{"resourceType":"CodeSystem","id":"adjudication","meta":{"lastUpdated":"2021-01-17T07:06:13.533+11:00","profile":["http://hl7.org/fhir/StructureDefinition/shareablecodesystem"]},"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-wg","valueCode":"fm"},{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status","valueCode":"draft"},{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm","valueInteger":1}],"url":"http://terminology.hl7.org/CodeSystem/adjudication","identifier":[{"system":"urn:ietf:rfc:3986","value":"urn:oid:2.16.840.1.113883.4.642.4.1171"}],"version":"4.0.1","name":"AdjudicationValueCodes","title":"Adjudication Value Codes","status":"draft","experimental":false,"publisher":"FHIR Project team","contact":[{"telecom":[{"system":"url","value":"http://hl7.org/fhir"}]}],"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.","copyright":"This is an example set.","caseSensitive":true,"valueSet":"http://hl7.org/fhir/ValueSet/adjudication","content":"complete","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"}]}