Extensions for Using Data Elements from FHIR R5 in FHIR R4
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Extensions for Using Data Elements from FHIR R5 in FHIR R4 - Downloaded Version null See the Directory of published versions

: R5V3ActInvoiceDetailGenericAdjudicatorCodeForR4 - TTL Representation

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:ValueSet ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "R5-v3-ActInvoiceDetailGenericAdjudicatorCode-for-R4"] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ValueSet R5-v3-ActInvoiceDetailGenericAdjudicatorCode-for-R4</b></p><a name=\"R5-v3-ActInvoiceDetailGenericAdjudicatorCode-for-R4\"> </a><a name=\"hcR5-v3-ActInvoiceDetailGenericAdjudicatorCode-for-R4\"> </a><p>This value set expansion contains 6 concepts.</p><table class=\"codes\"><tr><td><b>System</b></td><td><b>Version</b></td><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td><a name=\"R5-v3-ActInvoiceDetailGenericAdjudicatorCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-COIN\"> </a><code>http://terminology.hl7.org/CodeSystem/v3-ActCode</code></td><td>8.0.0</td><td style=\"white-space:nowrap\">  <a href=\"CodeSystem-v3-ActCode.html#v3-ActCode-COIN\">COIN</a></td><td>coinsurance</td><td><div><p>That portion of the eligible charges which a covered party must pay for each service and/or product. It is a percentage of the eligible amount for the service/product that is typically charged after the covered party has met the policy deductible. This amount represents the covered party's coinsurance that is applied to a particular adjudication result. It is expressed as a negative dollar amount in adjudication results.</p>\n</div></td></tr><tr><td><a name=\"R5-v3-ActInvoiceDetailGenericAdjudicatorCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-COINS\"> </a><code>http://terminology.hl7.org/CodeSystem/v3-ActCode</code></td><td>8.0.0</td><td style=\"white-space:nowrap\">  <a href=\"CodeSystem-v3-ActCode.html#v3-ActCode-COINS\">COINS</a></td><td>co-insurance</td><td><div><p>The covered party pays a percentage of the cost of covered services.</p>\n</div></td></tr><tr><td><a name=\"R5-v3-ActInvoiceDetailGenericAdjudicatorCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-COPAYMENT\"> </a><code>http://terminology.hl7.org/CodeSystem/v3-ActCode</code></td><td>8.0.0</td><td style=\"white-space:nowrap\">  <a href=\"CodeSystem-v3-ActCode.html#v3-ActCode-COPAYMENT\">COPAYMENT</a></td><td>patient co-pay</td><td><div><p>That portion of the eligible charges which a covered party must pay for each service and/or product. It is a defined amount per service/product of the eligible amount for the service/product. This amount represents the covered party's copayment that is applied to a particular adjudication result. It is expressed as a negative dollar amount in adjudication results.</p>\n</div></td></tr><tr><td><a name=\"R5-v3-ActInvoiceDetailGenericAdjudicatorCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-DEDUCTIBLE\"> </a><code>http://terminology.hl7.org/CodeSystem/v3-ActCode</code></td><td>8.0.0</td><td style=\"white-space:nowrap\">  <a href=\"CodeSystem-v3-ActCode.html#v3-ActCode-DEDUCTIBLE\">DEDUCTIBLE</a></td><td>deductible</td><td><div><p>That portion of the eligible charges which a covered party must pay in a particular period (e.g. annual) before the benefits are payable by the adjudicator. This amount represents the covered party's deductible that is applied to a particular adjudication result. It is expressed as a negative dollar amount in adjudication results.</p>\n</div></td></tr><tr><td><a name=\"R5-v3-ActInvoiceDetailGenericAdjudicatorCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-PAY\"> </a><code>http://terminology.hl7.org/CodeSystem/v3-ActCode</code></td><td>8.0.0</td><td style=\"white-space:nowrap\">  <a href=\"CodeSystem-v3-ActCode.html#v3-ActCode-PAY\">PAY</a></td><td>payment</td><td><div><p>The guarantor, who may be the patient, pays the entire charge for a service. Reasons for such action may include: there is no insurance coverage for the service (e.g. cosmetic surgery); the patient wishes to self-pay for the service; or the insurer denies payment for the service due to contractual provisions such as the need for prior authorization.</p>\n</div></td></tr><tr><td><a name=\"R5-v3-ActInvoiceDetailGenericAdjudicatorCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-SPEND\"> </a><code>http://terminology.hl7.org/CodeSystem/v3-ActCode</code></td><td>8.0.0</td><td style=\"white-space:nowrap\">  <a href=\"CodeSystem-v3-ActCode.html#v3-ActCode-SPEND\">SPEND</a></td><td>spend down</td><td><div><p>That total amount of the eligible charges which a covered party must periodically pay for services and/or products prior to the Medicaid program providing any coverage. This amount represents the covered party's spend down that is applied to a particular adjudication result. It is expressed as a negative dollar amount in adjudication results</p>\n</div></td></tr></table></div>"^^rdf:XMLLiteral ]
  ] ; # 
  fhir:extension ( [
fhir:url [
fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-wg>     ] ;
fhir:value [
a fhir:Code ;
fhir:v "fhir"     ]
  ] [
    ( fhir:extension [
fhir:url [
fhir:v "packageId"^^xsd:anyURI ;
fhir:l fhir:packageId       ] ;
fhir:value [
a fhir:Id ;
fhir:v "hl7.fhir.uv.xver-r5.r4"       ]     ] [
fhir:url [
fhir:v "version"^^xsd:anyURI ;
fhir:l fhir:version       ] ;
fhir:value [
a fhir:String ;
fhir:v "0.1.0"       ]     ] [
fhir:url [
fhir:v "uri"^^xsd:anyURI ;
fhir:l fhir:uri       ] ;
fhir:value [
a fhir:Uri ;
fhir:v "http://hl7.org/fhir/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r5.r4"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r5.r4>       ]     ] ) ;
fhir:url [
fhir:v "http://hl7.org/fhir/StructureDefinition/package-source"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/StructureDefinition/package-source>     ]
  ] [
fhir:url [
fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm>     ] ;
fhir:value [
a fhir:Integer ;
fhir:v 0 ;
      ( fhir:extension [
fhir:url [
fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom>         ] ;
fhir:value [
a fhir:Canonical ;
fhir:v "http://hl7.org/fhir/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r5.r4"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r5.r4>         ]       ] )     ]
  ] [
fhir:url [
fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status>     ] ;
fhir:value [
a fhir:Code ;
fhir:v "trial-use" ;
      ( fhir:extension [
fhir:url [
fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom>         ] ;
fhir:value [
a fhir:Canonical ;
fhir:v "http://hl7.org/fhir/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r5.r4"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r5.r4>         ]       ] )     ]
  ] ) ; # 
  fhir:url [
fhir:v "http://hl7.org/fhir/uv/xver/ValueSet/R5-v3-ActInvoiceDetailGenericAdjudicatorCode-for-R4"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/uv/xver/ValueSet/R5-v3-ActInvoiceDetailGenericAdjudicatorCode-for-R4>
  ] ; # 
  fhir:version [ fhir:v "0.1.0"] ; # 
  fhir:name [ fhir:v "R5V3ActInvoiceDetailGenericAdjudicatorCodeForR4"] ; # 
  fhir:title [ fhir:v "Cross-version ValueSet R5.ActInvoiceDetailGenericAdjudicatorCode for use in FHIR R4"] ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:experimental [ fhir:v false] ; # 
  fhir:date [ fhir:v "2026-03-17T21:02:03.8104715+00:00"^^xsd:dateTime] ; # 
  fhir:publisher [ fhir:v "FHIR Infrastructure"] ; # 
  fhir:contact ( [
fhir:name [ fhir:v "FHIR Infrastructure" ] ;
    ( fhir:telecom [
fhir:system [ fhir:v "url" ] ;
fhir:value [ fhir:v "http://www.hl7.org/Special/committees/fiwg" ]     ] )
  ] ) ; # 
  fhir:description [ fhir:v "This cross-version ValueSet represents content from `http://terminology.hl7.org/ValueSet/v3-ActInvoiceDetailGenericAdjudicatorCode|2.0.0` for use in FHIR R4."] ; # 
  fhir:jurisdiction ( [
    ( fhir:coding [
fhir:system [
fhir:v "http://unstats.un.org/unsd/methods/m49/m49.htm"^^xsd:anyURI ;
fhir:l <http://unstats.un.org/unsd/methods/m49/m49.htm>       ] ;
fhir:code [ fhir:v "001" ] ;
fhir:display [ fhir:v "World" ]     ] )
  ] ) ; # 
  fhir:purpose [ fhir:v "This value set is part of the cross-version definitions generated to enable use of the\r\nvalue set `http://terminology.hl7.org/ValueSet/v3-ActInvoiceDetailGenericAdjudicatorCode|2.0.0` as defined in FHIR R5\r\nin FHIR R4.\r\n\r\nThe source value set is bound to the following FHIR R5 elements:\r\n* \r\n\r\nNote that all concepts are included in this cross-version definition because no concepts have compatible representations\r\n\r\nFollowing are the generation technical comments:\r\n\nFHIR ValueSet `http://terminology.hl7.org/ValueSet/v3-ActInvoiceDetailGenericAdjudicatorCode|2.0.0`, defined in FHIR R5 does not have any mapping to FHIR R4"] ; # 
  fhir:compose [
    ( fhir:include [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/v3-ActCode>       ] ;
fhir:version [ fhir:v "8.0.0" ] ;
      ( fhir:concept [
fhir:code [ fhir:v "COIN" ] ;
fhir:display [ fhir:v "coinsurance" ]       ] [
fhir:code [ fhir:v "COINS" ] ;
fhir:display [ fhir:v "co-insurance" ]       ] [
fhir:code [ fhir:v "COPAYMENT" ] ;
fhir:display [ fhir:v "patient co-pay" ]       ] [
fhir:code [ fhir:v "DEDUCTIBLE" ] ;
fhir:display [ fhir:v "deductible" ]       ] [
fhir:code [ fhir:v "PAY" ] ;
fhir:display [ fhir:v "payment" ]       ] [
fhir:code [ fhir:v "SPEND" ] ;
fhir:display [ fhir:v "spend down" ]       ] )     ] )
  ] ; # 
  fhir:expansion [
fhir:timestamp [ fhir:v "2026-03-17T21:02:03.8104715+00:00"^^xsd:dateTime ] ;
    ( fhir:contains [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/v3-ActCode>       ] ;
fhir:version [ fhir:v "8.0.0" ] ;
fhir:code [ fhir:v "COIN" ] ;
fhir:display [ fhir:v "coinsurance" ]     ] [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/v3-ActCode>       ] ;
fhir:version [ fhir:v "8.0.0" ] ;
fhir:code [ fhir:v "COINS" ] ;
fhir:display [ fhir:v "co-insurance" ]     ] [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/v3-ActCode>       ] ;
fhir:version [ fhir:v "8.0.0" ] ;
fhir:code [ fhir:v "COPAYMENT" ] ;
fhir:display [ fhir:v "patient co-pay" ]     ] [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/v3-ActCode>       ] ;
fhir:version [ fhir:v "8.0.0" ] ;
fhir:code [ fhir:v "DEDUCTIBLE" ] ;
fhir:display [ fhir:v "deductible" ]     ] [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/v3-ActCode>       ] ;
fhir:version [ fhir:v "8.0.0" ] ;
fhir:code [ fhir:v "PAY" ] ;
fhir:display [ fhir:v "payment" ]     ] [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/v3-ActCode>       ] ;
fhir:version [ fhir:v "8.0.0" ] ;
fhir:code [ fhir:v "SPEND" ] ;
fhir:display [ fhir:v "spend down" ]     ] )
  ] . #