FHIR Cross-Version Extensions package for FHIR R4 from FHIR R4B - Version 0.0.1-snapshot-2. See the Directory of published versions
: Adjudication Codes - TTL Representation
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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .
# - resource -------------------------------------------------------------------
a fhir:CodeSystem ;
fhir:nodeRole fhir:treeRoot ;
fhir:id [ fhir:v "adjudication"] ; #
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <p>This code system http://terminology.hl7.org/CodeSystem/adjudication defines the following codes:</p>\n <table class=\"codes\">\n <tr>\n <td style=\"white-space:nowrap\">\n <b>Code</b>\n </td>\n <td>\n <b>Display</b>\n </td>\n <td>\n <b>Definition</b>\n </td>\n </tr>\n <tr>\n <td style=\"white-space:nowrap\">submitted\n <a name=\"adjudication-submitted\"> </a>\n </td>\n <td>Submitted Amount</td>\n <td>The total submitted amount for the claim or group or line item.</td>\n </tr>\n <tr>\n <td style=\"white-space:nowrap\">copay\n <a name=\"adjudication-copay\"> </a>\n </td>\n <td>CoPay</td>\n <td>Patient Co-Payment</td>\n </tr>\n <tr>\n <td style=\"white-space:nowrap\">eligible\n <a name=\"adjudication-eligible\"> </a>\n </td>\n <td>Eligible Amount</td>\n <td>Amount of the change which is considered for adjudication.</td>\n </tr>\n <tr>\n <td style=\"white-space:nowrap\">deductible\n <a name=\"adjudication-deductible\"> </a>\n </td>\n <td>Deductible</td>\n <td>Amount deducted from the eligible amount prior to adjudication.</td>\n </tr>\n <tr>\n <td style=\"white-space:nowrap\">unallocdeduct\n <a name=\"adjudication-unallocdeduct\"> </a>\n </td>\n <td>Unallocated Deductible</td>\n <td>The amount of deductible which could not allocated to other line items.</td>\n </tr>\n <tr>\n <td style=\"white-space:nowrap\">eligpercent\n <a name=\"adjudication-eligpercent\"> </a>\n </td>\n <td>Eligible %</td>\n <td>Eligible Percentage.</td>\n </tr>\n <tr>\n <td style=\"white-space:nowrap\">tax\n <a name=\"adjudication-tax\"> </a>\n </td>\n <td>Tax</td>\n <td>The amount of tax.</td>\n </tr>\n <tr>\n <td style=\"white-space:nowrap\">benefit\n <a name=\"adjudication-benefit\"> </a>\n </td>\n <td>Benefit Amount</td>\n <td>Amount payable under the coverage</td>\n </tr>\n </table>\n </div>"^^rdf:XMLLiteral
] ; #
fhir:extension ( [
( fhir:extension [
fhir:url [ fhir:v "packageId"^^xsd:anyURI ] ;
fhir:value [
a fhir:id ;
fhir:v "hl7.fhir.uv.xver-r4b.r4" ] ] [
fhir:url [ fhir:v "version"^^xsd:anyURI ] ;
fhir:value [
a fhir:string ;
fhir:v "0.0.1-snapshot-2" ] ] ) ;
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/package-source"^^xsd:anyURI ]
] [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"^^xsd:anyURI ] ;
fhir:value [
a fhir:code ;
fhir:v "fm" ]
] ) ; #
fhir:url [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI] ; #
fhir:version [ fhir:v "4.3.0"] ; #
fhir:name [ fhir:v "AdjudicationCodes"] ; #
fhir:title [ fhir:v "Adjudication Codes"] ; #
fhir:status [ fhir:v "draft"] ; #
fhir:experimental [ fhir:v false] ; #
fhir:date [ fhir:v "2025-09-13T16:38:45-04:00"^^xsd:dateTime] ; #
fhir:publisher [ fhir:v "Financial Management"] ; #
fhir:contact ( [
fhir:name [ fhir:v "Financial Management" ] ;
( fhir:telecom [
fhir:system [ fhir:v "url" ] ;
fhir:value [ fhir:v "http://www.hl7.org/Special/committees/fm" ] ] )
] ) ; #
fhir:description [ fhir:v "This value set includes a smattering of Adjudication codes."] ; #
fhir:jurisdiction ( [
( fhir:coding [
fhir:system [ fhir:v "http://unstats.un.org/unsd/methods/m49/m49.htm"^^xsd:anyURI ] ;
fhir:code [ fhir:v "001" ] ;
fhir:display [ fhir:v "World" ] ] )
] ) ; #
fhir:copyright [ fhir:v "This is an example set."] ; #
fhir:caseSensitive [ fhir:v true] ; #
fhir:content [ fhir:v "complete"] ; #
fhir:concept ( [
fhir:code [ fhir:v "submitted" ] ;
fhir:display [ fhir:v "Submitted Amount" ] ;
fhir:definition [ fhir:v "The total submitted amount for the claim or group or line item." ]
] [
fhir:code [ fhir:v "copay" ] ;
fhir:display [ fhir:v "CoPay" ] ;
fhir:definition [ fhir:v "Patient Co-Payment" ]
] [
fhir:code [ fhir:v "eligible" ] ;
fhir:display [ fhir:v "Eligible Amount" ] ;
fhir:definition [ fhir:v "Amount of the change which is considered for adjudication." ]
] [
fhir:code [ fhir:v "deductible" ] ;
fhir:display [ fhir:v "Deductible" ] ;
fhir:definition [ fhir:v "Amount deducted from the eligible amount prior to adjudication." ]
] [
fhir:code [ fhir:v "unallocdeduct" ] ;
fhir:display [ fhir:v "Unallocated Deductible" ] ;
fhir:definition [ fhir:v "The amount of deductible which could not allocated to other line items." ]
] [
fhir:code [ fhir:v "eligpercent" ] ;
fhir:display [ fhir:v "Eligible %" ] ;
fhir:definition [ fhir:v "Eligible Percentage." ]
] [
fhir:code [ fhir:v "tax" ] ;
fhir:display [ fhir:v "Tax" ] ;
fhir:definition [ fhir:v "The amount of tax." ]
] [
fhir:code [ fhir:v "benefit" ] ;
fhir:display [ fhir:v "Benefit Amount" ] ;
fhir:definition [ fhir:v "Amount payable under the coverage" ]
] ) . #
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