FHIR Cross-Version Extensions package for FHIR R4 from FHIR R4B
0.0.1-snapshot-2 - informative International flag

FHIR Cross-Version Extensions package for FHIR R4 from FHIR R4B - Version 0.0.1-snapshot-2. See the Directory of published versions

CodeSystem: Adjudication Codes

Official URL: http://terminology.hl7.org/CodeSystem/adjudication Version: 4.3.0
Standards status: Informative Maturity Level: 0 Responsible: Financial Management Computable Name: AdjudicationCodes

Copyright/Legal: This is an example set.

This value set includes a smattering of Adjudication codes.

This Code system is referenced in the content logical definition of the following value sets:

  • This CodeSystem is not used here; it may be used elsewhere (e.g. specifications and/or implementations that use this content)

This case-sensitive code system http://terminology.hl7.org/CodeSystem/adjudication defines the following codes:

CodeDisplayDefinition
submitted Submitted Amount The total submitted amount for the claim or group or line item.
copay CoPay Patient Co-Payment
eligible Eligible Amount Amount of the change which is considered for adjudication.
deductible Deductible Amount deducted from the eligible amount prior to adjudication.
unallocdeduct Unallocated Deductible The amount of deductible which could not allocated to other line items.
eligpercent Eligible % Eligible Percentage.
tax Tax The amount of tax.
benefit Benefit Amount Amount payable under the coverage