@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 -------------------------------------------------------------------

<http://hl7.org/fhir/5.0/ValueSet/R5-v3-ActInvoiceDetailGenericAdjudicatorCode-for-R4B> a fhir:ValueSet ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "R5-v3-ActInvoiceDetailGenericAdjudicatorCode-for-R4B"] ; # 
  fhir:text [
     fhir:status [ fhir:v "generated" ] ;
     fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ValueSet R5-v3-ActInvoiceDetailGenericAdjudicatorCode-for-R4B</b></p><a name=\"R5-v3-ActInvoiceDetailGenericAdjudicatorCode-for-R4B\"> </a><a name=\"hcR5-v3-ActInvoiceDetailGenericAdjudicatorCode-for-R4B\"> </a><p>This value set expansion contains 6 concepts.</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>System</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style=\"white-space:nowrap\"><a name=\"R5-v3-ActInvoiceDetailGenericAdjudicatorCode-for-R4B-http://terminology.hl7.org/CodeSystem/v3-ActCode-COIN\"> </a>  <a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-COIN\">COIN</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</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 style=\"white-space:nowrap\"><a name=\"R5-v3-ActInvoiceDetailGenericAdjudicatorCode-for-R4B-http://terminology.hl7.org/CodeSystem/v3-ActCode-COPAYMENT\"> </a>  <a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-COPAYMENT\">COPAYMENT</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</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 style=\"white-space:nowrap\"><a name=\"R5-v3-ActInvoiceDetailGenericAdjudicatorCode-for-R4B-http://terminology.hl7.org/CodeSystem/v3-ActCode-DEDUCTIBLE\"> </a>  <a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-DEDUCTIBLE\">DEDUCTIBLE</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</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 style=\"white-space:nowrap\"><a name=\"R5-v3-ActInvoiceDetailGenericAdjudicatorCode-for-R4B-http://terminology.hl7.org/CodeSystem/v3-ActCode-PAY\"> </a>  <a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-PAY\">PAY</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</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 style=\"white-space:nowrap\"><a name=\"R5-v3-ActInvoiceDetailGenericAdjudicatorCode-for-R4B-http://terminology.hl7.org/CodeSystem/v3-ActCode-SPEND\"> </a>  <a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-SPEND\">SPEND</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</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><tr><td style=\"white-space:nowrap\"><a name=\"R5-v3-ActInvoiceDetailGenericAdjudicatorCode-for-R4B-http://terminology.hl7.org/CodeSystem/v3-ActCode-COINS\"> </a>  <a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-COINS\">COINS</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</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></table></div>"^^rdf:XMLLiteral
  ] ; # 
  fhir:extension ( [
     fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"^^xsd:anyURI ] ;
     fhir:value [
       a fhir:code ;
       fhir:v "fhir"
     ]
  ] [
     fhir:extension ( [
       fhir:url [ fhir:v "packageId"^^xsd:anyURI ] ;
       fhir:value [
         a fhir:id ;
         fhir:v "hl7.fhir.uv.xver-r5.r4b"
       ]
     ] [
       fhir:url [ fhir:v "version"^^xsd:anyURI ] ;
       fhir:value [
         a fhir:string ;
         fhir:v "0.0.1-snapshot-2"
       ]
     ] ) ;
     fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/package-source"^^xsd:anyURI ]
  ] [
     fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm"^^xsd:anyURI ] ;
     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:value [
           a fhir:canonical ;
           fhir:v "http://hl7.org/fhir/5.0/ImplementationGuide/hl7.fhir.uv.xver-r5.r4b"^^xsd:anyURI ;
           fhir:link <http://hl7.org/fhir/5.0/ImplementationGuide/hl7.fhir.uv.xver-r5.r4b>
         ]
       ] )
     ]
  ] [
     fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status"^^xsd:anyURI ] ;
     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:value [
           a fhir:canonical ;
           fhir:v "http://hl7.org/fhir/5.0/ImplementationGuide/hl7.fhir.uv.xver-r5.r4b"^^xsd:anyURI ;
           fhir:link <http://hl7.org/fhir/5.0/ImplementationGuide/hl7.fhir.uv.xver-r5.r4b>
         ]
       ] )
     ]
  ] ) ; # 
  fhir:url [ fhir:v "http://hl7.org/fhir/5.0/ValueSet/R5-v3-ActInvoiceDetailGenericAdjudicatorCode-for-R4B"^^xsd:anyURI] ; # 
  fhir:version [ fhir:v "0.0.1-snapshot-2"] ; # 
  fhir:name [ fhir:v "R5_v3_ActInvoiceDetailGenericAdjudicatorCode_for_R4B"] ; # 
  fhir:title [ fhir:v "Cross-version VS for R5.ActInvoiceDetailGenericAdjudicatorCode for use in FHIR R4B"] ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:experimental [ fhir:v false] ; # 
  fhir:date [ fhir:v "2025-09-01T22:37:04.900441+10:00"^^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 concepts from http://terminology.hl7.org/ValueSet/v3-ActInvoiceDetailGenericAdjudicatorCode|2.0.0 for use in FHIR R4B. Concepts not present here have direct `equivalent` mappings crossing all versions from R5 to R4B."] ; # 
  fhir:jurisdiction ( [
     fhir:coding ( [
       fhir:system [ fhir:v "http://unstats.un.org/unsd/methods/m49/m49.htm"^^xsd:anyURI ] ;
       fhir:code [ fhir:v "001" ] ;
       fhir:display [ fhir:v "World" ]
     ] )
  ] ) ; # 
  fhir:compose [
     fhir:include ( [
       fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ] ;
       fhir:version [ fhir:v "8.0.0" ] ;
       fhir:concept ( [
         fhir:code [ fhir:v "COIN" ] ;
         fhir:display [ fhir:v "coinsurance" ]
       ] [
         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:code [ fhir:v "COINS" ] ;
         fhir:display [ fhir:v "co-insurance" ]
       ] )
     ] )
  ] ; # 
  fhir:expansion [
     fhir:timestamp [ fhir:v "2025-09-01T22:37:04.900441+10:00"^^xsd:dateTime ] ;
     fhir:contains ( [
       fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ] ;
       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: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: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: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:version [ fhir:v "8.0.0" ] ;
       fhir:code [ fhir:v "SPEND" ] ;
       fhir:display [ fhir:v "spend down" ]
     ] [
       fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ] ;
       fhir:version [ fhir:v "8.0.0" ] ;
       fhir:code [ fhir:v "COINS" ] ;
       fhir:display [ fhir:v "co-insurance" ]
     ] )
  ] . # 

# -------------------------------------------------------------------------------------