http://terminology.hl7.org/CodeSystem/adjudication|1.0.1

{
  "description" : "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.",
  "compose" : null,
  "package" : "hl7.terminology@6.3.0",
  "date" : "2025-05-01T01:35:10Z",
  "meta" : {
    "profile" : [ "http://hl7.org/fhir/StructureDefinition/shareablecodesystem" ],
    "lastUpdated" : "2024-04-24T00:00:00+00:00"
  },
  "publisher" : "Health Level Seven International",
  "content" : "complete",
  "name" : "AdjudicationValueCodes",
  "copyright" : "This material derives from the HL7 Terminology (THO). THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license",
  "experimental" : false,
  "resourceType" : "CodeSystem",
  "title" : "Adjudication Value Codes",
  "supliment" : null,
  "extension" : [ {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
    "valueCode" : "fm"
  }, {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
    "valueInteger" : 1
  } ],
  "status" : "active",
  "id" : "792c775b-c136-512a-ac73-74d417ce9008",
  "valueSet" : "http://terminology.hl7.org/ValueSet/adjudication",
  "url" : "http://terminology.hl7.org/CodeSystem/adjudication",
  "identifier" : [ {
    "value" : "urn:oid:2.16.840.1.113883.4.642.1.1171",
    "system" : "urn:ietf:rfc:3986"
  } ],
  "concept" : [ {
    "code" : "submitted",
    "display" : "Submitted Amount",
    "definition" : "The total submitted amount for the claim or group or line item."
  }, {
    "code" : "copay",
    "display" : "CoPay",
    "definition" : "Patient Co-Payment"
  }, {
    "code" : "eligible",
    "display" : "Eligible Amount",
    "definition" : "Amount of the change which is considered for adjudication."
  }, {
    "code" : "deductible",
    "display" : "Deductible",
    "definition" : "Amount deducted from the eligible amount prior to adjudication."
  }, {
    "code" : "unallocdeduct",
    "display" : "Unallocated Deductible",
    "definition" : "The amount of deductible which could not allocated to other line items."
  }, {
    "code" : "eligpercent",
    "display" : "Eligible %",
    "definition" : "Eligible Percentage."
  }, {
    "code" : "tax",
    "display" : "Tax",
    "definition" : "The amount of tax."
  }, {
    "code" : "benefit",
    "display" : "Benefit Amount",
    "definition" : "Amount payable under the coverage"
  } ],
  "caseSensitive" : true,
  "version" : "1.0.1",
  "contact" : [ {
    "telecom" : [ {
      "value" : "http://hl7.org",
      "system" : "url"
    }, {
      "value" : "hq@HL7.org",
      "system" : "email"
    } ]
  } ]
}