http://hl7.org/fhir/StructureDefinition/ClaimResponse|5.0.0

This resource provides the adjudication details from the processing of a Claim resource.

Structure JSON Dependencies FHIRSchema Other Versions Dependant (0)Elements Summary

element_id	types
ClaimResponse
ClaimResponse.identifier	Identifier
ClaimResponse.traceNumber	Identifier
ClaimResponse.status	code
ClaimResponse.type	CodeableConcept
ClaimResponse.subType	CodeableConcept
ClaimResponse.use	code
ClaimResponse.patient	Reference
ClaimResponse.created	dateTime
ClaimResponse.insurer	Reference
ClaimResponse.requestor	Reference
ClaimResponse.request	Reference
ClaimResponse.outcome	code
ClaimResponse.decision	CodeableConcept
ClaimResponse.disposition	string
ClaimResponse.preAuthRef	string
ClaimResponse.preAuthPeriod	Period
ClaimResponse.event	BackboneElement
ClaimResponse.event.type	CodeableConcept
ClaimResponse.event.when[x]	dateTime,Period
ClaimResponse.payeeType	CodeableConcept
ClaimResponse.encounter	Reference
ClaimResponse.diagnosisRelatedGroup	CodeableConcept
ClaimResponse.item	BackboneElement
ClaimResponse.item.itemSequence	positiveInt
ClaimResponse.item.traceNumber	Identifier
ClaimResponse.item.noteNumber	positiveInt
ClaimResponse.item.reviewOutcome	BackboneElement
ClaimResponse.item.reviewOutcome.decision	CodeableConcept
ClaimResponse.item.reviewOutcome.reason	CodeableConcept
ClaimResponse.item.reviewOutcome.preAuthRef	string
ClaimResponse.item.reviewOutcome.preAuthPeriod	Period
ClaimResponse.item.adjudication	BackboneElement
ClaimResponse.item.adjudication.category	CodeableConcept
ClaimResponse.item.adjudication.reason	CodeableConcept
ClaimResponse.item.adjudication.amount	Money
ClaimResponse.item.adjudication.quantity	Quantity
ClaimResponse.item.detail	BackboneElement
ClaimResponse.item.detail.detailSequence	positiveInt
ClaimResponse.item.detail.traceNumber	Identifier
ClaimResponse.item.detail.noteNumber	positiveInt
ClaimResponse.item.detail.reviewOutcome
ClaimResponse.item.detail.adjudication
ClaimResponse.item.detail.subDetail	BackboneElement
ClaimResponse.item.detail.subDetail.subDetailSequence	positiveInt
ClaimResponse.item.detail.subDetail.traceNumber	Identifier
ClaimResponse.item.detail.subDetail.noteNumber	positiveInt
ClaimResponse.item.detail.subDetail.reviewOutcome
ClaimResponse.item.detail.subDetail.adjudication
ClaimResponse.addItem	BackboneElement
ClaimResponse.addItem.itemSequence	positiveInt
ClaimResponse.addItem.detailSequence	positiveInt
ClaimResponse.addItem.subdetailSequence	positiveInt
ClaimResponse.addItem.traceNumber	Identifier
ClaimResponse.addItem.provider	Reference
ClaimResponse.addItem.revenue	CodeableConcept
ClaimResponse.addItem.productOrService	CodeableConcept
ClaimResponse.addItem.productOrServiceEnd	CodeableConcept
ClaimResponse.addItem.request	Reference
ClaimResponse.addItem.modifier	CodeableConcept
ClaimResponse.addItem.programCode	CodeableConcept
ClaimResponse.addItem.serviced[x]	date,Period
ClaimResponse.addItem.location[x]	CodeableConcept,Address,Reference
ClaimResponse.addItem.quantity	Quantity
ClaimResponse.addItem.unitPrice	Money
ClaimResponse.addItem.factor	decimal
ClaimResponse.addItem.tax	Money
ClaimResponse.addItem.net	Money
ClaimResponse.addItem.bodySite	BackboneElement
ClaimResponse.addItem.bodySite.site	CodeableReference
ClaimResponse.addItem.bodySite.subSite	CodeableConcept
ClaimResponse.addItem.noteNumber	positiveInt
ClaimResponse.addItem.reviewOutcome
ClaimResponse.addItem.adjudication
ClaimResponse.addItem.detail	BackboneElement
ClaimResponse.addItem.detail.traceNumber	Identifier
ClaimResponse.addItem.detail.revenue	CodeableConcept
ClaimResponse.addItem.detail.productOrService	CodeableConcept
ClaimResponse.addItem.detail.productOrServiceEnd	CodeableConcept
ClaimResponse.addItem.detail.modifier	CodeableConcept
ClaimResponse.addItem.detail.quantity	Quantity
ClaimResponse.addItem.detail.unitPrice	Money
ClaimResponse.addItem.detail.factor	decimal
ClaimResponse.addItem.detail.tax	Money
ClaimResponse.addItem.detail.net	Money
ClaimResponse.addItem.detail.noteNumber	positiveInt
ClaimResponse.addItem.detail.reviewOutcome
ClaimResponse.addItem.detail.adjudication
ClaimResponse.addItem.detail.subDetail	BackboneElement
ClaimResponse.addItem.detail.subDetail.traceNumber	Identifier
ClaimResponse.addItem.detail.subDetail.revenue	CodeableConcept
ClaimResponse.addItem.detail.subDetail.productOrService	CodeableConcept
ClaimResponse.addItem.detail.subDetail.productOrServiceEnd	CodeableConcept
ClaimResponse.addItem.detail.subDetail.modifier	CodeableConcept
ClaimResponse.addItem.detail.subDetail.quantity	Quantity
ClaimResponse.addItem.detail.subDetail.unitPrice	Money
ClaimResponse.addItem.detail.subDetail.factor	decimal
ClaimResponse.addItem.detail.subDetail.tax	Money
ClaimResponse.addItem.detail.subDetail.net	Money
ClaimResponse.addItem.detail.subDetail.noteNumber	positiveInt
ClaimResponse.addItem.detail.subDetail.reviewOutcome
ClaimResponse.addItem.detail.subDetail.adjudication
ClaimResponse.adjudication
ClaimResponse.total	BackboneElement
ClaimResponse.total.category	CodeableConcept
ClaimResponse.total.amount	Money
ClaimResponse.payment	BackboneElement
ClaimResponse.payment.type	CodeableConcept
ClaimResponse.payment.adjustment	Money
ClaimResponse.payment.adjustmentReason	CodeableConcept
ClaimResponse.payment.date	date
ClaimResponse.payment.amount	Money
ClaimResponse.payment.identifier	Identifier
ClaimResponse.fundsReserve	CodeableConcept
ClaimResponse.formCode	CodeableConcept
ClaimResponse.form	Attachment
ClaimResponse.processNote	BackboneElement
ClaimResponse.processNote.number	positiveInt
ClaimResponse.processNote.type	CodeableConcept
ClaimResponse.processNote.text	string
ClaimResponse.processNote.language	CodeableConcept
ClaimResponse.communicationRequest	Reference
ClaimResponse.insurance	BackboneElement
ClaimResponse.insurance.sequence	positiveInt
ClaimResponse.insurance.focal	boolean
ClaimResponse.insurance.coverage	Reference
ClaimResponse.insurance.businessArrangement	string
ClaimResponse.insurance.claimResponse	Reference
ClaimResponse.error	BackboneElement
ClaimResponse.error.itemSequence	positiveInt
ClaimResponse.error.detailSequence	positiveInt
ClaimResponse.error.subDetailSequence	positiveInt
ClaimResponse.error.code	CodeableConcept
ClaimResponse.error.expression	string
ClaimResponse
ClaimResponse.id	http://hl7.org/fhirpath/System.String
ClaimResponse.meta	Meta
ClaimResponse.implicitRules	uri
ClaimResponse.language	code
ClaimResponse.text	Narrative
ClaimResponse.contained	Resource
ClaimResponse.extension	Extension
ClaimResponse.modifierExtension	Extension
ClaimResponse.identifier	Identifier
ClaimResponse.traceNumber	Identifier
ClaimResponse.status	code
ClaimResponse.type	CodeableConcept
ClaimResponse.subType	CodeableConcept
ClaimResponse.use	code
ClaimResponse.patient	Reference
ClaimResponse.created	dateTime
ClaimResponse.insurer	Reference
ClaimResponse.requestor	Reference
ClaimResponse.request	Reference
ClaimResponse.outcome	code
ClaimResponse.decision	CodeableConcept
ClaimResponse.disposition	string
ClaimResponse.preAuthRef	string
ClaimResponse.preAuthPeriod	Period
ClaimResponse.event	BackboneElement
ClaimResponse.event.id	http://hl7.org/fhirpath/System.String
ClaimResponse.event.extension	Extension
ClaimResponse.event.modifierExtension	Extension
ClaimResponse.event.type	CodeableConcept
ClaimResponse.event.when[x]	dateTime,Period
ClaimResponse.payeeType	CodeableConcept
ClaimResponse.encounter	Reference
ClaimResponse.diagnosisRelatedGroup	CodeableConcept
ClaimResponse.item	BackboneElement
ClaimResponse.item.id	http://hl7.org/fhirpath/System.String
ClaimResponse.item.extension	Extension
ClaimResponse.item.modifierExtension	Extension
ClaimResponse.item.itemSequence	positiveInt
ClaimResponse.item.traceNumber	Identifier
ClaimResponse.item.noteNumber	positiveInt
ClaimResponse.item.reviewOutcome	BackboneElement
ClaimResponse.item.reviewOutcome.id	http://hl7.org/fhirpath/System.String
ClaimResponse.item.reviewOutcome.extension	Extension
ClaimResponse.item.reviewOutcome.modifierExtension	Extension
ClaimResponse.item.reviewOutcome.decision	CodeableConcept
ClaimResponse.item.reviewOutcome.reason	CodeableConcept
ClaimResponse.item.reviewOutcome.preAuthRef	string
ClaimResponse.item.reviewOutcome.preAuthPeriod	Period
ClaimResponse.item.adjudication	BackboneElement
ClaimResponse.item.adjudication.id	http://hl7.org/fhirpath/System.String
ClaimResponse.item.adjudication.extension	Extension
ClaimResponse.item.adjudication.modifierExtension	Extension
ClaimResponse.item.adjudication.category	CodeableConcept
ClaimResponse.item.adjudication.reason	CodeableConcept
ClaimResponse.item.adjudication.amount	Money
ClaimResponse.item.adjudication.quantity	Quantity
ClaimResponse.item.detail	BackboneElement
ClaimResponse.item.detail.id	http://hl7.org/fhirpath/System.String
ClaimResponse.item.detail.extension	Extension
ClaimResponse.item.detail.modifierExtension	Extension
ClaimResponse.item.detail.detailSequence	positiveInt
ClaimResponse.item.detail.traceNumber	Identifier
ClaimResponse.item.detail.noteNumber	positiveInt
ClaimResponse.item.detail.reviewOutcome
ClaimResponse.item.detail.adjudication
ClaimResponse.item.detail.subDetail	BackboneElement
ClaimResponse.item.detail.subDetail.id	http://hl7.org/fhirpath/System.String
ClaimResponse.item.detail.subDetail.extension	Extension
ClaimResponse.item.detail.subDetail.modifierExtension	Extension
ClaimResponse.item.detail.subDetail.subDetailSequence	positiveInt
ClaimResponse.item.detail.subDetail.traceNumber	Identifier
ClaimResponse.item.detail.subDetail.noteNumber	positiveInt
ClaimResponse.item.detail.subDetail.reviewOutcome
ClaimResponse.item.detail.subDetail.adjudication
ClaimResponse.addItem	BackboneElement
ClaimResponse.addItem.id	http://hl7.org/fhirpath/System.String
ClaimResponse.addItem.extension	Extension
ClaimResponse.addItem.modifierExtension	Extension
ClaimResponse.addItem.itemSequence	positiveInt
ClaimResponse.addItem.detailSequence	positiveInt
ClaimResponse.addItem.subdetailSequence	positiveInt
ClaimResponse.addItem.traceNumber	Identifier
ClaimResponse.addItem.provider	Reference
ClaimResponse.addItem.revenue	CodeableConcept
ClaimResponse.addItem.productOrService	CodeableConcept
ClaimResponse.addItem.productOrServiceEnd	CodeableConcept
ClaimResponse.addItem.request	Reference
ClaimResponse.addItem.modifier	CodeableConcept
ClaimResponse.addItem.programCode	CodeableConcept
ClaimResponse.addItem.serviced[x]	date,Period
ClaimResponse.addItem.location[x]	CodeableConcept,Address,Reference
ClaimResponse.addItem.quantity	Quantity
ClaimResponse.addItem.unitPrice	Money
ClaimResponse.addItem.factor	decimal
ClaimResponse.addItem.tax	Money
ClaimResponse.addItem.net	Money
ClaimResponse.addItem.bodySite	BackboneElement
ClaimResponse.addItem.bodySite.id	http://hl7.org/fhirpath/System.String
ClaimResponse.addItem.bodySite.extension	Extension
ClaimResponse.addItem.bodySite.modifierExtension	Extension
ClaimResponse.addItem.bodySite.site	CodeableReference
ClaimResponse.addItem.bodySite.subSite	CodeableConcept
ClaimResponse.addItem.noteNumber	positiveInt
ClaimResponse.addItem.reviewOutcome
ClaimResponse.addItem.adjudication
ClaimResponse.addItem.detail	BackboneElement
ClaimResponse.addItem.detail.id	http://hl7.org/fhirpath/System.String
ClaimResponse.addItem.detail.extension	Extension
ClaimResponse.addItem.detail.modifierExtension	Extension
ClaimResponse.addItem.detail.traceNumber	Identifier
ClaimResponse.addItem.detail.revenue	CodeableConcept
ClaimResponse.addItem.detail.productOrService	CodeableConcept
ClaimResponse.addItem.detail.productOrServiceEnd	CodeableConcept
ClaimResponse.addItem.detail.modifier	CodeableConcept
ClaimResponse.addItem.detail.quantity	Quantity
ClaimResponse.addItem.detail.unitPrice	Money
ClaimResponse.addItem.detail.factor	decimal
ClaimResponse.addItem.detail.tax	Money
ClaimResponse.addItem.detail.net	Money
ClaimResponse.addItem.detail.noteNumber	positiveInt
ClaimResponse.addItem.detail.reviewOutcome
ClaimResponse.addItem.detail.adjudication
ClaimResponse.addItem.detail.subDetail	BackboneElement
ClaimResponse.addItem.detail.subDetail.id	http://hl7.org/fhirpath/System.String
ClaimResponse.addItem.detail.subDetail.extension	Extension
ClaimResponse.addItem.detail.subDetail.modifierExtension	Extension
ClaimResponse.addItem.detail.subDetail.traceNumber	Identifier
ClaimResponse.addItem.detail.subDetail.revenue	CodeableConcept
ClaimResponse.addItem.detail.subDetail.productOrService	CodeableConcept
ClaimResponse.addItem.detail.subDetail.productOrServiceEnd	CodeableConcept
ClaimResponse.addItem.detail.subDetail.modifier	CodeableConcept
ClaimResponse.addItem.detail.subDetail.quantity	Quantity
ClaimResponse.addItem.detail.subDetail.unitPrice	Money
ClaimResponse.addItem.detail.subDetail.factor	decimal
ClaimResponse.addItem.detail.subDetail.tax	Money
ClaimResponse.addItem.detail.subDetail.net	Money
ClaimResponse.addItem.detail.subDetail.noteNumber	positiveInt
ClaimResponse.addItem.detail.subDetail.reviewOutcome
ClaimResponse.addItem.detail.subDetail.adjudication
ClaimResponse.adjudication
ClaimResponse.total	BackboneElement
ClaimResponse.total.id	http://hl7.org/fhirpath/System.String
ClaimResponse.total.extension	Extension
ClaimResponse.total.modifierExtension	Extension
ClaimResponse.total.category	CodeableConcept
ClaimResponse.total.amount	Money
ClaimResponse.payment	BackboneElement
ClaimResponse.payment.id	http://hl7.org/fhirpath/System.String
ClaimResponse.payment.extension	Extension
ClaimResponse.payment.modifierExtension	Extension
ClaimResponse.payment.type	CodeableConcept
ClaimResponse.payment.adjustment	Money
ClaimResponse.payment.adjustmentReason	CodeableConcept
ClaimResponse.payment.date	date
ClaimResponse.payment.amount	Money
ClaimResponse.payment.identifier	Identifier
ClaimResponse.fundsReserve	CodeableConcept
ClaimResponse.formCode	CodeableConcept
ClaimResponse.form	Attachment
ClaimResponse.processNote	BackboneElement
ClaimResponse.processNote.id	http://hl7.org/fhirpath/System.String
ClaimResponse.processNote.extension	Extension
ClaimResponse.processNote.modifierExtension	Extension
ClaimResponse.processNote.number	positiveInt
ClaimResponse.processNote.type	CodeableConcept
ClaimResponse.processNote.text	string
ClaimResponse.processNote.language	CodeableConcept
ClaimResponse.communicationRequest	Reference
ClaimResponse.insurance	BackboneElement
ClaimResponse.insurance.id	http://hl7.org/fhirpath/System.String
ClaimResponse.insurance.extension	Extension
ClaimResponse.insurance.modifierExtension	Extension
ClaimResponse.insurance.sequence	positiveInt
ClaimResponse.insurance.focal	boolean
ClaimResponse.insurance.coverage	Reference
ClaimResponse.insurance.businessArrangement	string
ClaimResponse.insurance.claimResponse	Reference
ClaimResponse.error	BackboneElement
ClaimResponse.error.id	http://hl7.org/fhirpath/System.String
ClaimResponse.error.extension	Extension
ClaimResponse.error.modifierExtension	Extension
ClaimResponse.error.itemSequence	positiveInt
ClaimResponse.error.detailSequence	positiveInt
ClaimResponse.error.subDetailSequence	positiveInt
ClaimResponse.error.code	CodeableConcept
ClaimResponse.error.expression	string