This page is part of the Da Vinci Prior Authorization Support (PAS) FHIR IG (v1.0.0: STU 1) based on FHIR R4. The current version which supercedes this version is 1.1.0. For a full list of available versions, see the Directory of published versions 
Mappings for the extension-itemAuthorizedDetail extension.
| AuthorizedItemDetail | ||
| Extension | ||
| id | n/a | |
| extension | n/a | |
| extension (productOrServiceCode) | ||
| id | n/a | |
| url | N/A | |
| value[x] | N/A | |
| value[x] (valueCodeableConcept) | N/A | |
| extension (productOrServiceCodeEnd) | n/a, N/A | |
| extension (modifier) | ||
| id | n/a | |
| url | N/A | |
| value[x] | N/A | |
| value[x] (valueCodeableConcept) | N/A | |
| extension (unitPrice) | ||
| id | n/a | |
| url | N/A | |
| value[x] | N/A | |
| extension (quantity) | ||
| id | n/a | |
| url | N/A | |
| value[x] | n/a, PQ, IVL<PQ>, MO, CO, depending on the values | |
| extension (epsdtIndicator) | n/a, N/A | |
| extension (nursingHomeLevelOfCare) | n/a, N/A | |
| extension (revenue) | ||
| id | n/a | |
| url | N/A | |
| value[x] | N/A | |
| value[x] (valueCodeableConcept) | N/A | |
| extension (revenueUnitRateLimit) | n/a, N/A | |
| extension (authorizedService) | n/a, N/A | |
| url | N/A | |