FHIR Extensions Pack
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This page is part of the FHIR Core Extensions Registry (v5.1.0-snapshot1: Release 5.1) 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

: FML Conversion for ClaimResponse: R4 to R5 - XML Representation

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<StructureMap xmlns="http://hl7.org/fhir">
  <id value="ClaimResponse4to5"/>
  <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/ClaimResponse4to5'</span>
<span style="color: #cc00cc">/// <b>name</b> = </span><span style="color: blue">'ClaimResponse4to5'</span>
<span style="color: #cc00cc">/// <b>title</b> = </span><span style="color: blue">'FML Conversion for ClaimResponse: R4 to R5'</span>
<span style="color: #cc00cc">/// <b>status</b> = </span><span style="color: blue">'active'</span>

<b>conceptmap</b><span style="color: navy"> &quot;</span>ClaimResponseStatus<span style="color: navy">&quot; {
</span><b>  prefix </b>s<span style="color: navy"> = &quot;</span><a href="http://hl7.org/fhir/R4/codesystem-fm-status.html" title="Financial Resource Status Codes">http://hl7.org/fhir/4.0/fm-status</a><span style="color: navy">&quot;
</span><b>  prefix </b>t<span style="color: navy"> = &quot;</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">&quot;
</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>&quot;entered-in-error&quot; <b>-</b> t<span style="color: navy">:</span><span style="color: navy">&quot;</span>entered-in-error<span style="color: navy">&quot;</span>
<span style="color: navy">}

</span><b>conceptmap</b><span style="color: navy"> &quot;</span>RemittanceOutcome<span style="color: navy">&quot; {
</span><b>  prefix </b>s<span style="color: navy"> = &quot;</span><a href="http://hl7.org/fhir/R4/codesystem-remittance-outcome.html" title="Claim Processing Codes">http://hl7.org/fhir/4.0/remittance-outcome</a><span style="color: navy">&quot;
</span><b>  prefix </b>t<span style="color: navy"> = &quot;</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">&quot;
</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"> &quot;</span>Use<span style="color: navy">&quot; {
</span><b>  prefix </b>s<span style="color: navy"> = &quot;</span><a href="http://hl7.org/fhir/R4/codesystem-claim-use.html" title="Use">http://hl7.org/fhir/4.0/claim-use</a><span style="color: navy">&quot;
</span><b>  prefix </b>t<span style="color: navy"> = &quot;</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">&quot;
</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"> &quot;</span><a href="http://hl7.org/fhir/R4/claimresponse.html" title="ClaimResponse">http://hl7.org/fhir/4.0/StructureDefinition/ClaimResponse</a><span style="color: navy">&quot; </span><b>alias </b>ClaimResponseR4 <b>as </b><b>source</b>
<b>uses</b><span style="color: navy"> &quot;</span><a href="http://hl7.org/fhir/R5/claimresponse.html" title="ClaimResponse">http://hl7.org/fhir/StructureDefinition/ClaimResponse</a><span style="color: navy">&quot; </span><b>alias </b>ClaimResponseR5 <b>as </b><b>target</b>

<b>imports</b><span style="color: navy"> &quot;</span>http://hl7.org/fhir/StructureMap/*4to5<span style="color: navy">&quot;
</span>
<b>group </b>ClaimResponse<span style="color: navy">(</span><b>source</b> <span style="color: maroon">src</span><span style="color: navy"> : </span>ClaimResponseR4, <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> &lt;&lt;type+&gt;&gt;</b><span style="color: navy"> {
</span>  src.identifier<span style="color: navy"><b> -&gt; </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> -&gt; </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 -&gt; tgt.traceNumber;</span>
  src.type<span style="color: navy"><b> -&gt; </b></span>tgt.type<span style="color: navy">;</span>
  src.subType<span style="color: navy"><b> -&gt; </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> -&gt; </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> -&gt; </b></span>tgt.patient<span style="color: navy">;</span>
  src.created<span style="color: navy"><b> -&gt; </b></span>tgt.created<span style="color: navy">;</span>
  src.insurer<span style="color: navy"><b> -&gt; </b></span>tgt.insurer<span style="color: navy">;</span>
  src.requestor<span style="color: navy"><b> -&gt; </b></span>tgt.requestor<span style="color: navy">;</span>
  src.request<span style="color: navy"><b> -&gt; </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> -&gt; </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> -&gt; </b></span>tgt.disposition<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.decision -&gt; tgt.decision;</span>
  src.preAuthRef<span style="color: navy"><b> -&gt; </b></span>tgt.preAuthRef<span style="color: navy">;</span>
  src.preAuthPeriod<span style="color: navy"><b> -&gt; </b></span>tgt.preAuthPeriod<span style="color: navy">;</span>
  src.payeeType<span style="color: navy"><b> -&gt; </b></span>tgt.payeeType<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.event as s -&gt; 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> -&gt; </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 -&gt; tgt.encounter;</span>
  src.addItem<b> as </b><span style="color: maroon">s</span><span style="color: navy"><b> -&gt; </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> -&gt; </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> -&gt; </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> -&gt; </b></span>tgt.fundsReserve<span style="color: navy">;</span>
  src.formCode<span style="color: navy"><b> -&gt; </b></span>tgt.formCode<span style="color: navy">;</span>
  src.form<span style="color: navy"><b> -&gt; </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> -&gt; </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> -&gt; </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> -&gt; </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> -&gt; </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 -&gt; tgt.type;</span>
<span style="color: #b36b00" title="This element was not defined prior to R5">// src.when : dateTime -&gt; tgt.when;</span>
<span style="color: #b36b00" title="This element was not defined prior to R5">// src.when : Period -&gt; 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> -&gt; </b></span>tgt.itemSequence<span style="color: navy">;</span>
  src.noteNumber<span style="color: navy"><b> -&gt; </b></span>tgt.noteNumber<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.traceNumber -&gt; tgt.traceNumber;</span>
  src.adjudication<b> as </b><span style="color: maroon">s</span><span style="color: navy"><b> -&gt; </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 -&gt; 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> -&gt; </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 -&gt; tgt.decision;</span>
<span style="color: #b36b00" title="This element was not defined prior to R5">// src.reason -&gt; tgt.reason;</span>
<span style="color: #b36b00" title="This element was not defined prior to R5">// src.preAuthRef -&gt; tgt.preAuthRef;</span>
<span style="color: #b36b00" title="This element was not defined prior to R5">// src.preAuthPeriod -&gt; 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> -&gt; </b></span>tgt.category<span style="color: navy">;</span>
  src.reason<span style="color: navy"><b> -&gt; </b></span>tgt.reason<span style="color: navy">;</span>
  src.amount<span style="color: navy"><b> -&gt; </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> -&gt; </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> -&gt; </b></span>tgt.detailSequence<span style="color: navy">;</span>
  src.noteNumber<span style="color: navy"><b> -&gt; </b></span>tgt.noteNumber<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.traceNumber -&gt; tgt.traceNumber;</span>
  src.subDetail<b> as </b><span style="color: maroon">s</span><span style="color: navy"><b> -&gt; </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> -&gt; </b></span>tgt.subDetailSequence<span style="color: navy">;</span>
  src.noteNumber<span style="color: navy"><b> -&gt; </b></span>tgt.noteNumber<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.traceNumber -&gt; 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> -&gt; </b></span>tgt.itemSequence<span style="color: navy">;</span>
  src.detailSequence<span style="color: navy"><b> -&gt; </b></span>tgt.detailSequence<span style="color: navy">;</span>
  src.subdetailSequence<span style="color: navy"><b> -&gt; </b></span>tgt.subdetailSequence<span style="color: navy">;</span>
  src.provider<span style="color: navy"><b> -&gt; </b></span>tgt.provider<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.traceNumber -&gt; tgt.traceNumber;</span>
  src.productOrService<span style="color: navy"><b> -&gt; </b></span>tgt.productOrService<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.revenue -&gt; tgt.revenue;</span>
  src.modifier<span style="color: navy"><b> -&gt; </b></span>tgt.modifier<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.productOrServiceEnd -&gt; tgt.productOrServiceEnd;</span>
  src.programCode<span style="color: navy"><b> -&gt; </b></span>tgt.programCode<span style="color: navy">;</span>
  src.serviced<span style="color: navy"> : </span>date<span style="color: navy"><b> -&gt; </b></span>tgt.serviced<span style="color: navy">;</span>
  src.serviced<span style="color: navy"> : </span>Period<span style="color: navy"><b> -&gt; </b></span>tgt.serviced<span style="color: navy">;</span>
  src.location<span style="color: navy"> : </span>CodeableConcept<span style="color: navy"><b> -&gt; </b></span>tgt.location<span style="color: navy">;</span>
  src.location<span style="color: navy"> : </span>Address<span style="color: navy"><b> -&gt; </b></span>tgt.location<span style="color: navy">;</span>
  src.location<span style="color: navy"> : </span>Reference<span style="color: navy"><b> -&gt; </b></span>tgt.location<span style="color: navy">;</span>
  src.quantity<span style="color: navy"><b> -&gt; </b></span>tgt.quantity<span style="color: navy">;</span>
  src.unitPrice<span style="color: navy"><b> -&gt; </b></span>tgt.unitPrice<span style="color: navy">;</span>
  src.factor<span style="color: navy"><b> -&gt; </b></span>tgt.factor<span style="color: navy">;</span>
  src.net<span style="color: navy"><b> -&gt; </b></span>tgt.net<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.tax -&gt; tgt.tax;</span>
  src.bodySite<b> as </b><span style="color: maroon">s</span><span style="color: navy"><b> -&gt; </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> -&gt; </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> -&gt; </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 -&gt; tgt.site;</span>
<span style="color: #b36b00" title="This element was not defined prior to R5">// src.subSite -&gt; 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> -&gt; </b></span>tgt.productOrService<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.traceNumber -&gt; tgt.traceNumber;</span>
  src.modifier<span style="color: navy"><b> -&gt; </b></span>tgt.modifier<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.productOrServiceEnd -&gt; tgt.productOrServiceEnd;</span>
  src.quantity<span style="color: navy"><b> -&gt; </b></span>tgt.quantity<span style="color: navy">;</span>
  src.unitPrice<span style="color: navy"><b> -&gt; </b></span>tgt.unitPrice<span style="color: navy">;</span>
  src.factor<span style="color: navy"><b> -&gt; </b></span>tgt.factor<span style="color: navy">;</span>
  src.net<span style="color: navy"><b> -&gt; </b></span>tgt.net<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.tax -&gt; tgt.tax;</span>
  src.noteNumber<span style="color: navy"><b> -&gt; </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> -&gt; </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> -&gt; </b></span>tgt.productOrService<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.traceNumber -&gt; tgt.traceNumber;</span>
  src.modifier<span style="color: navy"><b> -&gt; </b></span>tgt.modifier<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.productOrServiceEnd -&gt; tgt.productOrServiceEnd;</span>
  src.quantity<span style="color: navy"><b> -&gt; </b></span>tgt.quantity<span style="color: navy">;</span>
  src.unitPrice<span style="color: navy"><b> -&gt; </b></span>tgt.unitPrice<span style="color: navy">;</span>
  src.factor<span style="color: navy"><b> -&gt; </b></span>tgt.factor<span style="color: navy">;</span>
  src.net<span style="color: navy"><b> -&gt; </b></span>tgt.net<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.tax -&gt; tgt.tax;</span>
  src.noteNumber<span style="color: navy"><b> -&gt; </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> -&gt; </b></span>tgt.category<span style="color: navy">;</span>
  src.amount<span style="color: navy"><b> -&gt; </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> -&gt; </b></span>tgt.type<span style="color: navy">;</span>
  src.adjustment<span style="color: navy"><b> -&gt; </b></span>tgt.adjustment<span style="color: navy">;</span>
  src.adjustmentReason<span style="color: navy"><b> -&gt; </b></span>tgt.adjustmentReason<span style="color: navy">;</span>
  src.date<span style="color: navy"><b> -&gt; </b></span>tgt.date<span style="color: navy">;</span>
  src.amount<span style="color: navy"><b> -&gt; </b></span>tgt.amount<span style="color: navy">;</span>
  src.identifier<span style="color: navy"><b> -&gt; </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> -&gt; </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> -&gt; </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> -&gt; </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> -&gt; </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> -&gt; </b></span>tgt.text<span style="color: navy">;</span>
  src.language<span style="color: navy"><b> -&gt; </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> -&gt; </b></span>tgt.sequence<span style="color: navy">;</span>
  src.focal<span style="color: navy"><b> -&gt; </b></span>tgt.focal<span style="color: navy">;</span>
  src.coverage<span style="color: navy"><b> -&gt; </b></span>tgt.coverage<span style="color: navy">;</span>
  src.businessArrangement<span style="color: navy"><b> -&gt; </b></span>tgt.businessArrangement<span style="color: navy">;</span>
  src.claimResponse<span style="color: navy"><b> -&gt; </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> -&gt; </b></span>tgt.itemSequence<span style="color: navy">;</span>
  src.detailSequence<span style="color: navy"><b> -&gt; </b></span>tgt.detailSequence<span style="color: navy">;</span>
  src.subDetailSequence<span style="color: navy"><b> -&gt; </b></span>tgt.subDetailSequence<span style="color: navy">;</span>
  src.code<span style="color: navy"><b> -&gt; </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/4.0/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/4.0/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/4.0/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/ClaimResponse4to5"/>
  <version value="5.1.0-snapshot1"/>
  <name value="ClaimResponse4to5"/>
  <title value="FML Conversion for ClaimResponse: R4 to R5"/>
  <status value="active"/>
  <date value="2024-03-12T13:30:10+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="FMLConversionforClaimResponseR4toR5"/>
  <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/4.0/StructureDefinition/ClaimResponse"/>
    <mode value="source"/>
    <alias value="ClaimResponseR4"/>
  </structure>
  <structure>
    <url value="http://hl7.org/fhir/StructureDefinition/ClaimResponse"/>
    <mode value="target"/>
    <alias value="ClaimResponseR5"/>
  </structure>
  <import value="http://hl7.org/fhir/StructureMap/*4to5"/>
  <group>
    <name value="ClaimResponse"/>
    <extends value="DomainResource"/>
    <typeMode value="type-and-types"/>
    <input>
      <name value="src"/>
      <type value="ClaimResponseR4"/>
      <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 -&gt; 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 -&gt; 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 -&gt; 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 -&gt; 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>
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                   value="group ClaimResponseEvent(source src, target tgt) extends BackboneElement {
src.type -&gt; tgt.type;
src.when : dateTime -&gt; tgt.when;
src.when : Period -&gt; tgt.when;
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                     value="src.reviewOutcome as s -&gt; tgt.reviewOutcome as t then ClaimResponseItemReviewOutcome(s,t);"/>
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                   value="group ClaimResponseItemReviewOutcome(source src, target tgt) extends BackboneElement {
src.decision -&gt; tgt.decision;
src.reason -&gt; tgt.reason;
src.preAuthRef -&gt; tgt.preAuthRef;
src.preAuthPeriod -&gt; tgt.preAuthPeriod;
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        <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>