</b> <span style="color: maroon">src</span>, <b>target</b> <span style="color: maroon">tgt</span><span style="color: navy">)</span><b> extends </b>BackboneElement<span style="color: navy"> {
</span> src.productOrService<span style="color: navy"><b> -> </b></span>tgt.productOrService<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.traceNumber -> tgt.traceNumber;</span>
src.modifier<span style="color: navy"><b> -> </b></span>tgt.modifier<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.productOrServiceEnd -> tgt.productOrServiceEnd;</span>
src.quantity<span style="color: navy"><b> -> </b></span>tgt.quantity<span style="color: navy">;</span>
src.unitPrice<span style="color: navy"><b> -> </b></span>tgt.unitPrice<span style="color: navy">;</span>
src.factor<span style="color: navy"><b> -> </b></span>tgt.factor<span style="color: navy">;</span>
src.net<span style="color: navy"><b> -> </b></span>tgt.net<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.tax -> tgt.tax;</span>
src.noteNumber<span style="color: navy"><b> -> </b></span>tgt.noteNumber<span style="color: navy">;</span>
<span style="color: navy">}
</span><b>group </b>ClaimResponseTotal<span style="color: navy">(</span><b>source</b> <span style="color: maroon">src</span>, <b>target</b> <span style="color: maroon">tgt</span><span style="color: navy">)</span><b> extends </b>BackboneElement<span style="color: navy"> {
</span> src.category<span style="color: navy"><b> -> </b></span>tgt.category<span style="color: navy">;</span>
src.amount<span style="color: navy"><b> -> </b></span>tgt.amount<span style="color: navy">;</span>
<span style="color: navy">}
</span><b>group </b>ClaimResponsePayment<span style="color: navy">(</span><b>source</b> <span style="color: maroon">src</span>, <b>target</b> <span style="color: maroon">tgt</span><span style="color: navy">)</span><b> extends </b>BackboneElement<span style="color: navy"> {
</span> src.type<span style="color: navy"><b> -> </b></span>tgt.type<span style="color: navy">;</span>
src.adjustment<span style="color: navy"><b> -> </b></span>tgt.adjustment<span style="color: navy">;</span>
src.adjustmentReason<span style="color: navy"><b> -> </b></span>tgt.adjustmentReason<span style="color: navy">;</span>
src.date<span style="color: navy"><b> -> </b></span>tgt.date<span style="color: navy">;</span>
src.amount<span style="color: navy"><b> -> </b></span>tgt.amount<span style="color: navy">;</span>
src.identifier<span style="color: navy"><b> -> </b></span>tgt.identifier<span style="color: navy">;</span>
<span style="color: navy">}
</span><b>group </b>ClaimResponseProcessNote<span style="color: navy">(</span><b>source</b> <span style="color: maroon">src</span>, <b>target</b> <span style="color: maroon">tgt</span><span style="color: navy">)</span><b> extends </b>BackboneElement<span style="color: navy"> {
</span> src.number<span style="color: navy"><b> -> </b></span>tgt.number<span style="color: navy">;</span>
src.type<b> as </b><span style="color: maroon">s</span><b> where </b>code = 'display'<span style="color: navy"><b> -> </b></span> tgt.type = <b>create</b><span style="color: navy">(</span><span style="color: blue">'CodeableConcept'</span><span style="color: navy">)</span><b> as </b><span style="color: maroon">tc</span><span style="color: navy">, </span> tc.coding = <b>create</b><span style="color: navy">(</span><span style="color: blue">'Coding'</span><span style="color: navy">)</span><b> as </b><span style="color: maroon">tcc</span><span style="color: navy">, </span> tcc.system = <span style="color: blue">'http://hl7.org/fhir/note-type'</span><span style="color: navy">, </span> tcc.code = <span style="color: blue">'display'</span><span style="color: navy">, </span> tcc.display = <span style="color: blue">'display'</span><span style="color: navy">;</span>
src.type<b> as </b><span style="color: maroon">s</span><b> where </b>code = 'print'<span style="color: navy"><b> -> </b></span> tgt.type = <b>create</b><span style="color: navy">(</span><span style="color: blue">'CodeableConcept'</span><span style="color: navy">)</span><b> as </b><span style="color: maroon">tc</span><span style="color: navy">, </span> tc.coding = <b>create</b><span style="color: navy">(</span><span style="color: blue">'Coding'</span><span style="color: navy">)</span><b> as </b><span style="color: maroon">tcc</span><span style="color: navy">, </span> tcc.system = <span style="color: blue">'http://hl7.org/fhir/note-type'</span><span style="color: navy">, </span> tcc.code = <span style="color: blue">'print'</span><span style="color: navy">, </span> tcc.display = <span style="color: blue">'Print (Form)'</span><span style="color: navy">;</span>
src.type<b> as </b><span style="color: maroon">s</span><b> where </b>code = 'printoper'<span style="color: navy"><b> -> </b></span> tgt.type = <b>create</b><span style="color: navy">(</span><span style="color: blue">'CodeableConcept'</span><span style="color: navy">)</span><b> as </b><span style="color: maroon">tc</span><span style="color: navy">, </span> tc.coding = <b>create</b><span style="color: navy">(</span><span style="color: blue">'Coding'</span><span style="color: navy">)</span><b> as </b><span style="color: maroon">tcc</span><span style="color: navy">, </span> tcc.system = <span style="color: blue">'http://hl7.org/fhir/note-type'</span><span style="color: navy">, </span> tcc.code = <span style="color: blue">'printoper'</span><span style="color: navy">, </span> tcc.display = <span style="color: blue">'Print (Operator)'</span><span style="color: navy">;</span>
src.text<span style="color: navy"><b> -> </b></span>tgt.text<span style="color: navy">;</span>
src.language<span style="color: navy"><b> -> </b></span>tgt.language<span style="color: navy">;</span>
<span style="color: navy">}
</span><b>group </b>ClaimResponseInsurance<span style="color: navy">(</span><b>source</b> <span style="color: maroon">src</span>, <b>target</b> <span style="color: maroon">tgt</span><span style="color: navy">)</span><b> extends </b>BackboneElement<span style="color: navy"> {
</span> src.sequence<span style="color: navy"><b> -> </b></span>tgt.sequence<span style="color: navy">;</span>
src.focal<span style="color: navy"><b> -> </b></span>tgt.focal<span style="color: navy">;</span>
src.coverage<span style="color: navy"><b> -> </b></span>tgt.coverage<span style="color: navy">;</span>
src.businessArrangement<span style="color: navy"><b> -> </b></span>tgt.businessArrangement<span style="color: navy">;</span>
src.claimResponse<span style="color: navy"><b> -> </b></span>tgt.claimResponse<span style="color: navy">;</span>
<span style="color: navy">}
</span><b>group </b>ClaimResponseError<span style="color: navy">(</span><b>source</b> <span style="color: maroon">src</span>, <b>target</b> <span style="color: maroon">tgt</span><span style="color: navy">)</span><b> extends </b>BackboneElement<span style="color: navy"> {
</span> src.itemSequence<span style="color: navy"><b> -> </b></span>tgt.itemSequence<span style="color: navy">;</span>
src.detailSequence<span style="color: navy"><b> -> </b></span>tgt.detailSequence<span style="color: navy">;</span>
src.subDetailSequence<span style="color: navy"><b> -> </b></span>tgt.subDetailSequence<span style="color: navy">;</span>
src.code<span style="color: navy"><b> -> </b></span>tgt.code<span style="color: navy">;</span>
<span style="color: navy">}
</span></pre></div>
</text>
<contained>
<ConceptMap>
<id value="ClaimResponseStatus"/>
<status value="active"/>
<group>
<source value="http://hl7.org/fhir/4.3/fm-status"/>
<target value="http://hl7.org/fhir/fm-status"/>
<element>
<code value="active"/>
<target>
<code value="active"/>
<relationship value="related-to"/>
</target>
</element>
<element>
<code value="cancelled"/>
<target>
<code value="cancelled"/>
<relationship value="related-to"/>
</target>
</element>
<element>
<code value="draft"/>
<target>
<code value="draft"/>
<relationship value="related-to"/>
</target>
</element>
<element>
<code value="entered-in-error"/>
<target>
<code value="entered-in-error"/>
<relationship value="related-to"/>
</target>
</element>
</group>
</ConceptMap>
</contained>
<contained>
<ConceptMap>
<id value="RemittanceOutcome"/>
<status value="active"/>
<group>
<source value="http://hl7.org/fhir/4.3/remittance-outcome"/>
<target value="http://hl7.org/fhir/claim-outcome"/>
<element>
<code value="queued"/>
<target>
<code value="queued"/>
<relationship value="related-to"/>
</target>
</element>
<element>
<code value="complete"/>
<target>
<code value="complete"/>
<relationship value="related-to"/>
</target>
</element>
<element>
<code value="error"/>
<target>
<code value="error"/>
<relationship value="related-to"/>
</target>
</element>
<element>
<code value="partial"/>
<target>
<code value="partial"/>
<relationship value="related-to"/>
</target>
</element>
</group>
</ConceptMap>
</contained>
<contained>
<ConceptMap>
<id value="Use"/>
<status value="active"/>
<group>
<source value="http://hl7.org/fhir/4.3/claim-use"/>
<target value="http://hl7.org/fhir/claim-use"/>
<element>
<code value="claim"/>
<target>
<code value="claim"/>
<relationship value="related-to"/>
</target>
</element>
<element>
<code value="preauthorization"/>
<target>
<code value="preauthorization"/>
<relationship value="related-to"/>
</target>
</element>
<element>
<code value="predetermination"/>
<target>
<code value="predetermination"/>
<relationship value="related-to"/>
</target>
</element>
</group>
</ConceptMap>
</contained>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
<valueCode value="fhir"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
<valueInteger value="1">
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
<valueCanonical
value="http://hl7.org/fhir/extensions/ImplementationGuide/hl7.fhir.uv.extensions"/>
</extension>
</valueInteger>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
<valueCode value="trial-use">
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
<valueCanonical
value="http://hl7.org/fhir/extensions/ImplementationGuide/hl7.fhir.uv.extensions"/>
</extension>
</valueCode>
</extension>
<url value="http://hl7.org/fhir/StructureMap/ClaimResponse4Bto5"/>
<version value="5.1.0-ballot1"/>
<name value="ClaimResponse4Bto5"/>
<title value="FML Conversion for ClaimResponse: R4B to R5"/>
<status value="active"/>
<date value="2023-12-19T08:40:03+11:00"/>
<publisher value="HL7 International / FHIR Infrastructure"/>
<contact>
<telecom>
<system value="url"/>
<value value="http://www.hl7.org/Special/committees/fiwg"/>
</telecom>
</contact>
<description value="FMLConversionforClaimResponseR4BtoR5"/>
<jurisdiction>
<coding>
<system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
<code value="001"/>
</coding>
</jurisdiction>
<structure>
<url value="http://hl7.org/fhir/4.3/StructureDefinition/ClaimResponse"/>
<mode value="source"/>
<alias value="ClaimResponseR4B"/>
</structure>
<structure>
<url value="http://hl7.org/fhir/StructureDefinition/ClaimResponse"/>
<mode value="target"/>
<alias value="ClaimResponseR5"/>
</structure>
<import value="http://hl7.org/fhir/StructureMap/*4Bto5"/>
<group>
<name value="ClaimResponse"/>
<extends value="DomainResource"/>
<typeMode value="type-and-types"/>
<input>
<name value="src"/>
<type value="ClaimResponseR4B"/>
<mode value="source"/>
</input>
<input>
<name value="tgt"/>
<type value="ClaimResponseR5"/>
<mode value="target"/>
</input>
<rule>
<name value="identifier"/>
<source>
<context value="src"/>
<element value="identifier"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="identifier"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="status"/>
<source>
<context value="src"/>
<element value="status"/>
<variable value="v"/>
</source>
<target>
<context value="tgt"/>
<element value="status"/>
<transform value="translate"/>
<parameter>
<valueId value="v"/>
</parameter>
<parameter>
<valueString value="#ClaimResponseStatus"/>
</parameter>
<parameter>
<valueString value="code"/>
</parameter>
</target>
<documentation value="src.traceNumber -> tgt.traceNumber;"/>
</rule>
<rule>
<name value="type"/>
<source>
<context value="src"/>
<element value="type"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="type"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="subType"/>
<source>
<context value="src"/>
<element value="subType"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="subType"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="use"/>
<source>
<context value="src"/>
<element value="use"/>
<variable value="v"/>
</source>
<target>
<context value="tgt"/>
<element value="use"/>
<transform value="translate"/>
<parameter>
<valueId value="v"/>
</parameter>
<parameter>
<valueString value="#Use"/>
</parameter>
<parameter>
<valueString value="code"/>
</parameter>
</target>
</rule>
<rule>
<name value="patient"/>
<source>
<context value="src"/>
<element value="patient"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="patient"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="created"/>
<source>
<context value="src"/>
<element value="created"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="created"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="insurer"/>
<source>
<context value="src"/>
<element value="insurer"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="insurer"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="requestor"/>
<source>
<context value="src"/>
<element value="requestor"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="requestor"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="request"/>
<source>
<context value="src"/>
<element value="request"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="request"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="outcome"/>
<source>
<context value="src"/>
<element value="outcome"/>
<variable value="v"/>
</source>
<target>
<context value="tgt"/>
<element value="outcome"/>
<transform value="translate"/>
<parameter>
<valueId value="v"/>
</parameter>
<parameter>
<valueString value="#RemittanceOutcome"/>
</parameter>
<parameter>
<valueString value="code"/>
</parameter>
</target>
</rule>
<rule>
<name value="disposition"/>
<source>
<context value="src"/>
<element value="disposition"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="disposition"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
<documentation value="src.decision -> tgt.decision;"/>
</rule>
<rule>
<name value="preAuthRef"/>
<source>
<context value="src"/>
<element value="preAuthRef"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="preAuthRef"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="preAuthPeriod"/>
<source>
<context value="src"/>
<element value="preAuthPeriod"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="preAuthPeriod"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="payeeType"/>
<source>
<context value="src"/>
<element value="payeeType"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="payeeType"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
<documentation
value="src.event as s -> tgt.event as t then ClaimResponseEvent(s,t);"/>
</rule>
<rule>
<name value="item"/>
<source>
<context value="src"/>
<element value="item"/>
<variable value="s"/>
</source>
<target>
<context value="tgt"/>
<element value="item"/>
<variable value="t"/>
</target>
<dependent>
<name value="ClaimResponseItem"/>
<parameter>
<valueId value="s"/>
</parameter>
<parameter>
<valueId value="t"/>
</parameter>
</dependent>
<documentation value="src.encounter -> tgt.encounter;"/>
</rule>
<rule>
<name value="addItem"/>
<source>
<context value="src"/>
<element value="addItem"/>
<variable value="s"/>
</source>
<target>
<context value="tgt"/>
<element value="addItem"/>
<variable value="t"/>
</target>
<dependent>
<name value="ClaimResponseAddItem"/>
<parameter>
<valueId value="s"/>
</parameter>
<parameter>
<valueId value="t"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="total"/>
<source>
<context value="src"/>
<element value="total"/>
<variable value="s"/>
</source>
<target>
<context value="tgt"/>
<element value="total"/>
<variable value="t"/>
</target>
<dependent>
<name value="ClaimResponseTotal"/>
<parameter>
<valueId value="s"/>
</parameter>
<parameter>
<valueId value="t"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="payment"/>
<source>
<context value="src"/>
<element value="payment"/>
<variable value="s"/>
</source>
<target>
<context value="tgt"/>
<element value="payment"/>
<variable value="t"/>
</target>
<dependent>
<name value="ClaimResponsePayment"/>
<parameter>
<valueId value="s"/>
</parameter>
<parameter>
<valueId value="t"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="fundsReserve"/>
<source>
<context value="src"/>
<element value="fundsReserve"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="fundsReserve"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="formCode"/>
<source>
<context value="src"/>
<element value="formCode"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="formCode"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="form"/>
<source>
<context value="src"/>
<element value="form"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="form"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="processNote"/>
<source>
<context value="src"/>
<element value="processNote"/>
<variable value="s"/>
</source>
<target>
<context value="tgt"/>
<element value="processNote"/>
<variable value="t"/>
</target>
<dependent>
<name value="ClaimResponseProcessNote"/>
<parameter>
<valueId value="s"/>
</parameter>
<parameter>
<valueId value="t"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="communicationRequest"/>
<source>
<context value="src"/>
<element value="communicationRequest"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="communicationRequest"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="insurance"/>
<source>
<context value="src"/>
<element value="insurance"/>
<variable value="s"/>
</source>
<target>
<context value="tgt"/>
<element value="insurance"/>
<variable value="t"/>
</target>
<dependent>
<name value="ClaimResponseInsurance"/>
<parameter>
<valueId value="s"/>
</parameter>
<parameter>
<valueId value="t"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="error"/>
<source>
<context value="src"/>
<element value="error"/>
<variable value="s"/>
</source>
<target>
<context value="tgt"/>
<element value="error"/>
<variable value="t"/>
</target>
<dependent>
<name value="ClaimResponseError"/>
<parameter>
<valueId value="s"/>
</parameter>
<parameter>
<valueId value="t"/>
</parameter>
</dependent>
</rule>
</group>
<group>
<name value="ClaimResponseItem"/>
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<element value="factor"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="net"/>
<source>
<context value="src"/>
<element value="net"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="net"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
<documentation value="src.tax -> tgt.tax;"/>
</rule>
<rule>
<name value="noteNumber"/>
<source>
<context value="src"/>
<element value="noteNumber"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="noteNumber"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
</group>
<group>
<name value="ClaimResponseTotal"/>
<extends value="BackboneElement"/>
<input>
<name value="src"/>
<mode value="source"/>
</input>
<input>
<name value="tgt"/>
<mode value="target"/>
</input>
<rule>
<name value="category"/>
<source>
<context value="src"/>
<element value="category"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="category"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="amount"/>
<source>
<context value="src"/>
<element value="amount"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="amount"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
</group>
<group>
<name value="ClaimResponsePayment"/>
<extends value="BackboneElement"/>
<input>
<name value="src"/>
<mode value="source"/>
</input>
<input>
<name value="tgt"/>
<mode value="target"/>
</input>
<rule>
<name value="type"/>
<source>
<context value="src"/>
<element value="type"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="type"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="adjustment"/>
<source>
<context value="src"/>
<element value="adjustment"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="adjustment"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="adjustmentReason"/>
<source>
<context value="src"/>
<element value="adjustmentReason"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="adjustmentReason"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="date"/>
<source>
<context value="src"/>
<element value="date"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="date"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="amount"/>
<source>
<context value="src"/>
<element value="amount"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="amount"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="identifier"/>
<source>
<context value="src"/>
<element value="identifier"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="identifier"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
</group>
<group>
<name value="ClaimResponseProcessNote"/>
<extends value="BackboneElement"/>
<input>
<name value="src"/>
<mode value="source"/>
</input>
<input>
<name value="tgt"/>
<mode value="target"/>
</input>
<rule>
<name value="number"/>
<source>
<context value="src"/>
<element value="number"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="number"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="type"/>
<source>
<context value="src"/>
<element value="type"/>
<variable value="s"/>
<condition value="code = 'display'"/>
</source>
<target>
<context value="tgt"/>
<element value="type"/>
<variable value="tc"/>
<transform value="create"/>
<parameter>
<valueString value="CodeableConcept"/>
</parameter>
</target>
<target>
<context value="tc"/>
<element value="coding"/>
<variable value="tcc"/>
<transform value="create"/>
<parameter>
<valueString value="Coding"/>
</parameter>
</target>
<target>
<context value="tcc"/>
<element value="system"/>
<transform value="copy"/>
<parameter>
<valueString value="http://hl7.org/fhir/note-type"/>
</parameter>
</target>
<target>
<context value="tcc"/>
<element value="code"/>
<transform value="copy"/>
<parameter>
<valueString value="display"/>
</parameter>
</target>
<target>
<context value="tcc"/>
<element value="display"/>
<transform value="copy"/>
<parameter>
<valueString value="display"/>
</parameter>
</target>
</rule>
<rule>
<name value="type"/>
<source>
<context value="src"/>
<element value="type"/>
<variable value="s"/>
<condition value="code = 'print'"/>
</source>
<target>
<context value="tgt"/>
<element value="type"/>
<variable value="tc"/>
<transform value="create"/>
<parameter>
<valueString value="CodeableConcept"/>
</parameter>
</target>
<target>
<context value="tc"/>
<element value="coding"/>
<variable value="tcc"/>
<transform value="create"/>
<parameter>
<valueString value="Coding"/>
</parameter>
</target>
<target>
<context value="tcc"/>
<element value="system"/>
<transform value="copy"/>
<parameter>
<valueString value="http://hl7.org/fhir/note-type"/>
</parameter>
</target>
<target>
<context value="tcc"/>
<element value="code"/>
<transform value="copy"/>
<parameter>
<valueString value="print"/>
</parameter>
</target>
<target>
<context value="tcc"/>
<element value="display"/>
<transform value="copy"/>
<parameter>
<valueString value="Print (Form)"/>
</parameter>
</target>
</rule>
<rule>
<name value="type"/>
<source>
<context value="src"/>
<element value="type"/>
<variable value="s"/>
<condition value="code = 'printoper'"/>
</source>
<target>
<context value="tgt"/>
<element value="type"/>
<variable value="tc"/>
<transform value="create"/>
<parameter>
<valueString value="CodeableConcept"/>
</parameter>
</target>
<target>
<context value="tc"/>
<element value="coding"/>
<variable value="tcc"/>
<transform value="create"/>
<parameter>
<valueString value="Coding"/>
</parameter>
</target>
<target>
<context value="tcc"/>
<element value="system"/>
<transform value="copy"/>
<parameter>
<valueString value="http://hl7.org/fhir/note-type"/>
</parameter>
</target>
<target>
<context value="tcc"/>
<element value="code"/>
<transform value="copy"/>
<parameter>
<valueString value="printoper"/>
</parameter>
</target>
<target>
<context value="tcc"/>
<element value="display"/>
<transform value="copy"/>
<parameter>
<valueString value="Print (Operator)"/>
</parameter>
</target>
</rule>
<rule>
<name value="text"/>
<source>
<context value="src"/>
<element value="text"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="text"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="language"/>
<source>
<context value="src"/>
<element value="language"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="language"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
</group>
<group>
<name value="ClaimResponseInsurance"/>
<extends value="BackboneElement"/>
<input>
<name value="src"/>
<mode value="source"/>
</input>
<input>
<name value="tgt"/>
<mode value="target"/>
</input>
<rule>
<name value="sequence"/>
<source>
<context value="src"/>
<element value="sequence"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="sequence"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="focal"/>
<source>
<context value="src"/>
<element value="focal"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="focal"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="coverage"/>
<source>
<context value="src"/>
<element value="coverage"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="coverage"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="businessArrangement"/>
<source>
<context value="src"/>
<element value="businessArrangement"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="businessArrangement"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="claimResponse"/>
<source>
<context value="src"/>
<element value="claimResponse"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="claimResponse"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
</group>
<group>
<name value="ClaimResponseError"/>
<extends value="BackboneElement"/>
<input>
<name value="src"/>
<mode value="source"/>
</input>
<input>
<name value="tgt"/>
<mode value="target"/>
</input>
<rule>
<name value="itemSequence"/>
<source>
<context value="src"/>
<element value="itemSequence"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="itemSequence"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="detailSequence"/>
<source>
<context value="src"/>
<element value="detailSequence"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="detailSequence"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="subDetailSequence"/>
<source>
<context value="src"/>
<element value="subDetailSequence"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="subDetailSequence"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="code"/>
<source>
<context value="src"/>
<element value="code"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="code"/>
<variable value="vvv"/>
<transform value="create"/>
</target>
<dependent>
<name value="DefaultMappingGroupAnonymousAlias"/>
<parameter>
<valueId value="vvv"/>
</parameter>
<parameter>
<valueId value="vvv"/>
</parameter>
</dependent>
</rule>
</group>
</StructureMap>
IG © 2022+ HL7 International / FHIR Infrastructure. Package hl7.fhir.uv.extensions#5.1.0-ballot1 based on FHIR 5.0.0. Generated 2023-12-19
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