Extensions for Using Data Elements from FHIR R4 in FHIR STU3
0.1.0 - STU International flag

Extensions for Using Data Elements from FHIR R4 in FHIR STU3 - Downloaded Version null See the Directory of published versions

Extension: ExtensionClaimResponse_Item_Adjudication - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 0

Definitions for the ext-R4-ClaimResponse.ite.adjudication extension.

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

0. Extension
Definition

R4: ClaimResponse.item.adjudication


Optional Extension Element - found in all resources.

ShortR4: adjudicationOptional Extensions Element
Comments

Element ClaimResponse.item.adjudication is mapped to FHIR STU3 element ClaimResponse.item.adjudication as Equivalent.

Control10..*
This element is affected by the following invariants: ele-1
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
2. Extension.extension
Definition

An Extension


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

ShortExtensionAdditional Content defined by implementations
Comments

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

Control10..*
TypeExtension
Alternate Namesextensions, user content
SlicingThis element introduces a set of slices on Extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 4. Extension.extension:category
    Slice Namecategory
    Definition

    R4: ClaimResponse.item.adjudication.category

    ShortR4: Type of adjudication informationAdditional Content defined by implementations
    Comments

    Element ClaimResponse.item.adjudication.category is mapped to FHIR STU3 element ClaimResponse.item.adjudication.category as Equivalent. For example codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.

    Control10..1*
    TypeExtension
    Requirements

    Needed to enable understanding of the context of the other information in the adjudication. Element ClaimResponse.item.adjudication.category is mapped to FHIR STU3 element ClaimResponse.item.adjudication.category as Equivalent.

    6. Extension.extension:category.url
    Definition

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

    Shortidentifies the meaning of the extension
    Comments

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

    Control1..1
    Typeuri
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    Fixed Valuecategory
    8. Extension.extension:category.value[x]
    Definition

    A code to indicate the information type of this adjudication record. Information types may include the value submitted, maximum values or percentages allowed or payable under the plan, amounts that: the patient is responsible for in aggregate or pertaining to this item; amounts paid by other coverages; and, the benefit payable for this item.


    Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

    ShortType of adjudication informationValue of extension
    Comments

    For example codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.

    Control10..1
    BindingFor example codes, see For codes, see http://hl7.org/fhir/uv/xver/ValueSet/R4-adjudication-for-R3
    (example to http://hl7.org/fhir/uv/xver/ValueSet/R4-adjudication-for-R3)

    The adjudication codes.

    TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    10. Extension.extension:reason
    Slice Namereason
    Definition

    R4: ClaimResponse.item.adjudication.reason

    ShortR4: Explanation of adjudication outcomeAdditional Content defined by implementations
    Comments

    Element ClaimResponse.item.adjudication.reason is mapped to FHIR STU3 element ClaimResponse.item.adjudication.reason as Equivalent. For example may indicate that the funds for this benefit type have been exhausted.

    Control0..1*
    TypeExtension
    Requirements

    To support understanding of variance from adjudication expectations. Element ClaimResponse.item.adjudication.reason is mapped to FHIR STU3 element ClaimResponse.item.adjudication.reason as Equivalent.

    12. Extension.extension:reason.url
    Definition

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

    Shortidentifies the meaning of the extension
    Comments

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

    Control1..1
    Typeuri
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    Fixed Valuereason
    14. Extension.extension:reason.value[x]
    Definition

    A code supporting the understanding of the adjudication result and explaining variance from expected amount.


    Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

    ShortExplanation of adjudication outcomeValue of extension
    Comments

    For example may indicate that the funds for this benefit type have been exhausted.

    Control0..1
    BindingFor example codes, see For codes, see Adjudication Reason Codes
    (example to http://hl7.org/fhir/ValueSet/adjudication-reason|3.0.2)

    The adjudication reason codes.

    TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    16. Extension.extension:amount
    Slice Nameamount
    Definition

    R4: ClaimResponse.item.adjudication.amount

    ShortR4: amountAdditional Content defined by implementations
    Comments

    Element ClaimResponse.item.adjudication.amount is mapped to FHIR STU3 element ClaimResponse.item.adjudication.amount as Equivalent. For example: amount submitted, eligible amount, co-payment, and benefit payable.

    Control0..1*
    TypeExtension
    Requirements

    Most adjuciation categories convey a monetary amount. Element ClaimResponse.item.adjudication.amount is mapped to FHIR STU3 element ClaimResponse.item.adjudication.amount as Equivalent.

    18. Extension.extension:amount.url
    Definition

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

    Shortidentifies the meaning of the extension
    Comments

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

    Control1..1
    Typeuri
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    Fixed Valueamount
    20. Extension.extension:amount.value[x]
    Definition

    Monetary amount associated with the category.


    Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

    ShortMonetary amountValue of extension
    Comments

    For example: amount submitted, eligible amount, co-payment, and benefit payable.

    Control0..1
    TypeMoney, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal, CodeableConcept
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    22. Extension.extension:value
    Slice Namevalue
    Definition

    R4: ClaimResponse.item.adjudication.value

    ShortR4: valueAdditional Content defined by implementations
    Comments

    Element ClaimResponse.item.adjudication.value is mapped to FHIR STU3 element ClaimResponse.item.adjudication.value as Equivalent. For example: eligible percentage or co-payment percentage.

    Control0..1*
    TypeExtension
    Requirements

    Some adjudication categories convey a percentage or a fixed value. Element ClaimResponse.item.adjudication.value is mapped to FHIR STU3 element ClaimResponse.item.adjudication.value as Equivalent.

    24. Extension.extension:value.url
    Definition

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

    Shortidentifies the meaning of the extension
    Comments

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

    Control1..1
    Typeuri
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    Fixed Valuevalue
    26. Extension.extension:value.value[x]
    Definition

    A non-monetary value associated with the category. Mutually exclusive to the amount element above.


    Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

    ShortNon-monetary valueValue of extension
    Comments

    For example: eligible percentage or co-payment percentage.

    Control0..1
    Typedecimal, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, CodeableConcept
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    28. Extension.url
    Definition

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

    Shortidentifies the meaning of the extension
    Comments

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

    Control1..1
    Typeuri
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    Fixed Valuehttp://hl7.org/fhir/4.0/StructureDefinition/extension-ClaimResponse.item.adjudication
    30. Extension.value[x]
    Definition

    Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

    ShortValue of extension
    Control0..01
    TypeChoice of: base64Binary, boolean, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, Meta
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension

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

    0. Extension
    Definition

    R4: ClaimResponse.item.adjudication

    ShortR4: adjudication
    Comments

    Element ClaimResponse.item.adjudication is mapped to FHIR STU3 element ClaimResponse.item.adjudication as Equivalent.

    Control1..*
    Is Modifierfalse
    2. Extension.extension
    Control1..*
    SlicingThis element introduces a set of slices on Extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 4. Extension.extension:category
      Slice Namecategory
      Definition

      R4: ClaimResponse.item.adjudication.category

      ShortR4: Type of adjudication information
      Comments

      Element ClaimResponse.item.adjudication.category is mapped to FHIR STU3 element ClaimResponse.item.adjudication.category as Equivalent. For example codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.

      Control1..1
      Requirements

      Needed to enable understanding of the context of the other information in the adjudication. Element ClaimResponse.item.adjudication.category is mapped to FHIR STU3 element ClaimResponse.item.adjudication.category as Equivalent.

      6. Extension.extension:category.url
      Control1..1
      Fixed Valuecategory
      8. Extension.extension:category.value[x]
      Definition

      A code to indicate the information type of this adjudication record. Information types may include the value submitted, maximum values or percentages allowed or payable under the plan, amounts that: the patient is responsible for in aggregate or pertaining to this item; amounts paid by other coverages; and, the benefit payable for this item.

      ShortType of adjudication information
      Comments

      For example codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.

      Control1..1
      BindingFor example codes, see http://hl7.org/fhir/uv/xver/ValueSet/R4-adjudication-for-R3
      (example to http://hl7.org/fhir/uv/xver/ValueSet/R4-adjudication-for-R3)

      The adjudication codes.

      TypeCodeableConcept
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      10. Extension.extension:reason
      Slice Namereason
      Definition

      R4: ClaimResponse.item.adjudication.reason

      ShortR4: Explanation of adjudication outcome
      Comments

      Element ClaimResponse.item.adjudication.reason is mapped to FHIR STU3 element ClaimResponse.item.adjudication.reason as Equivalent. For example may indicate that the funds for this benefit type have been exhausted.

      Control0..1
      Requirements

      To support understanding of variance from adjudication expectations. Element ClaimResponse.item.adjudication.reason is mapped to FHIR STU3 element ClaimResponse.item.adjudication.reason as Equivalent.

      12. Extension.extension:reason.url
      Control1..1
      Fixed Valuereason
      14. Extension.extension:reason.value[x]
      Definition

      A code supporting the understanding of the adjudication result and explaining variance from expected amount.

      ShortExplanation of adjudication outcome
      Comments

      For example may indicate that the funds for this benefit type have been exhausted.

      Control0..1
      BindingFor example codes, see Adjudication Reason Codes
      (example to http://hl7.org/fhir/ValueSet/adjudication-reason|3.0.2)

      The adjudication reason codes.

      TypeCodeableConcept
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      16. Extension.extension:amount
      Slice Nameamount
      Definition

      R4: ClaimResponse.item.adjudication.amount

      ShortR4: amount
      Comments

      Element ClaimResponse.item.adjudication.amount is mapped to FHIR STU3 element ClaimResponse.item.adjudication.amount as Equivalent. For example: amount submitted, eligible amount, co-payment, and benefit payable.

      Control0..1
      Requirements

      Most adjuciation categories convey a monetary amount. Element ClaimResponse.item.adjudication.amount is mapped to FHIR STU3 element ClaimResponse.item.adjudication.amount as Equivalent.

      18. Extension.extension:amount.url
      Control1..1
      Fixed Valueamount
      20. Extension.extension:amount.value[x]
      Definition

      Monetary amount associated with the category.

      ShortMonetary amount
      Comments

      For example: amount submitted, eligible amount, co-payment, and benefit payable.

      Control0..1
      TypeMoney
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      22. Extension.extension:value
      Slice Namevalue
      Definition

      R4: ClaimResponse.item.adjudication.value

      ShortR4: value
      Comments

      Element ClaimResponse.item.adjudication.value is mapped to FHIR STU3 element ClaimResponse.item.adjudication.value as Equivalent. For example: eligible percentage or co-payment percentage.

      Control0..1
      Requirements

      Some adjudication categories convey a percentage or a fixed value. Element ClaimResponse.item.adjudication.value is mapped to FHIR STU3 element ClaimResponse.item.adjudication.value as Equivalent.

      24. Extension.extension:value.url
      Control1..1
      Fixed Valuevalue
      26. Extension.extension:value.value[x]
      Definition

      A non-monetary value associated with the category. Mutually exclusive to the amount element above.

      ShortNon-monetary value
      Comments

      For example: eligible percentage or co-payment percentage.

      Control0..1
      Typedecimal
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      28. Extension.url
      Control1..1
      Fixed Valuehttp://hl7.org/fhir/4.0/StructureDefinition/extension-ClaimResponse.item.adjudication
      30. Extension.value[x]
      Control0..0

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

      0. Extension
      Definition

      R4: ClaimResponse.item.adjudication

      ShortR4: adjudication
      Comments

      Element ClaimResponse.item.adjudication is mapped to FHIR STU3 element ClaimResponse.item.adjudication as Equivalent.

      Control1..*
      This element is affected by the following invariants: ele-1
      Is Modifierfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      2. Extension.id
      Definition

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

      Shortxml:id (or equivalent in JSON)
      Control0..1
      Typestring
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      4. Extension.extension
      Definition

      An Extension

      ShortExtension
      Control1..*
      TypeExtension
      SlicingThis element introduces a set of slices on Extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 6. Extension.extension:category
        Slice Namecategory
        Definition

        R4: ClaimResponse.item.adjudication.category

        ShortR4: Type of adjudication information
        Comments

        Element ClaimResponse.item.adjudication.category is mapped to FHIR STU3 element ClaimResponse.item.adjudication.category as Equivalent. For example codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.

        Control1..1
        TypeExtension
        Requirements

        Needed to enable understanding of the context of the other information in the adjudication. Element ClaimResponse.item.adjudication.category is mapped to FHIR STU3 element ClaimResponse.item.adjudication.category as Equivalent.

        8. Extension.extension:category.id
        Definition

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

        Shortxml:id (or equivalent in JSON)
        Control0..1
        Typestring
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        10. Extension.extension:category.extension
        Definition

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

        ShortAdditional Content defined by implementations
        Comments

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

        Control0..*
        TypeExtension
        Alternate Namesextensions, user content
        SlicingThis element introduces a set of slices on Extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 12. Extension.extension:category.url
          Definition

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

          Shortidentifies the meaning of the extension
          Comments

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

          Control1..1
          Typeuri
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          Fixed Valuecategory
          14. Extension.extension:category.value[x]
          Definition

          A code to indicate the information type of this adjudication record. Information types may include the value submitted, maximum values or percentages allowed or payable under the plan, amounts that: the patient is responsible for in aggregate or pertaining to this item; amounts paid by other coverages; and, the benefit payable for this item.

          ShortType of adjudication information
          Comments

          For example codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc.

          Control1..1
          BindingFor example codes, see http://hl7.org/fhir/uv/xver/ValueSet/R4-adjudication-for-R3
          (example to http://hl7.org/fhir/uv/xver/ValueSet/R4-adjudication-for-R3)

          The adjudication codes.

          TypeCodeableConcept
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          16. Extension.extension:reason
          Slice Namereason
          Definition

          R4: ClaimResponse.item.adjudication.reason

          ShortR4: Explanation of adjudication outcome
          Comments

          Element ClaimResponse.item.adjudication.reason is mapped to FHIR STU3 element ClaimResponse.item.adjudication.reason as Equivalent. For example may indicate that the funds for this benefit type have been exhausted.

          Control0..1
          TypeExtension
          Requirements

          To support understanding of variance from adjudication expectations. Element ClaimResponse.item.adjudication.reason is mapped to FHIR STU3 element ClaimResponse.item.adjudication.reason as Equivalent.

          18. Extension.extension:reason.id
          Definition

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

          Shortxml:id (or equivalent in JSON)
          Control0..1
          Typestring
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          20. Extension.extension:reason.extension
          Definition

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

          ShortAdditional Content defined by implementations
          Comments

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

          Control0..*
          TypeExtension
          Alternate Namesextensions, user content
          SlicingThis element introduces a set of slices on Extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 22. Extension.extension:reason.url
            Definition

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

            Shortidentifies the meaning of the extension
            Comments

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

            Control1..1
            Typeuri
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            Fixed Valuereason
            24. Extension.extension:reason.value[x]
            Definition

            A code supporting the understanding of the adjudication result and explaining variance from expected amount.

            ShortExplanation of adjudication outcome
            Comments

            For example may indicate that the funds for this benefit type have been exhausted.

            Control0..1
            BindingFor example codes, see Adjudication Reason Codes
            (example to http://hl7.org/fhir/ValueSet/adjudication-reason|3.0.2)

            The adjudication reason codes.

            TypeCodeableConcept
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            26. Extension.extension:amount
            Slice Nameamount
            Definition

            R4: ClaimResponse.item.adjudication.amount

            ShortR4: amount
            Comments

            Element ClaimResponse.item.adjudication.amount is mapped to FHIR STU3 element ClaimResponse.item.adjudication.amount as Equivalent. For example: amount submitted, eligible amount, co-payment, and benefit payable.

            Control0..1
            TypeExtension
            Requirements

            Most adjuciation categories convey a monetary amount. Element ClaimResponse.item.adjudication.amount is mapped to FHIR STU3 element ClaimResponse.item.adjudication.amount as Equivalent.

            28. Extension.extension:amount.id
            Definition

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

            Shortxml:id (or equivalent in JSON)
            Control0..1
            Typestring
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            30. Extension.extension:amount.extension
            Definition

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

            ShortAdditional Content defined by implementations
            Comments

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

            Control0..*
            TypeExtension
            Alternate Namesextensions, user content
            SlicingThis element introduces a set of slices on Extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 32. Extension.extension:amount.url
              Definition

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

              Shortidentifies the meaning of the extension
              Comments

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

              Control1..1
              Typeuri
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Fixed Valueamount
              34. Extension.extension:amount.value[x]
              Definition

              Monetary amount associated with the category.

              ShortMonetary amount
              Comments

              For example: amount submitted, eligible amount, co-payment, and benefit payable.

              Control0..1
              TypeMoney
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              36. Extension.extension:value
              Slice Namevalue
              Definition

              R4: ClaimResponse.item.adjudication.value

              ShortR4: value
              Comments

              Element ClaimResponse.item.adjudication.value is mapped to FHIR STU3 element ClaimResponse.item.adjudication.value as Equivalent. For example: eligible percentage or co-payment percentage.

              Control0..1
              TypeExtension
              Requirements

              Some adjudication categories convey a percentage or a fixed value. Element ClaimResponse.item.adjudication.value is mapped to FHIR STU3 element ClaimResponse.item.adjudication.value as Equivalent.

              38. Extension.extension:value.id
              Definition

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

              Shortxml:id (or equivalent in JSON)
              Control0..1
              Typestring
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              40. Extension.extension:value.extension
              Definition

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

              ShortAdditional Content defined by implementations
              Comments

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

              Control0..*
              TypeExtension
              Alternate Namesextensions, user content
              SlicingThis element introduces a set of slices on Extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 42. Extension.extension:value.url
                Definition

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

                Shortidentifies the meaning of the extension
                Comments

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

                Control1..1
                Typeuri
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                Fixed Valuevalue
                44. Extension.extension:value.value[x]
                Definition

                A non-monetary value associated with the category. Mutually exclusive to the amount element above.

                ShortNon-monetary value
                Comments

                For example: eligible percentage or co-payment percentage.

                Control0..1
                Typedecimal
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                46. Extension.url
                Definition

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

                Shortidentifies the meaning of the extension
                Comments

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

                Control1..1
                Typeuri
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                Fixed Valuehttp://hl7.org/fhir/4.0/StructureDefinition/extension-ClaimResponse.item.adjudication
                48. Extension.value[x]
                Definition

                Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                ShortValue of extension
                Control0..0
                TypeChoice of: base64Binary, boolean, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, Meta
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension