Extensions for Using Data Elements from FHIR STU3 in FHIR R5 - Downloaded Version null See the Directory of published versions

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Resource Profile: Profile_R3_Claim_R5

This cross-version profile allows STU3 Claim content to be represented via FHIR R5 Claim resources.

Usages:

• This Profile is not used by any profiles in this Implementation Guide

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Claim		0..*	Claim(5.0.0)	Claim, Pre-determination or Pre-authorization
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:organization		0..1	Reference(Cross-version Profile for STU3.Organization for use in FHIR R5(0.1.0) | Organization)	STU3: Responsible organization (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.organization Constraints: ext-1
extension:employmentImpacted		0..1	Period	STU3: Period unable to work (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.employmentImpacted Constraints: ext-1
extension:hospitalization		0..1	Period	STU3: Period in hospital (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.hospitalization Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored Constraints: ext-1
status	?!Σ	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
type	Σ	1..1	CodeableConcept	Category or discipline Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim.
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:type		0..1	CodeableConcept	STU3: Type or discipline URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.type Binding: ClaimTypeCodes (required): The type or discipline-style of the claim Constraints: ext-1
use	Σ	1..1	code	claim | preauthorization | predetermination Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim.
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:use		0..1	code	STU3: complete | proposed | exploratory | other URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.use Binding: R3ClaimUseForR5 (0.1.0) (required): Complete, proposed, exploratory, other Constraints: ext-1
patient	Σ	1..1	Reference(Patient)	The recipient of the products and services
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:patient		0..1	Reference(Resource)	STU3: The subject of the Products and Services additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
created	Σ	1..1	dateTime	Resource creation date
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Claim.status	Base	required	Financial Resource Status Codes	📍5.0.0	FHIR Std.
Claim.type	Base	extensible	Claim Type Codes	📍5.0.0	FHIR Std.
Claim.use	Base	required	Use	📍5.0.0	tx.fhir.org

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Claim	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Claim	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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Claim	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	error	Claim	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Claim	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	Claim.implicitRules, Claim.extension, Claim.extension:organization, Claim.extension:employmentImpacted, Claim.extension:hospitalization, Claim.modifierExtension, Claim.status, Claim.type, Claim.type.extension, Claim.type.extension:type, Claim.use, Claim.use.extension, Claim.use.extension:use, Claim.patient, Claim.patient.extension, Claim.patient.extension:patient, Claim.patient.reference, Claim.created	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	Claim.extension, Claim.extension:organization, Claim.extension:employmentImpacted, Claim.extension:hospitalization, Claim.modifierExtension, Claim.type.extension, Claim.type.extension:type, Claim.use.extension, Claim.use.extension:use, Claim.patient.extension, Claim.patient.extension:patient	Must have either extensions or value[x], not both	extension.exists() != value.exists()

This structure is derived from Claim

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Claim		0..*	Claim(5.0.0)	Claim, Pre-determination or Pre-authorization
meta
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:meta		0..1	Meta	STU3: meta additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.meta
text
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:text		0..1	(Complex)	STU3: text additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.text
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:organization		0..1	Reference(Cross-version Profile for STU3.Organization for use in FHIR R5(0.1.0) | Organization)	STU3: Responsible organization (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.organization
extension:employmentImpacted		0..1	Period	STU3: Period unable to work (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.employmentImpacted
extension:hospitalization		0..1	Period	STU3: Period in hospital (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.hospitalization
identifier
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:identifier		0..*	Identifier	STU3: Claim number additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.identifier
type
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:type		0..1	CodeableConcept	STU3: Type or discipline URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.type Binding: ClaimTypeCodes (required): The type or discipline-style of the claim
use
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:use		0..1	code	STU3: complete | proposed | exploratory | other URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.use Binding: R3ClaimUseForR5 (0.1.0) (required): Complete, proposed, exploratory, other
patient
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:patient		0..1	Reference(Resource)	STU3: The subject of the Products and Services additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
billablePeriod
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:billablePeriod		0..1	Period	STU3: Period for charge submission additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.billablePeriod
enterer
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:enterer		0..1	Reference(Resource)	STU3: Author additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
insurer
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:insurer		0..1	Reference(Resource)	STU3: insurer additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
provider
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:provider		0..1	Reference(Resource)	STU3: Responsible provider additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
related
claim
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:claim		0..1	Reference(Resource)	STU3: claim additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:reference		0..1	Identifier	STU3: Related file or case reference additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.related.reference
prescription
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:prescription		0..1	Reference(Resource)	STU3: Prescription authorizing services or products additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
originalPrescription
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:originalPrescription		0..1	Reference(Resource)	STU3: Original prescription if superceded by fulfiller additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
payee
party
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:resourceType		0..1	Coding	STU3: organization | patient | practitioner | relatedperson additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.payee.resourceType Binding: R3ExPayeeResourceTypeForR5 (0.1.0) (example): The type of Claim payee Resource
extension:party		0..1	Reference(Resource)	STU3: Party to receive the payable URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
referral
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:referral		0..1	Reference(Resource)	STU3: Treatment Referral additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
facility
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:facility		0..1	Reference(Resource)	STU3: Servicing Facility additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
careTeam
provider
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:provider		0..1	Reference(Resource)	STU3: Provider individual or organization additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
supportingInfo
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:timing		0..1	Period	STU3: timing additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.information.timing
extension:value		0..1	Attachment	STU3: Additional Data or supporting information additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.information.value
valueReference
Slices for extension				Content/Rules for all slices
extension:alternateReference		0..1	Reference(Resource)	STU3: Additional Data or supporting information additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
diagnosis
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:packageCode		0..1	CodeableConcept	STU3: Package billing code (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.diagnosis.packageCode Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis
diagnosisReference
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:alternateReference		0..1	Reference(Resource)	STU3: Patient's diagnosis additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
procedure
procedureReference
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:alternateReference		0..1	Reference(Resource)	STU3: Patient's list of procedures performed additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
insurance
coverage
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:coverage		0..1	Reference(Resource)	STU3: coverage additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
claimResponse
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:claimResponse		0..1	Reference(Resource)	STU3: claimResponse additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
accident
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:location		0..1	Address	STU3: Accident Place additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.accident.location
type
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:type		0..1	CodeableConcept	​STU3: type URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.accident.type Binding: http://terminology.hl7.org/ValueSet/v3-ActIncidentCode|2.0.0 (required): Type of accident: work place, auto, etc.
locationReference
Slices for extension				Content/Rules for all slices
extension:alternateReference		0..1	Reference(Resource)	STU3: Accident Place additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
item
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:serviced		0..1	Period	STU3: Date or dates of Service additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.item.serviced
extension:location		0..1	Address	STU3: Place of service additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.item.location
extension:subSite		0..*	CodeableConcept	STU3: Service Sub-location (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.item.subSite Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations
locationReference
Slices for extension				Content/Rules for all slices
extension:alternateReference		0..1	Reference(Resource)	STU3: Place of service additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
udi
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:udi		0..*	Reference(Resource)	STU3: Unique Device Identifier additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
encounter
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:encounter		0..*	Reference(Resource)	STU3: Encounters related to this billed item additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
detail
udi
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:udi		0..*	Reference(Resource)	STU3: Unique Device Identifier additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
subDetail
udi
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:udi		0..*	Reference(Resource)	STU3: Unique Device Identifier additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Claim		0..*	Claim(5.0.0)	Claim, Pre-determination or Pre-authorization
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:meta		0..1	Meta	STU3: meta additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.meta Constraints: ext-1
versionId	Σ	0..1	id	Version specific identifier
lastUpdated	Σ	0..1	instant	When the resource version last changed
source	Σ	0..1	uri	Identifies where the resource comes from
profile	Σ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
security	Σ	0..*	Coding	Security Labels applied to this resource Binding: AllSecurityLabels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag	Σ	0..*	Coding	Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: AllLanguages (required): IETF language tag for a human language Additional Bindings Purpose CommonLanguages Starter
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:text		0..1	(Complex)	STU3: text additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.text Constraints: ext-1
status		1..1	code	generated | extensions | additional | empty Binding: NarrativeStatus (required): The status of a resource narrative.
div	C	1..1	xhtml	Limited xhtml content Constraints: txt-1, txt-2
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:organization		0..1	Reference(Cross-version Profile for STU3.Organization for use in FHIR R5(0.1.0) | Organization)	STU3: Responsible organization (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.organization Constraints: ext-1
extension:employmentImpacted		0..1	Period	STU3: Period unable to work (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.employmentImpacted Constraints: ext-1
extension:hospitalization		0..1	Period	STU3: Period in hospital (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.hospitalization Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored Constraints: ext-1
identifier		0..*	Identifier	Business Identifier for claim
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:identifier		0..*	Identifier	STU3: Claim number additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.identifier Constraints: ext-1
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: IdentifierTypeCodes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	0..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	ΣC	0..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
traceNumber		0..*	Identifier	Number for tracking
status	?!Σ	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
type	Σ	1..1	CodeableConcept	Category or discipline Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim.
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:type		0..1	CodeableConcept	STU3: Type or discipline URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.type Binding: ClaimTypeCodes (required): The type or discipline-style of the claim Constraints: ext-1
coding	Σ	0..*	Coding	Code defined by a terminology system
text	Σ	0..1	string	Plain text representation of the concept
subType		0..1	CodeableConcept	More granular claim type Binding: ExampleClaimSubTypeCodes (example): A more granular claim typecode.
use	Σ	1..1	code	claim | preauthorization | predetermination Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim.
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:use		0..1	code	STU3: complete | proposed | exploratory | other URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.use Binding: R3ClaimUseForR5 (0.1.0) (required): Complete, proposed, exploratory, other Constraints: ext-1
value		0..1	code	Primitive value for code
patient	Σ	1..1	Reference(Patient)	The recipient of the products and services
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:patient		0..1	Reference(Resource)	STU3: The subject of the Products and Services additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
billablePeriod	Σ	0..1	Period	Relevant time frame for the claim
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:billablePeriod		0..1	Period	STU3: Period for charge submission additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.billablePeriod Constraints: ext-1
start	ΣC	0..1	dateTime	Starting time with inclusive boundary
end	ΣC	0..1	dateTime	End time with inclusive boundary, if not ongoing
created	Σ	1..1	dateTime	Resource creation date
enterer		0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Author of the claim
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:enterer		0..1	Reference(Resource)	STU3: Author additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
insurer	Σ	0..1	Reference(Organization)	Target
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:insurer		0..1	Reference(Resource)	STU3: insurer additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
provider	Σ	0..1	Reference(Practitioner | PractitionerRole | Organization)	Party responsible for the claim
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:provider		0..1	Reference(Resource)	STU3: Responsible provider additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
priority	Σ	0..1	CodeableConcept	Desired processing urgency Binding: ProcessPriorityCodes (example): The timeliness with which processing is required: stat, normal, deferred.
fundsReserve		0..1	CodeableConcept	For whom to reserve funds Binding: FundsReservationCodes (example): For whom funds are to be reserved: (Patient, Provider, None).
related		0..*	BackboneElement	Prior or corollary claims
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
claim		0..1	Reference(Claim)	Reference to the related claim
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:claim		0..1	Reference(Resource)	STU3: claim additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
relationship		0..1	CodeableConcept	How the reference claim is related Binding: ExampleRelatedClaimRelationshipCodes (example): Relationship of this claim to a related Claim.
reference		0..1	Identifier	File or case reference
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:reference		0..1	Identifier	STU3: Related file or case reference additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.related.reference Constraints: ext-1
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: IdentifierTypeCodes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	0..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	ΣC	0..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
prescription		0..1	Reference(DeviceRequest | MedicationRequest | VisionPrescription)	Prescription authorizing services and products
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:prescription		0..1	Reference(Resource)	STU3: Prescription authorizing services or products additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
originalPrescription		0..1	Reference(DeviceRequest | MedicationRequest | VisionPrescription)	Original prescription if superseded by fulfiller
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:originalPrescription		0..1	Reference(Resource)	STU3: Original prescription if superceded by fulfiller additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
payee		0..1	BackboneElement	Recipient of benefits payable
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
type		1..1	CodeableConcept	Category of recipient Binding: ClaimPayeeTypeCodes (example): A code for the party to be reimbursed.
party		0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson)	Recipient reference
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:resourceType		0..1	Coding	STU3: organization | patient | practitioner | relatedperson additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.payee.resourceType Binding: R3ExPayeeResourceTypeForR5 (0.1.0) (example): The type of Claim payee Resource Constraints: ext-1
extension:party		0..1	Reference(Resource)	STU3: Party to receive the payable URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
referral		0..1	Reference(ServiceRequest)	Treatment referral
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:referral		0..1	Reference(Resource)	STU3: Treatment Referral additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
encounter		0..*	Reference(Encounter)	Encounters associated with the listed treatments
facility		0..1	Reference(Location | Organization)	Servicing facility
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:facility		0..1	Reference(Resource)	STU3: Servicing Facility additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
diagnosisRelatedGroup		0..1	CodeableConcept	Package billing code Binding: ExampleDiagnosisRelatedGroupCodes (example)
event		0..*	BackboneElement	Event information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
type		1..1	CodeableConcept	Specific event Binding: DatesTypeCodes (example)
when[x]		1..1		Occurance date or period
whenDateTime			dateTime
whenPeriod			Period
careTeam		0..*	BackboneElement	Members of the care team
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
sequence		1..1	positiveInt	Order of care team
provider		1..1	Reference(Practitioner | PractitionerRole | Organization)	Practitioner or organization
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:provider		0..1	Reference(Resource)	STU3: Provider individual or organization additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
responsible		0..1	boolean	Indicator of the lead practitioner
role		0..1	CodeableConcept	Function within the team Binding: ClaimCareTeamRoleCodes (example): The role codes for the care team members.
specialty		0..1	CodeableConcept	Practitioner or provider specialization Binding: ExampleProviderQualificationCodes (example)
supportingInfo		0..*	BackboneElement	Supporting information
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:timing		0..1	Period	STU3: timing additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.information.timing Constraints: ext-1
extension:value		0..1	Attachment	STU3: Additional Data or supporting information additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.information.value Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
sequence		1..1	positiveInt	Information instance identifier
category		1..1	CodeableConcept	Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes.
code		0..1	CodeableConcept	Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes.
timing[x]		0..1		When it occurred
timingDate			date
timingPeriod			Period
value[x]		0..1		Data to be provided
value[x]All Types				Content/Rules for all Types
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
extension:alternateReference		0..1	Reference(Resource)	STU3: Additional Data or supporting information additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
valueBoolean			boolean
valueString			string
valueQuantity			Quantity
valueAttachment			Attachment
valueReference			Reference(Resource)
valueIdentifier			Identifier
reason		0..1	CodeableConcept	Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.
diagnosis		0..*	BackboneElement	Pertinent diagnosis information
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:packageCode		0..1	CodeableConcept	STU3: Package billing code (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.diagnosis.packageCode Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
sequence		1..1	positiveInt	Diagnosis instance identifier
diagnosis[x]		1..1		Nature of illness or problem Binding: ICD10Codes (example): Example ICD10 Diagnostic codes.
diagnosis[x]All Types				Content/Rules for all Types
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:alternateReference		0..1	Reference(Resource)	STU3: Patient's diagnosis additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
diagnosisCodeableConcept			CodeableConcept
diagnosisReference			Reference(Condition)
type		0..*	CodeableConcept	Timing or nature of the diagnosis Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge.
onAdmission		0..1	CodeableConcept	Present on admission Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.
procedure		0..*	BackboneElement	Clinical procedures performed
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
sequence		1..1	positiveInt	Procedure instance identifier
type		0..*	CodeableConcept	Category of Procedure Binding: ExampleProcedureTypeCodes (example): Example procedure type codes.
date		0..1	dateTime	When the procedure was performed
procedure[x]		1..1		Specific clinical procedure Binding: ICD10ProcedureCodes (example): Example ICD10 Procedure codes.
procedure[x]All Types				Content/Rules for all Types
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:alternateReference		0..1	Reference(Resource)	STU3: Patient's list of procedures performed additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
procedureCodeableConcept			CodeableConcept
procedureReference			Reference(Procedure)
udi		0..*	Reference(Device)	Unique device identifier
insurance	Σ	0..*	BackboneElement	Patient insurance information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
sequence	Σ	1..1	positiveInt	Insurance instance identifier
focal	Σ	1..1	boolean	Coverage to be used for adjudication
identifier		0..1	Identifier	Pre-assigned Claim number
coverage	Σ	1..1	Reference(Coverage)	Insurance information
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:coverage		0..1	Reference(Resource)	STU3: coverage additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
businessArrangement		0..1	string	Additional provider contract number
preAuthRef		0..*	string	Prior authorization reference number
claimResponse		0..1	Reference(ClaimResponse)	Adjudication results
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:claimResponse		0..1	Reference(Resource)	STU3: claimResponse additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
accident		0..1	BackboneElement	Details of the event
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:location		0..1	Address	STU3: Accident Place additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.accident.location Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
date		1..1	date	When the incident occurred
type		0..1	CodeableConcept	The nature of the accident Binding: ActIncidentCode (3.0.0) (extensible): Type of accident: work place, auto, etc.
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:type		0..1	CodeableConcept	​STU3: type URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.accident.type Binding: http://terminology.hl7.org/ValueSet/v3-ActIncidentCode|2.0.0 (required): Type of accident: work place, auto, etc. Constraints: ext-1
coding	Σ	0..*	Coding	Code defined by a terminology system
text	Σ	0..1	string	Plain text representation of the concept
location[x]		0..1		Where the event occurred
location[x]All Types				Content/Rules for all Types
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
extension:alternateReference		0..1	Reference(Resource)	STU3: Accident Place additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
locationAddress			Address
locationReference			Reference(Location)
patientPaid		0..1	Money	Paid by the patient
item		0..*	BackboneElement	Product or service provided
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:serviced		0..1	Period	STU3: Date or dates of Service additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.item.serviced Constraints: ext-1
extension:location		0..1	Address	STU3: Place of service additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.item.location Constraints: ext-1
extension:subSite		0..*	CodeableConcept	STU3: Service Sub-location (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.item.subSite Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
sequence		1..1	positiveInt	Item instance identifier
traceNumber		0..*	Identifier	Number for tracking
careTeamSequence		0..*	positiveInt	Applicable careTeam members
diagnosisSequence		0..*	positiveInt	Applicable diagnoses
procedureSequence		0..*	positiveInt	Applicable procedures
informationSequence		0..*	positiveInt	Applicable exception and supporting information
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		0..1	CodeableConcept	Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
productOrService		0..1	CodeableConcept	Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes.
productOrServiceEnd		0..1	CodeableConcept	End of a range of codes Binding: USCLSCodes (example)
request		0..*	Reference(DeviceRequest | MedicationRequest | NutritionOrder | ServiceRequest | SupplyRequest | VisionPrescription)	Request or Referral for Service
modifier		0..*	CodeableConcept	Product or service billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
programCode		0..*	CodeableConcept	Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
serviced[x]		0..1		Date or dates of service or product delivery
servicedDate			date
servicedPeriod			Period
location[x]		0..1		Place of service or where product was supplied Binding: ExampleServicePlaceCodes (example): Place of service: pharmacy, school, prison, etc.
location[x]All Types				Content/Rules for all Types
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
extension:alternateReference		0..1	Reference(Resource)	STU3: Place of service additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
locationCodeableConcept			CodeableConcept
locationAddress			Address
locationReference			Reference(Location)
patientPaid		0..1	Money	Paid by the patient
quantity		0..1	SimpleQuantity(5.0.0)	Count of products or services
unitPrice		0..1	Money	Fee, charge or cost per item
factor		0..1	decimal	Price scaling factor
tax		0..1	Money	Total tax
net		0..1	Money	Total item cost
udi		0..*	Reference(Device)	Unique device identifier
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:udi		0..1	Reference(Resource)	STU3: Unique Device Identifier additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
bodySite		0..*	BackboneElement	Anatomical location
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
site		1..*	CodeableReference(BodyStructure)	Location Binding: OralSiteCodes (example)
subSite		0..*	CodeableConcept	Sub-location Binding: SurfaceCodes (example)
encounter		0..*	Reference(Encounter)	Encounters associated with the listed treatments
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:encounter		0..1	Reference(Resource)	STU3: Encounters related to this billed item additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
detail		0..*	BackboneElement	Product or service provided
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
sequence		1..1	positiveInt	Item instance identifier
traceNumber		0..*	Identifier	Number for tracking
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		0..1	CodeableConcept	Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
productOrService		0..1	CodeableConcept	Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes.
productOrServiceEnd		0..1	CodeableConcept	End of a range of codes Binding: USCLSCodes (example)
modifier		0..*	CodeableConcept	Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
programCode		0..*	CodeableConcept	Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
patientPaid		0..1	Money	Paid by the patient
quantity		0..1	SimpleQuantity(5.0.0)	Count of products or services
unitPrice		0..1	Money	Fee, charge or cost per item
factor		0..1	decimal	Price scaling factor
tax		0..1	Money	Total tax
net		0..1	Money	Total item cost
udi		0..*	Reference(Device)	Unique device identifier
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:udi		0..1	Reference(Resource)	STU3: Unique Device Identifier additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
subDetail		0..*	BackboneElement	Product or service provided
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
sequence		1..1	positiveInt	Item instance identifier
traceNumber		0..*	Identifier	Number for tracking
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		0..1	CodeableConcept	Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
productOrService		0..1	CodeableConcept	Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes.
productOrServiceEnd		0..1	CodeableConcept	End of a range of codes Binding: USCLSCodes (example)
modifier		0..*	CodeableConcept	Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
programCode		0..*	CodeableConcept	Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
patientPaid		0..1	Money	Paid by the patient
quantity		0..1	SimpleQuantity(5.0.0)	Count of products or services
unitPrice		0..1	Money	Fee, charge or cost per item
factor		0..1	decimal	Price scaling factor
tax		0..1	Money	Total tax
net		0..1	Money	Total item cost
udi		0..*	Reference(Device)	Unique device identifier
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:udi		0..1	Reference(Resource)	STU3: Unique Device Identifier additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
total		0..1	Money	Total claim cost
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Claim.meta.security	Base	extensible	All Security Labels	📍5.0.0	tx.fhir.org
Claim.meta.tag	Base	example	Common Tags	📍5.0.0	FHIR Std.
Claim.language	Base	required	All Languages	📍5.0.0	FHIR Std.
Claim.text.status	Base	required	NarrativeStatus	📍5.0.0	FHIR Std.
Claim.identifier.use	Base	required	IdentifierUse	📍5.0.0	FHIR Std.
Claim.identifier.type	Base	extensible	Identifier Type Codes	📍5.0.0	FHIR Std.
Claim.status	Base	required	Financial Resource Status Codes	📍5.0.0	FHIR Std.
Claim.type	Base	extensible	Claim Type Codes	📍5.0.0	FHIR Std.
Claim.subType	Base	example	Example Claim SubType Codes	📍5.0.0	FHIR Std.
Claim.use	Base	required	Use	📍5.0.0	tx.fhir.org
Claim.patient.type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org
Claim.enterer.type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org
Claim.insurer.type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org
Claim.provider.type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org
Claim.priority	Base	example	Process Priority Codes	📍5.0.0	FHIR Std.
Claim.fundsReserve	Base	example	Funds Reservation Codes	📍5.0.0	FHIR Std.
Claim.related.claim.​type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org
Claim.related.relationship	Base	example	Example Related Claim Relationship Codes	📍5.0.0	FHIR Std.
Claim.related.reference.​use	Base	required	IdentifierUse	📍5.0.0	FHIR Std.
Claim.related.reference.​type	Base	extensible	Identifier Type Codes	📍5.0.0	FHIR Std.
Claim.prescription.type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org
Claim.originalPrescription.​type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org
Claim.payee.type	Base	example	Claim Payee Type Codes	📍5.0.0	FHIR Std.
Claim.payee.party.type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org
Claim.referral.type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org
Claim.facility.type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org
Claim.diagnosisRelatedGroup	Base	example	Example Diagnosis Related Group Codes	📍5.0.0	FHIR Std.
Claim.event.type	Base	example	Dates Type Codes	📍5.0.0	FHIR Std.
Claim.careTeam.provider.​type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org
Claim.careTeam.role	Base	example	Claim Care Team Role Codes	📍5.0.0	FHIR Std.
Claim.careTeam.specialty	Base	example	Example Provider Qualification Codes	📍5.0.0	FHIR Std.
Claim.supportingInfo.​category	Base	example	Claim Information Category Codes	📍5.0.0	FHIR Std.
Claim.supportingInfo.​code	Base	example	Exception Codes	📍5.0.0	FHIR Std.
Claim.supportingInfo.​reason	Base	example	Missing Tooth Reason Codes	📍5.0.0	FHIR Std.
Claim.diagnosis.diagnosis[x]	Base	example	ICD-10 Codes	📍5.0.0	FHIR Std.
Claim.diagnosis.type	Base	example	Example Diagnosis Type Codes	📍5.0.0	FHIR Std.
Claim.diagnosis.onAdmission	Base	example	Example Diagnosis on Admission Codes	📍5.0.0	FHIR Std.
Claim.procedure.type	Base	example	Example Procedure Type Codes	📍5.0.0	FHIR Std.
Claim.procedure.procedure[x]	Base	example	ICD-10 Procedure Codes	📍5.0.0	FHIR Std.
Claim.insurance.coverage.​type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org
Claim.insurance.claimResponse.​type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org
Claim.accident.type	Base	extensible	ActIncidentCode	📍3.0.0	THO v7.1
Claim.item.revenue	Base	example	Example Revenue Center Codes	📍5.0.0	FHIR Std.
Claim.item.category	Base	example	Benefit Category Codes	📍5.0.0	FHIR Std.
Claim.item.productOrService	Base	example	USCLS Codes	📍5.0.0	FHIR Std.
Claim.item.productOrServiceEnd	Base	example	USCLS Codes	📍5.0.0	FHIR Std.
Claim.item.modifier	Base	example	Modifier type Codes	📍5.0.0	FHIR Std.
Claim.item.programCode	Base	example	Example Program Reason Codes	📍5.0.0	FHIR Std.
Claim.item.location[x]	Base	example	Example Service Place Codes	📍5.0.0	FHIR Std.
Claim.item.udi.type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org
Claim.item.bodySite.​site	Base	example	Oral Site Codes	📍5.0.0	FHIR Std.
Claim.item.bodySite.​subSite	Base	example	Surface Codes	📍5.0.0	FHIR Std.
Claim.item.encounter.​type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org
Claim.item.detail.revenue	Base	example	Example Revenue Center Codes	📍5.0.0	FHIR Std.
Claim.item.detail.category	Base	example	Benefit Category Codes	📍5.0.0	FHIR Std.
Claim.item.detail.productOrService	Base	example	USCLS Codes	📍5.0.0	FHIR Std.
Claim.item.detail.productOrServiceEnd	Base	example	USCLS Codes	📍5.0.0	FHIR Std.
Claim.item.detail.modifier	Base	example	Modifier type Codes	📍5.0.0	FHIR Std.
Claim.item.detail.programCode	Base	example	Example Program Reason Codes	📍5.0.0	FHIR Std.
Claim.item.detail.udi.​type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org
Claim.item.detail.subDetail.​revenue	Base	example	Example Revenue Center Codes	📍5.0.0	FHIR Std.
Claim.item.detail.subDetail.​category	Base	example	Benefit Category Codes	📍5.0.0	FHIR Std.
Claim.item.detail.subDetail.​productOrService	Base	example	USCLS Codes	📍5.0.0	FHIR Std.
Claim.item.detail.subDetail.​productOrServiceEnd	Base	example	USCLS Codes	📍5.0.0	FHIR Std.
Claim.item.detail.subDetail.​modifier	Base	example	Modifier type Codes	📍5.0.0	FHIR Std.
Claim.item.detail.subDetail.​programCode	Base	example	Example Program Reason Codes	📍5.0.0	FHIR Std.
Claim.item.detail.subDetail.​udi.type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Claim	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Claim	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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Claim	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	error	Claim	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Claim	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	Claim.meta, Claim.meta.extension, Claim.meta.extension:meta, Claim.meta.versionId, Claim.meta.lastUpdated, Claim.meta.source, Claim.meta.profile, Claim.meta.security, Claim.meta.tag, Claim.implicitRules, Claim.language, Claim.text, Claim.text.extension, Claim.text.extension:text, Claim.text.status, Claim.text.div, Claim.extension, Claim.extension:organization, Claim.extension:employmentImpacted, Claim.extension:hospitalization, Claim.modifierExtension, Claim.identifier, Claim.identifier.extension, Claim.identifier.extension:identifier, Claim.identifier.use, Claim.identifier.type, Claim.identifier.system, Claim.identifier.value, Claim.identifier.period, Claim.identifier.assigner, Claim.traceNumber, Claim.status, Claim.type, Claim.type.extension, Claim.type.extension:type, Claim.type.coding, Claim.type.text, Claim.subType, Claim.use, Claim.use.extension, Claim.use.extension:use, Claim.patient, Claim.patient.extension, Claim.patient.extension:patient, Claim.patient.reference, Claim.patient.type, Claim.patient.identifier, Claim.patient.display, Claim.billablePeriod, Claim.billablePeriod.extension, Claim.billablePeriod.extension:billablePeriod, Claim.billablePeriod.start, Claim.billablePeriod.end, Claim.created, Claim.enterer, Claim.enterer.extension, Claim.enterer.extension:enterer, Claim.enterer.reference, Claim.enterer.type, Claim.enterer.identifier, Claim.enterer.display, Claim.insurer, Claim.insurer.extension, Claim.insurer.extension:insurer, Claim.insurer.reference, Claim.insurer.type, Claim.insurer.identifier, Claim.insurer.display, Claim.provider, Claim.provider.extension, Claim.provider.extension:provider, Claim.provider.reference, Claim.provider.type, Claim.provider.identifier, Claim.provider.display, Claim.priority, Claim.fundsReserve, Claim.related, Claim.related.extension, Claim.related.modifierExtension, Claim.related.claim, Claim.related.claim.extension, Claim.related.claim.extension:claim, Claim.related.claim.reference, Claim.related.claim.type, Claim.related.claim.identifier, Claim.related.claim.display, Claim.related.relationship, Claim.related.reference, Claim.related.reference.extension, Claim.related.reference.extension:reference, Claim.related.reference.use, Claim.related.reference.type, Claim.related.reference.system, Claim.related.reference.value, Claim.related.reference.period, Claim.related.reference.assigner, Claim.prescription, Claim.prescription.extension, Claim.prescription.extension:prescription, Claim.prescription.reference, Claim.prescription.type, Claim.prescription.identifier, Claim.prescription.display, Claim.originalPrescription, Claim.originalPrescription.extension, Claim.originalPrescription.extension:originalPrescription, Claim.originalPrescription.reference, Claim.originalPrescription.type, Claim.originalPrescription.identifier, Claim.originalPrescription.display, Claim.payee, Claim.payee.extension, Claim.payee.modifierExtension, Claim.payee.type, Claim.payee.party, Claim.payee.party.extension, Claim.payee.party.extension:resourceType, Claim.payee.party.extension:party, Claim.payee.party.reference, Claim.payee.party.type, Claim.payee.party.identifier, Claim.payee.party.display, Claim.referral, Claim.referral.extension, Claim.referral.extension:referral, Claim.referral.reference, Claim.referral.type, Claim.referral.identifier, Claim.referral.display, Claim.encounter, Claim.facility, Claim.facility.extension, Claim.facility.extension:facility, Claim.facility.reference, Claim.facility.type, Claim.facility.identifier, Claim.facility.display, Claim.diagnosisRelatedGroup, Claim.event, Claim.event.extension, Claim.event.modifierExtension, Claim.event.type, Claim.event.when[x], Claim.careTeam, Claim.careTeam.extension, Claim.careTeam.modifierExtension, Claim.careTeam.sequence, Claim.careTeam.provider, Claim.careTeam.provider.extension, Claim.careTeam.provider.extension:provider, Claim.careTeam.provider.reference, Claim.careTeam.provider.type, Claim.careTeam.provider.identifier, Claim.careTeam.provider.display, Claim.careTeam.responsible, Claim.careTeam.role, Claim.careTeam.specialty, Claim.supportingInfo, Claim.supportingInfo.extension, Claim.supportingInfo.extension:timing, Claim.supportingInfo.extension:value, Claim.supportingInfo.modifierExtension, Claim.supportingInfo.sequence, Claim.supportingInfo.category, Claim.supportingInfo.code, Claim.supportingInfo.timing[x], Claim.supportingInfo.value[x], Claim.supportingInfo.value[x].extension, Claim.supportingInfo.value[x].extension:alternateReference, Claim.supportingInfo.reason, Claim.diagnosis, Claim.diagnosis.extension, Claim.diagnosis.extension:packageCode, Claim.diagnosis.modifierExtension, Claim.diagnosis.sequence, Claim.diagnosis.diagnosis[x], Claim.diagnosis.diagnosis[x].extension, Claim.diagnosis.diagnosis[x].extension:alternateReference, Claim.diagnosis.type, Claim.diagnosis.onAdmission, Claim.procedure, Claim.procedure.extension, Claim.procedure.modifierExtension, Claim.procedure.sequence, Claim.procedure.type, Claim.procedure.date, Claim.procedure.procedure[x], Claim.procedure.procedure[x].extension, Claim.procedure.procedure[x].extension:alternateReference, Claim.procedure.udi, Claim.insurance, Claim.insurance.extension, Claim.insurance.modifierExtension, Claim.insurance.sequence, Claim.insurance.focal, Claim.insurance.identifier, Claim.insurance.coverage, Claim.insurance.coverage.extension, Claim.insurance.coverage.extension:coverage, Claim.insurance.coverage.reference, Claim.insurance.coverage.type, Claim.insurance.coverage.identifier, Claim.insurance.coverage.display, Claim.insurance.businessArrangement, Claim.insurance.preAuthRef, Claim.insurance.claimResponse, Claim.insurance.claimResponse.extension, Claim.insurance.claimResponse.extension:claimResponse, Claim.insurance.claimResponse.reference, Claim.insurance.claimResponse.type, Claim.insurance.claimResponse.identifier, Claim.insurance.claimResponse.display, Claim.accident, Claim.accident.extension, Claim.accident.extension:location, Claim.accident.modifierExtension, Claim.accident.date, Claim.accident.type, Claim.accident.type.extension, Claim.accident.type.extension:type, Claim.accident.type.coding, Claim.accident.type.text, Claim.accident.location[x], Claim.accident.location[x].extension, Claim.accident.location[x].extension:alternateReference, Claim.patientPaid, Claim.item, Claim.item.extension, Claim.item.extension:serviced, Claim.item.extension:location, Claim.item.extension:subSite, Claim.item.modifierExtension, Claim.item.sequence, Claim.item.traceNumber, Claim.item.careTeamSequence, Claim.item.diagnosisSequence, Claim.item.procedureSequence, Claim.item.informationSequence, Claim.item.revenue, Claim.item.category, Claim.item.productOrService, Claim.item.productOrServiceEnd, Claim.item.request, Claim.item.modifier, Claim.item.programCode, Claim.item.serviced[x], Claim.item.location[x], Claim.item.location[x].extension, Claim.item.location[x].extension:alternateReference, Claim.item.patientPaid, Claim.item.quantity, Claim.item.unitPrice, Claim.item.factor, Claim.item.tax, Claim.item.net, Claim.item.udi, Claim.item.udi.extension, Claim.item.udi.extension:udi, Claim.item.udi.reference, Claim.item.udi.type, Claim.item.udi.identifier, Claim.item.udi.display, Claim.item.bodySite, Claim.item.bodySite.extension, Claim.item.bodySite.modifierExtension, Claim.item.bodySite.site, Claim.item.bodySite.subSite, Claim.item.encounter, Claim.item.encounter.extension, Claim.item.encounter.extension:encounter, Claim.item.encounter.reference, Claim.item.encounter.type, Claim.item.encounter.identifier, Claim.item.encounter.display, Claim.item.detail, Claim.item.detail.extension, Claim.item.detail.modifierExtension, Claim.item.detail.sequence, Claim.item.detail.traceNumber, Claim.item.detail.revenue, Claim.item.detail.category, Claim.item.detail.productOrService, Claim.item.detail.productOrServiceEnd, Claim.item.detail.modifier, Claim.item.detail.programCode, Claim.item.detail.patientPaid, Claim.item.detail.quantity, Claim.item.detail.unitPrice, Claim.item.detail.factor, Claim.item.detail.tax, Claim.item.detail.net, Claim.item.detail.udi, Claim.item.detail.udi.extension, Claim.item.detail.udi.extension:udi, Claim.item.detail.udi.reference, Claim.item.detail.udi.type, Claim.item.detail.udi.identifier, Claim.item.detail.udi.display, Claim.item.detail.subDetail, Claim.item.detail.subDetail.extension, Claim.item.detail.subDetail.modifierExtension, Claim.item.detail.subDetail.sequence, Claim.item.detail.subDetail.traceNumber, Claim.item.detail.subDetail.revenue, Claim.item.detail.subDetail.category, Claim.item.detail.subDetail.productOrService, Claim.item.detail.subDetail.productOrServiceEnd, Claim.item.detail.subDetail.modifier, Claim.item.detail.subDetail.programCode, Claim.item.detail.subDetail.patientPaid, Claim.item.detail.subDetail.quantity, Claim.item.detail.subDetail.unitPrice, Claim.item.detail.subDetail.factor, Claim.item.detail.subDetail.tax, Claim.item.detail.subDetail.net, Claim.item.detail.subDetail.udi, Claim.item.detail.subDetail.udi.extension, Claim.item.detail.subDetail.udi.extension:udi, Claim.item.detail.subDetail.udi.reference, Claim.item.detail.subDetail.udi.type, Claim.item.detail.subDetail.udi.identifier, Claim.item.detail.subDetail.udi.display, Claim.total	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	Claim.meta.extension, Claim.meta.extension:meta, Claim.text.extension, Claim.text.extension:text, Claim.extension, Claim.extension:organization, Claim.extension:employmentImpacted, Claim.extension:hospitalization, Claim.modifierExtension, Claim.identifier.extension, Claim.identifier.extension:identifier, Claim.type.extension, Claim.type.extension:type, Claim.use.extension, Claim.use.extension:use, Claim.patient.extension, Claim.patient.extension:patient, Claim.billablePeriod.extension, Claim.billablePeriod.extension:billablePeriod, Claim.enterer.extension, Claim.enterer.extension:enterer, Claim.insurer.extension, Claim.insurer.extension:insurer, Claim.provider.extension, Claim.provider.extension:provider, Claim.related.extension, Claim.related.modifierExtension, Claim.related.claim.extension, Claim.related.claim.extension:claim, Claim.related.reference.extension, Claim.related.reference.extension:reference, Claim.prescription.extension, Claim.prescription.extension:prescription, Claim.originalPrescription.extension, Claim.originalPrescription.extension:originalPrescription, Claim.payee.extension, Claim.payee.modifierExtension, Claim.payee.party.extension, Claim.payee.party.extension:resourceType, Claim.payee.party.extension:party, Claim.referral.extension, Claim.referral.extension:referral, Claim.facility.extension, Claim.facility.extension:facility, Claim.event.extension, Claim.event.modifierExtension, Claim.careTeam.extension, Claim.careTeam.modifierExtension, Claim.careTeam.provider.extension, Claim.careTeam.provider.extension:provider, Claim.supportingInfo.extension, Claim.supportingInfo.extension:timing, Claim.supportingInfo.extension:value, Claim.supportingInfo.modifierExtension, Claim.supportingInfo.value[x].extension, Claim.supportingInfo.value[x].extension:alternateReference, Claim.diagnosis.extension, Claim.diagnosis.extension:packageCode, Claim.diagnosis.modifierExtension, Claim.diagnosis.diagnosis[x].extension, Claim.diagnosis.diagnosis[x].extension:alternateReference, Claim.procedure.extension, Claim.procedure.modifierExtension, Claim.procedure.procedure[x].extension, Claim.procedure.procedure[x].extension:alternateReference, Claim.insurance.extension, Claim.insurance.modifierExtension, Claim.insurance.coverage.extension, Claim.insurance.coverage.extension:coverage, Claim.insurance.claimResponse.extension, Claim.insurance.claimResponse.extension:claimResponse, Claim.accident.extension, Claim.accident.extension:location, Claim.accident.modifierExtension, Claim.accident.type.extension, Claim.accident.type.extension:type, Claim.accident.location[x].extension, Claim.accident.location[x].extension:alternateReference, Claim.item.extension, Claim.item.extension:serviced, Claim.item.extension:location, Claim.item.extension:subSite, Claim.item.modifierExtension, Claim.item.location[x].extension, Claim.item.location[x].extension:alternateReference, Claim.item.udi.extension, Claim.item.udi.extension:udi, Claim.item.bodySite.extension, Claim.item.bodySite.modifierExtension, Claim.item.encounter.extension, Claim.item.encounter.extension:encounter, Claim.item.detail.extension, Claim.item.detail.modifierExtension, Claim.item.detail.udi.extension, Claim.item.detail.udi.extension:udi, Claim.item.detail.subDetail.extension, Claim.item.detail.subDetail.modifierExtension, Claim.item.detail.subDetail.udi.extension, Claim.item.detail.subDetail.udi.extension:udi	Must have either extensions or value[x], not both	extension.exists() != value.exists()
txt-1	error	Claim.text.div	The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes	htmlChecks()
txt-2	error	Claim.text.div	The narrative SHALL have some non-whitespace content	htmlChecks()

This structure is derived from Claim

Summary

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.meta|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.text|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.organization|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.employmentImpacted|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.hospitalization|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.identifier|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.type|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.use|0.1.0
• http://hl7.org/fhir/StructureDefinition/alternate-reference|5.2.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.billablePeriod|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.related.reference|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.payee.resourceType|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.information.timing|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.information.value|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.diagnosis.packageCode|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.accident.location|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.accident.type|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.item.serviced|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.item.location|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.item.subSite|0.1.0

Maturity: 0

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Claim		0..*	Claim(5.0.0)	Claim, Pre-determination or Pre-authorization
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:organization		0..1	Reference(Cross-version Profile for STU3.Organization for use in FHIR R5(0.1.0) | Organization)	STU3: Responsible organization (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.organization Constraints: ext-1
extension:employmentImpacted		0..1	Period	STU3: Period unable to work (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.employmentImpacted Constraints: ext-1
extension:hospitalization		0..1	Period	STU3: Period in hospital (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.hospitalization Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored Constraints: ext-1
status	?!Σ	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
type	Σ	1..1	CodeableConcept	Category or discipline Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim.
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:type		0..1	CodeableConcept	STU3: Type or discipline URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.type Binding: ClaimTypeCodes (required): The type or discipline-style of the claim Constraints: ext-1
use	Σ	1..1	code	claim | preauthorization | predetermination Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim.
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:use		0..1	code	STU3: complete | proposed | exploratory | other URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.use Binding: R3ClaimUseForR5 (0.1.0) (required): Complete, proposed, exploratory, other Constraints: ext-1
patient	Σ	1..1	Reference(Patient)	The recipient of the products and services
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:patient		0..1	Reference(Resource)	STU3: The subject of the Products and Services additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
created	Σ	1..1	dateTime	Resource creation date
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Claim.status	Base	required	Financial Resource Status Codes	📍5.0.0	FHIR Std.
Claim.type	Base	extensible	Claim Type Codes	📍5.0.0	FHIR Std.
Claim.use	Base	required	Use	📍5.0.0	tx.fhir.org

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Claim	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Claim	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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Claim	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	error	Claim	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Claim	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	Claim.implicitRules, Claim.extension, Claim.extension:organization, Claim.extension:employmentImpacted, Claim.extension:hospitalization, Claim.modifierExtension, Claim.status, Claim.type, Claim.type.extension, Claim.type.extension:type, Claim.use, Claim.use.extension, Claim.use.extension:use, Claim.patient, Claim.patient.extension, Claim.patient.extension:patient, Claim.patient.reference, Claim.created	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	Claim.extension, Claim.extension:organization, Claim.extension:employmentImpacted, Claim.extension:hospitalization, Claim.modifierExtension, Claim.type.extension, Claim.type.extension:type, Claim.use.extension, Claim.use.extension:use, Claim.patient.extension, Claim.patient.extension:patient	Must have either extensions or value[x], not both	extension.exists() != value.exists()

Differential View

This structure is derived from Claim

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Claim		0..*	Claim(5.0.0)	Claim, Pre-determination or Pre-authorization
meta
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:meta		0..1	Meta	STU3: meta additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.meta
text
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:text		0..1	(Complex)	STU3: text additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.text
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:organization		0..1	Reference(Cross-version Profile for STU3.Organization for use in FHIR R5(0.1.0) | Organization)	STU3: Responsible organization (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.organization
extension:employmentImpacted		0..1	Period	STU3: Period unable to work (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.employmentImpacted
extension:hospitalization		0..1	Period	STU3: Period in hospital (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.hospitalization
identifier
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:identifier		0..*	Identifier	STU3: Claim number additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.identifier
type
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:type		0..1	CodeableConcept	STU3: Type or discipline URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.type Binding: ClaimTypeCodes (required): The type or discipline-style of the claim
use
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:use		0..1	code	STU3: complete | proposed | exploratory | other URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.use Binding: R3ClaimUseForR5 (0.1.0) (required): Complete, proposed, exploratory, other
patient
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:patient		0..1	Reference(Resource)	STU3: The subject of the Products and Services additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
billablePeriod
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:billablePeriod		0..1	Period	STU3: Period for charge submission additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.billablePeriod
enterer
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:enterer		0..1	Reference(Resource)	STU3: Author additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
insurer
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:insurer		0..1	Reference(Resource)	STU3: insurer additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
provider
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:provider		0..1	Reference(Resource)	STU3: Responsible provider additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
related
claim
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:claim		0..1	Reference(Resource)	STU3: claim additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:reference		0..1	Identifier	STU3: Related file or case reference additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.related.reference
prescription
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:prescription		0..1	Reference(Resource)	STU3: Prescription authorizing services or products additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
originalPrescription
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:originalPrescription		0..1	Reference(Resource)	STU3: Original prescription if superceded by fulfiller additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
payee
party
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:resourceType		0..1	Coding	STU3: organization | patient | practitioner | relatedperson additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.payee.resourceType Binding: R3ExPayeeResourceTypeForR5 (0.1.0) (example): The type of Claim payee Resource
extension:party		0..1	Reference(Resource)	STU3: Party to receive the payable URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
referral
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:referral		0..1	Reference(Resource)	STU3: Treatment Referral additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
facility
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:facility		0..1	Reference(Resource)	STU3: Servicing Facility additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
careTeam
provider
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:provider		0..1	Reference(Resource)	STU3: Provider individual or organization additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
supportingInfo
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:timing		0..1	Period	STU3: timing additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.information.timing
extension:value		0..1	Attachment	STU3: Additional Data or supporting information additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.information.value
valueReference
Slices for extension				Content/Rules for all slices
extension:alternateReference		0..1	Reference(Resource)	STU3: Additional Data or supporting information additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
diagnosis
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:packageCode		0..1	CodeableConcept	STU3: Package billing code (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.diagnosis.packageCode Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis
diagnosisReference
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:alternateReference		0..1	Reference(Resource)	STU3: Patient's diagnosis additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
procedure
procedureReference
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:alternateReference		0..1	Reference(Resource)	STU3: Patient's list of procedures performed additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
insurance
coverage
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:coverage		0..1	Reference(Resource)	STU3: coverage additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
claimResponse
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:claimResponse		0..1	Reference(Resource)	STU3: claimResponse additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
accident
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:location		0..1	Address	STU3: Accident Place additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.accident.location
type
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:type		0..1	CodeableConcept	​STU3: type URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.accident.type Binding: http://terminology.hl7.org/ValueSet/v3-ActIncidentCode|2.0.0 (required): Type of accident: work place, auto, etc.
locationReference
Slices for extension				Content/Rules for all slices
extension:alternateReference		0..1	Reference(Resource)	STU3: Accident Place additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
item
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:serviced		0..1	Period	STU3: Date or dates of Service additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.item.serviced
extension:location		0..1	Address	STU3: Place of service additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.item.location
extension:subSite		0..*	CodeableConcept	STU3: Service Sub-location (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.item.subSite Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations
locationReference
Slices for extension				Content/Rules for all slices
extension:alternateReference		0..1	Reference(Resource)	STU3: Place of service additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
udi
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:udi		0..*	Reference(Resource)	STU3: Unique Device Identifier additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
encounter
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:encounter		0..*	Reference(Resource)	STU3: Encounters related to this billed item additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
detail
udi
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:udi		0..*	Reference(Resource)	STU3: Unique Device Identifier additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
subDetail
udi
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:udi		0..*	Reference(Resource)	STU3: Unique Device Identifier additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
Documentation for this format

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Claim		0..*	Claim(5.0.0)	Claim, Pre-determination or Pre-authorization
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:meta		0..1	Meta	STU3: meta additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.meta Constraints: ext-1
versionId	Σ	0..1	id	Version specific identifier
lastUpdated	Σ	0..1	instant	When the resource version last changed
source	Σ	0..1	uri	Identifies where the resource comes from
profile	Σ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
security	Σ	0..*	Coding	Security Labels applied to this resource Binding: AllSecurityLabels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag	Σ	0..*	Coding	Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: AllLanguages (required): IETF language tag for a human language Additional Bindings Purpose CommonLanguages Starter
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:text		0..1	(Complex)	STU3: text additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.text Constraints: ext-1
status		1..1	code	generated | extensions | additional | empty Binding: NarrativeStatus (required): The status of a resource narrative.
div	C	1..1	xhtml	Limited xhtml content Constraints: txt-1, txt-2
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:organization		0..1	Reference(Cross-version Profile for STU3.Organization for use in FHIR R5(0.1.0) | Organization)	STU3: Responsible organization (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.organization Constraints: ext-1
extension:employmentImpacted		0..1	Period	STU3: Period unable to work (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.employmentImpacted Constraints: ext-1
extension:hospitalization		0..1	Period	STU3: Period in hospital (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.hospitalization Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored Constraints: ext-1
identifier		0..*	Identifier	Business Identifier for claim
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:identifier		0..*	Identifier	STU3: Claim number additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.identifier Constraints: ext-1
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: IdentifierTypeCodes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	0..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	ΣC	0..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
traceNumber		0..*	Identifier	Number for tracking
status	?!Σ	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
type	Σ	1..1	CodeableConcept	Category or discipline Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim.
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:type		0..1	CodeableConcept	STU3: Type or discipline URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.type Binding: ClaimTypeCodes (required): The type or discipline-style of the claim Constraints: ext-1
coding	Σ	0..*	Coding	Code defined by a terminology system
text	Σ	0..1	string	Plain text representation of the concept
subType		0..1	CodeableConcept	More granular claim type Binding: ExampleClaimSubTypeCodes (example): A more granular claim typecode.
use	Σ	1..1	code	claim | preauthorization | predetermination Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim.
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:use		0..1	code	STU3: complete | proposed | exploratory | other URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.use Binding: R3ClaimUseForR5 (0.1.0) (required): Complete, proposed, exploratory, other Constraints: ext-1
value		0..1	code	Primitive value for code
patient	Σ	1..1	Reference(Patient)	The recipient of the products and services
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:patient		0..1	Reference(Resource)	STU3: The subject of the Products and Services additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
billablePeriod	Σ	0..1	Period	Relevant time frame for the claim
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:billablePeriod		0..1	Period	STU3: Period for charge submission additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.billablePeriod Constraints: ext-1
start	ΣC	0..1	dateTime	Starting time with inclusive boundary
end	ΣC	0..1	dateTime	End time with inclusive boundary, if not ongoing
created	Σ	1..1	dateTime	Resource creation date
enterer		0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Author of the claim
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:enterer		0..1	Reference(Resource)	STU3: Author additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
insurer	Σ	0..1	Reference(Organization)	Target
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:insurer		0..1	Reference(Resource)	STU3: insurer additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
provider	Σ	0..1	Reference(Practitioner | PractitionerRole | Organization)	Party responsible for the claim
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:provider		0..1	Reference(Resource)	STU3: Responsible provider additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
priority	Σ	0..1	CodeableConcept	Desired processing urgency Binding: ProcessPriorityCodes (example): The timeliness with which processing is required: stat, normal, deferred.
fundsReserve		0..1	CodeableConcept	For whom to reserve funds Binding: FundsReservationCodes (example): For whom funds are to be reserved: (Patient, Provider, None).
related		0..*	BackboneElement	Prior or corollary claims
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
claim		0..1	Reference(Claim)	Reference to the related claim
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:claim		0..1	Reference(Resource)	STU3: claim additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
relationship		0..1	CodeableConcept	How the reference claim is related Binding: ExampleRelatedClaimRelationshipCodes (example): Relationship of this claim to a related Claim.
reference		0..1	Identifier	File or case reference
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:reference		0..1	Identifier	STU3: Related file or case reference additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.related.reference Constraints: ext-1
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: IdentifierTypeCodes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	0..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	ΣC	0..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
prescription		0..1	Reference(DeviceRequest | MedicationRequest | VisionPrescription)	Prescription authorizing services and products
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:prescription		0..1	Reference(Resource)	STU3: Prescription authorizing services or products additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
originalPrescription		0..1	Reference(DeviceRequest | MedicationRequest | VisionPrescription)	Original prescription if superseded by fulfiller
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:originalPrescription		0..1	Reference(Resource)	STU3: Original prescription if superceded by fulfiller additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
payee		0..1	BackboneElement	Recipient of benefits payable
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
type		1..1	CodeableConcept	Category of recipient Binding: ClaimPayeeTypeCodes (example): A code for the party to be reimbursed.
party		0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson)	Recipient reference
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:resourceType		0..1	Coding	STU3: organization | patient | practitioner | relatedperson additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.payee.resourceType Binding: R3ExPayeeResourceTypeForR5 (0.1.0) (example): The type of Claim payee Resource Constraints: ext-1
extension:party		0..1	Reference(Resource)	STU3: Party to receive the payable URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
referral		0..1	Reference(ServiceRequest)	Treatment referral
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:referral		0..1	Reference(Resource)	STU3: Treatment Referral additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
encounter		0..*	Reference(Encounter)	Encounters associated with the listed treatments
facility		0..1	Reference(Location | Organization)	Servicing facility
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:facility		0..1	Reference(Resource)	STU3: Servicing Facility additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
diagnosisRelatedGroup		0..1	CodeableConcept	Package billing code Binding: ExampleDiagnosisRelatedGroupCodes (example)
event		0..*	BackboneElement	Event information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
type		1..1	CodeableConcept	Specific event Binding: DatesTypeCodes (example)
when[x]		1..1		Occurance date or period
whenDateTime			dateTime
whenPeriod			Period
careTeam		0..*	BackboneElement	Members of the care team
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
sequence		1..1	positiveInt	Order of care team
provider		1..1	Reference(Practitioner | PractitionerRole | Organization)	Practitioner or organization
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:provider		0..1	Reference(Resource)	STU3: Provider individual or organization additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
responsible		0..1	boolean	Indicator of the lead practitioner
role		0..1	CodeableConcept	Function within the team Binding: ClaimCareTeamRoleCodes (example): The role codes for the care team members.
specialty		0..1	CodeableConcept	Practitioner or provider specialization Binding: ExampleProviderQualificationCodes (example)
supportingInfo		0..*	BackboneElement	Supporting information
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:timing		0..1	Period	STU3: timing additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.information.timing Constraints: ext-1
extension:value		0..1	Attachment	STU3: Additional Data or supporting information additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.information.value Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
sequence		1..1	positiveInt	Information instance identifier
category		1..1	CodeableConcept	Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes.
code		0..1	CodeableConcept	Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes.
timing[x]		0..1		When it occurred
timingDate			date
timingPeriod			Period
value[x]		0..1		Data to be provided
value[x]All Types				Content/Rules for all Types
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
extension:alternateReference		0..1	Reference(Resource)	STU3: Additional Data or supporting information additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
valueBoolean			boolean
valueString			string
valueQuantity			Quantity
valueAttachment			Attachment
valueReference			Reference(Resource)
valueIdentifier			Identifier
reason		0..1	CodeableConcept	Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.
diagnosis		0..*	BackboneElement	Pertinent diagnosis information
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:packageCode		0..1	CodeableConcept	STU3: Package billing code (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.diagnosis.packageCode Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
sequence		1..1	positiveInt	Diagnosis instance identifier
diagnosis[x]		1..1		Nature of illness or problem Binding: ICD10Codes (example): Example ICD10 Diagnostic codes.
diagnosis[x]All Types				Content/Rules for all Types
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:alternateReference		0..1	Reference(Resource)	STU3: Patient's diagnosis additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
diagnosisCodeableConcept			CodeableConcept
diagnosisReference			Reference(Condition)
type		0..*	CodeableConcept	Timing or nature of the diagnosis Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge.
onAdmission		0..1	CodeableConcept	Present on admission Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.
procedure		0..*	BackboneElement	Clinical procedures performed
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
sequence		1..1	positiveInt	Procedure instance identifier
type		0..*	CodeableConcept	Category of Procedure Binding: ExampleProcedureTypeCodes (example): Example procedure type codes.
date		0..1	dateTime	When the procedure was performed
procedure[x]		1..1		Specific clinical procedure Binding: ICD10ProcedureCodes (example): Example ICD10 Procedure codes.
procedure[x]All Types				Content/Rules for all Types
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:alternateReference		0..1	Reference(Resource)	STU3: Patient's list of procedures performed additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
procedureCodeableConcept			CodeableConcept
procedureReference			Reference(Procedure)
udi		0..*	Reference(Device)	Unique device identifier
insurance	Σ	0..*	BackboneElement	Patient insurance information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
sequence	Σ	1..1	positiveInt	Insurance instance identifier
focal	Σ	1..1	boolean	Coverage to be used for adjudication
identifier		0..1	Identifier	Pre-assigned Claim number
coverage	Σ	1..1	Reference(Coverage)	Insurance information
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:coverage		0..1	Reference(Resource)	STU3: coverage additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
businessArrangement		0..1	string	Additional provider contract number
preAuthRef		0..*	string	Prior authorization reference number
claimResponse		0..1	Reference(ClaimResponse)	Adjudication results
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:claimResponse		0..1	Reference(Resource)	STU3: claimResponse additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
accident		0..1	BackboneElement	Details of the event
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:location		0..1	Address	STU3: Accident Place additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.accident.location Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
date		1..1	date	When the incident occurred
type		0..1	CodeableConcept	The nature of the accident Binding: ActIncidentCode (3.0.0) (extensible): Type of accident: work place, auto, etc.
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:type		0..1	CodeableConcept	​STU3: type URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.accident.type Binding: http://terminology.hl7.org/ValueSet/v3-ActIncidentCode|2.0.0 (required): Type of accident: work place, auto, etc. Constraints: ext-1
coding	Σ	0..*	Coding	Code defined by a terminology system
text	Σ	0..1	string	Plain text representation of the concept
location[x]		0..1		Where the event occurred
location[x]All Types				Content/Rules for all Types
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
extension:alternateReference		0..1	Reference(Resource)	STU3: Accident Place additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
locationAddress			Address
locationReference			Reference(Location)
patientPaid		0..1	Money	Paid by the patient
item		0..*	BackboneElement	Product or service provided
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:serviced		0..1	Period	STU3: Date or dates of Service additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.item.serviced Constraints: ext-1
extension:location		0..1	Address	STU3: Place of service additional types URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.item.location Constraints: ext-1
extension:subSite		0..*	CodeableConcept	STU3: Service Sub-location (new) URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.item.subSite Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
sequence		1..1	positiveInt	Item instance identifier
traceNumber		0..*	Identifier	Number for tracking
careTeamSequence		0..*	positiveInt	Applicable careTeam members
diagnosisSequence		0..*	positiveInt	Applicable diagnoses
procedureSequence		0..*	positiveInt	Applicable procedures
informationSequence		0..*	positiveInt	Applicable exception and supporting information
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		0..1	CodeableConcept	Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
productOrService		0..1	CodeableConcept	Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes.
productOrServiceEnd		0..1	CodeableConcept	End of a range of codes Binding: USCLSCodes (example)
request		0..*	Reference(DeviceRequest | MedicationRequest | NutritionOrder | ServiceRequest | SupplyRequest | VisionPrescription)	Request or Referral for Service
modifier		0..*	CodeableConcept	Product or service billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
programCode		0..*	CodeableConcept	Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
serviced[x]		0..1		Date or dates of service or product delivery
servicedDate			date
servicedPeriod			Period
location[x]		0..1		Place of service or where product was supplied Binding: ExampleServicePlaceCodes (example): Place of service: pharmacy, school, prison, etc.
location[x]All Types				Content/Rules for all Types
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
extension:alternateReference		0..1	Reference(Resource)	STU3: Place of service additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
locationCodeableConcept			CodeableConcept
locationAddress			Address
locationReference			Reference(Location)
patientPaid		0..1	Money	Paid by the patient
quantity		0..1	SimpleQuantity(5.0.0)	Count of products or services
unitPrice		0..1	Money	Fee, charge or cost per item
factor		0..1	decimal	Price scaling factor
tax		0..1	Money	Total tax
net		0..1	Money	Total item cost
udi		0..*	Reference(Device)	Unique device identifier
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:udi		0..1	Reference(Resource)	STU3: Unique Device Identifier additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
bodySite		0..*	BackboneElement	Anatomical location
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
site		1..*	CodeableReference(BodyStructure)	Location Binding: OralSiteCodes (example)
subSite		0..*	CodeableConcept	Sub-location Binding: SurfaceCodes (example)
encounter		0..*	Reference(Encounter)	Encounters associated with the listed treatments
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:encounter		0..1	Reference(Resource)	STU3: Encounters related to this billed item additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
detail		0..*	BackboneElement	Product or service provided
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
sequence		1..1	positiveInt	Item instance identifier
traceNumber		0..*	Identifier	Number for tracking
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		0..1	CodeableConcept	Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
productOrService		0..1	CodeableConcept	Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes.
productOrServiceEnd		0..1	CodeableConcept	End of a range of codes Binding: USCLSCodes (example)
modifier		0..*	CodeableConcept	Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
programCode		0..*	CodeableConcept	Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
patientPaid		0..1	Money	Paid by the patient
quantity		0..1	SimpleQuantity(5.0.0)	Count of products or services
unitPrice		0..1	Money	Fee, charge or cost per item
factor		0..1	decimal	Price scaling factor
tax		0..1	Money	Total tax
net		0..1	Money	Total item cost
udi		0..*	Reference(Device)	Unique device identifier
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:udi		0..1	Reference(Resource)	STU3: Unique Device Identifier additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
subDetail		0..*	BackboneElement	Product or service provided
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
sequence		1..1	positiveInt	Item instance identifier
traceNumber		0..*	Identifier	Number for tracking
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		0..1	CodeableConcept	Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
productOrService		0..1	CodeableConcept	Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes.
productOrServiceEnd		0..1	CodeableConcept	End of a range of codes Binding: USCLSCodes (example)
modifier		0..*	CodeableConcept	Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
programCode		0..*	CodeableConcept	Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
patientPaid		0..1	Money	Paid by the patient
quantity		0..1	SimpleQuantity(5.0.0)	Count of products or services
unitPrice		0..1	Money	Fee, charge or cost per item
factor		0..1	decimal	Price scaling factor
tax		0..1	Money	Total tax
net		0..1	Money	Total item cost
udi		0..*	Reference(Device)	Unique device identifier
id		0..1	id	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:udi		0..1	Reference(Resource)	STU3: Unique Device Identifier additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference Constraints: ext-1
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	0..1	Identifier	Logical reference, when literal reference is not known
display	ΣC	0..1	string	Text alternative for the resource
total		0..1	Money	Total claim cost
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Claim.meta.security	Base	extensible	All Security Labels	📍5.0.0	tx.fhir.org
Claim.meta.tag	Base	example	Common Tags	📍5.0.0	FHIR Std.
Claim.language	Base	required	All Languages	📍5.0.0	FHIR Std.
Claim.text.status	Base	required	NarrativeStatus	📍5.0.0	FHIR Std.
Claim.identifier.use	Base	required	IdentifierUse	📍5.0.0	FHIR Std.
Claim.identifier.type	Base	extensible	Identifier Type Codes	📍5.0.0	FHIR Std.
Claim.status	Base	required	Financial Resource Status Codes	📍5.0.0	FHIR Std.
Claim.type	Base	extensible	Claim Type Codes	📍5.0.0	FHIR Std.
Claim.subType	Base	example	Example Claim SubType Codes	📍5.0.0	FHIR Std.
Claim.use	Base	required	Use	📍5.0.0	tx.fhir.org
Claim.patient.type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org
Claim.enterer.type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org
Claim.insurer.type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org
Claim.provider.type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org
Claim.priority	Base	example	Process Priority Codes	📍5.0.0	FHIR Std.
Claim.fundsReserve	Base	example	Funds Reservation Codes	📍5.0.0	FHIR Std.
Claim.related.claim.​type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org
Claim.related.relationship	Base	example	Example Related Claim Relationship Codes	📍5.0.0	FHIR Std.
Claim.related.reference.​use	Base	required	IdentifierUse	📍5.0.0	FHIR Std.
Claim.related.reference.​type	Base	extensible	Identifier Type Codes	📍5.0.0	FHIR Std.
Claim.prescription.type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org
Claim.originalPrescription.​type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org
Claim.payee.type	Base	example	Claim Payee Type Codes	📍5.0.0	FHIR Std.
Claim.payee.party.type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org
Claim.referral.type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org
Claim.facility.type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org
Claim.diagnosisRelatedGroup	Base	example	Example Diagnosis Related Group Codes	📍5.0.0	FHIR Std.
Claim.event.type	Base	example	Dates Type Codes	📍5.0.0	FHIR Std.
Claim.careTeam.provider.​type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org
Claim.careTeam.role	Base	example	Claim Care Team Role Codes	📍5.0.0	FHIR Std.
Claim.careTeam.specialty	Base	example	Example Provider Qualification Codes	📍5.0.0	FHIR Std.
Claim.supportingInfo.​category	Base	example	Claim Information Category Codes	📍5.0.0	FHIR Std.
Claim.supportingInfo.​code	Base	example	Exception Codes	📍5.0.0	FHIR Std.
Claim.supportingInfo.​reason	Base	example	Missing Tooth Reason Codes	📍5.0.0	FHIR Std.
Claim.diagnosis.diagnosis[x]	Base	example	ICD-10 Codes	📍5.0.0	FHIR Std.
Claim.diagnosis.type	Base	example	Example Diagnosis Type Codes	📍5.0.0	FHIR Std.
Claim.diagnosis.onAdmission	Base	example	Example Diagnosis on Admission Codes	📍5.0.0	FHIR Std.
Claim.procedure.type	Base	example	Example Procedure Type Codes	📍5.0.0	FHIR Std.
Claim.procedure.procedure[x]	Base	example	ICD-10 Procedure Codes	📍5.0.0	FHIR Std.
Claim.insurance.coverage.​type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org
Claim.insurance.claimResponse.​type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org
Claim.accident.type	Base	extensible	ActIncidentCode	📍3.0.0	THO v7.1
Claim.item.revenue	Base	example	Example Revenue Center Codes	📍5.0.0	FHIR Std.
Claim.item.category	Base	example	Benefit Category Codes	📍5.0.0	FHIR Std.
Claim.item.productOrService	Base	example	USCLS Codes	📍5.0.0	FHIR Std.
Claim.item.productOrServiceEnd	Base	example	USCLS Codes	📍5.0.0	FHIR Std.
Claim.item.modifier	Base	example	Modifier type Codes	📍5.0.0	FHIR Std.
Claim.item.programCode	Base	example	Example Program Reason Codes	📍5.0.0	FHIR Std.
Claim.item.location[x]	Base	example	Example Service Place Codes	📍5.0.0	FHIR Std.
Claim.item.udi.type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org
Claim.item.bodySite.​site	Base	example	Oral Site Codes	📍5.0.0	FHIR Std.
Claim.item.bodySite.​subSite	Base	example	Surface Codes	📍5.0.0	FHIR Std.
Claim.item.encounter.​type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org
Claim.item.detail.revenue	Base	example	Example Revenue Center Codes	📍5.0.0	FHIR Std.
Claim.item.detail.category	Base	example	Benefit Category Codes	📍5.0.0	FHIR Std.
Claim.item.detail.productOrService	Base	example	USCLS Codes	📍5.0.0	FHIR Std.
Claim.item.detail.productOrServiceEnd	Base	example	USCLS Codes	📍5.0.0	FHIR Std.
Claim.item.detail.modifier	Base	example	Modifier type Codes	📍5.0.0	FHIR Std.
Claim.item.detail.programCode	Base	example	Example Program Reason Codes	📍5.0.0	FHIR Std.
Claim.item.detail.udi.​type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org
Claim.item.detail.subDetail.​revenue	Base	example	Example Revenue Center Codes	📍5.0.0	FHIR Std.
Claim.item.detail.subDetail.​category	Base	example	Benefit Category Codes	📍5.0.0	FHIR Std.
Claim.item.detail.subDetail.​productOrService	Base	example	USCLS Codes	📍5.0.0	FHIR Std.
Claim.item.detail.subDetail.​productOrServiceEnd	Base	example	USCLS Codes	📍5.0.0	FHIR Std.
Claim.item.detail.subDetail.​modifier	Base	example	Modifier type Codes	📍5.0.0	FHIR Std.
Claim.item.detail.subDetail.​programCode	Base	example	Example Program Reason Codes	📍5.0.0	FHIR Std.
Claim.item.detail.subDetail.​udi.type	Base	extensible	Resource Types	📍5.0.0	tx.fhir.org

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Claim	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Claim	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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Claim	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	error	Claim	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Claim	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	Claim.meta, Claim.meta.extension, Claim.meta.extension:meta, Claim.meta.versionId, Claim.meta.lastUpdated, Claim.meta.source, Claim.meta.profile, Claim.meta.security, Claim.meta.tag, Claim.implicitRules, Claim.language, Claim.text, Claim.text.extension, Claim.text.extension:text, Claim.text.status, Claim.text.div, Claim.extension, Claim.extension:organization, Claim.extension:employmentImpacted, Claim.extension:hospitalization, Claim.modifierExtension, Claim.identifier, Claim.identifier.extension, Claim.identifier.extension:identifier, Claim.identifier.use, Claim.identifier.type, Claim.identifier.system, Claim.identifier.value, Claim.identifier.period, Claim.identifier.assigner, Claim.traceNumber, Claim.status, Claim.type, Claim.type.extension, Claim.type.extension:type, Claim.type.coding, Claim.type.text, Claim.subType, Claim.use, Claim.use.extension, Claim.use.extension:use, Claim.patient, Claim.patient.extension, Claim.patient.extension:patient, Claim.patient.reference, Claim.patient.type, Claim.patient.identifier, Claim.patient.display, Claim.billablePeriod, Claim.billablePeriod.extension, Claim.billablePeriod.extension:billablePeriod, Claim.billablePeriod.start, Claim.billablePeriod.end, Claim.created, Claim.enterer, Claim.enterer.extension, Claim.enterer.extension:enterer, Claim.enterer.reference, Claim.enterer.type, Claim.enterer.identifier, Claim.enterer.display, Claim.insurer, Claim.insurer.extension, Claim.insurer.extension:insurer, Claim.insurer.reference, Claim.insurer.type, Claim.insurer.identifier, Claim.insurer.display, Claim.provider, Claim.provider.extension, Claim.provider.extension:provider, Claim.provider.reference, Claim.provider.type, Claim.provider.identifier, Claim.provider.display, Claim.priority, Claim.fundsReserve, Claim.related, Claim.related.extension, Claim.related.modifierExtension, Claim.related.claim, Claim.related.claim.extension, Claim.related.claim.extension:claim, Claim.related.claim.reference, Claim.related.claim.type, Claim.related.claim.identifier, Claim.related.claim.display, Claim.related.relationship, Claim.related.reference, Claim.related.reference.extension, Claim.related.reference.extension:reference, Claim.related.reference.use, Claim.related.reference.type, Claim.related.reference.system, Claim.related.reference.value, Claim.related.reference.period, Claim.related.reference.assigner, Claim.prescription, Claim.prescription.extension, Claim.prescription.extension:prescription, Claim.prescription.reference, Claim.prescription.type, Claim.prescription.identifier, Claim.prescription.display, Claim.originalPrescription, Claim.originalPrescription.extension, Claim.originalPrescription.extension:originalPrescription, Claim.originalPrescription.reference, Claim.originalPrescription.type, Claim.originalPrescription.identifier, Claim.originalPrescription.display, Claim.payee, Claim.payee.extension, Claim.payee.modifierExtension, Claim.payee.type, Claim.payee.party, Claim.payee.party.extension, Claim.payee.party.extension:resourceType, Claim.payee.party.extension:party, Claim.payee.party.reference, Claim.payee.party.type, Claim.payee.party.identifier, Claim.payee.party.display, Claim.referral, Claim.referral.extension, Claim.referral.extension:referral, Claim.referral.reference, Claim.referral.type, Claim.referral.identifier, Claim.referral.display, Claim.encounter, Claim.facility, Claim.facility.extension, Claim.facility.extension:facility, Claim.facility.reference, Claim.facility.type, Claim.facility.identifier, Claim.facility.display, Claim.diagnosisRelatedGroup, Claim.event, Claim.event.extension, Claim.event.modifierExtension, Claim.event.type, Claim.event.when[x], Claim.careTeam, Claim.careTeam.extension, Claim.careTeam.modifierExtension, Claim.careTeam.sequence, Claim.careTeam.provider, Claim.careTeam.provider.extension, Claim.careTeam.provider.extension:provider, Claim.careTeam.provider.reference, Claim.careTeam.provider.type, Claim.careTeam.provider.identifier, Claim.careTeam.provider.display, Claim.careTeam.responsible, Claim.careTeam.role, Claim.careTeam.specialty, Claim.supportingInfo, Claim.supportingInfo.extension, Claim.supportingInfo.extension:timing, Claim.supportingInfo.extension:value, Claim.supportingInfo.modifierExtension, Claim.supportingInfo.sequence, Claim.supportingInfo.category, Claim.supportingInfo.code, Claim.supportingInfo.timing[x], Claim.supportingInfo.value[x], Claim.supportingInfo.value[x].extension, Claim.supportingInfo.value[x].extension:alternateReference, Claim.supportingInfo.reason, Claim.diagnosis, Claim.diagnosis.extension, Claim.diagnosis.extension:packageCode, Claim.diagnosis.modifierExtension, Claim.diagnosis.sequence, Claim.diagnosis.diagnosis[x], Claim.diagnosis.diagnosis[x].extension, Claim.diagnosis.diagnosis[x].extension:alternateReference, Claim.diagnosis.type, Claim.diagnosis.onAdmission, Claim.procedure, Claim.procedure.extension, Claim.procedure.modifierExtension, Claim.procedure.sequence, Claim.procedure.type, Claim.procedure.date, Claim.procedure.procedure[x], Claim.procedure.procedure[x].extension, Claim.procedure.procedure[x].extension:alternateReference, Claim.procedure.udi, Claim.insurance, Claim.insurance.extension, Claim.insurance.modifierExtension, Claim.insurance.sequence, Claim.insurance.focal, Claim.insurance.identifier, Claim.insurance.coverage, Claim.insurance.coverage.extension, Claim.insurance.coverage.extension:coverage, Claim.insurance.coverage.reference, Claim.insurance.coverage.type, Claim.insurance.coverage.identifier, Claim.insurance.coverage.display, Claim.insurance.businessArrangement, Claim.insurance.preAuthRef, Claim.insurance.claimResponse, Claim.insurance.claimResponse.extension, Claim.insurance.claimResponse.extension:claimResponse, Claim.insurance.claimResponse.reference, Claim.insurance.claimResponse.type, Claim.insurance.claimResponse.identifier, Claim.insurance.claimResponse.display, Claim.accident, Claim.accident.extension, Claim.accident.extension:location, Claim.accident.modifierExtension, Claim.accident.date, Claim.accident.type, Claim.accident.type.extension, Claim.accident.type.extension:type, Claim.accident.type.coding, Claim.accident.type.text, Claim.accident.location[x], Claim.accident.location[x].extension, Claim.accident.location[x].extension:alternateReference, Claim.patientPaid, Claim.item, Claim.item.extension, Claim.item.extension:serviced, Claim.item.extension:location, Claim.item.extension:subSite, Claim.item.modifierExtension, Claim.item.sequence, Claim.item.traceNumber, Claim.item.careTeamSequence, Claim.item.diagnosisSequence, Claim.item.procedureSequence, Claim.item.informationSequence, Claim.item.revenue, Claim.item.category, Claim.item.productOrService, Claim.item.productOrServiceEnd, Claim.item.request, Claim.item.modifier, Claim.item.programCode, Claim.item.serviced[x], Claim.item.location[x], Claim.item.location[x].extension, Claim.item.location[x].extension:alternateReference, Claim.item.patientPaid, Claim.item.quantity, Claim.item.unitPrice, Claim.item.factor, Claim.item.tax, Claim.item.net, Claim.item.udi, Claim.item.udi.extension, Claim.item.udi.extension:udi, Claim.item.udi.reference, Claim.item.udi.type, Claim.item.udi.identifier, Claim.item.udi.display, Claim.item.bodySite, Claim.item.bodySite.extension, Claim.item.bodySite.modifierExtension, Claim.item.bodySite.site, Claim.item.bodySite.subSite, Claim.item.encounter, Claim.item.encounter.extension, Claim.item.encounter.extension:encounter, Claim.item.encounter.reference, Claim.item.encounter.type, Claim.item.encounter.identifier, Claim.item.encounter.display, Claim.item.detail, Claim.item.detail.extension, Claim.item.detail.modifierExtension, Claim.item.detail.sequence, Claim.item.detail.traceNumber, Claim.item.detail.revenue, Claim.item.detail.category, Claim.item.detail.productOrService, Claim.item.detail.productOrServiceEnd, Claim.item.detail.modifier, Claim.item.detail.programCode, Claim.item.detail.patientPaid, Claim.item.detail.quantity, Claim.item.detail.unitPrice, Claim.item.detail.factor, Claim.item.detail.tax, Claim.item.detail.net, Claim.item.detail.udi, Claim.item.detail.udi.extension, Claim.item.detail.udi.extension:udi, Claim.item.detail.udi.reference, Claim.item.detail.udi.type, Claim.item.detail.udi.identifier, Claim.item.detail.udi.display, Claim.item.detail.subDetail, Claim.item.detail.subDetail.extension, Claim.item.detail.subDetail.modifierExtension, Claim.item.detail.subDetail.sequence, Claim.item.detail.subDetail.traceNumber, Claim.item.detail.subDetail.revenue, Claim.item.detail.subDetail.category, Claim.item.detail.subDetail.productOrService, Claim.item.detail.subDetail.productOrServiceEnd, Claim.item.detail.subDetail.modifier, Claim.item.detail.subDetail.programCode, Claim.item.detail.subDetail.patientPaid, Claim.item.detail.subDetail.quantity, Claim.item.detail.subDetail.unitPrice, Claim.item.detail.subDetail.factor, Claim.item.detail.subDetail.tax, Claim.item.detail.subDetail.net, Claim.item.detail.subDetail.udi, Claim.item.detail.subDetail.udi.extension, Claim.item.detail.subDetail.udi.extension:udi, Claim.item.detail.subDetail.udi.reference, Claim.item.detail.subDetail.udi.type, Claim.item.detail.subDetail.udi.identifier, Claim.item.detail.subDetail.udi.display, Claim.total	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	Claim.meta.extension, Claim.meta.extension:meta, Claim.text.extension, Claim.text.extension:text, Claim.extension, Claim.extension:organization, Claim.extension:employmentImpacted, Claim.extension:hospitalization, Claim.modifierExtension, Claim.identifier.extension, Claim.identifier.extension:identifier, Claim.type.extension, Claim.type.extension:type, Claim.use.extension, Claim.use.extension:use, Claim.patient.extension, Claim.patient.extension:patient, Claim.billablePeriod.extension, Claim.billablePeriod.extension:billablePeriod, Claim.enterer.extension, Claim.enterer.extension:enterer, Claim.insurer.extension, Claim.insurer.extension:insurer, Claim.provider.extension, Claim.provider.extension:provider, Claim.related.extension, Claim.related.modifierExtension, Claim.related.claim.extension, Claim.related.claim.extension:claim, Claim.related.reference.extension, Claim.related.reference.extension:reference, Claim.prescription.extension, Claim.prescription.extension:prescription, Claim.originalPrescription.extension, Claim.originalPrescription.extension:originalPrescription, Claim.payee.extension, Claim.payee.modifierExtension, Claim.payee.party.extension, Claim.payee.party.extension:resourceType, Claim.payee.party.extension:party, Claim.referral.extension, Claim.referral.extension:referral, Claim.facility.extension, Claim.facility.extension:facility, Claim.event.extension, Claim.event.modifierExtension, Claim.careTeam.extension, Claim.careTeam.modifierExtension, Claim.careTeam.provider.extension, Claim.careTeam.provider.extension:provider, Claim.supportingInfo.extension, Claim.supportingInfo.extension:timing, Claim.supportingInfo.extension:value, Claim.supportingInfo.modifierExtension, Claim.supportingInfo.value[x].extension, Claim.supportingInfo.value[x].extension:alternateReference, Claim.diagnosis.extension, Claim.diagnosis.extension:packageCode, Claim.diagnosis.modifierExtension, Claim.diagnosis.diagnosis[x].extension, Claim.diagnosis.diagnosis[x].extension:alternateReference, Claim.procedure.extension, Claim.procedure.modifierExtension, Claim.procedure.procedure[x].extension, Claim.procedure.procedure[x].extension:alternateReference, Claim.insurance.extension, Claim.insurance.modifierExtension, Claim.insurance.coverage.extension, Claim.insurance.coverage.extension:coverage, Claim.insurance.claimResponse.extension, Claim.insurance.claimResponse.extension:claimResponse, Claim.accident.extension, Claim.accident.extension:location, Claim.accident.modifierExtension, Claim.accident.type.extension, Claim.accident.type.extension:type, Claim.accident.location[x].extension, Claim.accident.location[x].extension:alternateReference, Claim.item.extension, Claim.item.extension:serviced, Claim.item.extension:location, Claim.item.extension:subSite, Claim.item.modifierExtension, Claim.item.location[x].extension, Claim.item.location[x].extension:alternateReference, Claim.item.udi.extension, Claim.item.udi.extension:udi, Claim.item.bodySite.extension, Claim.item.bodySite.modifierExtension, Claim.item.encounter.extension, Claim.item.encounter.extension:encounter, Claim.item.detail.extension, Claim.item.detail.modifierExtension, Claim.item.detail.udi.extension, Claim.item.detail.udi.extension:udi, Claim.item.detail.subDetail.extension, Claim.item.detail.subDetail.modifierExtension, Claim.item.detail.subDetail.udi.extension, Claim.item.detail.subDetail.udi.extension:udi	Must have either extensions or value[x], not both	extension.exists() != value.exists()
txt-1	error	Claim.text.div	The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes	htmlChecks()
txt-2	error	Claim.text.div	The narrative SHALL have some non-whitespace content	htmlChecks()

This structure is derived from Claim

Summary

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.meta|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.text|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.organization|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.employmentImpacted|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.hospitalization|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.identifier|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.type|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.use|0.1.0
• http://hl7.org/fhir/StructureDefinition/alternate-reference|5.2.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.billablePeriod|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.related.reference|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.payee.resourceType|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.information.timing|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.information.value|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.diagnosis.packageCode|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.accident.location|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.accident.type|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.item.serviced|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.item.location|0.1.0
• http://hl7.org/fhir/3.0/StructureDefinition/extension-Claim.item.subSite|0.1.0

Maturity: 0