|Financial Management Work Group||Maturity Level : 1||Draft||Use Context : Any|
This is a value set defined by the FHIR project.
|Title:||Adjudication Value Codes|
This value set includes a smattering of Adjudication Value codes which includes codes to indicate the amounts eligible under the plan, the amount of benefit, copays etc.
|Committee:||Financial Management Work Group|
|OID:||2.16.840.1.113883.4.642.3.596 (for OID based terminology systems)|
This is an example set.
|Source Resource||XML / JSON|
This value set is used in the following places:
This value set includes codes from the following code systems:
This value set contains 8 concepts
|submitted||Submitted Amount||The total submitted amount for the claim or group or line item.|
|eligible||Eligible Amount||Amount of the change which is considered for adjudication.|
|deductible||Deductible||Amount deducted from the eligible amount prior to adjudication.|
|unallocdeduct||Unallocated Deductible||The amount of deductible which could not allocated to other line items.|
|eligpercent||Eligible %||Eligible Percentage.|
|tax||Tax||The amount of tax.|
|benefit||Benefit Amount||Amount payable under the coverage|
See the full registry of value sets defined as part of FHIR.
Explanation of the columns that may appear on this page:
|Lvl||A few code lists that FHIR defines are hierarchical - each code is assigned a level. For value sets, levels are mostly used to organize codes for user convenience, but may follow code system hierarchy - see Code System for further information|
|Source||The source of the definition of the code (when the value set draws in codes defined elsewhere)|
|Code||The code (used as the code in the resource instance). If the code is in italics, this indicates that the code is not selectable ('Abstract')|
|Display||The display (used in the display element of a Coding ). If there is no display, implementers should not simply display the code, but map the concept into their application|
|Definition||An explanation of the meaning of the concept|
|Comments||Additional notes about how to use the code|