{
  "package" : "hl7.terminology.r4@6.3.0",
  "definition" : "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",
  "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
  "property" : [ {
    "_uri" : "http://hl7.org/fhir/concept-properties#status",
    "code" : "status",
    "valueCode" : "active"
  }, {
    "_uri" : "http://terminology.hl7.org/CodeSystem/utg-concept-properties#v3-internal-id",
    "code" : "internalId",
    "valueCode" : "21947"
  }, {
    "_uri" : "http://hl7.org/fhir/concept-properties#parent",
    "code" : "subsumedBy",
    "valueCode" : "_ActInvoiceDetailGenericAdjudicatorCode"
  } ],
  "codesystem" : "cbab4a87-49ca-5502-88d6-f33b5f07237f",
  "concept_id" : "48ca8491-5e38-52a7-b47f-21f61d8eaacf",
  "ancestors" : {
    "SPEND" : 0,
    "_ActInvoiceDetailCode" : 3,
    "_ActInvoiceElementCode" : 4,
    "_ActInvoiceDetailGenericCode" : 2,
    "_ActInvoiceDetailGenericAdjudicatorCode" : 1
  },
  "id" : "b3a6571f-e8e2-4e72-9bd5-438e9368f2f0",
  "code" : "SPEND",
  "display" : "spend down",
  "version" : "9.0.0"
}