Da Vinci Prior Authorization Support (PAS) FHIR IG
2.1.0 - STU 2.1 United States of America flag

This page is part of the Da Vinci Prior Authorization Support (PAS) FHIR IG (v2.1.0: STU 2) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Resource Profile: PASClaimBase - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 3

Definitions for the profile-claim-base resource profile.

Guidance on how to interpret the contents of this table can be found here

0. Claim
ShortPreauthorization
2. Claim.extension
SlicingThis element introduces a set of slices on Claim.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 4. Claim.extension:levelOfServiceType
    Slice NamelevelOfServiceType
    ShortA code specifying the level of service being requested (UM06)
    Control0..1
    TypeExtension(LevelOfServiceCode) (Extension Type: CodeableConcept)
    Must Supporttrue
    6. Claim.extension:conditionCode
    Slice NameconditionCode
    ShortUsed to indicate condition codes for various requests for service.
    Control0..*
    TypeExtension(ConditionCode) (Complex Extension)
    Must Supporttrue
    8. Claim.extension:homeHealthCareInformation
    Slice NamehomeHealthCareInformation
    ShortUsed to provide required information about home health care services. (CR6)
    Control0..1
    TypeExtension(HomeHealthCareInformation) (Complex Extension)
    Must Supporttrue
    10. Claim.identifier
    ShortBusiness identifier for claim
    NoteThis is a business identifier, not a resource identifier (see discussion)
    TypeIdentifier(PAS Identifier)
    Must Supporttrue
    12. Claim.identifier.system
    ShortSHOULD use a scheme of 'urn:trnorg:<TRN03>'
    14. Claim.status
    Must Supporttrue
    Pattern Valueactive
    16. Claim.use
    Must Supporttrue
    Pattern Valuepreauthorization
    18. Claim.patient
    TypeReference(PAS Beneficiary Patient)
    Must Supporttrue
    20. Claim.insurer
    Control1..?
    TypeReference(PAS Insurer Organization)
    Must Supporttrue
    22. Claim.provider
    TypeReference(PAS Requestor Organization, PAS PractitionerRole)
    Must Supporttrue
    Must Support TypesNo must-support rules about the choice of types/profiles
    24. Claim.careTeam
    Must Supporttrue
    SlicingThis element introduces a set of slices on Claim.careTeam. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ extension('http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-careTeamClaimScope').value.ofType(boolean)
    • 26. Claim.careTeam.extension
      Control1..?
      SlicingThis element introduces a set of slices on Claim.careTeam.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 28. Claim.careTeam.extension:careTeamClaimScope
        Slice NamecareTeamClaimScope
        Control1..1
        TypeExtension(CareTeamClaimScope) (Extension Type: boolean)
        Must Supporttrue
        30. Claim.careTeam.sequence
        Must Supporttrue
        32. Claim.careTeam.provider
        TypeReference(PAS Organization Base Profile, PAS PractitionerRole)
        Must Supporttrue
        Must Support TypesNo must-support rules about the choice of types/profiles
        34. Claim.careTeam.role
        Must Supporttrue
        36. Claim.careTeam.qualification
        Must Supporttrue
        38. Claim.careTeam:OverallClaimMember
        Slice NameOverallClaimMember
        ShortCare Team Providers that are applicable to all services being requested. NOTE: Only the first 14 can be sent in the X12 Request.
        Comments

        NOTE: Only the first 14 can be sent in the X12 Request.

        Control0..*
        Must Supporttrue
        40. Claim.careTeam:OverallClaimMember.extension
        Control1..?
        SlicingThis element introduces a set of slices on Claim.careTeam.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 42. Claim.careTeam:OverallClaimMember.extension:careTeamClaimScope
          Slice NamecareTeamClaimScope
          Control1..1
          TypeExtension(CareTeamClaimScope) (Extension Type: boolean)
          Must Supporttrue
          44. Claim.careTeam:OverallClaimMember.extension:careTeamClaimScope.value[x]
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Must Supporttrue
          Fixed Valuetrue
          46. Claim.careTeam:OverallClaimMember.role
          BindingThe codes SHALL be taken from https://valueset.x12.org/x217/005010/request/2010EA/NM1/1/01/00/98
          (required to https://valueset.x12.org/x217/005010/request/2010EA/NM1/1/01/00/98)

          Codes identifying a provider specialty. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.

          48. Claim.careTeam:OverallClaimMember.qualification
          BindingThe codes SHALL be taken from https://valueset.x12.org/x217/005010/request/2010EA/PRV/1/03/00/127
          (required to https://valueset.x12.org/x217/005010/request/2010EA/PRV/1/03/00/127)
          50. Claim.careTeam:ItemClaimMember
          Slice NameItemClaimMember
          ShortCare Team Providers that are applicable to a specific item (as referenced by that item). NOTE: Only the first 10 can be sent in the X12 Request.
          Comments

          NOTE: Only the first 10 can be sent in the X12 Request.

          Control0..*
          Must Supporttrue
          52. Claim.careTeam:ItemClaimMember.extension
          Control1..?
          SlicingThis element introduces a set of slices on Claim.careTeam.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 54. Claim.careTeam:ItemClaimMember.extension:careTeamClaimScope
            Slice NamecareTeamClaimScope
            Control1..1
            TypeExtension(CareTeamClaimScope) (Extension Type: boolean)
            Must Supporttrue
            56. Claim.careTeam:ItemClaimMember.extension:careTeamClaimScope.value[x]
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Must Supporttrue
            Fixed Valuefalse
            58. Claim.careTeam:ItemClaimMember.role
            BindingThe codes SHALL be taken from https://valueset.x12.org/x217/005010/request/2010F/NM1/1/01/00/98
            (required to https://valueset.x12.org/x217/005010/request/2010F/NM1/1/01/00/98)

            Codes identifying a provider specialty. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.

            60. Claim.careTeam:ItemClaimMember.qualification
            BindingThe codes SHALL be taken from https://valueset.x12.org/x217/005010/request/2010F/PRV/1/03/00/127
            (required to https://valueset.x12.org/x217/005010/request/2010F/PRV/1/03/00/127)
            62. Claim.supportingInfo
            Must Supporttrue
            SlicingThis element introduces a set of slices on Claim.supportingInfo. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ category
            • 64. Claim.supportingInfo.sequence
              Must Supporttrue
              66. Claim.supportingInfo.category
              BindingUnless not suitable, these codes SHALL be taken from PAS Supporting Info Type Value Set
              (extensible to http://hl7.org/fhir/us/davinci-pas/ValueSet/PASSupportingInfoType)
              Must Supporttrue
              68. Claim.supportingInfo:PatientEvent
              Slice NamePatientEvent
              ShortInformation about the dates of the event that are being requested.
              Control0..1
              Must Supporttrue
              70. Claim.supportingInfo:PatientEvent.category
              Pattern Value{
                "coding" : [{
                  "system" : "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes",
                  "code" : "patientEvent"
                }]
              }
              72. Claim.supportingInfo:PatientEvent.timing[x]
              Control1..?
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Must Supporttrue
              SlicingThis element introduces a set of slices on Claim.supportingInfo.timing[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • type @ $this
              • 74. Claim.supportingInfo:PatientEvent.timing[x]:timingDate
                Slice NametimingDate
                Control0..1
                Typedate
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                InvariantsFullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                76. Claim.supportingInfo:PatientEvent.timing[x]:timingPeriod
                Slice NametimingPeriod
                Control0..1
                TypePeriod
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Must Supporttrue
                78. Claim.supportingInfo:PatientEvent.timing[x]:timingPeriod.start
                Must Supporttrue
                InvariantsFullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                80. Claim.supportingInfo:PatientEvent.timing[x]:timingPeriod.end
                Must Supporttrue
                InvariantsFullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                82. Claim.supportingInfo:PatientEvent.value[x]
                Control0..0
                84. Claim.supportingInfo:AdmissionDates
                Slice NameAdmissionDates
                ShortInformation about the admission dates of a hospital admission being requested.
                Control0..1
                Must Supporttrue
                86. Claim.supportingInfo:AdmissionDates.category
                Pattern Value{
                  "coding" : [{
                    "system" : "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes",
                    "code" : "admissionDates"
                  }]
                }
                88. Claim.supportingInfo:AdmissionDates.timing[x]
                Control1..?
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Must Supporttrue
                SlicingThis element introduces a set of slices on Claim.supportingInfo.timing[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • type @ $this
                • 90. Claim.supportingInfo:AdmissionDates.timing[x]:timingDate
                  Slice NametimingDate
                  Control0..1
                  Typedate
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  InvariantsFullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                  92. Claim.supportingInfo:AdmissionDates.timing[x]:timingPeriod
                  Slice NametimingPeriod
                  Control0..1
                  TypePeriod
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Must Supporttrue
                  94. Claim.supportingInfo:AdmissionDates.timing[x]:timingPeriod.start
                  Must Supporttrue
                  InvariantsFullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                  96. Claim.supportingInfo:AdmissionDates.timing[x]:timingPeriod.end
                  Must Supporttrue
                  InvariantsFullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                  98. Claim.supportingInfo:AdmissionDates.value[x]
                  Control0..0
                  100. Claim.supportingInfo:DischargeDates
                  Slice NameDischargeDates
                  ShortInformation about the discharge dates of a hospital admission being requested.
                  Control0..1
                  Must Supporttrue
                  102. Claim.supportingInfo:DischargeDates.category
                  Pattern Value{
                    "coding" : [{
                      "system" : "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes",
                      "code" : "dischargeDates"
                    }]
                  }
                  104. Claim.supportingInfo:DischargeDates.timing[x]
                  Control1..?
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Must Supporttrue
                  SlicingThis element introduces a set of slices on Claim.supportingInfo.timing[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • type @ $this
                  • 106. Claim.supportingInfo:DischargeDates.timing[x]:timingDate
                    Slice NametimingDate
                    Control0..1
                    Typedate
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    InvariantsFullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                    108. Claim.supportingInfo:DischargeDates.timing[x]:timingPeriod
                    Slice NametimingPeriod
                    Control0..1
                    TypePeriod
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Must Supporttrue
                    110. Claim.supportingInfo:DischargeDates.timing[x]:timingPeriod.start
                    Must Supporttrue
                    InvariantsFullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                    112. Claim.supportingInfo:DischargeDates.timing[x]:timingPeriod.end
                    Must Supporttrue
                    InvariantsFullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                    114. Claim.supportingInfo:DischargeDates.value[x]
                    Control0..0
                    116. Claim.diagnosis
                    Must Supporttrue
                    118. Claim.diagnosis.sequence
                    Must Supporttrue
                    120. Claim.diagnosis.diagnosis[x]
                    BindingThe codes SHALL be taken from X12 278 Diagnosis Code Value Set
                    (required to http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278DiagnosisCodes)
                    TypeCodeableConcept, Reference(Condition)
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Must Supporttrue
                    122. Claim.diagnosis.type
                    Control0..1
                    BindingThe codes SHALL be taken from X12 278 Diagnosis Type Value Set
                    (required to http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278DiagnosisType)
                    Must Supporttrue
                    124. Claim.insurance
                    Must Supporttrue
                    126. Claim.insurance.sequence
                    Must Supporttrue
                    128. Claim.insurance.focal
                    Pattern Valuetrue
                    130. Claim.insurance.coverage
                    TypeReference(PAS Coverage)
                    Must Supporttrue
                    132. Claim.accident
                    Must Supporttrue
                    134. Claim.accident.date
                    Must Supporttrue
                    InvariantsFullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                    136. Claim.accident.type
                    BindingThe codes SHALL be taken from https://valueset.x12.org/x217/005010/request/2000E/UM/1/05/01/1362
                    (required to https://valueset.x12.org/x217/005010/request/2000E/UM/1/05/01/1362)

                    Codes identifying an accompanying cause of an illness, injury or an accident. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.

                    Must Supporttrue
                    138. Claim.accident.location[x]
                    TypeAddress, Reference(Location)
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Must Supporttrue
                    140. Claim.item
                    Must Supporttrue
                    142. Claim.item.extension
                    SlicingThis element introduces a set of slices on Claim.item.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 144. Claim.item.extension:itemTraceNumber
                      Slice NameitemTraceNumber
                      ShortUniquely identifies this claim item. (2000F-TRN)
                      Control0..*
                      TypeExtension(ItemTraceNumber) (Extension Type: Identifier(PAS Identifier))
                      Must Supporttrue
                      146. Claim.item.extension:authorizationNumber
                      Slice NameauthorizationNumber
                      ShortA string assigned by the UMO to an authorized review outcome associated with this service item.
                      Control0..1
                      TypeExtension(AuthorizationNumber) (Extension Type: string)
                      Must Supporttrue
                      148. Claim.item.extension:administrationReferenceNumber
                      Slice NameadministrationReferenceNumber
                      ShortA string assigned by the UMO to the original disallowed review outcome associated with this service item.
                      Control0..1
                      TypeExtension(AdministrationReferenceNumber) (Extension Type: string)
                      Must Supporttrue
                      150. Claim.item.extension:requestType
                      Slice NamerequestType
                      ShortA code that identifies the type of service being requested.
                      Control0..1
                      TypeExtension(ServiceItemRequestType) (Extension Type: CodeableConcept)
                      Must Supporttrue
                      152. Claim.item.extension:certificationType
                      Slice NamecertificationType
                      ShortA code representing the type of certification being requested (UM02)
                      Control0..1
                      TypeExtension(CertificationType) (Extension Type: CodeableConcept)
                      Must Supporttrue
                      154. Claim.item.extension:productOrServiceCodeEnd
                      Slice NameproductOrServiceCodeEnd
                      ShortUsed to provide the last code in a series of codes for the service being requested.
                      Control0..1
                      TypeExtension(ProductOrServiceCodeEnd) (Extension Type: CodeableConcept)
                      Must Supporttrue
                      156. Claim.item.sequence
                      Must Supporttrue
                      158. Claim.item.careTeamSequence
                      Must Supporttrue
                      160. Claim.item.diagnosisSequence
                      Must Supporttrue
                      162. Claim.item.informationSequence
                      Must Supporttrue
                      164. Claim.item.revenue
                      BindingThe codes SHALL be taken from AHA NUBC Revenue Value Set
                      (required to http://hl7.org/fhir/us/davinci-pas/ValueSet/AHANUBCRevenueCodes)
                      Must Supporttrue
                      166. Claim.item.category
                      BindingThe codes SHALL be taken from https://valueset.x12.org/x217/005010/request/2000F/UM/1/03/00/1365
                      (required to https://valueset.x12.org/x217/005010/request/2000F/UM/1/03/00/1365)

                      Codes identifying the classification of service. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.

                      Must Supporttrue
                      168. Claim.item.productOrService
                      BindingThe codes SHALL be taken from X12 278 Requested Service Type
                      (required to http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278RequestedServiceType)
                      Must Supporttrue
                      170. Claim.item.modifier
                      BindingThe codes SHALL be taken from X12 278 Requested Service Modifier Type
                      (required to http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278RequestedServiceModifierType)
                      Must Supporttrue
                      172. Claim.item.serviced[x]
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Must Supporttrue
                      SlicingThis element introduces a set of slices on Claim.item.serviced[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • type @ $this
                      • 174. Claim.item.serviced[x]:servicedDate
                        Slice NameservicedDate
                        Control0..1
                        Typedate
                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        InvariantsFullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                        176. Claim.item.serviced[x]:servicedPeriod
                        Slice NameservicedPeriod
                        Control0..1
                        TypePeriod
                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                        178. Claim.item.serviced[x]:servicedPeriod.start
                        InvariantsFullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                        180. Claim.item.serviced[x]:servicedPeriod.end
                        InvariantsFullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                        182. Claim.item.location[x]
                        BindingThe codes SHALL be taken from X12 278 Health Care Service Location Type Value Set
                        (required to http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278LocationType)
                        TypeCodeableConcept, Address, Reference(Location)
                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                        Must Supporttrue
                        184. Claim.item.quantity
                        Comments

                        For any exchange that must be converted to an X12 request, units SHALL be restricted to international units, days, units, minutes, hours, months, or visits.

                        TypeQuantity(PAS Quantity)
                        Must Supporttrue

                        Guidance on how to interpret the contents of this table can be found here

                        0. Claim
                        Definition

                        A provider issued list of professional services and products which have been provided, or are to be provided, to a patient which is sent to an insurer for reimbursement.

                        ShortPreauthorizationClaim, Pre-determination or Pre-authorization
                        Comments

                        The Claim resource fulfills three information request requirements: Claim - a request for adjudication for reimbursement for products and/or services provided; Preauthorization - a request to authorize the future provision of products and/or services including an anticipated adjudication; and, Predetermination - a request for a non-bind adjudication of possible future products and/or services.

                        Control0..*
                        Is Modifierfalse
                        Summaryfalse
                        Alternate NamesAdjudication Request, Preauthorization Request, Predetermination Request
                        Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                        dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
                        dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                        dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                        dom-6: A resource should have narrative for robust management (text.`div`.exists())
                        2. Claim.implicitRules
                        Definition

                        A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                        ShortA set of rules under which this content was created
                        Comments

                        Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                        Control0..1
                        Typeuri
                        Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        4. Claim.extension
                        Definition

                        An Extension


                        May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                        ShortExtensionAdditional content defined by implementations
                        Comments

                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                        Control0..*
                        TypeExtension
                        Is Modifierfalse
                        Summaryfalse
                        Alternate Namesextensions, user content
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        SlicingThis element introduces a set of slices on Claim.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 6. Claim.extension:levelOfServiceType
                          Slice NamelevelOfServiceType
                          Definition

                          A code specifying the level of service being requested (UM06)

                          ShortA code specifying the level of service being requested (UM06)
                          Control0..1
                          This element is affected by the following invariants: ele-1
                          TypeExtension(LevelOfServiceCode) (Extension Type: CodeableConcept)
                          Is Modifierfalse
                          Must Supporttrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          8. Claim.extension:conditionCode
                          Slice NameconditionCode
                          Definition

                          Information to supply various patient conditions.

                          ShortUsed to indicate condition codes for various requests for service.
                          Control0..*
                          This element is affected by the following invariants: ele-1
                          TypeExtension(ConditionCode) (Complex Extension)
                          Is Modifierfalse
                          Must Supporttrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          10. Claim.extension:homeHealthCareInformation
                          Slice NamehomeHealthCareInformation
                          Definition

                          Information needed for home health care requests.

                          ShortUsed to provide required information about home health care services. (CR6)
                          Control0..1
                          This element is affected by the following invariants: ele-1
                          TypeExtension(HomeHealthCareInformation) (Complex Extension)
                          Is Modifierfalse
                          Must Supporttrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          12. Claim.modifierExtension
                          Definition

                          May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                          ShortExtensions that cannot be ignored
                          Comments

                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                          Control0..*
                          TypeExtension
                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                          Summaryfalse
                          Requirements

                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          14. Claim.identifier
                          Definition

                          An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.


                          A unique identifier assigned to this claim.

                          ShortBusiness identifier for claimBusiness Identifier for claim
                          NoteThis is a business identifier, not a resource identifier (see discussion)
                          Control0..*
                          This element is affected by the following invariants: ele-1
                          TypeIdentifier(PAS Identifier)
                          Is Modifierfalse
                          Must Supporttrue
                          Requirements

                          Allows claims to be distinguished and referenced.

                          Alternate NamesClaim Number
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          16. Claim.identifier.extension:subDepartment
                          Slice NamesubDepartment
                          Definition

                          An additional element that provides a further subdivision within the organization granting the identifier.

                          ShortExtension
                          Control0..1
                          TypeExtension(IdentifierSubDepartment) (Extension Type: string)
                          Is Modifierfalse
                          Must Supporttrue
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          18. Claim.identifier.extension:jurisdiction
                          Slice Namejurisdiction
                          Definition

                          An additional element that provides the assigning jurisdiction of the identifier (i.e. provider state license number or state driver's license) so that it does not need to be mapped from the identifier system.

                          ShortExtension
                          Control0..1
                          TypeExtension(IdentifierJurisdiction) (Extension Type: CodeableConcept)
                          Is Modifierfalse
                          Must Supporttrue
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          20. Claim.identifier.use
                          Definition

                          The purpose of this identifier.

                          Shortusual | official | temp | secondary | old (If known)
                          Comments

                          Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                          Control0..1
                          BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
                          (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                          Identifies the purpose for this identifier, if known .

                          Typecode
                          Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Requirements

                          Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          22. Claim.identifier.system
                          Definition

                          Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                          ShortSHOULD use a scheme of 'urn:trnorg:<TRN03>'The namespace for the identifier value
                          Comments

                          Identifier.system is always case sensitive.

                          Control10..1
                          Typeuri
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                          Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          24. Claim.identifier.value
                          Definition

                          The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                          ShortThe value that is unique
                          Comments

                          If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                          Control10..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Example<br/><b>General</b>:123456
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          26. Claim.status
                          Definition

                          The status of the resource instance.

                          Shortactive | cancelled | draft | entered-in-error
                          Comments

                          This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                          Control1..1
                          BindingThe codes SHALL be taken from FinancialResourceStatusCodeshttp://hl7.org/fhir/ValueSet/fm-status|4.0.1
                          (required to http://hl7.org/fhir/ValueSet/fm-status|4.0.1)

                          A code specifying the state of the resource instance.

                          Typecode
                          Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'.

                          Pattern Valueactive
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          28. Claim.type
                          Definition

                          The category of claim, e.g. oral, pharmacy, vision, institutional, professional.

                          ShortCategory or discipline
                          Comments

                          The majority of jurisdictions use: oral, pharmacy, vision, professional and institutional, or variants on those terms, as the general styles of claims. The valueset is extensible to accommodate other jurisdictional requirements.

                          Control1..1
                          BindingUnless not suitable, these codes SHALL be taken from ClaimTypeCodeshttp://hl7.org/fhir/ValueSet/claim-type
                          (extensible to http://hl7.org/fhir/ValueSet/claim-type)

                          The type or discipline-style of the claim.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Summarytrue
                          Requirements

                          Claim type determine the general sets of business rules applied for information requirements and adjudication.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          30. Claim.use
                          Definition

                          A code to indicate whether the nature of the request is: to request adjudication of products and services previously rendered; or requesting authorization and adjudication for provision in the future; or requesting the non-binding adjudication of the listed products and services which could be provided in the future.

                          Shortclaim | preauthorization | predetermination
                          Control1..1
                          BindingThe codes SHALL be taken from Usehttp://hl7.org/fhir/ValueSet/claim-use|4.0.1
                          (required to http://hl7.org/fhir/ValueSet/claim-use|4.0.1)

                          The purpose of the Claim: predetermination, preauthorization, claim.

                          Typecode
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          This element is required to understand the nature of the request for adjudication.

                          Pattern Valuepreauthorization
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          32. Claim.patient
                          Definition

                          The party to whom the professional services and/or products have been supplied or are being considered and for whom actual or forecast reimbursement is sought.

                          ShortThe recipient of the products and services
                          Control1..1
                          TypeReference(PAS Beneficiary Patient, Patient)
                          Is Modifierfalse
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          The patient must be supplied to the insurer so that confirmation of coverage and service history may be considered as part of the authorization and/or adjudiction.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          34. Claim.created
                          Definition

                          The date this resource was created.

                          ShortResource creation date
                          Comments

                          This field is independent of the date of creation of the resource as it may reflect the creation date of a source document prior to digitization. Typically for claims all services must be completed as of this date.

                          Control1..1
                          TypedateTime
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Requirements

                          Need to record a timestamp for use by both the recipient and the issuer.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          36. Claim.insurer
                          Definition

                          The Insurer who is target of the request.

                          ShortTarget
                          Control10..1
                          TypeReference(PAS Insurer Organization, Organization)
                          Is Modifierfalse
                          Must Supporttrue
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          38. Claim.provider
                          Definition

                          The provider which is responsible for the claim, predetermination or preauthorization.

                          ShortParty responsible for the claim
                          Comments

                          Typically this field would be 1..1 where this party is responsible for the claim but not necessarily professionally responsible for the provision of the individual products and services listed below.

                          Control1..1
                          TypeReference(PAS Requestor Organization, PAS PractitionerRole, Practitioner, PractitionerRole, Organization)
                          Is Modifierfalse
                          Must Supporttrue
                          Must Support TypesNo must-support rules about the choice of types/profiles
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          40. Claim.priority
                          Definition

                          The provider-required urgency of processing the request. Typical values include: stat, routine deferred.

                          ShortDesired processing ugency
                          Comments

                          If a claim processor is unable to complete the processing as per the priority then they should generate and error and not process the request.

                          Control1..1
                          BindingFor example codes, see ProcessPriorityCodeshttp://hl7.org/fhir/ValueSet/process-priority
                          (example to http://hl7.org/fhir/ValueSet/process-priority)

                          The timeliness with which processing is required: stat, normal, deferred.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Summarytrue
                          Requirements

                          The provider may need to indicate their processing requirements so that the processor can indicate if they are unable to comply.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          42. Claim.careTeam
                          Definition

                          The members of the team who provided the products and services.

                          ShortMembers of the care team
                          Control0..*
                          TypeBackboneElement
                          Is Modifierfalse
                          Must Supporttrue
                          Summaryfalse
                          Requirements

                          Common to identify the responsible and supporting practitioners.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          SlicingThis element introduces a set of slices on Claim.careTeam. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ extension('http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-careTeamClaimScope').value.ofType(boolean)
                          • 44. Claim.careTeam.extension
                            Definition

                            An Extension


                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                            ShortExtensionAdditional content defined by implementations
                            Comments

                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                            Control10..*
                            TypeExtension
                            Is Modifierfalse
                            Summaryfalse
                            Alternate Namesextensions, user content
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            SlicingThis element introduces a set of slices on Claim.careTeam.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 46. Claim.careTeam.extension:careTeamClaimScope
                              Slice NamecareTeamClaimScope
                              Definition

                              A flag that indicates whether the care team applies to the entire claim or a single item.

                              ShortExtension
                              Control1..1
                              This element is affected by the following invariants: ele-1
                              TypeExtension(CareTeamClaimScope) (Extension Type: boolean)
                              Is Modifierfalse
                              Must Supporttrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              48. Claim.careTeam.modifierExtension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                              ShortExtensions that cannot be ignored even if unrecognized
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              TypeExtension
                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                              Summarytrue
                              Requirements

                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                              Alternate Namesextensions, user content, modifiers
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              50. Claim.careTeam.sequence
                              Definition

                              A number to uniquely identify care team entries.

                              ShortOrder of care team
                              Control1..1
                              TypepositiveInt
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supporttrue
                              Summaryfalse
                              Requirements

                              Necessary to maintain the order of the care team and provide a mechanism to link individuals to claim details.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              52. Claim.careTeam.provider
                              Definition

                              Member of the team who provided the product or service.

                              ShortPractitioner or organization
                              Control1..1
                              TypeReference(PAS Organization Base Profile, PAS PractitionerRole, Practitioner, PractitionerRole, Organization)
                              Is Modifierfalse
                              Must Supporttrue
                              Must Support TypesNo must-support rules about the choice of types/profiles
                              Summaryfalse
                              Requirements

                              Often a regulatory requirement to specify the responsible provider.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              54. Claim.careTeam.role
                              Definition

                              The lead, assisting or supervising practitioner and their discipline if a multidisciplinary team.

                              ShortFunction within the team
                              Comments

                              Role might not be required when there is only a single provider listed.

                              Control0..1
                              BindingFor example codes, see ClaimCareTeamRoleCodeshttp://hl7.org/fhir/ValueSet/claim-careteamrole
                              (example to http://hl7.org/fhir/ValueSet/claim-careteamrole)

                              The role codes for the care team members.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Requirements

                              When multiple parties are present it is required to distinguish the roles performed by each member.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              56. Claim.careTeam.qualification
                              Definition

                              The qualification of the practitioner which is applicable for this service.

                              ShortPractitioner credential or specialization
                              Control0..1
                              BindingFor example codes, see ExampleProviderQualificationCodeshttp://hl7.org/fhir/ValueSet/provider-qualification
                              (example to http://hl7.org/fhir/ValueSet/provider-qualification)

                              Provider professional qualifications.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Requirements

                              Need to specify which qualification a provider is delivering the product or service under.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              58. Claim.careTeam:OverallClaimMember
                              Slice NameOverallClaimMember
                              Definition

                              The members of the team who provided the products and services.

                              ShortCare Team Providers that are applicable to all services being requested. NOTE: Only the first 14 can be sent in the X12 Request.Members of the care team
                              Comments

                              NOTE: Only the first 14 can be sent in the X12 Request.

                              Control0..*
                              TypeBackboneElement
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Requirements

                              Common to identify the responsible and supporting practitioners.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              60. Claim.careTeam:OverallClaimMember.extension
                              Definition

                              An Extension


                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortExtensionAdditional content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control10..*
                              TypeExtension
                              Is Modifierfalse
                              Summaryfalse
                              Alternate Namesextensions, user content
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              SlicingThis element introduces a set of slices on Claim.careTeam.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 62. Claim.careTeam:OverallClaimMember.extension:careTeamClaimScope
                                Slice NamecareTeamClaimScope
                                Definition

                                A flag that indicates whether the care team applies to the entire claim or a single item.

                                ShortExtension
                                Control1..1
                                This element is affected by the following invariants: ele-1
                                TypeExtension(CareTeamClaimScope) (Extension Type: boolean)
                                Is Modifierfalse
                                Must Supporttrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                64. Claim.careTeam:OverallClaimMember.extension:careTeamClaimScope.extension
                                Definition

                                An Extension


                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                ShortExtensionAdditional content defined by implementations
                                Comments

                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                Control0..0*
                                TypeExtension
                                Is Modifierfalse
                                Summaryfalse
                                Alternate Namesextensions, user content
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                SlicingThis element introduces a set of slices on Claim.careTeam.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 66. Claim.careTeam:OverallClaimMember.extension:careTeamClaimScope.url
                                  Definition

                                  Source of the definition for the extension code - a logical name or a URL.

                                  Shortidentifies the meaning of the extension
                                  Comments

                                  The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                  Control1..1
                                  Typeuri
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  Fixed Valuehttp://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-careTeamClaimScope
                                  68. Claim.careTeam:OverallClaimMember.extension:careTeamClaimScope.value[x]
                                  Definition

                                  Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                  ShortValue of extension
                                  Control0..1
                                  Typeboolean, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, Expression, Signature, unsignedInt, time
                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Summaryfalse
                                  Fixed Valuetrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  70. Claim.careTeam:OverallClaimMember.modifierExtension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                  ShortExtensions that cannot be ignored even if unrecognized
                                  Comments

                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                  Control0..*
                                  TypeExtension
                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                  Summarytrue
                                  Requirements

                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                  Alternate Namesextensions, user content, modifiers
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  72. Claim.careTeam:OverallClaimMember.sequence
                                  Definition

                                  A number to uniquely identify care team entries.

                                  ShortOrder of care team
                                  Control1..1
                                  TypepositiveInt
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summaryfalse
                                  Requirements

                                  Necessary to maintain the order of the care team and provide a mechanism to link individuals to claim details.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  74. Claim.careTeam:OverallClaimMember.provider
                                  Definition

                                  Member of the team who provided the product or service.

                                  ShortPractitioner or organization
                                  Control1..1
                                  TypeReference(Practitioner, PractitionerRole, Organization)
                                  Is Modifierfalse
                                  Summaryfalse
                                  Requirements

                                  Often a regulatory requirement to specify the responsible provider.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  76. Claim.careTeam:OverallClaimMember.role
                                  Definition

                                  The lead, assisting or supervising practitioner and their discipline if a multidisciplinary team.

                                  ShortFunction within the team
                                  Comments

                                  Role might not be required when there is only a single provider listed.

                                  Control0..1
                                  BindingThe codes SHALL be taken from For example codes, see https://valueset.x12.org/x217/005010/request/2010EA/NM1/1/01/00/98http://hl7.org/fhir/ValueSet/claim-careteamrole
                                  (required to https://valueset.x12.org/x217/005010/request/2010EA/NM1/1/01/00/98)

                                  Codes identifying a provider specialty. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.


                                  The role codes for the care team members.

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Summaryfalse
                                  Requirements

                                  When multiple parties are present it is required to distinguish the roles performed by each member.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  78. Claim.careTeam:OverallClaimMember.qualification
                                  Definition

                                  The qualification of the practitioner which is applicable for this service.

                                  ShortPractitioner credential or specialization
                                  Control0..1
                                  BindingThe codes SHALL be taken from For example codes, see https://valueset.x12.org/x217/005010/request/2010EA/PRV/1/03/00/127http://hl7.org/fhir/ValueSet/provider-qualification
                                  (required to https://valueset.x12.org/x217/005010/request/2010EA/PRV/1/03/00/127)
                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Summaryfalse
                                  Requirements

                                  Need to specify which qualification a provider is delivering the product or service under.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  80. Claim.careTeam:ItemClaimMember
                                  Slice NameItemClaimMember
                                  Definition

                                  The members of the team who provided the products and services.

                                  ShortCare Team Providers that are applicable to a specific item (as referenced by that item). NOTE: Only the first 10 can be sent in the X12 Request.Members of the care team
                                  Comments

                                  NOTE: Only the first 10 can be sent in the X12 Request.

                                  Control0..*
                                  TypeBackboneElement
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summaryfalse
                                  Requirements

                                  Common to identify the responsible and supporting practitioners.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  82. Claim.careTeam:ItemClaimMember.extension
                                  Definition

                                  An Extension


                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                  ShortExtensionAdditional content defined by implementations
                                  Comments

                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                  Control10..*
                                  TypeExtension
                                  Is Modifierfalse
                                  Summaryfalse
                                  Alternate Namesextensions, user content
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  SlicingThis element introduces a set of slices on Claim.careTeam.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 84. Claim.careTeam:ItemClaimMember.extension:careTeamClaimScope
                                    Slice NamecareTeamClaimScope
                                    Definition

                                    A flag that indicates whether the care team applies to the entire claim or a single item.

                                    ShortExtension
                                    Control1..1
                                    This element is affected by the following invariants: ele-1
                                    TypeExtension(CareTeamClaimScope) (Extension Type: boolean)
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    86. Claim.careTeam:ItemClaimMember.extension:careTeamClaimScope.extension
                                    Definition

                                    An Extension


                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                    ShortExtensionAdditional content defined by implementations
                                    Comments

                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                    Control0..0*
                                    TypeExtension
                                    Is Modifierfalse
                                    Summaryfalse
                                    Alternate Namesextensions, user content
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    SlicingThis element introduces a set of slices on Claim.careTeam.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 88. Claim.careTeam:ItemClaimMember.extension:careTeamClaimScope.url
                                      Definition

                                      Source of the definition for the extension code - a logical name or a URL.

                                      Shortidentifies the meaning of the extension
                                      Comments

                                      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                      Control1..1
                                      Typeuri
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      Fixed Valuehttp://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-careTeamClaimScope
                                      90. Claim.careTeam:ItemClaimMember.extension:careTeamClaimScope.value[x]
                                      Definition

                                      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                      ShortValue of extension
                                      Control0..1
                                      Typeboolean, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, Expression, Signature, unsignedInt, time
                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supporttrue
                                      Summaryfalse
                                      Fixed Valuefalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      92. Claim.careTeam:ItemClaimMember.modifierExtension
                                      Definition

                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                      ShortExtensions that cannot be ignored even if unrecognized
                                      Comments

                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                      Control0..*
                                      TypeExtension
                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                      Summarytrue
                                      Requirements

                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                      Alternate Namesextensions, user content, modifiers
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      94. Claim.careTeam:ItemClaimMember.sequence
                                      Definition

                                      A number to uniquely identify care team entries.

                                      ShortOrder of care team
                                      Control1..1
                                      TypepositiveInt
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summaryfalse
                                      Requirements

                                      Necessary to maintain the order of the care team and provide a mechanism to link individuals to claim details.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      96. Claim.careTeam:ItemClaimMember.provider
                                      Definition

                                      Member of the team who provided the product or service.

                                      ShortPractitioner or organization
                                      Control1..1
                                      TypeReference(Practitioner, PractitionerRole, Organization)
                                      Is Modifierfalse
                                      Summaryfalse
                                      Requirements

                                      Often a regulatory requirement to specify the responsible provider.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      98. Claim.careTeam:ItemClaimMember.role
                                      Definition

                                      The lead, assisting or supervising practitioner and their discipline if a multidisciplinary team.

                                      ShortFunction within the team
                                      Comments

                                      Role might not be required when there is only a single provider listed.

                                      Control0..1
                                      BindingThe codes SHALL be taken from For example codes, see https://valueset.x12.org/x217/005010/request/2010F/NM1/1/01/00/98http://hl7.org/fhir/ValueSet/claim-careteamrole
                                      (required to https://valueset.x12.org/x217/005010/request/2010F/NM1/1/01/00/98)

                                      Codes identifying a provider specialty. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.


                                      The role codes for the care team members.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summaryfalse
                                      Requirements

                                      When multiple parties are present it is required to distinguish the roles performed by each member.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      100. Claim.careTeam:ItemClaimMember.qualification
                                      Definition

                                      The qualification of the practitioner which is applicable for this service.

                                      ShortPractitioner credential or specialization
                                      Control0..1
                                      BindingThe codes SHALL be taken from For example codes, see https://valueset.x12.org/x217/005010/request/2010F/PRV/1/03/00/127http://hl7.org/fhir/ValueSet/provider-qualification
                                      (required to https://valueset.x12.org/x217/005010/request/2010F/PRV/1/03/00/127)
                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summaryfalse
                                      Requirements

                                      Need to specify which qualification a provider is delivering the product or service under.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      102. Claim.supportingInfo
                                      Definition

                                      Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.

                                      ShortSupporting information
                                      Comments

                                      Often there are multiple jurisdiction specific valuesets which are required.

                                      Control0..*
                                      TypeBackboneElement
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summaryfalse
                                      Requirements

                                      Typically these information codes are required to support the services rendered or the adjudication of the services rendered.

                                      Alternate NamesAttachments Exception Codes Occurrence Codes Value codes
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      SlicingThis element introduces a set of slices on Claim.supportingInfo. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ category
                                      • 104. Claim.supportingInfo.modifierExtension
                                        Definition

                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                        ShortExtensions that cannot be ignored even if unrecognized
                                        Comments

                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                        Control0..*
                                        TypeExtension
                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                        Summarytrue
                                        Requirements

                                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                        Alternate Namesextensions, user content, modifiers
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        106. Claim.supportingInfo.sequence
                                        Definition

                                        A number to uniquely identify supporting information entries.

                                        ShortInformation instance identifier
                                        Control1..1
                                        TypepositiveInt
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supporttrue
                                        Summaryfalse
                                        Requirements

                                        Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        108. Claim.supportingInfo.category
                                        Definition

                                        The general class of the information supplied: information; exception; accident, employment; onset, etc.

                                        ShortClassification of the supplied information
                                        Comments

                                        This may contain a category for the local bill type codes.

                                        Control1..1
                                        BindingUnless not suitable, these codes SHALL be taken from For example codes, see PAS Supporting Info Type Value Sethttp://hl7.org/fhir/ValueSet/claim-informationcategory
                                        (extensible to http://hl7.org/fhir/us/davinci-pas/ValueSet/PASSupportingInfoType)
                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summaryfalse
                                        Requirements

                                        Required to group or associate information items with common characteristics. For example: admission information or prior treatments.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        110. Claim.supportingInfo:PatientEvent
                                        Slice NamePatientEvent
                                        Definition

                                        Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.

                                        ShortInformation about the dates of the event that are being requested.Supporting information
                                        Comments

                                        Often there are multiple jurisdiction specific valuesets which are required.

                                        Control0..1*
                                        TypeBackboneElement
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summaryfalse
                                        Requirements

                                        Typically these information codes are required to support the services rendered or the adjudication of the services rendered.

                                        Alternate NamesAttachments Exception Codes Occurrence Codes Value codes
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        112. Claim.supportingInfo:PatientEvent.modifierExtension
                                        Definition

                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                        ShortExtensions that cannot be ignored even if unrecognized
                                        Comments

                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                        Control0..*
                                        TypeExtension
                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                        Summarytrue
                                        Requirements

                                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                        Alternate Namesextensions, user content, modifiers
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        114. Claim.supportingInfo:PatientEvent.sequence
                                        Definition

                                        A number to uniquely identify supporting information entries.

                                        ShortInformation instance identifier
                                        Control1..1
                                        TypepositiveInt
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summaryfalse
                                        Requirements

                                        Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        116. Claim.supportingInfo:PatientEvent.category
                                        Definition

                                        The general class of the information supplied: information; exception; accident, employment; onset, etc.

                                        ShortClassification of the supplied information
                                        Comments

                                        This may contain a category for the local bill type codes.

                                        Control1..1
                                        BindingFor example codes, see ClaimInformationCategoryCodeshttp://hl7.org/fhir/ValueSet/claim-informationcategory
                                        (example to http://hl7.org/fhir/ValueSet/claim-informationcategory)

                                        The valuset used for additional information category codes.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Summaryfalse
                                        Requirements

                                        Required to group or associate information items with common characteristics. For example: admission information or prior treatments.

                                        Pattern Value{
                                          "coding" : [{
                                            "system" : "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes",
                                            "code" : "patientEvent"
                                          }]
                                        }
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        118. Claim.supportingInfo:PatientEvent.timing[x]
                                        Definition

                                        The date when or period to which this information refers.

                                        ShortWhen it occurred
                                        Control10..1
                                        TypeChoice of: date, Period
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supporttrue
                                        Must Support TypesNo must-support rules about the choice of types/profiles
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        SlicingThis element introduces a set of slices on Claim.supportingInfo.timing[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                        • type @ $this
                                        • 120. Claim.supportingInfo:PatientEvent.timing[x]:timingDate
                                          Slice NametimingDate
                                          Definition

                                          The date when or period to which this information refers.

                                          ShortWhen it occurred
                                          Control0..1
                                          Typedate, Period
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supporttrue
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          FullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                                          122. Claim.supportingInfo:PatientEvent.timing[x]:timingPeriod
                                          Slice NametimingPeriod
                                          Definition

                                          The date when or period to which this information refers.

                                          ShortWhen it occurred
                                          Control0..1
                                          TypePeriod, date
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          124. Claim.supportingInfo:PatientEvent.timing[x]:timingPeriod.start
                                          Definition

                                          The start of the period. The boundary is inclusive.

                                          ShortStarting time with inclusive boundary
                                          Comments

                                          If the low element is missing, the meaning is that the low boundary is not known.

                                          Control0..1
                                          This element is affected by the following invariants: per-1
                                          TypedateTime
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supporttrue
                                          Summarytrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          FullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                                          126. Claim.supportingInfo:PatientEvent.timing[x]:timingPeriod.end
                                          Definition

                                          The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

                                          ShortEnd time with inclusive boundary, if not ongoing
                                          Comments

                                          The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

                                          Control0..1
                                          This element is affected by the following invariants: per-1
                                          TypedateTime
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supporttrue
                                          Summarytrue
                                          Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          FullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                                          128. Claim.supportingInfo:PatientEvent.value[x]
                                          Definition

                                          Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.

                                          ShortData to be provided
                                          Comments

                                          Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.

                                          Control0..01
                                          TypeChoice of: boolean, string, Quantity, Attachment, Reference(Resource)
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summaryfalse
                                          Requirements

                                          To convey the data content to be provided when the information is more than a simple code or period.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          130. Claim.supportingInfo:AdmissionDates
                                          Slice NameAdmissionDates
                                          Definition

                                          Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.

                                          ShortInformation about the admission dates of a hospital admission being requested.Supporting information
                                          Comments

                                          Often there are multiple jurisdiction specific valuesets which are required.

                                          Control0..1*
                                          TypeBackboneElement
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Summaryfalse
                                          Requirements

                                          Typically these information codes are required to support the services rendered or the adjudication of the services rendered.

                                          Alternate NamesAttachments Exception Codes Occurrence Codes Value codes
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          132. Claim.supportingInfo:AdmissionDates.modifierExtension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                          ShortExtensions that cannot be ignored even if unrecognized
                                          Comments

                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                          Control0..*
                                          TypeExtension
                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                          Summarytrue
                                          Requirements

                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                          Alternate Namesextensions, user content, modifiers
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          134. Claim.supportingInfo:AdmissionDates.sequence
                                          Definition

                                          A number to uniquely identify supporting information entries.

                                          ShortInformation instance identifier
                                          Control1..1
                                          TypepositiveInt
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summaryfalse
                                          Requirements

                                          Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          136. Claim.supportingInfo:AdmissionDates.category
                                          Definition

                                          The general class of the information supplied: information; exception; accident, employment; onset, etc.

                                          ShortClassification of the supplied information
                                          Comments

                                          This may contain a category for the local bill type codes.

                                          Control1..1
                                          BindingFor example codes, see ClaimInformationCategoryCodeshttp://hl7.org/fhir/ValueSet/claim-informationcategory
                                          (example to http://hl7.org/fhir/ValueSet/claim-informationcategory)

                                          The valuset used for additional information category codes.

                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Summaryfalse
                                          Requirements

                                          Required to group or associate information items with common characteristics. For example: admission information or prior treatments.

                                          Pattern Value{
                                            "coding" : [{
                                              "system" : "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes",
                                              "code" : "admissionDates"
                                            }]
                                          }
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          138. Claim.supportingInfo:AdmissionDates.timing[x]
                                          Definition

                                          The date when or period to which this information refers.

                                          ShortWhen it occurred
                                          Control10..1
                                          TypeChoice of: date, Period
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supporttrue
                                          Must Support TypesNo must-support rules about the choice of types/profiles
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          SlicingThis element introduces a set of slices on Claim.supportingInfo.timing[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                          • type @ $this
                                          • 140. Claim.supportingInfo:AdmissionDates.timing[x]:timingDate
                                            Slice NametimingDate
                                            Definition

                                            The date when or period to which this information refers.

                                            ShortWhen it occurred
                                            Control0..1
                                            Typedate, Period
                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supporttrue
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            FullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                                            142. Claim.supportingInfo:AdmissionDates.timing[x]:timingPeriod
                                            Slice NametimingPeriod
                                            Definition

                                            The date when or period to which this information refers.

                                            ShortWhen it occurred
                                            Control0..1
                                            TypePeriod, date
                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                            Is Modifierfalse
                                            Must Supporttrue
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            144. Claim.supportingInfo:AdmissionDates.timing[x]:timingPeriod.start
                                            Definition

                                            The start of the period. The boundary is inclusive.

                                            ShortStarting time with inclusive boundary
                                            Comments

                                            If the low element is missing, the meaning is that the low boundary is not known.

                                            Control0..1
                                            This element is affected by the following invariants: per-1
                                            TypedateTime
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supporttrue
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            FullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                                            146. Claim.supportingInfo:AdmissionDates.timing[x]:timingPeriod.end
                                            Definition

                                            The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

                                            ShortEnd time with inclusive boundary, if not ongoing
                                            Comments

                                            The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

                                            Control0..1
                                            This element is affected by the following invariants: per-1
                                            TypedateTime
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supporttrue
                                            Summarytrue
                                            Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            FullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                                            148. Claim.supportingInfo:AdmissionDates.value[x]
                                            Definition

                                            Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.

                                            ShortData to be provided
                                            Comments

                                            Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.

                                            Control0..01
                                            TypeChoice of: boolean, string, Quantity, Attachment, Reference(Resource)
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summaryfalse
                                            Requirements

                                            To convey the data content to be provided when the information is more than a simple code or period.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            150. Claim.supportingInfo:DischargeDates
                                            Slice NameDischargeDates
                                            Definition

                                            Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.

                                            ShortInformation about the discharge dates of a hospital admission being requested.Supporting information
                                            Comments

                                            Often there are multiple jurisdiction specific valuesets which are required.

                                            Control0..1*
                                            TypeBackboneElement
                                            Is Modifierfalse
                                            Must Supporttrue
                                            Summaryfalse
                                            Requirements

                                            Typically these information codes are required to support the services rendered or the adjudication of the services rendered.

                                            Alternate NamesAttachments Exception Codes Occurrence Codes Value codes
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            152. Claim.supportingInfo:DischargeDates.modifierExtension
                                            Definition

                                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                            ShortExtensions that cannot be ignored even if unrecognized
                                            Comments

                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                            Control0..*
                                            TypeExtension
                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                            Summarytrue
                                            Requirements

                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                            Alternate Namesextensions, user content, modifiers
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            154. Claim.supportingInfo:DischargeDates.sequence
                                            Definition

                                            A number to uniquely identify supporting information entries.

                                            ShortInformation instance identifier
                                            Control1..1
                                            TypepositiveInt
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summaryfalse
                                            Requirements

                                            Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            156. Claim.supportingInfo:DischargeDates.category
                                            Definition

                                            The general class of the information supplied: information; exception; accident, employment; onset, etc.

                                            ShortClassification of the supplied information
                                            Comments

                                            This may contain a category for the local bill type codes.

                                            Control1..1
                                            BindingFor example codes, see ClaimInformationCategoryCodeshttp://hl7.org/fhir/ValueSet/claim-informationcategory
                                            (example to http://hl7.org/fhir/ValueSet/claim-informationcategory)

                                            The valuset used for additional information category codes.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Summaryfalse
                                            Requirements

                                            Required to group or associate information items with common characteristics. For example: admission information or prior treatments.

                                            Pattern Value{
                                              "coding" : [{
                                                "system" : "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes",
                                                "code" : "dischargeDates"
                                              }]
                                            }
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            158. Claim.supportingInfo:DischargeDates.timing[x]
                                            Definition

                                            The date when or period to which this information refers.

                                            ShortWhen it occurred
                                            Control10..1
                                            TypeChoice of: date, Period
                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supporttrue
                                            Must Support TypesNo must-support rules about the choice of types/profiles
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            SlicingThis element introduces a set of slices on Claim.supportingInfo.timing[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                            • type @ $this
                                            • 160. Claim.supportingInfo:DischargeDates.timing[x]:timingDate
                                              Slice NametimingDate
                                              Definition

                                              The date when or period to which this information refers.

                                              ShortWhen it occurred
                                              Control0..1
                                              Typedate, Period
                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supporttrue
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              FullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                                              162. Claim.supportingInfo:DischargeDates.timing[x]:timingPeriod
                                              Slice NametimingPeriod
                                              Definition

                                              The date when or period to which this information refers.

                                              ShortWhen it occurred
                                              Control0..1
                                              TypePeriod, date
                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              164. Claim.supportingInfo:DischargeDates.timing[x]:timingPeriod.start
                                              Definition

                                              The start of the period. The boundary is inclusive.

                                              ShortStarting time with inclusive boundary
                                              Comments

                                              If the low element is missing, the meaning is that the low boundary is not known.

                                              Control0..1
                                              This element is affected by the following invariants: per-1
                                              TypedateTime
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supporttrue
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              FullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                                              166. Claim.supportingInfo:DischargeDates.timing[x]:timingPeriod.end
                                              Definition

                                              The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

                                              ShortEnd time with inclusive boundary, if not ongoing
                                              Comments

                                              The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

                                              Control0..1
                                              This element is affected by the following invariants: per-1
                                              TypedateTime
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supporttrue
                                              Summarytrue
                                              Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              FullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                                              168. Claim.supportingInfo:DischargeDates.value[x]
                                              Definition

                                              Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.

                                              ShortData to be provided
                                              Comments

                                              Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.

                                              Control0..01
                                              TypeChoice of: boolean, string, Quantity, Attachment, Reference(Resource)
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summaryfalse
                                              Requirements

                                              To convey the data content to be provided when the information is more than a simple code or period.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              170. Claim.diagnosis
                                              Definition

                                              Information about diagnoses relevant to the claim items.

                                              ShortPertinent diagnosis information
                                              Control0..*
                                              TypeBackboneElement
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              Requirements

                                              Required for the adjudication by provided context for the services and product listed.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              172. Claim.diagnosis.modifierExtension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                              ShortExtensions that cannot be ignored even if unrecognized
                                              Comments

                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                              Control0..*
                                              TypeExtension
                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                              Summarytrue
                                              Requirements

                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                              Alternate Namesextensions, user content, modifiers
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              174. Claim.diagnosis.sequence
                                              Definition

                                              A number to uniquely identify diagnosis entries.

                                              ShortDiagnosis instance identifier
                                              Comments

                                              Diagnosis are presented in list order to their expected importance: primary, secondary, etc.

                                              Control1..1
                                              TypepositiveInt
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supporttrue
                                              Summaryfalse
                                              Requirements

                                              Necessary to maintain the order of the diagnosis items and provide a mechanism to link to claim details.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              176. Claim.diagnosis.diagnosis[x]
                                              Definition

                                              The nature of illness or problem in a coded form or as a reference to an external defined Condition.

                                              ShortNature of illness or problem
                                              Control1..1
                                              BindingThe codes SHALL be taken from For example codes, see X12 278 Diagnosis Code Value Sethttp://hl7.org/fhir/ValueSet/icd-10
                                              (required to http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278DiagnosisCodes)
                                              TypeCodeableConcept, Reference(Condition)
                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              Requirements

                                              Provides health context for the evaluation of the products and/or services.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              178. Claim.diagnosis.type
                                              Definition

                                              When the condition was observed or the relative ranking.

                                              ShortTiming or nature of the diagnosis
                                              Comments

                                              For example: admitting, primary, secondary, discharge.

                                              Control0..1*
                                              BindingThe codes SHALL be taken from For example codes, see X12 278 Diagnosis Type Value Sethttp://hl7.org/fhir/ValueSet/ex-diagnosistype
                                              (required to http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278DiagnosisType)
                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              Requirements

                                              Often required to capture a particular diagnosis, for example: primary or discharge.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              180. Claim.insurance
                                              Definition

                                              Financial instruments for reimbursement for the health care products and services specified on the claim.

                                              ShortPatient insurance information
                                              Comments

                                              All insurance coverages for the patient which may be applicable for reimbursement, of the products and services listed in the claim, are typically provided in the claim to allow insurers to confirm the ordering of the insurance coverages relative to local 'coordination of benefit' rules. One coverage (and only one) with 'focal=true' is to be used in the adjudication of this claim. Coverages appearing before the focal Coverage in the list, and where 'Coverage.subrogation=false', should provide a reference to the ClaimResponse containing the adjudication results of the prior claim.

                                              Control1..*
                                              TypeBackboneElement
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summarytrue
                                              Requirements

                                              At least one insurer is required for a claim to be a claim.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              182. Claim.insurance.modifierExtension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                              ShortExtensions that cannot be ignored even if unrecognized
                                              Comments

                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                              Control0..*
                                              TypeExtension
                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                              Summarytrue
                                              Requirements

                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                              Alternate Namesextensions, user content, modifiers
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              184. Claim.insurance.sequence
                                              Definition

                                              A number to uniquely identify insurance entries and provide a sequence of coverages to convey coordination of benefit order.

                                              ShortInsurance instance identifier
                                              Control1..1
                                              TypepositiveInt
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supporttrue
                                              Summarytrue
                                              Requirements

                                              To maintain order of the coverages.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              186. Claim.insurance.focal
                                              Definition

                                              A flag to indicate that this Coverage is to be used for adjudication of this claim when set to true.

                                              ShortCoverage to be used for adjudication
                                              Comments

                                              A patient may (will) have multiple insurance policies which provide reimbursement for healthcare services and products. For example a person may also be covered by their spouse's policy and both appear in the list (and may be from the same insurer). This flag will be set to true for only one of the listed policies and that policy will be used for adjudicating this claim. Other claims would be created to request adjudication against the other listed policies.

                                              Control1..1
                                              Typeboolean
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              Requirements

                                              To identify which coverage in the list is being used to adjudicate this claim.

                                              Pattern Valuetrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              188. Claim.insurance.coverage
                                              Definition

                                              Reference to the insurance card level information contained in the Coverage resource. The coverage issuing insurer will use these details to locate the patient's actual coverage within the insurer's information system.

                                              ShortInsurance information
                                              Control1..1
                                              TypeReference(PAS Coverage, Coverage)
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summarytrue
                                              Requirements

                                              Required to allow the adjudicator to locate the correct policy and history within their information system.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              190. Claim.accident
                                              Definition

                                              Details of an accident which resulted in injuries which required the products and services listed in the claim.

                                              ShortDetails of the event
                                              Control0..1
                                              TypeBackboneElement
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              Requirements

                                              When healthcare products and services are accident related, benefits may be payable under accident provisions of policies, such as automotive, etc before they are payable under normal health insurance.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              192. Claim.accident.modifierExtension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                              ShortExtensions that cannot be ignored even if unrecognized
                                              Comments

                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                              Control0..*
                                              TypeExtension
                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                              Summarytrue
                                              Requirements

                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                              Alternate Namesextensions, user content, modifiers
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              194. Claim.accident.date
                                              Definition

                                              Date of an accident event related to the products and services contained in the claim.

                                              ShortWhen the incident occurred
                                              Comments

                                              The date of the accident has to precede the dates of the products and services but within a reasonable timeframe.

                                              Control1..1
                                              Typedate
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supporttrue
                                              Summaryfalse
                                              Requirements

                                              Required for audit purposes and adjudication.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              FullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                                              196. Claim.accident.type
                                              Definition

                                              The type or context of the accident event for the purposes of selection of potential insurance coverages and determination of coordination between insurers.

                                              ShortThe nature of the accident
                                              Control0..1
                                              BindingThe codes SHALL be taken from Unless not suitable, these codes SHALL be taken from https://valueset.x12.org/x217/005010/request/2000E/UM/1/05/01/1362http://terminology.hl7.org/ValueSet/v3-ActIncidentCode
                                              (required to https://valueset.x12.org/x217/005010/request/2000E/UM/1/05/01/1362)

                                              Codes identifying an accompanying cause of an illness, injury or an accident. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.


                                              Type of accident: work place, auto, etc.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              Requirements

                                              Coverage may be dependant on the type of accident.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              198. Claim.accident.location[x]
                                              Definition

                                              The physical location of the accident event.

                                              ShortWhere the event occurred
                                              Control0..1
                                              TypeAddress, Reference(Location)
                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              Requirements

                                              Required for audit purposes and determination of applicable insurance liability.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              200. Claim.item
                                              Definition

                                              A claim line. Either a simple product or service or a 'group' of details which can each be a simple items or groups of sub-details.

                                              ShortProduct or service provided
                                              Control0..*
                                              TypeBackboneElement
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              Requirements

                                              The items to be processed for adjudication.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              202. Claim.item.extension
                                              Definition

                                              An Extension


                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                              ShortExtensionAdditional content defined by implementations
                                              Comments

                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                              Control0..*
                                              TypeExtension
                                              Is Modifierfalse
                                              Summaryfalse
                                              Alternate Namesextensions, user content
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              SlicingThis element introduces a set of slices on Claim.item.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • value @ url
                                              • 204. Claim.item.extension:itemTraceNumber
                                                Slice NameitemTraceNumber
                                                Definition

                                                Uniquely identifies this claim item. (2000F-TRN)

                                                ShortUniquely identifies this claim item. (2000F-TRN)
                                                Control0..*
                                                This element is affected by the following invariants: ele-1
                                                TypeExtension(ItemTraceNumber) (Extension Type: Identifier(PAS Identifier))
                                                Is Modifierfalse
                                                Must Supporttrue
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                206. Claim.item.extension:authorizationNumber
                                                Slice NameauthorizationNumber
                                                Definition

                                                A string assigned by the UMO to an authorized review outcome associated with this service item.

                                                ShortA string assigned by the UMO to an authorized review outcome associated with this service item.
                                                Control0..1
                                                This element is affected by the following invariants: ele-1
                                                TypeExtension(AuthorizationNumber) (Extension Type: string)
                                                Is Modifierfalse
                                                Must Supporttrue
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                208. Claim.item.extension:administrationReferenceNumber
                                                Slice NameadministrationReferenceNumber
                                                Definition

                                                A string assigned by the UMO to the original disallowed review outcome associated with this service item.

                                                ShortA string assigned by the UMO to the original disallowed review outcome associated with this service item.
                                                Control0..1
                                                This element is affected by the following invariants: ele-1
                                                TypeExtension(AdministrationReferenceNumber) (Extension Type: string)
                                                Is Modifierfalse
                                                Must Supporttrue
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                210. Claim.item.extension:requestType
                                                Slice NamerequestType
                                                Definition

                                                A code that identifies the type of service being requested.

                                                ShortA code that identifies the type of service being requested.
                                                Control0..1
                                                This element is affected by the following invariants: ele-1
                                                TypeExtension(ServiceItemRequestType) (Extension Type: CodeableConcept)
                                                Is Modifierfalse
                                                Must Supporttrue
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                212. Claim.item.extension:certificationType
                                                Slice NamecertificationType
                                                Definition

                                                A code representing the type of certification being requested (UM02)

                                                ShortA code representing the type of certification being requested (UM02)
                                                Control0..1
                                                This element is affected by the following invariants: ele-1
                                                TypeExtension(CertificationType) (Extension Type: CodeableConcept)
                                                Is Modifierfalse
                                                Must Supporttrue
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                214. Claim.item.extension:productOrServiceCodeEnd
                                                Slice NameproductOrServiceCodeEnd
                                                Definition

                                                Used to provide the last code in a series of codes for the service being requested.

                                                ShortUsed to provide the last code in a series of codes for the service being requested.
                                                Control0..1
                                                This element is affected by the following invariants: ele-1
                                                TypeExtension(ProductOrServiceCodeEnd) (Extension Type: CodeableConcept)
                                                Is Modifierfalse
                                                Must Supporttrue
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                216. Claim.item.modifierExtension
                                                Definition

                                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                ShortExtensions that cannot be ignored even if unrecognized
                                                Comments

                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                Control0..*
                                                TypeExtension
                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                Summarytrue
                                                Requirements

                                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                Alternate Namesextensions, user content, modifiers
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                218. Claim.item.sequence
                                                Definition

                                                A number to uniquely identify item entries.

                                                ShortItem instance identifier
                                                Control1..1
                                                TypepositiveInt
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Must Supporttrue
                                                Summaryfalse
                                                Requirements

                                                Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                220. Claim.item.careTeamSequence
                                                Definition

                                                CareTeam members related to this service or product.

                                                ShortApplicable careTeam members
                                                Control0..*
                                                TypepositiveInt
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Must Supporttrue
                                                Summaryfalse
                                                Requirements

                                                Need to identify the individuals and their roles in the provision of the product or service.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                222. Claim.item.diagnosisSequence
                                                Definition

                                                Diagnosis applicable for this service or product.

                                                ShortApplicable diagnoses
                                                Control0..*
                                                TypepositiveInt
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Must Supporttrue
                                                Summaryfalse
                                                Requirements

                                                Need to related the product or service to the associated diagnoses.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                224. Claim.item.informationSequence
                                                Definition

                                                Exceptions, special conditions and supporting information applicable for this service or product.

                                                ShortApplicable exception and supporting information
                                                Control0..*
                                                TypepositiveInt
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Must Supporttrue
                                                Summaryfalse
                                                Requirements

                                                Need to reference the supporting information items that relate directly to this product or service.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                226. Claim.item.revenue
                                                Definition

                                                The type of revenue or cost center providing the product and/or service.

                                                ShortRevenue or cost center code
                                                Control0..1
                                                BindingThe codes SHALL be taken from For example codes, see AHA NUBC Revenue Value Sethttp://hl7.org/fhir/ValueSet/ex-revenue-center
                                                (required to http://hl7.org/fhir/us/davinci-pas/ValueSet/AHANUBCRevenueCodes)
                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supporttrue
                                                Summaryfalse
                                                Requirements

                                                Needed in the processing of institutional claims.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                228. Claim.item.category
                                                Definition

                                                Code to identify the general type of benefits under which products and services are provided.

                                                ShortBenefit classification
                                                Comments

                                                Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                Control0..1
                                                BindingThe codes SHALL be taken from For example codes, see https://valueset.x12.org/x217/005010/request/2000F/UM/1/03/00/1365http://hl7.org/fhir/ValueSet/ex-benefitcategory
                                                (required to https://valueset.x12.org/x217/005010/request/2000F/UM/1/03/00/1365)

                                                Codes identifying the classification of service. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.


                                                Benefit categories such as: oral-basic, major, glasses.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supporttrue
                                                Summaryfalse
                                                Requirements

                                                Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                230. Claim.item.productOrService
                                                Definition

                                                When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.

                                                ShortBilling, service, product, or drug code
                                                Comments

                                                If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                                Control1..1
                                                BindingThe codes SHALL be taken from For example codes, see X12 278 Requested Service Typehttp://hl7.org/fhir/ValueSet/service-uscls
                                                (required to http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278RequestedServiceType)
                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supporttrue
                                                Summaryfalse
                                                Requirements

                                                Necessary to state what was provided or done.

                                                Alternate NamesDrug Code, Bill Code, Service Code
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                232. Claim.item.modifier
                                                Definition

                                                Item typification or modifiers codes to convey additional context for the product or service.

                                                ShortProduct or service billing modifiers
                                                Comments

                                                For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours.

                                                Control0..*
                                                BindingThe codes SHALL be taken from For example codes, see X12 278 Requested Service Modifier Typehttp://hl7.org/fhir/ValueSet/claim-modifiers
                                                (required to http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278RequestedServiceModifierType)
                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supporttrue
                                                Summaryfalse
                                                Requirements

                                                To support inclusion of the item for adjudication or to charge an elevated fee.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                234. Claim.item.serviced[x]
                                                Definition

                                                The date or dates when the service or product was supplied, performed or completed.

                                                ShortDate or dates of service or product delivery
                                                Control0..1
                                                TypeChoice of: date, Period
                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Must Supporttrue
                                                Must Support TypesNo must-support rules about the choice of types/profiles
                                                Summaryfalse
                                                Requirements

                                                Needed to determine whether the service or product was provided during the term of the insurance coverage.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                SlicingThis element introduces a set of slices on Claim.item.serviced[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                • type @ $this
                                                • 236. Claim.item.serviced[x]:servicedDate
                                                  Slice NameservicedDate
                                                  Definition

                                                  The date or dates when the service or product was supplied, performed or completed.

                                                  ShortDate or dates of service or product delivery
                                                  Control0..1
                                                  Typedate, Period
                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summaryfalse
                                                  Requirements

                                                  Needed to determine whether the service or product was provided during the term of the insurance coverage.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  FullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                                                  238. Claim.item.serviced[x]:servicedPeriod
                                                  Slice NameservicedPeriod
                                                  Definition

                                                  The date or dates when the service or product was supplied, performed or completed.

                                                  ShortDate or dates of service or product delivery
                                                  Control0..1
                                                  TypePeriod, date
                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Needed to determine whether the service or product was provided during the term of the insurance coverage.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  240. Claim.item.serviced[x]:servicedPeriod.start
                                                  Definition

                                                  The start of the period. The boundary is inclusive.

                                                  ShortStarting time with inclusive boundary
                                                  Comments

                                                  If the low element is missing, the meaning is that the low boundary is not known.

                                                  Control0..1
                                                  This element is affected by the following invariants: per-1
                                                  TypedateTime
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  FullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                                                  242. Claim.item.serviced[x]:servicedPeriod.end
                                                  Definition

                                                  The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

                                                  ShortEnd time with inclusive boundary, if not ongoing
                                                  Comments

                                                  The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

                                                  Control0..1
                                                  This element is affected by the following invariants: per-1
                                                  TypedateTime
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  FullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                                                  244. Claim.item.location[x]
                                                  Definition

                                                  Where the product or service was provided.

                                                  ShortPlace of service or where product was supplied
                                                  Control0..1
                                                  BindingThe codes SHALL be taken from For example codes, see X12 278 Health Care Service Location Type Value Sethttp://hl7.org/fhir/ValueSet/service-place
                                                  (required to http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278LocationType)
                                                  TypeCodeableConcept, Address, Reference(Location)
                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  Requirements

                                                  The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  246. Claim.item.quantity
                                                  Definition

                                                  The comparator is not used on a SimpleQuantity


                                                  The number of repetitions of a service or product.

                                                  ShortA fixed quantity (no comparator)Count of products or services
                                                  Comments

                                                  For any exchange that must be converted to an X12 request, units SHALL be restricted to international units, days, units, minutes, hours, months, or visits.

                                                  Control0..1
                                                  This element is affected by the following invariants: ele-1
                                                  TypeQuantity(PAS Quantity, SimpleQuantity)
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Requirements

                                                  Required when the product or service code does not convey the quantity provided.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                  sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())

                                                  Guidance on how to interpret the contents of this table can be found here

                                                  0. Claim
                                                  Definition

                                                  A provider issued list of professional services and products which have been provided, or are to be provided, to a patient which is sent to an insurer for reimbursement.

                                                  ShortPreauthorization
                                                  Comments

                                                  The Claim resource fulfills three information request requirements: Claim - a request for adjudication for reimbursement for products and/or services provided; Preauthorization - a request to authorize the future provision of products and/or services including an anticipated adjudication; and, Predetermination - a request for a non-bind adjudication of possible future products and/or services.

                                                  Control0..*
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Alternate NamesAdjudication Request, Preauthorization Request, Predetermination Request
                                                  Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                                                  dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
                                                  dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                                                  dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                                                  dom-6: A resource should have narrative for robust management (text.`div`.exists())
                                                  2. Claim.id
                                                  Definition

                                                  The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

                                                  ShortLogical id of this artifact
                                                  Comments

                                                  The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

                                                  Control0..1
                                                  Typeid
                                                  Is Modifierfalse
                                                  Summarytrue
                                                  4. Claim.meta
                                                  Definition

                                                  The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

                                                  ShortMetadata about the resource
                                                  Control0..1
                                                  TypeMeta
                                                  Is Modifierfalse
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  6. Claim.implicitRules
                                                  Definition

                                                  A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                                                  ShortA set of rules under which this content was created
                                                  Comments

                                                  Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                                                  Control0..1
                                                  Typeuri
                                                  Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  8. Claim.language
                                                  Definition

                                                  The base language in which the resource is written.

                                                  ShortLanguage of the resource content
                                                  Comments

                                                  Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

                                                  Control0..1
                                                  BindingThe codes SHOULD be taken from CommonLanguages
                                                  (preferred to http://hl7.org/fhir/ValueSet/languages)

                                                  A human language.

                                                  Additional BindingsPurpose
                                                  AllLanguagesMax Binding
                                                  Typecode
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  10. Claim.text
                                                  Definition

                                                  A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

                                                  ShortText summary of the resource, for human interpretation
                                                  Comments

                                                  Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

                                                  Control0..1
                                                  TypeNarrative
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Alternate Namesnarrative, html, xhtml, display
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  12. Claim.contained
                                                  Definition

                                                  These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

                                                  ShortContained, inline Resources
                                                  Comments

                                                  This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

                                                  Control0..*
                                                  TypeResource
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Alternate Namesinline resources, anonymous resources, contained resources
                                                  14. Claim.extension
                                                  Definition

                                                  An Extension

                                                  ShortExtension
                                                  Control0..*
                                                  TypeExtension
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  SlicingThis element introduces a set of slices on Claim.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • value @ url
                                                  • 16. Claim.extension:levelOfServiceType
                                                    Slice NamelevelOfServiceType
                                                    Definition

                                                    A code specifying the level of service being requested (UM06)

                                                    ShortA code specifying the level of service being requested (UM06)
                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1
                                                    TypeExtension(LevelOfServiceCode) (Extension Type: CodeableConcept)
                                                    Is Modifierfalse
                                                    Must Supporttrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    18. Claim.extension:conditionCode
                                                    Slice NameconditionCode
                                                    Definition

                                                    Information to supply various patient conditions.

                                                    ShortUsed to indicate condition codes for various requests for service.
                                                    Control0..*
                                                    This element is affected by the following invariants: ele-1
                                                    TypeExtension(ConditionCode) (Complex Extension)
                                                    Is Modifierfalse
                                                    Must Supporttrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    20. Claim.extension:homeHealthCareInformation
                                                    Slice NamehomeHealthCareInformation
                                                    Definition

                                                    Information needed for home health care requests.

                                                    ShortUsed to provide required information about home health care services. (CR6)
                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1
                                                    TypeExtension(HomeHealthCareInformation) (Complex Extension)
                                                    Is Modifierfalse
                                                    Must Supporttrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    22. Claim.modifierExtension
                                                    Definition

                                                    May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                    ShortExtensions that cannot be ignored
                                                    Comments

                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                    Control0..*
                                                    TypeExtension
                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                                                    Summaryfalse
                                                    Requirements

                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                    Alternate Namesextensions, user content
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    24. Claim.identifier
                                                    Definition

                                                    An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.

                                                    ShortBusiness identifier for claim
                                                    NoteThis is a business identifier, not a resource identifier (see discussion)
                                                    Control0..*
                                                    This element is affected by the following invariants: ele-1
                                                    TypeIdentifier(PAS Identifier)
                                                    Is Modifierfalse
                                                    Must Supporttrue
                                                    Requirements

                                                    Allows claims to be distinguished and referenced.

                                                    Alternate NamesClaim Number
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    26. Claim.identifier.id
                                                    Definition

                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                    ShortUnique id for inter-element referencing
                                                    Control0..1
                                                    Typestring
                                                    Is Modifierfalse
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    Summaryfalse
                                                    28. Claim.identifier.extension
                                                    Definition

                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                    ShortAdditional content defined by implementations
                                                    Comments

                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                    Control0..*
                                                    TypeExtension
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Alternate Namesextensions, user content
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    SlicingThis element introduces a set of slices on Claim.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • value @ url
                                                    • 30. Claim.identifier.extension:subDepartment
                                                      Slice NamesubDepartment
                                                      Definition

                                                      An additional element that provides a further subdivision within the organization granting the identifier.

                                                      ShortExtension
                                                      Control0..1
                                                      TypeExtension(IdentifierSubDepartment) (Extension Type: string)
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      32. Claim.identifier.extension:jurisdiction
                                                      Slice Namejurisdiction
                                                      Definition

                                                      An additional element that provides the assigning jurisdiction of the identifier (i.e. provider state license number or state driver's license) so that it does not need to be mapped from the identifier system.

                                                      ShortExtension
                                                      Control0..1
                                                      TypeExtension(IdentifierJurisdiction) (Extension Type: CodeableConcept)
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      34. Claim.identifier.use
                                                      Definition

                                                      The purpose of this identifier.

                                                      Shortusual | official | temp | secondary | old (If known)
                                                      Comments

                                                      Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                                                      Control0..1
                                                      BindingThe codes SHALL be taken from IdentifierUse
                                                      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                                                      Identifies the purpose for this identifier, if known .

                                                      Typecode
                                                      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summarytrue
                                                      Requirements

                                                      Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      36. Claim.identifier.type
                                                      Definition

                                                      A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                                                      ShortDescription of identifier
                                                      Comments

                                                      This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                                                      Control0..1
                                                      BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                                      (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                                                      A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Summarytrue
                                                      Requirements

                                                      Allows users to make use of identifiers when the identifier system is not known.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      38. Claim.identifier.system
                                                      Definition

                                                      Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                                                      ShortSHOULD use a scheme of 'urn:trnorg:<TRN03>'
                                                      Comments

                                                      Identifier.system is always case sensitive.

                                                      Control1..1
                                                      Typeuri
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Must Supporttrue
                                                      Summarytrue
                                                      Requirements

                                                      There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                                                      Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      40. Claim.identifier.value
                                                      Definition

                                                      The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                                                      ShortThe value that is unique
                                                      Comments

                                                      If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                                                      Control1..1
                                                      Typestring
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Must Supporttrue
                                                      Summarytrue
                                                      Example<br/><b>General</b>:123456
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      42. Claim.identifier.period
                                                      Definition

                                                      Time period during which identifier is/was valid for use.

                                                      ShortTime period when id is/was valid for use
                                                      Control0..1
                                                      TypePeriod
                                                      Is Modifierfalse
                                                      Summarytrue
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      44. Claim.identifier.assigner
                                                      Definition

                                                      Organization that issued/manages the identifier.

                                                      ShortOrganization that issued id (may be just text)
                                                      Comments

                                                      The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                                                      Control0..1
                                                      TypeReference(Organization)
                                                      Is Modifierfalse
                                                      Summarytrue
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      46. Claim.status
                                                      Definition

                                                      The status of the resource instance.

                                                      Shortactive | cancelled | draft | entered-in-error
                                                      Comments

                                                      This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                                                      Control1..1
                                                      BindingThe codes SHALL be taken from FinancialResourceStatusCodes
                                                      (required to http://hl7.org/fhir/ValueSet/fm-status|4.0.1)

                                                      A code specifying the state of the resource instance.

                                                      Typecode
                                                      Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Must Supporttrue
                                                      Summarytrue
                                                      Requirements

                                                      Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'.

                                                      Pattern Valueactive
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      48. Claim.type
                                                      Definition

                                                      The category of claim, e.g. oral, pharmacy, vision, institutional, professional.

                                                      ShortCategory or discipline
                                                      Comments

                                                      The majority of jurisdictions use: oral, pharmacy, vision, professional and institutional, or variants on those terms, as the general styles of claims. The valueset is extensible to accommodate other jurisdictional requirements.

                                                      Control1..1
                                                      BindingUnless not suitable, these codes SHALL be taken from ClaimTypeCodes
                                                      (extensible to http://hl7.org/fhir/ValueSet/claim-type)

                                                      The type or discipline-style of the claim.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Summarytrue
                                                      Requirements

                                                      Claim type determine the general sets of business rules applied for information requirements and adjudication.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      50. Claim.subType
                                                      Definition

                                                      A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service.

                                                      ShortMore granular claim type
                                                      Comments

                                                      This may contain the local bill type codes, for example the US UB-04 bill type code or the CMS bill type.

                                                      Control0..1
                                                      BindingFor example codes, see ExampleClaimSubTypeCodes
                                                      (example to http://hl7.org/fhir/ValueSet/claim-subtype)

                                                      A more granular claim typecode.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Some jurisdictions need a finer grained claim type for routing and adjudication.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      52. Claim.use
                                                      Definition

                                                      A code to indicate whether the nature of the request is: to request adjudication of products and services previously rendered; or requesting authorization and adjudication for provision in the future; or requesting the non-binding adjudication of the listed products and services which could be provided in the future.

                                                      Shortclaim | preauthorization | predetermination
                                                      Control1..1
                                                      BindingThe codes SHALL be taken from Use
                                                      (required to http://hl7.org/fhir/ValueSet/claim-use|4.0.1)

                                                      The purpose of the Claim: predetermination, preauthorization, claim.

                                                      Typecode
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Must Supporttrue
                                                      Summarytrue
                                                      Requirements

                                                      This element is required to understand the nature of the request for adjudication.

                                                      Pattern Valuepreauthorization
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      54. Claim.patient
                                                      Definition

                                                      The party to whom the professional services and/or products have been supplied or are being considered and for whom actual or forecast reimbursement is sought.

                                                      ShortThe recipient of the products and services
                                                      Control1..1
                                                      TypeReference(PAS Beneficiary Patient)
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Summarytrue
                                                      Requirements

                                                      The patient must be supplied to the insurer so that confirmation of coverage and service history may be considered as part of the authorization and/or adjudiction.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      56. Claim.billablePeriod
                                                      Definition

                                                      The period for which charges are being submitted.

                                                      ShortRelevant time frame for the claim
                                                      Comments

                                                      Typically this would be today or in the past for a claim, and today or in the future for preauthorizations and predeterminations. Typically line item dates of service should fall within the billing period if one is specified.

                                                      Control0..1
                                                      TypePeriod
                                                      Is Modifierfalse
                                                      Summarytrue
                                                      Requirements

                                                      A number jurisdictions required the submission of the billing period when submitting claims for example for hospital stays or long-term care.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      58. Claim.created
                                                      Definition

                                                      The date this resource was created.

                                                      ShortResource creation date
                                                      Comments

                                                      This field is independent of the date of creation of the resource as it may reflect the creation date of a source document prior to digitization. Typically for claims all services must be completed as of this date.

                                                      Control1..1
                                                      TypedateTime
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summarytrue
                                                      Requirements

                                                      Need to record a timestamp for use by both the recipient and the issuer.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      60. Claim.enterer
                                                      Definition

                                                      Individual who created the claim, predetermination or preauthorization.

                                                      ShortAuthor of the claim
                                                      Control0..1
                                                      TypeReference(Practitioner, PractitionerRole)
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Some jurisdictions require the contact information for personnel completing claims.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      62. Claim.insurer
                                                      Definition

                                                      The Insurer who is target of the request.

                                                      ShortTarget
                                                      Control1..1
                                                      TypeReference(PAS Insurer Organization)
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Summarytrue
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      64. Claim.provider
                                                      Definition

                                                      The provider which is responsible for the claim, predetermination or preauthorization.

                                                      ShortParty responsible for the claim
                                                      Comments

                                                      Typically this field would be 1..1 where this party is responsible for the claim but not necessarily professionally responsible for the provision of the individual products and services listed below.

                                                      Control1..1
                                                      TypeReference(PAS Requestor Organization, PAS PractitionerRole)
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Must Support TypesNo must-support rules about the choice of types/profiles
                                                      Summarytrue
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      66. Claim.priority
                                                      Definition

                                                      The provider-required urgency of processing the request. Typical values include: stat, routine deferred.

                                                      ShortDesired processing ugency
                                                      Comments

                                                      If a claim processor is unable to complete the processing as per the priority then they should generate and error and not process the request.

                                                      Control1..1
                                                      BindingFor example codes, see ProcessPriorityCodes
                                                      (example to http://hl7.org/fhir/ValueSet/process-priority)

                                                      The timeliness with which processing is required: stat, normal, deferred.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Summarytrue
                                                      Requirements

                                                      The provider may need to indicate their processing requirements so that the processor can indicate if they are unable to comply.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      68. Claim.fundsReserve
                                                      Definition

                                                      A code to indicate whether and for whom funds are to be reserved for future claims.

                                                      ShortFor whom to reserve funds
                                                      Comments

                                                      This field is only used for preauthorizations.

                                                      Control0..1
                                                      BindingFor example codes, see Funds Reservation Codes
                                                      (example to http://hl7.org/fhir/ValueSet/fundsreserve)

                                                      For whom funds are to be reserved: (Patient, Provider, None).

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Requirements

                                                      In the case of a Pre-Determination/Pre-Authorization the provider may request that funds in the amount of the expected Benefit be reserved ('Patient' or 'Provider') to pay for the Benefits determined on the subsequent claim(s). 'None' explicitly indicates no funds reserving is requested.

                                                      Alternate NamesFund pre-allocation
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      70. Claim.related
                                                      Definition

                                                      Other claims which are related to this claim such as prior submissions or claims for related services or for the same event.

                                                      ShortPrior or corollary claims
                                                      Comments

                                                      For example, for the original treatment and follow-up exams.

                                                      Control0..*
                                                      TypeBackboneElement
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Requirements

                                                      For workplace or other accidents it is common to relate separate claims arising from the same event.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      72. Claim.related.id
                                                      Definition

                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                      ShortUnique id for inter-element referencing
                                                      Control0..1
                                                      Typestring
                                                      Is Modifierfalse
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      Summaryfalse
                                                      74. Claim.related.extension
                                                      Definition

                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                      ShortAdditional content defined by implementations
                                                      Comments

                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                      Control0..*
                                                      TypeExtension
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Alternate Namesextensions, user content
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      76. Claim.related.modifierExtension
                                                      Definition

                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                      Comments

                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                      Control0..*
                                                      TypeExtension
                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                      Summarytrue
                                                      Requirements

                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                      Alternate Namesextensions, user content, modifiers
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      78. Claim.related.claim
                                                      Definition

                                                      Reference to a related claim.

                                                      ShortReference to the related claim
                                                      Control0..1
                                                      TypeReference(Claim)
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Requirements

                                                      For workplace or other accidents it is common to relate separate claims arising from the same event.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      80. Claim.related.relationship
                                                      Definition

                                                      A code to convey how the claims are related.

                                                      ShortHow the reference claim is related
                                                      Comments

                                                      For example, prior claim or umbrella.

                                                      Control0..1
                                                      BindingFor example codes, see ExampleRelatedClaimRelationshipCodes
                                                      (example to http://hl7.org/fhir/ValueSet/related-claim-relationship)

                                                      Relationship of this claim to a related Claim.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Some insurers need a declaration of the type of relationship.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      82. Claim.related.reference
                                                      Definition

                                                      An alternate organizational reference to the case or file to which this particular claim pertains.

                                                      ShortFile or case reference
                                                      Comments

                                                      For example, Property/Casualty insurer claim # or Workers Compensation case # .

                                                      Control0..1
                                                      TypeIdentifier
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Requirements

                                                      In cases where an event-triggered claim is being submitted to an insurer which requires a reference number to be specified on all exchanges.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      84. Claim.prescription
                                                      Definition

                                                      Prescription to support the dispensing of pharmacy, device or vision products.

                                                      ShortPrescription authorizing services and products
                                                      Control0..1
                                                      TypeReference(DeviceRequest, MedicationRequest, VisionPrescription)
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Required to authorize the dispensing of controlled substances and devices.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      86. Claim.originalPrescription
                                                      Definition

                                                      Original prescription which has been superseded by this prescription to support the dispensing of pharmacy services, medications or products.

                                                      ShortOriginal prescription if superseded by fulfiller
                                                      Comments

                                                      For example, a physician may prescribe a medication which the pharmacy determines is contraindicated, or for which the patient has an intolerance, and therefore issues a new prescription for an alternate medication which has the same therapeutic intent. The prescription from the pharmacy becomes the 'prescription' and that from the physician becomes the 'original prescription'.

                                                      Control0..1
                                                      TypeReference(DeviceRequest, MedicationRequest, VisionPrescription)
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Often required when a fulfiller varies what is fulfilled from that authorized on the original prescription.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      88. Claim.payee
                                                      Definition

                                                      The party to be reimbursed for cost of the products and services according to the terms of the policy.

                                                      ShortRecipient of benefits payable
                                                      Comments

                                                      Often providers agree to receive the benefits payable to reduce the near-term costs to the patient. The insurer may decline to pay the provider and choose to pay the subscriber instead.

                                                      Control0..1
                                                      TypeBackboneElement
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Requirements

                                                      The provider needs to specify who they wish to be reimbursed and the claims processor needs express who they will reimburse.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      90. Claim.payee.id
                                                      Definition

                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                      ShortUnique id for inter-element referencing
                                                      Control0..1
                                                      Typestring
                                                      Is Modifierfalse
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      Summaryfalse
                                                      92. Claim.payee.extension
                                                      Definition

                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                      ShortAdditional content defined by implementations
                                                      Comments

                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                      Control0..*
                                                      TypeExtension
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Alternate Namesextensions, user content
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      94. Claim.payee.modifierExtension
                                                      Definition

                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                      Comments

                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                      Control0..*
                                                      TypeExtension
                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                      Summarytrue
                                                      Requirements

                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                      Alternate Namesextensions, user content, modifiers
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      96. Claim.payee.type
                                                      Definition

                                                      Type of Party to be reimbursed: subscriber, provider, other.

                                                      ShortCategory of recipient
                                                      Control1..1
                                                      BindingFor example codes, see Claim Payee Type Codes
                                                      (example to http://hl7.org/fhir/ValueSet/payeetype)

                                                      A code for the party to be reimbursed.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Need to know who should receive payment with the most common situations being the Provider (assignment of benefits) or the Subscriber.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      98. Claim.payee.party
                                                      Definition

                                                      Reference to the individual or organization to whom any payment will be made.

                                                      ShortRecipient reference
                                                      Comments

                                                      Not required if the payee is 'subscriber' or 'provider'.

                                                      Control0..1
                                                      TypeReference(Practitioner, PractitionerRole, Organization, Patient, RelatedPerson)
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Need to provide demographics if the payee is not 'subscriber' nor 'provider'.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      100. Claim.referral
                                                      Definition

                                                      A reference to a referral resource.

                                                      ShortTreatment referral
                                                      Comments

                                                      The referral resource which lists the date, practitioner, reason and other supporting information.

                                                      Control0..1
                                                      TypeReference(ServiceRequest)
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Some insurers require proof of referral to pay for services or to pay specialist rates for services.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      102. Claim.facility
                                                      Definition

                                                      Facility where the services were provided.

                                                      ShortServicing facility
                                                      Control0..1
                                                      TypeReference(Location)
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Insurance adjudication can be dependant on where services were delivered.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      104. Claim.careTeam
                                                      Definition

                                                      The members of the team who provided the products and services.

                                                      ShortMembers of the care team
                                                      Control0..*
                                                      TypeBackboneElement
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Summaryfalse
                                                      Requirements

                                                      Common to identify the responsible and supporting practitioners.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      SlicingThis element introduces a set of slices on Claim.careTeam. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                      • value @ extension('http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-careTeamClaimScope').value.ofType(boolean)
                                                      • 106. Claim.careTeam.id
                                                        Definition

                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                        ShortUnique id for inter-element referencing
                                                        Control0..1
                                                        Typestring
                                                        Is Modifierfalse
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        Summaryfalse
                                                        108. Claim.careTeam.extension
                                                        Definition

                                                        An Extension

                                                        ShortExtension
                                                        Control1..*
                                                        TypeExtension
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        SlicingThis element introduces a set of slices on Claim.careTeam.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                        • value @ url
                                                        • 110. Claim.careTeam.extension:careTeamClaimScope
                                                          Slice NamecareTeamClaimScope
                                                          Definition

                                                          A flag that indicates whether the care team applies to the entire claim or a single item.

                                                          ShortExtension
                                                          Control1..1
                                                          This element is affected by the following invariants: ele-1
                                                          TypeExtension(CareTeamClaimScope) (Extension Type: boolean)
                                                          Is Modifierfalse
                                                          Must Supporttrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          112. Claim.careTeam.modifierExtension
                                                          Definition

                                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                          Comments

                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                          Control0..*
                                                          TypeExtension
                                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                          Summarytrue
                                                          Requirements

                                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                          Alternate Namesextensions, user content, modifiers
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          114. Claim.careTeam.sequence
                                                          Definition

                                                          A number to uniquely identify care team entries.

                                                          ShortOrder of care team
                                                          Control1..1
                                                          TypepositiveInt
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supporttrue
                                                          Summaryfalse
                                                          Requirements

                                                          Necessary to maintain the order of the care team and provide a mechanism to link individuals to claim details.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          116. Claim.careTeam.provider
                                                          Definition

                                                          Member of the team who provided the product or service.

                                                          ShortPractitioner or organization
                                                          Control1..1
                                                          TypeReference(PAS Organization Base Profile, PAS PractitionerRole)
                                                          Is Modifierfalse
                                                          Must Supporttrue
                                                          Must Support TypesNo must-support rules about the choice of types/profiles
                                                          Summaryfalse
                                                          Requirements

                                                          Often a regulatory requirement to specify the responsible provider.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          118. Claim.careTeam.responsible
                                                          Definition

                                                          The party who is billing and/or responsible for the claimed products or services.

                                                          ShortIndicator of the lead practitioner
                                                          Comments

                                                          Responsible might not be required when there is only a single provider listed.

                                                          Control0..1
                                                          Typeboolean
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summaryfalse
                                                          Requirements

                                                          When multiple parties are present it is required to distinguish the lead or responsible individual.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          120. Claim.careTeam.role
                                                          Definition

                                                          The lead, assisting or supervising practitioner and their discipline if a multidisciplinary team.

                                                          ShortFunction within the team
                                                          Comments

                                                          Role might not be required when there is only a single provider listed.

                                                          Control0..1
                                                          BindingFor example codes, see ClaimCareTeamRoleCodes
                                                          (example to http://hl7.org/fhir/ValueSet/claim-careteamrole)

                                                          The role codes for the care team members.

                                                          TypeCodeableConcept
                                                          Is Modifierfalse
                                                          Must Supporttrue
                                                          Summaryfalse
                                                          Requirements

                                                          When multiple parties are present it is required to distinguish the roles performed by each member.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          122. Claim.careTeam.qualification
                                                          Definition

                                                          The qualification of the practitioner which is applicable for this service.

                                                          ShortPractitioner credential or specialization
                                                          Control0..1
                                                          BindingFor example codes, see ExampleProviderQualificationCodes
                                                          (example to http://hl7.org/fhir/ValueSet/provider-qualification)

                                                          Provider professional qualifications.

                                                          TypeCodeableConcept
                                                          Is Modifierfalse
                                                          Must Supporttrue
                                                          Summaryfalse
                                                          Requirements

                                                          Need to specify which qualification a provider is delivering the product or service under.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          124. Claim.careTeam:OverallClaimMember
                                                          Slice NameOverallClaimMember
                                                          Definition

                                                          The members of the team who provided the products and services.

                                                          ShortCare Team Providers that are applicable to all services being requested. NOTE: Only the first 14 can be sent in the X12 Request.
                                                          Comments

                                                          NOTE: Only the first 14 can be sent in the X12 Request.

                                                          Control0..*
                                                          TypeBackboneElement
                                                          Is Modifierfalse
                                                          Must Supporttrue
                                                          Summaryfalse
                                                          Requirements

                                                          Common to identify the responsible and supporting practitioners.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          126. Claim.careTeam:OverallClaimMember.id
                                                          Definition

                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                          ShortUnique id for inter-element referencing
                                                          Control0..1
                                                          Typestring
                                                          Is Modifierfalse
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          Summaryfalse
                                                          128. Claim.careTeam:OverallClaimMember.extension
                                                          Definition

                                                          An Extension

                                                          ShortExtension
                                                          Control1..*
                                                          TypeExtension
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          SlicingThis element introduces a set of slices on Claim.careTeam.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                          • value @ url
                                                          • 130. Claim.careTeam:OverallClaimMember.extension:careTeamClaimScope
                                                            Slice NamecareTeamClaimScope
                                                            Definition

                                                            A flag that indicates whether the care team applies to the entire claim or a single item.

                                                            ShortExtension
                                                            Control1..1
                                                            This element is affected by the following invariants: ele-1
                                                            TypeExtension(CareTeamClaimScope) (Extension Type: boolean)
                                                            Is Modifierfalse
                                                            Must Supporttrue
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            132. Claim.careTeam:OverallClaimMember.extension:careTeamClaimScope.id
                                                            Definition

                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                            ShortUnique id for inter-element referencing
                                                            Control0..1
                                                            Typestring
                                                            Is Modifierfalse
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            Summaryfalse
                                                            134. Claim.careTeam:OverallClaimMember.extension:careTeamClaimScope.extension
                                                            Definition

                                                            An Extension

                                                            ShortExtension
                                                            Control0..0
                                                            TypeExtension
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            SlicingThis element introduces a set of slices on Claim.careTeam.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                            • value @ url
                                                            • 136. Claim.careTeam:OverallClaimMember.extension:careTeamClaimScope.url
                                                              Definition

                                                              Source of the definition for the extension code - a logical name or a URL.

                                                              Shortidentifies the meaning of the extension
                                                              Comments

                                                              The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                              Control1..1
                                                              Typeuri
                                                              Is Modifierfalse
                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                              Summaryfalse
                                                              Fixed Valuehttp://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-careTeamClaimScope
                                                              138. Claim.careTeam:OverallClaimMember.extension:careTeamClaimScope.value[x]
                                                              Definition

                                                              Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                              ShortValue of extension
                                                              Control0..1
                                                              Typeboolean
                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Must Supporttrue
                                                              Summaryfalse
                                                              Fixed Valuetrue
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              140. Claim.careTeam:OverallClaimMember.modifierExtension
                                                              Definition

                                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                              Comments

                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                              Control0..*
                                                              TypeExtension
                                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                              Summarytrue
                                                              Requirements

                                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                              Alternate Namesextensions, user content, modifiers
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                              142. Claim.careTeam:OverallClaimMember.sequence
                                                              Definition

                                                              A number to uniquely identify care team entries.

                                                              ShortOrder of care team
                                                              Control1..1
                                                              TypepositiveInt
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summaryfalse
                                                              Requirements

                                                              Necessary to maintain the order of the care team and provide a mechanism to link individuals to claim details.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              144. Claim.careTeam:OverallClaimMember.provider
                                                              Definition

                                                              Member of the team who provided the product or service.

                                                              ShortPractitioner or organization
                                                              Control1..1
                                                              TypeReference(Practitioner, PractitionerRole, Organization)
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Often a regulatory requirement to specify the responsible provider.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              146. Claim.careTeam:OverallClaimMember.responsible
                                                              Definition

                                                              The party who is billing and/or responsible for the claimed products or services.

                                                              ShortIndicator of the lead practitioner
                                                              Comments

                                                              Responsible might not be required when there is only a single provider listed.

                                                              Control0..1
                                                              Typeboolean
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summaryfalse
                                                              Requirements

                                                              When multiple parties are present it is required to distinguish the lead or responsible individual.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              148. Claim.careTeam:OverallClaimMember.role
                                                              Definition

                                                              The lead, assisting or supervising practitioner and their discipline if a multidisciplinary team.

                                                              ShortFunction within the team
                                                              Comments

                                                              Role might not be required when there is only a single provider listed.

                                                              Control0..1
                                                              BindingThe codes SHALL be taken from https://valueset.x12.org/x217/005010/request/2010EA/NM1/1/01/00/98
                                                              (required to https://valueset.x12.org/x217/005010/request/2010EA/NM1/1/01/00/98)

                                                              Codes identifying a provider specialty. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.

                                                              TypeCodeableConcept
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Requirements

                                                              When multiple parties are present it is required to distinguish the roles performed by each member.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              150. Claim.careTeam:OverallClaimMember.qualification
                                                              Definition

                                                              The qualification of the practitioner which is applicable for this service.

                                                              ShortPractitioner credential or specialization
                                                              Control0..1
                                                              BindingThe codes SHALL be taken from https://valueset.x12.org/x217/005010/request/2010EA/PRV/1/03/00/127
                                                              (required to https://valueset.x12.org/x217/005010/request/2010EA/PRV/1/03/00/127)
                                                              TypeCodeableConcept
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Need to specify which qualification a provider is delivering the product or service under.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              152. Claim.careTeam:ItemClaimMember
                                                              Slice NameItemClaimMember
                                                              Definition

                                                              The members of the team who provided the products and services.

                                                              ShortCare Team Providers that are applicable to a specific item (as referenced by that item). NOTE: Only the first 10 can be sent in the X12 Request.
                                                              Comments

                                                              NOTE: Only the first 10 can be sent in the X12 Request.

                                                              Control0..*
                                                              TypeBackboneElement
                                                              Is Modifierfalse
                                                              Must Supporttrue
                                                              Summaryfalse
                                                              Requirements

                                                              Common to identify the responsible and supporting practitioners.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              154. Claim.careTeam:ItemClaimMember.id
                                                              Definition

                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                              ShortUnique id for inter-element referencing
                                                              Control0..1
                                                              Typestring
                                                              Is Modifierfalse
                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                              Summaryfalse
                                                              156. Claim.careTeam:ItemClaimMember.extension
                                                              Definition

                                                              An Extension

                                                              ShortExtension
                                                              Control1..*
                                                              TypeExtension
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                              SlicingThis element introduces a set of slices on Claim.careTeam.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                              • value @ url
                                                              • 158. Claim.careTeam:ItemClaimMember.extension:careTeamClaimScope
                                                                Slice NamecareTeamClaimScope
                                                                Definition

                                                                A flag that indicates whether the care team applies to the entire claim or a single item.

                                                                ShortExtension
                                                                Control1..1
                                                                This element is affected by the following invariants: ele-1
                                                                TypeExtension(CareTeamClaimScope) (Extension Type: boolean)
                                                                Is Modifierfalse
                                                                Must Supporttrue
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                160. Claim.careTeam:ItemClaimMember.extension:careTeamClaimScope.id
                                                                Definition

                                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                ShortUnique id for inter-element referencing
                                                                Control0..1
                                                                Typestring
                                                                Is Modifierfalse
                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                Summaryfalse
                                                                162. Claim.careTeam:ItemClaimMember.extension:careTeamClaimScope.extension
                                                                Definition

                                                                An Extension

                                                                ShortExtension
                                                                Control0..0
                                                                TypeExtension
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                SlicingThis element introduces a set of slices on Claim.careTeam.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                • value @ url
                                                                • 164. Claim.careTeam:ItemClaimMember.extension:careTeamClaimScope.url
                                                                  Definition

                                                                  Source of the definition for the extension code - a logical name or a URL.

                                                                  Shortidentifies the meaning of the extension
                                                                  Comments

                                                                  The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                  Control1..1
                                                                  Typeuri
                                                                  Is Modifierfalse
                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                  Summaryfalse
                                                                  Fixed Valuehttp://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-careTeamClaimScope
                                                                  166. Claim.careTeam:ItemClaimMember.extension:careTeamClaimScope.value[x]
                                                                  Definition

                                                                  Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                                  ShortValue of extension
                                                                  Control0..1
                                                                  Typeboolean
                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Must Supporttrue
                                                                  Summaryfalse
                                                                  Fixed Valuefalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  168. Claim.careTeam:ItemClaimMember.modifierExtension
                                                                  Definition

                                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                                  Comments

                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                  Control0..*
                                                                  TypeExtension
                                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                  Summarytrue
                                                                  Requirements

                                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                  Alternate Namesextensions, user content, modifiers
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  170. Claim.careTeam:ItemClaimMember.sequence
                                                                  Definition

                                                                  A number to uniquely identify care team entries.

                                                                  ShortOrder of care team
                                                                  Control1..1
                                                                  TypepositiveInt
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Necessary to maintain the order of the care team and provide a mechanism to link individuals to claim details.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  172. Claim.careTeam:ItemClaimMember.provider
                                                                  Definition

                                                                  Member of the team who provided the product or service.

                                                                  ShortPractitioner or organization
                                                                  Control1..1
                                                                  TypeReference(Practitioner, PractitionerRole, Organization)
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Often a regulatory requirement to specify the responsible provider.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  174. Claim.careTeam:ItemClaimMember.responsible
                                                                  Definition

                                                                  The party who is billing and/or responsible for the claimed products or services.

                                                                  ShortIndicator of the lead practitioner
                                                                  Comments

                                                                  Responsible might not be required when there is only a single provider listed.

                                                                  Control0..1
                                                                  Typeboolean
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summaryfalse
                                                                  Requirements

                                                                  When multiple parties are present it is required to distinguish the lead or responsible individual.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  176. Claim.careTeam:ItemClaimMember.role
                                                                  Definition

                                                                  The lead, assisting or supervising practitioner and their discipline if a multidisciplinary team.

                                                                  ShortFunction within the team
                                                                  Comments

                                                                  Role might not be required when there is only a single provider listed.

                                                                  Control0..1
                                                                  BindingThe codes SHALL be taken from https://valueset.x12.org/x217/005010/request/2010F/NM1/1/01/00/98
                                                                  (required to https://valueset.x12.org/x217/005010/request/2010F/NM1/1/01/00/98)

                                                                  Codes identifying a provider specialty. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.

                                                                  TypeCodeableConcept
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  When multiple parties are present it is required to distinguish the roles performed by each member.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  178. Claim.careTeam:ItemClaimMember.qualification
                                                                  Definition

                                                                  The qualification of the practitioner which is applicable for this service.

                                                                  ShortPractitioner credential or specialization
                                                                  Control0..1
                                                                  BindingThe codes SHALL be taken from https://valueset.x12.org/x217/005010/request/2010F/PRV/1/03/00/127
                                                                  (required to https://valueset.x12.org/x217/005010/request/2010F/PRV/1/03/00/127)
                                                                  TypeCodeableConcept
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Need to specify which qualification a provider is delivering the product or service under.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  180. Claim.supportingInfo
                                                                  Definition

                                                                  Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.

                                                                  ShortSupporting information
                                                                  Comments

                                                                  Often there are multiple jurisdiction specific valuesets which are required.

                                                                  Control0..*
                                                                  TypeBackboneElement
                                                                  Is Modifierfalse
                                                                  Must Supporttrue
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Typically these information codes are required to support the services rendered or the adjudication of the services rendered.

                                                                  Alternate NamesAttachments Exception Codes Occurrence Codes Value codes
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  SlicingThis element introduces a set of slices on Claim.supportingInfo. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                  • value @ category
                                                                  • 182. Claim.supportingInfo.id
                                                                    Definition

                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                    ShortUnique id for inter-element referencing
                                                                    Control0..1
                                                                    Typestring
                                                                    Is Modifierfalse
                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                    Summaryfalse
                                                                    184. Claim.supportingInfo.extension
                                                                    Definition

                                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                    ShortAdditional content defined by implementations
                                                                    Comments

                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                    Control0..*
                                                                    TypeExtension
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Alternate Namesextensions, user content
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    186. Claim.supportingInfo.modifierExtension
                                                                    Definition

                                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                    Comments

                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                    Control0..*
                                                                    TypeExtension
                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                    Summarytrue
                                                                    Requirements

                                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                    Alternate Namesextensions, user content, modifiers
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    188. Claim.supportingInfo.sequence
                                                                    Definition

                                                                    A number to uniquely identify supporting information entries.

                                                                    ShortInformation instance identifier
                                                                    Control1..1
                                                                    TypepositiveInt
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Must Supporttrue
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    190. Claim.supportingInfo.category
                                                                    Definition

                                                                    The general class of the information supplied: information; exception; accident, employment; onset, etc.

                                                                    ShortClassification of the supplied information
                                                                    Comments

                                                                    This may contain a category for the local bill type codes.

                                                                    Control1..1
                                                                    BindingUnless not suitable, these codes SHALL be taken from PAS Supporting Info Type Value Set
                                                                    (extensible to http://hl7.org/fhir/us/davinci-pas/ValueSet/PASSupportingInfoType)
                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Must Supporttrue
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Required to group or associate information items with common characteristics. For example: admission information or prior treatments.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    192. Claim.supportingInfo.code
                                                                    Definition

                                                                    System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient for which care is sought.

                                                                    ShortType of information
                                                                    Control0..1
                                                                    BindingFor example codes, see ExceptionCodes
                                                                    (example to http://hl7.org/fhir/ValueSet/claim-exception)

                                                                    The valuset used for additional information codes.

                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Required to identify the kind of additional information.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    194. Claim.supportingInfo.timing[x]
                                                                    Definition

                                                                    The date when or period to which this information refers.

                                                                    ShortWhen it occurred
                                                                    Control0..1
                                                                    TypeChoice of: date, Period
                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    196. Claim.supportingInfo.value[x]
                                                                    Definition

                                                                    Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.

                                                                    ShortData to be provided
                                                                    Comments

                                                                    Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.

                                                                    Control0..1
                                                                    TypeChoice of: boolean, string, Quantity, Attachment, Reference(Resource)
                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summaryfalse
                                                                    Requirements

                                                                    To convey the data content to be provided when the information is more than a simple code or period.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    198. Claim.supportingInfo.reason
                                                                    Definition

                                                                    Provides the reason in the situation where a reason code is required in addition to the content.

                                                                    ShortExplanation for the information
                                                                    Comments

                                                                    For example: the reason for the additional stay, or why a tooth is missing.

                                                                    Control0..1
                                                                    BindingFor example codes, see MissingToothReasonCodes
                                                                    (example to http://hl7.org/fhir/ValueSet/missing-tooth-reason)

                                                                    Reason codes for the missing teeth.

                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Needed when the supporting information has both a date and amount/value and requires explanation.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    200. Claim.supportingInfo:PatientEvent
                                                                    Slice NamePatientEvent
                                                                    Definition

                                                                    Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.

                                                                    ShortInformation about the dates of the event that are being requested.
                                                                    Comments

                                                                    Often there are multiple jurisdiction specific valuesets which are required.

                                                                    Control0..1
                                                                    TypeBackboneElement
                                                                    Is Modifierfalse
                                                                    Must Supporttrue
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Typically these information codes are required to support the services rendered or the adjudication of the services rendered.

                                                                    Alternate NamesAttachments Exception Codes Occurrence Codes Value codes
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    202. Claim.supportingInfo:PatientEvent.id
                                                                    Definition

                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                    ShortUnique id for inter-element referencing
                                                                    Control0..1
                                                                    Typestring
                                                                    Is Modifierfalse
                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                    Summaryfalse
                                                                    204. Claim.supportingInfo:PatientEvent.extension
                                                                    Definition

                                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                    ShortAdditional content defined by implementations
                                                                    Comments

                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                    Control0..*
                                                                    TypeExtension
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Alternate Namesextensions, user content
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    206. Claim.supportingInfo:PatientEvent.modifierExtension
                                                                    Definition

                                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                    Comments

                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                    Control0..*
                                                                    TypeExtension
                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                    Summarytrue
                                                                    Requirements

                                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                    Alternate Namesextensions, user content, modifiers
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    208. Claim.supportingInfo:PatientEvent.sequence
                                                                    Definition

                                                                    A number to uniquely identify supporting information entries.

                                                                    ShortInformation instance identifier
                                                                    Control1..1
                                                                    TypepositiveInt
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    210. Claim.supportingInfo:PatientEvent.category
                                                                    Definition

                                                                    The general class of the information supplied: information; exception; accident, employment; onset, etc.

                                                                    ShortClassification of the supplied information
                                                                    Comments

                                                                    This may contain a category for the local bill type codes.

                                                                    Control1..1
                                                                    BindingFor example codes, see ClaimInformationCategoryCodes
                                                                    (example to http://hl7.org/fhir/ValueSet/claim-informationcategory)

                                                                    The valuset used for additional information category codes.

                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Required to group or associate information items with common characteristics. For example: admission information or prior treatments.

                                                                    Pattern Value{
                                                                      "coding" : [{
                                                                        "system" : "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes",
                                                                        "code" : "patientEvent"
                                                                      }]
                                                                    }
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    212. Claim.supportingInfo:PatientEvent.code
                                                                    Definition

                                                                    System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient for which care is sought.

                                                                    ShortType of information
                                                                    Control0..1
                                                                    BindingFor example codes, see ExceptionCodes
                                                                    (example to http://hl7.org/fhir/ValueSet/claim-exception)

                                                                    The valuset used for additional information codes.

                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Required to identify the kind of additional information.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    214. Claim.supportingInfo:PatientEvent.timing[x]
                                                                    Definition

                                                                    The date when or period to which this information refers.

                                                                    ShortWhen it occurred
                                                                    Control1..1
                                                                    TypeChoice of: date, Period
                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Must Supporttrue
                                                                    Must Support TypesNo must-support rules about the choice of types/profiles
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    SlicingThis element introduces a set of slices on Claim.supportingInfo.timing[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                                    • type @ $this
                                                                    • 216. Claim.supportingInfo:PatientEvent.timing[x]:timingDate
                                                                      Slice NametimingDate
                                                                      Definition

                                                                      The date when or period to which this information refers.

                                                                      ShortWhen it occurred
                                                                      Control0..1
                                                                      Typedate
                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                      Is Modifierfalse
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Must Supporttrue
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      FullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                                                                      218. Claim.supportingInfo:PatientEvent.timing[x]:timingPeriod
                                                                      Slice NametimingPeriod
                                                                      Definition

                                                                      The date when or period to which this information refers.

                                                                      ShortWhen it occurred
                                                                      Control0..1
                                                                      TypePeriod
                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                      Is Modifierfalse
                                                                      Must Supporttrue
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      220. Claim.supportingInfo:PatientEvent.timing[x]:timingPeriod.id
                                                                      Definition

                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                      ShortUnique id for inter-element referencing
                                                                      Control0..1
                                                                      Typestring
                                                                      Is Modifierfalse
                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                      Summaryfalse
                                                                      222. Claim.supportingInfo:PatientEvent.timing[x]:timingPeriod.extension
                                                                      Definition

                                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                      ShortAdditional content defined by implementations
                                                                      Comments

                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                      Control0..*
                                                                      TypeExtension
                                                                      Is Modifierfalse
                                                                      Summaryfalse
                                                                      Alternate Namesextensions, user content
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                      SlicingThis element introduces a set of slices on Claim.supportingInfo.timing[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                      • value @ url
                                                                      • 224. Claim.supportingInfo:PatientEvent.timing[x]:timingPeriod.start
                                                                        Definition

                                                                        The start of the period. The boundary is inclusive.

                                                                        ShortStarting time with inclusive boundary
                                                                        Comments

                                                                        If the low element is missing, the meaning is that the low boundary is not known.

                                                                        Control0..1
                                                                        This element is affected by the following invariants: per-1
                                                                        TypedateTime
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Must Supporttrue
                                                                        Summarytrue
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        FullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                                                                        226. Claim.supportingInfo:PatientEvent.timing[x]:timingPeriod.end
                                                                        Definition

                                                                        The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

                                                                        ShortEnd time with inclusive boundary, if not ongoing
                                                                        Comments

                                                                        The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

                                                                        Control0..1
                                                                        This element is affected by the following invariants: per-1
                                                                        TypedateTime
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Must Supporttrue
                                                                        Summarytrue
                                                                        Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        FullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                                                                        228. Claim.supportingInfo:PatientEvent.value[x]
                                                                        Definition

                                                                        Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.

                                                                        ShortData to be provided
                                                                        Comments

                                                                        Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.

                                                                        Control0..0
                                                                        TypeChoice of: boolean, string, Quantity, Attachment, Reference(Resource)
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summaryfalse
                                                                        Requirements

                                                                        To convey the data content to be provided when the information is more than a simple code or period.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        230. Claim.supportingInfo:PatientEvent.reason
                                                                        Definition

                                                                        Provides the reason in the situation where a reason code is required in addition to the content.

                                                                        ShortExplanation for the information
                                                                        Comments

                                                                        For example: the reason for the additional stay, or why a tooth is missing.

                                                                        Control0..1
                                                                        BindingFor example codes, see MissingToothReasonCodes
                                                                        (example to http://hl7.org/fhir/ValueSet/missing-tooth-reason)

                                                                        Reason codes for the missing teeth.

                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Needed when the supporting information has both a date and amount/value and requires explanation.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        232. Claim.supportingInfo:AdmissionDates
                                                                        Slice NameAdmissionDates
                                                                        Definition

                                                                        Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.

                                                                        ShortInformation about the admission dates of a hospital admission being requested.
                                                                        Comments

                                                                        Often there are multiple jurisdiction specific valuesets which are required.

                                                                        Control0..1
                                                                        TypeBackboneElement
                                                                        Is Modifierfalse
                                                                        Must Supporttrue
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Typically these information codes are required to support the services rendered or the adjudication of the services rendered.

                                                                        Alternate NamesAttachments Exception Codes Occurrence Codes Value codes
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        234. Claim.supportingInfo:AdmissionDates.id
                                                                        Definition

                                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                        ShortUnique id for inter-element referencing
                                                                        Control0..1
                                                                        Typestring
                                                                        Is Modifierfalse
                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                        Summaryfalse
                                                                        236. Claim.supportingInfo:AdmissionDates.extension
                                                                        Definition

                                                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                        ShortAdditional content defined by implementations
                                                                        Comments

                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                        Control0..*
                                                                        TypeExtension
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Alternate Namesextensions, user content
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        238. Claim.supportingInfo:AdmissionDates.modifierExtension
                                                                        Definition

                                                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                                        Comments

                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                        Control0..*
                                                                        TypeExtension
                                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                        Summarytrue
                                                                        Requirements

                                                                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                        Alternate Namesextensions, user content, modifiers
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        240. Claim.supportingInfo:AdmissionDates.sequence
                                                                        Definition

                                                                        A number to uniquely identify supporting information entries.

                                                                        ShortInformation instance identifier
                                                                        Control1..1
                                                                        TypepositiveInt
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        242. Claim.supportingInfo:AdmissionDates.category
                                                                        Definition

                                                                        The general class of the information supplied: information; exception; accident, employment; onset, etc.

                                                                        ShortClassification of the supplied information
                                                                        Comments

                                                                        This may contain a category for the local bill type codes.

                                                                        Control1..1
                                                                        BindingFor example codes, see ClaimInformationCategoryCodes
                                                                        (example to http://hl7.org/fhir/ValueSet/claim-informationcategory)

                                                                        The valuset used for additional information category codes.

                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Required to group or associate information items with common characteristics. For example: admission information or prior treatments.

                                                                        Pattern Value{
                                                                          "coding" : [{
                                                                            "system" : "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes",
                                                                            "code" : "admissionDates"
                                                                          }]
                                                                        }
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        244. Claim.supportingInfo:AdmissionDates.code
                                                                        Definition

                                                                        System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient for which care is sought.

                                                                        ShortType of information
                                                                        Control0..1
                                                                        BindingFor example codes, see ExceptionCodes
                                                                        (example to http://hl7.org/fhir/ValueSet/claim-exception)

                                                                        The valuset used for additional information codes.

                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Required to identify the kind of additional information.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        246. Claim.supportingInfo:AdmissionDates.timing[x]
                                                                        Definition

                                                                        The date when or period to which this information refers.

                                                                        ShortWhen it occurred
                                                                        Control1..1
                                                                        TypeChoice of: date, Period
                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Must Supporttrue
                                                                        Must Support TypesNo must-support rules about the choice of types/profiles
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        SlicingThis element introduces a set of slices on Claim.supportingInfo.timing[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                                        • type @ $this
                                                                        • 248. Claim.supportingInfo:AdmissionDates.timing[x]:timingDate
                                                                          Slice NametimingDate
                                                                          Definition

                                                                          The date when or period to which this information refers.

                                                                          ShortWhen it occurred
                                                                          Control0..1
                                                                          Typedate
                                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                          Is Modifierfalse
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Must Supporttrue
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          FullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                                                                          250. Claim.supportingInfo:AdmissionDates.timing[x]:timingPeriod
                                                                          Slice NametimingPeriod
                                                                          Definition

                                                                          The date when or period to which this information refers.

                                                                          ShortWhen it occurred
                                                                          Control0..1
                                                                          TypePeriod
                                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                          Is Modifierfalse
                                                                          Must Supporttrue
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          252. Claim.supportingInfo:AdmissionDates.timing[x]:timingPeriod.id
                                                                          Definition

                                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                          ShortUnique id for inter-element referencing
                                                                          Control0..1
                                                                          Typestring
                                                                          Is Modifierfalse
                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                          Summaryfalse
                                                                          254. Claim.supportingInfo:AdmissionDates.timing[x]:timingPeriod.extension
                                                                          Definition

                                                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                          ShortAdditional content defined by implementations
                                                                          Comments

                                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                          Control0..*
                                                                          TypeExtension
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Alternate Namesextensions, user content
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                          SlicingThis element introduces a set of slices on Claim.supportingInfo.timing[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                          • value @ url
                                                                          • 256. Claim.supportingInfo:AdmissionDates.timing[x]:timingPeriod.start
                                                                            Definition

                                                                            The start of the period. The boundary is inclusive.

                                                                            ShortStarting time with inclusive boundary
                                                                            Comments

                                                                            If the low element is missing, the meaning is that the low boundary is not known.

                                                                            Control0..1
                                                                            This element is affected by the following invariants: per-1
                                                                            TypedateTime
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Must Supporttrue
                                                                            Summarytrue
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            FullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                                                                            258. Claim.supportingInfo:AdmissionDates.timing[x]:timingPeriod.end
                                                                            Definition

                                                                            The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

                                                                            ShortEnd time with inclusive boundary, if not ongoing
                                                                            Comments

                                                                            The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

                                                                            Control0..1
                                                                            This element is affected by the following invariants: per-1
                                                                            TypedateTime
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Must Supporttrue
                                                                            Summarytrue
                                                                            Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            FullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                                                                            260. Claim.supportingInfo:AdmissionDates.value[x]
                                                                            Definition

                                                                            Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.

                                                                            ShortData to be provided
                                                                            Comments

                                                                            Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.

                                                                            Control0..0
                                                                            TypeChoice of: boolean, string, Quantity, Attachment, Reference(Resource)
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summaryfalse
                                                                            Requirements

                                                                            To convey the data content to be provided when the information is more than a simple code or period.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            262. Claim.supportingInfo:AdmissionDates.reason
                                                                            Definition

                                                                            Provides the reason in the situation where a reason code is required in addition to the content.

                                                                            ShortExplanation for the information
                                                                            Comments

                                                                            For example: the reason for the additional stay, or why a tooth is missing.

                                                                            Control0..1
                                                                            BindingFor example codes, see MissingToothReasonCodes
                                                                            (example to http://hl7.org/fhir/ValueSet/missing-tooth-reason)

                                                                            Reason codes for the missing teeth.

                                                                            TypeCodeableConcept
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Needed when the supporting information has both a date and amount/value and requires explanation.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            264. Claim.supportingInfo:DischargeDates
                                                                            Slice NameDischargeDates
                                                                            Definition

                                                                            Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.

                                                                            ShortInformation about the discharge dates of a hospital admission being requested.
                                                                            Comments

                                                                            Often there are multiple jurisdiction specific valuesets which are required.

                                                                            Control0..1
                                                                            TypeBackboneElement
                                                                            Is Modifierfalse
                                                                            Must Supporttrue
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Typically these information codes are required to support the services rendered or the adjudication of the services rendered.

                                                                            Alternate NamesAttachments Exception Codes Occurrence Codes Value codes
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            266. Claim.supportingInfo:DischargeDates.id
                                                                            Definition

                                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                            ShortUnique id for inter-element referencing
                                                                            Control0..1
                                                                            Typestring
                                                                            Is Modifierfalse
                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                            Summaryfalse
                                                                            268. Claim.supportingInfo:DischargeDates.extension
                                                                            Definition

                                                                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                            ShortAdditional content defined by implementations
                                                                            Comments

                                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                            Control0..*
                                                                            TypeExtension
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Alternate Namesextensions, user content
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                            270. Claim.supportingInfo:DischargeDates.modifierExtension
                                                                            Definition

                                                                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                                            Comments

                                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                            Control0..*
                                                                            TypeExtension
                                                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                            Summarytrue
                                                                            Requirements

                                                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                            Alternate Namesextensions, user content, modifiers
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                            272. Claim.supportingInfo:DischargeDates.sequence
                                                                            Definition

                                                                            A number to uniquely identify supporting information entries.

                                                                            ShortInformation instance identifier
                                                                            Control1..1
                                                                            TypepositiveInt
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            274. Claim.supportingInfo:DischargeDates.category
                                                                            Definition

                                                                            The general class of the information supplied: information; exception; accident, employment; onset, etc.

                                                                            ShortClassification of the supplied information
                                                                            Comments

                                                                            This may contain a category for the local bill type codes.

                                                                            Control1..1
                                                                            BindingFor example codes, see ClaimInformationCategoryCodes
                                                                            (example to http://hl7.org/fhir/ValueSet/claim-informationcategory)

                                                                            The valuset used for additional information category codes.

                                                                            TypeCodeableConcept
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Required to group or associate information items with common characteristics. For example: admission information or prior treatments.

                                                                            Pattern Value{
                                                                              "coding" : [{
                                                                                "system" : "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes",
                                                                                "code" : "dischargeDates"
                                                                              }]
                                                                            }
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            276. Claim.supportingInfo:DischargeDates.code
                                                                            Definition

                                                                            System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient for which care is sought.

                                                                            ShortType of information
                                                                            Control0..1
                                                                            BindingFor example codes, see ExceptionCodes
                                                                            (example to http://hl7.org/fhir/ValueSet/claim-exception)

                                                                            The valuset used for additional information codes.

                                                                            TypeCodeableConcept
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Required to identify the kind of additional information.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            278. Claim.supportingInfo:DischargeDates.timing[x]
                                                                            Definition

                                                                            The date when or period to which this information refers.

                                                                            ShortWhen it occurred
                                                                            Control1..1
                                                                            TypeChoice of: date, Period
                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Must Supporttrue
                                                                            Must Support TypesNo must-support rules about the choice of types/profiles
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            SlicingThis element introduces a set of slices on Claim.supportingInfo.timing[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                                            • type @ $this
                                                                            • 280. Claim.supportingInfo:DischargeDates.timing[x]:timingDate
                                                                              Slice NametimingDate
                                                                              Definition

                                                                              The date when or period to which this information refers.

                                                                              ShortWhen it occurred
                                                                              Control0..1
                                                                              Typedate
                                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                              Is Modifierfalse
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Must Supporttrue
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              FullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                                                                              282. Claim.supportingInfo:DischargeDates.timing[x]:timingPeriod
                                                                              Slice NametimingPeriod
                                                                              Definition

                                                                              The date when or period to which this information refers.

                                                                              ShortWhen it occurred
                                                                              Control0..1
                                                                              TypePeriod
                                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                              Is Modifierfalse
                                                                              Must Supporttrue
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              284. Claim.supportingInfo:DischargeDates.timing[x]:timingPeriod.id
                                                                              Definition

                                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                              ShortUnique id for inter-element referencing
                                                                              Control0..1
                                                                              Typestring
                                                                              Is Modifierfalse
                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                              Summaryfalse
                                                                              286. Claim.supportingInfo:DischargeDates.timing[x]:timingPeriod.extension
                                                                              Definition

                                                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                              ShortAdditional content defined by implementations
                                                                              Comments

                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                              Control0..*
                                                                              TypeExtension
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Alternate Namesextensions, user content
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                              SlicingThis element introduces a set of slices on Claim.supportingInfo.timing[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                              • value @ url
                                                                              • 288. Claim.supportingInfo:DischargeDates.timing[x]:timingPeriod.start
                                                                                Definition

                                                                                The start of the period. The boundary is inclusive.

                                                                                ShortStarting time with inclusive boundary
                                                                                Comments

                                                                                If the low element is missing, the meaning is that the low boundary is not known.

                                                                                Control0..1
                                                                                This element is affected by the following invariants: per-1
                                                                                TypedateTime
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Must Supporttrue
                                                                                Summarytrue
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                FullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                                                                                290. Claim.supportingInfo:DischargeDates.timing[x]:timingPeriod.end
                                                                                Definition

                                                                                The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

                                                                                ShortEnd time with inclusive boundary, if not ongoing
                                                                                Comments

                                                                                The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

                                                                                Control0..1
                                                                                This element is affected by the following invariants: per-1
                                                                                TypedateTime
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Must Supporttrue
                                                                                Summarytrue
                                                                                Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                FullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                                                                                292. Claim.supportingInfo:DischargeDates.value[x]
                                                                                Definition

                                                                                Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.

                                                                                ShortData to be provided
                                                                                Comments

                                                                                Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.

                                                                                Control0..0
                                                                                TypeChoice of: boolean, string, Quantity, Attachment, Reference(Resource)
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Summaryfalse
                                                                                Requirements

                                                                                To convey the data content to be provided when the information is more than a simple code or period.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                294. Claim.supportingInfo:DischargeDates.reason
                                                                                Definition

                                                                                Provides the reason in the situation where a reason code is required in addition to the content.

                                                                                ShortExplanation for the information
                                                                                Comments

                                                                                For example: the reason for the additional stay, or why a tooth is missing.

                                                                                Control0..1
                                                                                BindingFor example codes, see MissingToothReasonCodes
                                                                                (example to http://hl7.org/fhir/ValueSet/missing-tooth-reason)

                                                                                Reason codes for the missing teeth.

                                                                                TypeCodeableConcept
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Requirements

                                                                                Needed when the supporting information has both a date and amount/value and requires explanation.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                296. Claim.diagnosis
                                                                                Definition

                                                                                Information about diagnoses relevant to the claim items.

                                                                                ShortPertinent diagnosis information
                                                                                Control0..*
                                                                                TypeBackboneElement
                                                                                Is Modifierfalse
                                                                                Must Supporttrue
                                                                                Summaryfalse
                                                                                Requirements

                                                                                Required for the adjudication by provided context for the services and product listed.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                298. Claim.diagnosis.id
                                                                                Definition

                                                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                ShortUnique id for inter-element referencing
                                                                                Control0..1
                                                                                Typestring
                                                                                Is Modifierfalse
                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                Summaryfalse
                                                                                300. Claim.diagnosis.extension
                                                                                Definition

                                                                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                ShortAdditional content defined by implementations
                                                                                Comments

                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                Control0..*
                                                                                TypeExtension
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Alternate Namesextensions, user content
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                302. Claim.diagnosis.modifierExtension
                                                                                Definition

                                                                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                                Comments

                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                Control0..*
                                                                                TypeExtension
                                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                Summarytrue
                                                                                Requirements

                                                                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                Alternate Namesextensions, user content, modifiers
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                304. Claim.diagnosis.sequence
                                                                                Definition

                                                                                A number to uniquely identify diagnosis entries.

                                                                                ShortDiagnosis instance identifier
                                                                                Comments

                                                                                Diagnosis are presented in list order to their expected importance: primary, secondary, etc.

                                                                                Control1..1
                                                                                TypepositiveInt
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Must Supporttrue
                                                                                Summaryfalse
                                                                                Requirements

                                                                                Necessary to maintain the order of the diagnosis items and provide a mechanism to link to claim details.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                306. Claim.diagnosis.diagnosis[x]
                                                                                Definition

                                                                                The nature of illness or problem in a coded form or as a reference to an external defined Condition.

                                                                                ShortNature of illness or problem
                                                                                Control1..1
                                                                                BindingThe codes SHALL be taken from X12 278 Diagnosis Code Value Set
                                                                                (required to http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278DiagnosisCodes)
                                                                                TypeCodeableConcept
                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                Is Modifierfalse
                                                                                Must Supporttrue
                                                                                Summaryfalse
                                                                                Requirements

                                                                                Provides health context for the evaluation of the products and/or services.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                308. Claim.diagnosis.type
                                                                                Definition

                                                                                When the condition was observed or the relative ranking.

                                                                                ShortTiming or nature of the diagnosis
                                                                                Comments

                                                                                For example: admitting, primary, secondary, discharge.

                                                                                Control0..1
                                                                                BindingThe codes SHALL be taken from X12 278 Diagnosis Type Value Set
                                                                                (required to http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278DiagnosisType)
                                                                                TypeCodeableConcept
                                                                                Is Modifierfalse
                                                                                Must Supporttrue
                                                                                Summaryfalse
                                                                                Requirements

                                                                                Often required to capture a particular diagnosis, for example: primary or discharge.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                310. Claim.diagnosis.onAdmission
                                                                                Definition

                                                                                Indication of whether the diagnosis was present on admission to a facility.

                                                                                ShortPresent on admission
                                                                                Control0..1
                                                                                BindingFor example codes, see ExampleDiagnosisOnAdmissionCodes
                                                                                (example to http://hl7.org/fhir/ValueSet/ex-diagnosis-on-admission)

                                                                                Present on admission.

                                                                                TypeCodeableConcept
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Requirements

                                                                                Many systems need to understand for adjudication if the diagnosis was present a time of admission.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                312. Claim.diagnosis.packageCode
                                                                                Definition

                                                                                A package billing code or bundle code used to group products and services to a particular health condition (such as heart attack) which is based on a predetermined grouping code system.

                                                                                ShortPackage billing code
                                                                                Comments

                                                                                For example DRG (Diagnosis Related Group) or a bundled billing code. A patient may have a diagnosis of a Myocardial Infarction and a DRG for HeartAttack would be assigned. The Claim item (and possible subsequent claims) would refer to the DRG for those line items that were for services related to the heart attack event.

                                                                                Control0..1
                                                                                BindingFor example codes, see ExampleDiagnosisRelatedGroupCodes
                                                                                (example to http://hl7.org/fhir/ValueSet/ex-diagnosisrelatedgroup)

                                                                                The DRG codes associated with the diagnosis.

                                                                                TypeCodeableConcept
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Requirements

                                                                                Required to relate the current diagnosis to a package billing code that is then referenced on the individual claim items which are specific to the health condition covered by the package code.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                314. Claim.procedure
                                                                                Definition

                                                                                Procedures performed on the patient relevant to the billing items with the claim.

                                                                                ShortClinical procedures performed
                                                                                Control0..*
                                                                                TypeBackboneElement
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Requirements

                                                                                The specific clinical invention are sometimes required to be provided to justify billing a greater than customary amount for a service.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                316. Claim.procedure.id
                                                                                Definition

                                                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                ShortUnique id for inter-element referencing
                                                                                Control0..1
                                                                                Typestring
                                                                                Is Modifierfalse
                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                Summaryfalse
                                                                                318. Claim.procedure.extension
                                                                                Definition

                                                                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                ShortAdditional content defined by implementations
                                                                                Comments

                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                Control0..*
                                                                                TypeExtension
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Alternate Namesextensions, user content
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                320. Claim.procedure.modifierExtension
                                                                                Definition

                                                                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                                Comments

                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                Control0..*
                                                                                TypeExtension
                                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                Summarytrue
                                                                                Requirements

                                                                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                Alternate Namesextensions, user content, modifiers
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                322. Claim.procedure.sequence
                                                                                Definition

                                                                                A number to uniquely identify procedure entries.

                                                                                ShortProcedure instance identifier
                                                                                Control1..1
                                                                                TypepositiveInt
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Summaryfalse
                                                                                Requirements

                                                                                Necessary to provide a mechanism to link to claim details.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                324. Claim.procedure.type
                                                                                Definition

                                                                                When the condition was observed or the relative ranking.

                                                                                ShortCategory of Procedure
                                                                                Comments

                                                                                For example: primary, secondary.

                                                                                Control0..*
                                                                                BindingFor example codes, see ExampleProcedureTypeCodes
                                                                                (example to http://hl7.org/fhir/ValueSet/ex-procedure-type)

                                                                                Example procedure type codes.

                                                                                TypeCodeableConcept
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Requirements

                                                                                Often required to capture a particular diagnosis, for example: primary or discharge.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                326. Claim.procedure.date
                                                                                Definition

                                                                                Date and optionally time the procedure was performed.

                                                                                ShortWhen the procedure was performed
                                                                                Control0..1
                                                                                TypedateTime
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Summaryfalse
                                                                                Requirements

                                                                                Required for auditing purposes.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                328. Claim.procedure.procedure[x]
                                                                                Definition

                                                                                The code or reference to a Procedure resource which identifies the clinical intervention performed.

                                                                                ShortSpecific clinical procedure
                                                                                Control1..1
                                                                                BindingFor example codes, see ICD-10ProcedureCodes
                                                                                (example to http://hl7.org/fhir/ValueSet/icd-10-procedures)

                                                                                Example ICD10 Procedure codes.

                                                                                TypeChoice of: CodeableConcept, Reference(Procedure)
                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Requirements

                                                                                This identifies the actual clinical procedure.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                330. Claim.procedure.udi
                                                                                Definition

                                                                                Unique Device Identifiers associated with this line item.

                                                                                ShortUnique device identifier
                                                                                Control0..*
                                                                                TypeReference(Device)
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Requirements

                                                                                The UDI code allows the insurer to obtain device level information on the product supplied.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                332. Claim.insurance
                                                                                Definition

                                                                                Financial instruments for reimbursement for the health care products and services specified on the claim.

                                                                                ShortPatient insurance information
                                                                                Comments

                                                                                All insurance coverages for the patient which may be applicable for reimbursement, of the products and services listed in the claim, are typically provided in the claim to allow insurers to confirm the ordering of the insurance coverages relative to local 'coordination of benefit' rules. One coverage (and only one) with 'focal=true' is to be used in the adjudication of this claim. Coverages appearing before the focal Coverage in the list, and where 'Coverage.subrogation=false', should provide a reference to the ClaimResponse containing the adjudication results of the prior claim.

                                                                                Control1..*
                                                                                TypeBackboneElement
                                                                                Is Modifierfalse
                                                                                Must Supporttrue
                                                                                Summarytrue
                                                                                Requirements

                                                                                At least one insurer is required for a claim to be a claim.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                334. Claim.insurance.id
                                                                                Definition

                                                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                ShortUnique id for inter-element referencing
                                                                                Control0..1
                                                                                Typestring
                                                                                Is Modifierfalse
                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                Summaryfalse
                                                                                336. Claim.insurance.extension
                                                                                Definition

                                                                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                ShortAdditional content defined by implementations
                                                                                Comments

                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                Control0..*
                                                                                TypeExtension
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Alternate Namesextensions, user content
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                338. Claim.insurance.modifierExtension
                                                                                Definition

                                                                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                                Comments

                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                Control0..*
                                                                                TypeExtension
                                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                Summarytrue
                                                                                Requirements

                                                                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                Alternate Namesextensions, user content, modifiers
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                340. Claim.insurance.sequence
                                                                                Definition

                                                                                A number to uniquely identify insurance entries and provide a sequence of coverages to convey coordination of benefit order.

                                                                                ShortInsurance instance identifier
                                                                                Control1..1
                                                                                TypepositiveInt
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Must Supporttrue
                                                                                Summarytrue
                                                                                Requirements

                                                                                To maintain order of the coverages.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                342. Claim.insurance.focal
                                                                                Definition

                                                                                A flag to indicate that this Coverage is to be used for adjudication of this claim when set to true.

                                                                                ShortCoverage to be used for adjudication
                                                                                Comments

                                                                                A patient may (will) have multiple insurance policies which provide reimbursement for healthcare services and products. For example a person may also be covered by their spouse's policy and both appear in the list (and may be from the same insurer). This flag will be set to true for only one of the listed policies and that policy will be used for adjudicating this claim. Other claims would be created to request adjudication against the other listed policies.

                                                                                Control1..1
                                                                                Typeboolean
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Summarytrue
                                                                                Requirements

                                                                                To identify which coverage in the list is being used to adjudicate this claim.

                                                                                Pattern Valuetrue
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                344. Claim.insurance.identifier
                                                                                Definition

                                                                                The business identifier to be used when the claim is sent for adjudication against this insurance policy.

                                                                                ShortPre-assigned Claim number
                                                                                Comments

                                                                                Only required in jurisdictions where insurers, rather than the provider, are required to send claims to insurers that appear after them in the list. This element is not required when 'subrogation=true'.

                                                                                NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                                Control0..1
                                                                                TypeIdentifier
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Requirements

                                                                                This will be the claim number should it be necessary to create this claim in the future. This is provided so that payors may forward claims to other payors in the Coordination of Benefit for adjudication rather than the provider being required to initiate each adjudication.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                346. Claim.insurance.coverage
                                                                                Definition

                                                                                Reference to the insurance card level information contained in the Coverage resource. The coverage issuing insurer will use these details to locate the patient's actual coverage within the insurer's information system.

                                                                                ShortInsurance information
                                                                                Control1..1
                                                                                TypeReference(PAS Coverage)
                                                                                Is Modifierfalse
                                                                                Must Supporttrue
                                                                                Summarytrue
                                                                                Requirements

                                                                                Required to allow the adjudicator to locate the correct policy and history within their information system.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                348. Claim.insurance.businessArrangement
                                                                                Definition

                                                                                A business agreement number established between the provider and the insurer for special business processing purposes.

                                                                                ShortAdditional provider contract number
                                                                                Control0..1
                                                                                Typestring
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Summaryfalse
                                                                                Requirements

                                                                                Providers may have multiple business arrangements with a given insurer and must supply the specific contract number for adjudication.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                350. Claim.insurance.preAuthRef
                                                                                Definition

                                                                                Reference numbers previously provided by the insurer to the provider to be quoted on subsequent claims containing services or products related to the prior authorization.

                                                                                ShortPrior authorization reference number
                                                                                Comments

                                                                                This value is an alphanumeric string that may be provided over the phone, via text, via paper, or within a ClaimResponse resource and is not a FHIR Identifier.

                                                                                Control0..*
                                                                                Typestring
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Summaryfalse
                                                                                Requirements

                                                                                Providers must quote previously issued authorization reference numbers in order to obtain adjudication as previously advised on the Preauthorization.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                352. Claim.insurance.claimResponse
                                                                                Definition

                                                                                The result of the adjudication of the line items for the Coverage specified in this insurance.

                                                                                ShortAdjudication results
                                                                                Comments

                                                                                Must not be specified when 'focal=true' for this insurance.

                                                                                Control0..1
                                                                                TypeReference(ClaimResponse)
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Requirements

                                                                                An insurer need the adjudication results from prior insurers to determine the outstanding balance remaining by item for the items in the curent claim.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                354. Claim.accident
                                                                                Definition

                                                                                Details of an accident which resulted in injuries which required the products and services listed in the claim.

                                                                                ShortDetails of the event
                                                                                Control0..1
                                                                                TypeBackboneElement
                                                                                Is Modifierfalse
                                                                                Must Supporttrue
                                                                                Summaryfalse
                                                                                Requirements

                                                                                When healthcare products and services are accident related, benefits may be payable under accident provisions of policies, such as automotive, etc before they are payable under normal health insurance.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                356. Claim.accident.id
                                                                                Definition

                                                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                ShortUnique id for inter-element referencing
                                                                                Control0..1
                                                                                Typestring
                                                                                Is Modifierfalse
                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                Summaryfalse
                                                                                358. Claim.accident.extension
                                                                                Definition

                                                                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                ShortAdditional content defined by implementations
                                                                                Comments

                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                Control0..*
                                                                                TypeExtension
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Alternate Namesextensions, user content
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                360. Claim.accident.modifierExtension
                                                                                Definition

                                                                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                                Comments

                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                Control0..*
                                                                                TypeExtension
                                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                Summarytrue
                                                                                Requirements

                                                                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                Alternate Namesextensions, user content, modifiers
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                362. Claim.accident.date
                                                                                Definition

                                                                                Date of an accident event related to the products and services contained in the claim.

                                                                                ShortWhen the incident occurred
                                                                                Comments

                                                                                The date of the accident has to precede the dates of the products and services but within a reasonable timeframe.

                                                                                Control1..1
                                                                                Typedate
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Must Supporttrue
                                                                                Summaryfalse
                                                                                Requirements

                                                                                Required for audit purposes and adjudication.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                FullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                                                                                364. Claim.accident.type
                                                                                Definition

                                                                                The type or context of the accident event for the purposes of selection of potential insurance coverages and determination of coordination between insurers.

                                                                                ShortThe nature of the accident
                                                                                Control0..1
                                                                                BindingThe codes SHALL be taken from https://valueset.x12.org/x217/005010/request/2000E/UM/1/05/01/1362
                                                                                (required to https://valueset.x12.org/x217/005010/request/2000E/UM/1/05/01/1362)

                                                                                Codes identifying an accompanying cause of an illness, injury or an accident. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.

                                                                                TypeCodeableConcept
                                                                                Is Modifierfalse
                                                                                Must Supporttrue
                                                                                Summaryfalse
                                                                                Requirements

                                                                                Coverage may be dependant on the type of accident.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                366. Claim.accident.location[x]
                                                                                Definition

                                                                                The physical location of the accident event.

                                                                                ShortWhere the event occurred
                                                                                Control0..1
                                                                                TypeAddress
                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                Is Modifierfalse
                                                                                Must Supporttrue
                                                                                Summaryfalse
                                                                                Requirements

                                                                                Required for audit purposes and determination of applicable insurance liability.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                368. Claim.item
                                                                                Definition

                                                                                A claim line. Either a simple product or service or a 'group' of details which can each be a simple items or groups of sub-details.

                                                                                ShortProduct or service provided
                                                                                Control0..*
                                                                                TypeBackboneElement
                                                                                Is Modifierfalse
                                                                                Must Supporttrue
                                                                                Summaryfalse
                                                                                Requirements

                                                                                The items to be processed for adjudication.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                370. Claim.item.id
                                                                                Definition

                                                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                ShortUnique id for inter-element referencing
                                                                                Control0..1
                                                                                Typestring
                                                                                Is Modifierfalse
                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                Summaryfalse
                                                                                372. Claim.item.extension
                                                                                Definition

                                                                                An Extension

                                                                                ShortExtension
                                                                                Control0..*
                                                                                TypeExtension
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                SlicingThis element introduces a set of slices on Claim.item.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                • value @ url
                                                                                • 374. Claim.item.extension:itemTraceNumber
                                                                                  Slice NameitemTraceNumber
                                                                                  Definition

                                                                                  Uniquely identifies this claim item. (2000F-TRN)

                                                                                  ShortUniquely identifies this claim item. (2000F-TRN)
                                                                                  Control0..*
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  TypeExtension(ItemTraceNumber) (Extension Type: Identifier(PAS Identifier))
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  376. Claim.item.extension:authorizationNumber
                                                                                  Slice NameauthorizationNumber
                                                                                  Definition

                                                                                  A string assigned by the UMO to an authorized review outcome associated with this service item.

                                                                                  ShortA string assigned by the UMO to an authorized review outcome associated with this service item.
                                                                                  Control0..1
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  TypeExtension(AuthorizationNumber) (Extension Type: string)
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  378. Claim.item.extension:administrationReferenceNumber
                                                                                  Slice NameadministrationReferenceNumber
                                                                                  Definition

                                                                                  A string assigned by the UMO to the original disallowed review outcome associated with this service item.

                                                                                  ShortA string assigned by the UMO to the original disallowed review outcome associated with this service item.
                                                                                  Control0..1
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  TypeExtension(AdministrationReferenceNumber) (Extension Type: string)
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  380. Claim.item.extension:requestType
                                                                                  Slice NamerequestType
                                                                                  Definition

                                                                                  A code that identifies the type of service being requested.

                                                                                  ShortA code that identifies the type of service being requested.
                                                                                  Control0..1
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  TypeExtension(ServiceItemRequestType) (Extension Type: CodeableConcept)
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  382. Claim.item.extension:certificationType
                                                                                  Slice NamecertificationType
                                                                                  Definition

                                                                                  A code representing the type of certification being requested (UM02)

                                                                                  ShortA code representing the type of certification being requested (UM02)
                                                                                  Control0..1
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  TypeExtension(CertificationType) (Extension Type: CodeableConcept)
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  384. Claim.item.extension:productOrServiceCodeEnd
                                                                                  Slice NameproductOrServiceCodeEnd
                                                                                  Definition

                                                                                  Used to provide the last code in a series of codes for the service being requested.

                                                                                  ShortUsed to provide the last code in a series of codes for the service being requested.
                                                                                  Control0..1
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  TypeExtension(ProductOrServiceCodeEnd) (Extension Type: CodeableConcept)
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  386. Claim.item.modifierExtension
                                                                                  Definition

                                                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                                                  Comments

                                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                  Control0..*
                                                                                  TypeExtension
                                                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                  Alternate Namesextensions, user content, modifiers
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  388. Claim.item.sequence
                                                                                  Definition

                                                                                  A number to uniquely identify item entries.

                                                                                  ShortItem instance identifier
                                                                                  Control1..1
                                                                                  TypepositiveInt
                                                                                  Is Modifierfalse
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Must Supporttrue
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  390. Claim.item.careTeamSequence
                                                                                  Definition

                                                                                  CareTeam members related to this service or product.

                                                                                  ShortApplicable careTeam members
                                                                                  Control0..*
                                                                                  TypepositiveInt
                                                                                  Is Modifierfalse
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Must Supporttrue
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  Need to identify the individuals and their roles in the provision of the product or service.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  392. Claim.item.diagnosisSequence
                                                                                  Definition

                                                                                  Diagnosis applicable for this service or product.

                                                                                  ShortApplicable diagnoses
                                                                                  Control0..*
                                                                                  TypepositiveInt
                                                                                  Is Modifierfalse
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Must Supporttrue
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  Need to related the product or service to the associated diagnoses.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  394. Claim.item.procedureSequence
                                                                                  Definition

                                                                                  Procedures applicable for this service or product.

                                                                                  ShortApplicable procedures
                                                                                  Control0..*
                                                                                  TypepositiveInt
                                                                                  Is Modifierfalse
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  Need to provide any listed specific procedures to support the product or service being claimed.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  396. Claim.item.informationSequence
                                                                                  Definition

                                                                                  Exceptions, special conditions and supporting information applicable for this service or product.

                                                                                  ShortApplicable exception and supporting information
                                                                                  Control0..*
                                                                                  TypepositiveInt
                                                                                  Is Modifierfalse
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Must Supporttrue
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  Need to reference the supporting information items that relate directly to this product or service.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  398. Claim.item.revenue
                                                                                  Definition

                                                                                  The type of revenue or cost center providing the product and/or service.

                                                                                  ShortRevenue or cost center code
                                                                                  Control0..1
                                                                                  BindingThe codes SHALL be taken from AHA NUBC Revenue Value Set
                                                                                  (required to http://hl7.org/fhir/us/davinci-pas/ValueSet/AHANUBCRevenueCodes)
                                                                                  TypeCodeableConcept
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  Needed in the processing of institutional claims.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  400. Claim.item.category
                                                                                  Definition

                                                                                  Code to identify the general type of benefits under which products and services are provided.

                                                                                  ShortBenefit classification
                                                                                  Comments

                                                                                  Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                                                  Control0..1
                                                                                  BindingThe codes SHALL be taken from https://valueset.x12.org/x217/005010/request/2000F/UM/1/03/00/1365
                                                                                  (required to https://valueset.x12.org/x217/005010/request/2000F/UM/1/03/00/1365)

                                                                                  Codes identifying the classification of service. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.

                                                                                  TypeCodeableConcept
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  402. Claim.item.productOrService
                                                                                  Definition

                                                                                  When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.

                                                                                  ShortBilling, service, product, or drug code
                                                                                  Comments

                                                                                  If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                                                                  Control1..1
                                                                                  BindingThe codes SHALL be taken from X12 278 Requested Service Type
                                                                                  (required to http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278RequestedServiceType)
                                                                                  TypeCodeableConcept
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  Necessary to state what was provided or done.

                                                                                  Alternate NamesDrug Code, Bill Code, Service Code
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  404. Claim.item.modifier
                                                                                  Definition

                                                                                  Item typification or modifiers codes to convey additional context for the product or service.

                                                                                  ShortProduct or service billing modifiers
                                                                                  Comments

                                                                                  For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours.

                                                                                  Control0..*
                                                                                  BindingThe codes SHALL be taken from X12 278 Requested Service Modifier Type
                                                                                  (required to http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278RequestedServiceModifierType)
                                                                                  TypeCodeableConcept
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  To support inclusion of the item for adjudication or to charge an elevated fee.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  406. Claim.item.programCode
                                                                                  Definition

                                                                                  Identifies the program under which this may be recovered.

                                                                                  ShortProgram the product or service is provided under
                                                                                  Comments

                                                                                  For example: Neonatal program, child dental program or drug users recovery program.

                                                                                  Control0..*
                                                                                  BindingFor example codes, see ExampleProgramReasonCodes
                                                                                  (example to http://hl7.org/fhir/ValueSet/ex-program-code)

                                                                                  Program specific reason codes.

                                                                                  TypeCodeableConcept
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  408. Claim.item.serviced[x]
                                                                                  Definition

                                                                                  The date or dates when the service or product was supplied, performed or completed.

                                                                                  ShortDate or dates of service or product delivery
                                                                                  Control0..1
                                                                                  TypeChoice of: date, Period
                                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                  Is Modifierfalse
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Must Supporttrue
                                                                                  Must Support TypesNo must-support rules about the choice of types/profiles
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  Needed to determine whether the service or product was provided during the term of the insurance coverage.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  SlicingThis element introduces a set of slices on Claim.item.serviced[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                                                  • type @ $this
                                                                                  • 410. Claim.item.serviced[x]:servicedDate
                                                                                    Slice NameservicedDate
                                                                                    Definition

                                                                                    The date or dates when the service or product was supplied, performed or completed.

                                                                                    ShortDate or dates of service or product delivery
                                                                                    Control0..1
                                                                                    Typedate
                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summaryfalse
                                                                                    Requirements

                                                                                    Needed to determine whether the service or product was provided during the term of the insurance coverage.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    FullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                                                                                    412. Claim.item.serviced[x]:servicedPeriod
                                                                                    Slice NameservicedPeriod
                                                                                    Definition

                                                                                    The date or dates when the service or product was supplied, performed or completed.

                                                                                    ShortDate or dates of service or product delivery
                                                                                    Control0..1
                                                                                    TypePeriod
                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                    Is Modifierfalse
                                                                                    Summaryfalse
                                                                                    Requirements

                                                                                    Needed to determine whether the service or product was provided during the term of the insurance coverage.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    414. Claim.item.serviced[x]:servicedPeriod.id
                                                                                    Definition

                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                    ShortUnique id for inter-element referencing
                                                                                    Control0..1
                                                                                    Typestring
                                                                                    Is Modifierfalse
                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                    Summaryfalse
                                                                                    416. Claim.item.serviced[x]:servicedPeriod.extension
                                                                                    Definition

                                                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                    ShortAdditional content defined by implementations
                                                                                    Comments

                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                    Control0..*
                                                                                    TypeExtension
                                                                                    Is Modifierfalse
                                                                                    Summaryfalse
                                                                                    Alternate Namesextensions, user content
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                    SlicingThis element introduces a set of slices on Claim.item.serviced[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                    • value @ url
                                                                                    • 418. Claim.item.serviced[x]:servicedPeriod.start
                                                                                      Definition

                                                                                      The start of the period. The boundary is inclusive.

                                                                                      ShortStarting time with inclusive boundary
                                                                                      Comments

                                                                                      If the low element is missing, the meaning is that the low boundary is not known.

                                                                                      Control0..1
                                                                                      This element is affected by the following invariants: per-1
                                                                                      TypedateTime
                                                                                      Is Modifierfalse
                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                      Summarytrue
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      FullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                                                                                      420. Claim.item.serviced[x]:servicedPeriod.end
                                                                                      Definition

                                                                                      The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

                                                                                      ShortEnd time with inclusive boundary, if not ongoing
                                                                                      Comments

                                                                                      The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

                                                                                      Control0..1
                                                                                      This element is affected by the following invariants: per-1
                                                                                      TypedateTime
                                                                                      Is Modifierfalse
                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                      Summarytrue
                                                                                      Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      FullDateRule: Dates need to be a full date - YYYY-MM-DD ($this.toString().length() = 10)
                                                                                      422. Claim.item.location[x]
                                                                                      Definition

                                                                                      Where the product or service was provided.

                                                                                      ShortPlace of service or where product was supplied
                                                                                      Control0..1
                                                                                      BindingThe codes SHALL be taken from X12 278 Health Care Service Location Type Value Set
                                                                                      (required to http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278LocationType)
                                                                                      TypeCodeableConcept
                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                      Is Modifierfalse
                                                                                      Must Supporttrue
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      424. Claim.item.quantity
                                                                                      Definition

                                                                                      The comparator is not used on a SimpleQuantity

                                                                                      ShortA fixed quantity (no comparator)
                                                                                      Comments

                                                                                      For any exchange that must be converted to an X12 request, units SHALL be restricted to international units, days, units, minutes, hours, months, or visits.

                                                                                      Control0..1
                                                                                      This element is affected by the following invariants: ele-1
                                                                                      TypeQuantity(PAS Quantity)
                                                                                      Is Modifierfalse
                                                                                      Must Supporttrue
                                                                                      Requirements

                                                                                      Required when the product or service code does not convey the quantity provided.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                                                      sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                                                                                      426. Claim.item.unitPrice
                                                                                      Definition

                                                                                      If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

                                                                                      ShortFee, charge or cost per item
                                                                                      Control0..1
                                                                                      TypeMoney
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      The amount charged to the patient by the provider for a single unit.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      428. Claim.item.factor
                                                                                      Definition

                                                                                      A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                                                                                      ShortPrice scaling factor
                                                                                      Comments

                                                                                      To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                                                      Control0..1
                                                                                      Typedecimal
                                                                                      Is Modifierfalse
                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      430. Claim.item.net
                                                                                      Definition

                                                                                      The quantity times the unit price for an additional service or product or charge.

                                                                                      ShortTotal item cost
                                                                                      Comments

                                                                                      For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                                                      Control0..1
                                                                                      TypeMoney
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      Provides the total amount claimed for the group (if a grouper) or the line item.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      432. Claim.item.udi
                                                                                      Definition

                                                                                      Unique Device Identifiers associated with this line item.

                                                                                      ShortUnique device identifier
                                                                                      Control0..*
                                                                                      TypeReference(Device)
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      The UDI code allows the insurer to obtain device level information on the product supplied.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      434. Claim.item.bodySite
                                                                                      Definition

                                                                                      Physical service site on the patient (limb, tooth, etc.).

                                                                                      ShortAnatomical location
                                                                                      Comments

                                                                                      For example: Providing a tooth code, allows an insurer to identify a provider performing a filling on a tooth that was previously removed.

                                                                                      Control0..1
                                                                                      BindingFor example codes, see OralSiteCodes
                                                                                      (example to http://hl7.org/fhir/ValueSet/tooth)

                                                                                      The code for the teeth, quadrant, sextant and arch.

                                                                                      TypeCodeableConcept
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      Allows insurer to validate specific procedures.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      436. Claim.item.subSite
                                                                                      Definition

                                                                                      A region or surface of the bodySite, e.g. limb region or tooth surface(s).

                                                                                      ShortAnatomical sub-location
                                                                                      Control0..*
                                                                                      BindingFor example codes, see SurfaceCodes
                                                                                      (example to http://hl7.org/fhir/ValueSet/surface)

                                                                                      The code for the tooth surface and surface combinations.

                                                                                      TypeCodeableConcept
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      Allows insurer to validate specific procedures.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      438. Claim.item.encounter
                                                                                      Definition

                                                                                      The Encounters during which this Claim was created or to which the creation of this record is tightly associated.

                                                                                      ShortEncounters related to this billed item
                                                                                      Comments

                                                                                      This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

                                                                                      Control0..*
                                                                                      TypeReference(Encounter)
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      Used in some jurisdictions to link clinical events to claim items.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      440. Claim.item.detail
                                                                                      Definition

                                                                                      A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                                                                      ShortProduct or service provided
                                                                                      Control0..*
                                                                                      TypeBackboneElement
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      The items to be processed for adjudication.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      442. Claim.item.detail.id
                                                                                      Definition

                                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                      ShortUnique id for inter-element referencing
                                                                                      Control0..1
                                                                                      Typestring
                                                                                      Is Modifierfalse
                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                      Summaryfalse
                                                                                      444. Claim.item.detail.extension
                                                                                      Definition

                                                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                      ShortAdditional content defined by implementations
                                                                                      Comments

                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                      Control0..*
                                                                                      TypeExtension
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Alternate Namesextensions, user content
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                      446. Claim.item.detail.modifierExtension
                                                                                      Definition

                                                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                                                      Comments

                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                      Control0..*
                                                                                      TypeExtension
                                                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                      Summarytrue
                                                                                      Requirements

                                                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                      Alternate Namesextensions, user content, modifiers
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                      448. Claim.item.detail.sequence
                                                                                      Definition

                                                                                      A number to uniquely identify item entries.

                                                                                      ShortItem instance identifier
                                                                                      Control1..1
                                                                                      TypepositiveInt
                                                                                      Is Modifierfalse
                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      450. Claim.item.detail.revenue
                                                                                      Definition

                                                                                      The type of revenue or cost center providing the product and/or service.

                                                                                      ShortRevenue or cost center code
                                                                                      Control0..1
                                                                                      BindingFor example codes, see ExampleRevenueCenterCodes
                                                                                      (example to http://hl7.org/fhir/ValueSet/ex-revenue-center)

                                                                                      Codes for the revenue or cost centers supplying the service and/or products.

                                                                                      TypeCodeableConcept
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      Needed in the processing of institutional claims.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      452. Claim.item.detail.category
                                                                                      Definition

                                                                                      Code to identify the general type of benefits under which products and services are provided.

                                                                                      ShortBenefit classification
                                                                                      Comments

                                                                                      Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                                                      Control0..1
                                                                                      BindingFor example codes, see BenefitCategoryCodes
                                                                                      (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory)

                                                                                      Benefit categories such as: oral-basic, major, glasses.

                                                                                      TypeCodeableConcept
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      454. Claim.item.detail.productOrService
                                                                                      Definition

                                                                                      When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.

                                                                                      ShortBilling, service, product, or drug code
                                                                                      Comments

                                                                                      If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                                                                      Control1..1
                                                                                      BindingFor example codes, see USCLSCodes
                                                                                      (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                                                                      Allowable service and product codes.

                                                                                      TypeCodeableConcept
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      Necessary to state what was provided or done.

                                                                                      Alternate NamesDrug Code, Bill Code, Service Code
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      456. Claim.item.detail.modifier
                                                                                      Definition

                                                                                      Item typification or modifiers codes to convey additional context for the product or service.

                                                                                      ShortService/Product billing modifiers
                                                                                      Comments

                                                                                      For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.

                                                                                      Control0..*
                                                                                      BindingFor example codes, see ModifierTypeCodes
                                                                                      (example to http://hl7.org/fhir/ValueSet/claim-modifiers)

                                                                                      Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                                                      TypeCodeableConcept
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      To support inclusion of the item for adjudication or to charge an elevated fee.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      458. Claim.item.detail.programCode
                                                                                      Definition

                                                                                      Identifies the program under which this may be recovered.

                                                                                      ShortProgram the product or service is provided under
                                                                                      Comments

                                                                                      For example: Neonatal program, child dental program or drug users recovery program.

                                                                                      Control0..*
                                                                                      BindingFor example codes, see ExampleProgramReasonCodes
                                                                                      (example to http://hl7.org/fhir/ValueSet/ex-program-code)

                                                                                      Program specific reason codes.

                                                                                      TypeCodeableConcept
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      460. Claim.item.detail.quantity
                                                                                      Definition

                                                                                      The number of repetitions of a service or product.

                                                                                      ShortCount of products or services
                                                                                      Control0..1
                                                                                      TypeQuantity(SimpleQuantity)
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      Required when the product or service code does not convey the quantity provided.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      462. Claim.item.detail.unitPrice
                                                                                      Definition

                                                                                      If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

                                                                                      ShortFee, charge or cost per item
                                                                                      Control0..1
                                                                                      TypeMoney
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      The amount charged to the patient by the provider for a single unit.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      464. Claim.item.detail.factor
                                                                                      Definition

                                                                                      A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                                                                                      ShortPrice scaling factor
                                                                                      Comments

                                                                                      To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                                                      Control0..1
                                                                                      Typedecimal
                                                                                      Is Modifierfalse
                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      466. Claim.item.detail.net
                                                                                      Definition

                                                                                      The quantity times the unit price for an additional service or product or charge.

                                                                                      ShortTotal item cost
                                                                                      Comments

                                                                                      For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                                                      Control0..1
                                                                                      TypeMoney
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      Provides the total amount claimed for the group (if a grouper) or the line item.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      468. Claim.item.detail.udi
                                                                                      Definition

                                                                                      Unique Device Identifiers associated with this line item.

                                                                                      ShortUnique device identifier
                                                                                      Control0..*
                                                                                      TypeReference(Device)
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      The UDI code allows the insurer to obtain device level information on the product supplied.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      470. Claim.item.detail.subDetail
                                                                                      Definition

                                                                                      A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                                                                      ShortProduct or service provided
                                                                                      Control0..*
                                                                                      TypeBackboneElement
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      The items to be processed for adjudication.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      472. Claim.item.detail.subDetail.id
                                                                                      Definition

                                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                      ShortUnique id for inter-element referencing
                                                                                      Control0..1
                                                                                      Typestring
                                                                                      Is Modifierfalse
                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                      Summaryfalse
                                                                                      474. Claim.item.detail.subDetail.extension
                                                                                      Definition

                                                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                      ShortAdditional content defined by implementations
                                                                                      Comments

                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                      Control0..*
                                                                                      TypeExtension
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Alternate Namesextensions, user content
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                      476. Claim.item.detail.subDetail.modifierExtension
                                                                                      Definition

                                                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                                                      Comments

                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                      Control0..*
                                                                                      TypeExtension
                                                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                      Summarytrue
                                                                                      Requirements

                                                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                      Alternate Namesextensions, user content, modifiers
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                      478. Claim.item.detail.subDetail.sequence
                                                                                      Definition

                                                                                      A number to uniquely identify item entries.

                                                                                      ShortItem instance identifier
                                                                                      Control1..1
                                                                                      TypepositiveInt
                                                                                      Is Modifierfalse
                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      480. Claim.item.detail.subDetail.revenue
                                                                                      Definition

                                                                                      The type of revenue or cost center providing the product and/or service.

                                                                                      ShortRevenue or cost center code
                                                                                      Control0..1
                                                                                      BindingFor example codes, see ExampleRevenueCenterCodes
                                                                                      (example to http://hl7.org/fhir/ValueSet/ex-revenue-center)

                                                                                      Codes for the revenue or cost centers supplying the service and/or products.

                                                                                      TypeCodeableConcept
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      Needed in the processing of institutional claims.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      482. Claim.item.detail.subDetail.category
                                                                                      Definition

                                                                                      Code to identify the general type of benefits under which products and services are provided.

                                                                                      ShortBenefit classification
                                                                                      Comments

                                                                                      Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                                                      Control0..1
                                                                                      BindingFor example codes, see BenefitCategoryCodes
                                                                                      (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory)

                                                                                      Benefit categories such as: oral-basic, major, glasses.

                                                                                      TypeCodeableConcept
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      484. Claim.item.detail.subDetail.productOrService
                                                                                      Definition

                                                                                      When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.

                                                                                      ShortBilling, service, product, or drug code
                                                                                      Comments

                                                                                      If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                                                                      Control1..1
                                                                                      BindingFor example codes, see USCLSCodes
                                                                                      (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                                                                      Allowable service and product codes.

                                                                                      TypeCodeableConcept
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      Necessary to state what was provided or done.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      486. Claim.item.detail.subDetail.modifier
                                                                                      Definition

                                                                                      Item typification or modifiers codes to convey additional context for the product or service.

                                                                                      ShortService/Product billing modifiers
                                                                                      Comments

                                                                                      For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.

                                                                                      Control0..*
                                                                                      BindingFor example codes, see ModifierTypeCodes
                                                                                      (example to http://hl7.org/fhir/ValueSet/claim-modifiers)

                                                                                      Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                                                      TypeCodeableConcept
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      To support inclusion of the item for adjudication or to charge an elevated fee.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      488. Claim.item.detail.subDetail.programCode
                                                                                      Definition

                                                                                      Identifies the program under which this may be recovered.

                                                                                      ShortProgram the product or service is provided under
                                                                                      Comments

                                                                                      For example: Neonatal program, child dental program or drug users recovery program.

                                                                                      Control0..*
                                                                                      BindingFor example codes, see ExampleProgramReasonCodes
                                                                                      (example to http://hl7.org/fhir/ValueSet/ex-program-code)

                                                                                      Program specific reason codes.

                                                                                      TypeCodeableConcept
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      490. Claim.item.detail.subDetail.quantity
                                                                                      Definition

                                                                                      The number of repetitions of a service or product.

                                                                                      ShortCount of products or services
                                                                                      Control0..1
                                                                                      TypeQuantity(SimpleQuantity)
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      Required when the product or service code does not convey the quantity provided.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      492. Claim.item.detail.subDetail.unitPrice
                                                                                      Definition

                                                                                      If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

                                                                                      ShortFee, charge or cost per item
                                                                                      Control0..1
                                                                                      TypeMoney
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      The amount charged to the patient by the provider for a single unit.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      494. Claim.item.detail.subDetail.factor
                                                                                      Definition

                                                                                      A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                                                                                      ShortPrice scaling factor
                                                                                      Comments

                                                                                      To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                                                      Control0..1
                                                                                      Typedecimal
                                                                                      Is Modifierfalse
                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      496. Claim.item.detail.subDetail.net
                                                                                      Definition

                                                                                      The quantity times the unit price for an additional service or product or charge.

                                                                                      ShortTotal item cost
                                                                                      Comments

                                                                                      For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                                                      Control0..1
                                                                                      TypeMoney
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      Provides the total amount claimed for the group (if a grouper) or the line item.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      498. Claim.item.detail.subDetail.udi
                                                                                      Definition

                                                                                      Unique Device Identifiers associated with this line item.

                                                                                      ShortUnique device identifier
                                                                                      Control0..*
                                                                                      TypeReference(Device)
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      The UDI code allows the insurer to obtain device level information on the product supplied.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      500. Claim.total
                                                                                      Definition

                                                                                      The total value of the all the items in the claim.

                                                                                      ShortTotal claim cost
                                                                                      Control0..1
                                                                                      TypeMoney
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      Used for control total purposes.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))