FHIR Extensions Pack
5.1.0 - 5.1.0 (April 2024)
FHIR Extensions Pack
5.1.0 - 5.1.0 (April 2024)
This page is part of the FHIR Core Extensions Registry (v5.1.0: Release 5.1) based on FHIR (HL7® FHIR® Standard) v5.0.0. This is the current published version. 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="Claim5to4B"/>
<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/Claim5to4B'</span>
<span style="color: #cc00cc">/// <b>name</b> = </span><span style="color: blue">'Claim5to4B'</span>
<span style="color: #cc00cc">/// <b>title</b> = </span><span style="color: blue">'FML Conversion for Claim: R5 to R4B'</span>
<span style="color: #cc00cc">/// <b>status</b> = </span><span style="color: blue">'active'</span>
<b>conceptmap</b><span style="color: navy"> "</span>ClaimStatus<span style="color: navy">" {
</span><b> prefix </b>s<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><b> prefix </b>t<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>
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>Use<span style="color: navy">" {
</span><b> prefix </b>s<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><b> prefix </b>t<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>
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/R5/claim.html" title="Claim">http://hl7.org/fhir/StructureDefinition/Claim</a><span style="color: navy">" </span><b>alias </b>ClaimR5 <b>as </b><b>source</b>
<b>uses</b><span style="color: navy"> "</span><a href="http://hl7.org/fhir/R4B/claim.html" title="Claim">http://hl7.org/fhir/4.3/StructureDefinition/Claim</a><span style="color: navy">" </span><b>alias </b>ClaimR4B <b>as </b><b>target</b>
<b>imports</b><span style="color: navy"> "</span>http://hl7.org/fhir/StructureMap/*5to4B<span style="color: navy">"
</span>
<b>group </b>Claim<span style="color: navy">(</span><b>source</b> <span style="color: maroon">src</span><span style="color: navy"> : </span>ClaimR5, <b>target</b> <span style="color: maroon">tgt</span><span style="color: navy"> : </span>ClaimR4B<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">'#ClaimStatus'</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.billablePeriod<span style="color: navy"><b> -> </b></span>tgt.billablePeriod<span style="color: navy">;</span>
src.created<span style="color: navy"><b> -> </b></span>tgt.created<span style="color: navy">;</span>
src.enterer<span style="color: navy"><b> -> </b></span>tgt.enterer<span style="color: navy">;</span>
src.insurer<span style="color: navy"><b> -> </b></span>tgt.insurer<span style="color: navy">;</span>
src.provider<span style="color: navy"><b> -> </b></span>tgt.provider<span style="color: navy">;</span>
src.priority<span style="color: navy"><b> -> </b></span>tgt.priority<span style="color: navy">;</span>
src.fundsReserve<span style="color: navy"><b> -> </b></span>tgt.fundsReserve<span style="color: navy">;</span>
src.related<b> as </b><span style="color: maroon">s</span><span style="color: navy"><b> -> </b></span>tgt.related<b> as </b><span style="color: maroon">t</span><b> then </b>ClaimRelated<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.prescription<span style="color: navy"><b> -> </b></span>tgt.prescription<span style="color: navy">;</span>
src.originalPrescription<span style="color: navy"><b> -> </b></span>tgt.originalPrescription<span style="color: navy">;</span>
src.payee<b> as </b><span style="color: maroon">s</span><span style="color: navy"><b> -> </b></span>tgt.payee<b> as </b><span style="color: maroon">t</span><b> then </b>ClaimPayee<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.referral<span style="color: navy"><b> -> </b></span>tgt.referral<span style="color: navy">;</span>
src.facility<span style="color: navy"><b> -> </b></span>tgt.facility<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.encounter -> tgt.encounter;</span>
src.careTeam<b> as </b><span style="color: maroon">s</span><span style="color: navy"><b> -> </b></span>tgt.careTeam<b> as </b><span style="color: maroon">t</span><b> then </b>ClaimCareTeam<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.diagnosisRelatedGroup -> tgt.diagnosisRelatedGroup;</span>
src.supportingInfo<b> as </b><span style="color: maroon">s</span><span style="color: navy"><b> -> </b></span>tgt.supportingInfo<b> as </b><span style="color: maroon">t</span><b> then </b>ClaimSupportingInfo<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.diagnosis<b> as </b><span style="color: maroon">s</span><span style="color: navy"><b> -> </b></span>tgt.diagnosis<b> as </b><span style="color: maroon">t</span><b> then </b>ClaimDiagnosis<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.procedure<b> as </b><span style="color: maroon">s</span><span style="color: navy"><b> -> </b></span>tgt.procedure<b> as </b><span style="color: maroon">t</span><b> then </b>ClaimProcedure<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.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>ClaimInsurance<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.accident<b> as </b><span style="color: maroon">s</span><span style="color: navy"><b> -> </b></span>tgt.accident<b> as </b><span style="color: maroon">t</span><b> then </b>ClaimAccident<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.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>ClaimItem<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.patientPaid -> tgt.patientPaid;</span>
src.total<span style="color: navy"><b> -> </b></span>tgt.total<span style="color: navy">;</span>
<span style="color: navy">}
</span><b>group </b>ClaimRelated<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.claim<span style="color: navy"><b> -> </b></span>tgt.claim<span style="color: navy">;</span>
src.relationship<span style="color: navy"><b> -> </b></span>tgt.relationship<span style="color: navy">;</span>
src.reference<span style="color: navy"><b> -> </b></span>tgt.reference<span style="color: navy">;</span>
<span style="color: navy">}
</span><b>group </b>ClaimPayee<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.party<span style="color: navy"><b> -> </b></span>tgt.party<span style="color: navy">;</span>
<span style="color: navy">}
</span><span style="color: navy">// </span><span style="color: green">group ClaimEvent(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>ClaimCareTeam<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.provider<span style="color: navy"><b> -> </b></span>tgt.provider<span style="color: navy">;</span>
src.responsible<span style="color: navy"><b> -> </b></span>tgt.responsible<span style="color: navy">;</span>
src.role<span style="color: navy"><b> -> </b></span>tgt.role<span style="color: navy">;</span>
src.specialty<span style="color: navy"><b> -> </b></span>tgt.qualification<span style="color: navy">;</span>
<span style="color: navy">}
</span><b>group </b>ClaimSupportingInfo<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.category<span style="color: navy"><b> -> </b></span>tgt.category<span style="color: navy">;</span>
src.code<span style="color: navy"><b> -> </b></span>tgt.code<span style="color: navy">;</span>
src.timing<span style="color: navy"> : </span>date<span style="color: navy"><b> -> </b></span>tgt.timing<span style="color: navy">;</span>
src.timing<span style="color: navy"> : </span>Period<span style="color: navy"><b> -> </b></span>tgt.timing<span style="color: navy">;</span>
src.value<span style="color: navy"> : </span>boolean<span style="color: navy"><b> -> </b></span>tgt.value<span style="color: navy">;</span>
src.value<span style="color: navy"> : </span>string<span style="color: navy"><b> -> </b></span>tgt.value<span style="color: navy">;</span>
src.value<span style="color: navy"> : </span>Quantity<span style="color: navy"><b> -> </b></span>tgt.value<span style="color: navy">;</span>
src.value<span style="color: navy"> : </span>Attachment<span style="color: navy"><b> -> </b></span>tgt.value<span style="color: navy">;</span>
src.value<span style="color: navy"> : </span>Reference<span style="color: navy"><b> -> </b></span>tgt.value<span style="color: navy">;</span>
src.reason<span style="color: navy"><b> -> </b></span>tgt.reason<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.value : Identifier -> tgt.value;</span>
<span style="color: navy">}
</span><b>group </b>ClaimDiagnosis<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.diagnosis<span style="color: navy"> : </span>CodeableConcept<span style="color: navy"><b> -> </b></span>tgt.diagnosis<span style="color: navy">;</span>
src.diagnosis<span style="color: navy"> : </span>Reference<span style="color: navy"><b> -> </b></span>tgt.diagnosis<span style="color: navy">;</span>
src.type<span style="color: navy"><b> -> </b></span>tgt.type<span style="color: navy">;</span>
src.onAdmission<span style="color: navy"><b> -> </b></span>tgt.onAdmission<span style="color: navy">;</span>
<span style="color: navy">}
</span><b>group </b>ClaimProcedure<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.type<span style="color: navy"><b> -> </b></span>tgt.type<span style="color: navy">;</span>
src.date<span style="color: navy"><b> -> </b></span>tgt.date<span style="color: navy">;</span>
src.procedure<span style="color: navy"> : </span>CodeableConcept<span style="color: navy"><b> -> </b></span>tgt.procedure<span style="color: navy">;</span>
src.procedure<span style="color: navy"> : </span>Reference<span style="color: navy"><b> -> </b></span>tgt.procedure<span style="color: navy">;</span>
src.udi<span style="color: navy"><b> -> </b></span>tgt.udi<span style="color: navy">;</span>
<span style="color: navy">}
</span><b>group </b>ClaimInsurance<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.identifier<span style="color: navy"><b> -> </b></span>tgt.identifier<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.preAuthRef<span style="color: navy"><b> -> </b></span>tgt.preAuthRef<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>ClaimAccident<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.date<span style="color: navy"><b> -> </b></span>tgt.date<span style="color: navy">;</span>
src.type<span style="color: navy"><b> -> </b></span>tgt.type<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>
<span style="color: navy">}
</span><b>group </b>ClaimItem<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.careTeamSequence<span style="color: navy"><b> -> </b></span>tgt.careTeamSequence<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.traceNumber -> tgt.traceNumber;</span>
src.diagnosisSequence<span style="color: navy"><b> -> </b></span>tgt.diagnosisSequence<span style="color: navy">;</span>
src.procedureSequence<span style="color: navy"><b> -> </b></span>tgt.procedureSequence<span style="color: navy">;</span>
src.informationSequence<span style="color: navy"><b> -> </b></span>tgt.informationSequence<span style="color: navy">;</span>
src.revenue<span style="color: navy"><b> -> </b></span>tgt.revenue<span style="color: navy">;</span>
src.category<span style="color: navy"><b> -> </b></span>tgt.category<span style="color: navy">;</span>
src.productOrService<span style="color: navy"><b> -> </b></span>tgt.productOrService<span style="color: navy">;</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> <span style="color: navy">// </span><span style="color: green">src.patientPaid -> tgt.patientPaid;</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.udi<span style="color: navy"><b> -> </b></span>tgt.udi<span style="color: navy">;</span>
src.bodySite<b> as </b><span style="color: maroon">s</span><span style="color: navy"><b> -> </b></span>tgt.bodySite = <span style="color: maroon">s.site</span><span style="color: navy">;</span>
src.encounter<span style="color: navy"><b> -> </b></span>tgt.encounter<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>ClaimItemDetail<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 ClaimItemBodySite(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>ClaimItemDetail<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.revenue<span style="color: navy"><b> -> </b></span>tgt.revenue<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.traceNumber -> tgt.traceNumber;</span>
src.category<span style="color: navy"><b> -> </b></span>tgt.category<span style="color: navy">;</span>
src.productOrService<span style="color: navy"><b> -> </b></span>tgt.productOrService<span style="color: navy">;</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.quantity<span style="color: navy"><b> -> </b></span>tgt.quantity<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.patientPaid -> tgt.patientPaid;</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.udi<span style="color: navy"><b> -> </b></span>tgt.udi<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>ClaimItemDetailSubDetail<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>ClaimItemDetailSubDetail<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.revenue<span style="color: navy"><b> -> </b></span>tgt.revenue<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.traceNumber -> tgt.traceNumber;</span>
src.category<span style="color: navy"><b> -> </b></span>tgt.category<span style="color: navy">;</span>
src.productOrService<span style="color: navy"><b> -> </b></span>tgt.productOrService<span style="color: navy">;</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.quantity<span style="color: navy"><b> -> </b></span>tgt.quantity<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.patientPaid -> tgt.patientPaid;</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.udi<span style="color: navy"><b> -> </b></span>tgt.udi<span style="color: navy">;</span>
<span style="color: navy">}
</span></pre></div>
</text>
<contained>
<ConceptMap>
<id value="ClaimStatus"/>
<status value="active"/>
<group>
<source value="http://hl7.org/fhir/fm-status"/>
<target value="http://hl7.org/fhir/4.3/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="Use"/>
<status value="active"/>
<group>
<source value="http://hl7.org/fhir/claim-use"/>
<target value="http://hl7.org/fhir/4.3/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/Claim5to4B"/>
<version value="5.1.0"/>
<name value="Claim5to4B"/>
<title value="FML Conversion for Claim: R5 to R4B"/>
<status value="active"/>
<date value="2024-04-27T18:54:50+10:00"/>
<publisher value="HL7 International / FHIR Infrastructure"/>
<contact>
<telecom>
<system value="url"/>
<value value="http://www.hl7.org/Special/committees/fiwg"/>
</telecom>
</contact>
<description value="FMLConversionforClaimR5toR4B"/>
<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/StructureDefinition/Claim"/>
<mode value="source"/>
<alias value="ClaimR5"/>
</structure>
<structure>
<url value="http://hl7.org/fhir/4.3/StructureDefinition/Claim"/>
<mode value="target"/>
<alias value="ClaimR4B"/>
</structure>
<import value="http://hl7.org/fhir/StructureMap/*5to4B"/>
<group>
<name value="Claim"/>
<extends value="DomainResource"/>
<typeMode value="type-and-types"/>
<input>
<name value="src"/>
<type value="ClaimR5"/>
<mode value="source"/>
</input>
<input>
<name value="tgt"/>
<type value="ClaimR4B"/>
<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="#ClaimStatus"/>
</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="billablePeriod"/>
<source>
<context value="src"/>
<element value="billablePeriod"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="billablePeriod"/>
<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="enterer"/>
<source>
<context value="src"/>
<element value="enterer"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="enterer"/>
<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="provider"/>
<source>
<context value="src"/>
<element value="provider"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="provider"/>
<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="priority"/>
<source>
<context value="src"/>
<element value="priority"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="priority"/>
<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="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="related"/>
<source>
<context value="src"/>
<element value="related"/>
<variable value="s"/>
</source>
<target>
<context value="tgt"/>
<element value="related"/>
<variable value="t"/>
</target>
<dependent>
<name value="ClaimRelated"/>
<parameter>
<valueId value="s"/>
</parameter>
<parameter>
<valueId value="t"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="prescription"/>
<source>
<context value="src"/>
<element value="prescription"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="prescription"/>
<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="originalPrescription"/>
<source>
<context value="src"/>
<element value="originalPrescription"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="originalPrescription"/>
<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="payee"/>
<source>
<context value="src"/>
<element value="payee"/>
<variable value="s"/>
</source>
<target>
<context value="tgt"/>
<element value="payee"/>
<variable value="t"/>
</target>
<dependent>
<name value="ClaimPayee"/>
<parameter>
<valueId value="s"/>
</parameter>
<parameter>
<valueId value="t"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="referral"/>
<source>
<context value="src"/>
<element value="referral"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="referral"/>
<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="facility"/>
<source>
<context value="src"/>
<element value="facility"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="facility"/>
<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.encounter -> tgt.encounter;"/>
</rule>
<rule>
<name value="careTeam"/>
<source>
<context value="src"/>
<element value="careTeam"/>
<variable value="s"/>
</source>
<target>
<context value="tgt"/>
<element value="careTeam"/>
<variable value="t"/>
</target>
<dependent>
<name value="ClaimCareTeam"/>
<parameter>
<valueId value="s"/>
</parameter>
<parameter>
<valueId value="t"/>
</parameter>
</dependent>
<documentation
value="src.diagnosisRelatedGroup -> tgt.diagnosisRelatedGroup;"/>
</rule>
<rule>
<name value="supportingInfo"/>
<source>
<context value="src"/>
<element value="supportingInfo"/>
<variable value="s"/>
</source>
<target>
<context value="tgt"/>
<element value="supportingInfo"/>
<variable value="t"/>
</target>
<dependent>
<name value="ClaimSupportingInfo"/>
<parameter>
<valueId value="s"/>
</parameter>
<parameter>
<valueId value="t"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="diagnosis"/>
<source>
<context value="src"/>
<element value="diagnosis"/>
<variable value="s"/>
</source>
<target>
<context value="tgt"/>
<element value="diagnosis"/>
<variable value="t"/>
</target>
<dependent>
<name value="ClaimDiagnosis"/>
<parameter>
<valueId value="s"/>
</parameter>
<parameter>
<valueId value="t"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="procedure"/>
<source>
<context value="src"/>
<element value="procedure"/>
<variable value="s"/>
</source>
<target>
<context value="tgt"/>
<element value="procedure"/>
<variable value="t"/>
</target>
<dependent>
<name value="ClaimProcedure"/>
<parameter>
<valueId value="s"/>
</parameter>
<parameter>
<valueId value="t"/>
</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="ClaimInsurance"/>
<parameter>
<valueId value="s"/>
</parameter>
<parameter>
<valueId value="t"/>
</parameter>
</dependent>
</rule>
<rule>
<name value="accident"/>
<source>
<context value="src"/>
<element value="accident"/>
<variable value="s"/>
</source>
<target>
<context value="tgt"/>
<element value="accident"/>
<variable value="t"/>
</target>
<dependent>
<name value="ClaimAccident"/>
<parameter>
<valueId value="s"/>
</parameter>
<parameter>
<valueId value="t"/>
</parameter>
</dependent>
</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="ClaimItem"/>
<parameter>
<valueId value="s"/>
</parameter>
<parameter>
<valueId value="t"/>
</parameter>
</dependent>
<documentation value="src.patientPaid -> tgt.patientPaid;"/>
</rule>
<rule>
<name value="total"/>
<source>
<context value="src"/>
<element value="total"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="total"/>
<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="ClaimRelated"/>
<extends value="BackboneElement"/>
<input>
<name value="src"/>
<mode value="source"/>
</input>
<input>
<name value="tgt"/>
<mode value="target"/>
</input>
<rule>
<name value="claim"/>
<source>
<context value="src"/>
<element value="claim"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="claim"/>
<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="relationship"/>
<source>
<context value="src"/>
<element value="relationship"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="relationship"/>
<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="reference"/>
<source>
<context value="src"/>
<element value="reference"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="reference"/>
<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="ClaimPayee"/>
<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="party"/>
<source>
<context value="src"/>
<element value="party"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="party"/>
<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="ClaimCareTeam"/>
<extends value="BackboneElement"/>
<documentation
value="group ClaimEvent(source src, target tgt) extends BackboneElement {
src.type -> tgt.type;
src.when : dateTime -> tgt.when;
src.when : Period -> tgt.when;
}"/>
<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>
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<documentation
value="src.productOrServiceEnd -> tgt.productOrServiceEnd;"/>
</rule>
<rule>
<name value="programCode"/>
<source>
<context value="src"/>
<element value="programCode"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="programCode"/>
<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="servicedDate"/>
<source>
<context value="src"/>
<type value="date"/>
<element value="serviced"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="serviced"/>
<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="servicedPeriod"/>
<source>
<context value="src"/>
<type value="Period"/>
<element value="serviced"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="serviced"/>
<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="locationCodeableConcept"/>
<source>
<context value="src"/>
<type value="CodeableConcept"/>
<element value="location"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="location"/>
<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="locationAddress"/>
<source>
<context value="src"/>
<type value="Address"/>
<element value="location"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="location"/>
<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="locationReference"/>
<source>
<context value="src"/>
<type value="Reference"/>
<element value="location"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="location"/>
<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="quantity"/>
<source>
<context value="src"/>
<element value="quantity"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="quantity"/>
<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.patientPaid -> tgt.patientPaid;"/>
</rule>
<rule>
<name value="unitPrice"/>
<source>
<context value="src"/>
<element value="unitPrice"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="unitPrice"/>
<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="factor"/>
<source>
<context value="src"/>
<element value="factor"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<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="udi"/>
<source>
<context value="src"/>
<element value="udi"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="udi"/>
<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="bodySite"/>
<source>
<context value="src"/>
<element value="bodySite"/>
<variable value="s"/>
</source>
<target>
<context value="tgt"/>
<element value="bodySite"/>
<transform value="copy"/>
<parameter>
<valueId value="s.site"/>
</parameter>
</target>
</rule>
<rule>
<name value="encounter"/>
<source>
<context value="src"/>
<element value="encounter"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="encounter"/>
<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="detail"/>
<source>
<context value="src"/>
<element value="detail"/>
<variable value="s"/>
</source>
<target>
<context value="tgt"/>
<element value="detail"/>
<variable value="t"/>
</target>
<dependent>
<name value="ClaimItemDetail"/>
<parameter>
<valueId value="s"/>
</parameter>
<parameter>
<valueId value="t"/>
</parameter>
</dependent>
</rule>
</group>
<group>
<name value="ClaimItemDetail"/>
<extends value="BackboneElement"/>
<documentation
value="group ClaimItemBodySite(source src, target tgt) extends BackboneElement {
src.site -> tgt.site;
src.subSite -> tgt.subSite;
}"/>
<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="revenue"/>
<source>
<context value="src"/>
<element value="revenue"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="revenue"/>
<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.traceNumber -> tgt.traceNumber;"/>
</rule>
<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="productOrService"/>
<source>
<context value="src"/>
<element value="productOrService"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="productOrService"/>
<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="modifier"/>
<source>
<context value="src"/>
<element value="modifier"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="modifier"/>
<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.productOrServiceEnd -> tgt.productOrServiceEnd;"/>
</rule>
<rule>
<name value="programCode"/>
<source>
<context value="src"/>
<element value="programCode"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="programCode"/>
<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="quantity"/>
<source>
<context value="src"/>
<element value="quantity"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="quantity"/>
<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.patientPaid -> tgt.patientPaid;"/>
</rule>
<rule>
<name value="unitPrice"/>
<source>
<context value="src"/>
<element value="unitPrice"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="unitPrice"/>
<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="factor"/>
<source>
<context value="src"/>
<element value="factor"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<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="udi"/>
<source>
<context value="src"/>
<element value="udi"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="udi"/>
<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="subDetail"/>
<source>
<context value="src"/>
<element value="subDetail"/>
<variable value="s"/>
</source>
<target>
<context value="tgt"/>
<element value="subDetail"/>
<variable value="t"/>
</target>
<dependent>
<name value="ClaimItemDetailSubDetail"/>
<parameter>
<valueId value="s"/>
</parameter>
<parameter>
<valueId value="t"/>
</parameter>
</dependent>
</rule>
</group>
<group>
<name value="ClaimItemDetailSubDetail"/>
<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="revenue"/>
<source>
<context value="src"/>
<element value="revenue"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="revenue"/>
<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.traceNumber -> tgt.traceNumber;"/>
</rule>
<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="productOrService"/>
<source>
<context value="src"/>
<element value="productOrService"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="productOrService"/>
<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="modifier"/>
<source>
<context value="src"/>
<element value="modifier"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="modifier"/>
<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.productOrServiceEnd -> tgt.productOrServiceEnd;"/>
</rule>
<rule>
<name value="programCode"/>
<source>
<context value="src"/>
<element value="programCode"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="programCode"/>
<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="quantity"/>
<source>
<context value="src"/>
<element value="quantity"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="quantity"/>
<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.patientPaid -> tgt.patientPaid;"/>
</rule>
<rule>
<name value="unitPrice"/>
<source>
<context value="src"/>
<element value="unitPrice"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="unitPrice"/>
<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="factor"/>
<source>
<context value="src"/>
<element value="factor"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<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="udi"/>
<source>
<context value="src"/>
<element value="udi"/>
<variable value="vvv"/>
</source>
<target>
<context value="tgt"/>
<element value="udi"/>
<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 based on FHIR 5.0.0. Generated 2024-04-27
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