Claim.item.detail

A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

= Must Support, = Is Modifier, = QiCore defined extension

FieldCard.TypeDescription
sequence1..1IntegerA number to uniquely identify item entries.
revenue0..1ConceptThe type of revenue or cost center providing the product and/or service.
Binding: Codes for the revenue or cost centers supplying the service and/or products. (example)
category0..1ConceptCode to identify the general type of benefits under which products and services are provided.
Binding: Benefit categories such as: oral-basic, major, glasses. (example)
productOrService1..1ConceptWhen 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.
Binding: Allowable service and product codes. (example)
modifier0..*List<Concept>Item typification or modifiers codes to convey additional context for the product or service.
Binding: Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. (example)
programCode0..*List<Concept>Identifies the program under which this may be recovered.
Binding: Program specific reason codes. (example)
quantity0..1QuantityThe number of repetitions of a service or product.
unitPrice0..1MoneyIf 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.
factor0..1DecimalA 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.
net0..1MoneyThe quantity times the unit price for an additional service or product or charge.
udi0..*List<QICoreDevice>Unique Device Identifiers associated with this line item.
subDetail0..*List<item.detail.subDetail>A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.