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

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Resource Profile: Profile_R5_Claim_R3

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

Usages:

• Refer to this Profile: R5: Supporting information (new) and R5: Subject of the payment (new)

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	Claim, Pre-determination or Pre-authorization
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:traceNumber		0..*	Identifier	R5: Number for tracking (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.traceNumber
extension:encounter		0..*	Reference(Cross-version Profile for R5.Encounter for use in FHIR STU3(0.1.0) | Encounter)	R5: Encounters associated with the listed treatments (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.encounter
extension:diagnosisRelatedGroup		0..1	CodeableConcept	R5: Package billing code (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.diagnosisRelatedGroup Binding: Example Diagnosis Related Group Codes (example)
extension:event		0..*	(Complex)	R5: Event information (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.event
extension:patientPaid		0..1	Money	R5: Paid by the patient (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.patientPaid
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	0..1	code	active | cancelled | draft | entered-in-error Binding: Financial Resource Status Codes (required): A code specifying the state of the resource instance.
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Claim.status	Base	required	Financial Resource Status Codes	📍3.0.2	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-1	error	Claim	If the resource is contained in another resource, it SHALL NOT contain any narrative	contained.text.empty()
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	contained.where(('#'+id in %resource.descendants().reference).not()).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()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() | (children().count() > id.count())
ext-1	error	**ALL** extensions	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	Claim, Pre-determination or Pre-authorization
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:traceNumber		0..*	Identifier	R5: Number for tracking (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.traceNumber
extension:encounter		0..*	Reference(Cross-version Profile for R5.Encounter for use in FHIR STU3(0.1.0) | Encounter)	R5: Encounters associated with the listed treatments (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.encounter
extension:diagnosisRelatedGroup		0..1	CodeableConcept	R5: Package billing code (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.diagnosisRelatedGroup Binding: Example Diagnosis Related Group Codes (example)
extension:event		0..*	(Complex)	R5: Event information (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.event
extension:patientPaid		0..1	Money	R5: Paid by the patient (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.patientPaid
patient
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:patient		1..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: The recipient of the products and services additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
enterer
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:enterer		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Author of the claim 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	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: 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	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Party responsible for the claim 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	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: claim additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
prescription
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:prescription		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Prescription authorizing services and products 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	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Original prescription if superseded by fulfiller URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
payee
party
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:party		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Recipient reference 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	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: 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	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: 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	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Practitioner or organization URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
information
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:value		0..1	boolean, Identifier	R5: Data to be provided additional types URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.supportingInfo.value
valueReference
Slices for extension				Content/Rules for all slices
extension:alternateReference		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Data to be provided additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
diagnosis
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:onAdmission		0..1	CodeableConcept	R5: Present on admission (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.diagnosis.onAdmission Binding: R5ExDiagnosisOnAdmissionForR3 (0.1.0) (example): Present on admission.
diagnosisReference
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:alternateReference		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Nature of illness or problem additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
procedure
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:type		0..*	CodeableConcept	R5: Category of Procedure (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.procedure.type Binding: R5ExProcedureTypeForR3 (0.1.0) (example): Example procedure type codes.
extension:udi		0..*	Reference(Cross-version Profile for R5.Device for use in FHIR STU3(0.1.0) | Device)	R5: Unique device identifier (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.procedure.udi
procedureReference
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:alternateReference		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Specific clinical procedure additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
insurance
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:identifier		0..1	Identifier	R5: Pre-assigned Claim number (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.insurance.identifier
coverage
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:coverage		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: 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	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: claimResponse additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
accident
locationReference
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:alternateReference		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Where the event occurred additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
item
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:traceNumber		0..*	Identifier	R5: Number for tracking (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.traceNumber
extension:productOrServiceEnd		0..1	CodeableConcept	R5: End of a range of codes (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.productOrServiceEnd Binding: USCLS Codes (example)
extension:request		0..*	Reference(Cross-version Profile for R5.DeviceRequest for use in FHIR STU3(0.1.0) | DeviceRequest | Cross-version Profile for R5.MedicationRequest for use in FHIR STU3(0.1.0) | MedicationRequest | Cross-version Profile for R5.NutritionOrder for use in FHIR STU3(0.1.0) | NutritionOrder | Cross-version Profile for R5.ServiceRequest for use in FHIR STU3(0.1.0) | ReferralRequest | Cross-version Profile for R5.SupplyRequest for use in FHIR STU3(0.1.0) | SupplyRequest | Cross-version Profile for R5.VisionPrescription for use in FHIR STU3(0.1.0) | VisionPrescription)	R5: Request or Referral for Service (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.request
extension:patientPaid		0..1	Money	R5: Paid by the patient (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.patientPaid
extension:tax		0..1	Money	R5: Total tax (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.tax
locationReference
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:alternateReference		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Place of service or where product was supplied URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
udi
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:udi		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: 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..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Encounters associated with the listed treatments additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
detail
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:traceNumber		0..*	Identifier	R5: Number for tracking (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.traceNumber
extension:productOrServiceEnd		0..1	CodeableConcept	R5: End of a range of codes (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.productOrServiceEnd Binding: USCLS Codes (example)
extension:patientPaid		0..1	Money	R5: Paid by the patient (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.patientPaid
extension:tax		0..1	Money	R5: Total tax (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.tax
udi
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:udi		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Unique device identifier additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
subDetail
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:traceNumber		0..*	Identifier	R5: Number for tracking (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.subDetail.traceNumber
extension:productOrServiceEnd		0..1	CodeableConcept	R5: End of a range of codes (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.subDetail.productOrServiceEnd Binding: USCLS Codes (example)
extension:patientPaid		0..1	Money	R5: Paid by the patient (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.subDetail.patientPaid
extension:tax		0..1	Money	R5: Total tax (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.subDetail.tax
udi
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:udi		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: 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	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
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: Common Languages (extensible): A human language. Additional Bindings Purpose All Languages Max Binding
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
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:traceNumber		0..*	Identifier	R5: Number for tracking (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.traceNumber
extension:encounter		0..*	Reference(Cross-version Profile for R5.Encounter for use in FHIR STU3(0.1.0) | Encounter)	R5: Encounters associated with the listed treatments (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.encounter
extension:diagnosisRelatedGroup		0..1	CodeableConcept	R5: Package billing code (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.diagnosisRelatedGroup Binding: Example Diagnosis Related Group Codes (example)
extension:event		0..*	(Complex)	R5: Event information (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.event
extension:patientPaid		0..1	Money	R5: Paid by the patient (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.patientPaid
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier	Claim number
status	?!Σ	0..1	code	active | cancelled | draft | entered-in-error Binding: Financial Resource Status Codes (required): A code specifying the state of the resource instance.
type		0..1	CodeableConcept	Type or discipline Binding: Example Claim Type Codes (required): The type or discipline-style of the claim
subType		0..*	CodeableConcept	Finer grained claim type information Binding: Example Claim SubType Codes (example): A more granular claim typecode
use		0..1	code	complete | proposed | exploratory | other Binding: Use (required): Complete, proposed, exploratory, other
patient		0..1	Reference(Patient)	The subject of the Products and Services
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:patient		1..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: The recipient of the products and services additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
billablePeriod		0..1	Period	Period for charge submission
created		0..1	dateTime	Creation date
enterer		0..1	Reference(Practitioner)	Author
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:enterer		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Author of the claim URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
insurer		0..1	Reference(Organization)	Target
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:insurer		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: insurer additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
provider		0..1	Reference(Practitioner)	Responsible provider
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:provider		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Party responsible for the claim URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
organization		0..1	Reference(Organization)	Responsible organization
priority		0..1	CodeableConcept	Desired processing priority Binding: Process Priority Codes (example): The timeliness with which processing is required: STAT, normal, Deferred
fundsReserve		0..1	CodeableConcept	Funds requested to be reserved Binding: Funds Reservation Codes (example): For whom funds are to be reserved: (Patient, Provider, None).
related		0..*	BackboneElement	Related Claims which may be revelant to processing this claimn
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
claim		0..1	Reference(Claim)	Reference to the related claim
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:claim		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: claim additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
relationship		0..1	CodeableConcept	How the reference claim is related Binding: Example Related Claim Relationship Codes (example): Relationship of this claim to a related Claim
reference		0..1	Identifier	Related file or case reference
prescription		0..1	Reference(MedicationRequest | VisionPrescription)	Prescription authorizing services or products
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:prescription		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Prescription authorizing services and products URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
originalPrescription		0..1	Reference(MedicationRequest)	Original prescription if superceded by fulfiller
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:originalPrescription		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Original prescription if superseded by fulfiller URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
payee		0..1	BackboneElement	Party to be paid any benefits payable
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type		1..1	CodeableConcept	Type of party: Subscriber, Provider, other Binding: Claim Payee Type Codes (example): A code for the party to be reimbursed.
resourceType		0..1	Coding	organization | patient | practitioner | relatedperson Binding: ClaimPayeeResourceType (example): The type of Claim payee Resource
party		0..1	Reference(Practitioner | Organization | Patient | RelatedPerson)	Party to receive the payable
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:party		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Recipient reference URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
referral		0..1	Reference(ReferralRequest)	Treatment Referral
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:referral		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Treatment referral additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
facility		0..1	Reference(Location)	Servicing Facility
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:facility		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Servicing facility additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
careTeam		0..*	BackboneElement	Members of the care team
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
sequence		1..1	positiveInt	Number to covey order of careTeam
provider		1..1	Reference(Practitioner | Organization)	Provider individual or organization
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:provider		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Practitioner or organization URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
responsible		0..1	boolean	Billing provider
role		0..1	CodeableConcept	Role on the team Binding: Claim Care Team Role Codes (example): The role codes for the care team members.
qualification		0..1	CodeableConcept	Type, classification or Specialization Binding: Example Provider Qualification Codes (example): Provider professional qualifications
information		0..*	BackboneElement	Exceptions, special considerations, the condition, situation, prior or concurrent issues
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:value		0..1	boolean, Identifier	R5: Data to be provided additional types URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.supportingInfo.value
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
sequence		1..1	positiveInt	Information instance identifier
category		1..1	CodeableConcept	General class of information Binding: Claim Information Category Codes (example): The valuset used for additional information category codes.
code		0..1	CodeableConcept	Type of information Binding: Exception Codes (example): The valuset used for additional information codes.
timing[x]		0..1		When it occurred
timingDate			date
timingPeriod			Period
value[x]		0..1		Additional Data or supporting information
value[x]All Types				Content/Rules for all Types
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:alternateReference		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Data to be provided additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
valueString			string
valueQuantity			Quantity
valueAttachment			Attachment
valueReference			Reference(Resource)
reason		0..1	CodeableConcept	Reason associated with the information Binding: Missing Tooth Reason Codes (example): Reason codes for the missing teeth
diagnosis		0..*	BackboneElement	List of Diagnosis
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:onAdmission		0..1	CodeableConcept	R5: Present on admission (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.diagnosis.onAdmission Binding: R5ExDiagnosisOnAdmissionForR3 (0.1.0) (example): Present on admission.
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
sequence		1..1	positiveInt	Number to covey order of diagnosis
diagnosis[x]		1..1		Patient's diagnosis Binding: ICD-10 Codes (example): ICD10 Diagnostic codes
diagnosis[x]All Types				Content/Rules for all Types
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:alternateReference		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Nature of illness or problem additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
diagnosisCodeableConcept			CodeableConcept
diagnosisReference			Reference(Condition)
type		0..*	CodeableConcept	Timing or nature of the diagnosis Binding: Example Diagnosis Type Codes (example): The type of the diagnosis: admitting, principal, discharge
packageCode		0..1	CodeableConcept	Package billing code Binding: Example Diagnosis Related Group Codes (example): The DRG codes associated with the diagnosis
procedure		0..*	BackboneElement	Procedures performed
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:type		0..*	CodeableConcept	R5: Category of Procedure (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.procedure.type Binding: R5ExProcedureTypeForR3 (0.1.0) (example): Example procedure type codes.
extension:udi		0..*	Reference(Cross-version Profile for R5.Device for use in FHIR STU3(0.1.0) | Device)	R5: Unique device identifier (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.procedure.udi
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
sequence		1..1	positiveInt	Procedure sequence for reference
date		0..1	dateTime	When the procedure was performed
procedure[x]		1..1		Patient's list of procedures performed Binding: ICD-10 Procedure Codes (example): ICD10 Procedure codes
procedure[x]All Types				Content/Rules for all Types
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:alternateReference		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Specific clinical procedure additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
procedureCodeableConcept			CodeableConcept
procedureReference			Reference(Procedure)
insurance		0..*	BackboneElement	Insurance or medical plan
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:identifier		0..1	Identifier	R5: Pre-assigned Claim number (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.insurance.identifier
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
sequence		1..1	positiveInt	Service instance identifier
focal		1..1	boolean	Is the focal Coverage
coverage		1..1	Reference(Coverage)	Insurance information
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:coverage		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: coverage additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
businessArrangement		0..1	string	Business agreement
preAuthRef		0..*	string	Pre-Authorization/Determination Reference
claimResponse		0..1	Reference(ClaimResponse)	Adjudication results
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:claimResponse		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: claimResponse additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
accident		0..1	BackboneElement	Details about an accident
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
date		1..1	date	When the accident occurred see information codes see information codes
type		0..1	CodeableConcept	​The nature of the accident Binding: ActIncidentCode|2014-03-26 (required): Type of accident: work place, auto, etc.
location[x]		0..1		Accident Place
location[x]All Types				Content/Rules for all Types
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:alternateReference		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Where the event occurred additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
locationAddress			Address
locationReference			Reference(Location)
employmentImpacted		0..1	Period	Period unable to work
hospitalization		0..1	Period	Period in hospital
item		0..*	BackboneElement	Goods and Services
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:traceNumber		0..*	Identifier	R5: Number for tracking (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.traceNumber
extension:productOrServiceEnd		0..1	CodeableConcept	R5: End of a range of codes (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.productOrServiceEnd Binding: USCLS Codes (example)
extension:request		0..*	Reference(Cross-version Profile for R5.DeviceRequest for use in FHIR STU3(0.1.0) | DeviceRequest | Cross-version Profile for R5.MedicationRequest for use in FHIR STU3(0.1.0) | MedicationRequest | Cross-version Profile for R5.NutritionOrder for use in FHIR STU3(0.1.0) | NutritionOrder | Cross-version Profile for R5.ServiceRequest for use in FHIR STU3(0.1.0) | ReferralRequest | Cross-version Profile for R5.SupplyRequest for use in FHIR STU3(0.1.0) | SupplyRequest | Cross-version Profile for R5.VisionPrescription for use in FHIR STU3(0.1.0) | VisionPrescription)	R5: Request or Referral for Service (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.request
extension:patientPaid		0..1	Money	R5: Paid by the patient (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.patientPaid
extension:tax		0..1	Money	R5: Total tax (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.tax
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
sequence		1..1	positiveInt	Service instance
careTeamLinkId		0..*	positiveInt	Applicable careTeam members
diagnosisLinkId		0..*	positiveInt	Applicable diagnoses
procedureLinkId		0..*	positiveInt	Applicable procedures
informationLinkId		0..*	positiveInt	Applicable exception and supporting information
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: Example Revenue Center Codes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		0..1	CodeableConcept	Type of service or product Binding: Benefit SubCategory Codes (example): Benefit subcategories such as: oral-basic, major, glasses
service		0..1	CodeableConcept	Billing Code Binding: USCLS Codes (example): Allowable service and product codes
modifier		0..*	CodeableConcept	Service/Product billing modifiers Binding: Modifier type Codes (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 specific reason for item inclusion Binding: Example Program Reason Codes (example): Program specific reason codes
serviced[x]		0..1		Date or dates of Service
servicedDate			date
servicedPeriod			Period
location[x]		0..1		Place of service Binding: Example Service Place Codes (example): Place of service: pharmacy,school, prison, etc.
location[x]All Types				Content/Rules for all Types
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:alternateReference		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Place of service or where product was supplied URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
locationCodeableConcept			CodeableConcept
locationAddress			Address
locationReference			Reference(Location)
quantity		0..1	SimpleQuantity	Count of Products or Services
unitPrice		0..1	Money	Fee, charge or cost per point
factor		0..1	decimal	Price scaling factor
net		0..1	Money	Total item cost
udi		0..*	Reference(Device)	Unique Device Identifier
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:udi		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Unique device identifier additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
bodySite		0..1	CodeableConcept	Service Location Binding: Oral Site Codes (example): The code for the teeth, quadrant, sextant and arch
subSite		0..*	CodeableConcept	Service Sub-location Binding: Surface Codes (example): The code for the tooth surface and surface combinations
encounter		0..*	Reference(Encounter)	Encounters related to this billed item
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:encounter		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Encounters associated with the listed treatments additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
detail		0..*	BackboneElement	Additional items
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:traceNumber		0..*	Identifier	R5: Number for tracking (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.traceNumber
extension:productOrServiceEnd		0..1	CodeableConcept	R5: End of a range of codes (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.productOrServiceEnd Binding: USCLS Codes (example)
extension:patientPaid		0..1	Money	R5: Paid by the patient (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.patientPaid
extension:tax		0..1	Money	R5: Total tax (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.tax
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
sequence		1..1	positiveInt	Service instance
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: Example Revenue Center Codes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		0..1	CodeableConcept	Type of service or product Binding: Benefit SubCategory Codes (example): Benefit subcategories such as: oral-basic, major, glasses
service		0..1	CodeableConcept	Billing Code Binding: USCLS Codes (example): Allowable service and product codes
modifier		0..*	CodeableConcept	Service/Product billing modifiers Binding: Modifier type Codes (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 specific reason for item inclusion Binding: Example Program Reason Codes (example): Program specific reason codes
quantity		0..1	SimpleQuantity	Count of Products or Services
unitPrice		0..1	Money	Fee, charge or cost per point
factor		0..1	decimal	Price scaling factor
net		0..1	Money	Total additional item cost
udi		0..*	Reference(Device)	Unique Device Identifier
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:udi		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Unique device identifier additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
subDetail		0..*	BackboneElement	Additional items
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:traceNumber		0..*	Identifier	R5: Number for tracking (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.subDetail.traceNumber
extension:productOrServiceEnd		0..1	CodeableConcept	R5: End of a range of codes (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.subDetail.productOrServiceEnd Binding: USCLS Codes (example)
extension:patientPaid		0..1	Money	R5: Paid by the patient (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.subDetail.patientPaid
extension:tax		0..1	Money	R5: Total tax (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.subDetail.tax
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
sequence		1..1	positiveInt	Service instance
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: Example Revenue Center Codes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		0..1	CodeableConcept	Type of service or product Binding: Benefit SubCategory Codes (example): Benefit subcategories such as: oral-basic, major, glasses
service		0..1	CodeableConcept	Billing Code Binding: USCLS Codes (example): Allowable service and product codes
modifier		0..*	CodeableConcept	Service/Product billing modifiers Binding: Modifier type Codes (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 specific reason for item inclusion Binding: Example Program Reason Codes (example): Program specific reason codes
quantity		0..1	SimpleQuantity	Count of Products or Services
unitPrice		0..1	Money	Fee, charge or cost per point
factor		0..1	decimal	Price scaling factor
net		0..1	Money	Net additional item cost
udi		0..*	Reference(Device)	Unique Device Identifier
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:udi		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Unique device identifier additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	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.language	Base	extensible	Common Languages	📍3.0.2	tx.fhir.org
Claim.status	Base	required	Financial Resource Status Codes	📍3.0.2	FHIR Std.
Claim.type	Base	required	Example Claim Type Codes	📍3.0.2	FHIR Std.
Claim.subType	Base	example	Example Claim SubType Codes	📍3.0.2	FHIR Std.
Claim.use	Base	required	Use	📍3.0.2	FHIR Std.
Claim.priority	Base	example	Process Priority Codes	📍3.0.2	FHIR Std.
Claim.fundsReserve	Base	example	Funds Reservation Codes	📍3.0.2	FHIR Std.
Claim.related.relationship	Base	example	Example Related Claim Relationship Codes	📍3.0.2	FHIR Std.
Claim.payee.type	Base	example	Claim Payee Type Codes	📍3.0.2	FHIR Std.
Claim.payee.resourceType	Base	example	ClaimPayeeResourceType	📍3.0.2	FHIR Std.
Claim.careTeam.role	Base	example	Claim Care Team Role Codes	📍3.0.2	FHIR Std.
Claim.careTeam.qualification	Base	example	Example Provider Qualification Codes	📍3.0.2	FHIR Std.
Claim.information.category	Base	example	Claim Information Category Codes	📍3.0.2	FHIR Std.
Claim.information.code	Base	example	Exception Codes	📍3.0.2	FHIR Std.
Claim.information.reason	Base	example	Missing Tooth Reason Codes	📍3.0.2	FHIR Std.
Claim.diagnosis.diagnosis[x]	Base	example	ICD-10 Codes	📍3.0.2	FHIR Std.
Claim.diagnosis.type	Base	example	Example Diagnosis Type Codes	📍3.0.2	FHIR Std.
Claim.diagnosis.packageCode	Base	example	Example Diagnosis Related Group Codes	📍3.0.2	FHIR Std.
Claim.procedure.procedure[x]	Base	example	ICD-10 Procedure Codes	📍3.0.2	FHIR Std.
Claim.accident.type	Base	required	ActIncidentCode	📍2014-03-26	FHIR Std.
Claim.item.revenue	Base	example	Example Revenue Center Codes	📍3.0.2	FHIR Std.
Claim.item.category	Base	example	Benefit SubCategory Codes	📍3.0.2	FHIR Std.
Claim.item.service	Base	example	USCLS Codes	📍3.0.2	FHIR Std.
Claim.item.modifier	Base	example	Modifier type Codes	📍3.0.2	FHIR Std.
Claim.item.programCode	Base	example	Example Program Reason Codes	📍3.0.2	FHIR Std.
Claim.item.location[x]	Base	example	Example Service Place Codes	📍3.0.2	FHIR Std.
Claim.item.bodySite	Base	example	Oral Site Codes	📍3.0.2	FHIR Std.
Claim.item.subSite	Base	example	Surface Codes	📍3.0.2	FHIR Std.
Claim.item.detail.revenue	Base	example	Example Revenue Center Codes	📍3.0.2	FHIR Std.
Claim.item.detail.category	Base	example	Benefit SubCategory Codes	📍3.0.2	FHIR Std.
Claim.item.detail.service	Base	example	USCLS Codes	📍3.0.2	FHIR Std.
Claim.item.detail.modifier	Base	example	Modifier type Codes	📍3.0.2	FHIR Std.
Claim.item.detail.programCode	Base	example	Example Program Reason Codes	📍3.0.2	FHIR Std.
Claim.item.detail.subDetail.​revenue	Base	example	Example Revenue Center Codes	📍3.0.2	FHIR Std.
Claim.item.detail.subDetail.​category	Base	example	Benefit SubCategory Codes	📍3.0.2	FHIR Std.
Claim.item.detail.subDetail.​service	Base	example	USCLS Codes	📍3.0.2	FHIR Std.
Claim.item.detail.subDetail.​modifier	Base	example	Modifier type Codes	📍3.0.2	FHIR Std.
Claim.item.detail.subDetail.​programCode	Base	example	Example Program Reason Codes	📍3.0.2	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-1	error	Claim	If the resource is contained in another resource, it SHALL NOT contain any narrative	contained.text.empty()
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	contained.where(('#'+id in %resource.descendants().reference).not()).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()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() | (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()

This structure is derived from Claim

Summary

Mandatory: 0 element(2 nested mandatory elements)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.traceNumber|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.encounter|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.diagnosisRelatedGroup|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.event|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.patientPaid|0.1.0
• Unable to summarise extension http://hl7.org/fhir/StructureDefinition/alternate-reference (no extension found)
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.supportingInfo.value|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.diagnosis.onAdmission|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.procedure.type|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.procedure.udi|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.insurance.identifier|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.traceNumber|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.productOrServiceEnd|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.request|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.patientPaid|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.tax|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.traceNumber|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.productOrServiceEnd|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.patientPaid|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.tax|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.subDetail.traceNumber|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.subDetail.productOrServiceEnd|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.subDetail.patientPaid|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.subDetail.tax|0.1.0

Maturity: 0

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Claim		0..*	Claim	Claim, Pre-determination or Pre-authorization
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:traceNumber		0..*	Identifier	R5: Number for tracking (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.traceNumber
extension:encounter		0..*	Reference(Cross-version Profile for R5.Encounter for use in FHIR STU3(0.1.0) | Encounter)	R5: Encounters associated with the listed treatments (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.encounter
extension:diagnosisRelatedGroup		0..1	CodeableConcept	R5: Package billing code (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.diagnosisRelatedGroup Binding: Example Diagnosis Related Group Codes (example)
extension:event		0..*	(Complex)	R5: Event information (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.event
extension:patientPaid		0..1	Money	R5: Paid by the patient (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.patientPaid
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	0..1	code	active | cancelled | draft | entered-in-error Binding: Financial Resource Status Codes (required): A code specifying the state of the resource instance.
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Claim.status	Base	required	Financial Resource Status Codes	📍3.0.2	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-1	error	Claim	If the resource is contained in another resource, it SHALL NOT contain any narrative	contained.text.empty()
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	contained.where(('#'+id in %resource.descendants().reference).not()).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()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() | (children().count() > id.count())
ext-1	error	**ALL** extensions	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	Claim, Pre-determination or Pre-authorization
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:traceNumber		0..*	Identifier	R5: Number for tracking (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.traceNumber
extension:encounter		0..*	Reference(Cross-version Profile for R5.Encounter for use in FHIR STU3(0.1.0) | Encounter)	R5: Encounters associated with the listed treatments (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.encounter
extension:diagnosisRelatedGroup		0..1	CodeableConcept	R5: Package billing code (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.diagnosisRelatedGroup Binding: Example Diagnosis Related Group Codes (example)
extension:event		0..*	(Complex)	R5: Event information (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.event
extension:patientPaid		0..1	Money	R5: Paid by the patient (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.patientPaid
patient
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:patient		1..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: The recipient of the products and services additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
enterer
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:enterer		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Author of the claim 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	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: 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	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Party responsible for the claim 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	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: claim additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
prescription
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:prescription		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Prescription authorizing services and products 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	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Original prescription if superseded by fulfiller URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
payee
party
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:party		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Recipient reference 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	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: 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	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: 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	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Practitioner or organization URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
information
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:value		0..1	boolean, Identifier	R5: Data to be provided additional types URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.supportingInfo.value
valueReference
Slices for extension				Content/Rules for all slices
extension:alternateReference		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Data to be provided additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
diagnosis
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:onAdmission		0..1	CodeableConcept	R5: Present on admission (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.diagnosis.onAdmission Binding: R5ExDiagnosisOnAdmissionForR3 (0.1.0) (example): Present on admission.
diagnosisReference
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:alternateReference		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Nature of illness or problem additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
procedure
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:type		0..*	CodeableConcept	R5: Category of Procedure (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.procedure.type Binding: R5ExProcedureTypeForR3 (0.1.0) (example): Example procedure type codes.
extension:udi		0..*	Reference(Cross-version Profile for R5.Device for use in FHIR STU3(0.1.0) | Device)	R5: Unique device identifier (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.procedure.udi
procedureReference
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:alternateReference		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Specific clinical procedure additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
insurance
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:identifier		0..1	Identifier	R5: Pre-assigned Claim number (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.insurance.identifier
coverage
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:coverage		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: 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	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: claimResponse additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
accident
locationReference
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:alternateReference		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Where the event occurred additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
item
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:traceNumber		0..*	Identifier	R5: Number for tracking (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.traceNumber
extension:productOrServiceEnd		0..1	CodeableConcept	R5: End of a range of codes (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.productOrServiceEnd Binding: USCLS Codes (example)
extension:request		0..*	Reference(Cross-version Profile for R5.DeviceRequest for use in FHIR STU3(0.1.0) | DeviceRequest | Cross-version Profile for R5.MedicationRequest for use in FHIR STU3(0.1.0) | MedicationRequest | Cross-version Profile for R5.NutritionOrder for use in FHIR STU3(0.1.0) | NutritionOrder | Cross-version Profile for R5.ServiceRequest for use in FHIR STU3(0.1.0) | ReferralRequest | Cross-version Profile for R5.SupplyRequest for use in FHIR STU3(0.1.0) | SupplyRequest | Cross-version Profile for R5.VisionPrescription for use in FHIR STU3(0.1.0) | VisionPrescription)	R5: Request or Referral for Service (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.request
extension:patientPaid		0..1	Money	R5: Paid by the patient (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.patientPaid
extension:tax		0..1	Money	R5: Total tax (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.tax
locationReference
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:alternateReference		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Place of service or where product was supplied URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
udi
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:udi		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: 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..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Encounters associated with the listed treatments additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
detail
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:traceNumber		0..*	Identifier	R5: Number for tracking (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.traceNumber
extension:productOrServiceEnd		0..1	CodeableConcept	R5: End of a range of codes (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.productOrServiceEnd Binding: USCLS Codes (example)
extension:patientPaid		0..1	Money	R5: Paid by the patient (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.patientPaid
extension:tax		0..1	Money	R5: Total tax (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.tax
udi
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:udi		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Unique device identifier additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
subDetail
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:traceNumber		0..*	Identifier	R5: Number for tracking (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.subDetail.traceNumber
extension:productOrServiceEnd		0..1	CodeableConcept	R5: End of a range of codes (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.subDetail.productOrServiceEnd Binding: USCLS Codes (example)
extension:patientPaid		0..1	Money	R5: Paid by the patient (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.subDetail.patientPaid
extension:tax		0..1	Money	R5: Total tax (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.subDetail.tax
udi
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:udi		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: 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	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
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: Common Languages (extensible): A human language. Additional Bindings Purpose All Languages Max Binding
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
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:traceNumber		0..*	Identifier	R5: Number for tracking (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.traceNumber
extension:encounter		0..*	Reference(Cross-version Profile for R5.Encounter for use in FHIR STU3(0.1.0) | Encounter)	R5: Encounters associated with the listed treatments (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.encounter
extension:diagnosisRelatedGroup		0..1	CodeableConcept	R5: Package billing code (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.diagnosisRelatedGroup Binding: Example Diagnosis Related Group Codes (example)
extension:event		0..*	(Complex)	R5: Event information (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.event
extension:patientPaid		0..1	Money	R5: Paid by the patient (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.patientPaid
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier	Claim number
status	?!Σ	0..1	code	active | cancelled | draft | entered-in-error Binding: Financial Resource Status Codes (required): A code specifying the state of the resource instance.
type		0..1	CodeableConcept	Type or discipline Binding: Example Claim Type Codes (required): The type or discipline-style of the claim
subType		0..*	CodeableConcept	Finer grained claim type information Binding: Example Claim SubType Codes (example): A more granular claim typecode
use		0..1	code	complete | proposed | exploratory | other Binding: Use (required): Complete, proposed, exploratory, other
patient		0..1	Reference(Patient)	The subject of the Products and Services
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:patient		1..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: The recipient of the products and services additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
billablePeriod		0..1	Period	Period for charge submission
created		0..1	dateTime	Creation date
enterer		0..1	Reference(Practitioner)	Author
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:enterer		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Author of the claim URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
insurer		0..1	Reference(Organization)	Target
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:insurer		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: insurer additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
provider		0..1	Reference(Practitioner)	Responsible provider
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:provider		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Party responsible for the claim URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
organization		0..1	Reference(Organization)	Responsible organization
priority		0..1	CodeableConcept	Desired processing priority Binding: Process Priority Codes (example): The timeliness with which processing is required: STAT, normal, Deferred
fundsReserve		0..1	CodeableConcept	Funds requested to be reserved Binding: Funds Reservation Codes (example): For whom funds are to be reserved: (Patient, Provider, None).
related		0..*	BackboneElement	Related Claims which may be revelant to processing this claimn
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
claim		0..1	Reference(Claim)	Reference to the related claim
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:claim		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: claim additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
relationship		0..1	CodeableConcept	How the reference claim is related Binding: Example Related Claim Relationship Codes (example): Relationship of this claim to a related Claim
reference		0..1	Identifier	Related file or case reference
prescription		0..1	Reference(MedicationRequest | VisionPrescription)	Prescription authorizing services or products
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:prescription		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Prescription authorizing services and products URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
originalPrescription		0..1	Reference(MedicationRequest)	Original prescription if superceded by fulfiller
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:originalPrescription		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Original prescription if superseded by fulfiller URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
payee		0..1	BackboneElement	Party to be paid any benefits payable
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type		1..1	CodeableConcept	Type of party: Subscriber, Provider, other Binding: Claim Payee Type Codes (example): A code for the party to be reimbursed.
resourceType		0..1	Coding	organization | patient | practitioner | relatedperson Binding: ClaimPayeeResourceType (example): The type of Claim payee Resource
party		0..1	Reference(Practitioner | Organization | Patient | RelatedPerson)	Party to receive the payable
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:party		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Recipient reference URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
referral		0..1	Reference(ReferralRequest)	Treatment Referral
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:referral		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Treatment referral additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
facility		0..1	Reference(Location)	Servicing Facility
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:facility		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Servicing facility additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
careTeam		0..*	BackboneElement	Members of the care team
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
sequence		1..1	positiveInt	Number to covey order of careTeam
provider		1..1	Reference(Practitioner | Organization)	Provider individual or organization
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:provider		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Practitioner or organization URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
responsible		0..1	boolean	Billing provider
role		0..1	CodeableConcept	Role on the team Binding: Claim Care Team Role Codes (example): The role codes for the care team members.
qualification		0..1	CodeableConcept	Type, classification or Specialization Binding: Example Provider Qualification Codes (example): Provider professional qualifications
information		0..*	BackboneElement	Exceptions, special considerations, the condition, situation, prior or concurrent issues
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:value		0..1	boolean, Identifier	R5: Data to be provided additional types URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.supportingInfo.value
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
sequence		1..1	positiveInt	Information instance identifier
category		1..1	CodeableConcept	General class of information Binding: Claim Information Category Codes (example): The valuset used for additional information category codes.
code		0..1	CodeableConcept	Type of information Binding: Exception Codes (example): The valuset used for additional information codes.
timing[x]		0..1		When it occurred
timingDate			date
timingPeriod			Period
value[x]		0..1		Additional Data or supporting information
value[x]All Types				Content/Rules for all Types
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:alternateReference		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Data to be provided additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
valueString			string
valueQuantity			Quantity
valueAttachment			Attachment
valueReference			Reference(Resource)
reason		0..1	CodeableConcept	Reason associated with the information Binding: Missing Tooth Reason Codes (example): Reason codes for the missing teeth
diagnosis		0..*	BackboneElement	List of Diagnosis
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:onAdmission		0..1	CodeableConcept	R5: Present on admission (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.diagnosis.onAdmission Binding: R5ExDiagnosisOnAdmissionForR3 (0.1.0) (example): Present on admission.
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
sequence		1..1	positiveInt	Number to covey order of diagnosis
diagnosis[x]		1..1		Patient's diagnosis Binding: ICD-10 Codes (example): ICD10 Diagnostic codes
diagnosis[x]All Types				Content/Rules for all Types
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:alternateReference		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Nature of illness or problem additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
diagnosisCodeableConcept			CodeableConcept
diagnosisReference			Reference(Condition)
type		0..*	CodeableConcept	Timing or nature of the diagnosis Binding: Example Diagnosis Type Codes (example): The type of the diagnosis: admitting, principal, discharge
packageCode		0..1	CodeableConcept	Package billing code Binding: Example Diagnosis Related Group Codes (example): The DRG codes associated with the diagnosis
procedure		0..*	BackboneElement	Procedures performed
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:type		0..*	CodeableConcept	R5: Category of Procedure (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.procedure.type Binding: R5ExProcedureTypeForR3 (0.1.0) (example): Example procedure type codes.
extension:udi		0..*	Reference(Cross-version Profile for R5.Device for use in FHIR STU3(0.1.0) | Device)	R5: Unique device identifier (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.procedure.udi
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
sequence		1..1	positiveInt	Procedure sequence for reference
date		0..1	dateTime	When the procedure was performed
procedure[x]		1..1		Patient's list of procedures performed Binding: ICD-10 Procedure Codes (example): ICD10 Procedure codes
procedure[x]All Types				Content/Rules for all Types
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:alternateReference		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Specific clinical procedure additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
procedureCodeableConcept			CodeableConcept
procedureReference			Reference(Procedure)
insurance		0..*	BackboneElement	Insurance or medical plan
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:identifier		0..1	Identifier	R5: Pre-assigned Claim number (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.insurance.identifier
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
sequence		1..1	positiveInt	Service instance identifier
focal		1..1	boolean	Is the focal Coverage
coverage		1..1	Reference(Coverage)	Insurance information
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:coverage		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: coverage additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
businessArrangement		0..1	string	Business agreement
preAuthRef		0..*	string	Pre-Authorization/Determination Reference
claimResponse		0..1	Reference(ClaimResponse)	Adjudication results
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:claimResponse		0..1	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: claimResponse additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
accident		0..1	BackboneElement	Details about an accident
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
date		1..1	date	When the accident occurred see information codes see information codes
type		0..1	CodeableConcept	​The nature of the accident Binding: ActIncidentCode|2014-03-26 (required): Type of accident: work place, auto, etc.
location[x]		0..1		Accident Place
location[x]All Types				Content/Rules for all Types
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:alternateReference		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Where the event occurred additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
locationAddress			Address
locationReference			Reference(Location)
employmentImpacted		0..1	Period	Period unable to work
hospitalization		0..1	Period	Period in hospital
item		0..*	BackboneElement	Goods and Services
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:traceNumber		0..*	Identifier	R5: Number for tracking (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.traceNumber
extension:productOrServiceEnd		0..1	CodeableConcept	R5: End of a range of codes (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.productOrServiceEnd Binding: USCLS Codes (example)
extension:request		0..*	Reference(Cross-version Profile for R5.DeviceRequest for use in FHIR STU3(0.1.0) | DeviceRequest | Cross-version Profile for R5.MedicationRequest for use in FHIR STU3(0.1.0) | MedicationRequest | Cross-version Profile for R5.NutritionOrder for use in FHIR STU3(0.1.0) | NutritionOrder | Cross-version Profile for R5.ServiceRequest for use in FHIR STU3(0.1.0) | ReferralRequest | Cross-version Profile for R5.SupplyRequest for use in FHIR STU3(0.1.0) | SupplyRequest | Cross-version Profile for R5.VisionPrescription for use in FHIR STU3(0.1.0) | VisionPrescription)	R5: Request or Referral for Service (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.request
extension:patientPaid		0..1	Money	R5: Paid by the patient (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.patientPaid
extension:tax		0..1	Money	R5: Total tax (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.tax
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
sequence		1..1	positiveInt	Service instance
careTeamLinkId		0..*	positiveInt	Applicable careTeam members
diagnosisLinkId		0..*	positiveInt	Applicable diagnoses
procedureLinkId		0..*	positiveInt	Applicable procedures
informationLinkId		0..*	positiveInt	Applicable exception and supporting information
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: Example Revenue Center Codes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		0..1	CodeableConcept	Type of service or product Binding: Benefit SubCategory Codes (example): Benefit subcategories such as: oral-basic, major, glasses
service		0..1	CodeableConcept	Billing Code Binding: USCLS Codes (example): Allowable service and product codes
modifier		0..*	CodeableConcept	Service/Product billing modifiers Binding: Modifier type Codes (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 specific reason for item inclusion Binding: Example Program Reason Codes (example): Program specific reason codes
serviced[x]		0..1		Date or dates of Service
servicedDate			date
servicedPeriod			Period
location[x]		0..1		Place of service Binding: Example Service Place Codes (example): Place of service: pharmacy,school, prison, etc.
location[x]All Types				Content/Rules for all Types
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:alternateReference		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Place of service or where product was supplied URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
locationCodeableConcept			CodeableConcept
locationAddress			Address
locationReference			Reference(Location)
quantity		0..1	SimpleQuantity	Count of Products or Services
unitPrice		0..1	Money	Fee, charge or cost per point
factor		0..1	decimal	Price scaling factor
net		0..1	Money	Total item cost
udi		0..*	Reference(Device)	Unique Device Identifier
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:udi		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Unique device identifier additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
bodySite		0..1	CodeableConcept	Service Location Binding: Oral Site Codes (example): The code for the teeth, quadrant, sextant and arch
subSite		0..*	CodeableConcept	Service Sub-location Binding: Surface Codes (example): The code for the tooth surface and surface combinations
encounter		0..*	Reference(Encounter)	Encounters related to this billed item
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:encounter		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Encounters associated with the listed treatments additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
detail		0..*	BackboneElement	Additional items
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:traceNumber		0..*	Identifier	R5: Number for tracking (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.traceNumber
extension:productOrServiceEnd		0..1	CodeableConcept	R5: End of a range of codes (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.productOrServiceEnd Binding: USCLS Codes (example)
extension:patientPaid		0..1	Money	R5: Paid by the patient (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.patientPaid
extension:tax		0..1	Money	R5: Total tax (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.tax
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
sequence		1..1	positiveInt	Service instance
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: Example Revenue Center Codes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		0..1	CodeableConcept	Type of service or product Binding: Benefit SubCategory Codes (example): Benefit subcategories such as: oral-basic, major, glasses
service		0..1	CodeableConcept	Billing Code Binding: USCLS Codes (example): Allowable service and product codes
modifier		0..*	CodeableConcept	Service/Product billing modifiers Binding: Modifier type Codes (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 specific reason for item inclusion Binding: Example Program Reason Codes (example): Program specific reason codes
quantity		0..1	SimpleQuantity	Count of Products or Services
unitPrice		0..1	Money	Fee, charge or cost per point
factor		0..1	decimal	Price scaling factor
net		0..1	Money	Total additional item cost
udi		0..*	Reference(Device)	Unique Device Identifier
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:udi		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Unique device identifier additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
subDetail		0..*	BackboneElement	Additional items
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:traceNumber		0..*	Identifier	R5: Number for tracking (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.subDetail.traceNumber
extension:productOrServiceEnd		0..1	CodeableConcept	R5: End of a range of codes (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.subDetail.productOrServiceEnd Binding: USCLS Codes (example)
extension:patientPaid		0..1	Money	R5: Paid by the patient (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.subDetail.patientPaid
extension:tax		0..1	Money	R5: Total tax (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.subDetail.tax
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
sequence		1..1	positiveInt	Service instance
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: Example Revenue Center Codes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		0..1	CodeableConcept	Type of service or product Binding: Benefit SubCategory Codes (example): Benefit subcategories such as: oral-basic, major, glasses
service		0..1	CodeableConcept	Billing Code Binding: USCLS Codes (example): Allowable service and product codes
modifier		0..*	CodeableConcept	Service/Product billing modifiers Binding: Modifier type Codes (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 specific reason for item inclusion Binding: Example Program Reason Codes (example): Program specific reason codes
quantity		0..1	SimpleQuantity	Count of Products or Services
unitPrice		0..1	Money	Fee, charge or cost per point
factor		0..1	decimal	Price scaling factor
net		0..1	Money	Net additional item cost
udi		0..*	Reference(Device)	Unique Device Identifier
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:udi		0..*	?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]]	R5: Unique device identifier additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	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.language	Base	extensible	Common Languages	📍3.0.2	tx.fhir.org
Claim.status	Base	required	Financial Resource Status Codes	📍3.0.2	FHIR Std.
Claim.type	Base	required	Example Claim Type Codes	📍3.0.2	FHIR Std.
Claim.subType	Base	example	Example Claim SubType Codes	📍3.0.2	FHIR Std.
Claim.use	Base	required	Use	📍3.0.2	FHIR Std.
Claim.priority	Base	example	Process Priority Codes	📍3.0.2	FHIR Std.
Claim.fundsReserve	Base	example	Funds Reservation Codes	📍3.0.2	FHIR Std.
Claim.related.relationship	Base	example	Example Related Claim Relationship Codes	📍3.0.2	FHIR Std.
Claim.payee.type	Base	example	Claim Payee Type Codes	📍3.0.2	FHIR Std.
Claim.payee.resourceType	Base	example	ClaimPayeeResourceType	📍3.0.2	FHIR Std.
Claim.careTeam.role	Base	example	Claim Care Team Role Codes	📍3.0.2	FHIR Std.
Claim.careTeam.qualification	Base	example	Example Provider Qualification Codes	📍3.0.2	FHIR Std.
Claim.information.category	Base	example	Claim Information Category Codes	📍3.0.2	FHIR Std.
Claim.information.code	Base	example	Exception Codes	📍3.0.2	FHIR Std.
Claim.information.reason	Base	example	Missing Tooth Reason Codes	📍3.0.2	FHIR Std.
Claim.diagnosis.diagnosis[x]	Base	example	ICD-10 Codes	📍3.0.2	FHIR Std.
Claim.diagnosis.type	Base	example	Example Diagnosis Type Codes	📍3.0.2	FHIR Std.
Claim.diagnosis.packageCode	Base	example	Example Diagnosis Related Group Codes	📍3.0.2	FHIR Std.
Claim.procedure.procedure[x]	Base	example	ICD-10 Procedure Codes	📍3.0.2	FHIR Std.
Claim.accident.type	Base	required	ActIncidentCode	📍2014-03-26	FHIR Std.
Claim.item.revenue	Base	example	Example Revenue Center Codes	📍3.0.2	FHIR Std.
Claim.item.category	Base	example	Benefit SubCategory Codes	📍3.0.2	FHIR Std.
Claim.item.service	Base	example	USCLS Codes	📍3.0.2	FHIR Std.
Claim.item.modifier	Base	example	Modifier type Codes	📍3.0.2	FHIR Std.
Claim.item.programCode	Base	example	Example Program Reason Codes	📍3.0.2	FHIR Std.
Claim.item.location[x]	Base	example	Example Service Place Codes	📍3.0.2	FHIR Std.
Claim.item.bodySite	Base	example	Oral Site Codes	📍3.0.2	FHIR Std.
Claim.item.subSite	Base	example	Surface Codes	📍3.0.2	FHIR Std.
Claim.item.detail.revenue	Base	example	Example Revenue Center Codes	📍3.0.2	FHIR Std.
Claim.item.detail.category	Base	example	Benefit SubCategory Codes	📍3.0.2	FHIR Std.
Claim.item.detail.service	Base	example	USCLS Codes	📍3.0.2	FHIR Std.
Claim.item.detail.modifier	Base	example	Modifier type Codes	📍3.0.2	FHIR Std.
Claim.item.detail.programCode	Base	example	Example Program Reason Codes	📍3.0.2	FHIR Std.
Claim.item.detail.subDetail.​revenue	Base	example	Example Revenue Center Codes	📍3.0.2	FHIR Std.
Claim.item.detail.subDetail.​category	Base	example	Benefit SubCategory Codes	📍3.0.2	FHIR Std.
Claim.item.detail.subDetail.​service	Base	example	USCLS Codes	📍3.0.2	FHIR Std.
Claim.item.detail.subDetail.​modifier	Base	example	Modifier type Codes	📍3.0.2	FHIR Std.
Claim.item.detail.subDetail.​programCode	Base	example	Example Program Reason Codes	📍3.0.2	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-1	error	Claim	If the resource is contained in another resource, it SHALL NOT contain any narrative	contained.text.empty()
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	contained.where(('#'+id in %resource.descendants().reference).not()).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()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() | (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()

This structure is derived from Claim

Summary

Mandatory: 0 element(2 nested mandatory elements)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.traceNumber|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.encounter|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.diagnosisRelatedGroup|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.event|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.patientPaid|0.1.0
• Unable to summarise extension http://hl7.org/fhir/StructureDefinition/alternate-reference (no extension found)
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.supportingInfo.value|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.diagnosis.onAdmission|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.procedure.type|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.procedure.udi|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.insurance.identifier|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.traceNumber|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.productOrServiceEnd|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.request|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.patientPaid|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.tax|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.traceNumber|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.productOrServiceEnd|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.patientPaid|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.tax|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.subDetail.traceNumber|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.subDetail.productOrServiceEnd|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.subDetail.patientPaid|0.1.0
• http://hl7.org/fhir/5.0/StructureDefinition/extension-Claim.item.detail.subDetail.tax|0.1.0

Maturity: 0